Disparities in cataract surgery between Aboriginal and non-Aboriginal people in New South Wales, Australia

<b>Background:</b> To investigate variation in rates of cataract surgery in New South Wales (NSW), Australia by area of residence for Aboriginal and non-Aboriginal adults.<p></p> <b>Design:</b> Observational data linkage study of hospital admissions.<p></p> <b>Participants:</b> 289 646 NSW residents aged 30 years and over admitted to NSW hospitals for 444 551 cataract surgery procedures between 2001 and 2008.<p></p> <b>Methods:</b> Analysis of linked routinely collected hospital data using direct standardisation and multilevel negative binomial regression models accounting for clustering of individuals within Statistical Local Areas (SLAs).<p></p> <b>Main outcome measures:</b> Age-standardised cataract surgery rates and adjusted rate ratios (ARRs).<p></p> <b>Results:</b> Aboriginal people had lower rates of cataract procedures than non-Aboriginal people of the same age and sex, living in the same SLA (ARR 0.71, 95% CI 0.68-0.75). There was significant variation in cataract surgery rates across SLAs for both Aboriginal and non-Aboriginal people, with the disparity higher in major cities and less disadvantaged areas. Rates of surgery were lower for Aboriginal than non-Aboriginal people in most SLAs, but in a few, the rates were similar or higher for Aboriginal people.<p></p> <b>Conclusions:</b> Aboriginal people in NSW received less cataract surgery than non-Aboriginal people, despite evidence of higher cataract rates. This disparity was greatest in urban and wealthier areas. Higher rates of surgery for Aboriginal people observed in some specific locations are likely to reflect the availability of public ophthalmology services, targeted services for Aboriginal people and higher demand for surgery in these populations.<p></p&gt

University of Central Florida 1985 self study Southern Association of Colleges and Schools : Institute for Statistics self study report

University of Central Florida Research Institutes, Institute for Statistics, Self Study for Southern Association of Colleges and Schools, 1985

University of Central Florida 1985 self study Southern Association of Colleges and Schools : Institute for Statistics self study report

University of Central Florida Research Institutes, Institute for Statistics, Self Study for Southern Association of Colleges and Schools, 1985

National trends in Aboriginal and Torres Strait Islander smoking and quitting, 1994-2008

Objective: To describe the trends in the prevalence of smoking, quitting and initiation among Aboriginal and Torres Strait Islander men and women aged 18 years and over. Methods: Analysis of responses to smoking questions in national Indigenous surveys in 1994, 2002, 2004 and 2008. Results: Male Indigenous smoking prevalence fell significantly from 58.5% in 1994 to 52.6% in 2008, an absolute decrease of 0.4 (CI 0.1-0.7)% per year, with the same decline in remote and non- remote areas. Female smoking fell from 51.0% to 47.4%, with markedly different changes in remote and non-remote areas. In non-remote areas, there was an absolute decrease in female smoking of 0.5 (CI 0.2-0.9)% per year, but in remote areas, female smoking increased by 0.4 (CI 0.0-0.8)% per year. From 2002 to 2008, the percentage of ever-smokers who had quit (quit ratio) increased absolutely by 1% per year in both men and women, remote and non-remote areas. Results about trends in initiation were inconclusive. Conclusions and Implications: Health Minister Roxon has committed to halving the Indigenous smoking prevalence by 2018, and has dramatically increased Indigenous-specific funding and activity in tobacco control. The reported historical trends in this paper are encouraging as they occurred at a time when there was little such tobacco control activity focused on Aboriginal and Torres Strait Islander people. However, to meet the Minister’s goal, Indigenous smoking prevalence will need to fall more than six times as quickly as occurred from 1994 to 2008

Suicide in the Northern Territory, 1981-2002

Objective: To examine trends in suicide in the Northern Territory between 1981 and 2002, and demographic and other characteristics of people completing suicide in the Top End region in 2000-2002. Design: Retrospective descriptive analysis of Australian Bureau of Statistics death registration data and data from the NT Coroner's Office. Setting and participants: All residents of the NT who completed suicide between 1981 and 2002. Main outcome measures: Changes in the age-adjusted and age- and sex-specific rates of suicide in Indigenous and non-Indigenous NT residents over time; prior diagnosis of mental illness and use of alcohol or other drugs by those completing suicide. Results: The age-adjusted suicide rate in the NT increased significantly between 1981 and 2002 (P 0.05), respectively. Indigenous males aged under 45 years and non-Indigenous males aged 65 years and over were most at risk. In the Top End, a history of diagnosed mental illness was present in 49% of suicide cases, and misuse of alcohol or other drugs around the time of death was associated with 72% of suicide cases. Conclusion: Our study highlights the rising rate of suicide in the NT and suggests that suicide prevention initiatives need to specifically target Indigenous and non-Indigenous males in the age groups most at risk

Mapping a better future: how spatial analysis can benefit wetlands and reduce poverty in Uganda

This publication presents study carried on Ugandan abundant natural wealth. Its varied wetlands, including grass swamps, mountain bogs, seasonal floodplains, and swamp forests, provide services and products worth hundreds of millions of dollars per year, making them a vital contributor to the national economy. Ugandans use wetlands-;often called the country';s ";granaries for water";-;to sustain their lives and livelihoods. They rely on them for water, construction material, and fuel, and use them for farming, fishing, and to graze livestock. Wetlands supply direct or subsistence employment for 2.7 million people, almost 10 percent of the population. In many parts of the country, wetland products and services are the sole source for livelihoods and the main safety net for the poorest households. Sustainable management of Uganda';s wetlands is thus not only sound economic policy, it is also a potent strategy for poverty reduction. Recognizing this, Uganda';s Government was the first to create a national wetlands policy in Africa. Over the past decade, Uganda has also instituted the National Wetlands Information System, a rich database on the use and health of Uganda';s wetlands which in its coverage and detail is unique in Africa. This publication builds on those initiatives by combining information from the wetlands database with pioneering poverty location maps developed by the Uganda Bureau of Statistics. The new maps and accompanying analyses will help policy-makers classify wetlands by their main uses, conditions, and poverty profile and identify areas with the greatest need of pro-poor wetland management interventions. The information generated can also be fed into national poverty reduction strategies and resource management plans. This is an innovative, pragmatic approach to integrating efforts to reduce poverty while sustaining ecosystems which has implications for improving policy-making in Uganda and beyond

Mortality after admission for acute myocardial infarction in Aboriginal and non-Aboriginal people in New South Wales, Australia: a multilevel data linkage study

Background - Heart disease is a leading cause of the gap in burden of disease between Aboriginal and non-Aboriginal Australians. Our study investigated short- and long-term mortality after admission for Aboriginal and non-Aboriginal people admitted with acute myocardial infarction (AMI) to public hospitals in New South Wales, Australia, and examined the impact of the hospital of admission on outcomes. Methods - Admission records were linked to mortality records for 60047 patients aged 25–84 years admitted with a diagnosis of AMI between July 2001 and December 2008. Multilevel logistic regression was used to estimate adjusted odds ratios (AOR) for 30- and 365-day all-cause mortality. Results - Aboriginal patients admitted with an AMI were younger than non-Aboriginal patients, and more likely to be admitted to lower volume, remote hospitals without on-site angiography. Adjusting for age, sex, year and hospital, Aboriginal patients had a similar 30-day mortality risk to non-Aboriginal patients (AOR: 1.07; 95% CI 0.83-1.37) but a higher risk of dying within 365 days (AOR: 1.34; 95% CI 1.10-1.63). The latter difference did not persist after adjustment for comorbid conditions (AOR: 1.12; 95% CI 0.91-1.38). Patients admitted to more remote hospitals, those with lower patient volume and those without on-site angiography had increased risk of short and long-term mortality regardless of Aboriginal status. Conclusions - Improving access to larger hospitals and those with specialist cardiac facilities could improve outcomes following AMI for all patients. However, major efforts to boost primary and secondary prevention of AMI are required to reduce the mortality gap between Aboriginal and non-Aboriginal people

Criminal Justice Agencies in Maine, 1971

https://digitalmaine.com/usdoj_feddocs/1000/thumbnail.jp

Cigarette availability and price in low and high socioeconomic areas

Objective: To determine whether tobacco retailer density and cigarette prices differ between low and high socioeconomic status suburbs in South-East Queensland. Methods: A survey of retail outlets selling cigarettes was conducted in selected suburbs over a two-day period. The suburbs were identified by geographical cluster sampling based on their Index of Relative Socio-economic Advantage and Disadvantage score and size of retail complex within the suburb. All retail outlets within the suburb were visited and the retail prices for the highest ranking Australian brands were recorded at each outlet. Results: A significant relationship was found between Index of Relative Socioeconomic Advantage and Disadvantage score (in deciles) and the number of tobacco retail outlets (r=0.93, p=0.003), with the most disadvantaged suburbs having a greater number of tobacco retailers. Results also demonstrate that cigarettes were sold in a broader range of outlets in suburbs of low SES. The average price of the packs studied was significantly lower in the most disadvantaged suburbs compared to the most advantaged. While cigarettes were still generally cheaper in the most disadvantaged suburbs, the difference was no longer statistically significant when the average price of cigarette packs was compared according to outlet type (supermarket, newsagent, etc). Conclusions: In South-East Queensland, cigarettes are more widely available in the most disadvantaged suburbs and at lower prices than in the most advantaged suburbs

Socio-demographic factors drive regional differences in participation in the National Bowel Cancer Screening Program – An ecological analysis

© 2017 The Authors Objective: To examine if geographic variations in the participation rates in the National Bowel Cancer Screening Program (NBCSP) are related to population-level socio-demographic characteristics. Methods: Data reflecting participation in the NBCSP for 504 Local Government Areas (LGAs) between July 2011 and June 2013 were extracted from the Social Health Atlas of Australia. Logistic regression models were used to examine independent associations (odds ratios [ORs]) between participation, Remoteness Area (RA) and selected socio-demographic variables. Results: Compared to the participation rate for major cities (33.4%), participation was significantly higher in inner regional areas (36.5%, OR=1.15), but was much lower in remote (27.9%, OR=0.77) or very remote areas (25.0%, OR=0.65). When controlling for study period, gender, proportion of persons aged 65 years and older, Indigenous status, cultural background and socioeconomic status, significantly higher rates were observed in all non-metropolitan areas than in major cities. Indigenous status was strongly related to the poorer participation in remote areas. Conclusions: Socio-demographic characteristics, particularly Indigenous status, cultural background and population ageing, seem to be more important drivers of regional disparities in NBCSP participation than geographic remoteness. Implications for public health: This study provides important evidence to understand the regional disparities in participating in the national screening program