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PubMed1995

Migration and marital status. The case of Switzerland.

"The present study describes...a part of the interrelation of living arrangements and migration: The connection between marital status and spatial mobility. Moreover, the significance of the reasons for family migration will be assessed. [Section] 2 covers the relationship between family or household structure and change of residence and refers to the findings of other studies. The third [section] presents the empirical findings which are to be seen against the background of changing household and family patterns in Switzerland over the last 20 to 30 years. With the aid of aggregated data from censuses and population registration offices, the differences in migratory behaviour by socio-demographic characteristics are first shown: by age, sex, marital status and nationality. In addition, a distinction is made between intercommune, intercantonal and international migration. The initial findings of the descriptive analysis are followed by multivariate statistics produced with the aid of microdata from the Swiss Labour Force Survey." (SUMMARY IN FRE AND GER)

Age Factors↗
PubMed1989

Migration and motivation: the migrant's perspective.

Migration is often viewed as economically motivated. However, many of the studies on which this is based are a result of either aggregate data or retrospective questioning of migrants. The present study indicates that such approaches may give a distorted view of migrants' motives. The data indicate that nonmonetary career reasons are important instigators of migration among well-educated international migrants. In addition, these factors tend to be major perceived gains from migration. However, choice of destination is strongly influenced by location of friends and/or relatives. Reasons for discrepancies between this and previous studies are noted.

Americas↗
PubMed1993

A gray system decision model of the multiple factors for the educational levels among regional population.

"Using 1% statistics and 10% sample aggregate data of the fourth census, the authors analyze various comprehensive indexes reflecting the educational levels among the Chinese population, on the basis of which a multi-regional gray system decision model is established. The authors also conduct a preliminary analysis of the results of the calculation." Grayness is defined here as "incompleteness and uncertainty of information."

Asia↗
PubMedDate not supplied

[Reorder the disorder: disturbance and standardization variables].

"Spatial variations in crude death rates by cause-of-death may result among others from differences in the age structures of the populations of the regions and/or from the small numbers of deaths at certain ages or for certain cause-of-death. This paper addresses, on the one hand, the issue of controlling the impact of age structures (or of confounding factors, generally speaking) and, on the other hand, that of the chance variations in the results of the various standardization methods. Standardization is considered here from the viewpoint of causal modelling: controlling for age structures is a special case of controlling for confounding variables when using aggregate data. From this point of view, we have evaluated and compared the different standardization techniques and their ability to control for confounding factors. The construction of significance tests and confidence intervals has been pursued in order to evaluate the methods from the point of view of the statistical robustness of the standardized indices." (SUMMARY IN ENG AND ITA)

Age Factors↗
PubMed1999

Surveillance for AIDS-defining opportunistic illnesses, 1992-1997.

PROBLEM/CONDITION: Acquired immunodeficiency syndrome (AIDS)-defining opportunistic illnesses (OIs) are the major cause of morbidity and mortality among persons infected with human immunodeficiency virus (HIV). As a result of new treatments that reduce mortality for persons with AIDS, the number of persons living with AIDS is increasing, and the incidence of AIDS is decreasing. In 1997, an estimated 271,245 persons were living with AIDS in the United States and thus were at high risk for OIs. In 1997, an estimated 21,909 HIV-infected persons died with AIDS, nearly all as a result of OIs. REPORTING PERIOD COVERED: Aggregate data and trends for 1992-1997 were examined to determine a) the frequencies at which OIs occurred first; b) the incidence of OIs; c) the percentage of persons among those who have died who had had a given OI during their course of AIDS, and d) the frequency of prescriptions for antiretroviral therapy and prophylaxis for Pneumocystis carinii pneumonia (PCP) and for Mycobacterium avium complex disease (MAC). DESCRIPTION OF SYSTEM: Data were analyzed from the Adult/Adolescent Spectrum of HIV Disease (ASD) sentinel surveillance project, a prospective medical record review of HIV-infected persons aged > or = 13 years conducted in 11 U.S. cities. ASD data were standardized to national AIDS surveillance data for 1992-1997 by age; race; sex; country of birth; year of AIDS diagnosis; HIV exposure mode; and for incidence calculations, by CD4+ T-lymphocyte distribution. RESULTS: The incidence declined significantly for each of 15 of the 26 specific AIDS-defining OIs (p<0.05). PCP was the most common AIDS-defining OI to occur first (PCP was the first OI to occur for 36% of HIV-infected persons), the most common incident AIDS-defining OI (274 cases per 1000 person-years), and the most common AIDS-defining OI to have occurred during the course of AIDS (53% of persons who died with AIDS had PCP diagnosed at some time during their course of AIDS). Of persons with CD4+ T-lymphocyte counts <500 cells/microL, the number with prescriptions for triple combination therapy increased from zero in 1992 to 40% in 1997, and 80% of persons had a prescription for any antiretroviral therapy in 1997. Of persons with CD4+ T-lymphocyte counts <200 cells/microL, the percentage with prescriptions for PCP prophylaxis remained stable from 1992 through 1997 (range: 75% to 80%). Of persons with CD4+ T-lymphocyte counts <50 cells/microL, the percentage with prescriptions for MAC prophylaxis increased from 9% in 1992 to 44% in 1997. INTERPRETATIONS: The incidences of many OIs are decreasing primarily because of advances in HIV-related therapy. However, OIs are still occurring, especially when patients access care late during the course of disease. Even after accessing care, persons may develop OIs because of lack of prescription for prophylaxis, antiretroviral drug resistance, or poor adherence to therapy. During 1992-1997, most patients in need of PCP prophylaxis received a prescription for it; however, even in 1997, most patients in need of MAC prophylaxis did not receive a prescription for it. ACTIONS TAKEN: These surveillance data are used by persons involved with developing guidelines for preventing OIs to determine the importance of and trends in OIs and preventive therapy. CDC is developing population-based approaches for surveillance of HIV disease progression, OIs, and therapies with the goal of making these data available in more geographic areas to help assess public health and health-care programs.

AIDS-Related Opportunistic Infections↗
PubMed2002

Introduction of a hierarchy to LOINC to facilitate public health reporting.

Public health reporting of laboratory results requires unambiguous identification of the test performed and the result observed. Some laboratories are currently using Logical Observation Identifier Names and Codes (LOINC) for the electronic reporting of laboratory tests and their results to public health departments. Initial use revealed inconsistent identification and use of LOINC concepts by laboratories and public health agencies and an inability to systematically extend, for public health use, the tables when adding new concepts. We applied simple, logical rules to existing LOINC concepts to facilitate the creation of a hierarchy of concepts and to allow the identification and specification of appropriate terms for public health reporting and subsequent data aggregation. The hierarchy also allows the systematic addition of new concepts further supporting public health reporting. Application of the hierarchy is illustrated by using all laboratory LOINC concepts assigned to the subset of microbiology test types (CLASS MICRO).

Clinical Laboratory Information Systems↗
PubMed2002

[Efficiency assessment of investment in workers' health--economic issues].

The economic analysis of efficiency of investment in health care and health at large by means of cost-benefit or cost-effectiveness techniques is the subject of implementation work in a number of countries. Poland's integration with the countries of the European Union justifies the need to understand and to use economic analyses. Unfortunately, these activities encounter many methodological and executive barriers. The investments in workers' health are not only investments in health care and the improvement of working conditions, but also in compensations, including financial ones, resulting from adverse effects of factors influencing the health of working population. The financial reporting system that exists in Poland does not ensure the possibility of full presentation of the aggregated data on the financing of activities for workers' health and diminishing of the adverse effects of factors present in the work environment. The information on the outcome of the investments in workers' health come from different sources, which means that it applies to different groups subjected to the analysis. The problem lies not only in the assessment of profitability of health investments but also in the social problem of the division of the resultant costs and benefits among various branches of the national economy. Therefore, the analyses involving mutual relations between individual sectors that invest in workers' health and those that bear consequences is essential in the terms of economic analyses. The authors present the determinants of economic evaluation in regard to health of working population in Poland.

Cost-Benefit Analysis↗
PubMed2002

Day for night: should we staff a trauma center like a nightclub?

Most trauma services throughout the country are staffed on a fixed-call rotational basis. Staff is deployed in a linear fashion when trauma often occurs in a skewed sporadic fashion resulting in large fluctuations in volume, injury severity, and mechanism of injury. Medical error and increased mortality have been associated with certain admission times. We reviewed 8015 consecutive major trauma admissions over a 3-year period. When reviewing aggregate data we found a significant difference in mortality between patients admitted during the day (7:00 AM to 6:59 PM) compared with those admitted at night (7:00 PM to 6:59 AM) (10.1% vs 13.1%, P < 0.01). On further analysis the two populations were found to be significantly different in volume, Injury Severity Score (ISS), and mechanism of injury. More patients were admitted at night and on weekends. They had a higher ISS, higher frequency of penetrating trauma, and a higher likelihood of undergoing operative intervention. Multiple subset analyses were performed stratifying for ISS, time of admission, day of admission, and mechanism of injury using mortality rate as the end point. Six comparisons were performed: 1) morning versus night admission; 2) weekday versus weekend admission; 3) least busy day (Tuesday) versus busiest day (Sunday) admission; 4) weeknight versus weekend night admission; 5) in cases of penetrating trauma, morning versus night admission; and 6) in cases of blunt trauma, morning versus night admission. None of the six comparisons showed a significant difference in mortality. There was no significant difference in ISS-matched mortality related to fixed trauma call staffing.

After-Hours Care↗
PubMedDate not supplied

[Drinking water hardness and chronic degenerative diseases. III. Tumors, urolithiasis, fetal malformations, deterioration of the cognitive function in the aged and atopic eczema].

For several decades a causal relation has been hypothesised between drinking water hardness and cardiovascular and other chronic degenerative diseases in humans. Only recently some epidemiological studies also investigated the association between the concentration of the minerals responsible for the hardness of drinking water (calcium and magnesium) and other chronic diseases. Some case-control studies carried out in Taiwan using aggregated data showed a possible protective effect of water hardness toward the risk of dying from various neoplasms, though more research is needed on the issue, possibly based on individual data, to draw definitive conclusions. There is a substantial evidence that consumption of water with high levels of calcium does not increase, and maybe reduces the risk of developing urinary stones of the most common type in developed countries (calcium oxalate), on the contrary, there is no conclusive evidence on the relation between water hardness and foetal malformations, cognitive functions in old men, diabetes and eczema.

Aged↗
PubMedDate not supplied

African American nurse faculty satisfaction and scholarly productivity at predominantly white and historically black colleges and universities.

The aim of this study was to examine faculty satisfaction and the relationships among selected elements of African American women nurse faculty productivity at two types of institutions: predominantly white (PWCUs) and historically black colleges and universities (HBCUs). Organizational Culture Theory was used as the conceptual framework to provide the basis to explore the extent of productivity and levels of satisfaction among the study participants. Satisfaction was measured using a six-point Likert attitudinal scale. Scholarly Productivity was measured as the extent of published/submitted works (authorship), number and dollar amounts of grant submissions (grantsmanship) and elected/appointed positions held in professional organizations (leadership). Consistent with previous research studies of minority faculty in other disciplines, the current study found that the majority of African American women nurse faculty tended not to hold senior professorial rank, administrative positions, or tenure status. When comparisons were made between HBCU and PWCU faculty, however, a higher percentage of HBCU faculty reported holding Deanships or program coordinator positions and, on average, had slightly larger dollar amounts for funded grant awards and held significantly more leadership positions in professional nursing organizations. The aggregated data findings of this study did not support a strong relationship between selected elements of satisfaction with the academic institution's organizational culture and the scholarly productivity of African American women nurse faculty teaching at HBCUs and PWCUs. However, when the data were disaggregated by type school, moderately significant differences between HBCU and PWCU faculty were found, such that along several dimensions of the constructs of organizational culture the levels of dissatisfaction among PWCU faculty significantly skewed the overall data findings. In general, while PWCU faculty demonstrated higher levels of authorship, reported larger salaries, and held more tenured positions when compared with HBCU faculty, PWCU respondents tended to be significantly less satisfied with the leadership, environment, and socialization processes of their respective collegiate schools of nursing than were their HBCU counterparts. Among HBCU faculty the extent of productivity positively correlated with satisfaction for three of the six dimensions of organizational culture.

Adult↗
PubMed2003

School league tables: a new population based predictor of dental restorative treatment need.

AIM: To test whether dental restorative treatment need was related to the school league tables and level of social deprivation of the school ward. DESIGN: An ecological study using clinical data aggregated at school level, collected in the school dental screening examinations (1996-97), National Census (1991) and the results of the UK school league tables--Key Stage 2 SATs (1996-97). SETTING: State primary schools in the Greenwich District of SE London, UK (1996-97). SUBJECTS: 12,854 pupils (6-11 years of age) in 62 schools. OUTCOME MEASURE: The percentage of 6 to 11 year old pupils per school requiring dental restorative treatment. RESULTS: Deprivation as measured by the overall Jarman Under Privileged Area Index (UPA) of the school ward was not associated with dental restorative treatment need (p > 0.05). Only two components of the Jarman Index, level of unemployment and the number of lone parent families in the school ward were found to be significantly associated with dental restorative treatment need (p < 0.05). Results of stepwise multiple linear regression analysis showed that the association with the school league table results in all three subjects, English, Mathematics and Science remained statistically significant after adjusting for levels of unemployment and single parents. Results of multiple linear regression analysis showed that a high level of dental restorative treatment need was significantly associated with poor school league table results in English, Mathematics and Science (p < 0.05) after adjusting for the overall Jarman score of the school ward. A separate analysis for the 11-year-old pupils aggregated by school (n = 46 schools) gave similar results. CONCLUSIONS: Aggregate measures of academic achievement may be a potential indicator of dental restorative treatment need.

Child↗
PubMed1992

Comparison ratings of need importance after critical illness from family members with varied demographic characteristics.

This descriptive study compares ratings of importance of selected needs by family members after the first 3 days of critical illness with family member age, gender, relationship to patient, prior intensive care unit experience, and patient medical diagnosis. Family-need importance ratings from 905 subjects, collected by 27 nurse investigators in 15 states over a 10-year period (1980 to 1989) were used as an aggregate data base. Bivariate t tests and analysis of variance procedures were used to compare ratings of importance for support, comfort, information, proximity, and assurance needs with family member demographic characteristics. Results indicated that there were more similarities than differences on the ratings of importance for selected needs from various family members. Focusing on these similarities should be useful for developing and testing nursing interventions to help family members meet their needs after a critical illness event.

Adolescent↗
PubMed2003

Developing regional surveillance of sexually transmitted infection: a survey of the views of healthcare professionals in north west England.

Current surveillance of sexually transmitted infections in England and Wales relies on aggregated data collected by genitourinary medicine clinics. This system only allows limited analysis especially at a local level. A change to a disaggregate form of data collection could provide additional outputs at a local level. We undertook a survey of the views of those working in the prevention and control of sexually transmitted infections in the North West to determine what additional surveillance outputs would facilitate their work. Of respondents, 89% believed surveillance should deliver between four and nine types of analyses that can only be delivered by a surveillance system that is based on disaggregate data. Respondents indicated that it was acceptable for clinics to provide the data items required but that currently it was not feasible to do so because of workload constraints.

Attitude of Health Personnel↗
PubMed2002

Joining efforts in tackling the organ shortage: the Donor Action experience.

1. Donor Action takes a systematic approach towards achieving quality assurance in the whole donation process. It is designed to give hospitals participation and ownership of donation practices that can be tailored to meet identified needs in critical care units (CCUs). The program has been successfully introduced in 18 countries and in over 250 CCUs in North and South America, Europe and Asia. 2. Aggregated data collected in 162 CCUs in 10 countries showed significant losses of potential donors along the donation pathway. The major factor impacting on converting medically suitable cases with signs of brain death into potential donors was the willingness of CCU staff to formally diagnose brain death. Major reasons for non-donation in BD-diagnosed cases were non-referral (26.5%), family refusal (20%), or no approach of next-of-kin (13.2%). 3. Pre-intervention data show that professional training, clear role definitions, teamwork, comprehensive guidelines and consistent protocols dealing with all donation-related tasks in the CCU setting are critical to achieve optimal donation rates. 4. Implementation of these improvement measures in 10 countries have shown an immediate overall increase of donation rates of 59% after 1 year and a sustained, even growing effect on referral and donation rates in those countries with sufficient follow-up, proving a permanent impact of DA's methodology. 5. As a health-economic evaluation, based on the German case, shows that the implementation cost of the program in pilot centers was far below the investment thresholds. Donor Action is more cost-effective than other publicly reimbursed medical interventions. Incorporating health economic consequences of other cadaveric organ transplants into the analysis could even further improve the cost-benefit ratio of Donor Action compared with current organ donation practices.

Databases, Factual↗
PubMed2003

[Scaling effects on landscape pattern indices].

The methods of spatial data aggregation based on majority and random rules were used in this study to reveal the scaling effects on landscape pattern in a classified TM imagery with 8 land cover types. For the majority rule-based aggregations, the proportion of most common cover types increased slowly, while that of less common cover types decreased rapidly with increasing grain. For random rule-based aggregation, each cover remained its original area on the aggregated maps. The largest patch sizes of shrub decreased, and those of the others increased in the majority rule-based aggregations with increasing scales. For random rule, the largest patch size of water (smallest cover type) decreased, but that of the others increased. The smallest patch size of each cover type was equal to the square of grain sizes. The average patch size of each cover type increased with increasing scales. However, the average patch size of dominant cover types increased rapidly in majority rule-based aggregations, while that of less common cover types increased rapidly in random rule-based aggregation. The patch count of each cover types decreased substantially with increasing grain. Random rule-based aggregation made landscape more fragmented and remained more patches. The diversity decreased in majority rule-based aggregation, and maintained its original value in random rule-based aggregation with increasing scales. Aggregation indices decreased with increasing map and measurement resolution, and the landscape became more aggregated in majority rule-based aggregation. However, under fixed measurement resolution (e.g., 30 m), aggregation indices increased and cover types were more clustered with increasing resolution. Moran's I decreased rapidly with increasing measurement and map resolution, and each cover type tended to be arranged randomly and independently in space. However, under fixed measurement resolution (e.g., 30 m), Moran's I increased and cover types were more clustered on aggregated maps than on original map with increasing map resolution.

Ecosystem↗