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PubMed1992

Population-based mortality assessment--Baidoa and Afgoi, Somalia, 1992.

Since 1990, Somalia has been the site of an intense civil war that has disrupted health-care services and food delivery to a substantial part of the country. A regional drought, in combination with the ongoing civil disturbances, has further resulted in widespread famine. Multiple international government- and nongovernment-aid agencies are involved in the relief effort for Somalia. However, security problems in most areas of Somalia have prevented recent, systematic population-based assessments of the health and nutritional status of local Somali populations for use in directing relief efforts. To characterize the mortality of various Somali populations and to provide data on major population centers outside of the capital (Mogadishu), CDC, in collaboration with the United Nations Children's Fund (UNICEF) and the U.S. Agency for International Development, conducted a survey (1) of urban populations in a central region of Somalia (Figure 1). This report describes two pilot assessments performed during November 20-25 and December 5-6, 1992, in the towns of Baidoa and Afgoi.

Adolescent↗
PubMed2003

Substantial potential for reductions in coronary heart disease mortality in the UK through changes in risk factor levels.

STUDY OBJECTIVE: The UK government called for a 40% reduction in cardiovascular disease mortality in those aged under 75 by 2010. This paper examines the potential for cardiovascular risk factor changes to reduce coronary heart disease deaths in Scotland, and then extrapolates the findings to the UK population. DESIGN: Secondary analysis of published data using a previously validated mortality model. The model combines uptake and effectiveness of treatments with risk factor trends by sex and age group. It was used to estimate the expected reductions in coronary heart disease mortality: (a) if recent risk factor trends simply continued; (b) if additional risk factor reductions were achieved in line with Scandinavia and the United States. An "analysis of extremes" sensitivity analysis was then carried out. SETTING: Scotland and UK. PARTICIPANTS: Projected Scottish population aged 45+ in 2010 (2.4 million) and UK population of 26.8 million. MAIN RESULTS: Continuation of current trends would result in 2169 fewer coronary deaths in 2010 (minimum estimate 1191 from sensitivity analyses to maximum 3870). About 4749 fewer deaths (minimum 3085, maximum 7155) could be achieved by: (a) a reduction in smoking prevalence from 30% to 18% (about 1668 fewer deaths); (b) a mean population cholesterol reduction from 6.2 to 5.2 mmol/l (about 2167 fewer deaths); (c) a 3.7 mm Hg fall in diastolic blood pressure (about 914 fewer deaths). Extrapolation from the Scottish population to the UK suggests 24 000 fewer deaths in 2010 if current trends continue, or 53 000 fewer deaths with the additional reductions. CONCLUSIONS: With additional interventions it would be possible to almost halve current UK coronary heart disease mortality. Even without gains from medical treatments, the UK government target of 28 000 fewer deaths in 2010 does not seem challenging.

Adult↗
PubMedDate not supplied

Household projection methods.

"The role of household projections as a basis for forecasts of households at [the] national and sub-national level is discussed and a number of criteria for such projections are outlined. The projection method used by the Department of the Environment [in the United Kingdom] is examined in the context of these criteria and it is concluded that it is both practical and robust. However, it is open to criticism, first because of its failure to make the best use of the available data and of theoretical knowledge, and secondly because of its 'black box' nature. An alternative two-stage strategy is developed. The first stage involves constructing projections using a new curve-fitting method which takes account of within cohort life-cycle headship rate changes. The second is a method of analysing the resulting projections by modelling transition rates between different household states. Worked examples of both methods are presented."

Developed Countries↗
PubMed2006

Ecotoxicological assessment of sediment, suspended matter and water samples in the upper Danube River. A pilot study in search for the causes for the decline of fish catches.

GOALS, SCOPE AND BACKGROUND: Fish populations, especially those of the grayling (Thymallus thymallus), have declined over the last two decades in the upper Danube River between Sigmaringen and Ulm, despite intensive and continuous stocking and improvement of water quality since the 1970s. Similar problems have been reported for other rivers, e.g. in Switzerland, Great Britain, the United States and Canada. In order to assess if ecotoxicological effects might be related to the decline in fish catch at the upper Danube River, sediment, suspended matter and waste water samples from sewage treatment plants were collected at selected locations and analyzed in a bioanalytical approach using a battery of bioassays. The results of this pilot study will be used to decide if a comprehensive weight-of-evidence study is needed. METHODS: Freeze-dried sediments and suspended particulate matters were extracted with acetone in a Soxhlet apparatus. Organic pollutants from sewage water were concentrated using XAD-resins. In order to investigate the ecotoxicological burden, the following bioassays were used: (1) neutral red assay with RTL-W1 cells (cytotoxicity), (2) comet assay with RTL-W1 cells (genotoxicity), (3) Arthrobacter globiformis dehydrogenase assay (toxicity to bacteria), (4) yeast estrogen screen assay (endocrine disruption), (5) fish egg assay with the zebrafish (Danio rerio; embryo toxicity) and (6) Ames test with TA98 (mutagenicity). RESULTS AND DISCUSSION: The results of the in vitro tests elucidated a considerable genotoxic, cytotoxic, mutagenic, bacteriotoxic, embryotoxic and estrogenic burden in the upper Danube River, although with a very inhomogeneous distribution of effects. The samples taken from Riedlingen, for example, induced low embryo toxicity, but the second highest 17beta-estradiol equivalent concentration (1.8 ng/L). Using the fish egg assay with native sediments, a broad range of embryotoxic effects could be elucidated, with clear-cut dose-response relationships for the embryotoxic effects of contaminated sediments. With native sediments, embryotoxicity was clearly higher than with corresponding pore waters, thus corroborating the view that--at least for fish eggs--the bioavailability of particle-bound lipophilic substances in native sediments is higher than generally assumed. The effect observed most frequently in the fish egg assay was a developmental delay. A comparison of our own results with locations along the rivers Rhine and Neckar demonstrated similar or even higher ranges of ecotoxicological burdens in the Danube River. CONCLUSIONS: The complex pattern of ecotoxicological effects caused by environmental samples from the Danube River, when assessed in an in vitro biotest battery using both acute and more specific endpoints, showed that integration of different endpoints is essential for appropriate hazard assessment. Overall, the ecotoxicological hazard potential shown has indeed to be considered as one potential reason for the decline in fish catches at the upper Danube River. However, based on the results of this pilot study, it is not possible to elucidate that chemically induced alterations are responsible for the fish decline. RECOMMENDATIONS AND PERSPECTIVES: In order to confirm the ecological relevance of the in vitro results for the situation in the field and especially for the decline of the grayling and other fishes, further integrated investigations are required. For linking the weight of evidence obtained by in vitro assays and fish population investigations, the application of additional, more specific biomarkers (e.g. vitellogenin induction, EROD and micronucleus assay) has been initiated in fish taken from the field as well as in situ investigations.

Animals↗
PubMed2004

Prevalence of neurological disorders in Bangalore, India: a community-based study with a comparison between urban and rural areas.

A population-based neuroepidemiological survey of 102,557 individuals in urban and rural Bangalore in Southern India was conducted to determine the prevalence and pattern of neurological disorders. The study population included subjects from urban (51,502) and rural (51,055) areas, identified through a two-stage stratified random sampling method. Trained social workers administered the screening questionnaire, which had been tested and validated in an earlier pilot study and a neurologist examined the individuals who screened positive. Adults, children (<15 years) and elderly adults (>60 years) constituted 61, 34 and 5% of the study group, respectively. There was a distinct difference in education, occupation and income levels between urban and rural areas with all these parameters being lower in the rural population. In the surveyed population, 3,206 individuals with neurological disorders were detected resulting in crude and age-adjusted prevalence rates of 3,126 and 3,355 per 100,000 population, respectively. The prevalence rate among children, middle-aged (31-40 years) and elderly adults was 2,653, 3,932 and 5,012 per 100,000 population, respectively. The prevalence of neurological disorders among women (3,617) was higher compared with men (2,657). The prevalence rate in urban and rural populations was 2,190 and 4,070/1,00,000, respectively, implying that neurological disorders were twice as frequent in rural areas as in urban areas. The prevalence rates per 100,000 population of the most frequent disorders in the descending order of frequency were: headache (1,119), epilepsy (883), febrile convulsions (330), cerebrovascular disorder (150), and mental retardation (142). This large-scale population-based survey provides data that will be crucial for developing hospital and community-based neurological services in India and other developing countries.

Adolescent↗
PubMed2004

A systematic review of the epidemiology of status epilepticus.

Population-based data on the incidence, aetiology, and mortality associated with status epilepticus (SE) are required to develop preventative strategies for SE. Through a systematic review, we aimed to assess the methodological quality as well as similarities, and differences between available population based studies in order to arrive at conclusions on the epidemiology of SE. All population-based studies where primary outcome was incidence, aetiology or mortality of SE were identified through a systematic search and synthesized. Methodological quality of studies were independently rated by two examiners using a unique scoring system. Seven population-based projects on SE yielding nine published reports and five abstracts were reviewed. Quality scores were in the range of 19-34 with a possible maximum of 40 (kappa scores 0.67-1.0). The incidence of SE has a bimodal distribution with peaks in children aged less than a year and the elderly. Most SE were acute symptomatic. Short-term mortality was 7.6-22% and long-term mortality was 43%. Age and aetiology were the major determinants of mortality. There are few population-based studies on SE but most are of good quality. Most studies are primarily or exclusively based on adult populations. There is limited information on the association of ethnicity and socio-economic status and SE.

Age Distribution↗
PubMed2004

Prevalence of Parkinson's disease and parkinsonism in a Colombian population using the capture-recapture method.

Our objective was to estimate the prevalence of Parkinson's disease (PD) and Parkinsonism (Ps) in Antioquia (Colombia), using the Capture-Recapture method. The two biggest institutions for attending neurological patients in Antioquia were selected as sources for the use of the Capture-Recapture method. Prevalences of PD (PPD) and Ps (PPs) were estimated according to the following expression: PPD (or PPs) = n/Nl105. The number of cases (n) of PD (or Ps), n = a + b + c + d, where a = cases identified from the two sources, b = cases identified only in the first source, c = cases identified only in the second source, and d = nondetected cases from any source = bc/a. The projected Antioquian population for the year 2000 was used as denominator. Information obtained between January 1, 1996, and December 31, 2000, was reviewed in order to identify the clinical records of all patients that fulfilled the Ps or PD criteria. General prevalence of PD in Antioquia was 30.7/100.000 (C195% = 29.2-32.2), and that of Ps was 42.1/100.000 (CI95% = 40.3-43.8). Prevalence of PD in people older than 50 years was 176.4/100.000 (CI95% = 166.6-186.3) and that of Ps was of 339.6/100.000 (C195% = 326.0-353.2). Ps and PD prevalences in Antioquia were lower than the figures reported by the National Neuroepidemiologic Study (470/100.000) and similar to the estimated prevalence of these diseases in Caucasian populations (80 to 270/100.000). These findings evidence the great variability of PD prevalence in different regions; therefore, a nationwide study is necessary to determine the prevalence of PD and Ps in Colombia.

Adolescent↗
PubMed1995

[Demographic data and the potential demand for housing: a cohort approach].

"Canada Mortgage and Housing Corporation is actively involved in conducting research on demographic change and housing demand. Household projections are at the center of this research....CMHC is working with the Joint Center for Housing Studies at Harvard University to develop a cohort-based method for extrapolating headship and ownership rates. The method offers advantages over other approaches in that it recognizes differences between generations, provides a useful framework for analysis, and offers considerable flexibility in tailoring projection assumptions. Preliminary cohort-based potential housing demand projections show broad consistency with current low levels of housing market activity and point to continuation of some of the established trends in the past twenty years." (SUMMARY IN ENG AND SPA)

Americas↗
PubMed1991

Door-to-door prevalence survey of neurological diseases in a Sicilian population. Background and methods. The Sicilian Neuro-Epidemiologic Study (SNES) Group.

In three municipalities of Sicily, a prevalence survey of major neurological diseases was conducted door-to-door using screening and examination to find cases. This was the first large-scale neuroepidemiologic survey of that type undertaken in Italy: 24,496 persons were screened yielding 1,538 positives, of whom 1,408 were examined directly by neurologists and 110 were evaluated on the basis of existing medical documentation. In the article, we provide (1) a description of the population investigated and the survey methods employed; (2) details of the cooperation and the attrition experienced in the survey; and (3) age and sex tallies for the study population, including some on education level and occupation.

Adolescent↗
PubMed1982

U.S. population: where we are; where we're going.

This Bulletin reviews recent trends in the dynamics and character of the U.S. population, the outlook for the remainder of the 1980s, and prospects for longterm growth. Estimated at 232 million as of mid-1982, the U.S. population is currently growing at about 1% a year, one of the developed world's highest growth rates. Natural increase (births-deaths) still adds some 1.7 million people a year, despite the rapid postbaby boom fall in fertility to a near-record low rate of 1.9 births/woman in 1981. With increasing numbers of refugees, net legal immigration averaged 600,000/year in 1979-81 and the net inflow of illegal immigrants may now be 500,000 a year. Uncertainty over potentially large numbers of immigrants complicates projections of future U.S. population size. Currently, the U.S. death rate is at an alltime low. More than 1/2 the population now resides in the South and West. Rural areas and small towns grew faster than urban areas in the 1970s for the 1st time in over a century. Educational attainment is at an alltime high, as is labor force participation, due to increasing employment among women and the baby boom generation's arrival at working ages. The age composition of the population, with the bulge of the baby boom generation surrounded by the older "depression" generation born during the 1930s and the younger "baby bust" generation born since the end of the 1960s, presents special problems for U.S. society.

Abortion, Induced↗
PubMedDate not supplied

Community-based rehabilitation in the Philippines.

Rehabilitation in the Philippines has in the past been based on the Western model, with an emphasis on hospital departments located in the major cities. This approach is inappropriate for the majority of disabled people in the Republic as 70% of the population live in rural areas. A community-based programme was devised using local volunteers who had simple training. These volunteers can identify and support disabled people in their own villages, avoiding long journeys and expensive institutional care.

Community Health Services↗
PubMed1998

Survival of women with breast cancer in Europe: variation with age, year of diagnosis and country. The EUROCARE Working Group.

Breast cancer is the most frequent malignancy among women in developed countries. Prognosis is better than for other major cancers, and an improvement in survival has been reported for several populations in recent decades. Within the framework of EUROCARE, a population-based project concerned with the survival and care of cancer patients in Europe, we analysed data from 119,139 women diagnosed with breast cancer between 1978 and 1985 in 12 countries and followed for at least 6 years. Multiple regression models of relative survival, which take mortality from all other causes in each area into account, were used to estimate the effect of age, period of diagnosis and country on survival. For the comparison between countries, survival rates were age-standardised to the age structure of the entire study population. Women aged 40-49 years at diagnosis had the best prognosis in all countries and throughout the study period. Women younger than 30 years at diagnosis had a worse prognosis than those aged 30-39. The highest relative survival at 5 years was in Finland and Switzerland (about 74%), intermediate levels were found for Italy, France, The Netherlands, Denmark and Germany (about 70%) and the lowest rates were in Spain, the United Kingdom, Estonia and Poland (55-64%). During the 6 months following diagnosis, survival was highly dependent on age and was sharply lower in women older than 49 years. For women surviving more than 6 months after diagnosis, survival was similar for all ages, although women aged 40-49 still had the better prognosis. The average rate of death from breast cancer fell by about 2.5% for each year of diagnosis between 1978 and 1985. This improvement manifested mainly in younger and older women, for whom survival was initially less good. The largest improvement was seen in Poland (-15% death risk per year). We suggest that the better survival of women aged 40-49 at diagnosis is related to lower levels of circulating sex hormones, resulting in reduced stimulation of tumour cell growth. Early diagnosis may also be important in the peri-menopausal period due to increased diagnostic attention. Low survival in the United Kingdom may be due to inadequate adherence to consensus treatment guidelines and greater variation in treatment.

Adult↗
PubMed1993

Statistical graduation in local demographic analysis and projection.

"This paper considers parametric graduation for mortality, fertility and migration with particular reference to the development of parameterized local and regional demographic projections. Parametric graduations facilitate comparisons of demographic schedules across many areas and across time points--a feature which can be used to advantage in making forecasts of the three demographic components and thus in setting the assumptions for projections. Particular methodological issues raised are the questions of parsimony in fit and...of overdispersion in relation to binomial or Poisson assumptions. The analysis is illustrated with cross-sectional material for the 32 London boroughs and with time series at the level of Greater London."

Demography↗
PubMedDate not supplied

Sex education and family planning services for young adults: alternative urban strategies in Mexico.

In Mexico, youth face difficulties in obtaining reliable information on sex education and family planning through existing community programs. Two alternative strategies to provide these services are being tested in poor urban areas of Monterrey. In one experimental area, Integrated Youth Centers were established, which provide sex education and family planning services as well as counseling, academic tutoring, and recreational activities. In another area, trained young adults and community counselors work through informal networks to provide sex education and family planning information. Both utilization and the cost of these services are examined in the context of plans for expanding coverage in Mexico-U.S. border areas.

Adolescent↗
PubMed2006

Extracellular matrix molecules and synaptic plasticity: immunomapping of intracellular and secreted Reelin in the adult rat brain.

Reelin, a large extracellular matrix glycoprotein, is secreted by several neuron populations in the developing and adult rodent brain. Secreted Reelin triggers a complex signaling pathway by binding lipoprotein and integrin membrane receptors in target cells. Reelin signaling regulates migration and dendritic growth in developing neurons, while it can modulate synaptic plasticity in adult neurons. To identify which adult neural circuits can be modulated by Reelin-mediated signaling, we systematically mapped the distribution of Reelin in adult rat brain using sensitive immunolabeling techniques. Results show that the distribution of intracellular and secreted Reelin is both very widespread and specific. Some interneuron and projection neuron populations in the cerebral cortex contain Reelin. Numerous striatal neurons are weakly immunoreactive for Reelin and these cells are preferentially located in striosomes. Some thalamic nuclei contain Reelin-immunoreactive cells. Double-immunolabeling for GABA and Reelin reveals that the Reelin-immunoreactive cells in the visual thalamus are the intrinsic thalamic interneurons. High local concentrations of extracellular Reelin selectively outline several dendrite spine-rich neuropils. Together with previous mRNA data, our observations suggest abundant axoplasmic transport and secretion in pathways such as the retino-collicular tract, the entorhino-hippocampal ('perforant') path, the lateral olfactory tract or the parallel fiber system of the cerebellum. A preferential secretion of Reelin in these neuropils is consistent with reports of rapid, activity-induced structural changes in adult brain circuits.

Animals↗
PubMed2003

Translation from neurobiological data to music parameters.

Composers have explored different ways to use biological information for the realization of music. Throughout the decades, biological findings have been repeatedly indicated as a source of inspiration or a reservoir of extramusical material for musical composition. More radical and fertile are attempts to produce music systematically using biological data in processes called data sonification or biofeedback techniques. Presented here is a novel strategy of translation where populations of neurobiological data are converted into relational structures from which sound objects are generated by flexible and homogeneous control of the sound parameters. All brain data originate from experiments performed with standard anatomical and physiological techniques, and results of studies based on these experimental materials have already been published. During the translation processes, the information for every sound parameter (such as pitch, duration, envelope, and dynamics) is never derived from fixed transcriptions of data properties. Rather, the space and/or the time interrelations of data populations are used to obtain indexes for sound construction. In this way, equivalent sets of information are exploited to model, or sculpt, the different parameters of sound objects. Three examples from the last decade's personal productions are given. The first refers to the microformal aspects of sound aggregation and is based on data from a microstimulation experiment in the motor cortex. The second describes the earliest translation process developed for live performance with conventional instruments and is based on experiments using a conventional tract tracing technique to compare selected spinal-projecting cell populations in two differently organized brains. The third outlines a recent music production for three pianos based on data from experiments using the multiple fluorescent tract-tracing technique to simultaneously label different populations of thalamocortical neurons. The approach here described can potentially contribute to a unitary view of the different sound parameters and of the micro- and macroformal aspects of the compositional process.

Animals↗
PubMed2002

Body weight status of adults: United States, 1997-98.

OBJECTIVE: This report presents estimates for underweight, healthy weight, overweight, and obesity for U.S. adults aged 18 years and over. Based on self-reported height and weight, data are shown for selected population subgroups for both sexes and for men and women separately. METHODS: Body weight status of U.S. adults was estimated using data from the 1997-98 National Health Interview Survey (NHIS) for 68,556 adults aged 18 years and over and Body Mass Index (BMI) (weight/height2) criteria established by the World Health Organization (WHO). The NHIS is administered in households throughout the United States using computer-assisted personal interviews (CAPI). The combined overall response rate in 1997-98 was 77.2%. Statistics shown in this report were age adjusted to the 2000 projected U.S. population. FINDINGS: Over one-half of adults (54.7%) were overweight and 1 in 5 (19.5%) were obese in 1997-98. Women (49.5%) were more likely than men (36.3%) to be of healthy weight although men and women were equally likely to be obese. Obesity was most prevalent among middle-aged adults, among black non-Hispanic adults and Hispanic adults, and among adults with less education and lower income. Rates of obesity by marital status differed by gender: married men (20.4%) had higher rates of obesity than separated and divorced men (16.8%), and married women (18.4%) had lower rates of obesity than separated and divorced women (23.2%). Obesity was lowest among adults living in the West and those living in a metropolitan statistical area (MSA), but outside the central city (i.e., the suburbs). CONCLUSIONS: Overweight and obesity were widespread in the United States in 1997-98 and prevalence varied significantly by population subgroup.

Adolescent↗
PubMed1992

Projecting the number of new AIDS cases in the United States.

"This paper reviews the two leading methods used to project the number of AIDS cases: back calculation and extrapolation. These methods are assessed in light of key features of the HIV/AIDS epidemic and of data on the epidemic; they are also assessed in terms of the quality of the projections they yield. Our analysis shows that both methods have tended to overproject, often by sizable amounts, the number of AIDS cases in the United States....A new method for projecting AIDS cases is proposed that exploits knowledge about the process generating AIDS cases and that incorporates readily available information about rates of new HIV infection.... Relative to the method of extrapolation, this method projects 22,000 fewer new AIDS cases for 1995 (a 36% difference). This method also projects that intravenous drug users will replace homosexual/bisexual men as the dominant transmission category for AIDS."

Acquired Immunodeficiency Syndrome↗