Effects of improved street lighting on crime

Improved street lighting serves many functions and is used in both public and private settings. The prevention of personal and property crime is one of its objectives in public space, which is the main focus of this review. There are two main theories of why improved street lighting may cause a reduction in crime. The first suggests that improved lighting leads to increased surveillance of potential offenders (both by improving visibility and by increasing the number of people on the street) and hence to increased deterrence of potential offenders. The second suggests that improved lighting signals community investment in the area and that the area is improving, leading to increased community pride, community cohesiveness, and informal social control. The first theory predicts decreases in crime especially during the hours of darkness, while the second theory predicts decreases in crime during both daytime and nighttime. Results of this review indicate that improved street lighting significantly reduces crime. This lends support for the continued use of improved street lighting to prevent crime in public space. The review also found that nighttime crimes did not decrease more than daytime crimes. This suggests that a theory of street lighting focusing on its role in increasing community pride and informal social control may be more plausible than a theory focusing on increased surveillance and increased deterrence. Future research should be designed to test the main theories of the effects of improved street lighting more explicitly, and future lighting schemes should employ high quality evaluation designs with long-term followups

Misclassification of breast cancer as cause of death in a service screening area

Objective: The aim of this study was to assess the misclassification of cause of death for breast cancer cases, and to evaluate the differential misclassification between cases detected in an organized screening program and cases found in current clinical practice. Methods: All deaths occurring between 1999 and 2002 within breast cancer cases were linked to hospital discharge records. Death certificates and latest available hospital discharge notes were classified into various categories. We created a classification algorithm defining which combinations of categories (of death certificates and hospital discharge notes) suggested the probability of misclassification and the need for an in-depth diagnostic review. Questionable cases were reviewed by a team of experts in order to reach a consensus on cause of death. Based on our algorithmic classification and diagnostic review results, the agreement between original cause of death and that resulting from the assessment process was analyzed stratifying for every variable of interest. Results: According to death certificates, breast cancer was the cause of death in 66.9% of subjects, and after assessment this figure changed to 65.7%. The misclassification rate was 4.3% and did not differ significantly between screen-detected (4.7%) and non-screen-detected (4.3%) cases. Higher misclassification rates in favor of false positivity (cause of death wrongly attributed to breast cancer in death certificates) was observed for subjects with multiple cancers (6.5% vs. 1.9%), with no admission in the year before death (4.6% vs. 2.4%) and with an unknown cancer stage (4.9% vs 2.4% or 2.3%). Conclusions: The cause of death misclassification rate is modest, causing a slight overestimate of deaths attributed to breast cancer, and is not affected by modality of diagnosis. The study confirmed the validity of using cause-specific mortality for service screening evaluation. © 2008 Springer Science+Business Media B.V

Risk factors and containment of respiratory syncytial virus outbreak in a hematology and transplant unit

Respiratory syncytial virus (RSV) usually causes self-limiting upper respiratory tract infections, but can be associated with severe lower respiratory tract infection disease (LRTID) in infants and in patients with hematologic malignancies. We have analyzed the risk factors and the measures for containment within an outbreak of nosocomial RSV infections in a hematology and SCT unit. A total of 56 patients were affected (53 RSV-A and 3 RSV-B) including 32 transplant patients (16 allogeneic and 16 autologous). Forty (71%) of the 56 patients suffered from LRTID and 14 (35%) of the patients with LRTID subsequently died. However, because of concomitant infections with fungal and bacterial pathogens, the impact of RSV on the fatal outcome was difficult to assess. Multivariate analysis showed that low levels of IgG were significantly associated with fatal outcome (P=0.007), treatment with oral ribavirin represented a protective factor (P=0.02). An extremely protracted viral shedding was observed in this cohort of patients (median=30.5 days, range: 1–162 days), especially pronounced in patients after allogeneic transplantation (P=0.002). Implementation of rigorous isolation and barrier measures, although challenged by long-term viral carriers, was effective in containment of the outbreak

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