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Deprivation and mortality in Scotland, 1981 and 1991.

OBJECTIVE: To compare the mortality experience of Scottish postcode sectors characterised by socioeconomic census variables (Carstairs scores) in 1980-2 and 1990-2. METHODS: Variables derived from the 1981 and 1991 censuses were combined according to the method devised by Carstairs and Morris to obtain Carstairs scores for 1010 postcode sectors in Scotland in 1981 and 1001 sectors in 1991. For most analyses, these scores were grouped into seven deprivation categories ranging from affluent (category 1) to deprived (category 7) localities. MAIN OUTCOME MEASURES: Death rates and standardised mortality ratios for localities according to deprivation category. RESULTS: Postcode sectors in Scotland that were categorised as deprived in 1981 were relatively more deprived at the time of the 1991 census; the mortality experience of deprived localities relative to either Scotland or affluent neighbourhoods worsened over this period, with a 162% difference between the most affluent and most deprived categories in 1991-2. Although the age and sex standardised mortality for ages 0-64 in Scotland declined by 22% during the 1980s, the reduction in the deprived categories was only about half that of the affluent groups. Increases in the death rate for men (29%) and women (11%) aged 20-29 in the deprived groups were largely attributable to an increase in the rates of suicide. Death rates from ischaemic heart disease and carcinoma of the lung and bronchus at ages 40-69 were lower in all deprivation categories in 1990-2, but the reduction was greater in more affluent areas; the difference in rates for these conditions between affluent and deprived groups therefore increased over the decade. The observed worsening of the standardised mortality ratio for Glasgow relative to Scotland could be explained on the basis of these mortality differentials and the concentration of deprived postcode sectors in Glasgow. CONCLUSIONS: Differences in mortality experience linked to relative poverty increased in the 10 years between 1981 and 1991 censuses. Although mortality for Scotland as a whole is improving, the picture is one of an increasing distinction between the experience of the majority and that of a substantial minority of the population.

Adult↗

Calibration and comparison of the acoustic location methods used during the spring migration of the bowhead whale, Balaena mysticetus, off Pt. Barrow, Alaska, 1984-1993.

Between 1984 and 1993, visual and acoustic methods were combined to census the Bering-Chukchi-Beaufort bowhead whale, Balaena mysticetus, population. Passive acoustic location was based on arrival-time differences of transient bowhead sounds detected on sparse arrays of three to five hydrophones distributed over distances of 1.5-4.5 km along the ice edge. Arrival-time differences were calculated from either digital cross correlation of spectrograms (old method), or digital cross correlation of time waveforms (new method). Acoustic calibration was conducted in situ in 1985 at five sites with visual site position determined by triangulation using two theodolites. The discrepancy between visual and acoustic locations was <1%-5% of visual range and less than 0.7 degrees of visual bearing for either method. Comparison of calibration results indicates that the new method yielded slightly more precise and accurate positions than the old method. Comparison of 217 bowhead whale call locations from both acoustic methods showed that the new method was more precise, with location errors 3-4 times smaller than the old method. Overall, low-frequency bowhead transients were reliably located out to ranges of 3-4 times array size. At these ranges in shallow water, signal propagation appears to be dominated by the fundamental mode and is not corrupted by multipath.

Acoustics↗

Population distribution residing at different altitudes: implications for hypoxemia.

BACKGROUND: Hypoxemia can adversely affect health. The present study is aimed at estimating the prevalence of altitude-related low partial pressure of oxygen in arterial blood in Mexican population by means of census and geographic data. METHODS: Population, altitude, and characteristics of communities were obtained from the Mexican Institute of Statistics, Geography, and Informatics (INEGI). The population of each municipality (municipio) was assumed to have the same age distribution as that reported for the entire country. Partial pressure of oxygen in arterial blood (PaO(2)) was estimated from altitude and from a hypothetical alveolar-arterial oxygen gradient that increases with age. RESULTS: In Mexico, 3.95% of the population lives at altitudes 2,500 m above sea level. Census data for the year 1990 recount 3.6 million people distributed among 6,150 communities. Exposure to intermediate altitudes is considerable: one half of the Mexican population resides above 1,550 m, 32% above 2,000 m, 25% above 2,230 m, and 5% above 2,440 m. It was estimated that between 0.9 and 3.4% of the healthy population (between 800,000 and 3 million persons) have a resting PaO(2) <55 torr, a criterion frequently used for prescribing chronic oxygen therapy in patients with lung diseases. CONCLUSIONS; Although the exact prevalence of hypoxemia in Mexico awaits empirical data, a large number of people live in places where altitude may expose them to low partial pressure of oxygen in inspired air. Ensuing hypoxemia may adversely affect their health. Hypoxia may be particularly harmful to elderly persons and to patients suffering from respiratory diseases.

Adolescent↗

English language ability and mental health service utilisation: a census.

OBJECTIVE: To explore the relationship between English language proficiency and mental health service utilisation. METHODS: In September 1993, a sample census was conducted of all mental health services in the State of Victoria, including public and private hospital wards, outpatient consultations provided by psychiatrists and clinical psychologists, and primary mental health care provided by general practitioners. Response rates ranged from 37% for monolingual general practitioners (GPs) to 96% for inpatient units. Particular emphasis was placed on patients' English language proficiency and the role played by bilingual clinicians. RESULTS: Over 80% of inpatients received a diagnosis of either dementia or psychosis. This proportion was even greater in the case of patients with English language difficulties. The latter group of patients underutilised specialist outpatient services, and those using these services were less likely to receive psychotherapy than fluent English speakers. They utilised GPs for mental disorder at at least the same rate as other patients. There was a marked preference for bilingual GPs, with 80% of patients with poor English language skills consulting GPs who spoke their native language. CONCLUSION: There appears to be considerable underutilisation of specialist mental health services by patients who are not fluent in English. The liaison-consultation model of psychiatric care may be an effective way of addressing this problem, given the important role already played by billingual GPs in the psychiatric care of those whose native language is not English.

Adolescent↗

The use of the Beck Depression Inventory to screen for depression in the general population: a preliminary analysis.

OBJECTIVE: The aim of the present paper is to study the performance of Beck's Depression Inventory (BDI) as a screening instrument for depressive disorders in a general population sample. METHODS: 1250 subjects, from 18 to 64 years old, were randomly selected from the Santander (Spain) municipal census. A two-stage method was used: in the first stage, all individuals selected completed the BDI; in the second, 'probable cases' (BDI cut-off>/=13) and a random 5% sample of the total sample with a BDI score less than 13 were interviewed by psychiatrists using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), which generates diagnoses of depressive disorders. RESULTS: Our data confirm the predictive value of the selected cut-off point (12/13): 100% sensitivity, 99% specificity, 0. 72 PPV, 1 NPV, and 98% overall diagnostic value. The area under ROC (AUC) was found to be 0.99. There were no statistical differences in terms of sex or age. We conclude that the BDI is a good instrument for screening depressive disorders in community surveys.

Adolescent↗

Contraceptive use projections: 1990 to 2010.

Factors that will affect both contraceptive use and choice of method during the next 20 years are reviewed. Two factors are predictable: the changing age distribution of women and the revised upper-age limits for oral contraceptive use, with the effect of the latter as yet unknown. Less predictable factors include the number of women in each age group at risk for pregnancy, the effects of delayed childbearing and sterilization, and the impact of new contraceptive methods. Unpredictable factors include adverse publicity about oral contraceptives and breast cancer, concern about sexually transmitted diseases and acquired immunodeficiency syndrome, and changes in the availability of legal abortion. Numbers of women using oral contraception, other reversible methods, sterilization, and no method are projected from 1990 to 2010 under the assumption that use patterns in each age group resemble those observed in 1988. We conclude that discrepancies between projections of contraceptive use and fact are likely to occur because of the unpredictable nature of these few important variables.

Abortion, Legal↗

[Modeling matching error and its effect on estimates of census coverage error].

"In this paper, we propose a model for investigating the effect of matching error on the estimators of census undercount and illustrate its use for the 1990 [U.S.] census undercount evaluation program. The mean square error [MSE] of the dual system estimator is derived under the proposed model and the components of MSE arising from matching error are defined and explained. Under the assumed model, the effect of matching error on the MSE of the estimator of census undercount is investigated. Finally, a methodology for employing the model for the optimal design of matching error evaluation studies will be illustrated and the form of the estimators will be given."

Americas↗

Occupational fatalities due to animal-related events.

OBJECTIVE: To better understand the extent of animal-related fatalities in the workplace. METHODS: This study utilized Census of Fatal Occupational Injuries files from the US Department of Labor for the years 1992-1997 to describe the events surrounding human workplace fatalities associated with animals. RESULTS: During the 6-year time period, 350 workplace deaths could be associated with an animal-related event. Cattle and horses were the animals primarily involved, and workers in the agricultural industry experienced the majority of events. Many deaths involved transportation events, either direct collision with the animal or highway crashes trying to avoid collision with an animal. Exotic animals, primarily elephants and tigers, were responsible for a few deaths. A small number of workers died of a zoonotic infection. CONCLUSIONS: We found that approximately 1% of workplace fatalities are associated with an animal-related event. Methods to decrease the frequency of an animal injury are suggested.

Accidents, Occupational↗

[Analysis of the seasonality of birth effect in schizophrenic patients in Poland with the application of the seasonal decomposition method].

INTRODUCTION: Seasonality of the birth of patients diagnosed with schizophrenia is one of the most repetitive phenomena in epidemiological studies on this illness. The paper presents a review of the literature, with an emphasis on the research findings and development of methods used to investigate the phenomenon. AIM: The aim of the study was to analyze the phenomenon of birth seasonality in schizophrenic patients in the Polish population, using new methods of the seasonal decomposition analysis. METHODS: The study utilized birth dates of 13,668 patients diagnosed with schizophrenia according to the ICD-10 criteria, and discharged from all psychiatric hospitals in Poland in the years 1997-2000. The data on live births in the general population as published by the Main Statistical Office served as the reference group. 7,432,803 people were born in Poland in the years 1964-1976. Efforts were made to minimize the age-related incidence effect. In order to eliminate seasonal variations resulting from deviations in the number of births in the general population, an indicator of the number of births of patients diagnosed with schizophrenia per 10 thousand live births in the general population was created. A time series of 156 monthly observations covering the period of 13 years was produced. The data were analyzed using the Census II X- 11 method, one of the most recent methods to analyze time series and seasonal decomposition. RESULTS: The results confirm a 5-8% birth excess for schizophrenia in December and January.

Adolescent↗

Survey research in New Mexico Hispanics: some methodological issues.

A prevalence survey of respiratory diseases was conducted in Albuquerque, New Mexico, with the objective of explaining differing patterns of respiratory disease epidemiology in Hispanic and non-Hispanic whites (Anglos). The study population was selected at random from the 1978 R.L. Polk & Co. Directory. This paper focuses on methodological issues raised during the conduct of the study: response rates, potential language barriers and bias, and identification of Hispanics by surnames. Mail, telephone, and personal interview approaches were used to obtain adequate response rates, which ranged from 60% in Hispanic males to 78% in Anglo females; 22% of Hispanic males refused interview. Fewer Hispanics returned mailed questionnaires than responded to telephone interviewing. Spanish language was increasingly preferred as the respondent's age increased. Two methods of ethnic identification by surname (1980 Census List of Spanish Surnames and a computer program, GUESS (Generally Useful Ethnic Search System) were compared to the self-reported ethnicity of respondents. The GUESS Program was more sensitive than the census list, but the census list was more specific. The combination of both methods produced a 90% sensitivity and 97% specificity in males. Intermarriage reduced the accuracy in females.

Adult↗

Estimation of population denominators for public health studies at the tract, gender, and age-specific level.

In epidemiologic and public health studies of disease incidence in geographic subpopulations, attention is properly directed toward the ascertainment of accurate numerators. Population or person-years denominators are generally given less consideration, under the assumption that estimates produced by sources other than the state health department are sufficiently accurate. Here, we report our experience in estimating person-years denominators in the highly urbanized, rapidly expanding population of Maricopa County, Arizona. The usual sources of population estimates were found to be of little use for public health purposes, and so we report on a method for obtaining smoothed person-years figures that can accurately reflect population acceleration which varies from one time period to another. Our method is to regress the logarithm of census enumerations on quadratic or tertic polynomials in time. We describe how differential reliability of census figures can be incorporated into our procedure, and how the problem of missing census data can be handled by an iterated regression method. Our evidence suggests that the logarithmic regression model works well, even in the face of rapid and erratic population growth or decline.

Adolescent↗

Occupational fatalities of Hispanic construction workers from 1992 to 2000.

BACKGROUND: Hispanic construction employment has dramatically increased, yet published data on occupational risk is lacking. METHODS: Data from the Census of Fatal Occupational Injuries (CFOI) and current population survey (CPS) were examined from 1992 to 2000. Fatality rate, relative risk (RR), and risk index were calculated using CFOI fatality data and CPS data on hours worked, adjusted to full-time-equivalents (FTE). Data between 1996 and 2000 were combined to allow reliable comparisons of age and occupational groups. RR and 95% confidence intervals were calculated. RESULTS: In 2000, Hispanics constituted less than 16% of the construction workforce yet suffered 23.5% of fatal injuries. RRs were: helpers, construction trades, 2.31 (95% CI: 1.41-3.80); roofers 1.77 (95% CI: 1.38-2.28); carpenters 1.39 (95% CI: 1.08-1.79); and construction laborers 1.31 (95% CI: 1.17-1.46). CONCLUSIONS: Hispanic construction workers consistently faced higher RRs, for every year from 1992 to 2000 and for every age group. In 2000, Hispanic construction workers were nearly twice (1.84, 95% CI: 1.60-2.10) as likely to be killed by occupational injuries as their non-Hispanic counterparts.

Accidents, Occupational↗

Markers of inappropriate placement in acute psychiatric inpatient care: a five hospital study.

BACKGROUND: Previous researchers in the UK have measured the prevalence of the 'inappropriateness' of acute adult psychiatric inpatient placements by eliciting the judgements of health professionals. We extended the methodology by identifying inpatient sub-groups with stable characteristics that were associated with elevated risk of inappropriate placement, and by calculating the level of that risk. METHODS: A 1-day census was taken in five hospitals. Using a structured instrument, consultant psychiatrists recorded judgements on current placements, recommended alternative placements and stated why alternatives had not been used. Judgements were obtained for 100% of the 261 inpatients. Risk ratios and adjusted odds ratios were calculated to identify sub-groups that were at high risk. RESULTS: Eighty-eight inpatients were inappropriately placed, a point prevalence of 34% (95% CI 28-40%). Consultants recorded that services outside hospital, if available, could have supported most of these inpatients as an alternative to at least part of their hospital stay. Diagnostic rather than socio-demographic or administrative characteristics, in particular primary diagnoses of substance-related disorder, personality disorder, anxiety/stress, and schizophrenia with co-morbid substance misuse, were the strongest markers of elevated risk. CONCLUSIONS: The point prevalence of inappropriate placement within the British mental health-care system is considerable. Diagnostic categories are reasonable pragmatic markers. Further research should aim to identify a strong marker of risk within the numerically large sub-group of schizophrenia without substance misuse.

Adolescent↗

Do Highways Influence Density of Land Birds?

/ Land bird densities in roadside habitats were studied in 17 locations in central Finland by the line transect method. Two transects were censused in each location. The first transect was situated 25 m from highway edge and the second transect 200 m away from the first one. The results suggested that land bird density was lower closer to highways. Species that avoided the road included willow warbler (Phylloscopus trochilus), crossbills (Loxia spp.), and tree pipit (Anthus trivialis). The composition of the bird community did not vary significantly between the compared transects. Some species appeared to favour road-forest edges but this could not be confirmed with our data. These species were not the same as have been reported to favor clear-fellings-mature forest edges. Therefore, the edge effect does not seem to be the most important factor controlling relative bird densities immediately adjacent and further away from highways. The likelihood of avoiding the problems the highways are causing for bird density are been discussed.KEY WORDS: Highways; Infrastructure; Bird density; Landscape ecology

Journal Article↗

You are where you shop: grocery store locations, weight, and neighborhoods.

BACKGROUND: Residents in poor neighborhoods have higher body mass index (BMI) and eat less healthfully. One possible reason might be the quality of available foods in their area. Location of grocery stores where individuals shop and its association with BMI were examined. METHODS: The 2000 U.S. Census data were linked with the Los Angeles Family and Neighborhood Study (L.A.FANS) database, which consists of 2620 adults sampled from 65 neighborhoods in Los Angeles County between 2000 and 2002. In 2005, multilevel linear regressions were used to estimate the associations between BMI and socioeconomic characteristics of grocery store locations after adjustment for individual-level factors and socioeconomic characteristics of residential neighborhoods. RESULTS: Individuals have higher BMI if they reside in disadvantaged areas and in areas where the average person frequents grocery stores located in more disadvantaged neighborhoods. Those who own cars and travel farther to their grocery stores also have higher BMI. When controlling for grocery store census tract socioeconomic status (SES), the association between residential census tract SES and BMI becomes stronger. CONCLUSIONS: Where people shop for groceries and distance traveled to grocery stores are independently associated with BMI. Exposure to grocery store mediates and suppresses the association of residential neighborhoods with BMI and could explain why previous studies may not have found robust associations between residential neighborhood predictors and BMI.

Adult↗

Weight and place: a multilevel cross-sectional survey of area-level social disadvantage and overweight/obesity in Australia.

OBJECTIVE: To estimate variation between small areas in adult body mass index (BMI), and assess the importance of area level socioeconomic disadvantage in predicting BMI. METHODS: We identified all census collector districts (CCDs) in the 20 innermost Local Government Areas in metropolitan Melbourne, Australia, and ranked them by the percentage of low income households (< dollar 400/week). In all, 50 CCDs were randomly selected from the least, middle and most disadvantaged septiles of the ranked list and 4913 residents (61.4% participation rate) completed one of two surveys. Multilevel linear regression was used to estimate area level variance in BMI and the importance of area level socioeconomic disadvantage in predicting BMI. RESULTS: There were significant variations in BMI between CCDs for women, even after adjustment for individual and area SES (P = 0.012); significant area variation was not found for men. Living in the most versus least disadvantaged areas was associated with an average difference in BMI of 1.08 kg/m2 (95% CI: 0.48-1.68 kg/m2) for women, and of 0.93 kg/m2 (95% CI: 0.32-1.55 kg/m2) for men. Living in the mid versus least disadvantaged areas were associated with an average difference in BMI of 0.67 kg/m2 (95% CI: 0.09-1.26 kg/m2) for women, and 0.43 kg/m2 for men (95% CI: -0.16-1.01). CONCLUSION: These findings suggest that area disadvantage is an important predictor of adult BMI, and support the need to focus on improving local environments to reduce socioeconomic inequalities in overweight and obesity.

Adult↗

Microsatellite analysis of a population crash and bottleneck in the Mauna Kea silversword, Argyroxiphium sandwicense ssp. sandwicense (Asteraceae), and its implications for reintroduction.

The Mauna Kea silversword, Argyroxiphium sandwicense ssp. sandwicense, has experienced both a severe population crash associated with an increase in alien ungulate populations on Mauna Kea, and a population bottleneck associated with reintroduction. In this paper, we address the genetic consequences of both demographic events using eight microsatellite loci. The population crash was not accompanied by a significant reduction in number of alleles or heterozygosity. However, the population bottleneck was accompanied by significant reductions in observed number of alleles, effective number of alleles, and expected heterozygosity, though not in observed heterozygosity. The effective size of the population bottleneck was calculated using both observed heterozygosities and allele frequency variances. Both methods corroborated the historical census size of the population bottleneck of at most three individuals. The results suggest that: (i) small populations, even those that result from severe reductions in historical population size and extent, are not necessarily genetically depauperate; and (ii) species reintroduction plans need to be conceived and implemented carefully, with due consideration to the genetic impact of sampling for reintroduction.

Alleles↗