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The generation of spatial population distributions from census centroid data.

"Census data are commonly used in geographical analysis and to inform planning purposes, though at the disaggregate level the basis of enumeration poses difficulties. In this paper an approach to surface generation is described that offers the prospect of revealing an underlying population distribution from centroid-based data which is independent of zonal geography. It is suggested that this can serve a wide variety of analytical, cartographic, and policy purposes, including the creation of spatial indicators of economic and social conditions and enhancing the value of census data. The approach is illustrated by reference to an analysis of part of the valleys of South Wales, in the United Kingdom."

Censuses↗

[A measure to evaluate estimates from the population census].

"A measure of efficiency loss for the precision of estimates implied by sampling fractions reduction is described here....A study of the sampling fractions needed to guarantee a given precision level to estimate characteristics...is also performed. An application of the methodology suggested is included. The example is based on household characteristics investigated in [Brazil's]... Census of 1980, with estimates published at a county level and for the set of alternative sampling fractions for the 1990... Census." (SUMMARY IN ENG)

Americas↗

[The age correction of survival probabilities in cancer studies].

PURPOSE: Survival of elder oncological patients may depend on the tumor disease, on reasons not related to the underlying disease or simply on patient's age. Therefore patient' age has to be taken into account if the objective of an oncological study is the disease-related survival. Basically, there are 3 different approaches: multivariate statistical modelling, estimation of disease-related survival after censoring of cases with cause of death not due to the tumor disease, and consideration of demographical data in the general population. PATIENTS AND METHODS: Our paper deals with the age correction using the data from the 1986/88 census in Germany. We have written a computer program based on SPSSWIN, which allows an automated age correction. Using clinical data of radiotherapy after surgical therapy of bladder cancer, we illustrate the method. RESULTS: The estimated 5-year-survival using the age correction was--dependent on patient's age in the sample--10% up to 15% higher than the uncorrected rate. In the whole sample of 333 unselected patients, 5-year-survival was corrected from 47% to 59%. In the normal population adjusted for age- and sex-distribution, the expected survival rate was 80%. CONCLUSIONS: The age correction has substantial influence on survival analysis of male patients elder than 60 years and female patients elder than 70 years. It should therefore be used in oncological studies investigating long-term survival of patients in these age-groups.

Adult↗

[Current census rates in inpatients hospitalized in the Hospital de Poniente in Almería [Spain]].

OBJECTIVE: To study the current census rate of patients admitted to an internal medicine service. METHOD: We studied all patients admitted to the internal medicine service from January 1 to August 31, 2000 whose addresses were registered in four local authorities of our hospital district. We made exhaustive searches to ascertain whether these patients were included in the register in September 2000. RESULTS: We analyzed 1,095 admissions from a total of 1,759 up to August 31, 2000. Twenty-four percent corresponded to patients who were not registered. Fifty-eight percent of those not registered were aged more than 70 years. Twenty-seven percent of patients aged less than 40 years, most of whom were immigrants, were also unregistered. CONCLUSIONS: Twenty-four percent of the admissions to the internal medicine service that were studied corresponded to patients who were not registered with their respective local authorities. A possible explanation is the large immigrant population and the lack of registration among the elderly.

Aged↗

Adjusting the 1980 census of population and housing.

"In 1980, several cities and states sued the U.S. Census Bureau to correct census results. This correction would adjust for the differential undercounting of Blacks and Hispanics, especially in cities. In this article, the authors, each of whom testified for New York City and State in their joint lawsuit against the Census Bureau, describe the likely pattern of the undercount and present a method to adjust for it." The authors describe available methods for data adjustment and introduce a regression-based composite method of adjustment, which is used to estimate the undercounts for 66 areas. "As expected, we find that the highest undercount rates are in large cities, and the lowest are in states and state remainders with small percentages of Blacks and Hispanics. Next, we analyze how sensitive our estimates are to changes in data and modeling assumptions. We find that these changes do not affect the estimates very much. Our conclusion is that regardless of whether we use one of the simple methods or the composite method and regardless of how we vary the assumptions of the composite method, an adjustment reliably reduces population shares in states with few minorities and increases the shares of large cities."

Black or African American↗

[Analysis of an outbreak of viral meningitis in the province of Tucuman, Argentina].

OBJECTIVE: To confirm the occurrence of an outbreak of viral meningitis in 1996 in the province of Tucuman, Argentina, and to study the outbreak's epidemiological characteristics. METHODS: We analyzed information from the National Epidemiological Surveillance System of the Ministry of Health (MOH) of Argentina for 1994-1998 that had been provided by the MOH's Bureau of Epidemiology. We calculated incidence rates using population estimates for the years 1994-1998 developed by the National Statistics and Census Institute, based on the 1991 census. We studied frequencies with contingency tables, using the chi-square method with Yates' correction. Results were considered significant when P < 0.05. RESULTS: We confirmed the occurrence of an outbreak of 189 cases of viral meningitis between 11 February and 18 May 1996. The incidence of cases in Tucuman province increased between 1995 and 1996, from 0.5 to 19.3 cases per 100 000 person-years. That 1996 rate in Tucuman was significantly higher than what was seen in the rest of the country (2.8 cases per 100 000 person-years). Of the 189 cases, 142 of them (75.1%) occurred in children less than 9 years old. Out of 111 samples studied, 65 of them (58.6%) were enterovirus-positive. Through reverse transcription-nested polymerase chain reaction, enteroviruses were found in 66.3% (53/80) of the cases studied by this method, versus in only 29.6% (24/81) of the cases studied through viral isolation. In the 22 samples that were serotyped, echovirus type 4 was identified in 15 of them (68%): 5 by isolation, 3 by sequencing, and 7 by both methods. During the Tucuman outbreak, at least 56% of the cases were hospitalized. This viral meningitis outbreak shows the capacity of enteroviruses to spread and cause disease. CONCLUSIONS: The use of molecular methods makes it possible to rapidly diagnose the etiological virus and to better control an outbreak. Recognizing this outbreak in Tucuman sooner could have averted the majority of the hospitalizations and the indiscriminate use of antibiotics.

Adolescent↗

Premature death among teenage mothers.

OBJECTIVE: Some data suggest an association between teenage childbearing and premature death. Whether this possible increase in risk is associated with social circumstances before or after childbirth is not known. We studied premature death in relation to age at first birth, social background and social situation after first birth. DESIGN: Population-based cohort study. SETTING: Women born in Sweden registered in the 1985 Swedish Population Census. POPULATION: Swedish women born 1950-1964 who had their first infant before the age of 30 years (N= 460,434). METHODS: Information on the women's social background and social situation after first birth was obtained from Population Censuses. The women were followed up with regard to cause of death from December 1, 1990 to December 31, 1995. Mortality rate ratios and 95% confidence intervals (CI) were calculated. MAIN OUTCOME MEASURES: Mortality rates by cause of death. RESULTS: Independent of socio-economic background, teenage mothers faced an increased risk of premature death later in life compared with older mothers (rate ratio 1.6, 95% CI 1.4-1.9). The increased risk was most evident for deaths from cervical cancer, lung cancer, ischaemic heart disease, suicide, inflicted violence and alcohol-related diseases. Some, but not all, of these increases in risk were associated with the poorer social position of teenagers mothers. CONCLUSIONS: Teenage mothers, independent of socio-economic background, face an increased risk of premature death. Strategies to reduce teenage childbearing are likely to contribute to improved maternal and infant health.

Adolescent↗

Urban violence and African-American pregnancy outcome: an ecologic study.

OBJECTIVES: To ascertain the extent to which residence in violent communities is an independent risk factor for adverse pregnancy outcomes among impoverished (census tract median family income < $10,000/year) African-American mothers. DESIGN: A cross-sectional study was performed. METHODS: We performed multivariate analyses on 1983 Illinois vital records, Chicago Police Department violent crime rates, and 1980 United States Census income data. RESULTS: African-American mothers who resided in the most violent communities had a low birth weight rate of 16% compared to 12% for infants (N = 315) with mothers who lived in the least violent communities; odds ratio = 1.5 (1.0-2.1). The proportion of small-for-gestational-age infants was substantially elevated in mothers who resided in the most violent communities compared to mothers who lived in the least violent communities: 7% vs. 3%; odds ratio = 2.6 (1.5-2.1). In multivariate logistic regression models that controlled for individual risk factors, the adjusted odds ratios for low birth weight and small-for-gestational-age infants among mothers who resided in the most (compared to the least) violent communities were 1.1 (0.9-1.2) and 1.5 (1.1-2.1), respectively. CONCLUSION: We conclude that a community's violent crime rate is associated with intrauterine growth retardation among infants born to African-American women.

Adolescent↗

Population estimates for small areas in Canada.

The author outlines population estimation techniques used by Statistics Canada. "The objectives of this paper are to (i) describe the methodology and data sources for estimating the population for census divisions (CDs) and census metropolitan areas (CMAs), and (ii) present the results of the evaluations of 1986 population estimates."

Americas↗

Prognostic relevance of census-derived individual respondent incomes versus household incomes.

BACKGROUND: Census-based measures of income derived from median income of a geographic area are often used in health research. Many national census surveys gather information on both the respondent's individual income and the income for the entire household, giving researchers a choice of census income measures. We compared the extent to which individual respondent income and household income (both obtained from census data) are associated with outcomes in a cohort of patients with cardiac disease. METHODS: We used data from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH), where postal codes were linked to the Postal Code Conversion File (PCCF) to determine each patient's census Dissemination Areas (DA). DA-derived median household income and median individual income were obtained from the 2001 Canadian Census and survival outcomes were then directly determined for income groupings defined by quintile. Two-year survival adjusted for age and sex was described with a proportional hazards analysis. RESULTS: There were 9,397 patients undergoing cardiac catheterization between January 1, 2001 and March 31, 2002, with complete DA-level median income measures. Household income quintiles yielded a wider spread of survival across quintiles (range of 2-year estimated survival, 91.8% to 95.9% for household income versus 92.8% to 95.6% for respondent income), as well as a more progressive decline in survival as income decreased. This progressive decline was not seen for the respondent income measure. CONCLUSIONS: The greater spread and progressive decline of survival for household income relative to respondent income leads us to conclude that household income is the better socio-economic determinant of health in our data and for the outcome measure we studied.

Aged↗

Estimating the lesbian population: a capture-recapture approach.

STUDY OBJECTIVE: Little is known about the number of women who identify as lesbian. Estimates from the US range from 1% to nearly 10%. Accurate estimates are critical in order to meet lesbian's healthcare needs and to address health problems that may be more prevalent among them. This study used capture-recapture methods to estimate the lesbian population of Allegheny County, Pennsylvania. DESIGN: Mailing lists from four sources were used to identify lesbians. The capture-recapture method and log-linear modelling were used to estimate the number of lesbians in the defined geographical area, and the percentage of the female population they comprised there was determined through census data. SETTING: Allegheny County, Pennsylvania, USA. RESULTS: A total of 2185 unique names were identified. The capture-recapture method estimated that the total lesbian population of Allegheny County was 7031 (95% CI 5850 to 8576). Therefore, based on the 1990 census figures, the county's adult lesbian population was estimated to be 1.87% (95% CI 1.56% to 2.28%) of the adult female population. CONCLUSIONS: An estimate of the lesbian population is fundamental for addressing lesbian's health needs and for developing appropriate research programmes. Capture-recapture methods have the potential to provide accurate and reliable estimates of this population in any location.

Adult↗

Bacterial infections in infants 60 days and younger: epidemiology, resistance, and implications for treatment.

OBJECTIVE: To establish what might be more optimal initial antibiotic therapy for suspected invasive bacterial infections in infants 60 days or younger who are evaluated in the emergency department (ED). SETTING: Urban university-affiliated pediatric referral center with an average yearly ED census of 52000 visits during the study period. DESIGN AND METHODS: We assembled a retrospective case series of all positive blood, urine, and cerebrospinal fluid cultures in children 60 days or younger from January 1, 1994, through December 31, 1997, obtained from both inpatients and patients initially evaluated in the ED. From this case series we determined the frequency of bacterial pathogens responsible for such infections in this age group. Pathogens were defined as group B streptococcus, various enteric gram-negative rods (GNRs), Listeria monocytogenes, enterococcus, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type B, and Staphylococcus aureus. A subgroup analysis was performed to determine resistance patterns among the GNRs isolated from patients evaluated in the ED. RESULTS: A total of 367 pathogens were isolated: 187 (51.0%) in the neonatal intensive care unit, 153 (41.7%) in the ED, 20 (5.4%) in the inpatient wards, and 7 (1.9%) in the pediatric intensive care unit. Of the 121 pathogens isolated from 120 ED patients that were eligible for review, 94 (77.7%) were in the urine only, 16 (13.2%) in blood only, 4 (3.3%) in cerebrospinal fluid only, 3 (2.5%) in blood and cerebrospinal fluid, and 4 (3.3%) in blood and urine. Organisms isolated included GNRs (n = 96, 79.3%), group B streptococcus (n = 14, 11.6%), enterococcus (n = 7, 5.8%), S. pneumoniae (n = 3, 2.5%), and N. meningitidis (n = 1, 0.8%). No Listeria were isolated. Of the 96 GNRs isolated, 60 (62.5%; 95% confidence interval, 52.8%-72.1%) were ampicillin resistant. All were sensitive to gentamicin sulfate and cefotaxime sodium. CONCLUSIONS: Our results reveal 2 important facts: (1) during a 4-year period, no isolates of Listeria were identified from any patients 60 days or younger; and (2) of the 96 GNRs isolated from patients in the ED, more than 60% were ampicillin resistant. These data suggest that in similar centers with a low incidence of infection with Listeria and high levels of ampicillin resistance among GNRs, empiric use of ampicillin as part of a combination for presumed bacterial infections in patients 60 days or younger initially evaluated in the ED may be neither necessary nor beneficial. Consideration should be given to empiric initial antibiotic therapy using a third-generation cephalosporin with or without gentamicin.

Ampicillin↗

Dementia care needs in an area population: case register data and morbidity survey estimates.

OBJECTIVE: To compare case register data on the frequency and distribution of known dementia cases in a metropolitan area population with expected total numbers computed from a national disability survey. METHOD: Known cases were enumerated by a cross-sectional census of the Camberwell Dementia Register. Expected total numbers were calculated using the Cognitive Disability (CD) Planning Model, based on the OPCS national survey of disability, 1985-86. RESULTS: Cases ascertained by the Dementia Register census comprised one-fifth of expected total prevalence. The proportion of such cases was higher for persons in long-stay care (1 in 3) than for those in private households (1 in 7). According to the CD Planning Model, cases known to specialist agencies were on average no more severely disabled and dependent than those who were unknown. In terms of absolute numbers, the district nursing and home help services appeared to be the most important untapped sources of case detection, but other research indicates that general practice contacts (not included in the planning model) may be at least equally important. CONCLUSIONS: At any given time, a high proportion of dementia cases, whether in long-stay care or in the community, will be outside the purview of specialist services. Primary care agencies are a major potential source, and a systematic health screening of persons aged over 75 years could be used to realize this potential.

Aged↗

A cohort mortality study of leather tanners in Tuscany, Italy.

BACKGROUND: Work in leather tanning may involve exposure to a wide range of chemicals. Some of these are carcinogens or suspected carcinogens. Increased risk for a number of cancers have been reported, although there are considerable inconsistencies between studies. The present study investigates the mortality of leather tanners in Tuscany, Italy. METHODS: Tanneries were selected from the 1996 Valdarno Inferiore Tanneries Census and were in operation since December 31, 1970. Employees were followed until December 31, 1998 through company records, and the National and Regional Death Index. Demographic and work history data were abstracted from company payrolls. Regional mortality rates were used to calculate Standardized Mortality Ratio (SMR). Analyses were completed for the overall cohort (men and women) and for men who ever worked as of finisher, chrome tanners, and vegetable tanner (only men). RESULTS: The cohort consisted of 4,874 workers (4,150 males and 724 females) employed in 92 tanneries active in 1996 and operating on December 31, 1970. Ascertainment of vital status and cause of death were completed for all individuals by the end of follow-up, December 31, 1998. Males showed increases for cancer of the endocrine glands (SMR 5.67, 4 observed (obs), 90% Confidence Intervals (CI) 195-1,308), blood diseases (SMR 3.29, 4 obs, 90% CI 112-753), mental disorders (SMR 1.95, 6 obs, 90% CI 85-385), violence and accidents (SMR 1.30, 54 obs, 90% CI 102-163). Mortality from myeloid leukemia was increased in males (SMR 2.08, 5 obs, 90% CI 82-437) and in females (SMR 5.99, 2 obs, 90% CI 106-1,887). One death from nasal cancer was observed versus 0.2 expected. Mortality from lung cancer was increased among finishers (SMR 1.45, 19 obs, 90% CI 95-212), an increase was observed also for bladder cancer (SMR 1.25, 2 obs, 90% CI 22-393) and pancreatic cancer (SMR 1.20, 2 obs, 90% CI 21-379). CONCLUSIONS: The study confirms previous observations among tanners of increased mortality from lung, bladder, and pancreatic cancer. Noteworthy are the increased mortality from myeloid leukemia together with the new findings of an increased mortality from endocrine glands tumors, blood diseases, and psychiatric disorders which should be considered with caution because of the small number of cases and the novelty of the observation.

Accidents↗

Informal risk-sharing arrangements (IRSAs) in rural Burkina Faso: lessons for the development of community-based insurance (CBI).

In resource-poor environments, community-based insurance (CBI) is increasingly being propagated as a strategy to improve access of poor rural populations to modern health care. It has been repeatedly hypothesized that CBI schemes need to be grounded in national as well as local traditions of solidarity. This paper presents a typology of informal risk sharing arrangements (IRSAs) in a rural area of North-Western Burkina Faso and discusses their modus operandi as well as the underlying concepts of solidarity and reciprocity. The research was explicitly multi-disciplinary, combining anthropological and economic as well as qualitative and quantitative data collection methods. Focus group and interview data were complemented by a census of existing IRSAs. In addition to presenting the main features of existing institutions, the paper discusses whether IRSAs can serve as entry points for CBI schemes. In spite of the fact that existing IRSAs fulfil important solidarity functions in the rural Burkinian context, we conclude that they cannot serve as institutional models for more formalized CBI schemes. Community participation in a future CBI scheme will need to tap into existing notions of solidarity and mutuality. The CBI scheme itself, however, needs to be newly tailored.

Burkina Faso↗

Retail alcohol monopolies, underage drinking, and youth impaired driving deaths.

OBJECTIVE: To explore associations of state retail alcohol monopolies with underage drinking and alcohol-impaired driving deaths. DATA: Surveys on youth who drank alcohol and binge-drank recently and their beverage choices; census of motor vehicle fatalities by driver blood alcohol level. METHODS: Regressions estimated associations of monopolies with under-21 drinking, binge drinking, alcohol-impaired driving deaths, and odds a driver under 21 who died was alcohol-positive. RESULTS: About 93.8% of those ages 12-20 who consumed alcohol in the past month drank some wine or spirits. In states with a retail monopoly over spirits or wine and spirits, an average of 14.5% fewer high school students reported drinking alcohol in the past 30 days and 16.7% fewer reported binge drinking in the past 30 days than high school students in non-monopoly states. Monopolies over both wine and spirits were associated with larger consumption reductions than monopolies over spirits only. Lower consumption rates in monopoly states, in turn, were associated with a 9.3% lower alcohol-impaired driving death rate under age 21 in monopoly states versus non-monopoly states. Alcohol monopolies may prevent 45 impaired driving deaths annually. CONCLUSIONS: Continuing existing retail alcohol monopolies should help control underage drinking and associated harms.

Accidents, Traffic↗

The effects of a celebrity suicide on suicide rates in Hong Kong.

BACKGROUND: Deaths of celebrities, especially by suicide, can be followed by an increase in population suicide rates, particularly where there is extensive media reporting. We have examined the impact on suicides following the death of a famous Hong Kong pop singer whose death from suicide by jumping from a height, occurred on 1st April 2003, and resulted in extensive and often dramatic media coverage. METHODS: Data on suicides were obtained from the Hong Kong Census and Statistics Department and the Coroner's Court. The numbers of suicides in 2003 before and after the death of celebrity were compared to the same period in 1998-2002. The case files and suicide notes of people who died by suicide in 2003 were also studied qualitatively. RESULTS: There was a significant increase in suicides following the celebrity death, compared with the average over the preceding three months as well as the corresponding monthly average during 1998-2002. It was particularly marked in a subgroup comprising males, aged 25-39 years, many of whom died by jumping. The name of the celebrity was often mentioned in case files and suicide notes. LIMITATIONS: The statistical results in showing the excess of suicides were based on aggregated data only. CONCLUSIONS: This study provides further confirmation of the potential harmful consequences of sensational and excessive reporting of celebrity deaths.

Adult↗