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PubMed2006

Causes of inequality in life expectancy between Indigenous and non-Indigenous people in the Northern Territory, 1981-2000: a decomposition analysis.

OBJECTIVE: To identify the causes of the gap in life expectancy between Indigenous and non-Indigenous populations of the Northern Territory and how the causes have evolved over time. DESIGN AND SETTING: Analysis of NT death data over four 5-year periods, 1 January 1981 to 31 December 2000 inclusive. A decomposition method using discrete approximations (Vaupel and Romo) was applied to abridged life tables for the Indigenous and non-Indigenous populations of the NT. MAIN OUTCOME MEASURES: Contribution of causes of death, grouped according to global burden of disease groups and categories, to the life expectancy gap. RESULTS: The gap between the life expectancy of Indigenous and non-Indigenous people in the NT did not appear to narrow over time, but there was a marked shift in the causes of the gap. In terms of disease groups, the contribution of communicable diseases, maternal, perinatal and nutritional conditions halved during the 20 years to 2000. Meanwhile, the contribution of non-communicable diseases and conditions increased markedly. The contribution of injuries remained static. In terms of disease categories, the contribution of infectious diseases, respiratory infections and respiratory diseases declined considerably; however, these gains were offset by significantly larger increases in the contribution of cardiovascular diseases and diabetes for Indigenous women and cardiovascular diseases, cancers and digestive diseases for Indigenous men. CONCLUSIONS: The main contributors to the gap in life expectancy between the Indigenous and non-Indigenous populations were non-communicable diseases and conditions, which are more prevalent in ageing populations. With the life expectancy of Indigenous people in the NT expected to improve, it is important that public health initiatives remain focused on preventing and managing chronic diseases.

Cause of Death↗

PubMedDate not supplied

[Molecular and epidemiological characterization of HIV-infection in the Altai Territory].

The genetic analysis of the variants of HIV, type 1, circulating in the Altai Territory was made. The results obtained with the use of the serological analysis and the method of the comparative evaluation of the electrophoretic mobility of heteroduplexes demonstrated that almost all analyzed samples (98.3%) belonged to subtype A. Genetic differences between these viruses did not exceed 9.20%. Moreover, 86.8% of them contained mutation V771 in the protease-coding area. Thus, HIV of subtype A, characteristic of CIS countries and containing mutation V771, may be regarded as the dominating viruses in the Altai Territory and not the viruses of subtypes B, C or A/E, typical of comparatively less remote China.

HIV Infections↗

PubMed2004

Burden of disease and injury in Aboriginal and non-Aboriginal populations in the Northern Territory.

OBJECTIVE: To quantify the burden of disease and injury for the Aboriginal and non-Aboriginal populations in the Northern Territory. DESIGN AND SETTING: Analysis of Northern Territory data for 1 January 1994 to 30 December 1998 from multiple sources. MAIN OUTCOME MEASURES: Disability-adjusted life-years (DALYs), by age, sex, cause and Aboriginality. RESULTS: Cardiovascular disease was the leading contributor (14.9%) to the total burden of disease and injury in the NT, followed by mental disorders (14.5%) and malignant neoplasms (11.2%). There was also a substantial contribution from unintentional injury (10.4%) and intentional injury (4.9%). Overall, the NT Aboriginal population had a rate of burden of disease 2.5 times higher than the non-Aboriginal population; in the 35-54-year age group their DALY rate was 4.1 times higher. The leading causes of disease burden were cardiovascular disease for both Aboriginal men (19.1%) and women (15.7%) and mental disorders for both non-Aboriginal men (16.7%) and women (22.3%). CONCLUSIONS: A comprehensive assessment of fatal and non-fatal conditions is important in describing differentials in health status of the NT population. Our study provides comparative data to identify health priorities and facilitate a more equitable distribution of health funding.

Adolescent↗

PubMed1997

Improved CT diagnosis of acute middle cerebral artery territory infarcts with density-difference analysis.

A new postprocessing method is described for CT detection of acute middle cerebral artery (MCA) territory infarcts by histograph analysis of density values. The density values in each CT slice were histographically recorded for each hemisphere. A density-difference diagram was calculated by digital subtraction of the histogram of the left hemisphere from that of the right. Pixels within the highest density-difference ranges were highlighted. To investigate the value of this method CT studies of 30 patients with acute MCA territory infarcts and of 15 normal CT studies were analysed by two radiologists and neurosurgeons. CT images with and without postprocessing were assessed for the presence, site and size of infarcts. Follow-up CTwas used as control. With density-difference analysis (DDA) the detection rate for infarcts increased significantly (96 % compared to 61 %). In no case was a correct diagnosis made on the unpostprocessed images falsely revised with DDA. All normal CT studies were detected correctly using DDA.

Adolescent↗

PubMed1999

[Diagnosis of coronary disease: thallium-201 dipyridamole tomoscintigraphy of the myocardium].

OBJECTIVES: Determine the diagnostic performance of thallium-201 myocardial scintigraphy using dipyridamole injection for the detection of coronary heart disease (myocardial ischemia and/or necrosis). Determine for each coronary artery the degree of angiographic stenosis for optimal diagnostic performance. PATIENTS AND METHODS: The study included 309 patients who underwent coronarography within 6 months of the scintigraphy examination. None of the patients experienced a coronary event during this interval. Diagnostic performance of the scintigraphic exploration was compared with angiographic findings (stenosis 70%) used as the gold standard. The degree of angiographic stenosis for optimal scintigraphic performance was determined from the receiver operating characteristic (ROC) curves. RESULTS: The sensitivity of scintigraphy to detect angiographically demonstrated coronary disease was 84% with a specificity of 72%. The positive and negative predictive values were 87% and 66% respectively. Test accuracy was 80%. Sensitivity was better for detecting lesions of the anterior interventricular coronary than for the right coronary or circumflex. In addition, sensitivity varied with the number of vessels involved: 76% for single-vessel disease versus 90% for two- or three-vessel disease. The data analysis also suggested that an angiographic stenosis threshold of 50% provided optimal predictive value for scintigraphy for each of the three vessel territories. An analysis based on maximal stenosis in each patient, notwithstanding the congruency between lesion localization and diseased vessel territories, was found to provide less diagnostic precision. CONCLUSION: Thallium-201 dipyridamole myocardial scintigraphy offers diagnostic performance comparable to that established with thallium-201 scintigraphy performed after exercise alone. Scintigraphic detection of a perfusion defect generally corresponds to an angiographic stenosis of 50%.

Coronary Disease↗

PubMedDate not supplied

Environmental accounting for the lagoon of Venice and the case of fishing.

This paper presents the application of the eMergy evaluation, introduced by H.T. Odum as an efficient methodology of environmental accounting. The results of this analysis are a part of a wider sustainability assessment for the Province of Venice realized in 2003. Within a territorial sustainability analysis, it is necessary to implement an environmental accounting method, which is able: to precisely consider the boundaries of the investigated system (spatial scale); to arbitrarily separate the life of the investigated system into periods (temporal scale); to account for both economic and natural support to a given territorial system in order to implement a sustainable management of resources; to assess all the items supporting the system on the basis of a physical unit that is objective (while the traditional economic evaluation method is based on individual preferences, hence it is subjective). The Province of Venice is a very complex system due, on one hand, to the heavy and consolidated presence of industrial activity since the beginning of the 20th century and, on the other hand, to the principal natural ecosystem which characterizes it: the lagoon, the largest wetland in the Mediterranean Sea. The role of the lagoon, as a provider of resources and services is represented by the analysis of two aspects: the lagoon as an ecosystem on the basis of the evaluation of all flows that cyclically support its biotic activity and the lagoon as a productive system on the basis of the contribution of both natural and "economic" inputs that support human activity. In particular, the case of clam fishing will be presented to put on evidence the importance of natural inputs that are systematically neglected by the traditional accounting methodologies.

Animals↗

PubMed1999

Social integration and mortality in Australia.

OBJECTIVE: To investigate the relationship between social integration and mortality at the aggregate level of analysis. METHOD: The data were compiled from several Australian Bureau of Statistics documents. The unit of analysis was State (Territory)-year. The multivariate regression analysis included data from all States and the Australian Capital Territory for 1990-96. Five indicators of social integration--percentage of people living alone; divorce rate; unemployment rate; proportion of people who are discouraged job seekers; and unionization rate--were used as predictors of nine measures of mortality. RESULTS: Higher levels of social integration, as measured by all indicators except unionization, were associated with lower mortality rates. In the case of unionization, higher levels were associated with increased mortality rates. CONCLUSION: Studies concerning the relationship between social integration and health should investigate the 'type' and 'level' of social integration that is conducive to better health. IMPLICATIONS: To help reduce disparities in health and mortality across communities, public health researchers and policy makers need to closely monitor geographic and temporal trends in social integration measures. Social policies that emphasise investment in social integration or social capital through job creation and training, provision of gainful employment and social services for discouraged and marginalized workers, improved work conditions and social support may lower mortality directly or through their beneficial effects on health-promoting behaviours such as reduced levels of smoking, drinking and physical inactivity.

Australia↗

PubMed2004

Long-term neuroprotection induced by regional brain cooling with saline infusion into ischemic territory in rats: a behavioral analysis.

The neuroprotective effect of hypothermia has long been recognized. Our recent studies have demonstrated the significant therapeutic value of local brain cooling in the ischemic territory prior to reperfusion in stroke, with reduced infarction and inflammatory responses up to 48 hours of reperfusion. The goal of this study was to determine if local brain cooling, produced by infusion of cold saline, could induce long-term functional improvement after stroke. A hollow filament was used to block the middle cerebral artery (MCA) for 3 hours, and then to locally infuse the ischemic territory with 6 ml cold saline (20 degrees C) for 10 minutes prior to reperfusion. This brain cooling infusion induced a significant (p < 0.01) decrease in neurologic deficits and significantly (p < 0.01) improved motor behavior in ischemic rats after 14 days of reperfusion, compared with ischemic rats without local cold saline infusion. This improvement continued for up to 28 days after reperfusion. No significant difference in motor performance was observed between the brain cooling infusion and normal control groups. Significant (p < 0.01) reductions in infarct volume were also evident. In conclusion, a local cerebral hypothermia induced by local saline infusion prior to reperfusion produced a long-term functional recovery after ischemic stroke. A therapeutic procedure, which combines prereperfusion infusion into an ischemic region with coincident cerebral hypothermia and perhaps subsequent recanalization of an occluded intracranial vessel, may improve the outcome for stroke patients.

Animals↗

PubMed2003

Emergency presentations to Northern Territory public hospitals: demand and access analysis.

This study aims to quantify trends in emergency presentations to Northern Territory (NT) public hospitals over the past five years with respect to demand and access. Retrospective analysis was undertaken on data extracted from the NT Module of Caresys and the Hospital Morbidity Data System. There has been a 4.6% decrease in presentations to the five public hospitals between 1996 and 2001 compared to a 9.4% growth in the population. Despite the apparent decline in total presentations, the acuity of patients has increased dramatically over the same period. Access analysis of presentations seen within the recommended triage time revealed considerable variability, especially for triage categories 2, 3 and 4. The access block problem, discrepancies in recorded waiting time and irregularities among the regional hospitals within the triage system have also been identified. Recommendations including improved access to inpatient beds and admission to wards were developed in response to the changing role of the emergency department.

Appointments and Schedules↗

PubMedDate not supplied

[Criteria for the assessment of radon potential risk in territories].

The detailed analysis of criteria used in the different countries for an assessment of radon potential risk in territories was made. Such criteria as radon flux density from earth surface, radon concentration in soil air, specific activity of 226Ra in superficial soils were chosen. The analysis has revealed that the most reliable criterion is the value of equilibrium radon concentration in the soil air. The method of measurement of this value is specified.

Air Pollutants, Radioactive↗

PubMed2004

The architecture of chicken chromosome territories changes during differentiation.

BACKGROUND: Between cell divisions the chromatin fiber of each chromosome is restricted to a subvolume of the interphase cell nucleus called chromosome territory. The internal organization of these chromosome territories is still largely unknown. RESULTS: We compared the large-scale chromatin structure of chromosome territories between several hematopoietic chicken cell types at various differentiation stages. Chromosome territories were labeled by fluorescence in situ hybridization in structurally preserved nuclei, recorded by confocal microscopy and evaluated visually and by quantitative image analysis. Chromosome territories in multipotent myeloid precursor cells appeared homogeneously stained and compact. The inactive lysozyme gene as well as the centromere of the lysozyme gene harboring chromosome located to the interior of the chromosome territory. In further differentiated cell types such as myeloblasts, macrophages and erythroblasts chromosome territories appeared increasingly diffuse, disaggregating to separable substructures. The lysozyme gene, which is gradually activated during the differentiation to activated macrophages, as well as the centromere were relocated increasingly to more external positions. CONCLUSIONS: Our results reveal a cell type specific constitution of chromosome territories. The data suggest that a repositioning of chromosomal loci during differentiation may be a consequence of general changes in chromosome territory morphology, not necessarily related to transcriptional changes.

Animals↗

PubMed2001

Comparison of two-dimensional echocardiography and pulsed Doppler tissue imaging during dobutamine-atropine stress testing to detect coronary artery disease.

In order to compare the diagnostic accuracy of two-dimensional (2-D) echocardiography and pulsed Doppler tissue imaging (pDTI) during dobutamine-atropine stress testing (DAST) to detect significant coronary lesions, 41 patients underwent DAST (up to 40 microg/k/min of dobutamine with additional atropine during submaximal heart rate responses) and coronary angiography. Pulsed Doppler tissue sampling of territories corresponding to the left anterior descending (LAD), left circumflex (LCx), and right coronary arteries (RCAs) were performed in the apical four-chamber plus aorta and two-chamber apical views. The measurements were repeated at rest, at low dose (10 microg/k/min), and at peak stress. Pulsed DTI measurements included peak early systolic (Vs), peak early diastolic (Ve), and peak late diastolic (Va) velocities. Harmonic 2-D echocardiography was recorded at rest, low dose, peak stress, and recovery, and compared with pDTI assessment. Positive 2-D echocardiography was considered as infarction or ischemic response. The results were evaluated for the prediction of significant coronary stenosis (50% luminal narrowing). Feasibility of pDTI was 100%, 95%, and 98% for the LAD, the LCx, and RCA territories, respectively. At rest, Vs in territories supplied by arteries with coronary artery disease (CAD) (6.3 +/- 2.0 cm/sec) was not different from those without (6.6 +/- 2.1 cm/sec). Vs increased less in territories supplied by arteries with than without CAD (75 +/- 107% vs 102 +/- 69%, P = NS). Ve was lower in territories with CAD at rest (6.0 +/- 2.1 cm/sec vs 8.2 +/- 3.4 cm/sec, P < 0.0001) and low dose (7.2 +/- 2.1 cm/sec vs 8.8 +/- 3.6 cm/sec, P < 0.01), but similar at peak stress (7.6 +/- 3.5 cm/sec vs 8.1 +/- 3.3 cm/sec). Ve increase was similar in territories with (36 +/- 74%) than without CAD (15 +/- 6 4%). Va was similar at rest and low dose in territories with and without CAD (9.2 +/- 2.7 cm/sec vs 9.1 +/- 2.3 cm/sec and 10.9 +/- 3.1 vs 10.3 +/- 3.6 cm/sec, respectively), but lower at peak stress in territories with CAD (13.3 +/- 4.6 cm/sec vs 15.3 +/- 4.5 cm/sec, P = 0.05). The Va increase was lower in territories with CAD (43 +/- 37% vs 77 +/- 72%, P < 0.05). In a territory-based analysis, a failure to achieve Vs > or =10.5 cm/sec at peak stress in the LAD and LCx, and > or =10.0 cm/sec in the RCA territory, was found to be the more accurate limit to detect CAD in the corresponding arteries: sensitivity (95% confidence intervals): 63% (55-71), P = NS vs 2-D echocardiography: 59% (51-67); specificity 76% (68-84), P < 0.01 vs. 2-D echocardiography: 95% (89-100); and accuracy 69% (63-75), P = NS vs 2-D echocardiography: 76% (70-82). Thus, pDTI is feasible during DAST but not more accurate than 2-D echocardiography for the detection of significant CAD in a territory-based study.

Adrenergic beta-Agonists↗

PubMed1999

Steroid hormones and paternal care in the plainfin midshipman fish (Porichthys notatus).

The present study investigated the relationship between plasma steroid hormone levels and the expression ofpaternal behavior in the plainfin midshipman fish (Porichthys notatus), where males may simultaneously care for multiple clutches in different stages of development. Blood samples were collected from free-living parental males during that part of the breeding season when males may be found in various stages of parental care. Plasma 11-ketotestosterone levels were significantly higher in males with empty nests and nests containing only eggs than in males with nests containing embryos. All males with nests containing embryos had undetectable testosterone levels, whereas testosterone levels were detectable in many males with empty nests or nests containing only eggs. Estradiol levels were detectable in only a few males from nests with no eggs or nests containing only eggs. Cortisol levels were not correlated with stage of paternal care or with handling time. These results follow the frequently reported vertebrate pattern of declining androgen levels over the course of the breeding season or during the period of parental care. However, many male midshipman guarding nests containing only eggs had androgen levels similar to those of males whose nests contained no offspring. Thus the pattern of androgen levels exhibited by reproductively active parental male midshipman may reflect a compromise between investment in paternal care versus courtship and/or territoriality.

Animals↗

PubMed2002

Inbreeding depression and male fitness in black grouse.

The male lifetime lekking performance was studied, and related to inbreeding-outbreeding in a wild population of black grouse (Tetrao tetrix) in central Finland between 1989 and 1995. Inbreeding was measured as the mean heterozygosity and mean d(2) of 15 microsatellite loci. We found a significantly positive relationship between mean d(2) and lifetime copulation success (LCS), while the relationship between heterozygosity and LCS was close to significant. We also found that males that never obtained a lek territory had significantly lower mean heterozygosity than males that were observed on a territory at least during one mating season in their life. Furthermore, among males that were successful in obtaining a lek territory, LCS and mean d(2) were highest for those males that held central territories. We suggest that inbred males have a disadvantage (or outbred males have an advantage) in the competition for territories that may explain the relationships with LCS and inbreeding. Furthermore, the fact that mean d(2) was positively correlated with LCS whereas heterozygosity was not when we restricted the analysis to territorial males, suggests that mean d(2) provides more information about levels of inbreeding-outbreeding than heterozygosity alone, and potentially highlights the effects of heterosis. To our knowledge, this is the first time that measures of inbreeding and lifetime fitness have been linked in a non-isolated population. This is important in establishing that the relationships found in previous studies are not artefacts of low gene flow created by limited dispersal but a general feature of wild vertebrate populations.

Animals↗

PubMed1998

[Immune system in residents of territories contaminated with radionuclides after Chernobyl accident].

AIM: Study of the immunity and nonspecific defense factors in subjects living at a territory contaminated with radionuclides at a density of 1-5 Ci/km2 after the Chernobyl accident. MATERIALS AND METHODS: A total of 144 subjects aged 18 to 82 years living in the Sasovo region of the Ryazan district were examined. Three groups were distinguished with different density of contamination: 1) n = 54, 1-5 Ci/km2; 2) n = 36, conditionally pure territory; and 3) n = 54, living at the interface of the two territories. Blood analysis was carried out, nonspecific defense factors studied in the NBT test, and cellular and humoral immunity parameters investigated. RESULTS: Values of the NBT test, levels of the natural inhibitory factor and IgA, counts and functional activities of T lymphocytes and their subpopulations differed but negligibly from those in subjects living at pure territories. On the other hand, the counts of large granular lymphocytes were decreased and the incidence of autoimmune reactions to thyroid hormone antigens increased in the population exposed to low-dose ionizing radiation, which might be due to incorporation of radioactive iodine. CONCLUSION: The detected changes in the population exposed to low-dose radiation indicate that the history of exposure cannot be neglected, for such an exposure causes development of some diseases or alters their course.

Adolescent↗

PubMed2026

Global, regional, and national prevalence of second-hand smoke and attributable disease burden in 204 countries and territories, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023.

BACKGROUND: Second-hand smoke (SHS) exposure remains a major source of morbidity and mortality among non-smokers. This study presents the first dedicated Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) publication to systematically quantify SHS prevalence and evaluate its effect as a global risk factor across a broader range of outcomes. METHODS: Using the GBD 2023 comparative risk assessment framework, we estimated SHS exposure prevalence and attributable disease burden across 204 countries and territories from 1990 to 2023, stratified by age and sex. Exposure estimates were derived by synthesising population-based surveys and household composition data through spatiotemporal Gaussian process regression. Relative risks for nine health outcomes, now including asthma, were estimated using the Burden of Proof methodology, and applied to calculate attributable deaths and disability-adjusted life-years (DALYs). FINDINGS: In 2023, an estimated 2·71 billion (95% UI 2·44-3·02) people worldwide were exposed to SHS, including 767 million (687-858) children aged 0-14 years. Age-standardised prevalence was highest in southeast Asia, east Asia, and Oceania (48·4% [44·0-53·4]), with female individuals in some countries experiencing nearly 1·8 times the exposure prevalence of male individuals. Despite a 22·2% (10·6-32·4) decline in global age-standardised prevalence since 1990, this progress has not been sufficient to reduce the absolute number of exposed individuals, which has remained stable globally and has risen sharply in sub-Saharan Africa (98·5% [62·0-144·4] increase) and North Africa and the Middle East (72·1% [47·8-101·8] increase). In 2023, SHS exposure accounted for 1·66 million (1·33-2·07) deaths and 44·8 million (35·8-54·3) DALYs globally. Ischaemic heart disease was the leading contributor to SHS-attributable DALYs (12·0 million [9·31-15·2]) overall, while lower respiratory infections predominated among children (5·16 million [3·48-7·12]). INTERPRETATION: We estimated that SHS remains a substantial driver of global health loss, particularly through cardiovascular and paediatric respiratory diseases. Persistent geographical disparities and growing absolute numbers of exposed individuals in several regions underscore the urgent need for accelerated implementation and enforcement of comprehensive tobacco control measures, particularly to protect women and children in both public and domestic environments. FUNDING: Bloomberg Philanthropies and the Gates Foundation.

Journal Article↗

PubMedDate not supplied

[Cost-benefit analysis of a mammography screening program extended to all the national territory].

A cost-effectiveness analysis has been conducted in order to evaluate effects and costs of a nationwide mammographic breast cancer screening programme compared with no screening in a 30 years period. The analysis includes seven different phases of breast cancer, from the screening programme itself to the treatment of terminal illness. The estimates use italian published data and field studies. The calculations were performed with the Miscan computer simulation package: a programme providing for the screening of women aged 50-69 at two years intervals might be expected to result in a 1,650 deaths prevented and 14,500 years of life gained each year. The overall net costs of the programme were assessed at between 2,893 and 3,212 thousand million lire, the cost per life saved between 59.8 and 66.4 million lire and the cost per life-year gained between 6.6 and 7.3 million lire (between 10.7 and 11.5 million lire with a 5% discount rate, an estimate lower than that of German programme). The analysis produces important information for the Italian policy debate over mammography and it also contributes to the development of economic evaluation in our country.

Aged↗

PubMed1997

Dipyridamole-induced angina pectoris during sestamibi stress test in patients with significant coronary artery disease: clinical, angiographic, and nuclear determinants.

Intravenous dipyridamole induces angina pectoris (AP) in some patients with significant coronary artery disease (CAD). The aim of this prospective study was to identify the angiographic, nuclear, and clinical determinants. The authors examined 50 patients consecutively with significant CAD on coronary angiography. All antiischemic medications were stopped twenty-four hours (nitrates only 6 hours) before injection of dipyridamole (0.84 mg/kg). ECGs were taken before, during, and after this injection. The regional myocardial activity of Tc-99m-Sestamibi at rest and after dipyridamole injection was measured with single-photon emission computed tomography (SPECT). During dipyridamole injection 20 patients had AP, of whom 15 had ST segment depression on ECG (P < 0.001). The only significant difference on coronary angiography between patients with dipyridamole-induced AP and those without AP was the presence of collaterals (P < 0.05). In patients with AP and collaterals, ECG and SPECT changes were always noted in the collateralized territory. Subgroup analysis showed that patients without previous myocardial infarction (MI, n = 17, P < 0.05) or nontransmural MI (n = 17, P < 0.05) had a good correlation between collaterals and AP, whereas patients with a history of transmural MI (n = 16) did not. No further significant variables could be found as a predictor of AP after dipyridamole injection. These findings suggest that AP during dipyridamole stress test is due to ischemia, which is not related to the severity of CAD. Ischemia is probably due to coronary steal to the collateralized territory in patients without transmural MI. Dipyridamole-induced angina pectoris is predictive for collaterals and may indicate viability in patients with MI.

Angina Pectoris↗