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National oral health survey Zimbabwe 1995: Dental carries situation

INTERNATIONAL DENTAL JOURNAL 1999年第1期49卷 3-9页

作者： Frencken, JE Sithole, WD Mwaenga, R Htoon, HM Simon, E Dept Prevent & Community Dent NL-6500 HB Nijmegen Netherlands

Ten years after completion of the first national oral health survey, the second such survey was carried out in 1995. Application of a multi-stage sampling procedure resulted in 3,709 persons being examined according to the WHO oral health assessment form and criteria. The background variables studied were age, gender, type of location, socio-economic status. Comparison with results from major studies in other African nations are presented. It was concluded that the prevalence of dental caries in all age groups was high but that the severity was low. The prevalence of unmet treatment needs was very high with extraction as the predominant mode of treatment. The survey has shown that the vast majority of Zimbabweans are not receiving and/or are not seeking oral care.

关键词：年龄分布龋失补指数龋齿/流行病学牙健康调查氟化物/分析年患病率/发展趋势口腔保健患病率随机分配可重复性结果农村人口/统计学和数值数据性别分布市区人口/统计学和数值数据给水/分析津巴布韦/流行病学青少年成年人儿童学龄前女(雌)性人类男(雄)性

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The North Staffordshire Suicide Study: A case-control study of suicide in one health district

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PSYCHOLOGICAL MEDICINE 1999年第1期29卷 27-33页

作者： Boardman, AP Grimbaldeston, AH Handley, C Jones, PW Willmott, S Guys Hosp Div Psychiat & Psychol London SE1 9RT England S Staffordshire Hlth Author Stafford England Keele Univ Dept Psychiat Postgrad Med Sch Keele Staffs England Keele Univ Dept Math Keele Staffs England

Background. The aim of the study was to identify sociodemographic and clinical risk factors for death from suicide and undetermined injury in residents of one health district. Method. Data were collected on all cases of suicide (ICD-9 E950-959) and undetermined injury (ICD-9 E980-989) for residents in North Staffordshire Health District between 1991 and 1995. Controls, identified from the Coroner's inquest register, who died from other causes, were matched for age and sex. Results. Two hundred and twelve pairs of cases and matched controls were identified. Multivariate analysis (conditional logistic regression) showed that the risk of death due to suicide and undetermined death was associated with: recent separation, relationship difficulties, experience of financial difficulties, history of past criminal charges or contact with the police, a past history of deliberate self-harm, being on psychotropic medication at the time of death and a diagnosis of bipolar affective disorder. For sociodemographic variables, a univariate analysis found associations between the cases and being separated, living alone, having a past history of criminal charges and unemployment. Cases were more likely to have a psychiatric disorder, past history of deliberate self-harm and a past history of psychiatric contact for themselves or a family member. Controls were more likely to have a current medical disorder. Cases were more likely than controls to be on any form of medication at the time of death and to have received a prescription for psychotropic or nonpsychotropic medication in the week and month before death. Cases were more likely than controls to have had contact with medical services in the week and month before death, with the general practitioner in the week before death and with psychiatric services at any time in the year before death. Strong associations were found between suicide and undetermined injury and life events such as recent separation and bereavement, and financia

关键词：病例对照研究生活变动事件病人接受卫生保健的程度回顾性研究危险因素农村人口/统计学和数值数据自杀/心理学自杀/统计学和数值数据市区人口/统计学和数值数据青少年成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Cohort changes in illegal drug use among arrestees in Manhattan: From the heroin injection generation to the blunts generation

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SUBSTANCE USE & MISUSE 1999年第13期34卷 1733-1763页

作者： Golub, AL Johnson, BD Natl Dev & Res Inst Inc Inst Special Populat Res New York NY 10048 USA

This paper identifies three inner-city cohorts differing by birth year and preferred drugs that routinely passed through Manhattan's criminal justice system from 1987 through 1997: The Heroin Injection Generation born 1945-54, the Cocaine/Crack Generation born 1955-69, and the Blunts (marijuana plus tobacco) Generation born since 1970. The future prospects for the Blunts Generation may be modestly enhanced by their continued avoidance of cocaine, crack, and heroin-despite the fact that many of them are being reared in severely distressed households and are developing few skills for legal jobs.

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Urban-rural mental health differences in Great Britain: findings from the National Morbidity Survey

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PSYCHOLOGICAL MEDICINE 2000年第2期30卷 269-280页

作者： Paykel, ES Abbott, R Jenkins, R Brugha, TS Meltzer, H Univ Cambridge Dept Psychiat Cambridge England Dept Hlth London SE1 6TE England Off Natl Stat London England

Background. Studies of urban-rural differences in prevalence of non-psychotic mental disorder have not given consistent findings. Such differences have received relatively little study in Great Britain. Methods. Data from 9777 subjects in the Household Survey of the National Morbidity Survey of Great Britain were analysed for differences between urban, semi-rural and rural areas. Psychiatric morbidity was assessed by scores on the Revised Clinical Interview Schedule (CIS-R), together with alcohol dependence, drug dependence, receipt of treatment from general practitioners. Associations with other characteristics were examined by logistic regression. Results. Urban subjects had higher rates than rural of CIS-R morbidity, alcohol dependence and drug dependence, with semi-rural subjects intermediate. Urban subjects also tended to be members of more deprived social groups, with more adverse living circumstances and greater life stress, factors themselves associated with disorder. Urban-rural differences in alcohol and drug dependence were no longer significant after adjustment for these factors by logistic regression, and differences on CIS-R morbidity were considerably reduced. There were no differences in reatment. Conclusions. There are considerable British urban-rural differences in mental health, which may largely be attributable to more adverse urban social environments.

关键词：慢性酒精中毒/诊断慢性酒精中毒/流行病学横断面研究健康调查发病率精神障碍/诊断精神障碍/流行病学精神卫生服务/统计学和数值数据农村人口/统计学和数值数据物质相关性障碍/诊断物质相关性障碍/流行病学市区人口/统计学和数值数据青少年成年人女(雌)性人类男(雄)性中年人

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Violent injuries among adolescents: Declining morbidity and mortality in an urban population

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ANNALS OF EMERGENCY MEDICINE 2001年第3期37卷 292-300页

作者： Cheng, TL Wright, JL Fields, CB Brenner, RA O'Donnell, R Schwarz, D Scheidt, PC Childrens Natl Med Ctr Dept Gen Pediat & Adolescent Med Washington DC 20010 USA George Washington Univ Sch Med Childrens Res Inst Washington DC USA George Washington Univ Sch Publ Hlth Washington DC USA Childrens Natl Med Ctr Dept Emergency Med Washington DC 20010 USA NICHHD Bethesda MD 20892 USA Childrens Hosp Philadelphia Craig Dalsimer Div Adolescent Med Philadelphia PA 19104 USA

Study objective: Adolescent homicide rates are decreasing nationally for unclear reasons. We explore changes in intentional injury morbidity and mortality within the context of other injuries and specific causes. Methods: We performed surveillance of hospital, medical examiner, and vital records for nonfatal injury among adolescents age 10 to 19 years living in the District of Columbia from June 15, 1996, to June 15, 1998, and fatal injury from 1989 to 1998. Results: Over the 2-year study period, 15,190 adolescents were seen for injury, resulting in an event-based rate of 148 injuries per 1,000 adolescents per year;7% required hospitalization, and 0.8% died. Interpersonal intentional injuries accounted for 25% of all injuries, 45% of hospitalizations, and 85% of injury deaths. Assault morbidity decreased with no change noted for unintentional and self-inflicted injury. Firearm injuries, stabs, and assaults with other objects showed the largest decrease, with no decrease in unarmed assaults. Injury mortality peaked in 1993 and has declined since. Firearms caused 72% to 90% of all injury deaths from 1989 to 1998, most the result of homicide. Conclusion: There has been a decline in intentional injury rates over the study periods related to decreased weapon injury;data suggest a change in the lethality of fighting methods but no change in unarmed fighting behavior.

关键词：死亡原因哥伦比亚特区杀人/发展趋势回顾性研究市区人口/统计学和数值数据暴力/统计学和数值数据创伤和损伤/死亡率创伤枪击/死亡率青少年儿童女(雌)性人类男(雄)性

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A two-decades (1975 to 1995) long experience in the incidence, in-hospital and long-term case-fatality rates of acute myocardial infarction: A community-wide perspective

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第6期33卷 1533-1539页

作者： Goldberg, RJ Yarzebski, J Lessard, D Gore, JM Univ Massachusetts Sch Med Dept Med Div Cardiovasc Med Worcester MA 01655 USA

OBJECTIVES The purpose of the present study is to describe changes over two decades (1975 to 1995) in the incidence, in-hospital and long term case-fatality rates associated with acute myocardial infarction (AMI) from a multihospital community-wide perspective. BACKGROUND Despite the magnitude of, and mortality associated with acute myocardial infarction (AMI), relatively limited population-based data are available to describe recent and temporal trends;, the attack and case-fatality rates associated with AMI from a representative population-based perspective. METHODS The community-based study included 5,270 residents of the Worcester, Massachusetts, metropolitan area hospitalized with confirmed initial AMI in all metropolitan Worcester, Massachusetts, hospitals (1990 census population = 437,000) in 10 one-year periods between 1975 and 1995. RESULTS The age-adjusted incidence rates of initial AMI increased between 1975 (244 per 100,000) and 1981 (272 per 100,00) after which time these rates declined through 1995 (184 per 100,000) The crude and multivariable-adjusted in-hospital case-fatality rates exhibited a consistent decline between 1975/1978 (17.8%), 1986/1988 (17.0%) and 1993/1995 (11.7%). Although there were no statistically significant differences in the unadjusted long-term case-fatality rates of discharged hospital survivors over the periods under study, declines in the multivariable-adjusted risk of dying within the first year after hospital discharge were observed between the earliest and most recently discharged patients with AMI. CONCLUSIONS The results of this population-based study of patients with validated initial AMI provide encouragement for efforts directed at th, primary and secondary prevention of AMI given declining incidence and case-fatality rates. (C) 1999 by the American College of Cardiology.

关键词：横断面研究无病生存随访研究医院死亡率/发展趋势发病率马萨诸塞/人种学心肌梗死/死亡率存活率市区人口/统计学和数值数据成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Decreasing seasonal variation of births in schizophrenia

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PSYCHOLOGICAL MEDICINE 2000年第2期30卷 315-324页

作者： Suvisaari, JM Haukka, JK Tanskanen, AJ Lönnqvist, JK Natl Publ Hlth Inst Dept Mental Hlth & Alcohol Res FIN-00300 Helsinki Finland Natl Publ Hlth Inst Dept Nutr FIN-00300 Helsinki Finland

Background. Patients with schizophrenia have a winter-spring excess of births compared with the general population, the cause of which is unresolved. Fluctuations in the magnitude of the seasonal variation may provide clues to its aetiology. Methods. All Finnish patients with schizophrenia born between 1950 and 1969 (N = 15 892) were identified from two nationwide health-care registers. Their background demographic information was obtained from the Population Register Centre, which also provided monthly numbers of births in each municipality of Finland as multidimensional tables, with sex and year, month and place of birth as marginals. The incidence of schizophrenia was modelled using Poisson regression analysis, with sex, onset age, birth cohort, place of birth (urban/rural), trend and seasonal variation as explanatory variables. We also constructed a monthly time series and decomposed it into three components - seasonal, trend and remainder. Results. Seasonal variation of births among patients born in the 1950s, especially between 1955 and 1959, was marked, but decreased among patients born in the 1960s. No interaction between place of birth or sex and seasonal variation was observed. The incidence was higher among the rural-born than the urban-born, but declined more slowly among the urban-born than the rural-born. Conclusions. The intensity of the factor causing the seasonal variation of births in schizophrenia may be decreasing. Urban birth may be emerging as a risk factor for schizophrenia in Finland, as elsewhere.

关键词：横断面研究芬兰/流行病学发病率寿命表危险因素农村人口/统计学和数值数据精神分裂症/流行病学精神分裂症/病因学季节市区人口/统计学和数值数据成年人女(雌)性人类男(雄)性中年人

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ST-segment deviation during 24-hour ambulatory electrocardiographic monitoring and exercise stress test in healthy male subjects 51 to 75 years of age: The Copenhagen City Heart Study

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AMERICAN HEART JOURNAL 1999年第6期137卷 1070-1074页

作者： Vaage-Nilsen, M Rasmussen, V Sorum, C Jensen, G Univ Copenhagen Rigshosp Copenhagen City Heart Study DK-1168 Copenhagen Denmark Hvidovre Univ Hosp Dept Cardiol Copenhagen Denmark

Background Although ST-segment deviation has been evaluated and used during many years both on continuous electrocardiographic Holter monitoring and during exercise stress testing, considerable controversy still remains concerning the prevalence and diagnostic significance of fortuitously discovered ST-segment deviation in asymptomatic healthy persons. Methods and Results The occurrence of ST-segment deviation was studied in a population of 63 clinically healthy male subjects 51 to 75 years of age, with the use of 24-hour Hotter monitoring and exercise stress testing. The subjects were recruited from the Copenhagen City Heart Study and were without cardiovascular risk factors, chronic diseases, or medication and without cardiovascular events during 5 to 12 years before and 3 to 5 years after admission. The specificity, that is, the probability of displaying a negative test result in healthy subjects without disease, was 1.0 when using as criterion for significant ST-segment deviation a horizontal or descending ST-segment depression of >0.20 mV or ST-segment elevation greater than or equal to 0.15 mV during Holier monitoring, and acceptable, for example, 0.95, when using as criterion a horizontal or descending ST-segment depression of greater than or equal to 0.15 mV during Hotter monitoring or at the exercise test, respectively. Furthermore, the specificity was 0.95 when a horizontal or downsloping ST-segment depression of 0.1 mV was displayed in both the Holter and exercise electrocardiographic recording system. Conclusions Thus in asymptomatic persons, the usual criterion for significant ST-segment depression of 0.1 mV can be applied when occurring in both electrocardiographic recording systems. However, if one test alone is used, the criterion of significant ST-segment depression should be 0.15 mV. Absence of ST-segment deviation during Holter monitoring and exercise stress testing, indicated with a specificity of 1.0 or 0.95 according to choice of criterion, imp

关键词：运动试验/仪器和设备运动试验/方法运动试验/统计学和数值数据随访研究病人遴选前瞻性研究质量控制参考值可重复性结果敏感性与特异性统计学非参数市区人口/统计学和数值数据人类男(雄)性中年人

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Prevalence of urinary incontinence among institutionalized patients: A cross-sectional epidemiologic study in a midsized city in northern Italy

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UROLOGY 2000年第2期56卷 245-249页

作者： Aggazzotti, G Pesce, F Grassi, D Fantuzzi, G Righi, E De Vita, D Santacroce, S Artibani, W Univ Modena & Reggio Emilia Dept Urol I-41100 Modena Italy Univ Modena & Reggio Emilia Dept Biomed Sci Epidemiol Methodol & Hyg I-41100 Modena Italy

Objectives. To determine the prevalence of urinary incontinence among institutionalized elderly people. Methods. A cross-sectional study was conducted on 839 subjects, resident in 14 residential or nursing homes. A questionnaire was administered to the study population and their clinical records were reviewed. Results. The overall prevalence of urinary incontinence was 54.5%, higher in women (59.8%) than in men (39.2%). The prevalence increased significantly with age, from 26.5% in subjects 65 years old or younger to 73.7% in subjects 95 years old or older;with worsening of mental status, from 36.2% in well-oriented subjects to 76.7% in poorly oriented subjects;and with worsening of mobility, from 23.8% in self-sufficient subjects to 82.1% in bedridden patients. The prevalence was significantly associated with parity, from 54.1% in nulliparous women to 65.4% in multiparous women. Urinary incontinence was also associated with urinary tract infection, constipation, and fecal incontinence. Conclusions. The results of our Study are in accordance with other similar studies. That more than one half of the elderly residents of nursing and residential homes have urinary incontinence shows the relevance of this condition. We believe that urinary incontinence in institutionalized elderly people can be managed essentially by measures of tertiary prevention, aimed at reducing the handicapping conditions and at slowing down the process of self-sufficiency impairment. UROLOGY 56: 245-249, 2000. (C) 2000, Elsevier Science Inc.

关键词：年龄因素卡方分布横断面研究老人疗养院/统计学和数值数据收容入院意大利/流行病学患病率危险因素性别因素市区人口/统计学和数值数据尿失禁/流行病学成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Continuing low colon cancer incidence in African populations

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AMERICAN JOURNAL OF GASTROENTEROLOGY 2000年第4期95卷 859-860页

作者： Segal, I Edwards, CA Walker, ARP Chris Hani Baragwanath Hosp African Inst Digest Dis ZA-2013 Johannesburg South Africa Univ Glasgow Dept Nutr Glasgow Lanark Scotland S African Inst Med Res Johannesburg South Africa

In all big towns and cities in developing populations there are ongoing transitions in environmental factors—in dietary composition, physical activity, smoking practice, alcohol consumption, and stress. Contemporaneously, changes have occurred in the patterns of health/ill-health experienced. In South Africa, apart from major falls in the morbidity and mortality of young children, the urban African population has raced ahead of the white population in respect to the prevalence of obesity in women, hypertension, and diabetes (1). Yet, in remarkable contrast, minimal changes have occurred in the incidence of colonic diseases—diverticular disease, inflammatory bowel disease, and colorectal cancer. Furthermore, colorectal polyps, the precursor of most colorectal cancers, are nearly absent (2, 3). The age-standardized incidence rate per 100,000 population for colorectal cancer is 2.2; it is 18.7 for the local white population (4). Yet in African-Americans, the incidence rate of colon cancer alone, 32.8, is almost the highest in the world (5).

关键词：非洲大陆世系人群结肠肿瘤/人种学结肠肿瘤/病因学横断面研究发展中国家饮食习惯发病率危险因素南非/流行病学市区人口/统计学和数值数据成年人儿童女(雌)性人类男(雄)性

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