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PubMed1996

HIV risk among Latino gay men in the Southwestern United States.

Using two different methods-bar and community household sampling-159 Latino gay men were recruited in the city of Tucson, Arizona. In addition to demographics, the study questionnaire assessed participants' sexual activity during the last 30 days with primary and nonprimary partners, condom use in the last year, and eight psychosocial constructs that have been predictive of HIV risk in different studies of (mostly white) gay/bisexual men. Questionnaires were available only in English; this Latino sample is thus likely to overrepresent highly acculturated, English-speaking men. Results show that 22% of the sample engaged in unprotected anal intercourse with nonmonogamous partners during the last 30 days; 51% of the sample reported at least one instance of unprotected anal intercourse during the last year. Of those men who practiced any anal intercourse during the last 30 days, 67% practiced unprotected anal intercourse with primary partners and 44% practiced unprotected intercourse with casual partners. Thus, the majority of Latino gay men who practiced anal intercourse in the month prior to the interview were not using condoms. Men who practiced unprotected intercourse with nonmonogamous partners reported lower annual incomes and were less educated. Two cognitive variables (behavioral intentions and perceptions of self-efficacy and self-control) and two behavioral variables (sex under the influence of alcohol and/or drugs and sex in public environments) emerged as the most important correlates of HIV risk.

Adult↗
PubMed2002

Differences in cause-specific patterns of unintentional injury mortality among 15-44-year-olds in income-based country groups.

OBJECTIVES: The aim of the present study was to investigate the cause-specific patterns of unintentional injury mortality among 15-44-year-olds in various income-based country groups, and to analyze which specific causes contribute the most to the unintentional injury mortality in each country group. MATERIALS AND METHODS: Cross-sectional data on the five most common causes of unintentional injury mortality by age-sex specific subgroups were compiled for 57 countries from the World Health Statistics Annuals for the year 1993 (1991-1994 if information for 1993 was unavailable). Data were categorized into four income-based country groups according to their gross national product (GNP) per capita for the year 1993. The differences between means and rate ratios of low, lower-middle, and upper-middle income countries were calculated by comparing them with those of the high-income countries. Regression analysis was performed to determine the trends in the direction of income for each specific cause of unintentional injury mortality by age-sex. RESULTS: For any of the specific causes of unintentional injury mortality there was an inverse relationship between mortality rates and GNP per capita except for motor vehicle traffic (MVT) among the 15-24-year-old age group. MVT accidents were the most common cause and contributed 26-77% of all unintentional injury mortality. The second most common cause was poisoning in all country groups except low-income countries where drowning dominated for males and mixed causes for females. Upper-middle income countries represented the highest MVT mortality in all age-sex subgroups except among 15-24-year-old females for which high-income countries displayed the highest rate. For other causes, lower-middle income represented the highest rates with a few exceptions. In the 15-24-year age group, the rate ratio of motor vehicle traffic mortality was higher in high-income countries compared to low-income countries, while in the 35-44-year age group, all other country groups showed a higher rate ratio than high-income countries. Drowning for males and burns for females in the low and middle-income countries were significantly higher than in high-income countries.

Accidental Falls↗
PubMed1998

Socioeconomic factors associated with suicide in elderly populations in British Columbia: an 11-year review.

OBJECTIVE: The effects of socioeconomic factors on suicide rates in the general population are widely documented. Few of these reports have specifically studied the effects of socioeconomic variables on suicide rates in the elderly population. Elderly persons have the highest suicide rates of any age-group. This group is different from the rest of the population insofar as suicide is concerned. For example, since most elderly persons are no longer in the labour force, it would be expected that they would be affected differently by economic factors such as unemployment. We report the findings of an ecological study of old-age suicide in British Columbia over an 11-year period. METHODS: We obtained information on all suicide counts (International Classification of Diseases [ICD-9] codes E590-959) recorded in the 21 health units of British Columbia over the 11-year period from October 1, 1981, to September 30, 1991, from the Division of Vital Statistics of the Province of British Columbia and Statistics Canada. Social, economic, and demographic information for the health units was obtained from census data and included the number of persons per household, proportion of the population that lived in 1-person households, immigration and migration rates for each region, proportion of the population with less than grade 9 education, proportion with less than grade 12 certification, marital status rates, unemployment rates by gender, average household income, average census family income, and labour-force participation rate by gender. We calculated overall and gender-specific suicide rates for elderly persons (65 years and older) and younger populations. Using Poisson regression analyses, we determined the cross-sectional and longitudinal relative risks associated with the socioeconomic variables for the units, and we also examined trends in suicide rates. RESULTS: There were 4630 suicides in the 11-year period. The mean suicide rate (per 100,000 population) for those over age 9 years was 18.6 (between health unit SD 5.2, 95% confidence interval [CI] = 17.0-20.2). The elderly have a higher suicide rate in every region. The male suicide rates (mean = 26.9, SD 6.4, 95% CI = 24.0-30.0) are higher than female rates (mean = 7.5, SD 1.7, 95% CI = 6.8-8.3) in every region. The factors influencing suicides were different for elderly males and elderly females. In all analyses, suicide rates in elderly females remained essentially stable across age-groups and units and over the years. Elderly male suicide rates varied across units and age-groups and over the years. CONCLUSIONS: Suicide rates are highest in males over age 74 years. There are regional differences in elderly suicide rates and the factors that influence them. Longitudinal and cross-sectional risk factors differ, and there are gender differences in the risk factors. For both elderly males and females, suicide rates appear to be influenced by social factors in the population as a whole, not just in the elderly population. Male and female employment patterns are associated with elderly male suicide rates, even though the latter are not in the labour force. For suicide in elderly women the important factors are population education, income, and migration levels.

Age Distribution↗
PubMed2003

Inadequate follow-up for abnormal Pap smears in an urban population.

PURPOSE: To determine the factors associated with inadequate follow-up for abnormal Pap smears among a cohort of Boston women from urban academic clinics. METHODS: Subjects were women > 18 years with abnormal cervical cytology between February 1999 and April 2000. Inadequate follow-up was defined as lack of subsequent cervical cytology or pathology specimen within four months of the initial abnormal specimen for high-grade lesions or within 7 months for low-grade lesions. RESULTS: Of the 423 subjects, the mean age was 33 years. Sixty percent were black, 23% Hispanic, 15% white, 2% Asian. The population was largely uninsured or publically insured. The overall inadequate follow-up rate was 38%. In bivariate analysis, age was a significant risk factor; 46% of women ages 18-29 had inadequate follow-up (p < 0.01). In multivariate analysis, women aged 18-29 years were more likely than women 50 years and older to have inadequate follow-up (OR 2.7, 95% CI 1.1-6.4), as were women with Medicaid insurance compared with private insurance (OR 1.9, 95% CI 1.01-3.5). After 12 months, 26% of women with abnormal Pap smears still had not received follow-up. CONCLUSIONS: In a predominantly urban minority population, the overall rate of inadequate follow-up for abnormal Pap smears was high at 38%. Programs to address follow-up of abnormal cervical cytology should focus on minority populations, especially younger and all low-income women.

Adolescent↗
PubMed1998

Sociodemographic distribution of pediatric dental caries: NHANES III, 1988-1994.

This article examines the extent to which caries prevalence and untreated caries vary in children by ethnicity and household income level. Data from the Third National Health and Nutrition Examination Survey, 1988-1994, for 10,332 children 2 to 18 years of age indicate that lower-income children and Mexican-American and African-American children are more likely to have a higher prevalence of caries and more unmet treatment needs than their higher-income and non-Hispanic white counterparts.

Adolescent↗
PubMed1995

Demographic change, rising earnings inequality, and the distribution of personal well-being, 1959-1989.

This paper uses new methods to determine the sources of the sharp fall and then the steep rise in personal income inequality between 1959 and 1989. The increase in the proportion of single-head families tended to boost inequality over the entire period. Forty percent of the reduction in income inequality in the 1960s occurred because of the decline in earnings inequality among male heads of families; more than one-third of the increase in inequality after 1969 occurred because inequality in male earnings soared. Since 1979 females' gains in earnings have increased inequality because these gains have been concentrated increasingly in families with high incomes.

Adult↗
PubMed2006

Exceptions to the rule: healthy deprived areas and unhealthy wealthy areas.

In general, inhabitants of low socio-economic areas are unhealthier than inhabitants of high socio-economic areas, but some areas are an exception to this rule. These exceptions imply that other factors besides the socio-economic level of an area contribute to the health of the inhabitants of an area, e.g. environmental factors. In our study we concentrate on areas within the Netherlands that are healthier or unhealthier than could be expected based on their socio-economic level. This study first identifies these areas and secondly determines which area characteristics distinguish these areas from those areas where the level of health is in agreement with their socio-economic level. We used nation-wide data on neighbourhood differences in population composition (gender, age, marital status and ethnicity), urbanisation and two health indicators: mortality and hospitalisation rates. In the Netherlands, many areas are healthier or unhealthier than could be expected based on their income level alone. Areas with higher mortality rates than expected are mainly urban areas with high percentages of elderly people and persons living alone. Similar but opposite associations are observed for areas with lower mortality rates than expected, which are further characterised by a low percentage of non-western immigrants. Areas with lower hospitalisation rates than expected are mainly rural areas with few non-western immigrants. From these results, we conclude that urbanisation and residential segregation based on age, ethnicity and marital status might be important contributors to geographical health inequalities.

Adolescent↗
PubMed2004

Prevalence of self-assessed tooth discolouration in the United Kingdom.

AIMS: To determine the prevalence of perceived tooth discolouration in the United Kingdom and to investigate socio-demographic variations and satisfaction with own tooth colour. METHODS: A national cross-sectional questionnaire study was carried out using a multistage random probability sample. Assessment of people's perceptions of their own tooth colour was conducted by asking study participants to match colour to the closest of a set of photocards demonstrating different levels of tooth discolouration. A separate question asked how satisfied they were with their tooth colour. Information on socio-demographic characteristics of the population were gathered at the same time. ANALYSIS: Data was coded and entered into SPSS software. Descriptive statistics were used to determine the prevalence of perceived discolouration and satisfaction with own tooth colour. Bivariate and regression analyses were performed to explore the effect of socio-demographic variations. RESULTS: The self-assessment exercise was completed for 3215 subjects. Half of the study population perceived their tooth colour to be normal and 6% perceived that they had severe discolouration, the remainder reported themselves to have levels of tooth discolouration between these two extremes. Satisfaction with tooth colour decreased with increased discolouration. Sex, age, income and smoking, had statistically significant effects on the prevalence of perceived discolouration (P< 0.01). CONCLUSIONS: Half of the people in this study perceived themselves to have tooth discolouration. Results suggest that the general public is concerned about dental appearance in terms of tooth colour, indicated by public dissatisfaction with relatively mildly discoloured teeth. Findings may suggest that a further increase in the demand of tooth whitening services and cosmetic dentistry in general is likely. The changing emphasis and level of perceived dissatisfaction need to be taken into account in planning dental services. Evidence based approaches are needed for the appropriate management of patients who demand treatment of mild discolouration.

Adolescent↗
PubMed2001

Low family income and food insufficiency in relation to overweight in US children: is there a paradox?

OBJECTIVES: To investigate associations between family income, food insufficiency, and being overweight in US children aged 2 to 7 and 8 to 16 years, to discuss mechanisms that may explain these associations, and to propose design and data requirements for further research that could effectively examine this issue. METHODS: Data from the Third National Health and Nutrition Examination Survey were analyzed. Children were classified as food insufficient if the family respondents reported that their family sometimes or often did not get enough food to eat. The prevalence of overweight was compared by family income category and food sufficiency status within age-, sex-, and race-ethnic-specific groups. Odds ratios for food insufficiency are reported, adjusted for family income and other potential confounding factors. RESULTS: Among older non-Hispanic white children, children in families with low income were significantly more likely to be overweight than children in families with high income. There were no significant differences by family income for younger non-Hispanic white children, non-Hispanic black children, or Mexican American children. After adjusting for confounding variables, there were no differences in overweight by food sufficiency status, except that younger food-insufficient girls were less likely to be overweight, and non-Hispanic white older food-insufficient girls were more likely to be overweight than food-sufficient girls (P<.10). CONCLUSION: Further research to evaluate whether food insecurity causes overweight in American children requires longitudinal quantitative and in-depth qualitative methods.

Adolescent↗
PubMed2002

Utilization of dental health services among middle-aged people in Sweden and Denmark.

In 1999, questionnaires were sent to random samples of 1001 Swedish citizens aged 55-79 years and 1175 Danish citizens aged 45-69 years. Various questions were asked concerning dental conditions, dental visit frequency per year, and money spent annually on dental care, etc. The objectives were to assess differences in the utilization of dental services and to compare out-of-pocket costs for dental care in Sweden and Denmark with control for age, gender, dental conditions and income. More than 80% of the subjects reported that a dentist had examined them less than 1 year previously. However, 77% of the Danes reported dental visits twice a year or more compared to 28% of the Swedes. Although the Danes reported a more frequent use of dental services, they had poorer dental conditions compared to the Swedes. Even though the Swedes used dental services less often than the Danes did, more subjects reported high 12-month out-of-pocket costs. In the present study, separate models were constructed for the two countries because there could be different mechanisms at play, as indicated by the results. The different insurance systems along with different degrees of commercialization in the two countries might be the most decisive factors in this context.

Age Factors↗
PubMed1990

Electrosensory systems in fish.

A close integration of behavioral, neurophysiological, and neuroanatomical approaches has guided research on the neural basis of electrosensation and the generation of behaviors associated with this modality. By postulating neuronal implementations of specific computations in sensory information processing, behavioral studies have been crucial in focusing studies at the neuronal level onto behaviorally relevant structural and functional aspects. Physiological and anatomical studies have analyzed a) neural networks underlying the distributed processing of sensory information, b) the role of descending recurrent pathways and efference copy mechanisms for the filtering of incoming information, c) the significance of multiple topographic representations for sensory information processing, and d) the modulation of sensory and motor structures through various transmitters and receptor subtypes. Developmental studies have explored the significance of steroid hormones for the tuning of electroreceptors to the frequency of an endogenous neuronal oscillator which drives the electric current pulses necessary for their stimulation. Embryological studies have revealed that the development of mechanoreceptors and electroreceptors in the fish's skin is induced by the innervation of primary afferent nerve fibers which are specific with regard to their central connections as well as with regard to the type of receptor induced in the periphery.

Animals↗
PubMed1995

Gender influences on earnings of obstetrician-gynecologists.

OBJECTIVE: To test the hypothesis that the observed difference in earnings between male and female obstetrician-gynecologists could be explained by variations in productivity and human capital. METHODS: Data from a 1991 national survey of ACOG Fellows were used to provide a descriptive analysis of male and female obstetrician-gynecologists' demographic characteristics, net income, experience, practice characteristics, workload, and practice activities. Variables found to have a significant impact on net income or to vary significantly by sex were included in a multiple regression analysis. RESULTS: Twenty-one percent of the 1286 survey respondents were female obstetrician-gynecologists. Women were almost twice as likely as men to be in salaried positions (P < .001) and more than twice as likely to have less than 10 years of experience (P < .001). Women reported fewer annual patient-contact hours (P < .05) and performed fewer than half as many hysterectomies (P < .001). Average annual earnings for women were 71% of men's annual net income (P < .001). The multivariate regression analysis found that male-female differences in the factors included in the analysis (ie, workload, experience, practice type) resulted in an 18.7% male-female income gap. The analysis also revealed an income gap of 14.2% that was not accounted for by differences in the objective factors included in the model. CONCLUSION: More than half of the overall male-female income gap was explained by differences in personal and practice characteristics. However, female obstetrician-gynecologists earned 14.2% less than men, after controlling for variations in productivity and human capital.

Adult↗
PubMed1990

Health and social inequities in Malta.

This paper focuses on the sources that are thought to lead to the genesis of health and social inequity in a small island community. It is largely a descriptive exposition, the main aim of which is to introduce the topic in Malta. Small size is the key geographical factor. This fact is dwelt upon to stress that although there are differences, say, between the two inhabitable islands, such differences are very small. Social homogeneity and an almost indiscernible urban-rural difference are strong factors that reduce any tendency for regional inequities. Socio-cultural factors in Malta are largely determined by family life and its relation with the established church. The traditional Catholic way of life is depicted as gradually giving way to a more secular lifestyle. Politics is represented as the prime factor for causing division within the this society. This is not without reason since this factor has taken over the other cause of division, namely parochialism. Political factors determine the distribution of resources including health resources. The important economic factors are that there are no great differences between the high income and the low income groups. However, due importance must always be given to the subterranean economy. The health profile is that of a developed country with low infant mortality and a long life expectancy. Infectious diseases have been on the decline and their persistence is usually linked to areas that have remained underdeveloped. The disadvantaged groups identified are the chronically unemployed, single mothers, possibly a section of the migrant population and the elderly.

Cause of Death↗
PubMed2006

Health disparities in Canada today: some evidence and a theoretical framework.

This paper documents contemporary evidence on patterns of health disparities in Canada and suggests theoretical mechanisms that give rise to these patterns. The overall health of Canadians, as measured by life expectancy or mortality, has improved dramatically over the past 30 years and some disparities have diminished slightly (e.g., life expectancy by income group for men), while others have increased (e.g., diabetes for Aboriginal peoples). Arguably the most egregious health disparities in Canada are those existing between Aboriginals and the rest of the Canadian population. This paper focuses specifically on three social determinants and their effects on disparities in health; Aboriginal status, income, and place. Overall we take the approach that disparities in health could be alleviated by reducing inequities in the distribution of these determinants. We further argue that these social determinants are proxies for opportunities, resources and constraints; all of which influence health outcomes. We suggest that policies focus on reducing the social inequities that lead to health disparities in Canada, rather than focusing on the disparities in health alone. Since the social determinants described here have been found to influence an array of disease outcomes, tackling them, rather than their outcomes, may have a greater overall influence on the health of the population.

Aged↗
PubMed2004

Young adults in Massachusetts: who is at risk of being uninsured?

PURPOSE: To identify sociodemographic factors associated with being uninsured among young adults in a state sample (Massachusetts) and to examine the independent association of insurance status with the young adult's reporting no health maintenance visit (check-up) in the past 2 years or reporting an inability to afford needed health care in the last 12 months. METHODS: Secondary analysis of data from the Massachusetts Behavioral Risk Factor Surveillance System for the years 1998-2000. In this cross-sectional study, data were examined for 1673 19- to 24-years-olds who provided information on sociodemographic variables, health insurance status, perceived inability to afford care, and health care use. Multiple logistic regression was used to estimate the odds of being uninsured. Subsequently, multiple logistic regression was used to estimate the odds of having no check-up in the last 2 years and of reporting the inability to afford needed health care in the last year. RESULTS: 15% of young adults were uninsured, including 20% of males and 10% of females. For both genders, the adjusted odds of being uninsured were lower for students and higher for those with a household income between 15,000 dollars and 24,999 dollars. Uninsured young men, but not women, had significantly higher odds of not having a routine check-up in the last 2 years. Uninsured young adults of both genders had significantly higher odds of reporting the inability to afford needed care in the past 12 months. CONCLUSIONS: Programs and policies that seek to reduce the rates of uninsured young adults should especially target males and nonstudents. Improving health insurance coverage, especially for young adult males, may be associated with improved preventive health care access.

Adult↗
PubMed2006

The closed structure of an archaeal DNA ligase from Pyrococcus furiosus.

DNA ligases join single-strand breaks in double-stranded DNA, and are essential to maintain genome integrity in DNA metabolism. Here, we report the 1.8 A resolution structure of Pyrococcus furiosus DNA ligase (PfuLig), which represents the first full-length atomic view of an ATP-dependent eukaryotic-type DNA ligase. The enzyme comprises the N-terminal DNA-binding domain, the middle adenylation domain, and the C-terminal OB-fold domain. The architecture of each domain resembles those of human DNA ligase I, but the domain arrangements differ strikingly between the two enzymes. The closed conformation of the two "catalytic core" domains at the carboxyl terminus in PfuLig creates a small compartment, which holds a non-covalently bound AMP molecule. This domain rearrangement results from the "domain-connecting" role of the helical extension conserved at the C termini in archaeal and eukaryotic DNA ligases. The DNA substrate in the human open-ligase is replaced by motif VI in the Pfu closed-ligase. Both the shapes and electrostatic distributions are similar between motif VI and the DNA substrate, suggesting that motif VI in the closed state mimics the incoming substrate DNA. Two basic residues (R531 and K534) in motif VI reside within the active site pocket and interact with the phosphate group of the bound AMP. The crystallographic and functional analyses of mutant enzymes revealed that these two residues within the RxDK sequence play essential and complementary roles in ATP processing. This sequence is also conserved exclusively among the covalent nucleotidyltransferases, even including mRNA-capping enzymes with similar helical extensions at the C termini.

Adenosine Monophosphate↗