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PubMed2001

The bicalutamide Early Prostate Cancer Program. Demography.

BACKGROUND: The optimal treatment for early prostate cancer has yet to be established. A well-tolerated hormonal therapy such as bicalutamide could be a useful treatment option in this setting, either as adjuvant or immediate therapy. A major collaborative clinical trials program was set up to investigate bicalutamide as a treatment option for local prostate cancer (localized or locally advanced disease). METHODS: The bicalutamide Early Prostate Cancer program comprises three randomized, double-blind, placebo-controlled trials of similar design that are being conducted in distinct geographical areas (North America; Australia, Europe, Israel, South Africa and Mexico; and Scandinavia). Men with T1b-4N0-1M0 (TNM 1997) prostate cancer have been randomized on a 1:1 basis to receive bicalutamide 150 mg daily or placebo. Recruitment to the program closed in July 1998, and follow-up is ongoing. Study endpoints include time to clinical progression, overall survival and tolerability. RESULTS: 8113 men aged 38 to 93 years (mean 66.9) were randomized over a 3-year period. 67.4% of the enrolled patients had localized disease (T1-2) and 66.4% had a Gleason score </=6 at study entry, while the majority of patients had node-negative (N0) disease; only 3.1% in two of the studies and none in the third study had confirmed N+ disease. Overall, 71.8% of the patients received therapy of primary curative intent within 16 weeks of randomization; the remainder received watchful waiting as their primary approach. Across the program, the two randomized groups are well balanced. CONCLUSION: This is the largest randomized clinical trial program to date in local prostate cancer and is expected to provide critical information on the role of bicalutamide as an addition to standard care for patients with local prostate cancer who have received a therapy of curative intent or are candidates for watchful waiting.

Journal Article↗
PubMed1994

Phenomenology, demography and diagnosis in late paraphrenia.

One hundred and one patients with late paraphrenia were examined using the Present State Examination. The established high prevalence rates of female gender, the unmarried state and sensory impairment were confirmed. All of the symptoms of schizophrenia, with the exception of formal thought disorder, were found in the subjects with approximately the same prevalence as reported in schizophrenics with a symptom onset in younger life. The presence of visual hallucinosis was significantly associated with visual impairment, but the same association was not found between auditory hallucinations and deafness. Mean age at onset of symptoms was high at 74.1 years. Using ICD-10 diagnostic criteria the patients were categorized as schizophrenia (61.4%), delusional disorder (30.7%) and schizoaffective disorder (7.9%). Patients in these diagnostic categories differed in their pre-morbid IQ estimations, current cognitive state measured by the Mini-Mental State Examination and in the number of scored positive psychotic PSE symptoms and their systematization of and preoccupation with delusions and hallucinations. There were no significant differences between the patients in the ICD-10 schizophrenia and delusional disorder groups in terms of age at symptom onset, sex ratio, response to treatment, being unmarried, the presence of insight or sensory impairment. The high degree of clinical similarity between patients with late paraphrenia combined with the inability of ICD-10 to define diagnostic subgroups that correspond to patient clusters derived from clinical symptoms or which are meaningfully different from each other in terms of demographic and prognostic factors provide a strong argument for the retention of late paraphrenia as the most appropriate diagnosis for such patients.

Aged↗
PubMed2002

Perceived need for mental health care: influences of diagnosis, demography and disability.

BACKGROUND: Recent major epidemiological studies have adopted increasingly multidimensional approaches to assessment. Several of these have included some assessment of perceived need for mental health care. The Australian National Survey of Mental Health and Wellbeing, conducted in 1997, included a particularly detailed examination of this construct, with an instrument with demonstrated reliability and validity. METHODS: A clustered probability sample of 10641 Australians responded to the field questionnaire for this survey, including questions on perceived need either where there had been service utilization, or where a disorder was detected by administration of sections of the Composite International Diagnostic Interview. The confidentialized unit record file generated from the survey was analysed for determinants of perceived need. RESULTS: Perceived need is increased in females, in people in the middle years of adulthood, and in those who have affective disorders or co-morbidity. Effects of diagnosis and disability can account for most of the differences in gender specific rates. With correction for these effects through regression, there is less perceived need for social interventions and possibly more for counselling in females; disability is confirmed as strongly positively associated with perceived need, as are the presence of affective disorders or co-morbidity. CONCLUSIONS: The findings of this study underscore the imperative for mental health services to be attentive and responsive to consumer perceived need. The substantial majority of people who are significantly disabled by mental health problems are among those who see themselves as having such needs.

Activities of Daily Living↗
PubMed1998

Analysis of survival data with multiple causes of failure: a comparison of hazard- and logistic-regression models with application in demography.

"The purpose of the paper is to compare results of estimation and inference concerning covariate effects as obtained from two approaches to the analysis of survival data with multiple causes of failure. The first approach involves a dynamic model for the cause-specific hazard rate. The second is based on a static logistic regression model for the conditional probability of having had an event of interest. The influence of sociodemographic characteristics on the rate of family initiation and, more importantly, on the choice between marriage and cohabitation as a first union, is examined. We found that results, generally, are similar across the methods considered. Some issues in relation to censoring mechanisms and independence among causes of failure are discussed."

Family Characteristics↗
PubMed2001

The EUROPA trial: design, baseline demography and status of the substudies.

BACKGROUND: Angiotensin-converting enzyme inhibitors do reduce both mortality and morbidity in patients with left ventricular dysfunction, recent myocardial infarction and hypertension. However, the long-term effects in patients with coronary artery disease have not been established. The EUROPA study is designed to assess the long-term (3-4 years) effects of perindopril on the reduction of cardiac events in patients with proven stable coronary artery disease but with no evidence of heart failure. STUDY DESIGN AND METHODS: EUROPA is a 12236 patient, randomised, double-blind, placebo-controlled and multicentre trial. EUROPA had an initial run-in period of 4 weeks during which patients received 4 and then 8 mg of perindopril daily to assess tolerance to maximum dose. This was followed by a double-blind randomisation to either perindopril or placebo. Patients were followed-up at 3 and 6 months and then 6 monthly until the last patient included in the main study completes the 3-year follow-up. EUROPA includes five sub-studies. Each of these sub-studies investigates the effects of perindopril on a different aspect of coronary artery disease: endothelial dysfunction, atherosclerosis progression regression, diabetes mellitus, inflammation, thrombosis, neurohormonal activation. Patients are characterised genetically to assess characteristics associated with improved or unfavourable outcome. The final results of EUROPA will be available in 2002.

Adult↗
PubMed2004

Effects of mercury on the life table demography of the rotifer Brachionus calyciflorus Pallas (Rotifera).

Mercury is highly toxic to a variety of aquatic organisms including zooplankton. The functioning of freshwater ecosystems can be altered if rotifers, being a natural food link between phytoplankton and fish larvae, are contaminated by mercuric compounds. In order to detect age-specific responses of the rotifer Brachionus calyciflorus to mercury toxicity (5 nominal concentrations as chloride viz. 0, 0.000625, 0.00125, 0.0025 and 0.005 mg l(-1)), we used the standard life table method at two different food (Chlorella vulgaris) levels (0.5 x 10(6) and 1.5 x 10(6) cells ml(-1)). Data indicated that increase in mercury concentration had an increasingly intense negative effect on many of the life history variables, while at higher food levels, its impact was less. A nearly rectangular survivorship pattern was obtained in controls, especially at higher food levels. This trend gradually changed to a steep fall as the concentration of the heavy metal in the medium increased from 0 to 0.005 mg l(-1). At any given food density, increase in the mercury concentration resulted in decreased age-specific reproduction. A maximum of 3.5 offspring female(-1) was observed in controls at higher food density. The average lifespan varied from 6 to 8 days at low food level, depending on the heavy metal concentration in the medium. The corresponding values at high food level varied from 8 to 12 days. Regardless of mercury concentration in the medium, gross and net reproductive values varied from 10 to 33 and 4 to 19 offspring female(-1). The longest generation time (about 9 days) of B. calyciflorus was obtained at 1.5 x 10(6) cells ml(-1) food density in control, while the shortest was 5 days at low food level and high (0.005 mg l(-1)) mercury concentration in the medium. Depending on the food level and heavy metal concentration in the medium, the rate of population growth (r) varied from 0.32 to 0.62 d(-1). In general, higher food level resulted in higher r. Except generation time, all other derived variables were significantly influenced by food level and the heavy metal concentration in the medium.

Analysis of Variance↗
PubMed2000

Selection based on merit versus demography: implications across race and gender lines.

In a replication and extension of the study by M. E. Heilman, M. C. Simon, and D. P. Repper (1987), 201 undergraduates participated in a simulation in which they experienced differing selection procedures and outcome feedback. Selection procedures did not have the deleterious effects on women that were found previously. Instead, race interacted with gender to moderate this relationship, and outcome played a significant role in participant self-evaluations. Black participants rated their leadership ability highest when both chosen preferentially and given negative outcome feedback, apparently because of a desire to maintain positive self-esteem. The latter explanation was supported in a follow-up study in which undergraduates (n = 80) worked in groups and received negative outcome feedback from either a racially similar or racially different experimenter. Theoretical and practical implications relating to diversity and self-appraisal management are discussed.

Black or African American↗
PubMed2025

Genomic analysis of differentiation and demography of the formerly conspecific agile (Dipodomys agilis) and Dulzura (D. simulans) kangaroo rats.

Karyotype variation within Pacific kangaroo rat Dipodomys agilis motivated its division in 1997 into the agile kangaroo rat (AKR, D. agilis, 2N&#x2009;=&#x2009;62) in the north of its range in California, and Dulzura kangaroo rat (DKR, D. simulans, 2N&#x2009;=&#x2009;60) to the south, with a suspected sympatric zone south of the San Gabriel and San Bernardino Mountains. This division was supported by our whole genome sequencing that sampled a ~120&#x2009;km transect from north of the mountains to SW Riverside County. The taxa showed marked genetic differentiation, with no evidence of hybridization or sympatry. AKR was found at the southern edge of the mountains, precluding the mountain barrier driving isolation, suggesting ecological separation linked to habitat differences between the mountains and the arid area to the south. Adding four additional Dipodomys species, we estimated genetic divergence times in the genus back to &#x223c;3.5&#x2009;mya. AKR and DKR diverged from D. stephensi &#x223c;1.7&#x2009;mya, and from each other &#x223c;0.5&#x2009;mya, when their joint effective population size (Ne) was ~100,000. After separation, DKR's Ne declined to ~20,000, while AKR's was little changed. More recently their Ne converged at ~50,000. Runs of homozygosity were longer in AKR, indicating a smaller neighborhood size, which may have promoted the karyotype change; however, nucleotide diversity was higher in AKR, but both had levels typical for rodents, indicating neither experienced recent bottlenecks. These patterns provide a baseline for any future conservation efforts. More generally, this study shows how a detailed genomic study can resolve taxonomic and demographic questions among morphologically indistinguishable taxa.

Animals↗
PubMed2002

The demography of slow aging in male and female Drosophila mutant for the insulin-receptor substrate homologue chico.

Hypomorphic mutants affecting the Drosophila insulin/IGF signal pathway are reported to increase longevity in females but not in males. To understand this sex-difference, we conducted a large-scale demographic study with three new isogenic strains of alleles at chico, the insulin-receptor substrate homologue. We verify that female dwarf homozygotes (ch1/ch1) and normal-sized heterozygotes (ch1/+) are long-lived, as originally reported. We find for the first time that male heterozygotes are long-lived relative to wildtype, by about 50%. The life span of male ch1/ch1 is similar to that of wildtype but these dwarf males age at a slow demographic rate. The levels of demographic frailty and of age-independent mortality are elevated in ch1/ch1 males, counteracting the effect of slow aging upon life expectancy. Mortality deceleration occurs amongst the oldest-old wildtype adults, as seen in many organisms. Remarkably, in similarly sized cohorts of male and female ch1/ch1 and of male ch1/+ mortality deceleration is absent. Mortality deceleration is a phenotype of chico.

Aging↗
PubMed1990

The prevalence of Trypanosoma cruzi and the demography of dog populations after insecticidal spraying of houses: a predictive model.

A three-year demographic and seroparasitological follow-up of the canine population of a rural area of Argentina endemic for Chagas' disease was carried out in order to (a) describe the population dynamics of domestic dogs, and (b) predict the decrease in the prevalence of Trypanosoma cruzi among these reservoirs after indoor spraying of houses with residual insecticides. For the latter project we designed an age-structured model with a discrete time scale. We assumed a time-dependent exponential decay in the frequency of infected hosts proportional to the host mortality rate, and also assumed and that no differential mortality existed between infected and non-infected dogs. Validation of the model was carried out, and yielded an extremely close fit between observed and theoretical values. The relevance of the model as an aid to designing strategies for the control of animal domestic reservoirs of T. cruzi, and the role of dogs as efficient sentinels of re-infestation of an area, are discussed.

Animals↗