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PubMed2003

Characterization of a novel dimorphism in the 5' flanking region of the short tandem repeat (STR) locus, c-fes/fps (FES).

The FES short tandem repeat (STR) locus contains seven to 14 repeats of the tetranucleotide sequence ATTT. A novel 10 base pair dimorphism in the 5' flanking region of the FES locus was characterized in four broad populations: African-American, Hispanic, Caucasian, and Asian. The absence of the 10 base pair sequence, or (-) allele, was closely linked to FES STR alleles with 10 or fewer repeats. The presence of the 10 base pair sequence, or (+) allele, was closely linked to FES STR alleles with 12 or more repeats. The (-) and (+) alleles occurred equally often in FES STR allele 11. The nucleotide sequence (5'-GGCTGTTTTG-3') of the (+) allele, located 179 base pairs upstream of the FES STR, was determined to be consistent within and among the four populations. Statistical and sequence analysis confirmed the linkage between the two polymorphic sites. The results indicate that the exclusion rate of the FES locus is increased, above that for the STR alone, when both polymorphic characteristics are considered.

5' Flanking Region↗
PubMed2006

Are paediatric burns more common in asylum seekers? An analysis of paediatric burn admissions.

The number of asylum seekers in Ireland has increased dramatically over the last 10 years. Based on our impression that the number of children admitted to our burn unit was disproportionately represented by children of asylum seekers we performed an audit to establish (1) what proportion of admissions are from this subgroup and (2) the characteristics of their burns. All paediatric burn admissions from May 2003 to April 2004 were reviewed. Data collected from a retrospective chart review included patient demographics and details of the burn injuries. The National Census of 2002 and the Office of the Refugee Applications Commissioner were consulted for population statistics. Total burn admissions for the period were 126: Irish nationals (n=107), non-national residents (n=2), asylum seekers (n=14) and patients of unknown asylum status (n=3, excluded from study). In the asylum seeker group, the median age was 18.6 months (range 10 months-5.3 years) with the majority less than 2 years (n=11). All burns occurred in the domestic setting. Scalds accounted for 13 cases, one contact burn occurred from a hot grill. The median total body surface area burned was 5.7% (range 1.5-26%). The National Census of 2002 recorded a population of 3,917,203. With less than 12,000 asylum seekers in the country, they comprise only approximately 0.3% of the population yet they account for 11.4% of the burn patients admitted to our unit, p<0.0001. Children of asylum seekers are over-represented in our series of paediatric admissions for burns and are more likely than Irish children to sustain a burn at a younger age and in the domestic setting. This may indicate an increased risk of injury and warrants further investigation.

Accidents, Home↗
PubMed1993

Diabetes prevalence from health insurance data: evaluation of estimates by comparison with a population-based diabetes register.

UNLABELLED: At present in Germany, data on the prevalence of diabetes can only be obtained by modelling health insurance data. The National Diabetes Register of the former (East) German Democratic Republic which, between 1960 and 1990, monitored approximately 98% of all diabetic subjects, provides a tool for evaluating epidemiological estimates from other data sources. Therefore, the following data bases were compared for the year 1988: (1) a 5% random-sample (n = 6478) of all subjects insured at a local statutory health insurance company in the city of Dormund; (2) related data from the population-based diabetes register of former East-Berlin and (3) of the former German Democratic Republic. All data were standardized by sex and age according to the 1988 population statistics of the Federal Republic of (West) Germany thus resulting in the apparent diabetes prevalence of the Western part of Germany at that time. RESULTS: total prevalence rates were (1) 4.8%, (2) 4.9%, and (3) 4.4% (p < 0.05). The percentages of insulin-treated patients were (1) 18%, (2) 19%, and (3) 16%, respectively. 54% (1), 37% (p < 0.05) (2), and 42% (p < 0.05) (3), of the patients received oral antidiabetic drugs. It is concluded that the three samples are comparable and that the diabetes prevalence rates as estimated from health insurance data and from the two population-based registers give corresponding conclusions. Sample-based health insurance data may provide a useful and reliable tool for epidemiological studies on diabetes mellitus.

Adult↗
PubMed1998

Mortality and survival in myasthenia gravis: a Danish population based study.

OBJECTIVES: To study mortality and survival of patients with myasthenia gravis. METHODS: 290 patients with myasthenia gravis were studied, including 212 incident cases identified during a comprehensive epidemiological study of myasthenia gravis in western Denmark 1975-89. Follow up was performed on 31 December 1994. Survival curves were constructed using the life table method. Patient data were compared with data from the public Danish population statistics. Death certificates were provided from the National Registry of Death. RESULTS: The annual average crude mortality rate was 1.8 per million (range 1.5-2.2). The myasthenia gravis related mortality rate (myasthenia gravis as underlying or contributory cause) was 1.4 per million (range 1.1-1.8). The age specific mortality rates were low below 50 years. After this age the mortality increased with age in both sexes; after 60 years more rapidly in men than in women. The overall survival rates three, five, 10, and 20 years from diagnosis were 85%, 81%, 69%, and 63% respectively. The survival of both sexes was shorter than that of the corresponding Danish population. Old age at diagnosis, a classification in Osserman-Genkins group IIB or III, and the presence of a thymoma were associated with a less favourable prognosis. The three, five, 10, and 20 year survival rates of thymectomised patients were 94%, 94%, 86%, and 79% respectively. The corresponding figures for the non-thymectomised patients were 78%, 71%, 56%, and 51%. A Cox regression analysis showed that this apparently significant effect of thymectomy was because the thymectomised patients were younger than the non-thymectomised patients. Furthermore, at the time of diagnosis of myasthenia gravis the non-thymectomised patients had a higher frequency of serious conditions associated with myasthenia gravis than the thymectomised patients. CONCLUSION: Patients with myasthenia gravis generally have a relative good prognosis although their survival is shorter than that of the corresponding population. Old age, a classification in Osserman-Genkins group III, and the presence of a thymoma are associated with a less favourable prognosis. In this study, the apparently significant effect of thymectomy was because the thymectomised patients were younger than non-thymectomised patients and because the non-thymctomised patients had a higher frequency of serious conditions associated with myasthenia gravis.

Age Distribution↗
PubMed2000

Distinct categories of immunologic changes in frail elderly.

Immune changes and their relationships in a frail elderly population (N=116, age 70-103, median 86 years) were defined in comparison to a healthy younger group. Previous immune studies in the elderly have generally focused on one or few parameters without correlation analyses. Furthermore, the study populations have been active elderly in relatively small numbers. A total of 33 immune parameters representing many aspects of the immune system were quantified. Most changes in the frail elderly were parallel to those reported in active elderly. A classification tree analysis revealed that increased plasma activation markers (neopterin and sTNF-R) and increased CD28 expression on CD8 T cells and proliferative response separated the aged and control populations. Statistical procedures utilizing principal components analyses, partial correlations and exploratory factor analyses all indicated that immunologic parameters in frail elderly are grouped in three major clusters of immunologic results. These involved (a) increased plasma levels of neopterin and sTNF receptor indicating elevated IFNgamma and TNF cytokine activity; (b) increased proportion of mature (CD45RO) versus naïve (CD45RA) T cells; and (c) a diverse group of related changes including impaired proliferative response, reduced T cells, CD28 and CD25 expression, B cell percentage and lower CD4:CD8 ratios and increased HLA-DR expression. These findings emphasize that several different groups of immune parameters but not 33 independent immune changes, occurred in the aged population.

ADP-ribosyl Cyclase↗
PubMed1996

[Saugrain's censuses: genesis of a hypothesis].

Many historians of population have tried to determine the origins of the population statistics published in the Dénombrement du Royaume (1709) and in the Nouveau Dénombrement du Royaume (1720) by Claude Saugrain. J. Hussenet provides new developments; his main document is a manuscript kept in the Senate arkivs listing, at the time of Regency, more than 38,000 french settlements classified. The Dictionnaire géographique du Royaume de France seems to be the copy of a much older book commissioned by the Contrôle général des Finances. Claude Saugrain may have used it for his publication of 1709 and to a smaller extent for the one of 1720. A close examination of this document shows that the Contrôle général concern was to evaluate rather count the population.

Censuses↗
PubMed1995

The Healthy Eating Index: design and applications.

OBJECTIVE: To develop an index of overall diet quality. DESIGN: The Healthy Eating Index (HEI) was developed based on a 10-component system of five food groups, four nutrients, and a measure of variety in food intake. Each of the 10 components has a score ranging from 0 to 10, so the total possible index score is 100. METHODS/SUBJECTS: Data from the 1989 and 1990 Continuing Survey of Food Intake by Individuals were used to analyze the HEI for a representative sample of the US population. STATISTICAL ANALYSES PERFORMED: Frequencies, correlation coefficients, means. RESULTS: The mean HEI was 63.9; most people scored neither very high nor very low. No one component of the index dominated the HEI score. People were most likely to do poorly in the fruit, saturated fat, grains, vegetable, and total fat categories. The HEI correlated positively and significantly with most nutrients; as the total HEI increased, intake for a range of nutrients also increased. DISCUSSION/CONCLUSIONS: The HEI is a useful index of overall diet quality of the consumer. The US Department of Agriculture will use the HEI to monitor changes in dietary intake over time and as the basis of nutrition promotion activities for the population.

Adolescent↗
PubMed2004

The 2011 Census: a proposed design for England and Wales.

This article sets out the proposed design for a 2011 Census in England and Wales, as part of the ONS's proposed future population statistics system. The design draws on experiences from the 2001 Census and changes in available technology, and takes account of the many comments received from respondents to a Discussion Paper published in October 2003 and of views expressed at a joint ONS/RSS Conference on 11-12 November 2003. The article highlights the statistical and operational strategic aims for the 2011 Census, the major changes proposed from the 2001 approach, and gives an indication of the benefits and risks. It is important to note that this design remains a proposal at present, the elements of which will be subject to further research building on comments received during consultation and a detailed testing programme over the coming years.

Censuses↗
PubMed1997

Serological prevalence of Hypoderma species in cattle in Great Britain (1995/96) and the relative value of serological surveillance over clinical observation.

Sera from 100,400 cattle on 2850 farms in England, Scotland and Wales were tested for the presence of antibodies to Hypoderma species between the end of November 1995 and the end of February 1996. Twelve animals were resampled because the initial results were equivocal but only one of them was confirmed as seropositive. This animal was a bull imported from Belgium which had been treated with an approved warble fly treatment within 24 hours of arrival at its destination in Great Britain. No seropositive animals were confirmed within the native British cattle population. Statistical analysis of these data indicates that the probable maximum number of infested cattle herds in Great Britain is 112. To detect the disease by direct clinical observation would require more than 500 herds to be infested, indicating that the serological testing of this number of cattle and farms is more than four times as sensitive as clinical observation for the detection of hypodermosis.

Animals↗
PubMed1999

Prevalence of hereditary hearing impairment in adults.

This contribution, part of an EU-Concerted Action on the genetics of hearing impairment (H.E.A.R.), describes the preliminary estimated prevalence of hereditary hearing impairment based on retrospective data from a clinical series. Of 27,692 subjects examined in the period 1987-91, we sampled 1265 suffering from unilateral or bilateral hereditary hearing impairment, which is roughly 5% of those examined (n = 384 (31%) male; n = 881 (69%) female). Median age of the subjects is 70 years (range 22-98). Subdividing them into 10-year birth cohorts and applying the local annual population statistics, the prevalence of an overall age-related hereditary hearing impairment was roughly estimated to be 3.2/1000, reflecting prevalences as a function of age from 0.8 to 9.4/1000--prevalence in females being significantly more than in males (4.1/1000 and 2.1/1000, respectively). Overall, a moderate hearing impairment of median 51 dB in the better hearing ear was found, averaged across 0.5-4 kHz, this being fairly constant up to the age of 60, when a significant reduction in hearing sensitivity developed. No significant differences are present as a function of gender, except for the birth cohorts 1910-19 and 1920-29. The most frequent type of hereditary hearing impairment in this sample is otosclerosis, comprising 2% of the total clinical series with a rough population prevalence estimate of 1.4/1000. It is concluded that the established database may be of importance in the aggregation of very rare diseases, and for providing the inspiration for future prospective population studies, resulting in knowledge on the epidemiology of hereditary hearing impairment in adults.

Adult↗
PubMed1999

Assessment of phylloquinone and dihydrophylloquinone dietary intakes among a nationally representative sample of US consumers using 14-day food diaries.

OBJECTIVE: To estimate dietary intakes of phylloquinone and dihydrophylloquinone in a representative sample of the American population using 14-day food diaries. DESIGN: Vitamin K food composition data were applied to 14-day food diaries completed by a nationally representative sample of approximately 2,000 households that participated in a Market Research Corporation of America menu census survey between July 1991 and June 1992. Dietary intakes were estimated for phylloquinone and dihydrophylloquinone. SUBJECTS: Subjects were 4,741 men, women and children with demographic characteristics similar to those of the US census population. STATISTICAL ANALYSIS PERFORMED: Descriptive statistics and 2-sample t tests. RESULTS: Mean reported intakes of phylloquinone among adults increased with age. Men and women in the 18- to 44-year-old groups reported mean phylloquinone intakes below the current Recommended Dietary Allowance for vitamin K. Of all study participants, 99.3% reported consumption of dihydrophylloquinone during the 14 days of diet recording; reported intakes peaked before the age of 6 years; after the age of 6 years intakes were constant. APPLICATIONS: The Market Research Corporation of America data provide a reference range for dietary intakes of 2 forms of vitamin K in the US diet: phylloquinone and dihydrophylloquinone. Given the putative role of vitamin K in bone mineralization, low intakes of phylloquinone reported among young adults highlight the need to educate the US population about the requirement for and sources of vitamin K. The abundance of dihydrophylloquinone in the US diet suggests the need for study of its biological activity relative to phylloquinone.

Adolescent↗
PubMed2003

Cancer in Greenlandic Inuit 1973-1997: a cohort study.

The increasing westernization of the Arctic countries may influence the very particular cancer profile of these populations. Our objective was to investigate the development in cancer incidence from 1973 to 1997 in a large and well-defined Inuit population in Greenland. Greenland is part of the Danish Kingdom, and population statistics covering both countries are available from the same registry resource. Data from the Danish Civil Registration System and from the Danish Cancer Registry were used to calculate age-standardized cancer incidence rates for the periods 1973-1987 and 1988-1997 for persons born in Greenland. Using rates for Denmark, sex-specific standardized incidence ratios (SIRs) for 1988-1997 were calculated. Furthermore, age- and sex-specific incidence rates in the 2 periods were calculated for selected cancers. Total cancer incidence increased from 248.5 to 277.9 per 100,000 person-years in men and from 269.4 to 302.2 per 100,000 person-years in women. The incidence of lung, stomach, breast and colon cancer increased, whereas the incidence of cervical cancer decreased. Compared to the Caucasian population in Denmark, high SIRs were found for cancers of the nasopharynx, salivary gland, esophagus, stomach and cervix and low SIRs for testis, bladder, prostate, breast and hematologic cancers. Overall cancer incidence among Greenlandic Inuit is increasing as a result of increases in several cancers that are common in Western populations. A significant increase in the incidence of stomach cancer in both sexes, which contrasts global trends for this cancer, warrants further investigation.

Cohort Studies↗
PubMed1999

Radon-induced lung cancer in smokers and non-smokers: risk implications using a two-mutation carcinogenesis model.

Three sets of data (population statistics in non-smokers, data from an investigation of the smoking habits of British doctors and a study of Colorado uranium miners) were used to analyse lung cancer in humans as a function of exposure to radon and smoking. One of the aims was to derive implications for radon risk estimates. The data were analysed using a two-mutation radiation carcinogenesis model and a stepwise determination of the model parameters. The basic model parameters for lung cancer were derived from the age dependence fit of the spontaneous lung cancer incidence in non-smokers. The effect of smoking was described by two additional parameters and, subsequently, the effect of radon by three other parameters; these five parameters define the dependence of the two mutation steps on smoking and exposure to radon. Using this approach, a consistent fit and comprehensive description of the three sets of data have been achieved, and the parameters could, at least partly, be related to cellular radiobiological data. The model results explain the different effect of radon on non-smokers and smokers as seen in epidemiological data. Although the analysis was only applied to a limited number of populations, lung cancer incidence as a result of radon exposure is estimated to be about ten times higher for people exposed at the age of about 15 than at about 50, although this effect is masked (especially for smokers) by the high lung cancer incidence from smoking. Using the model to calculate the lung cancer risks from lifetime exposure to radon, as is the case for indoor radon, higher risks were estimated than previously derived from epidemiological studies of the miners' data. The excess absolute risk per unit exposure of radon is about 1.7 times higher for smokers of 30 cigarettes per day than for non-smokers, even though, as a result of the low spontaneous tumour incidence in the non-smokers, the excess relative risk per unit exposure for the smokers is about 20 times lower than for the non-smokers. This prediction could have serious consequences for the transfer of risk estimates between populations. Although the solution of the model presented here is not unique but dependent on the model assumptions, the predictions and risk implications are sufficiently supported to justify a thorough investigation of the applicability of the model to other radon data sets.

Adolescent↗
PubMed1991

Inbreeding in Finland.

We have compiled data on the frequency of first-cousin marriages in Finland using royal dispensation records for the time period 1810-1872 and national population statistics for the time period 1878-1920. For the earlier period, 0.315% of Finland's marriages were contracted between first cousins (2,331 of 739,387). During the second time period, 0.174% of Finland's marriages took place between first cousins (1,325 of 761,976). These figures, which yield average kinship coefficients of 0.00020 and 0.00011, respectively, show that the level of inbreeding in Finland due to first-cousin marriage has been quite low. An analysis of individual parishes shows that first-cousin marriages are, on average, substantially less frequent than predicted by a random-mating model. In order to evaluate determinants of first-cousin marriage, several predictive variables have been examined: parish ethnic composition (proportion of Swedish and Finnish speakers), husband's occupation (graded into 6 socioeconomic levels), geographic distance between spouses' premarital residences, population density, parish endogamy, and urban vs. rural residence. Various logistic and linear regression models were analyzed in which consanguinity was the dependent variable. The best predictors of consanguinity were ethnic composition and occupation. The other variables were not in general significant predictors. These results show that many of the "mate availability" factors that would be predicted theoretically to account for consanguinity variation (population density, geographic isolation, urban vs. rural residence) do not. Instead, the best predictors of consanguinity at the first-cousin level are cultural factors such as ethnicity and occupation. Evaluation of cultural variables can provide a greatly enriched interpretation of complex biosocial phenomena such as inbreeding.

Consanguinity↗
PubMedDate not supplied

Initial management of trauma by a trauma team: effect on timeliness of care in a teaching hospital.

The objective of this study was to determine if timeliness of care would improve after implementation of the team approach in trauma management in a single teaching hospital. To make this determination, we used a before-and-after retrospective cohort series for a 550-bed teaching and tertiary referral hospital that was not a level 1 trauma center. We included all patients who presented to the Emergency Department and who were admitted to St. Paul's Hospital because of trauma during 2 baseline months (May and November 1987; n = 111) and 2 follow-up months (May and November 1990; n = 142). In 1988, a formal trauma team was developed to coordinate the care of trauma patients who were seen in the Emergency Department. Indications for calling the trauma team were based on the criteria of the American College of Surgeons for triage to a trauma center. We calculated elapsed time from assessment in the Emergency Department to arrival of the trauma surgeon, discharge from the Emergency Department, and arrival of the patient in the operating room (for urgent or emergent surgery). We also determined the Revised Trauma Score, the Injury Severity Score (1985 version), the crude mortality ratio, and the Z statistic (population outcome comparison). After implementation of the trauma team, median elapsed time from initial nursing assessment in the Emergency Department to arrival in the operating Room for blunt trauma patients decreased from 11.33 to 4.82 hours (P = .05), but there were no significant differences in any other measures of timeliness, crude mortality, or adjusted mortality. We conclude that implementation of a trauma team in a teaching hospital is associated with a minimal effect on timeliness of care for admitted trauma patients.

Adolescent↗
PubMed2004

Poisoning in older adults: a 5-year experience of US poison control centers.

BACKGROUND: Poisoning in older adults has received relatively little attention. OBJECTIVE: To describe poison exposures in older adults reported to US poison centers and identify substances that pose a unique risk to this population. METHODS: A retrospective review of human exposures for patients aged >or=60 years reported to the American Association of Poison Control Center's Toxic Exposure Surveillance System from 1993 to 1997 was performed. Frequencies and cross-tabulations were used to describe the data. Hazard factor analysis was conducted to identify medications that pose risk in this population. Statistical analysis included chi(2) and Fisher's exact test for hazard factors. RESULTS: A total of 298,713 poison exposure cases were reported to US poison centers involving individuals aged >or=60 years between 1993 and 1997. The proportion of cases in this age group also steadily increased from 2.5% of all cases in 1993 to 3.4% of all cases in 1997. The mean age of the patients was 64.7 years, and 34.1% were males. Hazard factor analysis was conducted on unintentional exposures and adverse reactions to pharmaceutical agents to determine medications that posed increased risk to older adults. The substance categories that had the highest hazard factor were radiopharmaceuticals, asthma therapies, anti-coagulants, anesthetics, and antidepressants. CONCLUSIONS: Therapeutic errors and adverse reactions to medications are common reasons for major effects and fatal outcomes among older adults reported to poison centers. Understanding poisoning issues specific to this population may help direct future outreach education efforts.

Aged↗
PubMed1995

Surveillance of mortality and cancer incidence among Swedish graphite electrode workers.

Mortality and cancer incidence were investigated among 901 workers at a Swedish company manufacturing graphite electrodes. Current and previous measurements of personal exposure to benzo[a]pyrene were used to calculate individual exposure estimates. Smoking habits were investigated by questionnaire. There were 42 deaths during the study period (1968-1989), whereas 32.3 would be expected, based on age, sex, time, and county-specific population statistics. Three cancers of the respiratory system were found vs 1.2 expected. The overall mortality was slightly elevated, mainly due to an increased number of deaths from external causes. Thus far, no excess risk of cancer has been documented in this cohort. The results indicate that an increased risk of respiratory cancer may be present, but influence from chance cannot be ruled out due to small numbers. The cohort will be under continued surveillance.

Benzo(a)pyrene↗
PubMed1997

[Air pollution in Switzerland--quantification of health effects using epidemiologic data].

Public health costs ascribable to air pollution are socialized in our society. To quantify the damage to public health, epidemiologic studies are needed. We present the methods and epidemiologic background data which form the basis for estimating the public health effect ascribable to air pollution. The figures are presented per 1 million "average" Swiss population and per 10 micrograms/m3 increase in long-term annual mean particulate pollution (PM10). Quantification was restricted to the health effects given below (due to lack of complete data for other effects or to avoid duplicating health effects which may be described by overlapping measurements). In parenthesis we present (1) the mean effect estimates (+/-1 SE) (% increase per 10 micrograms/m3 increment in PM10) derived from national and international epidemiologic studies, and (2) the expected absolute additional health effects (+/-1 SE) per 1 million Swiss population and per 10 micrograms/m3 increment in PM10, based on Swiss population statistics: total mortality (long-term estimates from the 2 US cohort studies) (+4.4% [+/-1.1]/349 [+/-91] premature deaths per year); prevalence of chronic bronchitis in adults (+25% [+8.4]/increase in long-term prevalence by 3,513 [+/-1.475]); bronchitis among children (35% [+/-13]/5,180 [+/-2,590] additional children sufferers in a year); repeated cough among children (+54% [+/-8.8]/23,490 [+/-5,873] additional children per year); cough/phlegm in adults (+12.8% [+/-7.8]/1.56 [+/-1.08] million person-days per year); hospital admissions for respiratory diseases (+1.47% [+/-0.5]/71 [+/-24] additional admissions or 1,104 (+/-390) hospital days); admissions for cardiovascular diseases (+0.9% [+/-0.25]/70 [+19] admissions; 970 (+/-270) hospital days); restricted activity days (+10.5% [+/-0.77]/0.42 [+/-0.03] million person-days); days with asthma attacks among the 6.7% asthmatics (Swiss prevalence) (+5.3% [+/-2.1]/ 240,000 [+/-102,000] additional person-days). Conservative assumptions were used throughout the study and thus the true effects are likely to be larger. Estimates of Swiss population exposure distribution would be needed to apply these results to the entire population. This step, and monetary quantification of these total effects, were the second and third elements (not shown in this report) of this Swiss government funded project. Although individual relative risks of air pollution are rather slight, the public health burden of even moderate pollution may be substantial.

Adult↗