Underprivileged areas and health care planning: implications of use of Jarman indicators of urban deprivation.

OBJECTIVE--To analyse critically the use of the Jarman underprivileged area index in health care planning and distribution of resources. DESIGN--The original derivation of the score was examined and evidence to support criticisms of the use of underprivileged area scores examined. MAIN OUTCOME MEASURES--Discrepancies between areas classified as deprived according to the index and areas known to require government funding; the extent of the bias towards family practitioner areas in London; and how the results of using the Jarman index compared with those when another deprivation index based on different indicators was used. RESULTS--The use of electroal wards as geographical areas for which deprivation payments are made is unsatisfactory as the wards vary considerably in size. Of the 20 district health authorities with the highest underprivileged area scores in England, 12 were in London, and four of the six family practitioner committee areas with the highest scores were in London. No health authority or family practitioner committee area in the Northern region had one of the top 20 or 10 scores respectively. When an alternative deprivation index was used to determine the allocation of resources to doctors there was considerable variation compared with the Jarman index. CONCLUSION--The Jarman index underprivileged area score is an inappropriate measure to use for health care planning and distribution of resources. There is a need for a revised measure for allocating deprivation payments to general practitioners.     

Is the Jarman underprivileged area score valid?

A recently published validation of an underprivileged area score, which is intended to reflect factors that increase general practice workload or pressure on their services, was incomplete; a validation based on criteria other than the opinion of general practitioners is also required. Areas with higher mortality from diseases where general practitioner intervention can reduce mortality substantially are likely to have a greater need for general practice services. Similarly, the need for general practitioner services should be higher where the incidence of such treatable conditions is higher. This paper describes the association between Jarman''s score and (a) mortality from causes that are amenable to general practice intervention and (b) incidence of two diseases where general practice intervention is important. Using these data the score appears to have external criterion validity and thus is likely to reflect, at least crudely, the need for general practitioner services.     

Water fluoridation,tooth decay in 5 year olds,and social deprivation measured by the Jarman score: analysis of data from British dental surveys.

OBJECTIVE: To examine the effect of water fluoridation, both artificial and natural, on dental decay, after socioeconomic deprivation was controlled for. DESIGN: Ecological study based on results from the NHS dental surveys in 5 year olds in 1991-2 and 1993-4 and Jarman underprivileged area scores from the 1991 census. SETTING: Electoral wards in three areas: Hartlepool (naturally fluoridated), Newcastle and North Tyneside (fluoridated), and Salford and Trafford (non-fluoridated). SUBJECTS: 5 year old children (n = 10,004). INTERVENTION: Water fluoridation (artificial and occurring naturally). MAIN OUTCOME MEASURE: Ward tooth decay score (score on the "decayed, missing, and filled tooth index" for each electoral ward). RESULTS: Multiple linear regression showed a significant interaction between Jarman score for ward, mean number of teeth affected by decay, and both types of water fluoridation. This confirms that the more deprived an area, the greater benefit derived from fluoridation, whether natural or artificial (R2 = 0.84, P < 0.001). At a Jarman score of zero (national mean score) there was a predicted 44% reduction in decay in fluoridated areas, increasing to a 54% reduction in wards with a Jarman score of 40 (very deprived). The area with natural fluoridation (at a level of 1.2 parts per million-higher than levels in artificially fluoridated areas) had a 66% reduction in decay, with a 74% reduction in wards with a Jarman score of 40. CONCLUSION: Tooth decay is confirmed as a disease associated with social deprivation, and the more socially deprived areas benefit more from fluoridation. Widespread water fluoridation is urgently needed to reduce the "dental health divide" by improving the dental health of the poorer people in Britain.     

A Jarman/Bell model of primate feeding niches

Some of the behavioral-ecological variation in the primate order can be explained by reference to a general model known as the Jarman/Bell principle. This principle involves a scaling relationship between metabolism and body size which suggests that body size is a fundamental tactic in an animal's feeding strategy. Relatively accurate predictions regarding the diets of primates of known body weight follow from this model. In addition, it can be expanded to predict the kinds of adaptations that would appear in animals that deviate from the expected size/diet pattern. The model is general enough such that, when joined with feeding strategy theory, it can be applied to extinct organisms. In this context it is suggested that Pleistocene hominid ecology was characterized more by omnivory than carnivory.     

Tret'yakov,N.N., Koshkin,E.I., Novikov,N.N., Makrushin,N.M., Pil'shchikova,N.V., Karnaukhova,T.V., and Loseva,A.S., Fiziologiya i biokhimiya sel'skokhozyaistvennykh rastenii (Physiology and Biochemistry of Crop Plants), Moscow: Kolos, 1998

Russian Journal of Plant Physiology -     

Pollen-Derived Haploids of Nicotiana Knightiana, N. raimondii, and N. attenuata

Haploid plantlets were obtained in large numbers in three diploid,24-chromosome species of Nicotiana by culture of anthers ator just past the first pollen mitosis. The three species wereN. Knightiana, N. raimondii, and N. attentiata. Efficiency ofhaploid production varied from about 10 per cent in N. attenuatacultures to 30 and 38 per cent respectively in cultures of N.raimondii and N. Knightiana. H-medium without hormones and standardcultural conditions were used. N. Knightiana appeared to beespecially suitable for haploid studies on account of its highplantlet productivity, low chromosome number, and distinctivekaryotype.     

Transformation of Nicotiana tabacum,N. debneyi,and N. rustica: Inheritance and protoplast expression of antibiotic resistance

Agrobacterium tumefaciens strains harbouring plasmid vectors pBCAT1, pVU1011 or pMON806 were used to transform leaf explants of Nicotiana tabacum cultivars Delgold and Candel, N. debneyi, and N. rustica var. NRT. Transgenic plants resistant to the selective agents kanamycin, hygromycin or methotrexate were regenerated and used as sources of leaf mesophyll protoplasts. Protoplasts divided and regenerated plants in the presence of selective agents at levels inhibitory to protoplasts of non-transformed plants. Cross-resistance of protoplasts to more than one selective agent was not observed in this study which suggests that this approach may lead to an efficient interspecific somatic hybrid selection system.     

Pathogenicity of Nocardia caviae,N. asteroides and N. brasiliensis

The pathogenicity ofNocardia caviae, N. asteroides andN. brasiliensis has been tested for white mice, guinea pigs and rabbits and chorio-allantoic membrane of the developing chick embryo. Altogether, 14 strains belonging to the 3Nocardia species originating from soil, human and animal sources in India or abroad were tested. All of them proved pathogenic though the degree of virulence varied from strain to strain. Incorporation of hog gastric mucin in the inoculum enhanced the virulence of all the 3Nocardia species for white mice.N. caviae strains were uniformly more virulent than those ofN. asteroides andN. brasiliensis.In the white mice inoculated intraperitoneally, a greater dissemination of the disease was apparent withN. caviae than withN. asteroides. Of the 6 strains ofN. caviae tested, 5 disseminated to the lung, 3 to the heart and 2 to the brain. InN. asteroides dissemination of the disease to the brain was observed with 2 of its 3 strains.N. brasiliensis showed no dissemination.N. caviae was found to be equally virulent for white mice, guinea pigs and rabbits. On the other hand,N. asteroides andN. brasiliensis were more virulent for white mice than for guinea pigs and rabbits. The lesions caused byN. caviae in mice, guinea pigs and rabbits persisted up to 4 weeks. In strong contrast to this the lesions due toN. asteroides andN. brasiliensis found in the guinea pigs and rabbits showed a strong tendency towards spontaneous clearance.Histologically, the lesions caused byN. caviae, N. asteroides andN. brasiliensis in mice, guinea pigs and rabbits were in the form of abscesses which showed an acute or chronic reaction. In the case ofN. caviae these abscesses showed both granules and freely dispersed cocco-bacillary bodies or filaments. As forN. asteroides it occurred in the form of cocco-bacillary bodies or filaments whereasN. brasiliensis consistently produced granules in the lesions.The lesions caused by the 3Nocardia species on the chorio-allantoic membrane of the developing chick embryo were in the form of abscesses which contained cocco-bacillary bodies and branching filaments but no granules.This forms a part of the thesis submitted by P.V.K. for Ph. D. degree, of the University of Delhi.     

Biological and chemical characteristics of allergen preparations from Neisseria (N. meningitidis, N. gonorrhoeae, N. perflava)]

Various methods of isolating allergen fractions from N. meningitidis, N. gonorrhoeae and N. perflava were tested. The biological activity of the preparation was found to depend on the method of its production, which determined its chemical composition. When gonococcal and meningococcal allergens and N. perflava allergen were used in skin tests, cross reactions were observed. Nevertheless, as the intensity and size of skin reaction was much greater when a homologous preparation was administered, it was possible to differentiate the presence of sensitization to a definite microbial species. Electrophoresis in acrylamide gel revealed the heterogeneity of allergen preparations. The ability of the preparation to induce skin reaction was not connected with its serological properties.     

DNA methylation in thermophilic bacteria: N4-methylcytosine, 5-methylcytosine, and N6-methyladenine.

While determining the minor and major base composition of the DNA from 17 types of thermophilic bacteria by high performance liquid chromatography (HPLC) of enzymatic digests, we have discovered a novel base, N4-methylcytosine (m4C). Its structure was proven by comparison of the DNA-derived nucleoside to the analogous authentic compound by HPLC, UV spectroscopy, and mass spectroscopy. Eight of the bacterial DNAs contained m4C. Only two contained the common minor base, 5-methylcytosine (m5C), and neither of these was from an extreme thermophile. The other prevalent modified base of bacterial DNA, N6-methyladenine (m6A), was found in nine of the DNAs. Restriction analysis revealed that four of the DNAs had dam-type (Gm6ATC) methylation patterns. Due to the propensity of m5C residues to be deaminated by heat to thymine residues and to inefficient repair of the resulting mismatched base pairs, thermophiles with optimal growth temperatures of greater than or equal to 60 degrees C generally may avoid having m5C in their genomes. Instead, some of them have deamination-resistant m4C residues.