Disease mapping of early- and late-stage cancer to monitor inequalities in early detection: a study of cutaneous malignant melanoma

We consider disease mapping of early- and late-stage cancer, in order to identify and monitor inequalities in early detection. Our method is demonstrated by mapping cancer incidence at high geographical resolution using data on 10,302 cutaneous malignant melanoma (CMM) cases within the 3.7 million population of South-West Sweden. The cases were geocoded into small-areas, each with a population size between 600 and 2600 and accessible socio-demographic data. Using the disease mapping application Rapid Inquiry Facility (RIF) 4.0, we produced regional maps to visualise spatial variations in stage I, II and III–IV CMM incidences, complemented by local maps to explore the variations within two urban areas. Pronounced spatial disparities in stage I CMM incidence were revealed by the regional and local maps. Stage I CMM incidence was markedly higher in wealthier small-areas, in particular within each urban area. A twofold higher stage I incidence was observed, on average, in the wealthiest small-areas (upper quintile) than in the poorest small-areas (lower quintile). We identified in the regional map of stage III–IV CMM two clusters of higher or lower than expected late-stage incidences which were quite distinct from those identified for stage I. In conclusion, our analysis of CMM incidences supported the use of this method of cancer stage incidence mapping for revealing geographical and socio-demographic disparities in cancer detection

Responsible aquaculture: warm water fish preparation management and preparation of guidelines

Responsible aquaculture is a new concept in Iran but in some countries there are good historical performances. In fact this concept is as the spacial challenge for developing countries in order to improvement of aquaculturist livelihood. In bangladesh, near to 60% of the people, which the most of are villagers, live under the poor line. Developing the NGOs and their activities to reach the responsible aquaculture objectives were so effective, since this activity has been knew as profitable acuaculture and many international workshops, symposiums and conferences have been held in this regard all the world. In this project, a complex of parameters affected on preparing management of warmwater fish farms have been studied with using previous studies and experiments of different countries and executive guidelines of four modules prepared including: -Guidline of preparing of warmwater fish ponds -Guidline of water enrichment and using fertilization in warmwater fish ponds -Guidline of using aeration in warmwater fish ponds -Guidline of stocking method in warmwater fish pond

The association between active participation in a sports club, physical activity and social network on the development of lung cancer in smokers: a case-control study

<p>Abstract</p> <p>Background</p> <p>This study analyses the effect of active participation in a sports club, physical activity and social networks on the development of lung cancer in patients who smoke. Our hypothesis is that study participants who lack social networks and do not actively participate in a sports club are at a greater risk for lung cancer than those who do.</p> <p>Methods</p> <p>Data for the study were taken from the <b>Co</b>logne <b>Smo</b>king <b>S</b>tudy (<b>CoSmoS</b>), a retrospective case-control study examining potential psychosocial risk factors for the development of lung cancer. Our sample consisted of n = 158 participants who had suffered lung cancer (diagnosis in the patient document) and n = 144 control group participants. Both groups had a history of smoking.</p> <p>Data on social networks were collected by asking participants whether they participated in a sports club and about the number of friends and relatives in their social environment. In addition, sociodemographic data (gender, age, education, marital status, residence and religion), physical activity and data on pack years (the cumulative number of cigarettes smoked by an individual, calculated by multiplying the number of cigarettes smoked per day by the number of years the person has smoked divided by 20) were collected to control for potential confounders. Logistic regression was used for the statistical analysis.</p> <p>Results</p> <p>The results reveal that participants who are physically active are at a lower risk of lung cancer than those who are not (adjusted OR = 0.53*; CI = 0.29-0.97). Older age and lower education seem also to be risk factors for the development of lung cancer. The extent of smoking, furthermore, measured by pack years is statistically significant. Active participation in a sports club, number of friends and relatives had no statistically significant influence on the development of the cancer.</p> <p>Conclusions</p> <p>The results of the study suggest that there is a lower risk for physically active participants to develop lung cancer. In the study sample, physical activity seemed to have a greater protective effect than participation in a sports club or social network of friends and relatives. Further studies have to investigate in more detail physical activity and other club participations.</p

Life events, social support and sense of coherence among frequent attenders in primary health care

Objectives: The aim of this survey was to compare stressful life events, social support and sense of coherence (SOC) between frequent attenders (FAs) and normal attenders (controls) in primary health care. Study design: A cross-sectional study was conducted in a primary healthcare centre in the south-west of Sweden. Methods: A postal questionnaire was sent to 263 frequent attenders and 703 normal attenders. The questionnaire comprised sociodemographic variables and scales of stressful life events, social support and SOC. The results from the questionnaire were compared between the groups, and the significance of the variables in terms of attendance was tested in a multiple regression analysis. Results: More of the FAs were secondarily single, they had more chronic diseases and were more often living on a sickness/disablement pension than the controls. FAs did not report more stressful life events than the controls nor was their experience of events more negative. Social support was as strong among FAs as among controls, and it had no significant effect on their frequent attendance. FAs had a significantly weaker SOC compared with controls. The variables that significantly influenced frequent attendance were high age [odds ratio (OR)=1.02], chronic disease (OR=3.08), sickness/disablement pension (OR=2.46) and SOC (OR=0.97). Conclusions: SOC had a significant influence on frequent attendance in primary health care, but stressful life events and social support did not. FAs did not report more stressful life events. However, due to an inadequate coping strategy, indicated by a weak SOC, the life events probably caused them more symptoms and diseases, and thereby a higher consulting frequency. (c) 2005 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved

The self-reported health condition of women after their participation in a stress management programme: a pilot study

From a public health perspective, it is important to develop effective measures to deal with stress which are based on the individual's participation, such as stress management provided in group sessions. Therefore, the aim of the present study was to compare and evaluate the self-reported health condition of women in terms of their general symptoms, stress and sense of coherence (SOC) after participation in a stress management programme. The intervention, which had a modified crossover design and involved 40 women divided into two groups (G1 and G2), comprised eight meetings, the content of which was both theoretical and practical, and included information about stress, stress management, massage and mental training. A questionnaire was filled in on three occasions: before and after the intervention (8 weeks later), and after another 8 weeks (16 weeks later). The questionnaire contained 60 items comprising background factors, general symptoms, stress and SOC. No significant differences existed between the groups at baseline. In favour of the intervention, significant differences were found between the groups with regard to fewer general symptoms (P = 0.035) as well as a tendency to stress reduction (P = 0.060). A comparison within groups showed that both groups had a significant reduction in symptoms after the intervention (G1, P = 0.002; and G2, P = 0.003) and in reduced stress (both P = 0.001). After a further 8 weeks, both groups still showed significantly fewer general symptoms and reduced stress, as well as significant improvements with regard to SOC (G1, P = 0.012; and G2, P = 0.026). These findings indicate that the combination of mental training and massage in this stress management programme had a positive influence on the women's health condition. The pilot study design could be used in a full-scale study with randomised groups

Echocardiographic prediction of patent ductus arteriosus in need of therapeutic intervention

Aim: To evaluate the efficacy of various echocardiographic markers in predicting a patent ductus arteriosus (PDA) in need of treatment. Methods: Forty-five preterm infants with a mean (SD) gestational age of 27.7 (1.9) weeks underwent echocardiography at a postnatal age of 24 +/- 6 and 72 +/- 6 h. Four echocardiographic markers were studied: ductus diameter, ductal flow Doppler curves, the left atrial to aortic root (LA/Ao) ratio and Doppler pixels representing ductal shunting. Results: Twenty-eight infants had a PDA with a detectable left-to-right shunt. Of these, 12 (43%) were treated for a shunt through the PDA. Ductal diameter was the most accurate echocardiographic marker when it came to predicting a significant shunt, with a sensitivity of 89%, a specificity of 70%, a positive likelihood ratio of 2.97 and a negative likelihood ratio of 0.16 at the age of 72 h. The efficacy of the method at 72 h of age was 84%. The corresponding efficacy of the pulsatile Doppler curve was 72%, percentage of green colour pixels 63% and the LA/Ao ratio 53%. Conclusion: Ductus diameter appears to be the most important variable in determining the need for therapeutic intervention for PDA in preterm infants

Subjective social status in association with various health and socioeconomic indicators in Tehran

Aim: Socioeconomic status (SES) is one of the most important determinants of health. Subjective social status (SSS) is a popular SES indicator. The objective of this study is to compare the associations between health and various SES indicators in order to examine whether SSS is a proper SES indicator. Subject and methods: In this 2013 cross-sectional study, 1,995 Tehrani residents were selected through multi-stage random sampling. The questionnaires included items on subjective and objective SES, self-rated health (SRH) and objective health status. The crude and adjusted associations between health and SES indicators were assessed using bivariate and multiple logistic regressions. Results: The crude associations between SSS and all assessed health outcomes were significant. After adjustment of the wealth index, consumption, education and occupation, the associations between SSS and SRH (OR = 0.69, CI 95 : 0.55�0.86) and having cardiovascular (OR = 0.73, CI 95 : 0.58�0.92), musculoskeletal (OR = 0.81, CI 95 : 0.70�0.94), asthma and other respiratory diseases (OR = 0.71, CI 95 : 0.54�0.92) still remained significant. The adjusted associations between SSS and having hypertension and diabetes were not significant. SSS had a stronger correlation with the wealth index (Spearman r = 0.42) compared to other SES indicators. Conclusion: SSS showed a significant association with most of the health outcomes, independent of other SES indicators; therefore, it can be used in health research, though it is not an exact alternative for other objective SES indicators. © 2016, Springer-Verlag Berlin Heidelberg

Life expectancy in the province of Halland, Sweden, 1911-50: the progress of public health in a long-living population

Background: Life expectancy in Sweden is currently one of the longest in the world. The population of Halland has the longest life expectancy in Sweden. Aim: Life expectancy in the province of Halland and Sweden as a whole during 1911-50 was studied and the findings are discussed in the light of local historical data. Method: A trend analysis of risk ratio of death and life expectancy for Halland and Sweden was done for the period 1911-50 with regard to calendar year, age, and sex using a Poisson model. Results: The risk ratio between Halland and Sweden was 0.83 for 1911 and 0.76 for 1950. The risk ratio of death for women was lower compared with men and this difference increased over time. At the start of the study period life expectancy for men and women was higher in Halland (58.5 and 60.1 years, respectively) compared with Sweden (54.7 and 56.4 years, respectively) with a difference of approximately 3.8 years. At the end of the study period this difference in life expectancy for men and women in Halland (71.3 and 72.3 years, respectively) and the nation ( 68.0 and 69.2 years, respectively) had decreased to approximately 3.3 years. Conclusion: The long life expectancy seen in Halland today can be traced back to the early twentieth century. The starting point for this development seems to be a lower infant mortality in Halland compared with Sweden as a nation during the 1880-90. The basis for this might have been a greater increase of food production during the whole nineteenth century as well as other socioeconomic characteristics of Halland compared with the rest of the country

A comparison of small-area deprivation indicators for public-health surveillance in Sweden

Aims: The aims of this study were to construct a small-area index of multiple deprivation (IMD) from single deprivation indicators (SDIs) and to compare the explanatory power of the IMD and SDIs with regard to mortality. We considered a small-area division of Sweden consisting of 5985 DeSO (Demografiska statistikområden), each with a population size between 653 and 4243 at the end of 2018. Methods: Four SDIs were provided by open-source data: (a) the proportion of inhabitants with a low economic standard; (b) the proportion of inhabitants aged 25–64 years with ⩽12 years of schooling; (c) the proportion of inhabitants aged 16–64 years who were not in paid employment; and (d) the proportion of inhabitants who lived in a rented apartment/house. A four-indicator IMD was constructed using factor analysis. As a validation, the IMD and SDIs were compared by exploring their DeSO-level associations with spatially smoothed death rates, with robustness checks of associations across different small-area contexts defined by degree of urbanisation and distribution of immigrants from non-Western countries. Results: The constructed IMD and SDI1 performed essentially equally and outperformed SDI2, SDI3 and SDI4. Associations between IMD/SDI1 and the spatially smoothed death rates were most pronounced within the age range 60–79 years, showing 5–8% lowered rates among those categorised in the least deprived quintiles of IMD and SDI1, respectively, and 7–9% elevated rates among those categorised in the most deprived quintiles. These associations were consistent within each small-area context. Conclusions: We suggest prioritisation of SDI1, that is, a DeSO-level deprivation indicator based on open-access data on economic standard, for public-health surveillance in Sweden