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PubMed1986

Regulation of intracellular iron distribution in K562 human erythroleukemia cells.

Following a pulse with 59Fe-transferrin, K562 erythroleukemia cells incorporate a significant amount of 59Fe into ferritin. Conditions or manipulations which alter the supply of iron to cells result in changes in the rate of ferritin biosynthesis with consequent variations in the size of the ferritin pool. Overnight exposure to iron donors such as diferric transferrin or hemin increases the ferritin level 2-4- or 6-8-fold above that of the control, respectively. Treatment with the anti-human transferrin receptor antibody, OKT9 (which reduces the iron uptake by decreasing the number of transferrin receptors) lowers the ferritin level by approximately 70-80% with respect to the control. The fraction of total cell-associated 59Fe (given as a pulse via transferrin) that becomes ferritin bound is proportional to the actual ferritin level and is independent of the instantaneous amount of iron taken up. This has allowed us to establish a curve that correlates different levels of intracellular ferritin with corresponding percentages of incoming iron delivered to ferritin. Iron released from transferrin appears to distribute to ferritin according to a partition function; the entering load going into ferritin is set for a given ferritin level over a wide range of actual amounts of iron delivered.

Biological Transport↗
PubMed1999

The global distribution of physicians and nurses.

AIM: To explore the global distribution of physicians and nurses and the influence of gross national product per capita on this distribution, using available United Nations' (UN) sources. OBJECTIVES: to compare the international distribution of physicians and nurses by country; to examine the influence of gross national product per capita (GNP) on the global distribution of physicians and nurses; to explore the assumptions underlying the recommendations of The World Development Report 1993 Investing in Health for health workforce substitution; and to consider the implications for future studies of global health labour distribution. DESIGN: A database was compiled from various UN sources on 147 countries. Using some of the variables from this database, a general linear regression model for log GNP per capita on each of the two dependent variables (log nurses and log physicians per 1000 population) was produced. Standardized residuals obtained from these bivariate regressions were calculated and plotted against each other to determine the relationship between the global distribution of physicians to population and that of nurses. From this analysis outlying countries could also be identified. RESULTS: Ratios of physicians to population by country varied from 0. 02 to 4.4 per 1000 population (or from 1 to 227 and 1-50,000 population), and nurses from 0.03 to 16.4 (or from 1 to 61 and 1-33, 000 population). There was a positive correlation (r = 0.84, P < 0. 001) between the number of physicians per 1000 population and the number of nurses per 1000 population. GNP explained 49% of the variation in physicians and 40% in nurses. Ranking of countries according to their standardized deviation from mean regression lines for GNP against health personnel in countries with both the lowest incomes and lowest numbers of health personnel, resulted in little change from the original rankings of ratios of physicians and nurses relative to population. For some of the wealthiest countries, there was a marked fall in global ranking and for some middle income countries a marked improvement in ranking. CONCLUSION: 70% of the distribution of nurses globally can be explained by the distribution of physicians, and the influence of GNP per capita on the global distribution of physicians and nurses appears to be substantial. In only a minority of the world's very poorest countries is there evidence to suggest that higher numbers of nurses substitute for low numbers of physicians. Standardization of the distributions by GNP demonstrates that many countries (but not the poorest) regress to within one standard deviation of the mean expected distribution. This suggests that countries could set optimum levels of physicians and nurses within the limits of their GNP. More realistically, the findings suggest that recommendations for modification of the structure of countries' health labour forces as a component of health care reform may be more difficult to achieve than at first appears. The potential unreliability of the data sources used, and the implications for the accuracy of the findings, are discussed.

Female↗
PubMed1999

Income inequality and homicide rates in Rio de Janeiro, Brazil.

OBJECTIVES: This study determined the effect of income inequality on homicide rates in the state of Rio de Janeiro, Brazil. METHODS: We conducted an ecological study at 2 geographical levels, municipalities in the state of Rio de Janeiro and administrative regions in the municipality of Rio de Janeiro. The association between homicide and income inequality was tested by multiple regression procedures, with adjustment for other socioeconomic indicators. RESULTS: For the municipalities of Rio de Janeiro State, no association between homicide and income concentration was found an outcome that can be explained by the municipalities' different degrees of urbanization. However, for the administrative regions in the city of Rio de Janeiro, the 2 income inequality indicators were strongly correlated with the outcome variable (P < .01). Higher homicide rates were found precisely in the sector of the city that has the greatest concentration of slum residents and the highest degree of income inequality. CONCLUSIONS: The findings suggest that social policies specifically aimed at low-income urban youth, particularly programs to reduce the harmful effects of relative deprivation, may have an important impact on the homicide rate.

Adolescent↗
PubMed1984

Rural development strategies and their health and nutrition-mediated effects on fertility: a review of the literature.

In this review of literature sources from several relevant disciplines, the author attempts to examine the support for theoretical linkages between rural development strategies, on the one hand, and the possible effects of these strategies on fertility rates. Nutrition and health status of women and children are interposed as intermediate effects. Development strategies are classified according to their objectives, whether to promote community participation, to increase agricultural production and productivity, to extend services to populations or, finally, to raise income. In terms of possible fertility outcomes, strategies emphasizing extension of services, especially health and nutrition services, are viewed as most effective. Community participation is essential but not sufficient for the process. Increasing agricultural production and productivity appears to depend for its effectiveness on how equitably benefits are distributed, whether food production is increased as part of the program, and whether health, nutrition and family planning are specific components. Raising income, finally, is effective only if food and services are equitably distributed.

Agriculture↗
PubMed1995

Pupillary response among VDU users in daylighted workplaces.

Daylighted workplaces can complicate the viewing of visual display unit (VDU) tasks. Incoming direct- and/or reflected-daylight components can distort surface luminance distributions in both the direct- and screen-reflected visual fields. Pupillary response to these sources moreover may differ significantly, for example, between window- and interior-exposures, affecting bilateral depth of field and accommodation. Accordingly, it is hypothesized that pupil diameter is a valid ergonomic indicator of visual comfort for viewing targets at workplaces with varying daylighting exposures. This hypothesis is tested by measuring the pupillary response of four VDU users, each while viewing three targets at each of six different workplaces in a daylighted room. An iriscorder is used to record pupil diameter independently for left and right eyes in response to keyboard, screen, and background-surround surface luminances. The significant differences in pupil diameter among the three targets at the six positions can be explained by the luminance differences rendered by the incoming daylight. On this basis, it is further hypothesized that smaller pupil diameters in response to a limited range of graduated luminances correspond to more comfortable viewing conditions. Provision of these viewing conditions hold implications for VDU workplace layout, work organization, and control of electric lighting and cooling loads.

Adult↗
PubMed1998

Relative income expectations, expected malpractice premium costs, and other determinants of physician specialty choice.

We analyze the effects of relative income expectations, expected malpractice premium cost, and other economic and noneconomic factors on physician specialty choice. The data for this paper are taken from responses of medical students who completed the Association of American Medical Colleges' Medical School Questionnaire and graduated from medical school in 1995. A random utility model is used to guide our thinking; the econometric technique is multinomial logit regression. Selection of a surgical or support specialty is found to be positively income motivated, while the influence of expected relative income is negatively related to the choice of primary-care and medical practices. Concern over malpractice premium cost is negatively related to surgical and positively related to primary-care selection. Other important determinants of choice are planned location of practice, length of residency, type of medical school attended, score on the science problems section of the Medical College Admission Test, predictable working hours and perceived prestige of the specialty. Policies that alter expected relative income, length of residency, desired location of practice, medical school attended, predictable working hours, and prestige of practice, rather than financial aid, may be appropriate for correcting a perceived maldistribution of physicians among specialties.

Adult↗
PubMed2004

Trends in geographic disparities in allocation of health care resources in the US.

OBJECTIVES: This study aimed to examine current level and historical trends in health resources distribution in the US; to investigate the relationships between both levels and trends of inequality with--geographic location, inequality of income and rates per capita of hospital-beds and physicians. METHODS: The Gini Coefficient was used to measure variations in distribution of physicians and hospital-beds (at the county level) during three decades. RESULTS: Physician distribution has become less equitable, while hospital-beds' equity has increased. physicians' distribution exhibited a geographic trend, becoming more equitable in the West. No association was found between equality in hospital-beds' distribution and rates of hospital-beds per capita. CONCLUSIONS: Rates per capita might not be sufficient in determining availability of resources. Further research is needed to determine implications for health outcomes.

Beds↗
PubMed1985

Asian immigrants in Canada: some findings from 1981 census.

Immigrant characteristics in Canada are analyzed using data from the 1981 census. "The purpose of this paper is to focus on Asian immigrants and to compare them with immigrants born in the United Kingdom, and also to compare them with Canadian-born persons with respect to age, sex, marital status composition, educational attainment, labour force participation, class of worker, occupation and income." (summary in FRE, SPA)

Age Distribution↗
PubMed2000

Community firearms, community fear.

To examine how perceptions of safety are influenced as more people in a community acquire firearms, we conducted a nationally representative random-digit-dial survey of 2,500 adults and asked whether respondents would feel more safe, less safe, or equally safe if more people in their community were to acquire guns. We used multivariable logistic regression to explore correlates of perceived safety while taking into account various confounders. Fifty percent of respondents reported that they would feel less safe if more people in their community were to own guns; 14% reported they would feel more safe. Women and minorities were more likely than were men and Whites to feel less safe as others acquire guns, with Odds ratios of 1.7 and 1.5, respectively. Our findings suggest that most Americans are not impervious to the psychological effects of guns in their community, and that, by a margin or more than 3 to 1, more guns make others in the community feel less safe rather than more safe.

Adult↗
PubMed1993

The human/animal bond as a correlate of family functioning.

This study investigated whether selected family characteristics are predictive of family functioning. The intent was to examine whether family cohesion and adaptability could be predicted from the characteristics of family education, income, marital status, and level of pet attachment. A survey research design was used to distribute questionnaires to families in therapy in six southeastern states. Findings indicated that 15% of the variance in family adaptability could be significantly (p < .05) accounted for by the combination of family education, income, marital status, and pet attachment. However, variance in family cohesion could not be significantly accounted for by this combination of variables. Family pet attachment was significantly (p < .05) correlated with both family adaptability and family cohesion. Clinical practice implications of these findings for nurses and other health care professionals are discussed, and recommendations for future studies are identified.

Adaptation, Psychological↗
PubMedDate not supplied

Childhood cancer: its impact and financial costs for Australian families.

This study evaluated the impact and financial costs of childhood cancer for Australian families by means of a nonrandomized retrospective cross-sectional survey at the oncology department of a large metropolitan pediatric hospital. The Family Impact Scale (a standardized questionnaire) and the self-reported economic burden (a questionnaire on expenses and lifestyle changes) were utilized. Results of the family impact score were compared to a previously published cohort of children with insulin-dependent diabetes mellitus. The participants were 56 parents of children newly diagnosed with cancer in the year 2002. In addition to the expected high social and emotional impacts, the majority of families reported suffering from great or moderate economic hardship. Factors predictive for families at risk included single parenthood, lower household income, and greater distance from the hospital. The results show that the distribution of resources is not equitable and is currently failing to negate significant financial stresses for many Australian families.

Adolescent↗
PubMed1979

An evaluation of income incentives and board-certification trends.

In this paper the author examines income differentials between board-certified and non-board-certified physicians to determine whether the trend toward board certification is consistent with economic incentives. Although simple income comparisons indicate substantial differentials by certification status, after adjustments are made for specialty-mix, age distribution, and hours worked, the remaining differential is small. However, results by specialty indicate that physicians are most likely to become certified in specialties with the largest income differentials.

Adult↗
PubMed2005

Gender differences in retirement decisions in Hong Kong.

The study of labor force participation at older ages and the process of retirement do not have a long tradition in Asia's newly developed societies. This study, based on telephone survey of 950 respondents, examines various socio-economic factors that would influence retirement decision among older workers in Hong Kong. The findings show that older men were more likely to participate in the labor force than older women. Interestingly, older workers, in particular older women, with pension were less likely to retire. Having a working spouse decreased the likelihood of retirement and older workers, in particular older women, living with married children were more likely to retire. Poor health also discourages the propensity to continue working at old age. These findings confirm that retirement entails much more than just a decision to stop work, and that there were gender differences in retirement decision. Finally, several policy challenges, with reference to elderly women, concerning older workers' labor force participation were discussed.

Age Distribution↗
PubMed1999

Selected results of the tuberculosis control program in the Czech Republic.

There are probably several causes why steady decrease of tuberculosis incidence stopped. The aim of our work was to investigate a possible relation of tuberculosis incidence in smaller administrative areas with several social and economic characteristics. The individual data were taken from the Information System of Bacillary Tuberculosis, based on laboratory reporting network. Tuberculosis incidence dropped to 19.8/100,000 in 1987 and since then it fluctuates around that level. The levels in districts ranged from 1.9 to 45.6 in 1997. The social status, overcrowding, air pollution and unemployment rates are weakly correlated with tuberculosis incidence. These unfavourable values of social, economical and ecological indicators are linked with more industrialised parts of the country. Age and gender analysis shows that male population aged from 40-60 is the most affected population with higher rates of smear positive pulmonary TB. These rates are positively linked with a size of the municipality, in larger towns higher number of those cases are detected. Contrary to that, relatively higher rates of pulmonary tuberculosis are in elderly women in smaller municipalities. There is a suspicion about important role of relative poverty in the epidemiology of tuberculosis in the Czech Republic. The results indicate that we should concentrate our effort to reduce the incidence of tuberculosis mainly in economically active male population.

Adolescent↗
PubMedDate not supplied

Low back pain in a rural community in South West Nigeria.

A cross sectional in South West Nigeria to determined the prevalence and risk factors for low back pain within the community. Nine hundred adults were selected using a multistage sampling technique. A questionnaire was administered which sought information on demographic characteristics, smoking status, presence of low back pain in the last 12 months and at the time of the survey and the duration and severity of the low back pain. Three hundred and sixty one (40% of the population) had low back pain in the last 12 months while (303) 33% had low back pain at the time of the study. The prevalence among males was higher than among females; 44.7% and 35.6% respectively. The prevalence of low back pain was highest mong farmers (mostly men) and lowest among petty traders (mostly women). The severity and mean duration of low back pain was also highest among farmers. Risk factors highlighted on bivariate analysis were male sex and farming as an occupational category but neither of these were sustained in multivariate analysis, an indication that male preponderance in this study is related to occupational factors. This study concludes that low back pain is prevalent in rural income communities and may occur at levels similar to those reported in high income countries.

Adult↗