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Background The aim of the present study was to investigate cancer risk among women working in the Norwegian pulp and paper industry. The cohort included a total of 4,247 workers employed for at least one year between 1920 and 1993 (108,095 person-years), 85% of them as paper or administration workers. Methods The follow-up period for cancer was from 1953–1993. No data of exposure measurements were available. The analyses were based on comparisons of standard incidence ratios. The expected numbers of cancer cases were calculated using the five-year age-specific incidence rates for the entire female population. Results During the follow-up period, 380 new cases of cancer were observed vs. 322 expected (SIR = 1.2, 95% CI = 1.07–1.30). An excess risk of ovarian cancer was found (SIR = 1.5, 95% CI = 1.07–2.09). The SIR was highest among those younger than 55 years, and mostly among those working in paper departments. Short-term workers showed increased risk of lung and bladder cancer. Conclusions Based on results from the present study, the increased risk of ovarian cancer is difficult to interpret, since existing knowledge of its etiology is limited. However, these women might have been exposed to various work-related agents such as talc, microbes, and different types of paper dust. Am. J. Ind. Med. 36:108–113, 1999. © 1999 Wiley-Liss, Inc.

Objectives:Dyspnoea is an unspecific severe presenting sign, which can be life threatening and requires prompt treatment. Dyspnoeic cats often have significant underlying disease. Underlying aetiologies in cats that presented with dyspnoea were reviewed, and associations with patient signalment and outcome were investigated. Methods:The case records of 90 dyspnoeic cats were retrospectively reviewed and separated into different groups depending on aetiology (cardiac, respiratory, neoplastic and trauma). Duration of clinical signs, presentation, hospitalisation length and survival were analysed. Results:Cardiac (38 per cent), respiratory (32 per cent) and neoplastic (20 per cent) diseases were common causes of feline dyspnoea. Cats with respiratory causes had longer duration of clinical signs (P

Arterial hypertension and proteinuria are risk factors for chronic kidney disease. A mobile clinic was parked in a central plaza of 11 Italian cities to check blood pressure (BP), prescribe antihypertensive drugs, assess for proteinuria, and provide awareness about hypertension. Among 3757 patients, 56% were hypertensive, 37% were not diabetic nor proteinuric with BP >or=140/90 mm Hg, 17% were diabetic or proteinuric with BP >or=130/80 mm Hg, and 11% were on treatment with BP at target. Among 1204 treated patients, 400 (33%) had controlled BP. Among all 2114 hypertensive patients, only 1344 (64%) were aware of their hypertension. Awareness was greater among treated patients at target (99%). As many as 523 (14%) patients had proteinuria >or=30 mg/dL. The authors conclude that awareness of people walking in the street about their BP and proteinuria is insufficient. Mobile screening clinics may increase public awareness and detection of hypertension and proteinuria in the general community and detect patients at risk for chronic kidney disease.

The age distribution of a population is a product of a century of demographic history. This paper describes how the history of births, deaths, and migrations has fashioned the US age distribution in 2018. It also shows how that history, combined with contemporary processes, was actively producing changes in the age distribution between 2013 and 2018. Changes in survivorship, migration, and births all contributed to population aging during this period, with a declining growth rate of births the leading contributor. Using a novel approach, the paper demonstrates how the inertia reflected in changing age distributions sheds light on the future population of the United States. Massive growth in the population above age 70 will occur by 2033 if recent age patterns of age‐specific mortality and migration are maintained.

The incidence of type 1 diabetes is increasing in Denmark as well as the rest of the world. Due to diabetes-related micro- and macrovascular complications, the morbidity and the mortality is higher among type 1 diabetic patients. The aim of this thesis was to examine a population-based cohort of 727 type 1 diabetic patients from Fyn County, Denmark, with an onset of diabetes before 1 July 1973 in order to: 1 Evaluate the all-cause mortality rates and the influence of sex, duration of diabetes and calendar year of diagnosis in a 33-year follow-up (Paper I). 2 Examine glycaemic regulation, lipids and renal dysfunction as risk factors for all-cause mortality, cardiovascular mortality and IHD (Paper II). 3 Estimate the prevalence of DR as well as the 25-year incidence of PDR and associated risk factors in long-time surviving patients (Paper III). 4 To compare the grading of DR between ETDRS seven standard field 30° stereoscopic colour films and nine field 45° monoscopic digital colour images in long-term surviving patients (Paper IV). In the years 1973–2006 an overall MR of 22.3 per 1000 person-years was found. Furthermore a relative mortality of 3.4 was found as compared to the general population in Denmark. The relative mortality was especially high for patients aged 30–39 (SMR 9.8). There was a tendency towards a better survival for patients diagnosed after 1964. This was especially seen for men. Diabetes was the most common cause of death for those who died in the group. In 1993–1996 blood samples were drawn and glycaemic regulation, lipids and renal markers were subsequently used as predictors of all-cause mortality, cardiovascular mortality and ischaemic heart disease. Glycaemic regulation, dyslipidaemia and creatinine were all significantly associated with all three endpoints. Furthermore, variations in glycaemic control were also identified as a risk factor for overall mortality. Two hundred and one patients were examined for diabetic retinopathy in 1981–1982 and 2007–2008. At follow-up, 97.0% had DR and 42.9% of all patients without PDR at baseline developed this during the follow-up period. Patients who had had a poor glycaemic regulation as well as those who had NPDR at baseline were more likely to develop PDR than the remaining patients. On the other hand, other risk factors such as high blood pressure and proteinuria did not predict PDR. In the comparative study between ETDRS seven standard field 30° stereoscopic colour films and nine field 45° monoscopic digital colour images, 43 eyes of 43 patients were examined in 2008. A poor correlation was found between the two methods: only 29.3% were graded alike. In the remaining, the level of DR was graded higher in the digital photos. Among these, PDR was detected in three eyes using digital photos but remained undetected on all films. This suggests that digital photos with wide fields are the best way to detect DR in long-term type 1 diabetic patients. Overall, it is concluded that mortality is still higher among type 1 diabetic patients. This depends, among other things, on glycaemic regulation, lipid status and, partly, renal dysfunction. Diabetic retinopathy is almost universal in long-term type 1 diabetic patients, and almost half of all patients will develop PDR in 25 years. Nine field digital photos provide the best grading of retinopathy in long-term type 1 diabetic patients.

Objectives/Hypothesis: Eosinophilic esophagitis is a rather new disease entity diagnosed with increasing frequency. The main symptoms in adults are dysphagia and food impaction. The aim of this review is to summarize the present knowledge about adult eosinophilic esophagitis, and in particular to cast light on certain issues of concern for the ear, nose, and throat (ENT) specialist. Study Design: Scientific review. Methods: The biomedical literature on adult eosinophilic esophagitis was reviewed regarding epidemiology, etiology, subjective symptoms and objective signs, diagnosis, treatment, and prognosis with an emphasis on matters of interest for the ENT specialist. PubMed was used as the search engine. Results: Among the 393 papers on eosinophilic esophagitis published in PubMed, only 162 deal with adults. During the last few decades, the annual number of papers has been exponentially increasing. A high prevalence of eosinophilic esophagitis in combination with a diagnostic delay suggests the existence of an unacceptable number of undiagnosed cases. This calls for increased attention. Endoscopic examination, including proper biopsies, verifies the diagnosis. Untreated, the disease will lead to substantial distress and in some cases even strictures. Keeping the diagnosis in mind will avoid improper treatment and the risk of accidental perforation. Conclusions: It is imperative that ENT specialists recognize patients with eosinophilic esophagitis. Laryngoscope, 2009

Aim To examine the scientific evidence regarding the association between characteristics of social networks of injection drug users (IDUs) and the sharing of drug injection equipment. Methods A search was performed on MEDLINE, EMBASE, BIOSIS, Current Contents, PsycINFO databases and other sources to identify published studies on social networks of IDUs. Papers were selected based on their examination of social network factors in relation to the sharing of syringes and drug preparation equipment (e.g. containers, filters, water). Additional relevant papers were found from the reference list of identified articles. Results Network correlates of drug equipment sharing are multi-factorial and include structural factors (network size, density, position, turnover), compositional factors (network member characteristics, role and quality of relationships with members) and behavioural factors (injecting norms, patterns of drug use, severity of drug addiction). Factors appear to be related differentially to equipment sharing. Conclusions Social network characteristics are associated with drug injection risk behaviours and should be considered alongside personal risk behaviours in prevention programmes. Recommendations for future research into the social networks of IDUs are proposed.

In many men from the PLCO screening trial authors from the USA identified risk factors for BPH. Their findings are interesting; Asian Americans were at the lowest risk of clinical BPH, with alcohol and possibly cigarettes related to a lower risk for the condition. Three further papers investigate various epidemiological aspects of LUTS. I think that it is important for we urologists to have a sound epidemiological knowledge of this subject, to answer the increasingly educated questions of our patients. A further paper from Barcelona describes the results of a urodynamic study in patients with bladder calculi. The authors found that bladder stones are not necessarily associated with BOO, and that the results of urodynamic testing are not influenced by their presence. OBJECTIVE To identify risk factors for benign prostatic hyperplasia (BPH). SUBJECTS AND METHODS Medical history data, including reported urological conditions and treatments, and risk factor data were collected from 34 694 participants in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, a randomized controlled trial designed to evaluate methods for the early detection of cancer. RESULTS Asian men had the lowest risks (odds ratio, 95% confidence interval) for nocturia (0.7, 0.5–0.9), physician-diagnosed BPH (0.3, 0.2–0.5) and transurethral prostatectomy (TURP, 0.2, 0.1–0.6), while risks for Whites and Blacks were similar for most measures of BPH. Greater alcohol intake was associated with decreased nocturia (P trend = 0.002), BPH (P trend < 0.001) and TURP (P trend

Summary We conducted a sero-epidemiological study of kala-azar in two endemic communities (Kasaini and Gidhaniya) situated in the Terai (plain) of eastern Nepal. Direct agglutination test (DAT) was used as a serological test for screening. Capillary blood samples were collected by filter paper method from 601 (96%) people of a total population of 628 in Kasaini and from 482 (94%) people of 515 in Gidhaniya. Positive DAT titres (1:2000) were found in 66 (6.09%) of 1083 sera tested. The male‐female seroprevalence ratio was 1.44:1 and the age group of 15 years and above was most affected. Among the bone marrow aspirates collected from 66 DAT seropositive cases, only 19 were positive for Leishmania donovani (LD bodies). Of the 47 DAT seropositive but LD bodies’ negative cases, three were clinically active cases of kala-azar. Another nine developed clinical symptoms of kala-azar during 6 months follow-up and 23 were cases that had received prior treatment for kala-azar (within 1 year). The results of this study show the potential of the DAT on filter paper as a screening test for the surveillance of kala-azar at a community level.

In this section there are papers describing studies into nocturnal polyuria, the overactive bladder in Asian men and the use of extracorporeal magnetic stimulation for female urinary incontinence. There are also papers which evaluate the cost implications of microwave thermotherapy, the accumulation of proteoglycans in prostatic hyperplasia, and the presentation and management of urethral calculi. The last two papers in this section have nothing directly to do with the lower urinary tract. Indeed, they do not fit into any of the groups of papers in the journal but I felt that they were of general interest to the readership of the BJU International, and so felt they could really be put into any section! OBJECTIVE To determine the age prevalence of nocturnal polyuria among older women in the community, and to investigate the relationship between nocturnal polyuria and nocturia. PATIENTS AND METHODS In all, 1183 women aged ≥ 50 years, who were registered with a family doctor practice and who had taken part in a prevalence study, were sent brief questionnaires and a frequency/volume chart (FVC) to complete. RESULTS There were 227 FVCs with adequate data and 264 completed questionnaires available for analysis. The prevalence of nocturnal polyuria increased disproportionately with age. There was no clear relationship between nocturia or nocturnal polyuria and daytime frequency, nor was there a clear relationship between diuretic use and nocturnal polyuria. CONCLUSION Nocturnal polyuria is common among women in the community and not obviously related to daytime frequency. Night-time symptoms are common in women as well as men, and are troublesome to them.

This paper presents the results of a prospective study of maternal morbidity during the ante-partum period in rural areas of Bangladesh. The data came from a survey of Maternal Morbidity in Bangladesh, conducted by the Bangladesh Institute of Research for Promotion of Essential and Reproductive Health and Technologies (BIRPERHT) during the period from November 1992 to December 1993. Since then no such national level survey has been conducted in Bangladesh. This paper employs multiple-decrement life table technique, a convenient way of analysing the risks of different types of disease conditions that women experience during the antenatal period for different age categories. The high-risk complications such as ante-partum haemorrhage, excessive vomiting, fits/convulsion and oedema were considered in this study. In this study a cause specific model was applied to explore the differences in the risks exerted at different ages of reproductive life attributable to some selected complications of pregnancy. The results of this study indicate that women of age 25–29 years are less susceptible to most of the selected life-threatening and high-risk complications during pregnancy such as haemorrhage, fits/convulsion and oedema. However, younger women (age

This paper focuses on the relationship between social engagement, particularly civic engagement, and education. It is well known that more highly educated people are more likely to engage in voluntary work in formalized settings. It has been difficult to disentangle the effect of higher education from that of family origin and occupational socialization. This paper examines the effects of tertiary education on the social and civic engagement of young people, using the British Household Panel Study. The social and civic activity of young people is observed in their late teens, before entering the labour market or tertiary education, and compared with that of the same young people in their early 20s, after completing tertiary education courses or gaining labour market experience. It was found that the social and civic engagement of young people who would enter higher education was higher in their late teens than that of their peers who did not enter. However, higher education had a small additional effect on civic engagement, for both young and mature students. The children of professionals were the social grouping most likely to be involved in civic activities. The relationship of higher education, professional occupations and family socialization is discussed.

In 1992 in this Journal (Konigsberg and Frankenberg [1992] Am. J. Phys. Anthropol. 89:235–256), we wrote about the use of maximum likelihood methods for the “estimation of age structure in anthropological demography.” More specifically, we presented a particular method (the “iterated age-length key”) from the fisheries literature and suggested that the method could be used in human and primate demography and paleodemography as well. In our paper (section titled “Some Future Directions”), we spelled out two broad areas that we expected to see develop over the ensuing years. First, we felt that the use of explicit likelihood methods would open up interest in basic estimation issues, such as the calculation of standard errors for demographic estimates and the formulation of tests for whether samples differed in their demographic structure. Second, we felt that the time was ripe for hazards analyses that would incorporate the uncertainty in estimation that follows from using age “indicators” rather than known ages. While some of these developments have occurred during the last decade, few have been reported in the American Journal of Physical Anthropology. In this paper we resolve some issues from our 1992 paper, and attempt to redress this deficit in the literature by reviewing some recent developments in paleodemography over the past decade. Am J Phys Anthropol 117:297–309, 2002. © 2002 Wiley-Liss, Inc.

This paper provides up‐to‐date data on service use for mental health problems and disorders among adults aged 18‐79 years in Germany derived from the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1‐MH; N=4483). Data are based exclusively on self‐report. Respondents were examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview DIA‐X/M‐CIDI to assess diagnoses according to the criteria of DSM‐IV‐TR. Service use, i.e. contact to mental health care services, due to mental health problems was assessed for the past 12 months and lifetime, by type of sector and type of institution. Among respondents with a 12‐month diagnosis of a mental disorder, 23.5% of the women and 11.6% of the men reported any service use in the past 12 months. Service use depends on type of diagnosis, comorbidity and socio‐demographic characteristics. Lowest 12‐month utilization rates were found for substance use disorders (15.6%; lifetime use 37.3%), highest for psychotic disorders (40.5%; lifetime 72.1%). Further, a considerable time lap was found between disorder onset and subsequent service use among the majority of cases with anxiety and mood disorders. This paper provides self‐reported epidemiological data on mental health service use in Germany, complementing administrative statistics and the predecessor mental health module of the German Health Interview and Examination Survey (GHS‐MHS) from 1998. Despite considerable changes in the mental health field in Germany and the existence of a comprehensive mental health care system without major financial barriers, we find no indications of substantially higher utilization rates for mental disorders as compared to other comparable European countries. Further, no indications of major overall changes in utilization rates are apparent. To pinpoint areas with unmet needs, more detailed analyses of the data are needed taking into account type, frequency, and adequacy of service use and treatment of mental disorders. Appropriately matched comparisons with the GHS‐MHS are needed to identify changes in patterns of utilization and interventions by type of disorder. Copyright © 2014 John Wiley & Sons, Ltd.

The paper compares three different methods for performing disease incidence prediction based on simple interpolation techniques. The first method assumes that the age-period specific numbers of observed cases follow a Poisson distribution and the other two methods assume a normal distribution for the incidence rates. The main emphasis of the paper is on assessing the reliability of the three methods. For this purpose, ex post predictions produced by each method are checked for different cancer sites using data from the Cancer Control Region of Turku in Finland. In addition, the behaviour of the estimators of predicted expected values and prediction intervals, crucial for investigation of the reliability of prediction, are assessed using a simulation study. The prediction method making use of the Poisson assumption appeared to be the most reliable of the three approaches. The simulation study found that the estimator of the length of the prediction interval produced by this method has the smallest coverage error and is the most precise.

One in five nurses on the United Kingdom (UK) professional register is aged 50 years or older. Over the next few years, the profession will lose, through retirement, many of its most experienced practitioners. The significance for policy makers and for employers of this age-shift is two-fold. Firstly it is clear that greater numbers of nurses and midwives are reaching, or soon will reach, potential retirement age. Secondly many more nurses are now reaching their middle years and they are likely to have different requirements and attitudes to nursing work. This paper examines the employment policy and practice of the ageing of the UK nursing population. The paper examines data from official sources, and information from attitudinal surveys and case studies with employing organizations to assess the major effects of the ageing of the nursing workforce. Key findings are that the age profile of those nurses working in the National Health Service appears to be 'younger' than that of the total population, with the age profile of nurses working in nursing homes and as practice nurses being older than that of the NHS nursing workforce. However, the overall age profile of NHS nurses masks considerable variation between specialties and trusts, and the 'pool' of potential nurse returners from which the NHS and other employers attempts to recruit, is declining in numbers, as it too ages. Other major issues requiring policy attention are the provision of appropriate flexible hours to older nurses who have caring responsibilities, improving access to continuing professional development, and reducing pension provision inflexibility.

Numerous studies have highlighted significant correlations between major psychiatric disorders and criminal behavior. However, the plethora of literature on criminality among patients with major psychiatric disorders originated in the West. The objective of the present paper is to review criminal behavior among individuals with mental illness in Arab countries. Attributes of individuals assessed by forensic psychiatric committees and identifying various aspects that may reinforce criminality among individuals with mental illness were considered. Following the PRISMA guidelines, a systematic review of literature from three databases (Scopus, PubMed, and Web of Science) was carried out. A total of 20 articles were included. The publications span between 1975 and 2020 and originated in seven different Arab countries including Egypt, Kuwait, Iraq, Saudi Arabia, Tunisia, Jordan, and Algeria. Individuals evaluated by forensic psychiatric committees were predominantly males. Excluding substance use disorder, psychotic disorders were the most commonly diagnosed disorders among individuals evaluated by forensic psychiatry committees. Concerning schizophrenia, concomitant substance use and nonadherence to therapy were significantly associated with increased criminality. The review demonstrates that substance use is certainly linked to violence. There is a significant association between mental illness and criminal behavior. Therefore, awareness of different characteristics and risk factors behind criminal behavior among mentally ill offenders could allow us to design and implement effective preventative measures. The Arab's contribution in this field of forensic psychiatry is relatively small. Indeed, further investigation and contributions from the Arab world are required.

I. INTRODUCTION In the late 1970s and early 1980s, Charles Hulten and Frank Wykoff [1979; 1981a; 1981b] undertook a major effort to estimate economic depreciation for the U.S. capital stock. Their pioneering work, which analyzed prices for many used assets, became the primary reference for estimates of economic depreciation. However, since then research on depreciation has been limited, despite the need to examine the robustness of Hulten and Wykoff's results and to cover assets omitted from their studies. In addition, little work has been done to estimate retirement distributions, which also play an important role in the construction of capital stocks. This paper provides new evidence on the depreciation and retirement patterns of machine tools, a grouping that includes many types of equipment that cut or form metal. The data were collected from a survey of dealers belonging to the Machinery Dealers National Association. These dealers provided information on the prices of used machine tools from their own sales records. They also estimated certain facets of the retirement distribution for machine tools, including the average service life, the direction of change in the average life since the mid-1970s, and the ages by which 25 percent and 75 percent of an investment cohort are retired. Machine tools can be divided into two broad groups. The first consists of the conventional machines that require manual control from an operator. Although the design and safety of these conventional machines has improved over the years, the pace of technical progress has been slow. The second group consists of numerically controlled machines, which are more highly automated than their conventional counterparts.(1) American manufacturers began to install numerically controlled machines in large numbers during the 1970s, and these machines have continued to replace conventional if machines on the factory floor. However, at the time of my survey, conventional machines still represented the bulk of machine tools operating in the United States, and the estimates of depreciation and retirement in this paper refer strictly to conventional machines. The paper is organized as follows. Section II traces the adoption of numerically controlled machines by U.S. industry and then models how this phenomenon would have affected the depreciation and retirement patterns of conventional machine tools. Section III briefly describes the data set. Section IV analyzes the information on retirement patterns provided by the dealers, while section V presents the estimates of economic depreciation. Section VI summarizes my findings and suggests avenues for further research. II. ADOPTION OF NUMERICALLY CONTROLLED MACHINES: EVIDENCE AND IMPLICATIONS At roughly five-year intervals since the 1920s, American Machinist magazine has conducted an in-depth inventory of the stock of machine tools used by American manufacturers. For a detailed breakdown of machine types, the inventory provides information on the number of machines in use and the age distribution of this stock. Table I uses the American Machinist surveys to characterize the adoption of numerically controlled machines in the United States since the mid-1970s. As shown on the first line, the share of numerically controlled machines in the total machine-tool stock rose from 1.8 percent in 1976-78 to 9.2 percent in 1989. This five-fold increase in the share of numerically controlled machines in the existing stock implies a considerably higher share of these machines in new investment. Indeed, as shown in the right-hand columns of the table, numerically controlled machines represented 17.1 percent and 25.2 percent of all machine tools acquired during 1979-83 and 1985-89, respectively.2 Thus, numerically controlled machines have become a significant part of total U.S. investment in machine tools. Table I also shows that the adoption of numerically controlled machines has varied widely across machine categories. …

The occurrence of Mitsuokella dentalis in periodontitis was determined by culture and DNA probe detection. Subgingival paper-point samples from 480 periodontitis patients were transported in VMGA III, plated onto brucella agar with 5% sheep blood and incubated anaerobically for 7 days. Presumptive identification was based on a colony morphology resembling a water drop and biochemical characteristics. DNA probe detection was performed on paper-point samples using a digoxigenin-labeled cellular M. dentalis DNA probe in a dot-blot assay. Culture and DNA probe identified M. dentalis in 18.1% and in 80.7% of the study patients, respectively. M. dentalis isolates produced phosphatases, galactosidase, glucosidase and acetylglucosaminidase and showed high in vitro sensitivity to metronidazole. This study revealed that M. dentalis is a constituent of the pathogenic microbiota in human periodontitis. The periodontopathic potential of the organism is unknown.

BACKGROUND Among American Indians/Alaskan Natives (AI/ANs), suicides are disproportionately high among those younger than 40 years of age. This paper examines suicide and alcohol intoxication (postmortem BAC ≥ 0.08 g/dl) by age among Whites and AI/ANs to better understand the reasons for the high rate of suicide among AI/ANs for those younger than 40. METHODS Data come from the restricted 2003 to 2016 National Violent Death Reporting System (NVDRS), with postmortem information on 79,150 White and AI/AN suicide decedents of both genders who had a BAC test in 32 states of the United States. RESULTS Among Whites, 39.3% of decedents legally intoxicated are younger than 40 years of age, while among AI/ANs the proportion is 72.9% (p

This paper studies the determinants of output volatility in a panel of 22 OECD countries. In contrast to the existing literature, we avoid ad hoc estimates of volatility based on rolling windows, and we account for possible non‐stationarity. Specifically, output volatility is modelled within an unobserved components model where the volatility series is the outcome of both macroeconomic determinants and a latent integrated process. A Bayesian model selection approach tests for the presence of the non‐stationary component. The results point to demographics and government size as important determinants of macroeconomic (in)stability. A larger share of prime‐age workers is associated with lower output volatility, while higher public expenditure increases volatility.

State-specific statutes providing legal consequences for perpetrating domestic violence in the presence of a child have been enacted across the United States between 1996 and 2012. This paper examines the impact of this child welfare legislation, using a difference-in-differences approach. We find a significant drop in domestic violence-related homicide rates, when considering a wide range of victim-offender relationships. However, this result does not hold for marital homicides, suggesting that for this subpopulation, the risk of reprisal and consequent reduction in reporting may be counterbalancing the hypothesized deterrent impacts of the legislation.

Objective: To examine national ladder‐related fall injury patterns and trends, and compare the changes over time in occupational and non‐occupational falls across age groups. Methods: Analysis of national hospital morbidity data to examine trends over time and differences between groups. Results: There were 41,092 hospitalised falls from ladders in Australia over the ten year period from July 2002 to June 2012, rising from 3,374 hospitalisations in 2002/03 to 4,945 hospitalisations in 2011/12. The age standardised rate of ladder‐related fall hospitalisations rose significantly for males, and a higher increase was evident in people aged over 60 years. Occupational falls accounted for 20% of hospitalisations, and the hospitalisation rate for both occupational and non‐occupational falls increased significantly over the ten year period. Conclusions: With almost 5,000 hospital admissions per year in recent years and a significant rise in the rate of hospitalisations over the past decade, this paper highlights the importance of focusing injury prevention efforts to reduce the growing number of ladder‐related falls. Implications: This study demonstrates the significant burden that ladder‐related falls are continuing to have on the community, both in the occupational and domestic setting.

Background & Aims In 2015, a national Egyptian health issue survey was conducted to describe the prevalence of hepatitis C virus (HCV) infection. In this paper, we describe the HCV burden in 2015, compare the results with the national survey conducted in 2008, and discuss the implications of the new findings on prevention of HCV in Egypt. Methods A multistage probability sampling approach was used, similar to the national demographic survey conducted in 2008. More than 90% of sampled individuals complied with the interview and provided blood samples. Results In the 15–59-year age groups, the prevalence of HCV antibody was found to be 10.0% (95% CI 9.5–10.5) and that of HCV RNA to be 7.0% (95% CI 6.6–7.4). In children, 1–14 years old, the prevalence of HCV antibody and HCV RNA were 0.4% (95% CI 0.3–0.5) and 0.2% (95% CI 0.1–0.3) respectively. Approximately, 3.7 million persons have chronic HCV infection in the age group 15–59 in 2015. An estimated 29% reduction in HCV RNA prevalence has been seen since 2008, which is largely attributable to the ageing of the group infected 40–50 years ago during the mass schistosomiasis treatment campaigns. Prevention efforts may have also contributed to this decline, with an estimated 75% (95% CI 6–45) decrease in HCV incidence in the 0–19 year age groups over the past 20 years. Conclusions These findings can be used to shape future HCV prevention policies in Egypt.

Using survey data from 280 farmers in Jianghan Plain, China, this paper establishes an evaluation index system for three dimensions of farmers' flood perceptions and then uses the entropy method to estimate their overall flood perception. Farmers' flood perceptions exhibit the following characteristics: (i) their flood-occurrence, flood-prevention, and overall flood perceptions gradually increase with age, whereas their flood-effects perception gradually decreases; (ii) their flood-occurrence and flood-effects perceptions gradually increase with a higher level of education, whereas their flood-prevention perception gradually decreases and their overall flood perception shows nonlinear change; (iii) flood-occurrence, flood-effects, and overall flood perceptions are higher among farmers who serve in public offices than among those who do not do so; (iv) the flood-occurrence, flood-effects, and overall flood perceptions of farmers who work off-farm are higher than those of farmers who work solely on-farm, contrary to the flood-prevention perception; and (v) the flood-effects and flood-prevention perceptions of male farmers are lower than those of female farmers, but the flood-occurrence and overall flood perceptions of male farmers are higher than those of female farmers.

Introduction This paper reports the key findings of the Faculty of Radiation Oncology 2014 workforce census and compares the results with earlier surveys. Methods The census was conducted in mid-2014 with distribution to all radiation oncologists, educational affiliates and trainees listed on the college database. There were six email reminders and responses were anonymous. The overall response rate was 76.1%. Results The age range of fellows was 32–96 (mean = 49 years, median = 47 years). The majority of the radiation oncologists were male (n = 263, 63%). The minority of radiation oncologists were of Asian descent (n = 43, 13.4%). Radiation oncologists graduated from medical school on average 23 years ago (median = 22 years). A minority of fellows (n = 66, 20%) held another postgraduate qualification. Most radiation oncologists worked, on average, at two practices (median = 2, range 1–7). Practising radiation oncologists worked predominantly in the public sector (n = 131, 49%), but many worked in both the public and private sectors (n = 94, 37%), and a minority worked in the private sector only (n = 38, 14%). The largest proportion of the workforce was from New South Wales accounting for 29% of radiation oncologists. Radiation oncologists worked an average of 43 h/week (median = 43 h, range 6–80). Radiation oncologists who worked in the private sector worked less hours than their public sector or public/private sector colleagues. (38.3 vs. 42.9 vs. 44.3 h, P = 0.042). Victorians worked the fewest average hours per week at 38 h and West Australians the most at 46 h/week. Radiation oncologists averaged 48 min for each new case, 17 min per follow up and 11 min for a treatment review. Radiation oncologists averaged 246 new patients per year (median = 250, range = 20–600) with men (average = 268), Western Australians (average = 354) and those in private practice seeing more (average = 275). Most radiation oncologists considered themselves as specialists (n = 151, 60%), but nearly all those from South Australia were generalists (n = 15, 94%) as were three-quarters of those from private practice. A minority of radiation oncologist respondents (10%) intended to retire within 5 years with a further 16% within 10 years.There was a stabilisation of trainee numbers in Australia and New Zealand with no increase compared with 2010 (142 in 2014 vs. 143 in 2010). The most common age bracket for trainees remained 31–35 years. One-third of trainees were of Asian descent and nearly half held other degrees. The majority of trainees were satisfied with their career, but 30% were not entirely satisfied. Nearly half of trainee respondents would have reconsidered their choice of specialty had they known about the possible oversupply in the workforce with 12.4% undecided about continuing their career in radiation oncology. There were still 16% of trainees with no protected time during the working week, and a further 21% with only 1 h. Only one trainee respondent preferred to work in private practice, and job availability remained a concern for 89% of respondents. Conclusions The radiation oncologist workforce numbers have increased at a much slower rate, and unemployment remained low. Many parameters remained similar to the 2010 survey. However, there has been a decrease in the average number of new patients seen per year, working hours and also a slight decrease in the time spent per new patient. The trainee numbers have stabilised, but job availability remained a concern. A significant proportion of trainees were not satisfied with their career.

Two aspects of the relationship between family unit income and the age of the head of the family unit are examined in this exploratory paper. First, in connection with the recent discussion in the U.S. about the “fair” level of income of the aged population, the economic well-being of various age of head groups is examined for the U.S., Canada, Norway, and Israel. Problems inherent in comparing income distributions across countries are described briefly, and the sensitivity of the estimates to definitional differences is discussed. Relative incomes of the different age groups are then compared within and between countries. Relative mean incomes, relative median incomes, relative mean incomes adjusted for size of unit in alternative ways, distributions of age groups among income quintiles, and relative income shares within age groups are compared. The focus is on aged units. It is found that, using these crude measures, aged units in the U.S. are roughly as well off relative to the other age groups as aged groups in the other countries examined. In the second section of the paper, a U.S. microdata file is reweighted to be consistent with the distributions by age of head of Norway and Canada. Relative income shares of quintiles are computed before and after reweighting and compared with the shares for Norway and Canada. The reweighting to Norway's age distribution increased differences in relative income shares between the two countries; the reweighting to Canada's age distribution slightly decreased differences.

The previous paper in this series argued that whole plant development is best viewed as a population-type process in which attention is focused on the production of modular plant parts. This approach is of more relevance to quantifying whole plants architecture than conventional growth analysis. The present paper describes an experiment in which the growth of two cultivars of Fuchsia was followed as a developing system of meristems. The noted features of growth and development were the changes in numbers of meristems as the plants produced flowers, the age distribution of vegetative meristems and the probabilities of transition between different modular states as the plant developed.

In confronting problems of employment and unemployment, students of the labour market, and economists in general have focused mainly on the determination of the level of such variables. Much less attention has been paid to such questions as: how many persons have entered the area of employment and the labour force in various time periods, and how many have exited; their sex and age distribution; and the determinants of the level and structure of flows amongst the various labour market conditions. Yet it appears superfluous to underscore the relevance of such questions. To illustrate, suffice it to recall that in Italy, the present level of employment is essentially the same today as it was in 1961‘; but this has not prevented whole generations of young people from 'stably’entering the employment area, albeit with varying degrees of difficulty in different periods. As for the numerous statistical surveys of labour market flows in a range of countries, and as for the works of job search theorists2, it should be observed that such surveys and analyses essentially concern conjunctural phenomena. Consequently, these authors have paid no attention to the distinction between short-run turnover and generational turnover, or to the extremely singular characteristics of the statistical data on flows. An attempt to construct labour market models that present an integrated version of the 'structural’aspects of the market in terms of stock and flows is therefore lacking. The present study sets forth various objectives and is divided into two parts. In the first, an analysis of several controversial terminological aspects of the concepts of stock and flow is presented, and an attempt is made to point out those theoretical structures which have been responsible for the long-prevailing neglect of the labour market flows, particularly long-run flows. Then the problem of defining the concepts of short-run and generational turnover will be confronted in light of an analysis of the statistical methods used in the surveys; finally, a methodology for measuring generational flows is proposed. In the second part of the paper a model based on generational flows, as previously defined, will be presented together with a computational procedure capable to produce long run estimates of alternative scenarios of labour demand and supply and of the structure of employment by sex and age. A brief summary of some of the empirical results obtained applying our model and forecasting procedure to the Italian labour market will also be discussed in the final part of the paper.

Aim Smoking is known to have a deleterious effect onCrohn’s disease (CD). The present study addressed thespecific impact of smoking on the outcome of surgeryfor CD.Method A review of the National Surgical QualityImprovement Program (NSQIP) database (2005–2012)identified 7631 patients with CD who underwent surgi-cal resection. Patients were stratified based on smokingstatus and were compared with univariate statisticaltests. Generalized linear regression and multiple logisticregressions were used to model the impact of smokingon the surgical outcome [length of stay (LOS), mortal-ity, postoperative complications and readmission]. Toconfirm the validity of the regression models and toevaluate the influence of smoking in comparable patientcohorts, a propensity score match was also performed.Results There were 2047 (26.8%) patients with CDidentified as current smokers, and 5584 (74.2%) identi-fied as non- or ex-smokers. Smokers were more likely tohave a pulmonary comorbidity, preoperative weight lossand a higher American Society of Anesthesiologists clas-sification. No differences in mortality were observedbetween smokers and non- or ex-smokers in univariateanalysis. In multivariate analysis, smoking status was notsignificantly associated with LOS. Morbidity (OR 1.20,P = 0.003), particularly infectious (OR 1.30,P < 0.001) and pulmonary (OR 1.87, P < 0.001) com-plications, and readmission (OR 1.58, P = 0.004) weresignificantly associated with smoking status. These find-ings were validated on propensity-score matching analy-sis.Conclusion In patients with CD, the detrimental effectsof smoking on surgical outcomes are driven by infec-tious and pulmonary complications, and by an increasedlikelihood of readmission.Keywords Inflammatory bowel disease, tobacco,NSQIP, readmissions, complications, propensity-scoreWhat does this paper add to the literature?Tobacco use is associated with deleterious effects on theactivity and severity of Crohn’s disease. This study pro-vides a more focused estimate of the attributable impactof smoking on adverse postoperative results, demon-strating that they are driven by infectious and pulmo-nary complications.

Chronic rhinosinusitis (CRS) is characterized by inflammation of the mucosa of the nose and paranasal sinuses with a duration of at least 12 consecutive weeks and is a common otorhinolaryngologic disease that is frequently encountered in everyday practice (1). Although CRS is not a life-threatening disease, not all patients are cured or achieve control of their symptoms, even with maximal medical management or surgical intervention. The symptoms in CRS patients with (CRSwNP) and without nasal polyps (CRSsNP) are considerably overlapping, while patients with CRSwNP have higher symptom scores and more nasal symptoms (2). Patients with CRSwNP are particularly recalcitrant to usual therapies, and this type of CRS is increasingly prevalent (3). The persistent symptoms can result in facial pain/headache, impairments in general health, vitality and social functioning, stress disorders and other problems that affect patients’ lives and work (4–7). The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) group proposed clear guidelines for a symptom-based definition of rhinosinusitis that has been validated and accepted in epidemiological studies (1,8,9). The European postal survey of 57 128 adults in 12 countries reported that the overall prevalence of EP3OS-defined CRS was 10.9% and ranged from 6.9% to 27.1% in 19 centres (10). A recent survey reported a prevalence of EP3OS-defined CRS of 5.51% in Sao Paulo, Brazil (11). Some authors have used the data from the National Population Health Survey to estimate the prevalence of CRS and found prevalences of 6.95% in Korea (12) and 5.7% among female and 3.4% among male Canadians (13). The 2012 National Health Interview Survey of 34 525 adults found that 12% of adults have been told by a doctor or other health professional that they have sinusitis, and these self-reported doctor-diagnosed prevalences of sinusitis were 15% and 9% among males and females, respectively. The vital health statistic data revealed that CRS is more prevalent than other common chronic respiratory diseases, such as chronic obstructive pulmonary disease (3%) and asthma (8%) (14). Based on this high prevalence, some studies in the USA have claimed that CRS poses an enormous health and economic burden to individuals, the community and society (15). When accounting for the entire population into account, the health burden of CRS is speculated to be huge in Asia; nevertheless, little is known about the actual situation. A survey of 4554 Danes reported a CRS prevalence of 7.8% compared to the overall prevalence of 10.9% in 19 European centres (10,16). The National Health Interview Survey of US adults revealed a decreasing trend in CRS from 16% in 1997 to 14% in 2006 and 12% in 2012 (14,17,18). The literature suggests that the prevalence and patterns of CRS might vary by region and population and change over time due to environmental changes and the development of health care. The previous epidemiological data regarding CRS are mainly from western studies, and little is known regarding the potential socio-economic disparities. In Asia, large-scale epidemiological studies are required to update information about the prevalence of CRS, and such studies would provide information for the assessment of the disease burden and the development and promotion of public health policies associated with CRS. We conducted a cross-sectional investigation in seven major Chinese cities. This study aimed to provide a better understanding of the epidemiological characteristics of CRS, including its prevalence and associations with socio-economic factors and tobacco smoke.

This paper reports on a 6-year study (April 2006 to April 2012) and a follow-up of a 9-month baseline survey of the pattern of dermatoses in Calabar, the capital of Cross River State in southern Nigeria. Prior to the time of this study, this region had not benefited from the services of a resident dermatologist for over a century.Data on the age, gender, and diagnoses of 1307 consecutive new patients attending the relatively new dermatology clinic at the University of Calabar Teaching Hospital during the study period were obtained and analyzed. Most diagnoses were based on clinical findings but were supported by relevant laboratory investigations and histopathologic examinations when necessary.The male : female ratio of patients was 1 : 1.5. The mean ± standard deviation age of the patients was 27.7 ± 17.2 years (range: 4 weeks to 84 years). A total of 1459 diagnoses were recorded; 143 patients had more than one dermatosis. Diagnoses were broadly divided into 10 groups. Allergic/hypersensitivity diseases represented the most common group (30.4%), followed by infections/infestations (28.9%). A comparison of this study with others from various geopolitical zones of Nigeria revealed some similarities. Dermatophytosis and acne were consistent reasons for visits to dermatologists in all zones.Despite the wide spectrum of dermatoses observed, a small number of diseases account for a sizeable percentage of diagnoses. The pattern of dermatoses in Calabar is similar to that in other parts of the country. Climate and socioeconomic factors are synergistic in causing dermatoses that remain a major cause of morbidity in all age groups and both genders across Nigeria.

Existing analyses of trends in disability free life expectancy (DFLE) are mainly at aggregate level (national or broad regional). However, major differences in DFLE, and trends in these expectancies, exist between different neighbourhoods within regions, so supporting a small area perspective. However, this raises issues regarding the stability of conventional life table estimation methods at small area scales. This paper advocates a Bayesian borrowing strength technique to model trends in mortality and disability differences across 625 small areas in London, using illness data from the 2001 and 2011 population Censuses, and deaths data for two periods centred on the Census years. From this analysis, estimates of total life expectancy and DFLE are obtained. The spatio-temporal modelling perspective allows assessment of whether significant compression or expansion of morbidity has occurred in each small area. Appropriate models involve random effects that recognise correlation and interaction effects over relevant dimensions of the observed deaths and illness data (areas, ages), as well as major spatial trends (e.g. gradients in health and mortality according to area deprivation category). Whilst borrowing strength is a primary consideration (and demonstrated by raised precision for estimated life expectancies), so also is model parsimony. Therefore, pure borrowing strength models are compared with models allowing selection of random age-area interaction effects using a spike-slab prior, and in fact borrowing strength combined with random effects selection provides better fit.

The literature is clear that Hispanic immigrants have lower prevalence rates of substance use disorders and other alcohol- and drug-related problems than their U.S.-born counterparts (Grant, Stinson, Hasin, Dawson, Chou, & Anderson, 2004; Maldonado-Molina, Reingle, Jennings, & Prado, 2011). Because Hispanics are a highly heterogeneous group, there are likely to be substantial differences in the prevalence rates in risk behavior between different nationalities of Hispanic adults. For instance, the literature is clear that Mexican Americans and Puerto Ricans have the highest alcohol-related mortality rates among all Hispanic national groups (Caetano, Vaeth, Rodriguez, 2012; Chartier, Vaeth, & Caetano, 2014). Despite the indisputable evidence in support of the “Immigrant Paradox”, in which immigrants have better health outcomes than U.S.-born Hispanics, there is evidence that the corresponding health outcomes of the Hispanic population may depend on the age at which individuals migrate to the U.S (Alegria, 2007; Vega et al., 2004). Several studies have assessed the impact of age of immigration on health outcomes, including psychiatric disorders and illicit drug use. Alegria et al. (2007) found that adults who immigrated to the United States before age 6 had much higher rates of depressive and anxiety disorders. Rates of substance use disorders in general were also higher among those who immigrated earlier (age 6 or younger) compared to those who immigrated at age 7 or older. Using a sample of Mexican Americans, Vega and colleagues (2004) found qualitative differences in immigrants who migrated at age 13 or younger in mood, anxiety and substance use disorders. Other studies have substantiated this link between immigration age and mental health disorders and alcohol use disorders (Alderete, Vega, Kolody, & Aguilar-Gaxiola, 2000). Further, increased duration of residence in the U.S. has been associated with cigarette, alcohol and illicit drug use among Cuban and Nicaraguan youth (Gfroerer & Tan, 2003). In fact, a study by Cheung et al. (2011) found evidence of a “sensitive period” of acculturation in which those who immigrate as a child become more acculturated than adult immigrants, even when living in the U.S. for the same period of time. Therefore, age of immigration seems to have an effect on risk behavior. The proposed mechanism for the relationship between these poor alcohol- and drug-related outcomes among early immigrants is rapid acquisition of normative drinking and drug using behavior that is often modeled by peers native to the United States. This immigration-assimilation effect has been operationalized by generation and viewed as a linear process, where successive generations experience increasingly negative health outcomes (Maldonado-Molina, Reingle, Jennings, & Prado, 2011). However, in light of the developmental research on immigration, culture, and mental health and substance use outcomes, it is likely that Hispanics who immigrated at a very young age are more amenable to the new culture than those who immigrated during their teenage years or later. Immigration to the US at a young age will increase the time in which a person is exposed to the US culture, potentially in a manner similar to those who are born in the US (Alergria, 2007). The exposure to US culture, assimilation, and adoption of American cultural values, has been consistently identified as having poor effects on several dimensions of health (Maldonado-Molina et al., 2011; Alegria et al., 2007; Caetano et al., 2012). Specifically, Caetano and colleagues (2012) suggested that these alcohol-related problems observed among Mexican Americans may be the result of assimilation and acculturation stress, which in turn, leads to increased levels of alcohol consumption. Given the theoretical potential for early immigrants to have cultural exposure levels similar to those who were US born, the purpose of this paper is to systematically determine the age of immigration that puts adults who immigrated at a young age at risk for alcohol- and drug use problems in adulthood. To answer this research question, we used two samples of Mexican Americans residing in two distinct contexts: the U.S.-Mexico border, and cities not proximal to the border. In light of the previous research, we hypothesize that adults who immigrated to the United States prior to adolescence have a qualitatively distinct experience in the U.S. compared to adults who immigrate during late adolescence or adulthood. Developmentally, youth are most vulnerable to social pressures during early adolescence, and the combined stresses of adolescence and acculturation may compound the risk of problematic alcohol and drug use. We expect to observe differences between early immigrants and late immigrants in binge drinking, lifetime alcohol status, number of standard drinks consumed each week, DSM-V Alcohol Use Disorder, and illicit drug use. We also hypothesize that those who immigrate before adolescence have alcohol and drug use behavior that mirrors Mexican American adults who were born in the U.S.-born. Finally, we expect to find differences in alcohol (current drinking status, binge drinking, and number of standard drinks per week) and drug use outcomes by age of immigration, across both the U.S.-Mexico border and non-border contexts. We expect that the age of immigration effect may be greater for alcohol and drug use on the border, as earlier immigration implies longer exposure to the border’s known risk factors for alcohol use and risky behavior (Caetano et al., 2012, 2013; Mills et al., 2012; in press; Office of National Drug Control Policy, 1999). This study is unique in that the population includes a sample of both Mexican Americans living proximal and distal to the U.S.-Mexico border. The U.S.-Mexico border is a unique location, characterized by a high concentration of Mexican Americans, poverty, low education, drug trafficking and related violence (Lusk, Staudt, & Moya, 2012). Alcohol is easily accessible across the border, as the legal drinking age in Mexico is 18; and unlike the U.S., the drinking age is not strictly enforced in Mexico (U.S. Department of State, 2013). Therefore, we are able to compare Mexican Americans living at the border with Mexican Americans living distal to the border, and whether the age of immigration remains a risk factor for alcohol and drug use in both locales.

I. INTRODUCTION We exploit temporal and geographic demographic variation to estimate the relationship between a population's age distribution and carbon dioxide (C[O.sub.2]) emissions in a panel of 46 countries from 1990 to 2006. To reduce potential omitted variable bias, we instrument for the age distribution with lagged birth rates and control for total population and total gross domestic product (GDP). A higher share of prime working-age (35-49) individuals within a country leads to higher C[O.sub.2] emissions, while younger and older populations have lower C[O.sub.2] emissions according to our results. Emissions of C[O.sub.2] account for about half of the radiative forcing from anthropogenic sources that are considered the primary contributors to global warming. The Intergovernmental Panel on Climate Change (2007) predicts increases in average surface temperatures in the range of 1.1 -6.4[degrees]C (2-11,5[degrees]F) by the end of the century. Climate change has created the threat of substantial environmental damage, with the possibility of catastrophic consequences for many throughout the world. As a result, both academics and policy-makers are interested in C[O.sub.2] emissions. The literature aimed at explaining C[O.sub.2] emissions usually focuses on the size and affluence of the population. This approach can be traced back to the seminal work by Ehrlich and Holdren (1971), the biologist and physicist who argued that population size has a disproportionate impact on the environment. The impact is generally assumed to depend upon technology, leading to the well-known IPAT identity (or Kaya identity for C[O.sub.2] emissions), I = P x A x T, where I is environmental impact, P is population size, A is affluence (GDP per capita), and T is a technology index. More recent literature has focused on models of the technology index and how the index changes over time (e.g., due to improvements in abatement technology). The widely cited Intergovernmental Panel on Climate Change studies use several variations of the IPAT model to produce regional emissions forecasts, which are then aggregated to the global level. Structural studies by economists (e.g., Nordhaus 2009) have also attempted to forecast global C[O.sub.2] emissions using estimates of GDP from production functions and world population size. Although these studies have frequently used geographic density of the population as well as its size as explanatory variables, and have allowed for nonlinearity in size, most have ignored the age distribution within the population. (1) A few papers have begun to address this potential oversight by explicitly including the age distribution in studies of C[O.sub.2] emissions. Dalton et al. (2008) build a structural overlapping generations model to forecast U.S. C[O.sub.2] emissions. (2) In their model simulations, population aging has a big effect on future emissions. Our empirical findings support Dalton et al. (2008), but our approach is most closely related to Cole and Neumayer (2004). (3) Cole and Neumayer (2004) also use a cross-country panel to estimate the effect of demographic change on C[O.sub.2] emissions in an IPAT type regression model. While Cole and Neumayer (2004) include age group shares as controls, the groups (younger than 15, 15-64, and 65+) are too wide to capture the effect we posit, and they do not instrument for the age distribution as we do. Cole and Neumayer (2004) mainly focus on changes in total population, whereas we are interested in the age distribution effect for a given population size. Our ordinary least square (OLS) estimates indicate that a country's level of C[O.sub.2] emissions depends on its age distribution. In addition to population size, the regressions include total GDP and a full set of time and country dummies as controls. We use the fraction of the population aged 35-49, or working share, as the main explanatory variable. Changes in the working share across time, not common to all countries, and independent of GDP and total population provide the variation used to estimate the age distribution's effect. …

Aim : Cancer burden measured in disability adjusted life years (DALYs) captures survival and disability impacts of incident cancers. In this paper, we estimate the prospective burden of disease arising from 27 cancer sites diagnosed in 2006, by sex and ethnicity; and determine how its distribution differs from that for incidence rates alone. Methods : Using a prospective approach, Markov and cancer disease models were used to estimate DALYs with inputs of population counts, incidence and excess mortality rates, disability weights, and background mortality. DALYs were discounted at 3.5% per year. Results : The age standardised Māori:non‐Māori incidence rate ratios were 1.00 for males and 1.19 for females, whereas for DALYs they were greater at 1.42 for males and 1.68 for females. The total burden of cancer for 2006 incident cases (i.e. not age standardised) was estimated to be approximately 127,000 DALYs. Breast (27%), lung (14%) and colorectal (13%) cancers for females and lung (16%), colorectal (14%), and prostate (16%) cancers for males were the top contributors. By ethnicity, Māori experienced a substantially higher burden from lung cancer (around 25% for both sexes). Conclusions: Due to Māori both having higher rates of cancers with a worse survival (e.g. lung cancer), and tending to have worse survival for each cancer site, ethnic disparities in the age‐standardised DALY burden were greater than those for incidence (rate ratios of 1.52 and 1.07 respectively, sexes pooled).

Please cite this paper as: Adhin et al. (2012) Trends of Influenza infection in Suriname. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12037. The trends of influenza infection in Suriname were assessed from February 2010 through February 2011. Testing of 393 patients with symptoms of acute respiratory infection (ARI) revealed 15·3% Influenza B and 18·6% could be identified as influenza A positive, consisting of 56% influenza A(H1N1)pdm09 and 44% seasonal A(H3N2). Influenza infection occurred throughout the year, and all three influenza types affected young children as the primary population. The annual incidence of A(H1N1)pdm09 was 6·88 per 100 000 inhabitants [CI] 4·87–9·45. The spread of influenza could neither be linked to tourist flow from the Netherlands nor to contact rates related to school schedules.

Early treatment for primary undescended testis (UDT) is necessary to prevent testicular degeneration and improve fertility. The general recommended age for orchidopexy is before 2 years of age. Comparing the age distribution of orchidopexy between different services may give an indirect indication of the quality of the child health services, since timely diagnosis and referral will lead to boys undergoing orchidopexy at the optimal age. This paper reviews the age distribution of boys having orchidopexies for UDT between 1997 and 2006 in the South Island of New Zealand and the state of Victoria, Australia: 64.2% of boys on the South Island and 48.0% of boys in Victoria had orchidopexies before the age of 5. There was a considerable difference in the proportions of children from 0 to 4 years and from 10 to 14 years between the two regions. No distinct trend in age was seen in either population during the period reviewed. These results show that many boys do not receive treatment for UDT at the optimal age. Age at orchidopexy may be an indicator of the quality (in terms of diagnosis, access and timeliness) of a region's paediatric surgical service and may identify where attention should be paid if earlier diagnosis and referral is to be achieved.

Please cite this paper as: Jhung et al. (2011) Preliminary results of 2009 pandemic influenza surveillance in the United States using the Aggregate Hospitalization and Death Reporting Activity. Influenza and Other Respiratory Viruses 5(5), 321–327. Background To augment established influenza surveillance systems in the United States, the Centers for Disease Control and Prevention and the Council of State and Territorial Epidemiologists implemented the Aggregate Hospitalization and Death Reporting Activity (AHDRA) in August 2009. The AHDRA was designed to meet increased demands for timely and detailed information describing illness severity during the 2009 H1N1 influenza A (pH1N1) pandemic response. Objectives We describe the implementation of AHDRA and provide preliminary results from this new surveillance activity. Methods All 50 US states were asked to report influenza-associated hospitalizations and deaths to AHDRA each week using either a laboratory-confirmed or syndromic surveillance definition. Aggregate counts were used to calculate age-specific weekly and cumulative rates per 100 000, and laboratory-confirmed reports were used to estimate the age distribution of pH1N1 influenza-associated hospitalizations and deaths. Results From August 30, 2009, through April 6, 2010, AHDRA identified 41 689 laboratory-confirmed influenza-associated hospitalizations and 2096 laboratory-confirmed influenza-associated deaths. Aggregate Hospitalization and Death Reporting Activity rates peaked earlier than hospitalization and death rates seen in previous influenza seasons with other surveillance systems, and the age distribution of cases revealed a tendency for hospitalizations and deaths to occur in persons

Estimating disease burden in the older population can be problematic, due to a dearth of measurements that take into account population dynamics, small population sizes, and age-related disease distribution issues. Age itself explains a substantial amount of the variability in population disease rates. However, in many common techniques to account for age, such as age standardization and age categorization, age is treated as a nuisance parameter. In this paper, we present a method, the slope-intercept method for population log-linear estimation (SIMPLE), to assess disease burden in the Medicare population of the US. We demonstrate the utility and potential limitations of this straightforward and crude method in assessing age-related morbidity, mortality, and case-fatality on multiple geographic levels. We highlight several examples of when this measure is most applicable using examples abstracted from a comprehensive administrative database of hospitalizations in older adults. Traditional measurements of disease burden are compared with the measurements extracted from this modeling method for comparison purposes. We also present spatial and temporal associations between the two measurements the SIMPLE method produces.

This paper described the epidemiology and controlling experiences of influenza H1N1 in Hangzhou in the past 1 year. A total of 2,078 cases confirmed by real-time quantitative PCR till March 31, 2010, were analyzed by SPSS 12.0 software. During the early pandemic stage, a patient must be tested for H1N1 nucleic acid once he/she had influenza-like symptoms with the epidemiological history in 7 days, and be diagnosed if it was positive. But in the pandemic peak, we made efforts to identify and save severe cases combined with pneumonia or hypoxemia or respiratory failure or septic shock or multiple organ dysfunctions and failure. In general, the prevalence was 2.77/100,000 (2,078/7,510,844); severity rate, 10.44% (217/2,078); fatality rate, 0.48% (10/2,078). The carrier and secondary attack rate were 9.52% (58/612) and 8.66% (53/612), respectively. About 50% of serious cases and 100% of deaths had the basic underlying diseases: cardiovascular diseases, 13.66% (25/217); chronic lung disease, 12.02% (22/217); pregnant, 7.1% (13/217). Of all cases aged from 1 month to 89 years, 52.99% (1,435/2,708) were in the 10-29 years, with most of them distributed in downtown area. The timeline showed two epidemic peaks occurred in September and November 2009, respectively. Furthermore, the hemagglutinin gene remained 99% identical with the American and vaccine strains, but only 70% with the 1947-2008 Chinese strains. In conclusion, Hangzhou pandemic influenza H1N1 was caused by the highly conserved virus, with low prevalence, transmission, and mortality, because we took efficient controlling methods.

This paper analyzes the direct and indirect impacts of Brazil's Family Health Program, using municipality level mortality data from the Brazilian Ministry of Health, and individual level data from the Brazilian household survey. We estimate the effects of the program on mortality and on household behavior related to child labor and schooling, employment of adults, and fertility. We find consistent effects of the program on reductions in mortality throughout the age distribution, but mainly at earlier ages. Municipalities in the poorest regions of the country benefit particularly from the program. For these regions, implementation of the program is also robustly associated with increased labor supply of adults, reduced fertility, and increased school enrollment. Evidence suggests that the Family Health Program is a highly cost-effective tool for improving health in poor areas.

Objective This paper examined the 12-month rate of mental disorders and subsequent service use among Canadian seniors aged 65–79 and 80 and over and adults aged 20–49 and 50–64. Methods This is a secondary analysis of data [n = 33 695] of the population-based Canadian Community Health survey, Cycle 1.2 (CCHS 1.2). Major Depressive Episodes (MDEs), specific Anxiety Disorders (AD) and Alcohol Abuse/Dependence rates were assessed. Results The 12-month rates for the two senior groups aged 65–79 and 80+ for MDEs, ADs, and Substance Dependence (SD) are 1.7% and 1.6%; 1.4% and 0.8%; and 0.1% and 0.0%, respectively. Seniors aged 65–79 and 80+ had significantly lower rates than adults aged 20–49 and 50–64 for all mental disorders and SD. Among the total sample, seniors aged 65–79 and 80+ had significantly lower utilization rates than adults aged 20–49 and 50–64 for all three provider categories (GP only, GP and Other Health Professional, Any Other Health Professional but GP). Females aged 65–79 and 80+ were less likely to have reported service use for mental health reasons as opposed to those females aged 20–49 and 50–64. Males aged 65–79 and 80+ were more likely to have reported having used mental health services in the past 12 months as opposed to males aged 20–49 and 50–64. Conclusions The presence of common mental disorders is lower in seniors as compared to younger adults. Age and gender influence mental health service utilization rates. Copyright © 2010 John Wiley & Sons, Ltd.

Context: The Indian subcontinent is one of the most populous regions in the world. Given the projected rapid population growth and ageing of the population, age-related macular degeneration (AMD) is likely to emerge as a major public health threat in the near future. However, existing literature on AMD in the region is scarce. Methods: This paper reviews the epidemiology and risk factors of AMD in the Indian subcontinent. Results: Data on AMD in India show prevalences ranging from 1.8% to 4.7%. Blindness prevalence studies in Pakistan, Bangladesh and Nepal have also reported rates of 2.1% to 8.7% for all blindness attributable to AMD. Age-related macular degeneration is therefore a significant cause of visual morbidity in these countries. To date, no reliable epidemiological data on AMD or blindness have been published for Sri Lanka, Afghanistan, Maldives or Bhutan. Conclusions: The prevalence of AMD in the region is likely to follow a trend similar to that seen in the developed world in the coming years. Eye care policies should therefore make provisions for this chronic age-related eye disease. In addition, there is an urgent need for more data on the epidemiology of AMD in the Indian subcontinent.

This paper analyses the recent evolution of life expectancy in Latin American and Caribbean countries, and evaluates how much it has contributed to the overall improvements in welfare. We argue that increases in life expectancy between 1960 and 2000, which were largely independent of income, represented gains in welfare comparable to the ones derived from income growth. For countries in the region, estimates of welfare improvements accounting for health increase the numbers obtained from income alone by 40% on average. The available evidence suggests that improvements in public health infrastructure - such as provision of treated water and sewerage services - and large-scale immunization programs may have been the key factors behind the mortality reductions observed in the period.

Despite seclusion being described as one of the most ethically- and legally-controversial management options available, it remains a widely-used clinical strategy for managing disruptive, aggressive, and violent behaviour. This study sought to determine how frequently seclusion was used, the common characteristics of those secluded and not secluded, and the degree to which the Level of Service Inventory - Revised: Screening Version (LSI-R: SV) could predict seclusion. The study was retrospective, covering the first 2 years of operation of a statewide forensic psychiatry hospital in Victoria, Australia. Data were collected from individual case files, electronic databases, and paper copies of records pertaining to violent incidents and episodes of seclusion. Eighty five (44%) of the 193 patients admitted during this period were secluded. Those secluded were significantly younger and had a more established psychiatric history. LSI-R: SV scores were significantly and positively associated with being secluded. A statistical model containing three LSI-R: SV items, along with age on admission and psychiatric history, achieved an area under the curve of 0.74. Seclusion is used on a regular basis in response to a range of different forms of aggressive behaviour of different severity. The LSI-R: SV demonstrated moderate-to-good accuracy in predicting seclusion and warrants further research using detailed prospective methodologies.

The increasing prevalence of specific language impairment (SLI) is a matter of current debate.Speech and language therapists and other authorities in Finland have discussed the prevalence of SLI since the 1990s. This discussion has been based on international studies because of the lack of national studies. This paper presents the first Finnish prevalence study of SLI in primary healthcare and, thus, participates in the international discussion on the prevalence of SLI. Furthermore, two samples of delayed language development (DLD) were studied.This is a retrospective study from 1989-1999. It was conducted on the population of one of the biggest towns in Finland, and was collected from the statistical records of speech and language therapists.The prevalence of SLI increased, and this increase was statistically significant. The prevalence of SLI was less than 1% in age group 0-6 years and, thus, presents a much lower prevalence than international discussion has suggested. SLI seems to be present particularly in boys though it was also increasing in girls. Furthermore, children with SLI seem to be more affected by receptive difficulties over the period studied. Particularly important is the observation that the prevalence of DLD was also increasing, and together with SLI they suggest a prevalence rate of 2.5% in Finland.The low prevalence of SLI in this study might be a consequence of the path of intervention that effectively separates SLI from delayed language development. Furthermore, the questions of language specific features needs to be emphasized. The findings of this study suggest that the prevalence of SLI increased as did the prevalence of DLD. The range of prevalence estimates of SLI in different studies raises the need for national and international epidemiological studies of SLI with equal criteria of assessment in each language.