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PubMed1996

Prevalence and severity of asthma, rhinitis, and eczema in Singapore schoolchildren.

This study was part of an international effort to evaluate the epidemiology of asthma and allergic diseases around the world. The aim was to assess the prevalence and severity of these disorders in Singapore schoolchildren. The international study of asthma and allergies in childhood (ISAAC) written questionnaire was administered to 6238 schoolchildren. The respondents were parents of a 6-7 year cohort (n = 2030), and schoolchildren aged 12-15 years (n = 4208). The overall cumulative and 12 month prevalence of wheezing were 22% and 12%, respectively. The prevalence of doctor diagnosed asthma was 20%. Rhinitis was reported by 44% and chronic rashes by 12%. Multiple logistic regression analysis showed that a higher prevalence of wheezing and rhinitis was associated with males, and subjects of higher socioeconomic status (based on type of housing and total family income). More severe asthma related symptoms were present in Malays and Indians than in the Chinese. Allergic disorders are common in Singapore and prevalence is comparable to some populations in the West. Demographic and socioeconomic factors appear to influence the prevalence and severity of these disorders.

Adolescent↗
PubMedDate not supplied

Video lottery terminal access and gambling among high school students in Montréal.

BACKGROUND: Gambling is a risky behaviour that involves uncertain financial outcomes, can be addictive, and has been associated with strongly adverse social and public health outcomes. We wanted to assess whether socio-economic and gambling-related-opportunity environments of neighbourhoods affected the uptake of video lottery terminal (VLT) gambling among Montréal youth. METHODS: Spatial and statistical analyses were conducted to examine geographical patterns of neighbourhood socio-economic conditions, VLT sites (n=407), and high school locations (n=305) within the Montréal Census Metropolitan Area (CMA). VLT concentration within high school neighbourhoods was measured to examine how the number of VLT opportunities varies according to socio-economic status of the school neighbourhood. A student survey was analyzed using logistic regression analysis to explore the role of individual (student) characteristics and environmental (neighbourhood) characteristics in predicting the VLT gambling behaviours reported among a sample (n=1206) of high school students. RESULTS: Video lottery gambling opportunities are more prevalent near schools located in socio-economically deprived neighbourhoods compared with schools located in more affluent neighbourhoods. The principal individual risk factors for VLT gambling were shown to be male sex, peer VLT-use, substance use, as well as the after-school routines of youth. INTERPRETATION: The spatial distribution of VLTs reflects local geographies of socio-economic disadvantage and may have a pronounced impact on students attending schools in lower income neighbourhoods, especially those with individual risk factors. Efforts to reduce gambling-related public health costs may want to take into account the socio-spatial distribution of gambling opportunities, particularly in the local environments that youth frequent.

Adolescent↗
PubMed1997

Social profile of first-year dentistry students at the University of Sydney.

There has been constant interest in the background of dentistry students over the years. This paper, based on the data amassed by surveying the first-year dentistry students of 1994 and 1995, builds on previous questionnaires and publications, and shows that certain trends in student make-up, predicted earlier, have been checked. The article examines such features as the gender breakdown of first-year students, age at the end of their first year, their own and their parents' countries of origin, English and non-English language proficiency, type of school attended, parents' occupations, parents' highest level of education, motivations for choosing dentistry as a career, aptitude for a career in dentistry, and previous studies and employment. The data are analysed with the view to determining changes over time in the social composition of dentistry students.

Adult↗
PubMed2003

[Prevalence of overweight and obesity and associated factors among adolescents in the Northeast and Southeast regions of Brazil, 1996 to 1997].

The purpose of this study was to assess the prevalence and factors associated with overweight and obesity (OW/O) among Brazilian adolescents, based on the Living Standards Survey conducted in 1996 and 1997 (IBGE, 1998a). The sample included 1,027 and 854 adolescents aged 15 to 19 years from the Northeast and Southeast regions, respectively. Body Mass Index (w/h2) was calculated. Statistical analysis considered expansion factors and sample design. Prevalence of OW/O was 8.45% in the Northeast and 11.53% in the Southeast. In the Northeast there was a higher risk of OW/O for girls (PR = 3.00), with the same situation in both urban (PR = 3.21) and rural areas (PR = 2.27). In the Southeast, the risk of OW/O was lower among girls (PR = 0.58). The same situation occurred in girls from urban areas (PR = 0.51), but in rural areas there was an increased risk among girls (PR = 1.86). Per capita monthly income was associated with the risk of OW/O among boys in both regions. Programs to prevent OW/O should incorporate nutritional reeducation and encourage physical exercise, besides considering socioeconomic, cultural, and regional differences and the location of the target population.

Adolescent↗
PubMed2004

[Smoking-attributable productivity loss in Germany--a partial sickness cost study based on the human capital potential method].

PURPOSE: Costs of productivity loss for the Federal Republic of Germany attributable to smoking in 1999 was to be determined. METHODS: Mortality and morbidity attributable to smoking is determined by a 0.5 % sample of the smoking behaviour of the German population (microcensus 1999) and the relative mortality risks of smokers (US-American cancer prevention study II). Tobacco smoke-associated cancer illnesses, cardiovascular diseases, respiratory tract diseases and illnesses of children under one year are considered. Calculation of the productivity-relevant consequences of smoking due to morbidity and mortality is effected according to the so-called human potential capital method. RESULTS: In Germany total of 607,393 working years were lost because of smoking in the year 1999. The costs of productivity loss are estimated at 14,480 billion euro. From this 4,525 billion euro are allotted to premature mortality, 5.759 billion euro to permanent disablement and 4.196 billion euro to temporary incapacitation for work. If the costs of productivity loss by smoking are referred to the gross national product (BSP) in the year 1999, an economical damage at a value of 0.74 % of BSPs results. This corresponds to a productivity loss of 379 euro per present or former smoker. The sensitivity analysis manifests that the inclusion of "non-marketable production" results in an immense rise productivity losses attributable to smoking. However, it should be noted that in times of mass unemployment the human capital method which is based on full employment does not measure the actual, but only the potential productivity loss cost. CONCLUSIONS: This partial disease cost study shows that immense economic productivity losses are associated with smoking. This loss of resources can justify a purposeful promotion of studies regarding cost effectiveness of anti-smoking therapeutic measures or preventive measures against smoking. But it should be considered that the use of the human potential capital method results in an overestimation of the actual productivity losses by smoking. In future the costs of productivity losses attributable to smoking should be determined by the friction cost method. With this procedure a more realistic estimation of productivity-relevant costs of smoking is possible.

Adult↗
PubMed1981

Equity in the distribution of quality of care.

This article examines whether the quality of health care services in the United States is equitably distributed across all groups in the population, especially groups defined by age, race, sex, and income characteristics. The framework within which the question is answered draws distinctions among structural, process, and outcome inequities. The available evidence suggests that all three types of inequity are present, at least to some extent. However, there are too many gaps and weaknesses in what is known about this issue to reveal systematic patterns or to support broad generalizations. The need for additional research on this issue is discussed, as are the policy implications of what is already known about equity in the distribution of quality of care.

Age Factors↗
PubMed2004

A quantification of preventable unintentional childhood injury mortality in the United States.

OBJECTIVE: To calculate the preventable fraction of unintentional childhood injury deaths in the United States. DESIGN: Ecological study of cause specific unintentional childhood injury mortality rates across the 50 states (and the District of Columbia) of the United States (US) over the 10 year period 1989-98. METHODS: The internet accessible database from the National Center for Injury Prevention and Control was used in order to estimate unintentional childhood (0-14 years) injury mortality rates by external cause and time trends over the study period for each of the US states and for the four major geographical regions of the country. In the principal analysis, a calculation was made of the fraction and absolute number of unintentional childhood injury deaths that could have been prevented annually if the mortality rate in the region with the lowest rate also existed in the remaining three. In another scenario, the lowest external cause specific unintentional childhood injury mortality rates from the 50 US states and the District of Columbia were summed to provide the "ideal" lowest conceivable unintentional childhood injury mortality rate from all causes. Ecological correlations between unintentional childhood injury mortality rates from specified external causes, median income, and percent of the population with a college degree were made. MAIN OUTCOME MEASURES: Unintentional childhood injury mortality rates by cause. RESULTS: Unintentional childhood injury mortality rate declined by 3.5% per year in the country as a whole. If every region of the US had experienced the same injury rate as the Northeast, then one third of all unintentional childhood injuries would not have occurred. More optimistic scenarios indicate that up to two thirds of all unintentional childhood injury deaths could be prevented. Across states, unintentional childhood injury mortality is strongly inversely related to median income. CONCLUSIONS: About one third of all unintentional childhood injury deaths in the US are preventable with the means and resources available in the Northeastern states. Among the relevant characteristics in the Northeast region, in comparison with other US regions, are the higher education level of parents, the lower gun ownership, the higher population density that implies shorter distances traveled by cars, a better developed emergency medical system, and the existence of several injury prevention programs.

Accident Prevention↗
PubMed1980

Nuclear scattering radiography.

The quasi-elastic scattering of 1 GeV protons permits the three-dimensional reconstruction of the density distribution in extended bodies. Fast multiwire proportional chambers are used to localize the position of every incoming and outgoing charged particle and to determine the coordinates at the interaction vertex. This article describes tests on a human head fixed on formalin. The comparison with computed tomography scans and anatomical sections is encouraging. Slices with a volume element of 5.5 mm3 illustrate the sensitivity of the method. The results also demonstrate the ability of the method to select the density distribution of hydrogen by making use of the kinematic relations specific to elastic scattering. Trials of this method in living humans are being planned.

Brain↗
PubMed1991

Fluorosis of deciduous teeth and first permanent molars in a rural Kenyan community.

The severity and distribution of fluorosis in the deciduous dentition of 76 children in a low-income community near Nairobi were studied. Seventeen children comprised a low-F (fluoride) group (water less than 0.7 ppm F) and 59 a high-F group (water approximately 9 ppm F). The high-F group had scores greater than or equal to 5 in the Thylstrup & Fejerskov classification system for 29% of the deciduous tooth surfaces, compared with 7% in the low-F group. Comparison between the scores of the second deciduous and the first permanent molars showed no significant difference in the high-F group (p greater than 0.001), whereas the deciduous molar was significantly less severely affected in the low-F group (p less than 0.001). The deciduous molars of the two groups differed significantly (p less than 0.002), but not the permanent molars (p greater than 0.10). Early introduction of tea might have been a major contributor to the distributions of fluorosis, particularly in the low-F group.

Adolescent↗
PubMed1995

Mortality in regions and local authority districts in the 1990s: exploring the relationship with deprivation.

Regional and local authority patterns of mortality in England and Wales for both males and females are presented for the latest available years (1989-93). The familiar geographic pattern of higher mortality in the north and west and lower mortality to the south and east of the country has continued into the 1990s and there has been no significant widening or narrowing in the mortality gap between the worst and the best regions during the 1980s. The local authorities with higher mortality are still predominantly in urban areas. Using a modified form of the Department of Environment's 1991 deprivation index, mortality in more than 350 English local authorities in 1989-93 was analysed to study the interaction between socio-economic and geographic variables. There is a very strong relationship between mortality and deprivation at the local authority level measured by this new index, with a tendency for higher mortality to be associated with greater deprivation. This relationship is most marked for males, but is still strong for females.

Adolescent↗
PubMedDate not supplied

[Evaluative research on the distribution of health videocassettes destined for a disadvantaged Montreal population].

The present article describes the implementation and the evaluation of an intervention done in the context of a heart health community and multifactorial program. The intervention aimed to offer six videocassettes on cardiovascular health to a low-income and low-educated clientele through five video-clubs. All videoclubs (n = 5) from St. Henri/Petite Bourgogne agreed to distribute the videocassettes free of charge. Two components were examined: admissibility by videoclubs' owner and clientele's receptivity towards the intervention. Results showed that all videoclubs offered free display and service for the videocassettes. The article also presents a discussion of the feasibility and the possibilities to broaden this type of action.

Adult↗
PubMed2005

Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors.

INTRODUCTION: With respect to reducing mortality, advances in cancer treatment have not been as effective as those for other chronic diseases; effective screening methods are available for only a few cancers. Primary prevention through lifestyle and environmental interventions remains the main way to reduce the burden of cancers. In this report, we estimate mortality from 12 types of cancer attributable to nine risk factors in seven World Bank regions for 2001. METHODS: We analysed data from the Comparative Risk Assessment project and from new sources to assess exposure to risk factors and relative risk by age, sex, and region. We applied population attributable fractions for individual and multiple risk factors to site-specific cancer mortality from WHO. FINDINGS: Of the 7 million deaths from cancer worldwide in 2001, an estimated 2.43 million (35%) were attributable to nine potentially modifiable risk factors. Of these, 0.76 million deaths were in high-income countries and 1.67 million in low-and-middle-income nations. Among low-and-middle-income regions, Europe and Central Asia had the highest proportion (39%) of deaths from cancer attributable to the risk factors studied. 1.6 million of the deaths attributable to these risk factors were in men and 0.83 million in women. Smoking, alcohol use, and low fruit and vegetable intake were the leading risk factors for death from cancer worldwide and in low-and-middle-income countries. In high-income countries, smoking, alcohol use, and overweight and obesity were the most important causes of cancer. Sexual transmission of human papilloma virus is a leading risk factor for cervical cancer in women in low-and-middle-income countries. INTERPRETATION: Reduction of exposure to key behavioural and environmental risk factors would prevent a substantial proportion of deaths from cancer.

Adolescent↗
PubMed1999

Accessing data from external centralized sources to enhance analysis of a completed clinical trial.

After the data collection phase of a clinical trial has been completed, new hypotheses may surface which require additional data before they can be tested. In the Veterans Affairs Cooperative Study on Single Drug Therapy of Hypertension, we investigated the relationship between location of the participating center, race and ability to control blood pressure. The analysis indicated poorer blood pressure control among sites located in the "stroke belt" (southeastern United States), especially among African-Americans. We sought to determine whether the effect was attributable to socioeconomic patterns; however, income data were not collected as part of the original study. Therefore, we accessed centralized data bases to obtain zipcode-level income information for the randomized study patients. This approach yielded estimates of income data for 94.3% of the patients and compared favorably to data acquisition rates for variables which were collected prospectively in the study.

Antihypertensive Agents↗
PubMed2005

Income, family characteristics, and physical violence toward children.

OBJECTIVE: This paper discusses the ways in which existing microeconomic theories of partner abuse, intra-family bargaining, and distribution of resources within families may contribute to our current understanding of physical child abuse. The empirical implications of this discussion are then tested on data from the 1985 National Family Violence Survey (NFVS) in order to estimate the effects of income, family characteristics, and state characteristics on physical violence toward children. METHODOLOGY: The sample consists of 2,760 families with children from the NFVS. Probit and ordered probit models are used to explore relationships between income, family characteristics, state characteristics, and physical violence toward children among single-parent and two-parent families. RESULTS: In both single-parent and two-parent families, depression, maternal alcohol consumption, and history of family violence affect children's probabilities of being abused. Additionally, income is significantly related to violence toward children in single-parent families. CONCLUSIONS: These results reinforce earlier findings that demographic characteristics, maternal depression, maternal alcohol use, and intra-family patterns of violence may largely contribute to child abuse. This research also suggests that income may play a substantially more important role in regard to parental violence in single-parent families than in two-parent families.

Adult↗