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PubMed2003

Differential of HIV prevalence in women and men who attended sexually transmitted disease clinics at HIV sentinel surveillance sites in Kenya, 1990-2001.

Several studies in sub-Saharan Africa have reported that HIV prevalence in young women is higher than in young men. We used data from Kenya HIV sentinel surveillance conducted from 1990 to 2001 among sexually transmitted disease (STD) patients (15-49 years old) to investigate consistency of gender differentials over time and their risk factors. Of the 15,889 STD patients, the HIV prevalence ranged from 16.0% in 1990 to 41.8% in 1997. The odds ratios (ORs) of HIV infection for women compared to men decreased by age; women 15-24 years were nearly twice as likely as men of the same ages to be HIV infected (OR 1.7 [1.5-2.0]), but risk in those >44 years was almost equal (OR 0.8 [95% CI 0.7-1.2]). The odds of HIV infection for women compared to men were twice in unmarried patients (OR 2.1 [95% CI 1.8-2.3]). This association persisted after controlling for age groups or marital status, residence, level of education, and presence of STD syndromes. This pattern had been consistent over 12 years. Adolescent women with symptoms of STDs should be a focus for the HIV/STD intervention programmes because of their high risk for HIV.

Adolescent↗
PubMed1998

Trauma exposure, postmigration stressors, and symptoms of anxiety, depression and post-traumatic stress in Tamil asylum-seekers: comparison with refugees and immigrants.

Compared to research on displaced persons whose refugee status has been endorsed prior to arriving in Western countries, there is little systematic information available about levels of past trauma, postmigration living difficulties and psychiatric symptoms amongst asylum-seekers who claim refugee status only after arrival. Asylum-seekers, authorized refugees and immigrants of Tamil background were recruited by personal contact and mail-out in Sydney, Australia. A total of 62 subjects, constituting approximately 60% of the estimated pool of Tamil asylum-seekers, agreed to participate in the study. They returned statistically significantly higher scores than immigrants (n = 104) on measures of past trauma, symptoms of anxiety, depression and post-traumatic stress, and on all dimensions of postmigration difficulties. Asylum-seekers did not differ from refugees (n = 30) on measures of past trauma or psychiatric symptoms, but they scored higher on selective components of postmigration stress relating to difficulties associated with their insecure residency status. Although limited by sampling and diagnostic constraints, the present study suggests that asylum-seekers may be a high-risk group in relation to ongoing stress in the postmigration period.

Acculturation↗
PubMed1990

Use of coded mortality data to assess area cancer rates: impact of residence reporting and coding errors.

In spite of their limitations, mortality data are used in many epidemiologic and public health settings. In this investigation, the authors examined the extent to which community cancer mortality rates were affected by incorrect reporting or coding of residence on death certificates. Observed and expected cancer mortality for two adjacent communities in northern rural Minnesota for the periods 1970-1974 and 1980-1984 were obtained from computerized state mortality data. Using statewide rates to obtain expected values, standardized mortality ratios for total cancers for both periods combined were 138 for men (101 observed deaths) and 148 for women (86 observed deaths). These excesses were statistically significant (p less than 0.05). However, after review of data from the actual death certificates, city maps, and information from city officials, 44 of the 187 total cancer deaths (24%) were found to have had an incorrectly reported or coded residence status. After removal of these cases, the standardized mortality ratio for total cancers for males went from 138 to 107, and for females the standardized mortality ratio went from 148 to 111. No standardized mortality ratios remained statistically significant. These findings may have implications for those who use mortality data for assessing cancer rates in communities in rural areas.

Death Certificates↗
PubMed1999

Pathways from war trauma to posttraumatic stress symptoms among Tamil asylum seekers, refugees, and immigrants.

Path analysis was used to examine the antecedents of posttraumatic stress (PTS) symptoms in Tamil asylum-seekers, refugees, and immigrants in Australia. The Harvard Trauma Questionnaire and a postmigration living difficulties questionnaire were completed by 62 asylum-seekers, 30 refugees, and 104 immigrants who responded to a mail-out. Demographic characteristics, residency status, and measures of trauma and postmigration stress were fitted to a structural model in PTS symptoms. Premigration trauma exposure accounted for 20% of the variance of PTS symptoms. Postmigration stress contributed 14% of the variance. Although limited by sampling constraints and retrospective measurement, the study supports the notion that both traumatic and posttraumatic events contribute to the expression of PTS symptoms.

Adult↗
PubMed1983

Regional labor markets and the household migration decision.

"The current work extends the modeling of the household migration decision to take into account location-specific influences and relates these to regional wage differentials. This allows for more complete analysis of real wage gains or losses associated with migration and inferences regarding the nature of equilibrium or disequilibrium wage differentials between regions." Data are from the Michigan Panel Study of Income Dynamics for the period 1976-1978. "The results indicate systematic and often substantial influences of household location on the nominal wage and on both job and residence mobility. Based on these findings, comparisons of wage growth patterns are made for those changing jobs and region of residence status. Although compared to other households the wage growth of these migrants is on average lower before migration and higher after migration, the analysis provides no support for arguments that nominal regional wage differentials reflect systematic ordering of real wage differentials. This finding suggests that real wage gains are closely tied to the interregional migration decision but are not related to regional nominal wage differentials in a simple fashion."

Americas↗
PubMed2000

US graduate medical education, 1999-2000.

This report examines data collected through the American Medical Association Annual Survey of Graduate Medical Education Programs for 1999-2000 and compares these data with similar data collected during the past several years. The number of resident physicians enrolled during 1999-2000 was 606 more than during the previous year; graduates of US osteopathic medical schools (USDOs) had the greatest proportional increase (5.2%). The number of physicians entering graduate medical education (GME) for the first time in 1999-2000 (n = 22,320) also increased, with the number of USDOs increasing the most, by 14.5%, followed by international medical graduates (IMGs) at 6.5%. Between academic years 1998-1999 and 1999-2000, the number of physicians with prior US GME occupying first-year positions for which prior GME was not required (GY1 positions) increased by more than 300 (12%). Compared with graduates of US allopathic and osteopathic medical schools (USMGs), IMGs were more likely to seek additional training after graduating from a program. However, this was not true of IMGs who were US citizens or who had been naturalized or had permanent residency status. For the second year in a row, the number of white graduates of US allopathic medical schools (USMDs) entering GME has declined (2.0%), while the number of Hispanic GY1 USMDs has increased by 10.5%. The number of Asian GY1 USMDs increased steadily (11.0%) but the number of blacks decreased by 7.1% from 1998-1999. Growth continues, both in numbers and in heterogeneity of physicians in training, and must be considered in the future development of policy to guide US GME. JAMA. 2000;284:1121-1126

Ambulatory Care↗
PubMed2001

Personality-based typology of adolescent male sexual offenders: differences in recidivism rates, victim-selection characteristics, and personal victimization histories.

California Psychological Inventory scores from 112 adolescent male sexual offenders aged 12-19 (M = 15.59, SD = 1.46) were examined. A cluster analysis of factor-derived scores revealed four personality-based subgroups: Antisocial/Impulsive, Unusual/Isolated, Overcontrolled/Reserved, and Confident/Aggressive. Significant differences were observed between groups regarding history of physical abuse, parental marital status, residence of the offenders, and whether or not offenders received criminal charges for their index sexual assaults. Subgroup membership was unrelated to victim age, victim gender, and offenders' history of sexual victimization. Recidivism data (criminal charges) were collected for a period ranging from 2 to 10 years (M = 6.23, SD = 2.02). Offenders in the two more pathological groups (Antisocial/Impulsive and Unusual/Isolated) were most likely to be charged with a subsequent violent (sexual or nonsexual) or nonviolent offense. The four-group typology based solely on personality functioning is remarkably similar to that found by W. R. Smith, C. Monastersky, and R. M. Deisher in 1987 from their cluster analysis of MMPI scores. In addition to implications for risk prediction, the present typology is suggestive of differential etiological pathways and treatment needs.

Adolescent↗
PubMed1995

Utilization of dental services in refugees in Sweden 1975-1985.

Prior to 1940 the population of Sweden was one of the most homogeneous in Europe, with only 0.5% foreign born. Fifty years later, in 1990, the proportion of immigrants was around 15%. In order to describe and analyze consumption of dental care in different refugee groups in Sweden, data registered by the Department of Immigration and the National Social Insurance Board, on a random sample of 2489 refugees arriving in Sweden 1975-85, were merged. Information on nationality, date of arrival in Sweden, date of granting of permanent resident status and statistics on consumption of dental care were retrieved. During the period studied a total of 50,521 refugees arrived in Sweden. The average interval between arrival in Sweden and the first dental visit was 4.5 yr (95% < 1: 4.2-4.7). The total treatment time during the first course of treatment was 165.5 min (95% < 1: 148.7-182.3). Consumption of dental care did not decrease with an increased number of treatments. Only 38% of the refugees had visited a dentist at all in Sweden. With increasing number of years in Sweden the number of courses of dental treatment increased, but 41% of the refugees who had visited the dentist in Sweden had done so only once. This study shows a low utilization of dental services among refugees in Sweden in general. Refugees with dental visits in Sweden, in particular, had a high dental consumption.

Adolescent↗
PubMedDate not supplied

A comparison of the health status of Riverdale residents with residents of the rest of Toronto based on the Toronto Community Health Survey.

OBJECTIVES: To compare the health status of Riverdale residents with residents of the rest of Toronto. DESIGN: Cross-sectional telephone survey. SETTING: Toronto. TIME FRAME: October 1988-June 1989. PARTICIPANTS: Four hundred and fourteen residents of Riverdale, a residential-industrial area of Toronto, and 866 residents of the rest of Toronto, age 15 years and older in households with telephones. MAIN RESULTS: Respondents in Riverdale compared to respondents in the rest of Toronto were more likely to speak languages other than English, have less formal education, and be of Oriental ethnic origin. Perceived health status varied between the two areas, but no significant difference existed in diagnosed morbidity. Riverdale respondents were much more aware of food and soil contamination than respondents from the rest of Toronto.

Adolescent↗
PubMed1996

Diet and risk of non-Hodgkin lymphoma in older women.

OBJECTIVE: To test whether high dietary intakes of fat, protein, and milk are associated with the development of non-Hodgkin lymphoma in older women. DESIGN: Prospective cohort study with a 7-year follow-up period. SETTING: General community. PARTICIPANTS: Sample of 35 156 Iowa women aged 55 to 69 years with no prior history of cancer who returned the 1986 baseline questionnaire. MAIN OUTCOME MEASURE: Non-Hodgkin lymphoma (104 incident cases). MAIN RESULTS: After controlling for age, marital status, residence, total energy intake, and transfusion history, the relative risks (RRs) for the highest tertile of intake compared with the lowest were 2.00 (95% confidence interval [CI], 1.21-3.30; P for trend = .01) for animal fat, 1.69 (95% CI, 1.07-2.67; P for trend = .02) for saturated fat, and 1.90 (95% CI, 1.18-3.04; P for trend = .01) for monounsaturated fat, and there was no association with vegetable fat or polyunsaturated fat. Greater intake of animal protein (RR = 1.52; 95% CI, 0.94-2.44; P for trend = .08), but not vegetable protein, was associated with elevated risk, and this was mainly explained by greater consumption of red meat (RR = 1.98; 95% CI, 1.13-3.47; P for trend = .02) and hamburger in particular (RR = 2.35; 95% CI, 1.23-4.48; P for trend = .02). Milk and dairy product consumption were not associated with elevated risk. There was also a decreased risk of non-Hodgkin lymphoma with greater consumption of fruits (RR = 0.64; 95% CI, 0.40-1.05; P for trend = .07). CONCLUSIONS: A high-meat diet and a high intake of fat from animal sources is associated with an increased risk of non-Hodgkin lymphoma in older women.

Aged↗
PubMed1992

Beta-blockers and depression. Evidence against an association.

OBJECTIVE: To evaluate the relationship between beta-blockers and depression. DESIGN: Case-control study. SETTING: New Jersey Medicaid recipients during July 1980 to December 1983. PARTICIPANTS: New depression case patients (N = 4302) were identified from Medicaid claims for depression markers (antidepressant drugs, in-hospital depression diagnosis, or electroconvulsive therapy). Control patients were randomly selected and matched on the basis of Medicaid enrollment on the case patients' date for first depression marker (index date), birth year, sex, race, and nursing home residency status. MAIN EXPOSURE MEASURE: beta-Blocker use as evidenced by prescription claims in the year before the index date. RESULTS: Case patients overall were more likely to have taken beta-blockers (simple, matched odds ratio [OR] of 1.45; 95% confidence interval [CI], 1.29 to 1.62). Controlling for confounders (benzodiazepine use, frequent outpatient visits, and frequent use of medications other than beta-blockers) resulted in a null effect (OR = 0.98; 95% CI, 0.87 to 1.12). The ORs were consistently lower for case patients with a depression diagnosis or electroconvulsive therapy than for cases with only antidepressant use as a marker. These results did not vary by age, sex, race, nursing home status, or use of other selected specific medications. CONCLUSIONS: Ongoing beta-blocker use was not causally related to markers of depression. The difference between this study and those it contradicts is that this one identified certain confounding variables that accounted for the apparent relationship.

Adrenergic beta-Antagonists↗
PubMed1996

Risk of monoclonal gammopathy of undetermined significance: a case-referent study.

A retrospective study was conducted in 285 cases of monoclonal gammopathy of undetermined significance (MGUS) and in 570 sex- and age-matched hospital controls in order to investigate the possible association between socioeconomic status, residence, alcohol and tobacco habits, occupation, occupational exposure to toxic substances, chronic antigenic stimulation, and risk of MGUS. Significant associations with the risk of MGUS were found for farmers (P < 0.005) and for workers in industry (P < 0.025). Occupational exposure to asbestos, fertilizers, mineral oils and petroleum, paints and related products, pesticides, and radiation was significantly (P < 0.05) associated with an increase in risk of MGUS. Chronic immune-stimulating conditions, when considered as a group, presented a significant (P < 0.025) association with the risk of MGUS, but no specific disease has been found to be significantly associated. These data are in agreement with the previous reports on multiple myeloma, suggesting that these factors may play an important role in the development of monoclonal gammopathies. However, these findings need to be confirmed in prospective larger population-based studies.

Adult↗
PubMed1996

Racial differences in survival of female breast cancer in the Detroit metropolitan area.

BACKGROUND: In the United States, breast cancer survival is worse among African-American women compared with white women. This difference in survival is likely due to several factors, including tumor biology and/or access to care. In this analysis, we evaluated the effects of sociodemographic and clinical variables on differences in breast cancer survival among African-American and white women. METHODS: The study population included 10,502 women (82% white, 18% African-American), diagnosed between 1988 and 1992 and identified through the Metropolitan Detroit Cancer Surveillance System, a member of the Surveillance, Epidemiology and End-Results (SEER) Program. Cox proportional hazards regression was used to estimate the relative risk of death comparing African-American women with white women after controlling for variables believed to influence survival. RESULTS: The mean age at diagnosis was 61 years and average length of follow-up was 34 months (range, 1-78 months). African-American women were more likely to present with regional or distant disease (45%) than were white women (37%). Although white women had better survival than African-American women during the first 4 years postdiagnosis (P < 0.0001), there were no significant differences in survival by race for women who lived longer than 4 years (P = 0.64). There was a significant interaction between age and race. The unadjusted relative risk of dying for African-American women compared with white women was 2.35 (95% confidence interval [CI], 1.88-2.93) for women younger than 50 years of age, and was 1.66 (95% CI, 1.46-1.88) for women age 50 years or older. After controlling for age, tumor size, stage, histologic grade, census-derived socioeconomic status, and residency training status, the relative risk was 1.68 (95% CI, 1.27-2.24) for women younger than 50 years of age and 1.33 (95% CI, 1.13-1.56) for women age 50 years and older. Adjustment for marital status, hospital size, and the proportion of Medicaid or Medicare discharges had no further effect on the relative risk. CONCLUSIONS: Known factors that predict survival differences between African-American and white women are more prevalent among women younger than age 50.

Aged↗
PubMed1984

Lung cancer in nonsmokers.

Among 2668 patients with newly diagnosed lung cancer interviewed between 1971 and 1980, 134 cases occurred in "validated" nonsmokers. The proportion of nonsmokers among all cases was 1.9% (37 of 1919) for men and 13.0% (97 of 749) for women, giving a sex ratio of 1:2.6. Kreyberg Type II (mainly adenocarcinoma) was more common among nonsmoking cases, especially women, than among all lung cancer cases. Comparison of cases with equal numbers of age-, sex-, race-, and hospital-matched nonsmoking controls showed no differences by religion, proportion of foreign-born, marital status, residence (urban/rural), alcohol consumption or Quetelet's index. Male cases tended to have higher proportions of professionals and to be more educated than controls. No differences in occupation or occupational exposure were seen in men. Among women, cases were more likely than controls to have worked in a textile-related job (relative risk = 3.10, 95% confidence interval 1.11-8.64), but the significance of this finding is not clear. Preliminary data on exposure to passive inhalation of tobacco smoke, available for a subset of cases and controls, showed no differences except for more frequent exposure among male cases than controls to sidestream tobacco smoke at work. The need for more complete information on exposure to secondhand tobacco smoke is discussed.

Age Factors↗
PubMed1986

Melanoma in Western Australia 1975-76 to 1980-81: trends in demographic and pathological characteristics.

Trends in incidence rates of cutaneous malignant melanoma in Western Australia from 1975-76 to 1980-1981 have been examined with reference to age, sex, body site, presence or absence of dermal invasion, tumour thickness, histological type, socioeconomic status and occupation. The incidence rates of all melanomas increased from 22.1 to 31.5 per 100,000 person-years in males and from 23.6 to 28.6 in females. In males, the relative annual increase in the incidence of invasive melanoma was 2.2%, and in females it was 5.6%. In-situ melanomas had larger relative increases in incidence (28% per annum in males and 10% in females) and the thickness of invasive lesions decreased between 1975-76 and 1980-81. The relative increase in incidence of invasive melanomas was greatest on the body sites with the highest rates initially--the trunk in males and the lower limbs in females. There was an increase in the proportion of invasive lesions classified as superficial spreading melanoma. The increase in incidence of in situ melanomas was largely restricted to the head and neck in older men of high socioeconomic status resident in Perth. This trend in in-situ melanoma was mainly due to an increase in the recorded incidence of Hutchinson's melanotic freckle. It may have been, in part, an artefact due to increased recognition of Hutchinson's melanotic freckle in this sub-group of the population.

Adolescent↗
PubMed2000

Sex identification and mating in the blue-ringed octopus, Hapalochlaena lunulata.

We studied the reproductive behaviour of the blue-ringed octopus, Hapalochlaena lunulata, in the laboratory by examining 15 male-male and nine male-female interactions. The initiation of physical contact was independent of sex, size or residency status, and there were no noticeable changes in behaviour such as sexual displays associated with courtship or aggression prior to contact. Males did not distinguish between females or other males and copulated (defined as the insertion of the hectocotylus into the mantle cavity of another octopus) readily with both. Spermatophores were released in all copulations with females but not with males. The duration of copulation was significantly longer in male-female interactions (median 160.5 min) than in male-male interactions (median 30 s). Although male-male copulations ended passively with the withdrawal of the hectocotylus by the initiating animal, male-female copulations were always terminated by the females following an intense struggle. These studies suggest the inability of male H. lunulata to determine the sexual identity of potential mates prior to the insertion of the hectocotylus and demonstrate the active role of the female during copulation. Copyright 2000 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed2000

Survival regression analysis: a powerful tool for evaluating fighting and assessment.

Theoretical models of animal contests frequently generate predictions about how asymmetries (e.g. differences in size, residence status) between contestants affect fight duration. Linear regression and nonparametric correlation analyses are commonly used to test the fit of data to such models. We show how survival regression analysis (SRA) is a powerful technique for studying the effect of asymmetries on the duration of contests. SRA, which is under-utilized by students of animal behaviour, offers several advantages over more frequently used procedures. It provides unbiased parameter estimates even when including censored data (i.e. results of contests that have not ended at the time when observations are stopped). The analysis of hazard functions, which is a component of SRA, is an easy way to test for consistency with predictions of the sequential assessment game model. These and other advantages of SRA are illustrated by using SRA and more conventional methods to analyse the effect of asymmetries on contest duration for encounters between female Mediterranean tarantulas, Lycosa tarentula (L.). It is hoped that this example of the advantages of SRA will encourage more widespread use of this powerful technique. Copyright 2000 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed1975

Mycotic flora of the interdigital spaces of the human foot: a preliminary investigation.

A qualitative and quantitative study of the mycotic flora of the interdigital spaces of 27 male volunteers yielded 1,291 moulds and 598 yeasts. Concurrently, a study of garden soil was conducted in order to obtain data concerning the transient-resident status of the fungi recovered from the feet. Of the 120 genera and species of fungi isolated, 51 were recovered from the volunteers, 53 from the soil, and 16 from both categories. The most commonly recovered fungi from the toewebs, in order to occurrence, were Torulopsis candida, Mycelia Sterilia, T. maris, Rhodotorula rubra, Cryptococcus albidus, and species of Aspergillus and Penicillium. Without sign of infection, Cryptococcus neoformans was isolated from 5 volunteers. Candida albicans was not recovered from any subject. Trichophyton mentagraphytes was recovered from 7 volunteers and T. rubrum from one.

Adult↗