BIRDS AS SCAVENGERS OF REFUSE IN UGANDA

Refuse tips, abattoirs and fishing villages provide an important source of food for several species of large scavenging birds in Uganda. The most numerous are Marabou Storks, Hooded Vultures, Black Kites and Pied Crows. Estimates of the populations of these species are given for Kampala, several smaller towns in Uganda and Rwenzori National Park (where there is an important fishing industry). Crows and kites are spread widely through Kampala and the population densities of both species exceed 12 km^-2 (the latter seasonally). On average there were about 200 Hooded Vultures at the Kampala abattoir and nearly as many Marabous at the refuse tips. Abattoirs and refuse tips in smaller towns often had proportionately higher populations of scavengers than Kampala. The food consumption of these birds is calculated to be nearly 100 t per year in Kampala and 800 t per year in Rwenzori National Park. It is suggested that although man, through his various activities, provides most of the food for these scavengers, they are beneficial to him in the sense that the food which they eat might otherwise become a health hazard.     

Serum lipid levels and factors affecting atherogenic index in Japanese children

An evaluation was made of the serum lipid levels and factors relating to atherogenicity in schoolchildren in Akita, Japan, in order to determine actual conditions and promote awareness of health. The subjects were 2878 boys and 2729 girls aged 9, 12 and 15 years, who lived in cities, towns and villages in the Akita prefecture. Physical and lifestyle data including serum lipids were collected from the subjects in their schools under the direction of the prefectural board of education. Total cholesterol levels were found to be nearly equal to those currently representative for Japanese children, ethnically situated between blacks and whites in the United States of America. Atherogenic indices (AIs) were lower than those in all other countries owing to the elevated high-density lipoprotein (HDL) cholesterol levels observed in this study. According to data obtained from the questionnaires that were part of the study, regularly taking breakfast and exercising in sports clubs seems connected to maintaining lower atherogenicity in childhood.     

Prevalence of Obesity and Associated Risk Factors in a Turkish Population (Trabzon City,Turkey)

Objective: To estimate the prevalence of overweight and obesity (general and central) in the Trabzon Region and its associations with demographic factors (age, sex, marital status, reproductive history in women, and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, and obesity), lifestyle factors (smoking habits, physical activity, and alcohol consumption), and hypertension in the adult population. Research Methods and Procedures: A sample of households was systematically selected from the central province of Trabzon and its five towns, namely, Sürmene, Vakfikebir, Maçka, Hayrat, and Tonya. A total of 5016 subjects (2728 women and 2288 men) were included in the study. Individuals more than 20 years old were selected from their family health cards. Demographic factors, socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure and diastolic blood pressure levels were measured for all subjects. Study procedures were carried out in the local health centers in each town over an 8‐month period. Obesity was defined as BMI ≥ 30 kg/m² and overweight as BMI = 25.0 to 29.9 kg/m². Results: The prevalence of obesity was 23.5%: 29.4% in women and 16.5% in men. The combined prevalence of both overweight and obesity was 60.3%. The prevalence of abdominal obesity was 29.4%: 38.9% among women and 18.1% among men. The prevalence of obesity increased with age, being highest in the 60‐ to 69‐year‐old age group (40.8%) but lower again in the 70+ age group. Obesity was associated positively with marital status, parity, cessation of cigarette smoking, alcohol consumption, and household income and inversely with level of education, cigarette use, and physical activity. Also, obesity was associated positively with hypertension. Discussion: In the Trabzon Region, 60.3% of the adult population presents with some excess weight. Obesity is a major public health problem that requires generalized interventions to prevent it among the adult population.     

Social life factors affecting the mortality, longevity, and birth rate of total Japanese population: effects of rapid industrialization and urbanization

To expand upon the findings that lower mortality was found in Japanese urban areas in contrast to the Western model where in the US and Britain the risk of death was higher in metropolitan areas and conurbations, 22 social life indicators are examined among 46 prefectures in Japan in terms of their effect on age specific mortality, life expectancy, and age adjusted marriage, divorce, and birth rates. The effects of these factors on age adjusted mortality for 8 major working and nonworking male populations, where also analyzed. The 22 social life factors were selected from among 227 indicators in the system of Statistical Indicators on Life. Factor analysis was used to classify the indicators into 8 groups of factors for 1970 and 7 for 1975. Factors 1-3 for both years were rural or urban residence, low income and unemployment, and prefectural age distribution. The 4th for 1970 was home help for the elderly and for 1975, social mobility. The social life indicators were classified form 1 to 8 as rural residence in 1970 and 1975, urban residence, low income, high employment, old age, young age, social mobility, and home help for the elderly which moved from 8th place in 1970 to 1st in 1975. Between 1960-75, rapid urbanization took place with the proportion of farmers, fishermen, and workers declining from 43% in 1960 to 19% in 1975. The results of stepwise regression analysis indicate a positive relationship of urban residence with mortality of men and women except school-aged and middle-aged women, and the working populations, as well as life expectancy at birth for males and females and ages 20 and 40 years for males. Rural residence was positively associated with the male marriage rate, whereas the marriage rate for females was affected by industrialization and urbanization. High employment and social mobility were positively related to the female marriage rate. Low income was positively related to the divorce rate for males and females. Rural residence and high employment were positively related to the birth rate. The birth rate is higher in rural areas. Mortality of professional, engineering, and administrative workers was slightly lower than the total working population, while sales workers, those in farming, fishing, and forestry, and in personal and domestic service had significantly higher mortality. The mortality of the nonworking population was 6-8 times higher than sales, transportation, and communication, and personal and domestic service as well as the total population.     

Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention

HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff’s spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15–19 years), adults aged 30–34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff’s spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed.     

Modernization,Sexual Risk-Taking,and Gynecological Morbidity among Bolivian Forager-Horticulturalists

Sexual risk-taking and reproductive morbidity are common among rapidly modernizing populations with little material wealth, limited schooling, minimal access to modern contraception and healthcare, and gendered inequalities in resource access that limit female autonomy in cohabiting relationships. Few studies have examined how modernization influences sexual risk-taking and reproductive health early in demographic transition. Tsimane are a natural fertility population of Bolivian forager-farmers; they are not urbanized, reside in small-scale villages, and lack public health infrastructure. We test whether modernization is associated with greater sexual risk-taking, report prevalence of gynecological morbidity (GM), and test whether modernization, sexual risk-taking and parity are associated with greater risk of GM. Data were collected from 2002–2010 using interviews, clinical exams, and laboratory analysis of cervical cells. We find opposing effects of modernization on both sexual risk-taking and risk of GM. Residential proximity to town and Spanish fluency are associated with greater likelihood of men’s infidelity, and with number of lifetime sexual partners for men and women. However, for women, literacy is associated with delayed sexual debut after controlling for town proximity. Fifty-five percent of women present at least one clinical indicator of GM (n = 377); 48% present inflammation of cervical cells, and in 11% the inflammation results from sexually transmitted infection (trichomoniasis). Despite having easier access to modern healthcare, women residing near town experience greater likelihood of cervical inflammation and trichomoniasis relative to women in remote villages; women who are fluent in Spanish are also more likely to present trichomoniasis relative to women with moderate or no fluency. However, literate women experience lower likelihood of trichomoniasis. Parity has no effect on risk of GM. Our results suggest a net increase in risk of reproductive morbidity among rapidly modernizing, resource-stressed populations.     

Outlook for survivors of childhood in sub-Saharan Africa: adult mortality in Tanzania. Adult Morbidity and Mortality Project.

OBJECTIVE--To measure age and sex specific mortality in adults (15-59 years) in one urban and two rural areas of Tanzania. DESIGN--Reporting of all deaths occurring between 1 June 1992 and 31 May 1995. SETTING--Eight branches in Dar es Salaam (Tanzania''s largest city), 59 villages in Morogoro rural district (a poor rural area), and 47 villages in Hai district (a more prosperous rural area). SUBJECTS--40,304 adults in Dar es Salaam, 69,964 in Hai, 50,465 in Morogoro rural. MAIN OUTCOME MEASURES--Mortality and probability of death between 15 and 59 years of age (45Q15). RESULTS--During the three year observation period a total of 4929 deaths were recorded in adults aged 15-59 years in all areas. Crude mortalities ranged from 6.1/1000/year for women in Hai to 15.9/1000/year for men in Morogoro rural. Age specific mortalities were up to 43 times higher than rates in England and Wales. Rates were higher in men at all ages in the two rural areas except in the age group 25 to 29 years in Hai and 20 to 34 years in Morogoro rural. In Dar es Salaam rates in men were higher only in the 40 to 59 year age group. The probability of death before age 60 of a 15 year old man (45Q15) was 47% in Dar es Salaam, 37% in Hai, and 58% in Morogoro; for women these figures were 45%, 26%, and 48%, respectively. (The average 45Q15s for men and women in established market economies are 15% and 7%, respectively.) CONCLUSION--Survivors of childhood in Tanzania continue to show high rates of mortality throughout adult life. As the health of adults is essential for the wellbeing of young and old there is an urgent need to develop policies that deal with the causes of adult mortality.     

Technical efficiency of small-scale fishing households in Tanzanian coastal villages: an empirical analysis

The effort to conserve fisheries resources and improve the welfare of small-scale fishing households is an important objective of poverty reduction strategies in Tanzania. The success of such strategies depends on both the diversity and the level of efficiency within small-scale fishing households. This paper examines the technical efficiency of Tanzanian small-scale fishing households, based on data from two coastal villages located near Bagamoyo and Zanzibar, using a stochastic frontier model with technical inefficiency. The estimated mean technical efficiency of small-scale fishing households was 52%, showing that they were operating far below optimum efficiency. The efficiency of individual fishing households was positively associated with fishing experience, size of farming land, distance to the fishing ground and potential market integration; it was negatively related to non-farm employment and bigger household sizes. Future policies aimed at conservation and development in fishing communities should provide mechanisms that improve the access of small-scale fishing households to less-destructive fishing tools (via the provision of credit facilities) and to markets, as well as the creation of new employment opportunities in other sectors. In addition, measures which check the use of illegal fishing gear, overcapitalisation and open-access problems should be considered.     

Weight and earnings among childbearing women in Metropolitan Cebu,Philippines (1983–2002)

We estimated the relationship between weight status and earnings among women participating in the Cebu Longitudinal Health and Nutrition Surveys between 1983 and 2002 conducted in Cebu, Philippines. Women working for pay were selected for the analysis. We used fixed effects estimation to account for unobserved time invariant characteristics related to weight. After correcting for potential bias due to unobserved heterogeneity, our results suggest that the earnings of obese or overweight women in Cebu (Philippines) were not less than women of normal weight. The relation between earnings and weight exists only among self-employed women or women working in more than one type of activity. No discrimination was found among women working for wages or per piece rate. In contrast, among self-employed and women working in more than one type of activity we found that underweight women earn less than do those with normal weight.     

Contamination of river water by Cryptosporidium parvum oocysts in western Japan

In Japan, only a few rivers have been inspected for Cryptosporidium parvum contamination, and the methods used had low sensitivity. In 1998 and 1999, we used a method with higher sensitivity to examine all large rivers used as sources of water supply in one prefecture (which we divided into four areas) in western Japan for Cryptosporidium oocysts. One sample was collected at each of 156 sites along 18 rivers, and samples were tested for Cryptosporidium oocysts by immunomagnetic separation. Samples were classified as being obtained on an island with livestock and fishing industries, a densely populated urban area, a western region including farming villages, or a still more rural northern area with agriculture and fishing. Restriction fragment length polymorphism analysis was used for identification of the C. parvum found as the bovine or human type. C. parvum was detected in at least one sample from 13 of the 18 rivers and in 47% (74 of 156) of the samples. One-third to all of the samples from each area contained C. parvum oocysts. The number of C. parvum oocysts per 20 liters of river water varied in the same pattern as the number of cattle kept in the four kinds of areas (as determined by the Mantel extension test). Oocysts isolated were of the bovine type; the C. parvum detected in rivers probably came from cattle kept in that valley. As we had expected, when tested with a more sensitive method, river water in western Japan was found to be greatly contaminated with C. parvum oocysts, as reported in other countries.     

Patterns of mortality in second generation Irish living in England and Wales: longitudinal study.

OBJECTIVE--To examine the mortality of second generation Irish living in England and Wales. DESIGN--Longitudinal study of 1% of the population of England and Wales (longitudinal study by the Office of Population Censuses and Surveys (now the Office for National Statistics)) followed up from 1971 to 1989. SUBJECTS--3075 men and 3233 women aged 15 and over in 1971. MAIN OUTCOME MEASURES--Age and sex specific standardised mortality ratios for all causes, cancers, coronary heart disease, cerebrovascular diseases, respiratory diseases, and injuries and poisonings. Deaths were also analysed by socioeconomic indicators. RESULTS--786 deaths were traced to men and 762 to women. At working ages (men, aged 15-64; women, 15-59) the mortality of men (standardised mortality ratio 126) and women (129) was significantly higher than that of all men and all women. At ages 15-44, relative disadvantages were even greater both for men (145) and for women (164). Mortality was raised for most major causes of death. Significant excess mortality from cancers was seen for men of working age (132) and for women aged 60 and over (122). At working ages mortality of the second generation Irish in every social class and in the categories of car access and housing tenure was higher than that of all men and all women in the corresponding categories. Adjusting for these socioeconomic indicators did not explain the excess mortality. CONCLUSION--Mortality of second generation Irish men and women was higher than that of all men and all women and for most major causes of death. While socioeconomic factors remain important, cultural and lifestyle factors are likely to contribute to this adverse mortality.     

Characterization of Ehrlichia species from Ixodes ovatus ticks at the foot of Mt. Fuji, Japan

A total of 390 adult ticks (288 Ixodes ovatus and 102 I. persulcatus ) collected at the foot of Mt. Fuji and two near cities in Shizuoka prefecture, Japan, were examined for Ehrlichia infection by isolation with laboratory mice from whole tick tissues. Ehrlichial DNAs were detected from the spleens of mice inoculated with tissues from I. ovatus, but not I. persulcatus. The prevalence of ehrlichiae in the ticks was estimated to be ca. 3%. The 16S rDNA analysis revealed that the sequences of 8 ehrlichial isolates (termed "Shizuoka" isolates) obtained were identical, and they were very similar, but not identical, to those of two Ehrlichia species strain variants recently isolated in Japan, followed by Ehrlichia chaffeensis in the US. Analysis of parts of the omp-1 multigene family specific for monocytic ehrlichiosis agents showed that the Shizuoka isolates were distinct from other ehrlichial organisms. The Shizuoka isolates caused death in immunocompetent laboratory mice, suggesting that they are highly pathogenic in mice. The data show that the Shizuoka isolates are likely to be a new strain variant of Ehrlichia species in Japan. Further characterization and surveillance will be required in Japan due to the presence of these human ehrlichiosis agent-like organisms.     

Prevalence of gallstones and risk factors in Caucasian women in a rural Canadian community.

The prevalence of gallstones and gallbladder disease was studied in a rural Caucasian population. All the women aged 15 to 50 years were asked to complete a questionnaire, undergo cholecystography and keep a food record for 4 consecutive days. The gallbladder status was assessed in 73%. The prevalence of gallstones in this population, 167/1000, was considerably higher than that reported in the Framingham study (59/1000) but was not significantly different from that recently found in Micmac Indian women living nearby in Canada (211/1000). In contrast to all the other studies in Caucasian women, this study showed the prevalence of gallstones to peak between the ages of 30 and 39 years. The risk factors, controlled for age, were found to be obesity, a narrow range of daily energy intake, a low daily calcium intake and limited activity. Discriminant analysis showed that skinfold thickness and range of daily energy intake or all measures of obesity together correctly separated the persons with gallstones from those without.     

The changing pattern of cardiovascular risk factors: the CroHort study

Croatia has a long tradition of non-communicable disease prevention, but also obstacles to the implementation of preventive programs related to the general attenuation of public health and primary health care sector. The aim of this study was to determine trends in behavioral and biomedical risk factors and evaluate primary non-communicable disease and cardiovascular prevention. Physical inactivity was a leading risk factor with increasing trend and prevalence of 33.9% and 38.9% in men and women in 2008. In 2008, obesity was present in 26.1% and 34.1%, and hypertension in 65.8% and 59.7% of men and women. During the follow-up only smoking and alcohol consumption in men decreased significantly, while alcohol consumption and obesity in women, and hypertension in both sexes significantly increased. In the present situation, with the existing trends and environment it will not be possible to stop negative trends. Revitalization of public health activities and primary health care is essential.     

Traditional CVD risk factors and socio-economic deprivation in Roma minority population of Croatia

Researches into health inequalities consistently show disadvantages in health status, morbidity and mortality for various ethnic minority groups. Current knowledge about prevention of cardiovascular diseases (CVD) mainly derives from studies carried out in populations of European origin while the evidences involving Roma population are scarce. Roma, an ethnic minority of northern Indian origin, live in many countries throughout the world and are well known for preserved traditions and resistance to assimilation. They are most often marginalized economically, spatially, politically and in terms of culture. In order to assess the health status and health-related lifestyle attributes, a multidisciplinary anthropological and epidemiological community-based study was carried out including a total of 423 members of the Bayash Roma minority population living in two regions of Croatia (144 men and 279 women, aged 18-84 yrs). Hypertension (HT) was found in 24.8% Bayash Roma (21.5% men and 26.5% women) using standard diagnostic criteria (i.e. BP > or = 140/90 mm Hg or taking antihypertensive therapy). The prevalence increases from 5.9% in the age group 18-34 yrs; 35.0% in the age group 35-64 yrs, and 51.4% in the age group 65+ yrs. The prevalence of hypertension in the Bayash Roma is almost half of the magnitude of what is usually reported for the general population of Croatia. It is also lower when compared with other European populations and this finding is not due to comparatively younger average age of the Bayash sample. The significant association of hypertension with age and BMI was confirmed in this study and the importance of non-traditional SES-related CVD risk factors was highlighted. Smoking is a part of traditional Roma life-style and with 70% of smokers almost the entire population is equally exposed to this risk factor in their family environment. Since homogenously distributed, this risk factor did not show to be a significant predictor of hypertension. The extent to which hypertension is influenced by traditional CVD risk factors as well as by some SES indicators was also assessed using a forward stepwise method of the multivariate logistic analysis. Each risk factor was explored as quantitative variable as well as qualitative one using various cut-offs. The best model showed to be the one having age and BMI presented as quantitative variables and sex, region, smoking status, income and schooling years as categorical ones; with cut-off 3 for number of income sources and 8 for the number of schooling years. In spite of the low prevalence of hypertension, the presented results are showing that Bayash Roma are bearing a high CVD risk factors load. We expect that with westernization of their life-style and along with increase of the economic power, the proportion of CVD in population of Bayash Roma will also increase. Therefore, it is important to recognize the need for early cardiovascular disease risk factors prevention in this minority population.     

太湖一级保护区非点源磷污染的定量化研究

采用田间实验与实地调查相结合的方法,研究了太湖一级保护区武进市雪堰镇水稻季节各种类型非点源磷污染的负荷分配情况。结果表明,雪堰镇各种类型农业非点源污染中,农田磷排放总量为1313kg,占排放总量的56．2％;农村居民磷排放总量为442kg,占排放总量的18．9％;城镇居民磷排放总量为518kg．占排放总量的22．2％;养殖业磷排放总量为62kg,占排放总量的2．7％．在当前的非点源磷污染治理中,除采取有力措施控制农田养分外,对于城镇和农村居民生活污水和人粪尿的排放也应引起重视。     

Evaluation of a proposed breast cancer screening regimen.

The Forrest working group on breast cancer screening recommended routine mammography for women in the United Kingdom at ages 50, 53, 56, 59, 62, and 65. Benefits were costed at about 3000 pounds for each life year recovered, but there was no estimate of the cost of each life saved, and the consequent reduction in mortality from breast cancer in the general population of the United Kingdom was not estimated. The present study addressed both of these issues using an interactive computer modelling process. Long term savings were calculated at 900 deaths a year in England and Wales--that is, about 8% of the total deaths from breast cancer--and 9% of life years currently lost. The cost of each death saved from breast cancer was estimated at 39,000 pounds.     

陇中黄土高原农村经济结构变化对退耕还林(草)的响应

黄土高原退耕还林(草)政策的实施有效改善了区域生态环境,然而其对社会经济的影响存在明显的地域差异。以甘肃省定西市安定区近郊凤翔镇和远郊鲁家沟镇为例,采用重复测定方差分析、主响应曲线分析和相关分析等解析2镇1998—2015年农村经济结构及收入变化对退耕还林(草)政策实施的响应特征,确定退耕还林(草)政策实施驱动的土地利用变化与农村收入之间的关系。研究发现:(1)退耕还林(草)政策实施解释了2镇70.4%的农业收入结构差异,因政策的实施推动了小麦等夏粮作物向玉米、马铃薯等秋粮作物的转变,进而影响了农业收入结构的变化;(2)退耕还林(草)政策对农村经济结构的影响弱于对农业收入结构的影响,它解释了2镇54.1%的农村经济结构差异,近郊凤翔镇农村经济收入明显高于远郊鲁家沟镇。退耕还林(草)政策对以农业为主导产业的远郊鲁家沟镇农村经济结构影响相对较小,近郊凤翔镇工业、服务业和商业餐饮业等非农产业占农村经济总收入的比重随着农业收入比重的降低而有所提高;(3)退耕还林(草)政策的实施带动了该区种植业结构的转变,这在一定程度上缩小了凤翔镇和鲁家沟镇农村集体收入之间的差距;(4)退耕还林(草)政策实施过程中,梯田面积、玉米和马铃薯等秋粮作物种植面积的增加提高了农村居民纯收入。研究认为退耕还林(草)在实施过程中需考虑地域差异,依据区域经济发展状况进行相应调整,在推动种植业发展的同时还应兼顾林业、牧业和一些非农产业发展,最终实现生态环境恢复与农村经济的协调发展。     

浙江省磐安县1973年—1985年蛇伤流行病学研究

对磐安县１９７３年￣１９８５年的蛇伤流行病学进行了回顾性调查。普查了全国２个国营林场、１个农场、３５６个行政村屯。１３年累计人口２４１２８８４人,其中蛇伤数为７３５人次（男５４６人次,女１８９人次）,死亡１０人。年平均发病数５６．５４人,发病率为２９．７／万,年均病死０．７７人,病死率为１．７７％,死亡率为０．０３７／万。各种致伤蛇种数高低依次是蛇蛇、竹叶青蛇、五步蛇、眼镜蛇、银环蛇、烙铁头蛇等。     

Control of blood pressure in Scotland: the rule of halves.

OBJECTIVE--Audit of detection, treatment, and control of hypertension in adults in Scotland. DESIGN--Cross sectional survey with random population sampling. SETTING--General practice centres in 22 Scottish districts. SUBJECTS--5123 Men and 5236 women aged 40-59 in the Scottish heart health study, randomly selected from 22 districts throughout Scotland, of whom 1262 men and 1061 women had hypertension (defined as receiving antihypertensive treatment or with blood pressure above defined cut off points). MAIN OUTCOME MEASURE--Hypertension (assessed by standardised recording, questionnaire on diagnosis, and antihypertensive drug treatment) according to criteria of the World Health Organisation (receiving antihypertensive treatment or blood pressure greater than or equal to 160/95 mm Hg, or both) and to modified criteria of the British Hypertension Society. RESULTS--In half the men with blood pressure greater than or equal to 160/95 mm Hg hypertension was undetected (670/1262, 53%), in half of those in whom it had been detected it was untreated (250/592, 42%), and in half of those receiving treatment it was not controlled (172/342, 50%). In women the numbers were: 486/1061, 46%; 188/575, 33%; and 155/387, 40% respectively. Assessment of blood pressure according to the British Hypertension Society''s recommendations showed an improvement, but in only a quarter of men and 42% of women was hypertension detected and treated satisfactorily (142/561, 215/514 respectively). IMPLICATIONS--The detection and control of hypertension in Scotland is unsatisfactory, affecting management of this and other conditions, such as high blood cholesterol concentration, whose measurement is opportunistic and selective and depends on recognition of other risk factors.