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Annual variation in birth rate of people who subsequently develop schizophrenia

BRITISH JOURNAL OF PSYCHIATRY 1999年第6期175卷 522-527页

作者： Adams, W Kendell, RE University of Edinburgh Medical School

Background Previous attempts to decide whether there is significant year-to-year variation in the birth rate of people who subsequently develop schizophrenia have given conflicting results, probably because of differences in the statistical methods employed. Aims To determine whether there is significant year-to-year variation in the birth rate. Method Variation in the birth rate for the period 1921 - 1960 was studied in three separate national data sets - English, Danish and Scottish - using cubic splines to smooth the distribution curve before calculating residuals from a Poisson distribution. Results Over-dispersion was found in all three data sets, particularly in the Danish and Scottish data. However, the correlation between the sets of standardised residuals derived from the three data sets was only statistically significant for Denmark v. England. Conclusions There was statistically significant year-to-year variation in the birth rate of people who subsequently developed schizophrenia in three countries in north-west Europe in the years 1921 - 1960. This is potentially a clue to the nature of the environmental determinants of schizophrenia, but better data will be needed before useful explanatory hypotheses can be generated and tested. Declaration of interest No external Funding;no conflict of interest.

关键词：出生率丹麦/流行病学英格兰/流行病学发病率精神分裂症/流行病学精神分裂症/病因学苏格兰/流行病学统计数据温度成年人老年人人类中年人

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People at risk of schizophrenia - Sample characteristics of the first 100 cases in the Edinburgh High-Risk Study.

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BRITISH JOURNAL OF PSYCHIATRY 1999年第6期174卷 547-553页

作者： Hodges, A Byrne, M Grant, E Johnstone, E Univ Edinburgh Dept Psychiat Edinburgh EH10 5HF Midlothian Scotland

Background The Edinburgh High-Risk Study is designed to explore the underlying pathogenesis of schizophrenia. Aims To establish the sample characteristics of the first 100 subjects in this study of young adults at risk of schizophrenia for genetic reasons, and to compare them with appropriate controls. Method Details of the recruitment of the first 100 high-risk subjects aged 16-25 years into a prospective Scotland-wide study are given. Subjects and 30 age and gender-matched normal controls were interviewed using the PSE, SADS-L and SIS and an unstructured psychiatric interview. Results Some significant differences emerged between the high-risk group and the control group, namely in previous psychiatric history (31 v. 6.3%), forensic contacts(19 v. 3.1%) and delinquent behaviour (20 v. 3.1 %). There were also differences in some parameters from the SIS: childhood social isolation, interpersonal sensitivity, social isolation, suicidal ideation, restricted affect, oddness and disordered speech. Conclusions These differences may represent increased risk of developing schizophrenia although their true significance will not be revealed until the cohort has been followed through the at-risk years.

关键词：酒精中毒/流行病学队列研究精神卫生服务/利用病人接受卫生保健的程度病人遴选前瞻性研究危险因素精神分裂症/流行病学精神分裂症/病因学苏格兰/流行病学成年人女(雌)性人类男(雄)性

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A test to detect replication in HIV serological data labelled by birth date based on the number of matching pairs in a sample

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STATISTICS IN MEDICINE 1999年第13期18卷 1641-1656页

作者： Greenhalgh, D Doyle, MT Univ Strathclyde Dept Stat & Modelling Sci Glasgow G1 1XH Lanark Scotland

Diagnoses of HIV infection are reported to the Public Health Laboratory Service (PHLS) by microbiologists through a voluntary confidential surveillance scheme. Names are not recorded on the database but the date of birth of the individual concerned is usually available. This paper discusses a statistical method to detect repeated counting of individuals in these and similar data based on the number of matching pairs in the sample. The test is based on the theoretical result that the null hypothesis of all birth dates equally likely and all individuals distinct minimizes the expected number of matching pairs in the sample. Five of the 16 birth years in the sample taken in 1991 show evidence of more replication than would be expected by chance using a 5 per cent level test. When the test is repeated taking into account a small but statistically significant seasonal variation in the birth rate, the results are very similar. Copyright (C) 1999 John Wiley & Sons, Ltd.

关键词：周年纪念日和特殊事件疾病报告/统计学和数值数据英格兰/流行病学表格和记录管理/统计学和数值数据 HIV感染/流行病学配对分析概率登记/统计学和数值数据苏格兰/流行病学季节威尔士/流行病学成年人人类中年人

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The effects of pravastatin on hospital admission in hypercholesterolemic middle-aged men - West of Scotland Coronary Prevention Study

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第4期33卷 909-915页

作者： Shepherd, J Cobbe, SM Lorimer, AR McKillop, JH Ford, I Packard, CJ Macfarlane, PW Isles, C Oliver, MF Lever, AF Brown, BW Ledingham, JGG Pocock, SJ Rifkind, BM Valiance, BD Ballantyne, D Norrie, J Anderson, L Duncan, D Kean, S Lawrence, A McGrath, J Montgomery, V Percy, M Pomphrey, E Whitehouse, A Cameron, P Parker, P Porteous, F Fletcher, L Kilday, C Sheat, D Latif, S Kennedy, J Bell, MA Birrell, R Mellies, M Meyer, J Campbell, W Univ Glasgow Royal Infirm Dept Med Cardiol Glasgow G31 2ER Lanark Scotland Univ Glasgow Royal Infirm Dept Med & Pathol Biochem Glasgow G31 2ER Lanark Scotland Univ Glasgow Royal Infirm Dept Stat Glasgow G31 2ER Lanark Scotland

OBJECTIVES The purpose of the study was to assess the effect of lipid reduction with pravastatin on hospital admissions in middle-aged men with hypercholesterolemia in the West of Scotland Coronary Prevention Study. BACKGROUND A prospective, randomized controlled trial was undertaken in primary care centers in the West of Scotland. METHODS A total of 6,595 participants randomized to receive pravastatin 40 mg or placebo daily were followed up for a mean of 4.9 years (range 3.5 to 6.1 years). Analysis of hospital admissions was undertaken according to the "intention to treat" principle both for cardiovascular diseases and noncardiovascular diseases (including malignant neoplasms, psychiatric diagnoses, trauma and other causes). A secondary analysis of hospitalization in patients who were greater than or equal to 75% compliant was performed. RESULTS During the trial, 2,198 (33%) of the 6,595 men were admitted to hospital on 4,333 occasions, of which 1,234 (28%) were for cardiovascular causes. Pravastatin reduced the number of subjects requiring hospital admission for cardiovascular causes by 21% (95% CI [confidence interval] 9 to 31, p = 0.0008) overall, and by 27% (95% CI 15 to 38) in compliant participants. The number of admissions per 1,000 subject-years for cardiovascular disease was reduced by 10.8 (95% CI 4 to 17.4, p = 0.0013) in all subjects, and by 15.6 (95% CI 8.3 to 23, p < 0.0001) in compliant participants. Pravastatin had no significant influence on hospital admission for any noncardiovascular diagnostic category. There were 13.4 fewer admissions per 1,000 subject years for all causes in the pravastatin-treated group (95% CI -0.4 to 27.3, p = 0.076). No significant difference in duration of hospital stay was found between the pravastatin and placebo patients in any diagnostic group. CONCLUSIONS Pravastatin therapy reduced the burden of hospital admissions for cardiovascular disease, without any adverse effect on noncardiovascular hospitalization. (J Am Col

关键词：抗胆固醇血症药/治疗应用冠心病/流行病学冠心病/预防和控制随访研究高胆固醇血症/药物疗法高胆固醇血症/流行病学脂类/血液病人入院/统计学和数值数据普伐他丁/治疗应用初级卫生保健前瞻性研究苏格兰/流行病学人类男(雄)性中年人

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Spatial competing risk models in disease mapping

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STATISTICS IN MEDICINE 2000年第17-18期19卷 2451-2467页

作者： Lawson, AB Williams, FLR Univ Aberdeen Dept Math Sci Aberdeen AB24 3UE Scotland Univ Dundee Dept Epidemiol & Publ Hlth Dundee DD1 4HN Scotland

Often it is required that the 'health status' of an area must be assessed and this involves the analysis of a range of different diseases within one study window. This often arises, for example, when disease cluster alarms are sounded and there is a need to provide a general overview of health in the vicinity of the cluster area. Our approach leads to the consideration of the joint spatial distribution of a 'basket' of diseases. We examine the use of weighting schemes within our general formulation, and extensions to count data and spatio-temporal modelling. Copyright (C) 2000 John Wiley & Sons, Ltd.

关键词：空气污染/副作用似然函数模型统计学死亡率/发展趋势危险因素苏格兰/流行病学小地区分析人类

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A study of methadone in fatalities in the Strathclyde region, 1991-1996

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MEDICINE SCIENCE AND THE LAW 1999年第3期39卷 233-242页

作者： Cooper, GAA Seymour, A Cassidy, MT Oliver, JS Univ Glasgow Dept Forens Med & Sci Glasgow G12 8QQ Lanark Scotland

There was a substantial increase in the percent of drug screens testing positive for methadone between 1991 and 1996 in the Strathclyde region of Scotland. Seventy-nine per cent (n=136) of these deaths were drug-related, involving methadone either alone or in combination with other drugs such as diazepam, temazepam, alcohol and morphine. The involvement of methadone in the majority of these fatalities was due to diversion of legitimate supply. This paper highlights the dangers of resuming methadone consumption following a period of abstinence or when taken in combination with other drugs.

关键词：死亡原因美沙酮/血液美沙酮/中毒阿片相关性障碍/死亡率回顾性研究苏格兰/流行病学物质相关性障碍/死亡率青少年成年人女(雌)性人类男(雄)性中年人

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Isolated finger injuries in children - incidence and aetiology

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INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 2000年第8期31卷 571-573页

作者： Doraiswamy, NV Baig, H Royal Hosp Sick Children Dept Accid & Emergency Med Glasgow G3 8SJ Lanark Scotland

Details were recorded prospectively in a specifically designed questionnaire for ail children presenting to the Accident and Emergency Department with isolated finger injuries over a period of 6 months, in order to understand the incidence and aetiology. Among the 426 injuries in 283 children, most occurred at home (59%) more in the < 5 year age group (38%), involving the middle finger (25%) and terminal phalanges (47%). "Jamming/crushing" was the commonest reason (48%), mostly caused by a child (59%) at the living room door (32%) and more commonly at the hinge side (49%). Nail injuries were seen in 48% of cases and 16 amputations of terminal phalanges were noticed in 15 children. Tendon injuries were only caused when cut by sharp objects, and were not caused by jamming/crushing. Both children and adults should be educated about causation, reiterating that damage to fingers can be prevented or reduced by observing safety measures. (C) 2000 Elsevier Science Ltd. All rights reserved.

关键词：事故家庭截肢创伤性/流行病学截肢创伤性/病因学指损伤/流行病学指损伤/病因学发病率指(趾)甲/损伤前瞻性研究苏格兰/流行病学儿童儿童学龄前人类

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The epidemiology of open long bone fractures

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INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 1998年第7期29卷 529-534页

作者： Court-Brown, CM Rimmer, S Prakash, U McQueen, MM Royal Infirm Edinburgh EH3 9YW Midlothian Scotland

Open long bone fractures occur with a frequency of 11.5 per 100 000 persons per year. They are more common in males and they have a bimodal age distribution. Open fractures of the tibial diaphysis are the commonest, but open femoral diaphyseal, distal femoral and proximal tibial fractures tend to occur in the most seriously injured patients. Lower limb open fractures are move severe than open fractures of the upper limbs. Not only is the soft tissue damage less in open upper limb fractures, but there are fewer associated musculoskeletal injuries. (C) 1998 Elsevier Science Ltd. All rights reserved.

关键词：事故交通/统计学和数值数据年龄分布四肢/损伤股骨骨折/流行病学前臂损伤/流行病学骨折开放性/流行病学肱骨骨折/流行病学苏格兰/流行病学胫骨骨折/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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Multivariate spatial models for event data

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STATISTICS IN MEDICINE 2000年第17-18期19卷 2469-2478页

作者： Leyland, AH Langford, IH Rasbash, J Goldstein, H Univ Glasgow MRC Social & Publ Hlth Sci Unit Glasgow G12 8RZ Lanark Scotland Univ E Anglia Ctr Social & Econ Res Global Environm Norwich NR4 7TJ Norfolk England Inst Educ Multilevel Models Project London England

This paper describes how estimates made for event rates in small areas may be enhanced through spatial modelling of the data - taking the geographical location of each area into account - and through the addition of further information from each area. In particular we consider the use of spatial models to predict more than one outcome simultaneously. This is done by writing the spatial model as a multi-level model and subsequently enhancing this to encompass a multivariate data structure;estimates are obtained using iterative generalized least squares in the software package MLwiN. The example given considers mortality due to two causes - neoplasms and circulatory disease - in 143 postcode sectors in Greater Glasgow Health Board, Scotland. In addition, a measure of socio-economic deprivation is available for each area. Correlations between causes within areas, between areas within causes and between areas and causes are quantified, as are the relative contributions of the heterogeneous and spatial parts of the model. The results suggest a tendency for there to be pockets with high mortality rates due to neoplasms, whilst mortality due to circulatory disease follows a much smoother pattern. After taking deprivation into account, the spatial component accounts for just 19 per cent of the variation in the mortality due to neoplasms in Greater Glasgow but 66 per cent of the mortality due to circulatory disease. Copyright (C) 2000 John Wiley & Sons, Ltd.

关键词：年龄因素算法模型统计学死亡率/发展趋势多元分析苏格兰/流行病学小地区分析社会经济因素女(雌)性人类男(雄)性

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Suicide in prisons - Reflection of the communities served, or exacerbated risk?

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BRITISH JOURNAL OF PSYCHIATRY 1999年第1期175卷 50-55页

作者： Gore, SM MRC Biostat Unit Cambridge CB2 2SR England

Background A recent review showed that opioid users' deaths from suicide were 10 times as common as expected on the basis of age and gender. Surveys showing prisoners' high prevalence of injecting or opioid dependence have led to a new statistical approach to prison suicides. Aims To estimate the expected number of UK prison suicides annually, having taken account of inmates' age, gender and opioid dependence. Method By gender, estimate the effective number of individuals (in terms of community-equivalent suicide risk) For whom prisons have a duty of care as 10 times the number of opioid-dependent inmates plus the number of non-opioid user inmates. Apply the gender and age-appropriate national suicide rates to work out the expected number of prison suicides. Results The Scottish Prison Service can expect 7.1 suicides per annum, and annual totals up to 12 without exacerbation of suicides due to incarceration. For the Prison Service in England and Wales, 19.3 suicides per annum can be expected in prisons. and annual totals may range up to 28 without indicating incarceration;the total of self-inflicted deaths was 47 in 1993-94. Conclusions Prisons cannot prevent all suicides. An alert may be warranted if prison suicides exceed 12 per annum in Scotland, or 28 in England and Wales. Liebling (1996) has criticised naive statistical approaches to prison suicide which do not adequately account for the vulnerability profile of prisoners, including previous psychiatric contact, major drink or drug problems and unstable employment history;see also Lewis & Sloggett (1998), and Platt et al (1988) on the striking relationship between parasuicide and social class. Recently, and importantly, Harris & Barraclough (1998) have reviewed the age and gender-adjusted excess mortality of mental disorder, with one section devoted to the high excess mortality, including from suicide, associated with opioid use. Opioid users' deaths from suicide were 10 times as numerous as expected on the bas

关键词：年龄分布阿片相关性障碍/流行病学患病率囚犯/统计学和数值数据危险因素苏格兰/流行病学性别分布自杀/预防和控制自杀/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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