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At least 1,783 records · Page 99Linked to original sources
PubMed2001

Prevalence and incidence of multiple sclerosis in Catania, Sicily.

OBJECTIVE: An epidemiologic survey was conducted to determine the prevalence and incidence of MS in the city of Catania, Sicily, Italy. Prevalence rate was calculated as point prevalence at January 1,1995, and incidence during 1974 to 1995. METHODS: The authors studied the frequency of MS in the community of Catania in a population of 333,075 inhabitants according to the 1991 census. The primary sources for the case ascertainment were the neurologic and motor rehabilitation departments, the MS Center, the Italian MS Association, private neurologists, and family doctors. All patients who satisfied the Poser criteria for clinically definite MS, laboratory-supported definite MS, clinically probable MS, and laboratory-supported probable MS were considered prevalent and incident cases. RESULTS: One hundred ninety-five patients with MS who had had the onset of disease on prevalence day in a population of 333,075 inhabitants were detected. The prevalence rate was 58.5 per 100,000 (95% CI 50.7 to 67.5). Prevalence was higher in women (62.0/100,000) than in men (54.8/100,000). The age-specific prevalence showed a peak in the group aged 35 to 44 (145.1/100,000). From 1975 to 1994, 170 subjects with MS had the clinical onset of the disease. The mean annual incidence was 2.3 per 100,000 (95% CI 2.0 to 2.6). Age-specific incidence showed a peak in the group aged 25 to 34 (6.32/100,000). Incidence for 5-year intervals increased from 1.3 during 1975 to 1979 to 3.9 during 1990 to 1994. CONCLUSIONS: These prevalence and incidence rates are close to those reported in other similar surveys carried out in Italy and southern Europe.

Adult↗
PubMed2006

Autism spectrum disorders in relation to distribution of hazardous air pollutants in the san francisco bay area.

OBJECTIVE: To explore possible associations between autism spectrum disorders (ASD) and environmental exposures, we linked the California autism surveillance system to estimated hazardous air pollutant (HAP) concentrations compiled by the U.S. Environmental Protection Agency. METHODS: Subjects included 284 children with ASD and 657 controls, born in 1994 in the San Francisco Bay area. We assigned exposure level by census tract of birth residence for 19 chemicals we identified as potential neurotoxicants, developmental toxicants, and/or endocrine disruptors from the 1996 HAPs database. Because concentrations of many of these were highly correlated, we combined the chemicals into mechanistic and structural groups, calculating summary index scores. We calculated ASD risk in the upper quartiles of these group scores or individual chemical concentrations compared with below the median, adjusting for demographic factors. RESULTS: The adjusted odds ratios (AORs) were elevated by 50% in the top quartile of chlorinated solvents and heavy metals [95% confidence intervals (CIs) , 1.1-2.1], but not for aromatic solvents. Adjusting for these three groups simultaneously led to decreased risks for the solvents and increased risk for metals (AORs for metals: fourth quartile = 1.7 ; 95% CI, 1.0-3.0 ; third quartile = 1.95 ; 95% CI, 1.2-3.1) . The individual compounds that contributed most to these associations included mercury, cadmium, nickel, trichloroethylene, and vinyl chloride. CONCLUSIONS: Our results suggest a potential association between autism and estimated metal concentrations, and possibly solvents, in ambient air around the birth residence, requiring confirmation and more refined exposure assessment in future studies.

Air Pollutants↗
PubMedDate not supplied

[University-trained nurses in Mexico: an assessment of educational atrition and labor wastage].

OBJECTIVE: To estimate and analyze the rate of wastage among university-trained nurses during their training period and in the labour market. MATERIAL AND METHODS: Wastage at the training stage was estimated using data from ANUIES for the 1978-2002 period. We used the 2000 Population and Household Census database to estimate job market wastage. Concepts and formulas were defined for the valuation of both areas. RESULTS: The Rate of Education Wastage (TDE) for the generation cohort finishing in the year 2002 reached 252 per 1000, far below the 1987 rate, which was 555 per 1000. Regarding the job market, 55.2% of the total graduates who finished university studies and carried out post-graduate studies in nursing, now perform paid activities in the field of nursing, 15.4% work in activities different from their original training, and 16.2% are dedicated to household duties. The Global Rate of Labor Wastage (TGDL, per its abbreviation in Spanish) is 410 per 1000 thousand who obtained a degree in nursing at the university. CONCLUSIONS: There is an important degree of wastage in the population holding a university nursing degree, both in the training and in the job market areas, an unacceptable situation that calls for immediate action by incumbent institutions.

Education, Nursing↗
PubMed1985

Land tenure patterns and child health in southern Brazil: the relationship between agricultural production, malnutrition and child mortality.

The relationships between infant mortality, malnutrition, and land tenure patterns in the State of Rio Grande do Sul, Brazil, were investigated with data from demographic and agricultural censuses, vital statistics, and dietary surveys, complemented by a large nutritional survey in urban and rural areas. These studies employed a variety of analytical methods and revealed that young children in areas with large ranches, livestock-raising, and a high proportion of agricultural wage-earners presented a higher mortality and had a poorer nutritional status than children in areas with small properties, crop agriculture, and self-employed family workers. Children of landowners showed least malnutrition and the smaller risk of death compared to children of laborers, although the differential seems to have narrowed in recent years. The main conclusion is that land tenure patterns play a very important role in determining early mortality and malnutrition in this Brazilian state.

Adolescent↗
PubMedDate not supplied

[Identification of the groups most vulnerable to infant malnutrition through the measuring of poverty level].

OBJECTIVE: To test an instrument measuring the socioeconomic level, specially designed for low income urban populations, to be used in the identification of groups more vulnerable to infant malnutrition. POPULATION AND METHODS: This is a cross-sectional study, with a sample of 477 children aged 12 to 59 months old living in low income census sectors at "Vila Grande Cruzeiro", in Porto Alegre, RS. The children were submitted to anthropometric evaluation and their families were stratified according to socioeconomic level measured through an instrument developed in Chile for urban poor populations and adapted to local conditions. Children with weight/age, height/age and/or weight/height below - 2 standard deviation from the median of the reference population (NCHS) were considered malnourished. RESULTS: The children from families belonging to the lowest quartile in the socioeconomic classification had a 3.4 times higher chance of having low weight for age, a 2.7 times higher chance of being stunted and a 11.0 times higher chance of presenting low weight for height, controlling for potential confounders. CONCLUSION: The instrument measuring poverty level was useful to identify those children with higher risk for malnutrition.

English Abstract↗
PubMed1984

Epidemiologic study of work-related diseases. Methodological problems of register-based studies.

The efficient execution of an occupational epidemiologic study requires accurate information on both exposure and effect. In this paper emphasis is placed on the use of registers of occupation or disease as tools in the undertaking of descriptive and analytical epidemiologic studies. While cancer registers are a common information source nowadays, their validity is not always consistently good. Other sources of information, such as industry records, professional membership listings, and disease notifications are also used. The inaccuracies of these registers--established usually for nonepidemiologic purposes--are outlined. Specific examples are used to illustrate the problems and pitfalls involved in interpreting the derived results. The study populations discussed range from the high enumeration feasible with life-long occupational groupings, such as pathologists and sea pilots, to attempts to trace individuals whose "membership" in an exposure group might be residence in the American Embassy in Moscow or recognition as short-service military personnel exposed to A-bomb testing a generation ago. The recent development of using census-based occupational information to trace mortality and morbidity is also discussed.

Epidemiologic Methods↗
PubMed2000

The use of patient registers to estimate migration.

This article presents information discussed at the recent regional seminars on population statistics. It describes a new data source for estimating internal migration between local and health authorities in England and Wales, discusses the way that the data have been collected and processed, and how limitations in the raw data have been addressed. It then goes on to explain the way that the new internal migration estimates have been used in the calculation of population estimates for local and health authorities. This is a change to the method of estimating migration in the calculation of population estimates.

Censuses↗
PubMed2004

Child mortality in a West African population protected with insecticide-treated curtains for a period of up to 6 years.

OBJECTIVES: To determine the impact of insecticide-treated curtains (ITC) on all-cause child mortality (6-59 months) over a period of six years. To determine whether initial reductions in child mortality following the implementation of ITC are sustained over the longer term or whether "delayed" mortality occurs. METHODS: A rural population of ca 100 000 living in an area with high, seasonal Plasmodium falciparum transmission was studied in Burkina Faso. Annual censuses were conducted from 1993 to 2000 to measure child mortality. ITC to cover doors, windows, and eaves were provided to half the population in 1994 with the remainder receiving ITC in 1996. Curtains were re-treated or, if necessary, replaced annually. FINDINGS: Over six years of implementation of ITC, no evidence of the shift in child mortality from younger to older children was observed. Estimates of the reduction in child mortality associated with ITC ranged from 19% to 24%. CONCLUSIONS: In our population there was no evidence to suggest that initial reduction in child mortality associated with the introduction of insecticide-treated materials was subsequently compromised by a shift in child mortality to older-aged children. Estimates of the impact of ITC on child mortality in this population range from 19% to 24%.

Animals↗
PubMed2003

Population ageing in the Balkan countries.

INTRODUCTION: As we enter the third millennium, we are witnessing an unprecedented rapid expansion of the population of older persons in both the developed and developing world. The total worldwide aged population (aged 60 and older) is projected to rise from 605 million in 2000 to 1.2 billion in 2025 and to nearly 2 billion in 2050. AIM: To study the process of population ageing in Bulgaria and Balkan countries and to reveal its main characteristics, similarities and differences as compared to other European countries. MATERIAL AND METHODS: Primary information was obtained from the European Database "Health for all", the European Public Health Information Network for Eastern Europe and the US Census Bureau International Database. Total, male and female old and youth dependency ratios and ratio of people over 65 to 0-14 years were calculated and trends were followed for 30 years. Countries were ranked and compared with Europe and East European countries. RESULTS: From 1970 to 1999 the old dependency ratio increased dramatically in Bulgaria (14.2-23.6%), Greece (17.2-24.7%), Romania and Slovenia. The ratio of old to young people surpassed 100% in Greece (107.3%, for female 122.6%) and in Bulgaria (99.7% and 116.8%, respectively). Albanian and Turkish populations differ substantially from the other Balkan countries. DISCUSSION: Population ageing creates great socio-economic and health problems--slower economic growth, lack of young labour force, higher tax charges on working-age population, etc. The process in Balkan countries is aggravated by the rise of inflation, unemployment and other socio-economic factors. CONCLUSION: All Balkan countries face multiple challenges posed by population ageing. Most of them experience the same demographic tendencies as for market economy countries even though their economic development is far worse. This is especially true for Bulgaria.

Adolescent↗
PubMed1992

The geographic distribution of measles in the United States, 1980 through 1989.

OBJECTIVE: To describe the geographic distribution of measles cases in the United States by county for the 10-year period from 1980 through 1989. DESIGN: Ecological analysis of national measles surveillance data. METHODS: Measles cases reported to the Morbidity and Mortality Weekly Report from 1980 through 1989 were analyzed. Data from the 1980 and 1990 US censuses were used to produce demographic profiles for each of the 3137 countries. Outcome variables examined included mean annual incidence and number of years reporting measles, with use of Spearman's rank correlation coefficients to examine the association between the demographic and the two outcome variables. RESULTS: A total of 56,775 measles cases were reported during the decade. Of the nation's 3137 counties, 1690 (53.9%) did not report any cases; only 17 (0.5%) reported measles in all 10 years. Counties reporting measles more frequently during the decade had higher median populations, population densities, and percentage of black and Hispanic populations than those counties reporting less frequently. Population size, population density, and percentage of Hispanic population were associated with number of years reporting measles and mean annual measles incidence rate. Measles cases in counties reporting measles every year predominantly occurred in unvaccinated preschoolers; cases in counties reporting less frequently predominantly occurred in vaccinated school-aged children. CONCLUSIONS: This analysis illustrates the focal nature of measles in the United States during the past decade. Most counties have not reported a single case of measles during the entire decade, and only 17 counties reported measles every year. Targeted strategies are needed to improve age-appropriate immunization levels among preschool-aged children living in large inner-city areas.

Adolescent↗
PubMed2004

The maldistribution of general practitioners in England and Wales: 1974-2003.

BACKGROUND: The geographical distribution of general practitioners (GPs) is a persistent policy concern within the National Health Service. Maldistribution across family health service authorities in England and Wales fell between 1974 and the mid-1980s but then remained, at best, constant until the mid-1990s. AIM: To estimate levels of maldistribution over the period 1994-2003 and to examine the long-term trend in maldistribution from 1974-2003. DESIGN: Annual snapshots from the GP census. SETTING: One hundred 2001 'frozen' health authorities in England and Wales for 1994-2003 and 98 family health service authorities for 1974-1995. METHOD: Ratios of GPs to raw and need-adjusted populations were calculated for each health authority for each year using four methods of need adjustment: age-related capitation payments, national age- and sex-specific consultation rates, national age- and sex-specific limiting long-term illness rates, and health authority-specific mortality. Three summary measures of maldistribution across health authorities in the GP to population ratio--the decile ratio, the Gini coefficient, and the Atkinson index--were calculated for each year. RESULTS: Maldistribution of GPs as measured by the Gini coefficient and Atkinson index increased from the mid-1980s to 2003, but the decile ratio showed little change over the entire 1974-2003 period. Unrestricted GP principals and equivalents were more equitably distributed than other types of GP. CONCLUSION: The 20% increase in the number of unrestricted GPs between 1985 and 2003 did not lead to a more equal distribution.

Demography↗
PubMed2005

[Healthy life expectancy in the occupied segment of the Turin population].

BACKGROUND: The indicators of healthy life expectancy measure differences in health among various population subgroups more sensitively than do indicators of mortality. OBJECTIVES: The aim of the study was to analyze some of the above indicators to evaluate the differences among occupational categories in Turin. METHODS: Mortality tables by occupation were calculated on Turin residents, aged 18-64 years in 1991, using the Turin Longitudinal Study which combines personal, census, and health information for the residents of the city. Longitudinal assessments of health expectancy were obtained by means of record-linkage with the Cancer Registry, the Diabetes Registry, and hospital discharge records. In addition, prevalence estimates of good health, disability, and chronic illness, obtained from ISTAT (Central Statistics Institute) investigations in 1999-2000 were combined with mortality data using Sullivan's algorithm. RESULTS: Among men there was a systematic disadvantage in almost all indicators of health expectancy for some manual occupations, while jobs requiring more qualifications were more advantaged. The health profile for women was more controversial, with an overall disadvantage among women who were professional consultants, although this group showed substantial variability: the legal professions had the lowest life and health expectancies, with approximately 3 years of life less than the health professions, which were among the most advantaged. DISCUSSION: The various indicators gave results which were at times conflicting, especially because the information obtained from the available sources had major limitations. The development of indicators needs to aim for greater homogeneity between mortality and health data to ensure maximum comparability.

Adolescent↗
PubMed1995

[Diabetes mellitus mortality in Spain: a comparative analysis between Spanish provinces in the period of 1981-1986].

OBJECTIVE: To find and compare mortality because of diabetes mellitus (DM) among the different provinces of Spain in the 1981 to 1986 period. SETTING: The natural movement of population figures of the National Institute of Statistics (INE) and the census of 1981 and register of 1986 were used. DESIGN: A descriptive observation study of a crossover type. Standardisation of rates by the indirect method. Calculation of the ratio of standardised mortality for each province. RESULTS: At the national level, the Communities with an excess of mortality in 1981 were Andalusia, Melilla, the Community of Valencia, Murcia, the Balearics, the Canaries and Extremadura, as well as the provinces of Tarragona, Gerona, Ciudad Real and Albacete. In 1986 the following still had excess of mortality: Andalusia, the Community of Valencia, Murcia, the Balearics, the Canaries, Asturias and Cantabria, along with the provinces of Badajoz and Pontevedra. CONCLUSIONS: The provinces with an excess mortality because of diabetes mellitus are geographically grouped (with some exceptions) in the south and south-east of Spain and the island communities.

Adult↗
PubMed2001

Diphenhydramine for the prevention of akathisia induced by prochlorperazine: a randomized, controlled trial.

STUDY OBJECTIVES: The utility of intravenous prochlorperazine as an antiemetic agent and abortive therapy for headache may be limited by the frequent occurrence of akathisia, the distressing effects of which have been shown to disrupt patient care. We tested the hypothesis that adjuvant diphenhydramine reduces the incidence of akathisia induced by prochlorperazine. METHODS: This randomized, double-blind, placebo-controlled trial was conducted in the emergency department of an academic tertiary care medical center with an annual census of 95,000 emergency patient visits. We enrolled a convenience sample of 100 adult patients who received 10 mg of intravenous prochlorperazine for the treatment of nausea/vomiting or headache. Subjects were randomly assigned to receive a 2-minute infusion of prochlorperazine with either 50 mg of diphenhydramine or placebo. The incidence of akathisia at 1 hour was measured by using explicit diagnostic criteria. To measure the influence of treatment on sedation, the subjects noted, on a 100-mm visual analog scale, their degree of sedation before and after treatment. RESULTS: Akathisia developed in 18 (36%) of 50 subjects in the control group and in 7 (14%) of 50 subjects in the diphenhydramine group, a 61% relative reduction. The addition of adjunct diphenhydramine resulted in an absolute reduction of 22% in the incidence of akathisia (95% confidence interval [CI] 6% to 38%; P = .01). The odds ratio for akathisia with the use of adjuvant diphenhydramine was 0.39 (95% CI 0.18 to 0.85). Mean sedation scores increased 12 mm after infusion of prochlorperazine alone (95% CI 3 to 21 mm) compared with a 33-mm increase after infusion of prochlorperazine with adjuvant diphenhydramine (95% CI 24 to 42 mm). The 12-mm difference between the groups was statistically significant (95% CI 9 to 34 mm, P < .001). CONCLUSION: Adjuvant diphenhydramine reduces the incidence of akathisia induced by prochlorperazine and is associated with an increase in sedation.

Adolescent↗
PubMed1992

A comparison of four methods for projecting households.

"The purpose of this paper is to extend the headship rate method for projecting households to encompass both sexes. Four models are considered that explicitly incorporate the impact of changes in the number of men and women on the number and joint age distribution of husband-wife households. The models are applied to the Philippines using data from the 1988 National Demographic Survey to project households to 2010. The models are also evaluated by 'backcasting' and comparing the results with special tabulations from the 1970 and 1980 censuses and the 1975 National Demographic Survey."

Age Distribution↗
PubMed1998

Clinical aspects of vasectomies performed in the United States in 1995.

OBJECTIVES: Currently, no surveillance system collects data on the numbers and characteristics of vasectomies performed annually in the United States. This study provides nationwide data on the numbers of vasectomies and the use of no-scalpel vasectomy, various occlusion methods, fascial interposition, and protocols for analyzing semen after vasectomy. METHODS: A retrospective mail survey (with telephone follow-up) was conducted of 1800 urology, family practice, and general surgery practices drawn from the American Medical Association's Physician Master File and stratified by specialty and census region. Mail survey and telephone follow-up yielded an 88% response rate. RESULTS: In 1995, approximately 494,000 vasectomies are estimated to have been performed by 15,800 physicians in the United States. Urologists performed 76% of all vasectomies, and nearly all (93%) urology practices performed vasectomies in 1995. Nearly one third (29%) of vasectomies in 1995 were no-scalpel vasectomies, and 37% of physicians performing no-scalpel vasectomies taught themselves the procedure. The most common occlusion method in 1995 (used for 38% of all vasectomies) was concurrent use of ligation and cautery. In 1995, slightly less than half (48%) of all physicians surveyed interposed the fascial sheath over one end of the vas when performing a vasectomy. Protocols for ensuring azoospermia varied: 56% of physicians required one postvasectomy semen specimen; 39% required two, and 5%, three or more. CONCLUSIONS: No-scalpel vasectomy, used by nearly one third of U.S. physicians, has become an accepted part of urologic care. Physicians' variations in occlusion methods, use of fascial interposition, and postvasectomy protocols underscore the need for large scale, controlled, and statistically valid studies to determine the efficacy of occlusion methods and fascial interposition, as well as whether azoospermia is the only determination of a successful vasectomy.

Adult↗
PubMed1999

Burden of migraine in the United States: disability and economic costs.

BACKGROUND: Migraine is a common disabling disease but its economic burden has not been adequately quantified. OBJECTIVE: To estimate the burden of migraine in the United States with respect to disability and economic costs. METHODS: The following data sources were used: published data, the Baltimore County Migraine Study, MEDSTAT's MarketScan medical claims data set, and statistics from the Census Bureau and the Bureau of Labor Statistics. Disability was expressed as bedridden days. Charges for migraine-related treatment were used as direct cost inputs. The human capital approach was used in the estimation of indirect costs. RESULTS: Migraineurs required 3.8 bed rest days for men and 5.6 days for women each year, resulting in a total of 112 million bedridden days. Migraine costs American employers about $13 billion a year because of missed workdays and impaired work function; close to $8 billion was directly due to missed workdays. Patients of both sexes aged 30 to 49 years incurred higher indirect costs compared with younger or older employed patients. Annual direct medical costs for migraine care were about $1 billion and about $100 was spent per diagnosed patient. Physician office visits accounted for about 60% of all costs; in contrast, emergency department visits contributed less than 1% of the direct costs. CONCLUSIONS: The economic burden of migraine predominantly falls on patients and their employers in the form of bedridden days and lost productivity. Various screening and treatment regimens should be evaluated to identify opportunities to reduce the disease burden.

Absenteeism↗