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PubMed2006

The acquisition of stimulus equivalence in individuals with fragile X syndrome.

BACKGROUND: Few studies have employed stimulus equivalence procedures to teach individuals with intellectual disabilities (IDs) new skills. To date, no studies of stimulus equivalence have been conducted in individuals with fragile X syndrome (FXS), the most common known cause of inherited ID. METHOD: Five adolescents with FXS were taught basic math and geography skills by using a computerized stimulus equivalence training programme administered over 2 days in 2-h sessions. RESULTS: Four of the five participants learned the math relations, with one participant demonstrating stimulus equivalence at post-test. Three of the five participants learned the geography relations, with all three of these participants demonstrating stimulus equivalence at post-test. CONCLUSIONS: These data indicate that computerized stimulus equivalence procedures, conducted in time-limited sessions, may help individuals with FXS learn new skills. Hypotheses concerning the failure of some participants to learn the training relations and to demonstrate stimulus equivalence at post-test are discussed.

Adolescent↗
PubMed1994

Farmer's lung precipitins in Doubs (a department of France): prevalence and diagnostic value.

In a French region where farmer's lung (FL) is common, we determined the prevalence of FL precipitins in dairy farmers and analyzed the relation between the presence of FL precipitins and the clinical probability of the disease. All the exposed dairy farmers of both sexes (n = 2555) from five districts of the Doubs department were asked to respond to a medical and professional questionnaire. A total of 1763 (69%) farmers agreed to participate. Precipitins tests were conducted in 551 (31%) farmers who showed any respiratory symptom and in a random sample of 100 asymptomatic farmers. Serum for each farmer was analyzed by both double diffusion and immunoelectrophoresis against Micropolyspora faeni (MF) and extracts of moldy hay (HE) from Doubs. The 651 farmers were then divided into four groups (G 1-4) with a decreasing probability of FL (G1: typical FL symptoms; G4: asymptomatic farmers). The estimated prevalence of precipitins in the whole population was as follows: 1) by double diffusion, against HE: 83%, against MF: 27%; 2) by immunoelectrophoresis, against HE: 26%, against MF: 19%. There was a close "linear" relation between the prevalence of precipitins detected by immunoelectrophoresis against HE and the symptoms: 51% in G1, 36% in G2, 29% in G3, and 13% in G4. Precipitins detected by immunoelectrophoresis were also related to exposure and geography (more immunization in tableland area than in plain or mountain area). Presence of precipitins detected by double diffusion was not related to symptoms, exposure, or geography.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

Geographical variation in life expectancy at birth in England and Wales is largely explained by deprivation.

STUDY OBJECTIVE: To describe the population mortality profile of England and Wales by deprivation and in each government office region (GOR) during 1998, and to quantify the influence of geography and deprivation in determining life expectancy. DESIGN: Construction of life tables describing age specific mortality rates and life expectancy at birth from death registrations and estimated population counts. Life tables were created for (a) quintiles of income deprivation based on the income domain score of the index of multiple deprivation 2000, (b) each GOR and Wales, and (c) every combination of deprivation and geography. SETTING: England and Wales.PATIENTS/ PARTICIPANTS: Residents of England and Wales, 1998. MAIN RESULTS: Life expectancy at birth varies with deprivation quintile and is highest in the most affluent groups. The differences are mainly attributable to differences in mortality rates under 75 years of age. Regional life expectancies display a clear north-south gradient. Linear regression analysis shows that deprivation explains most of the geographical variation in life expectancy. CONCLUSIONS: Geographical patterns of life expectancy identified within these data for England and Wales in 1998 are mainly attributable to variations in deprivation status as defined by the IMD 2000 income domain score.

Adolescent↗
PubMed2002

GIS and disease.

Geographic information systems (GIS) and related technologies like remote sensing are increasingly used to analyze the geography of disease, specifically the relationships between pathological factors (causative agents, vectors and hosts, people) and their geographical environments. GIS applications in the United States have described the sources and geographical distributions of disease agents, identified regions in time and space where people may be exposed to environmental and biological agents, and mapped and analyzed spatial and temporal patterns in health outcomes. Although GIS show great promise in the study of disease, their full potential will not be realized until environmental and disease surveillance systems are developed that distribute data on the geography of environmental conditions, disease agents, and health outcomes over time based on user-defined queries for user-selected geographical areas.

Animals↗
PubMed2004

Spatial accessibility of primary care: concepts, methods and challenges.

Primary care is recognized as the most important form of healthcare for maintaining population health because it is relatively inexpensive, can be more easily delivered than specialty and inpatient care, and if properly distributed it is most effective in preventing disease progression on a large scale. Recent advances in the field of health geography have greatly improved our understanding of the role played by geographic distribution of health services in population health maintenance. However, most of this knowledge has accrued for hospital and specialty services and services in rural areas. Much less is known about the effect of distance to and supply of primary care on primary care utilization, particularly in the U.S.For several reasons the shortage of information is particularly acute for urban areas, where the majority of people live. First, explicit definitions and conceptualizations of healthcare access have not been widely used to guide research. An additional barrier to progress has been an overwhelming concern about affordability of care, which has garnered the majority of attention and research resources. Also, the most popular measures of spatial accessibility to care - travel impedance to nearest provider and supply level within bordered areas - lose validity in congested urban areas. Better measures are needed. Fortunately, some advances are occurring on the methodological front. These can improve our knowledge of all types of healthcare geography in all settings, including primary care in urban areas.This paper explains basic concepts and measurements of access, provides some historical background, outlines the major questions concerning geographic accessibility of primary care, describes recent developments in GIS and spatial analysis, and presents examples of promising work.

Journal Article↗
PubMed1997

Epidemiology of multiple sclerosis in US veterans: VII. Risk factors for MS.

In previous papers of this series, we explored the epidemiology of MS, examining the effects of race, sex, geography, latitude and climate, migration, age at onset, population ancestry, and individual ethnicity on the risk of MS, using an unusually large cohort of MS cases and pre-illness matched controls comprising US veterans of World War II (WWII) and the Korean Conflict (KC). In this paper, we examine primarily the effect of other factors on the risk of MS in this cohort and their relation to those previously studied. We found here that latitude tier of residence at entry into active duty (EAD), years of education, and socioeconomic class (coded from occupation) were similarly associated with MS risk among white men, black men, and white women. Higher levels of each factor showed increased MS risk. Multivariate analyses indicated that for white male WWII subjects an urban address, 9 or more years of education, uncorrected visual acuity less than 20/20 at EAD, a more northern latitude, and a higher proportion of the subject's EAD state population reporting Swedish ancestry each significantly increased the risk of MS. White male KC subjects showed roughly the same patterns, except that uncorrected visual acuity less than 20/20 was associated with lower MS risk (ancestry/ethnicity was not studied). For black male WWII and KC subjects combined, a similar analysis (omitting ancestry/ethnicity) showed that only latitude at EAD and 9 or more years of education were independently associated with a significantly higher MS risk, and for WWII plus KC white women (also without ancestry/ethnicity), only latitude was a significant risk factor in these multivariate analyses. The smaller number of subjects, especially in these last two groups, limited the power to detect statistically significant risks in these last analyses. Similarities to white men of WWII in univariate analyses for all other groups suggest that findings for the former would otherwise apply to the latter. Although the interpretations of these associations may be obscure, in addition to geography, age, sex, and race, per se, higher socioeconomic status is significantly associated with higher MS risk in black and white men and in white women in the United States.

Black or African American↗
PubMed2005

The association between presence of children in the home and firearm-ownership and -storage practices.

OBJECTIVE: American children's ready access to firearms contributes to high rates of firearm-related injuries. Understanding the factors that influence storage decisions is critical for prevention. This study examined the influence of geography and presence of children <16 years old in the home on firearm-ownership and storage decisions of northeast-Ohio residents. METHODS: Analysis was based on 522 responses to randomized telephone surveys of urban and rural households in northeast Ohio. Relationships between 4 dependent variables (firearm ownership, type of firearm owned, reasons for owning, and storage) and 2 independent variables (geography and presence of children in the home) were evaluated using odds ratios and multinomial logistic regression. RESULTS: Firearms were significantly more common in rural (31%) than in urban (13%) households. Twenty-two percent of gun owners reported securing all firearms with trigger locks or storing them in locked safes, drawers, or gun cabinets; 12% reported storing guns unlocked and either loaded or together with ammunition. Most gun owners (66%) reported storing all firearms unlocked, unloaded, and separate from ammunition. Rural respondents without children were approximately twice as likely as those with children to have handguns, but children did not influence long-gun ownership. In the urban group, the presence of children was not related to likelihood of firearm ownership. Having children in the home was not significantly associated with higher rates of safe storage for either group. DISCUSSION: These results illustrate the inadequacy of 1-size-fits-all interventions and highlight the need to better understand gun owners' reasoning about children and guns to design and implement successful interventions. Physicians and others interested in reducing pediatric exposure to firearms cannot be credible messengers on gun-safety topics if they cannot demonstrate an understanding of the issues from the perspective of patients and their families.

Child↗
PubMed2005

[Assessment of completeness of death reporting in Brazilian states for the year 2000].

OBJECTIVE: To estimate and evaluate the completeness of adult death reporting for all Brazilian states. METHODS: Death statistics from the Brazilian Institute of Geography and Statistics (IBGE) and the Brazilian Ministry of Health for the period between 1999 and 2001 were compared by sex. Three techniques were used to evaluate the extent of death underreporting. The final estimate followed previously set criteria, resulting in four evaluation categories. RESULTS: For the first time, the Brazilian Institute of Geography and Statistics reported fewer deaths than the Ministry of Health. Death reporting showed to be at least "satisfactory" in all states in the South, Southeast, Mid-West and part of the Northeast region. The remaining states, from the Northeastern state of Piauí toward the North, were classified as "average" except for the state of Roraima. Fuller death reporting was seen among males. CONCLUSIONS: Increased death reporting was seen in all regions, particularly for those in North and Northeast regions. If this trend will continue, all Brazilian states will likely exceed 80% reporting by the year 2010.

Adult↗
PubMed2004

Metric variation among geographic populations of the Chagas vector Triatoma dimidiata (Hemiptera: Reduviidae: Triatominae) and related species.

Eight Triatoma dimidiata populations from different geographic regions were compared along with related species using traditional morphometry of head characters. A method for removing allometric change was used for the intraspecific comparisons, and scaling for the isometric change of size was used for the interspecific comparisons. The intraspecific comparison showed significant head shape differences between T. dimidiata populations correlating with geography, showing a separation between the northern, intermediate, and southern collections (more evident in females), and supporting the idea that this species includes several evolutionarily divergent populations. The positioning of one sylvatic group from Guatemala did not correlate with geography, because it was more closely related to a distinct population of Colombia. This sylvatic group was found in caves, while the Colombian specimens, although collected in houses, may have migrated from nearby caves. Evolutionary and/or ecological influences could be responsible for the head shape similarities between these two groups: a common ancestral origin of both populations or a morphological convergence caused by similar environmental pressures. The interspecific comparisons included four other regional species of the same genus, three of them belonging to the phyllosoma complex (T. pallidipennis, T. mexicana, and T. ryckmani, the latter provisionally) and the fourth one classified in the protracta complex (T. nitida). Both complexes were readily separated by their head dimensions, even after size adjustment, and our data support inclusion of T. dimidiata within the phyllosoma complex.

Animals↗
PubMedDate not supplied

Targeted sampling protocol as prelude to bacterial source tracking with Enterococcus faecalis.

Recent studies suggest that host origin databases for bacterial source tracking (BST) must contain a large number of isolates because bacterial subspecies change with geography and time. A new targeted sampling protocol was developed as a prelude to BST to minimize these changes. The research was conducted on the Sapelo River, a tidal river on the Georgia coast. A general sampling of the river showed fecal enterococcal numbers ranging from <10 (below the limit of detection) to 990 colony-forming units (CFU) per 100 mL. Locations with high enterococcal numbers were combined with local knowledge to determine targeted sampling sites. Fecal enterococcal numbers around one site ranged from <10 to 24,000 CFU per 100 mL. Bacterial source tracking was conducted to determine if a wastewater treatment facility at the site was responsible for this contamination. The fecal indicator bacterium was Enterococcus faecalis. Ribotyping, automated with a RiboPrinter (DuPont Qualicon, Wilmington, DE), was the BST method. Thirty-seven ribotypes were observed among 83 Ent. faecalis isolates obtained from the Sapelo River and the wastewater lagoon. Sixteen ribotypes were associated with either the river or the lagoon, and only five ribotypes (14%) were shared. Nevertheless, these five ribotypes represented 39 of the 83 Ent. faecalis isolates, almost a majority (47%). These results suggest that the fecal contamination in the river came from the wastewater treatment facility. As a prelude to BST, targeted sampling minimized subspecies changes with geography and time, and eliminated the need for a permanent host origin database by restricting BST to a small geographic area and requiring sampling to be completed in one day.

Animals↗
PubMed1993

Self-perceived creativity and vividness of mental imagery.

We report the joint influence of creativity factors on mental imagery among 1361 university students of Fine Arts, Mathematics, and Geography and History. Creativity accounted for 1% of the variance in imagery among Fine Arts students, 4% among Mathematics students, 2% among Geography and History students, and 3% in the whole sample.

Adolescent↗
PubMed1995

Incidence of gastric cancer and prevalence of chronic gastritis in outpatients: comparison between two geographical areas in Finland.

We present some evidence that there exists a positive relationship between the incidence of gastric cancer and the prevalence rate of chronic gastritis, regarding the time trends and geography of these diseases in Finland. Both gastric cancer and chronic gastritis have declined in occurrence during the last 15 years, and there exists a similar geographic distribution of these diseases in Finland on the north-south axis: both are more prevalent in Lapland than in Southern Finland. The distribution of the socioeconomic conditions in Finland also shows a north-south axis: the proportion of people with low social class, number of children (birth rate) per household is higher, and the yearly income on average is lower in Lapland than in Southern Finland. We conclude that the epidemiology of chronic gastritis and gastric cancer show similar epidemiological features, regarding at least the time trends and geography of these diseases in Finland.

Adult↗
PubMed2005

An evaluation of the costs, effectiveness and quality of renal replacement therapy provision in renal satellite units in England and Wales.

OBJECTIVES: To survey of the structure, processes and organisation of renal satellite units (RSUs) in England and Wales (Phase 1), and to compare the effectiveness, acceptability, accessibility and economic impact of chronic haemodialysis performed in RSUs compared to main renal units (MRUs) (Phase 2). DATA SOURCES: Phase 1: all renal satellite units in England and Wales. Phase 2: haemodialysis patients in a representative sample (based on geography, site, private--public ownership, medical input) of 12 RSUs and their MRUs. REVIEW METHODS: Phase 1 consisted of a questionnaire survey. Semi-structured interviews were held in a representative sample of 24 RSUs with the senior clinician, senior nurse and manager. Phase 2 consisted of a cross-sectional comparison of patients in these RSUs and patients in the parent MRUs deemed suitable for satellite care by senior staff. Clinical information was obtained from medical notes and unit computer systems. Generic and disease specific health-related quality of life (HRQoL) measures were used. Co-morbidity was assessed by the Wright/Khan Index, the Lister/Chandna score, the Modified Charlson Index, and the Karnofsky Performance Score. Statistical analyses compared RSU versus MRU patients and took account of the paired and clustered nature of the data. RESULTS: In Phase 1, responses were received from 74/80 (93%) of RSUs; 2600 patients were being treated in these RSUs. The interviews were generally positive about the impact of RSUs in terms of improved accessibility and a better environment for chronic haemodialysis (HD) patients, and in expanding renal replacement therapy patients (RRT) capacity. In Phase 2, some 82% of eligible patients took part, 394 patients in the 12 RSUs and 342 in the parent MRUs. The response rate was similar in both groups. There were no significant differences in clinical processes of care. Most clinical outcomes were similar, especially after pooled analysis, although a few parameters were statistically significantly different -- notably the proportion achieving Renal Association Standards for adequacy of dialysis as measured by the urea reduction ratio (URR) was higher in the RSU patients. Patient-specific quality of life did not differ except on the patient satisfaction questions from the KDQOL, which were scored higher by the RSU sample. Strength of preference for health status on and off dialysis was very similar between the groups, as were EQ-5D utilities. Major adverse events were not common in the RSU patients, although there were many hypotensive episodes on HD, a proportion of which affected the duration of the HD session. Of the costs measured, the only difference that was statistically significant was for District Nurse visits. Of particular note was that despite the MRU group having a higher proportion of patients hospitalised, this did not translate into a statistically significant budgetary impact in terms of the total cost per patient of hospitalisations or mean cost per patient per hospitalisation. CONCLUSIONS: This study has shown that RSUs are an effective alternative to MRU HD for a wide spectrum of patients. They improve geographic access for more dispersed areas and reduce patients' travel time, and are generally more acceptable to patients on several criteria. There does not seem to be an adverse impact of care in the RSUs although comparative long-term prospective data are lacking. The evidence suggests that satellite development could be successfully expanded; not all MRUs have any satellites and many have only a few. No single RSU model can be recommended but key factors would include local geography, the likely catchment population and the type of patients to be treated. There is a need for more basic budgetary information linking activity and expenditure to be available and more transparent, to perform at least an insightful top-down costing of the two care settings. Other areas suggested for further research include: a comparison of adverse events occurring in MRUs and RSUs with longer duration and larger numbers to identify more severe events, along with the more research into the scope for preventing such events, and a study into the patients deemed ineligible for satellite care. International comparisons of satellite care would also be useful.

Adult↗
PubMed2001

[Russian genofond. Genogeography of surnames].

Surnames are traditionally used in population genetics as "quasi-genetic" markers (i.e., analogs of genes) when studying the structure of the gene pool and the factors of its microevolution. In this study, spatial variation of Russian surnames was analyzed with the use of computer-based gene geography. Gene geography of surnames was demonstrated to be promising for population studies on the total Russian gene pool. Frequencies of surnames were studied in 64 sel'sovets (rural communities; a total of 33 thousand persons) of 52 raions (districts) of 22 oblasts (regions) of the European part of Russia. For each of 75 widespread surnames, an electronic map of its frequency was constructed. Summary maps of principal components were drawn based on all maps of individual surnames. The first 5 of 75 principal components accounted for half of the total variance, which indicates high resolving power of surnames. The map of the first principal component exhibits a trend directed from the northwestern to the eastern regions of the area studied. The trend of the second component was directed from the southwestern to the northern regions of the area studied, i.e., it was close to latitudinal. This trend almost coincided with the latitudinal trend of principal components for three sets of data (genetic, anthropological, and dermatoglyphical). Therefore, the latitudinal trend may be considered the main direction of variation of the Russian gene pool. The similarity between the main scenarios for the genetic and quasi-genetic markers demonstrates the effectiveness of the use of surnames for analysis of the Russian gene pool. In view of the dispute between R. Sokal and L.L. Cavalli-Sforza about the effects of false correlations, the maps of principal components of Russian surnames were constructed by two methods: through analysis of maps and through direct analysis of original data on the frequencies of surnames. An almost complete coincidence of these maps (correlation coefficient rho = 0.96) indicates that, taking into account the reliability of the data, the resultant maps of principal components have no errors of false correlations.

Gene Pool↗
PubMed1992

[Problem of the relationship of probable and real ecologic pathology].

Ecology plays more and more important role as an etiological factor of human diseases: congenital defects, tumours, immunodyzergies, hematopoietic and endocrine disorders. Two directions should be taken into consideration in establishing the role of ecology in human disease: pathology itself and ecogenic factor. The first one consists of the complex "populations at risk-pattern of mortality-ecogenic diseases, the second direction is "geography of potentially ecogenic diseases-correlation with geography of environmental pollution-eco-etiological factor". The analysis of death causes may form an alternative to generalized ecomedical analysis having a low informative value. Additional problem of ecological pathology is an ecogenically induced weakness, premorbid and latent states.

Cause of Death↗
PubMed2006

[Crimean-Congo Hemorrhagic Fever].

Crimean-Congo Hemorrhagic Fever (CCHF) virus is a tick-borne virus, which is a member of Bunyaviridae family, Nairovirus genus. CCHF virus has been isolated from 31 different tick species so far, and genus Hyalomma includes the basic vectors of which H. anatolicum, H. marginatum, H. detritum, H. dromedarii, H. excavatum and H. turanicum are frequently found in the geography in which Turkey takes place. The virus is transmitted via the bite of infected ticks or direct contact with CCHF infected patients and the products of infected animals. Following 2-9 days incubation period, the disease abruptly starts with fever, feeling cold, shivering, headache, muscle and joint aches. After a few days hemorrhage develops at various parts of the body. Since an effective vaccine and a specific antiviral therapy have not been found yet, the high mortality rate which may reach to 10-60%, and a wide geography affecting approximately 40 countries including Turkey, CCHF attracts the attention of both scientific and mediatic world, in recent years. In this article, the structure, vectors and reservoirs of CCHF virus, together with the epidemiology, clinical features, laboratory diagnosis and strategies of treatment and prevention, have been reviewed.

Animals↗
PubMed1998

[The ecologic component of the geographic variation of the Northern Eurasian gene pool and its archaeological age].

The problem of the relationship between the state of the gene pool and population health was formulated. The subdivision into latitudinal zones, which is a characteristic feature of the northern Eurasian gene pool, was studied. This subdivision was expressed in the geographical distribution of the second principal component (PC2.G) of the total variance of 100 allelic frequencies for 34 polymorphic loci. It was suggested that this distribution of PC2.G resulted from the genetic adaptation of the population to the latitudinal zonality that is characteristic of northern Eurasia. It was also suggested that the latitudinal geographic variation was not inherent in the northern Eurasian gene pool and was younger than its total historical age. The evolutionary age of the principal components of the gene pool was estimated based on the geography of the principal components of the geographic variability of the late Paleolithic material culture, as well as the paleogeography of the Quaternary period. It was demonstrated that the first principal component of the modern gene pool was almost completely formed in the late Pleistocene; hence, its age is at least 16,000-26,000 years. The age of the second principal component (PC2.G) was estimated at less than 12,000-15,000 years; it was mostly formed in Holocene. A hypothesis was advanced that genetic adaptation occurs at the cost of population health, with the cost increasing as the evolutionary age of the genetic adaptation decreases. It was suggested that the latitudinal zonality of gene pool was accompanied by a similar zonality in the geography of morbidity as a cost of genetic adaptation.

Adaptation, Physiological↗
PubMed1998

[Climatic changes and transmissible diseases].

Transmissible disease geography can be defined as the study of the spatial expression of pathogenic processes. The three main elements implicated in this study are environmental conditions affecting biophysical dynamics, political, economic, social, and cultural events, and evolution of pathogenic agents under the influence of the first two factors. A number of pathogenic areas or regions can be delimited in function of different combinations of these factors. These territories are subject to rapid change and variation. Meteorological changes and cycles are contributing factors. However the underlying mechanisms appear to be increasingly affected by human activity. Several disturbing signs have been attributed to man including desertification, drought, and global warming, but the cause-and-effect relationship is unsure. Much research is in progress but resulting data remains contradictory except insofar as to confirm the complexity of atmospheric phenomena. The natural geography of transmissible diseases is affected by these variations but it is mainly the expression of the dialogue between man and nature.

Climate↗