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PubMed1980

Use of Bernoulli census and log-linear methods for estimating the prevalence of spina bifida in livebirths and the completeness of vital record reports in New York State.

Data from birth certificates (BC), death certificates (DC) and medical rehabilitation files (MR) were analyzed to estimate the livebirth prevalence of spina bifida in upstate New York in 1969-1974 and the completeness of the data sources. Birth certificates listed about 68% of cases, death certificates about 27% and medical rehabilitation files about 25%. The three sources together, it is estimated, included only about 80% of cases in the population. For each source, comparisons of estimates of completeness derived using each of the other two as reference sources were found to be useful for evaluating the likelihood of source dependence. The estimated livebirth prevalence rate, adjusting for incomplete reporting and the observed negative dependence of MR and DC sources, was 0.85 per 1000 livebirths by both Bernoulli census and log-linear methods. Taking into account in addition evidence for a BC-DC positive dependence, the resulting prevalence rate estimates were slightly higher, 0.88 per 1000 by log-linear methods and 0.90 per 1000 by the Bernoulli census approach. In view of the likely BC-DC positive dependence, it is suggested that Bernoulli census estimates derived using only these two sources without some ancillary third data source are likely to be biased to a false low figure. Nevertheless, estimates from BC and DC alone may still be useful in establishing that the prevalence rate is above some minimum figure, for example a "breakeven" prevalence rate, in cost-benefit analyses of a possible prevention program.

Birth Certificates↗
PubMed1986

Which countries will follow the Scandinavian lead in taking a register-based census of population?

"During the past twenty years Scandinavian countries have made changes in the methods of taking population and housing censuses that are more fundamental than any seen since modern census methods were first introduced two hundred years ago. These countries extract their census data in part or in whole from administrative registers. If other countries in Western Europe were to adopt this approach, most of them would have to make major improvements to their administrative records. But the primary reasons for making such improvements are concerned with administration and policy rather than statistics, namely, the need to secure a more effective and fairer system of public administration and to enable governments to exercise a wider range of policy options."

Censuses↗
PubMed1989

Empirical Bayes estimation of undercount in the decennial census.

Empirical Bayes methods are used to estimate the extent of the undercount at the local level in the 1980 U.S. census. "Grouping of like subareas from areas such as states, counties, and so on into strata is a useful way of reducing the variance of undercount estimators. By modeling the subareas within a stratum to have a common mean and variances inversely proportional to their census counts, and by taking into account sampling of the areas (e.g., by dual-system estimation), empirical Bayes estimators that compromise between the (weighted) stratum average and the sample value can be constructed. The amount of compromise is shown to depend on the relative importance of stratum variance to sampling variance. These estimators are evaluated at the state level (51 states, including Washington, D.C.) and stratified on race/ethnicity (3 strata) using data from the 1980 postenumeration survey (PEP 3-8, for the noninstitutional population)."

Americas↗
PubMed1998

A census-based design for the recruitment of a community sample of older adults: efficacy and costs.

PURPOSE: This is a report of the scientific and cost implications of a census-based design to identify residents aged 55 and over for a community study of the effects of aging on physical function. METHODS: A census of residents in a study community was conducted by the use of a mailed questionnaire. For households that did not complete and return the mailed census questionnaire, contact was attempted first by telephone and then by home visit. A comparison was made of the unit costs and characteristics of subjects identified by the different methods. RESULTS: A total of 3509 age-eligible subjects were identified (78.3% by mailer, 19.5% by telephone, and 2.0% by home visit). Costs per enrolled age-eligible subject were lower for mailing and telephone ($7.76 and $4.72 respectively) than for home visit ($36.25). Subjects identified by home visit were significantly younger than subjects identified either by mail or telephone. After adjustment for age, subjects identified by telephone had less education and income and poorer health and functional status than subjects identified by mail. With the exception of age, there were no significant differences between subjects identified by mailer and home visit. CONCLUSIONS: A mailed questionnaire with telephone recontact is a practical strategy for community-based recruitment. Recontact of subjects by telephone can be expected to identify subjects who are not well-represented in a sample based only on a mailer. In contrast, the home visit is expensive and identifies subjects who do not differ meaningfully from those identified by mailer.

Aged↗
PubMed1996

Case mix in the "downsizing" state hospital.

OBJECTIVE: The study examined whether local variations in levels of community-based services affect the case mix of state hospitals undergoing census reduction. METHODS: Trends in case mix over a 14-year period were analyzed at two Massachusetts state hospitals, one of which underwent more rapid census reduction due to expanded community resources in the catchment area it served. Data on patients' hospital use and on sociodemographic and diagnostic characteristics obtained from 1977, 1986, and 1991 assessments of the hospitals' populations were compared. These time points represented the beginning, midpoint, and end of the census reduction period. Data from 1991 on patients' behavioral and functional status were also examined. RESULTS: Parallel trends on many dimensions were evident at the two hospitals as their censuses fell. By 1986 the hospital operating in the area with greater community services had fewer elderly and long-stay patients but a higher number of admissions per patient. In 1991 this hospital's population also had more patients with high-risk violent behaviors and lower levels of functioning. CONCLUSIONS: Although alternative treatment settings allow diversion of many types of patients from state hospitals, expanded community-based services and alternative inpatient beds have not diverted some patient subgroups, including recidivists and patients with behaviors that present risks in other settings. Plans for meeting the clinical needs and behavioral challenges posed by such patients must be part of any further deinstitutionalization or privatization efforts.

Adolescent↗
PubMed2002

Semi-automated method of quantifying vasculature of 1-methyl-1-nitrosourea-induced rat mammary carcinomas using immunohistochemical detection.

Studies of the vascularization of autochthonous rodent mammary tumors are limited in number, and the majority have used Factor VIII staining for blood vessel detection. Moreover, little effort has been directed at measuring the vascularization of tissue immediately adjacent to a tumor despite its central importance in the process of angiogenesis. Thirty-six chemically-induced mammary carcinomas and tissue immediately adjacent to these carcinomas were used to develop a census counting method for quantitative assessment of intra- and extra-tumor vascularization. Blood vessels were identified using antiserum directed against either CD31 or Factor VIII. Techniques used to create digitized images of all tumors and the semi-automated methods for circumscribing the extra-tumoral region are described. For Factor VIII, CD31 allowed greater discrimination of blood vessels with areas <25 microm(2) and demonstrated crisp staining of blood vessels, with minimal background and excellent preservation of tissue architecture. Census counting data support the use of CD31 for quantifying both intra- and extra-tumoral vascularization. This method provides a basis for standardizing the approach to evaluation of experimentally induced premalignant and malignant mammary lesions in rodent model systems used to investigate potential anti-angiogenic cancer preventive agents.

Animals↗
PubMed1992

The value of capture-recapture methods even for apparent exhaustive surveys. The need for adjustment for source of ascertainment intersection in attempted complete prevalence studies.

Almost all reported prevalence studies of which we are aware make exhaustive attempts to find diagnosed individuals and report all affected individuals, but make no attempt to estimate or adjust for missing cases. Yet very simple methods introduced in the planning stage of a prevalence study may enable investigators, or at least those subsequently reading their reports, to derive such adjusted estimates. If investigators keep track of the nature of the ascertainment of cases by source and collect and report data that allow calculation of the number of cases by source intersection, then they, or at least others, may derive estimates of missing cases and of the total population affected, by using readily available analogues of capture-recapture methods developed for wildlife populations censuses. Unfortunately, such methods are often inappropriately disparaged or ignored by epidemiologists. The derived estimates are sensitive to assumptions about dependence or independence ("interaction") of various sources, assumptions that sometimes are unprovable, and these estimates have some uncertainty because of statistical fluctuation. Moreover, most investigators who attempt exhaustive prevalence studies apparently believe that they have ascertained all cases and that there is no need to attempt to adjust for, let alone provide data pertinent to, the number of missing cases or to use a statistical method that will at best imply a certain imprecision to their result. Yet a survey that reports prevalence data without adjustment for, or data on, source intersection in essence makes an estimate of missing cases--zero--while providing no quantitative grounds for that claim. The results of all such surveys should be regarded with skepticism because, at best (if the case reports are accurate), they provide only a lower boundary of prevalence. We illustrate the grounds for these views by analyzing data from an apparently exhaustive prevalence study that used at least 14 distinct sources for ascertainment, including advertising, to find cases. Available limited data on source intersection provided in the report enable the plausible inference that the study missed about 25-40% of cases. We urge that no attempted complete prevalence studies be presented without data on ascertainment by source intersection.

Bias↗
PubMedDate not supplied

Issues regarding data on race and ethnicity: the Census Bureau experience.

In this paper, the authors describe some of the complexities of collecting and presenting data on race and ethnicity based on the experiences of the Bureau of the Census. Different methods of data collection, different content and format of questions, and different definitions make it difficult to collect consistent race and ethnic data across data systems. The Bureau of the Census experiences have shown that changing ethnic self-identity and concepts, intent of the question, consistency of reporting, and the classification of persons of mixed racial parentage affect the quality of the data. These are some of the issues that must be addressed as statistical agencies and researchers seek to provide comparable race and ethnic data.

Data Collection↗
PubMed2002

Census of radiological machines in Radiodiagnostic Services of public and recognized hospitals in the Campania Region.

AIM: The present study provides a census of equipment in use by Radiodiagnostic Services in public hospitals and institutes recognized by the Region of Campania in the year 2000. The type, date of installation and distribution of the equipment were considered in relation to the number of hospital beds and the resident population. MATERIALS AND METHODS: A census was taken of all the public hospitals and institutes recognized by the Region of Campania in the period running from January 1999 to April 2000. Data were collected using an appropriate form asking for details of the number of machines and the model, manufacturer and year of installation, under six categories: traditional radiology, mammography, US, CT, MR and angiography. The data were analyzed by provinces, combining the different machines into five-year periods depending on the date of their installation. RESULTS: Traditional radiology equipment accounts for 71% of the total. The mean for the Region stands at 23 machines per 1000 beds. The mean date of installation was 1986. Mammography machines account for 8% of the total. The mean for the Region stands at 2.6 machines per 1000 beds. The mean date of installation was 1991. Echography machines account for 10.3% of the total. The mean for the Region stands at 3.4 machines per 1000 beds. The mean date of installation was 1992. Angiography machines account for 3.2% of the total. The mean for the Region stands at 1.1 machines per 1000 beds. The mean date of installation was 1985. CTs account for 6.4% of the total. The mean for the Region stands at 2.1 machines per 1000 beds. The mean date of installation was 1993. MR account for 1.1% of the total. The mean for the Region stands at 0.4 machines per 1000 beds. The mean date of installation was 1995. CONCLUSIONS: Technological and scientific improvements and growing attention to the quality of medical care expected by patients mean that constant modification and adaptation are needed to meet demands. In planning measures designed to provide new radiological equipment and modernize existing equipment in the Region it would certainly be useful to eliminate the unevenness of the services provided. In conclusion, it is crucial that the local administrations and health authorities in the Campania Region establish a regular census, with proper assessment of the obsolescence of radiological equipment and its distribution throughout the area, in order to comply with international standards.

Equipment and Supplies↗
PubMed1995

Primary liver cancer and renal cell carcinoma in laundry and dry-cleaning workers in Denmark.

OBJECTIVES: Previous studies have shown an excess risk of primary liver cancer among women working in laundries and dry-cleaning shops in Denmark at the time of the census in 1970. During the period 1970-1987, 14 cases of primary liver cancer were observed (standardized mortality ratio 2.7, 95% confidence interval 1.5-4.5). A nested case-referent study was undertaken in order to classify laundry workers and dry-cleaning workers separately. According to hints in the literature, renal-cell carcinomas were also included in this analysis. METHODS: Original census forms from 1970 were retrieved from the Danish National Record Office for the 17 cases with primary liver cancer and the 16 cases with renal-cell carcinoma and five matched referents per case. RESULTS: All of the 17 patients with primary liver cancer worked in laundries in 1970, whereas only 74% of the referents worked in laundries. Neither was the risk of renal-cell carcinoma associated with dry-cleaning work (relative risk 0.7, 95% CI 0.2-2.6). CONCLUSIONS: The excess risk of primary liver cancer observed for women working in laundries and dry-cleaning shops in Denmark is not likely to be explained by exposure to dry-cleaning solvents. Excessive alcohol consumption is not a likely explanation either, and the excess risk therefore remains unexplained.

Carcinoma, Renal Cell↗
PubMed2000

Reliability and validity of disability questions for US Census 2000.

OBJECTIVES: We investigated the validity and proxy reliability of 7 new disability questions from the 2000 US census ("Census 2000"). METHODS: A total of 131 people with disabilities and their proxies from St Louis, Mo, and Massachusetts were interviewed, and responses were compared for concordance. Responses also were compared with responses to questions from the Behavioral Risk Factor Surveillance System (BRFSS) and the Activities of Daily Living (ADL) instrument. RESULTS: Overall, proxies reported more impairment than did people with disabilities, and agreement was low (kappa = 0.24-0.55). Concordance was moderate between the census questions and their BRFSS and ADL counterparts. CONCLUSIONS: The Census 2000 questions may not provide an accurate profile of disability in America.

Activities of Daily Living↗
PubMed1999

Estimating population size by genotyping faeces.

Population size is a fundamental biological parameter that is difficult to estimate. By genotyping coyote (Canis latrans) faeces systematically collected in the Santa Monica Mountains near Los Angeles, California, we exemplify a general, non-invasive method to census large mammals. Four steps are involved in the estimation. First, presumed coyote faeces are collected along paths or roadways where coyotes, like most carnivores, often defaecate and mark territorial boundaries. Second, DNA is extracted from the faeces and species identity and sex is determined by mitochondrial DNA and Y-chromosome typing. Third, hypervariable microsatellite loci are typed from the faeces. Lastly, rarefaction analysis is used to estimate population size from faecal genotypes. This method readily provides a point count estimate of population size and sex ratio. Additionally, we show that home range use paternity and kinship can be inferred from the distribution and relatedness patterns of faecal genotypes.

Animals↗
PubMed1998

Lithium in the over-65s: who is taking it and who is monitoring it? A survey of older adults on lithium in the Cambridge Mental Health Services catchment area.

OBJECTIVES: To determine the prevalence of lithium therapy in the over-65s in the Cambridge Mental Health Services catchment area, to obtain a profile of this group and to find out how well and by whom lithium treatment is being monitored. METHODS: A census was carried out of patients over the age of 65 in the Cambridge Mental Health Services catchment area who were on lithium therapy on 1 February 1995. The records of these patients were examined retrospectively for demographic details, details of lithium therapy, information about lithium monitoring and risk factors associated with lithium treatment. RESULTS: One hundred and forty-eight patients were identified representing a point prevalence of 0.27%. GPs carried out lithium monitoring for the majority of this group and 47% had not been seen by a psychiatrist in the 12 months leading up to the census date. Thirty-two per cent of the group were on thyroxine treatment or had raised TSH levels. CONCLUSIONS: The prevalence of lithium therapy in this study was greater than the prevalences reported in studies of patients of all ages. Standards of monitoring varied widely and were not always better where psychiatrists monitored the treatment, although psychiatrists were more likely than GPs to monitor renal function. There was a high rate of thyroid dysfunction in the study group.

Aged↗
PubMed2003

Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population.

OBJECTIVE: To estimate the prevalence, incidence, survival, and disease characteristics of systemic sclerosis (SSc) in the Detroit tricounty area. METHODS: A census of SSc cases for the period 1989-1991 was conducted in the Detroit area, using multiple sources for case identification. Diagnoses were verified by medical record review. Capture-recapture analysis was used to estimate the total SSc population. Cases of localized scleroderma (morphea and linear disease) were excluded. RESULTS: Based on 706 verified cases of SSc, prevalence was initially estimated to be 242.0 cases per million adults (95% confidence interval [95% CI] 213-274), with an annual incidence of 19.3 new cases per million adults per year (95% CI 12.4-30.2). Capture-recapture analysis, based on the degree of overlap of verified cases among multiple sources, resulted in a revised prevalence estimate of 276 cases per million adults (95% CI 245-310). Sex- and race-specific prevalence estimates were significantly higher for women than for men, and for blacks than for whites. The average age at diagnosis was significantly younger for blacks than for whites. Compared with white patients, black patients were almost twice as likely to have diffuse disease (prevalence proportion ratio 1.86, 95% CI 1.48-2.35). Median survival was approximately 11 years. Factors negatively affecting survival included male sex (hazard ratio 1.81, 95% CI 1.29-2.55) and older age at diagnosis (hazard ratio 1.04, 95% CI 1.03-1.05). CONCLUSION: This study establishes baseline estimates of SSc occurrence and characteristics in a large US cohort consisting primarily of black adults and white adults. These data should facilitate research regarding the role of geographic, ethnic, racial, and environmental factors for this disease in comparison populations.

Adult↗
PubMed2003

Factors associated with antipsychotic drug use in residential care: changes between 1990 and 1997.

BACKGROUND: There is limited information from population-based studies about the rates of antipsychotic drug use in residential and nursing homes in the UK, and associated adverse effects. OBJECTIVES: To examine the relationship between antipsychotic drug prescription, cognitive impairment and disturbed behaviour in this population over time, and to identify possible adverse consequences of their use. METHODS: Two censuses of the residential and nursing home population aged 65 years and older in Leicestershire, carried out in 1990 and 1997. A questionnaire was completed by care staff for each resident, including information on demographic details, physical functioning, cognitive impairment, behaviour disturbance, urinary incontinence, falls, mobility, daytime alertness (1997 only), and prescribed medication. RESULTS: The prevalence of staff-rated moderate or severe cognitive impairment increased from 38.0% in 1990 to 44.3% in 1997. The prevalence of staff-rated disturbed behaviour decreased from 11.8% in 1990 to 10.4% in 1997. Cognitive impairment was strongly associated with disturbed behaviour in both years. The prescription rate of antipsychotic drugs increased from 17.8% in 1990 to 21.9% in 1997. There was no significant change in the prescription rates to cognitively impaired residents between 1990 and 1997 (29.1% vs 30.7%). In residents without cognitive impairment, the prescription rate rose from 10.7% to 15.0%. Antipsychotic drug use was independently associated with: younger age, type of home (1990 only), cognitive impairment, offensive behaviour, lower ADL dependency (1990 only), antidepressant drug use, reported urinary incontinence and greater mobility. There was no association with increased liability to falls or drowsiness. In the cognitively unimpaired residents, antipsychotic drug use was not associated with urinary incontinence in 1997, and there was an association with increased drowsiness in that year. CONCLUSIONS: The only significant change in antipsychotic drug prescribing practice in this population over the period covered by this study was an increase in the prescription rate in cognitively unimpaired residents in 1997, possibly related to mental hospital closures. Urinary incontinence was the principal adverse effect of antipsychotic drug use observed in the group as a whole. Changes in the adverse effects associated with antipsychotic drug use may be a function of the increasing frailty.

Activities of Daily Living↗
PubMed1995

Thinking of England and taking care: family building strategies and infant mortality in England and Wales, 1891-1911.

"Debates concerning the origins and development of the late nineteenth- to early twentieth-century declines in marital fertility and infant mortality in England and Wales have been centred largely on the material provided by answers to the ¿special' questions in the 1911 census. In their published form these figures have restricted researchers to an examination of large scale geographic and social class differences in the levels and rates of decline of the two phenomena. This paper outlines research conducted on a sample of individual census returns from the 1911 census. From this data it becomes clear that for Victorian and Edwardian England ¿where one lived' was rather more important than ¿who one was' in determining both family building strategies and the survival of those children born."

Birth Rate↗