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PubMed1993

The prevalence of seasonal affective disorder is low among descendants of Icelandic emigrants in Canada.

OBJECTIVE: To examine whether a genetic selection within the Icelandic population helps it to adapt to the long arctic winter. PARTICIPANTS AND SETTING: The target population was a group of adults in the Interlake district of Manitoba, Canada, wholly descended from Icelandic emigrants. The ancestry of every individual in this group can be traced back to 1840. DESIGN: The Seasonal Pattern Assessment Questionnaire was mailed to a random sample of the study population. The data were compared with results obtained with similar methods in populations in Iceland and on the eastern seaboard of the United States. MAIN OUTCOME MEASURES: Prevalence rates of seasonal affective disorder and subsyndromal seasonal affective disorder. RESULTS: The prevalence rates of seasonal affective disorder and subsyndromal seasonal affective disorder were found to be 1.2% and 3.3%, respectively, in this group of Canadians of wholly Icelandic descent. These are significantly lower than those measured with similar methods among people living along the east coast of the United States (chi 2 = 12.6 and 14.4, respectively, P < .001). Standardized rate ratio for this group compared with the American group was 0.18 for seasonal affective disorder and 0.38 for subsyndromal seasonal affective disorder. CONCLUSIONS: This is the second study to find the prevalence of seasonal affective disorder and subsyndromal seasonal affective disorder to be lower among Icelanders or their descendants than among populations along the east coast of the United States. The results indicate that the relationship between prevalence of these disorders and geographic latitude is more complex than has previously been suggested; genetic adaptation in Icelandic populations may play an important role.

Age Factors↗
PubMed2004

Effects of age, comorbidity and lifestyle factors on erectile function: Tampere Ageing Male Urological Study (TAMUS).

OBJECTIVES: We estimated the effects of sociodemographic, medical and lifestyle factors on erectile function in a population-based sample of 50- to 75-year-old Finnish men. METHODS: The target population consisted of all non-institutionalized men aged 50, 60 or 70 years residing in the study area in 1994. The questionnaire was mailed to 3143 men in 1994 and 2198 (70%) responded. A repeat survey was carried out in 1999 with questionnaires mailed to 2864 men in the baseline sample, who were still alive, and 2133 (75%) responded. Erectile function was assessed by two questions on the subject's ability to achieve and maintain an erection sufficient for intercourse and function was classified into none, minimal, moderate or complete erectile dysfunction (ED) for analysis with scores 0-3 respectively. RESULTS: The mean ED score increased markedly with age. It increased from 0.82 for men aged 50 years to 1.85 for those aged 75. After controlling for the effects of sociodemographic, medical and lifestyle factors, the mean ED score increased by 1.1% (95%CI 1.0-1.3) per year of age. Mean ED score increased most slowly between the ages of 50 and 55 years (regression coefficients (r)=0.02 or 0.6% for one year increments, p=0.89) and most rapidly between 60 and 70 years (r=0.06 or 1.8%, p<0.001). In addition to age, diabetes (r=17.5%), heart disease (r=6.5%), hypertension (r=5.1%), cerebrovascular disease (5.8%) and smoking (4.6%) were associated with an increased risk of ED. CONCLUSIONS: Erectile dysfunction increases markedly with age, especially after the age of 60 years. Smokers and men with diabetes, heart disease, hypertension, and cerebrovascular disease are at increased risk.

Age Factors↗
PubMed2003

Estimation of effects of dioxins and dioxin-like PCBs on wildlife population--a case study on common cormorant.

We presented a method for quantitatively evaluating the effects of chemical pollutants in the environment on a wildlife population. We expressed the effects of exposure to dioxins and dioxin-like PCBs in Tokyo Bay sediment on a common cormorant (Phalacrocorax carbo) population in two ways. One was the changes in the intrinsic growth rate, and the other was the changes in the gross population size. The effects of exposure to the compounds were estimated by using the method of population ecology and available field data. Common cormorant population at Shinobazu Pond in Tokyo, Japan during 1974-1986 was selected as the target population. Intrinsic growth rate or gross size of the population based on the calculated residual level of dioxins and dioxin-like PCBs in the period was estimated to decrease to 89% or 85% of that without exposure to the compounds, respectively.

Animals↗
PubMed2001

Batch co-digestion of multi-component agro-wastes.

In certain parts of the developing world conventional energy supplies such as electricity, gas, coal and petroleum by-products are either unavailable, too capital intensive to install, are unjustifiable due to low population densities in some semi-arid regions, or are simply unaffordable to the target population. In Zimbabwe, it has been assessed that only biomass energy can conveniently provide both lighting and space heating. Therefore, means of generating biogas from agricultural and other organic wastes, and to encourage their use is a policy which has been adopted by Zimbabwe's Department of Energy. In this study cattle slurry was mixed with a range of solid wastes and allowed to digest in 11 batch digesters. The mixtures which were used were selected on the basis of centroid design with the objective of determining whether there was either synergism or antagonism. Two trials were carried out, one based on cattle slurry, chicken manure (CM) and molasses (Mol), the other based on sheep and goat manure, chicken manure and surplus activated sludge. The criteria for judging the success of a co-digestion were volatile solids (VS) reduction, total methane production and methane yield. In the first trial, the analysis based on the methane yield showed that there was no antagonism and that the mixture of 30% cattle slurry/30% CM/40% Mol gave a synergistic effect. The analysis based on the VS destruction, however, did show that there was some very slight antagonism. In the second trial, the analysis based on the methane yield showed that there was both antagonism and synergism and that the synergism produced an extra 6.7% methane. The analysis based on the VS destruction also showed that there was both antagonism and synergism but that the effects were small.

Agriculture↗
PubMed1999

Microbe-induced cytoplasmic incompatibility as a mechanism for introducing transgenes into arthropod populations.

Many arthropods are infected with maternally transmitted, intracellular bacteria of the genus Wolbachia. These infections often produce 'cytoplasmic incompatibility' (CI)--reduced egg-hatch frequencies when uninfected females mate with infected males or when males and females carrying different Wolbachia strains mate. Because infected females often enjoy a fitness advantage--they are effectively immune to any effects from males carrying the same Wolbachia strain--Wolbachia and associated cytoplasmic elements can spread rapidly through natural populations. Wolbachia might therefore drive transgenes associated with disease control or pest abatement into populations. In this paper, simple mathematical analyses are presented of three alternative strategies for 'CI drive'. The analyses reveal which parameters must be estimated in order to predict population dynamics, and they demonstrate stringent requirements for initially driving and/or maintaining transgenes in target populations.

Animals↗
PubMed1991

Drug use patterns in Northern Territory Aboriginal communities 1986-1987.

During April to November 1986 and May to October 1987, a systematic survey of patterns of use of alcohol, kava, tobacco and analgesics by Northern Territory Aboriginal people aged 15 years and older was conducted. The objectives of the study were to ascertain the prevalence of drug use, the frequency of drug use and the quantity of drugs used. In addition, information about Aboriginal people's perceptions of the drugs, their beliefs about drug use and the value of drugs in their culture was collected. This paper describes only the quantitative aspects of drug use of this population. A stratified sampling procedure was used to sample 10 per cent of the target population. Using two survey instruments, an individual questionnaire and a group questionnaire, data were gathered from 1764 Aboriginal people living in the Northern Territory. As a whole, the Northern Territory Aboriginal people have a drug consumption pattern quite distinct from urban Australians.

Journal Article↗
PubMed2004

Epidemiologic studies of PCB congener profiles in North American fish consuming populations.

Long range atmospheric and stream transport and oceanic currents drive the ecologic process of PCB deposition in the abiotic environment. In contrast short range transport via bioaccumulation-biomagnification up the food chain determines PCB congener profiles and concentrations and their adverse effects in biological organisms. Two research approaches to congeners, with potential to associate specific adverse human health effects with PCB concentrations in indigenous small populations, are summarized in this study. The field epidemiological approach includes giving questionnaires to target population groups in conjunction with sampling for PCBs (and selected persistent organic pollutants and metals), in foods purchased or hunted and collected by Inuit peoples. Direct determination of contaminant levels in food sources and among individuals in selected comparative subpopulations is also presented.

Animals↗
PubMed1995

Diffusion of an effective tobacco prevention program. Part I: Evaluation of the dissemination phase.

As health promotion methods are proven effective, the diffusion and widespread implementation of successful programs can significantly reduce behaviors that pose risks to health within a targeted population. The Smart Choices Diffusion Project developed and evaluated a dissemination intervention program that targeted 128 school districts in east Texas. The project employed a theory-based model to disseminate information about a proven tobacco prevention program to opinion leaders in each district. These opinion leaders were asked to personally communicate the program information within their district using a videotape and printed materials, and advocate for program adoption. In addition to personal communication, a newsletter linked school districts. Opinion leaders in 52% of the districts showed the videotape, which modeled program adoption. A quasi-experimental design was used to evaluate the impact of the dissemination phase on teachers' and administrators' readiness to adopt a tobacco prevention program. Evaluation of the dissemination phase revealed no differences between the intervention and comparison districts in a district's readiness to adopt a tobacco prevention program. However, in intervention districts where school administrators viewed the videotape, the administrators were more likely to perceive the innovative program as having a relative advantage and to perceive their district's organizational and social environment as supportive of adopting the program.

Administrative Personnel↗
PubMed2004

Contribution of three components to individual cancer risk predicting breast cancer risk in Italy.

We used data from a multicentre case-control study conducted in Italy between 1991 and 1994 on over 2500 cases of breast cancer and a comparable number of controls, and estimates of breast cancer incidence in Italy to compute individual breast cancer risk for Italian women. The estimated probabilities between age 50 and 80 ranged from approximately 5% (for a woman with no family history and low modifiable risk profile) to about 30% (for a woman with young family history and high modifiable risk) on the basis of various women's baseline characteristics. Expected numbers of breast cancer cases using the present model were compared with those based on the USA Gail model, and with the observed ones in the comparison group of the Italian Tamoxifen Trial. These show a closer agreement between the observed and the expected total numbers of breast cancers than the USA Gail model. Thus, the Gail model can be improved for use in other populations by using estimates of incidence and risk which are more appropriate to the target population.

Adult↗
PubMed1991

Effects of interleukin-1 and tumor necrosis factor-alpha on astrocytes, microglia, oligodendrocytes, and glial precursors in vitro.

Microglia and astrocytes undergo proliferative and differentiative changes in vivo after trauma or diseases such as multiple sclerosis (MS). Oligodendrocytes are destroyed in lesions in MS. Interleukin-1 (IL1) and tumor necrosis factor-alpha (TNF alpha) are involved in inflammation of the central nervous system and are elevated in MS. We have investigated the changes in cell morphology and cell number induced by IL1 and TNF alpha in purified and mixed populations of primary rat brain microglia, astrocytes, oligodendrocytes, and glial precursors. Depending on the target population, proliferation, differentiation, or inhibition of cultured cells was observed. The data also suggest that interactions among cell populations occur and support the hypothesis that IL1 and TNF alpha effects may be indirect, possibly through induction of other factors.

Animals↗
PubMed2004

Use of Medicare claims data to monitor provider-specific performance among patients with severe chronic illness.

This study illustrates that Medicare claims can be used to measure population-based, provider-specific rates of resource inputs, utilization, and Medicare spending. The target populations are seventy-seven cohorts of chronically ill Medicare enrollees who received most of their care from seventy-seven well-known U.S. hospitals. Striking variations are documented in resource inputs and use of services during the last six months of life. The patterns of care seen in the progression of chronic illness correlate highly with care received during previous periods. We believe that hospital-specific measures can be helpful in identifying providers with acceptable quality indices who are also relatively efficient in managing chronic illness.

Chronic Disease↗
PubMed1999

Direct costs of hip fractures in patients over 60 years of age in Belgium.

OBJECTIVE: Osteoporosis-related costs are now considered a major burden for health authorities in most developed countries. An accurate and exhaustive evaluation of these costs would be a major contribution to health economic studies evaluating the efficiency of screening and prevention strategies. Osteoporosis is the most frequent underlying cause of femoral neck fractures in the elderly; these fractures weigh heavily on healthcare budgets. However, in Belgium, very few data on the financial burden of hip fractures are available and no updated estimates have been made. The goal of this paper is to estimate the direct medical expenditures associated with hip fractures in Belgium in 1996. DESIGN AND SETTING: This 1-year population-based cross-sectional study is conducted from the social security perspective. The target population in this study are men and women aged 60 years and over. PATIENTS AND PARTICIPANTS: We selected patients who had been hospitalised for a hip fracture during the year 1996 who were also affiliated with a registered social security organisation (covering 25% of the Belgian population). The sample constituted 2374 patients. INTERVENTIONS: For each of these patients, we collected an exhaustive and detailed list of healthcare resource use as well as nursing home admissions following the hip fracture event. Cost items investigated in the analysis were inpatient hospital costs and outpatient costs. Mean annual costs per case recorded in the sample were then extrapolated to the whole country on the basis of an exhaustive list of diagnoses having lead to all countrywide hospitalisations (1,700,000 hospital stays/year). MAIN OUTCOME MEASURES AND RESULTS: The mean hospital inpatient costs for hip fracture were evaluated at 332,148 Belgian francs (BeF) [$US8977] per case and BeF4,367,746,200 ($US118,047,194) for the whole country (10 million inhabitants). Patients with a hip fracture experienced an annual BeF27,825 ($US752) extra outpatient cost during the year following this fracture event, after correcting for costs related to additional comorbidity already present before the hip fracture. Finally, after a proximal femoral neck fracture, the rate of nursing home admission was higher, both for men and women at any age compared with age- and gender-matched population. CONCLUSIONS: With a total cost (acute hospital and outpatient costs) of BeF4,667,894,950 ($US126,159,323) per year in Belgium, proximal femoral neck fracture should be considered a major health economic problem and appropriate measures to prevent this disease should be rapidly undertaken.

Aged↗
PubMed2003

Health risks of residential exposure to polycyclic aromatic hydrocarbons.

A disease prevalence study and follow-up health surveillance were conducted among residents of an African-American community situated at the site of a former creosote wood-treatment facility contaminated with polycyclic aromatic hydrocarbons. Household interviews were conducted among 214 residents living around the hazardous waste site (target population) and 212 comparison residents in a neighborhood 2.4 km away from the site. Target area residents reported a higher prevalence of skin rashes than comparison residents (relative risk [RR] = 5.7; 95% confidence interval [CI] = 3.0, 10.9). The prevalence of reported rashes increased with increasing levels of anthracene detected in yards (test for linear trend, p = 0.02). With adjustment for environmental worry, reports of chronic bronchitis and difficulties becoming pregnant did not differ significantly between target and comparison residents (p > 0.05).

Adolescent↗
PubMed1990

The nonstress test.

No currently available single test of fetal well-being is a universal, infallible clinical tool that stands apart from the more general context of the total pregnancy. It is tempting to place a substantial emphasis on the results of a test when medical decision-making is needed. Perhaps some sense of proportion should be invoked at this point, beginning with the recognition that fetal heart rate data, regardless of how they are obtained, provide a limited window to view the fetus and its environment. The fact remains that the relatively low incidence of real fetal compromise and subsequent poor outcomes biases the efficacy of the NST and other well-being tools. Most high-risk populations have a prevalence of poor outcomes of approximately 10 per cent; consequently, the target population for any assessment test is quite small. One must be reassured by the extremely large reported experience of Platt et al that nonstress testing is clinically useful in the overwhelming majority of cases. The NST appears to be an excellent predictor of the healthy fetus. The test is very good at predicting the fetus who does not require acute or premature obstetric intervention: it thereby prevents pregnancies from being subjected to unnecessary iatrogenic risks and from incurring tremendous medical and emotional costs. Can the NST be improved? I think that there is still considerable opportunity for making this test more effective and accurate. Our experience supports the concepts of standardized testing conditions, the use of baseline data in addition to reactivity alone, the prolongation of test sessions to achieve a more representative view of the fetus, and ultimately an automated analysis that will aid the clinician in making more reliable assessments of the fetal heart rate data present in the actual tracing. It would be useful to see the NST better integrated into management schemes that incorporate other assessment techniques as well as pertinent clinical data. The tendency to view the test as a "stand alone" modality has underscored weaknesses inherent in all surveillance methods that have a naturally limited perspective on complex developmental and adaptive problems. There is also a need for the development of academic standards so that collected experiences can be directly compared and communication of testing results made less ambiguous. These are some of the goals that should be set for the future and whose realization will effect better care for the unique population served by obstetricians.

Female↗
PubMed1993

Screening for cervical cancer in Poland.

Despite the growing number of PAP tests performed in Poland every year, (approximately 3 million per year in 1992) the mortality rates of cervical cancer are stable or increasing. With the intention of changing this unfavourable situation, a team of specialists in 1988 has developed a model for cervical cancer screening in Poland. Six experimental centres were chosen for the implementation of this model. The principles of the screening system were as follows: 1) population-based; 2) individual invitations; 3) computer assisted; 4) reproducible; 5) cytotechnicians' participation; 6) target population 30-60 years; 7) frequency of PAP tests: every 3 years. Preliminary data from the population of 25,841 which was covered by the screening campaign in Warsaw showed a 70.1% attendance rate and detectability of 3 cases per 1,000 screened women.

Adult↗
PubMed1998

Glutamate receptor targeting to synaptic populations on Purkinje cells is developmentally regulated.

Selective targeting of neurotransmitter receptors to specific synapse populations occurs in adult neurons, but little is known about the development of these receptor distribution patterns. In this study, we demonstrate that a specific developmental switch occurs in the targeting of a receptor to an identified synapse population. Localization of delta and AMPA glutamate receptors at parallel and climbing fiber synapses on the developing Purkinje cells was studied using postembedding immunogold. Delta receptors were found to be abundant on postsynaptic membranes at parallel fiber synapses from postnatal day 10 (P10) to adult. In contrast, delta receptors were found to be high at climbing fiber synapses only at P10 and P14. Thus, a major finding of this paper is that high levels of delta receptors are transiently expressed in climbing fiber synapses in the second postnatal week. Labeling of synapses with anti-delta receptor antibody at P10 was limited to the postsynaptic membrane of excitatory synapses and was absent from GABAergic synapses. Unlike delta receptor immunolabeling, AMPA receptor immunolabeling (GluR2/3 and GluR2 antibodies) was high in the postsynaptic membranes of synapses at early postnatal ages (P2 and P5) and was higher in climbing fiber synapses than in parallel fiber synapses from P10 to adult. The present study shows that synapse-specific targeting of glutamate receptors in Purkinje cells is developmentally regulated, with the postsynaptic receptor composition established during synapse maturation. This composition is not dependent on the nature of the initial establishment of synaptic connections.

Animals↗
PubMed1999

Assessing the application of HIV and AIDS related education and counselling on the Internet.

This study reviewed Internet technological capabilities for counselling and several appropriate counselling models and assessed the application of HIV/AIDS related counselling on the Internet. Sixteen health professionals in HIV/AIDS related face-to-face counselling positions were interviewed: their HIV/AIDS service background was limited to Texas-certified HIV pre/post test counsellors. Texas-licensed counsellors in HIV/AIDS service field and HIV/AIDS case managers and social workers. Duration of interviews ranged from 30 min to 60 min and were recorded on audio cassette for review and analysis. Responses were generated using an editing style of the long-interview process. Edited responses were then analyzed for content and themes. Four major themes evolved from interview responses: counsellor-client relationship, target population, ethics and operation. Major concerns included the lack of visual and verbal cues during interaction, problems of accessibility by the neediest, confidentiality, impersonal experience and increased client separation/isolation. Greater benefits may be attained by targeting the younger segment of the population and other health professionals. A majority of respondents indicated support for additional development of Internet-based HIV/AIDS related counselling.

Adult↗
PubMedDate not supplied

Methods of pain assessment in residents of long-term care facilities: a pilot study.

OBJECTIVES: Structured programs for routine pain assessment and treatment are necessary to optimize care for residents of long-term care facilities (LTCFs). A pilot study was designed to develop, implement, and evaluate a system for pain assessment and monitoring in a LTCF. Additional goals were to determine whether a verbal and/or non-verbal tool adequately assess pain in residents of LTCFs and whether the pharmacologic therapy for pain changes with the implementation of a pain assessment and monitoring system. DESIGN: Quantitative, nonexperimental design using two pain assessment tools. SETTING: The study was conducted at a LTCF in a rural midwestern setting. PARTICIPANTS: The study population for phase I included residents on any pain medication (regularly scheduled or as needed) on the secure dementia unit. The target population for phase II consisted of residents on any pain medication on an open unit. INTERVENTION: Training was provided to the nursing staff on how to use two pain assessment tools, one verbal (colored visual analog scale) and one nonverbal (observed pain target behaviors), and documentation. In addition, a continuing education program on pain assessment and management in elderly residents and barriers to pain management in LTCFs was offered to medical providers. MEASUREMENTS: Evaluation with the colored visual analog scale (CVAS) occurred twice daily. Pain target behaviors were monitored throughout the day and recorded by nursing staff at the end of each shift. All residents in the study population were monitored daily for six months. RESULTS: Most of the residents on both units were unable to use the verbal tool; however, the nonverbal tool was used successfully for all residents studied. On the dementia unit, the use of pain medications increased, and pain target behaviors decreased during the study period; on the open unit, the use of pain medications remained stable, and pain target behaviors decreased. CONCLUSION: These data suggest that an increase in awareness of pain may facilitate an improvement in the assessment and management of pain in residents of LTCFs. The feasibility of the nonverbal pain monitoring method shown in this study has positive implications on quality of care issues if generalizable to a larger population.

Aged↗