Fifty years of violent war deaths from Vietnam to Bosnia: analysis of data from the world health survey programme

Objective To provide an accurate estimate of violent war deaths. Design Analysis of survey data on mortality, adjusted for sampling bias and censoring, from nationally representative surveys designed to measure population health. Estimated deaths compared with estimates in database of passive reports.Setting 2002-3 World health surveys, in which information was collected from one respondent per household about sibling deaths, including whether such deaths resulted from war injuries.Main outcome measure Estimated deaths from war injuries in 13 countries over 50 years.Results From 1955 to 2002, data from the surveys indicated an estimated 5.4 million violent war deaths (95% confidence interval 3.0 to 8.7 million) in 13 countries, ranging from 7000 in the Democratic Republic of Congo to 3.8 million in Vietnam. From 1995 to 2002 survey data indicate 36 000 war deaths annually (16 000 to 71 000) in the 13 countries studied. Data from passive surveillance, however, indicated a figure of only a third of this. On the basis of the relation between world health survey data and passive reports, we estimate 378 000 globalwar deaths annually from 1985-94, the last years for which complete passive surveillance data were available.Conclusions The use of data on sibling history from peacetime population surveys can retrospectively estimate mortality from war. War causes more deaths than previously estimated, and there is no evidence to support a recent decline in war deaths.     

A population genetic study of cleft chin in India

The paper reports data on cleft chin in 900 individuals from Kerala. The results of all surveys in India in which the cleft chin was observed have been tabulated. Gene frequency analysis has been attempted. Wide variations in gene frequencies were found for the gene cl. The major racial groups in India tend to follow definite trends. The trait varies from dimples to furrows, and is independent of age but reveals sex differences. A plea is made to collect more family, twin and population data.     

Adequacy of terrestrial fauna surveys for the preparation of Environmental Impact Assessments in the mining industry of Western Australia

Summary   The Western Australian Environmental Protection Authority has indicated that terrestrial fauna surveys undertaken for the purpose of preparing Environmental Impact Assessment (EIA) are providing inadequate information for decision-makers to assess development impacts on biodiversity and ecosystems. This study examined the current standard of terrestrial vertebrate fauna surveys undertaken as the basis for preparing an EIA. In the absence of a protocol to assess current standards of terrestrial fauna surveys, 'best practice' was defined and quantified through consultation with an 'expert panel'. Data from fauna surveys contained in 15 recent EIA reports from the Goldfields region of Western Australia were critically examined to determine the extent of compliance with 'best practice'. The majority of surveys performed poorly against the established criteria. A few reports addressed many of the issues comprehensively, however, at least 50% failed to mention or adequately address a high proportion of criteria considered essential, including searches of government databases, detection of rare/endangered fauna and multiseasonal sampling. All reports failed to employ sufficient trapping effort at both the biotope and landscape scales to adequately assess terrestrial vertebrate fauna biodiversity. These results indicate the need to redress minimum standards for terrestrial fauna surveys in order to meet the expectations of the EIA process.     

Secular trend in the occurrence of asthma among children and young adults: critical appraisal of repeated cross sectional surveys.

OBJECTIVES: To review repeated surveys of the rising prevalence of obstructive lung disease among children and young adults and determine whether systematic biases may explain the observed trends. DESIGN: Review of published reports of repeated cross sectional surveys of asthma and wheezing among children and young adults. The repeated surveys used the same sampling frame, the same definition of outcome variables, and equivalent data collection methods. SETTING: Repeated surveys conducted anywhere in the world. SUBJECTS: All repeated surveys whose last set of results were published in 1983 or later. MAIN OUTCOME MEASURES: Lifetime and current prevalences of asthma and current prevalence of wheezing. The absolute increase (yearly percentage) in the prevalences of asthma and wheezing was calculated and compared between studies. RESULTS: 16 repeated surveys fulfilled the inclusion criteria. 12 reported increases in the current prevalence of asthma (from 0.09% to 0.97% a year) and eight reported increases in the current prevalence of wheezing (from 0.14% to 1.24% a year). Changes in labelling are likely to have occurred for the reporting of asthma, and information biases may have occurred for the reporting of wheezing. Only one study reported an increase in an objective measurement. CONCLUSIONS: The evidence for increased prevalences of asthma and wheezing is weak because the measures used are susceptible to systematic errors. Until repeated surveys incorporating more objective data are available no firm conclusions about increases in obstructive lung disease among children and young adults can be drawn.     

Forward to the past: race,the colour scale and Michael Banton

This study examined differences in religious participation and spirituality among African Americans, Caribbean blacks (black Caribbeans) and non-Hispanic whites. Data are taken from the National Survey of American Life, a nationally representative study of African Americans, black Caribbeans and non-Hispanic whites. Selected measures of organizational, non-organizational and subjective religious participation were examined. African American and Caribbean blacks were largely similar in their reports of religious involvement; both groups generally indicated higher levels of religious participation than non-Hispanic whites. African Americans were more likely than black Caribbeans to be official members of their places of worship, engage in activities (choirs, church clubs) at their place of worship and request prayer from others. Black Caribbeans reported reading religious materials more frequently than African Americans. The discussion notes the importance of examining ethnic differences within the black American population of the United States.     

Dissection of a continuous distribution: red cell galactokinase activity in blacks.

A significant difference between blacks and whites in the distribution of red cell galactokinase (GALK) has been found by Tedesco et al. [2]. From the shapes of the distributions, it was inferred that whites are essentially all homozygous for one allele (GALKA), but blacks are polymorphic. A second allele (GALKP), for lower GALK activity, is presented at high frequency in blacks but rare or absent in whites. This paper presents a method which, assuming the genetic model presented, estimates the genotype composition of the black sample. We make some reasonable biochemical assumptions and fit a mixture of three normal distributions to the black data to obtain an estimate of p, the frequency of GALKA in blacks. The fit of the model to the data is excellent and the best estimate of p is .217 +/- .025. Since admixture of white genes in blacks from the United States is known to be about 20%, the value of p implies that virtually all GALKA alleles were introduced by admixture, and that the ancestral black population was monomorphic for GALKP. If whites are indeed monomorphic for GALKA, they differ from unmixed blacks by a full gene substitution at the locus for GALK.     

A comparison of estimates of relative abundance from a weakly structured mass‐participation bird atlas survey and a robustly designed monitoring scheme

Estimates of population size are frequently used in conservation. Volunteer‐conducted surveys are often the only source of information available, but their reliability is unclear. We compare data from a weakly structured national bird atlas collected by volunteer surveyors free to choose where and when to visit with data from an independent suite of monitoring surveys that used a stratified sampling design. We focus on the Mount Lofty Ranges, South Australia, a region that has lost most of its native vegetation. Both datasets comprise several thousand 20‐min 2‐ha searches carried out between 1999 and 2007. The atlas dataset reported more species, and covered habitats more comprehensively, but showed greater variability in the temporal and spatial distribution of survey effort. However, after we restricted the atlas dataset to native eucalypt woodlands, reporting rates from the two schemes were very strongly correlated. The structured surveys tended to record more species that are normally detected by call and the unstructured surveys recorded more species using edges and open habitats. Minimum population estimates from the two datasets agreed very well. The strength of concordance depended on whether overflying birds were included, highlighting the importance of distinguishing such records in future surveys. We conclude that appropriate calibration using selected regional surveys, including surveys to estimate absolute densities, can enable volunteer‐collected and weakly structured atlas data to be used to generate robust occupancy and minimum population estimates for many species at a regional scale.     

Black spaces,black places: Strategic assimilation and identity construction in middle-class suburbia

While white ethnics and immigrants of colour have been studied in terms of their attempts to assimilate into the American mainstream, sociologists assume that ongoing racial discrimination obviates the need for an extensive examination of the actual assimilation trajectories of middle-class blacks. Many middle-class blacks travel from the black to the white world rather than existing exclusively in one racially distinct environment. Yet, we do not fully understand how middle-class blacks conceptualize their own integration into American society. Drawing on data collected through in-depth interviews with middle-class blacks and ethnographic research in a white and a black suburb, I establish the link between an affinity for black spaces and the alternative assimilation trajectories of middle-class blacks. I find that middle-class blacks engage in a variant of segmented assimilation, privileging the black world as a site for socializing even if they live in a white suburb. This selective pattern of assimilation, what I term strategic assimilation, suggests that this population of middle-class blacks does not perceive itself as permanently constrained to the bottom rung of a racial hierarchy.     

A Novel Approach for Measuring the Burden of Uncomplicated Plasmodium falciparum Malaria: Application to Data from Zambia

Measurement of malaria burden is fraught with complexity, due to the natural history of the disease, delays in seeking treatment or failure of case management. Attempts to establish an appropriate case definition for a malaria episode has often resulted in ambiguities and challenges because of poor information about treatment seeking, patterns of infection, recurrence of fever and asymptomatic infection. While the primary reason for treating malaria is to reduce disease burden, the effects of treatment are generally ignored in estimates of the burden of malaria morbidity, which are usually presented in terms of numbers of clinical cases or episodes, with the main data sources being reports from health facilities and parasite prevalence surveys. The use of burden estimates that do not consider effects of treatment, leads to under-estimation of the impact of improvements in case management. Official estimates of burden very likely massively underestimate the impact of the roll-out of ACT as first-line therapy across Africa. This paper proposes a novel approach for estimating burden of disease based on the point prevalence of malaria attributable disease, or equivalently, the days with malaria fever in unit time. The technique makes use of data available from standard community surveys, analyses of fever patterns in malaria therapy patients, and data on recall bias. Application of this approach to data from Zambia for 2009–2010 gave an estimate of 2.6 (95% credible interval: 1.5–3.7) malaria attributable fever days per child-year. The estimates of recall bias, and of the numbers of days with illness contributing to single illness recalls, could be applied more generally. To obtain valid estimates of the overall malaria burden using these methods, there remains a need for surveys to include the whole range of ages of hosts in the population and for data on seasonality patterns in confirmed case series.     

An Analysis of the Proportion of the U.S. Population that Ingests Soil or Other Non-Food Substances

Reliable quantitative data are lacking that document the prevalence of ingestion of soil and other “non-food” substances among U.S. children and adults. This article explores the proportion of the U.S. population that ingests substances such as soil, clay, starch, paint, or plaster. We compiled data from the National Health and Nutrition Examination Survey (NHANES) collected from years 1971–1975 (NHANES I) and 1976–1980 (NHANES II) because these particular surveys asked participants specific questions about non-food ingestion practices. We examined the prevalence of the behavior across multiple demographic variables, such as age, gender, education, and income level. Approximately 1% (NHANES II) to 2.5% (NHANES I) of the U.S. population ingests some type of non-food substance. The most notable variation across the demographic subgroups studied was the difference in estimated prevalence among young children (1 to <3 years) compared to older children and adults. Estimated prevalence was also higher among blacks compared to whites and within lower compared to higher socioeconomic groups. This analysis helps fill data gaps on the relative pattern of non-food ingestion practices on a national scale. This information provides perspective for risk assessors when evaluating exposure variables and for risk managers when weighing risk management alternatives.     

Duration between marriage and first birth and marital instability

This paper considers whether marital instability varies by the duration between marriage and 1st birth among ever-married white and black American women. Analysis of data from the June 1985 Current Population Survey suggests that the duration between marriage and 1st birth has a generally monotonic relationship with the probability of white women separating or divorcing from their 1st marriage; the relationship has remained relatively constant over time. For blacks, no consistent association is found between marital dissolution and the duration between marriage and 1st birth. Black women having a premarital conception and postmarital birth and those having their 1st birth during their 2nd year of marriage have a similarly high risk of dissolution. Conversely, blacks having their 1st birth 8-12 or 25-42 months after marrying have a low probability of dissolution. Childless women and those with premarital births generally has the greatest probability of marital disruption for whites. Racial differences may occur because blacks view the 1st birth and marriage differently than whites. That is, because blacks are much more likely to have premarital births and to have a shorter duration between marriage and 1st birth, blacks and whites in the same 1st birth interval category may be dissimilar and have different values resulting in a differential effect of the timing of the 1st birth on marital instability by race. Caution is needed when interpreting the pattern of association between delayed childbearing (and to a lesser extent, births occuring a few years after marriage) and marital instability. Results for whites were similar at each marriage duration and it is assumed delayed childbearing was not a result of marital instability. Marital instability was expected to have its strongest effect on the timing of the 1st birth during the 1st years of marriage. Marital instability may be partially responsible for the delaying of childbearing among blacks. However, blacks who delay but are married at 1st birth have a relatively low risk of separating or divorcing.     

Univariate and multivariate methods for sexing the sacrum

Metric data on 200 sacra of known sex, age and race are analyzed to determine the usefulness of conventional observations for determining sex in this bone. Results of the univariate analysis show that significant sex differences in the sacrum involve primarily the top portion of the bone for both whites and blacks. However, measurements of curvature are important sex differences in the sample of blacks. A new index relating the S1 body to sacral breadth is proposed as more useful in classifying the bones by sex than indices involving other measurements. Discriminant analysis shows that the sample of whites can be analyzed significantly better by this method than by using an index. The choice of univariate or multivariate method must depend on the condition of the bone, and will be influenced to some extent by the race from which the sample is drawn.     

Trends of Abdominal Adiposity in White,Black, and Mexican‐American Adults, 1988 to 2000

Objective: To describe changes in the distribution of waist circumference (WC) and abdominal obesity (AO) in white, black, and Mexican‐American adults from 1988 through 2000. Research Methods and Procedures: Nationally representative cross‐sectional surveys of adults 20 to 79 years of age were examined using data from U.S. National Health and Nutrition Examination Surveys of 1988 to 1994 and 1999 to 2000. AO was defined as WC ≥102 cm in men and ≥88 cm in women. Results: There was a gradient of increasing WC and AO with increasing age in both study periods in whites and blacks. In men, the average increase between the study periods in overall WC in whites, blacks, and Mexican Americans were 3, 3.3, and 3.4 cm, respectively. The corresponding values in women were 2.4, 5.3, and 3.7 cm, respectively. In men, the percentage change in prevalence of AO between 1988 and 2000 ranged from 5.5% in Mexican‐American men to 8.2% in white men. In women, there was a 1.7% decrease in AO in Mexican Americans, whereas there was an increase of 6.3% for whites and 7% for blacks. Discussion: Despite increased understanding of the need for screening and treatment for obesity, this study indicates increasing prevalence of AO in white and black Americans. Without concerted effort to reduce the prevalence of overall obesity, the increasing prevalence of AO is likely to lead to increased prevalence of metabolic syndromes in the United States. Our results highlight the need to design evidence‐based programs that show promise for long‐term health behavior changes to facilitate the prevention of AO and related comorbidities.     

Waist circumference values are increasing beyond those expected from BMI increases

Objective: The objective of this investigation was to examine the relationship between BMI and waist circumference (WC) by gender and race subgroups from U.S. population‐based data from 1959 to 2004 and to investigate the trend in WC over calendar time. Research Methods and Procedures: Demographic and anthropometric cross‐sectional data on 30,730 participants 18 to 79 years old across five national surveys were included. We regressed WC on BMI while controlling for age in each time period for blacks and whites by gender. Results: The relationship between BMI and WC as characterized by the slope of the linear regression of WC on BMI does not seem to be changing significantly over time. A small (range, 0.08 to 0.27 cm/yr) increase in WC over time was observed. Discussion: The implications of these findings for public health and for understanding any extant changes in the BMI‐mortality rate relationship remain to be elucidated.     

Screening of the Philadelphia variant of galactokinase in racially unmixed black Africans: first results.

In previous reports, it was emphasized that the gene GALKA of galactokinase was the predominant allele in white populations and that another allele, GALKP, which reduces red blood cell activity (RBC GALK), was common in black people. In a group of black Americans living in Philadelphia, the frequency of GALKA was found to be very close to values expected from independent estimation of white admixture. The authors have suggested that the ancestors of these blacks might have been virtually all GALKP homozygous. We have looked for carriers of GALKP genotypes among 73 black Africans; only 33 probands were shown to have a low RBC GALK. To detect white admixture, immunoglobulin allotypes Km and Gm were investigated in 50 individuals of the sample; 15 GALKP carriers with low RBC GALK and 30 of 35 individuals with normal RBC GALK shared Gm phenotypes exclusive to blacks. Our work demonstrates for the first time the polymorphism of GALK in black Africans in the absence of white admixture.     

Disagreement in spousal reports of current contraceptive use in sub-Saharan Africa

Contraceptive prevalence is a key variable estimated from Demographic and Health Surveys. But the prevalence estimated from reports of husbands differs widely from that estimated for wives. In this research, using data from six Demographic and Health Surveys of sub-Saharan Africa, reports from spouses in monogamous couples with no other reported sex partners in the recent period are examined. Agreement ranged from 47% to 82%, but among couples in which one or both reported use, the 'both' category represented less than half in all nations except Zimbabwe. Husbands generally had higher reports of condoms, periodic abstinence and pills but fewer reports of the IUD, injections and female sterilization. Either discussion of family planning with the spouse and/or higher socioeconomic status was associated with agreement in most of the surveys. Ambiguities in the survey question regarding current use need to be reduced, perhaps with an added probe question for non-permanent methods.     

Estimating mean time to reach a milestone, using retrospective data.

In surveys to estimate the mean age at menarche (or another milestone reached by the whole population), interviewed girls in the age range can respond that menarche (a) has not occurred or (b) has occurred or (c) occurred at a certain age t. Answers of type (a) and (b) are called status quo data. Answers of type (a) and (c) are called retrospective data.One kind of data is assumed. The distribution of age at menarche may also be assumed to be normal or not necessarily normal. This gives four possible sets of assumptions. Estimators, with their asymptotic distributions and optimal sampling allocations, are found for the case of retrospective data and non-normal distribution. These estimators are compared in examples with previously proposed estimators based on the other sets of assumptions. In these examples, retrospective data should certainly be used if available and reliable.     

Initial screening transferrin saturation values, serum ferritin concentrations, and HFE genotypes in whites and blacks in the Hemochromatosis and Iron Overload Screening Study

We compared initial screening data of 44,082 white and 27,124 black Hemochromatosis and Iron Overload Screening (HEIRS) Study participants. Each underwent serum transferrin saturation (TfSat) and ferritin (SF) measurements without regard to fasting, and HFE C282Y and H63D genotyping. Elevated measurements were defined as: TfSat more than 50% (men), more than 45% (women); and SF more than 300 ng/ml (men), more than 200 ng/ml (women). Mean TfSat and percentages of participants with elevated TfSat were significantly greater in whites than in blacks. Mean SF and percentages of participants with elevated SF were significantly greater in blacks than in whites. TfSat and SF varied by gender and age in whites and blacks. Prevalences of genotypes that included either C282Y or H63D were significantly greater in whites than in blacks. The prevalence of elevated TfSat and SF plus genotypes C282Y/C282Y, C282Y/H63D, or H63D/H63D was 0.006 in whites and 0.0003 in blacks. Among whites with HFE C282Y homozygosity, 76.8% of men and 46.9% of women had elevated TfSat and SF values. Three black participants had HFE C282Y homozygosity; one had elevated TfSat and SF values. Possible explanations for differences in TfSat and SF in whites and blacks and pertinence to the detection of hemochromatosis, iron overload, and other disorders with similar phenotypes are discussed.