Historical epidemiology and the structural analysis of mortality

Attempts to explain long-term variations in pre-transitional Western European mortality in terms of changing living standards have met with little success, and this has led to the view that such variations were biologically, or climatically determined. This conclusion can, however, be avoided by a fuller specification of the determinants of exposure to infection that incorporates the dimensions of spatial structure. This paper advances a model of the proximate determinants of exposure and resistance to infection, and derives predictions for the mortality patterns of pretransitional metropolitan centres that are tested against data from London c1670–1830. The latter generally bear out the predictions of the model whilst also demonstrating the importance of certain features of England’s political economy over this period

Avoidable Hospitalizations

Georgia Health Policy Center worked to improve health care in eight of the most rural, medically under served states in the country. The Center conducted research and provided strategic planning for eight Southern states: Alabama, Arkansas, Georgia, Louisiana, Mississippi, South Carolina, East Texas and West Virginia

Traditional Versus Nontraditional Instructional and Assessment Differences in 8th-Grade History-Social Science Achievement

In southern California school districts, 8th grade students in history-social science (H-SS) classes did not perform well on the California Standards Test (CST). To improve student performance, middle school H-SS teachers in some districts received staff development in the use of authentic assessment, the understanding and application of multiple intelligences theory, and the application of a student centered focus in lesson design and instruction. The purpose of this comparative pretest/posttest study was to determine if there was significant achievement difference between 2 8th-grade U.S. H-SS classes taught in 2 districts. The research question addressed a significant difference in CST H-SS achievement scores between 8th-grade students taught using multiple intelligences strategies and authentic assessments (n = 28) and those who were taught using traditional strategies and curriculum assessments (n = 31). The theoretical foundation for this study was constructivism. Post-data from archived student scores on the CST H-SS test were collected and analyzed using an analysis of covariance (ANCOVA), controlling for varying differences in CST pre-test H-SS scores. There was a statistically significant difference in posttest CST H-SS scores between the 2 groups (F = 10.491, p \u3c .002), with the nontraditional group scoring higher. Based on the findings, it is recommended that district leaders provide professional development opportunities for teachers in nontraditional constructivist instructional strategies that support student-centered instruction. These endeavors may lead to positive social change if H-SS teachers change instruction and assessment methods to improve student achievement, thus, meeting graduation requirements and enhancing citizenship development

Genetic analysis of amyotrophic lateral sclerosis identifies contributing pathways and cell types

Despite the considerable progress in unraveling the genetic causes of amyotrophic lateral sclerosis (ALS), we do not fully understand the molecular mechanisms underlying the disease. We analyzed genome-wide data involving 78,500 individuals using a polygenic risk score approach to identify the biological pathways and cell types involved in ALS. This data-driven approach identified multiple aspects of the biology underlying the disease that resolved into broader themes, namely, neuron projection morphogenesis, membrane trafficking, and signal transduction mediated by ribonucleotides. We also found that genomic risk in ALS maps consistently to GABAergic interneurons and oligodendrocytes, as confirmed in human single-nucleus RNA-seq data. Using two-sample Mendelian randomization, we nominated six differentially expressed genes (ATG16L2, ACSL5, MAP1LC3A, MAPKAPK3, PLXNB2, and SCFD1) within the significant pathways as relevant to ALS. We conclude that the disparate genetic etiologies of this fatal neurological disease converge on a smaller number of final common pathways and cell types

A database management capability for Ada

The data requirements of mission critical defense systems have been increasing dramatically. Command and control, intelligence, logistics, and even weapons systems are being required to integrate, process, and share ever increasing volumes of information. To meet this need, systems are now being specified that incorporate data base management subsystems for handling storage and retrieval of information. It is expected that a large number of the next generation of mission critical systems will contain embedded data base management systems. Since the use of Ada has been mandated for most of these systems, it is important to address the issues of providing data base management capabilities that can be closely coupled with Ada. A comprehensive distributed data base management project has been investigated. The key deliverables of this project are three closely related prototype systems implemented in Ada. These three systems are discussed

The prevalence of glaucoma in indigenous Australians within Central Australia: the Central Australian Ocular Health Study

Aims To determine the prevalence of glaucoma within the indigenous Australian population living in central Australia. Methods 1884 individuals aged ≥20 years, living in one of 30 remote communities within the statistical local area of ‘Central Australia,’ were recruited for this study. This equated to 36% of those aged ≥20 years and 67% of those aged ≥40 years within this district. Slit-lamp examination of the anterior segment and intraocular pressure measurement, followed by stereoscopic slit-lamp funduscopy of the optic nerve, was performed. Selected patients underwent automated visual-field testing. The diagnosis of glaucoma was based on pre-existing definitions. Glaucoma prevalence data are presented. Results Seventeen individuals had glaucoma (0.90%). Causes of secondary glaucoma were found in four with neovascular glaucoma, two with uveitic glaucoma and four who had developed glaucoma subsequent to trauma or surgery. The remaining seven had no identifiable cause for their glaucoma and were thus classified as open-angle glaucoma equating to a prevalence of 0.52% (95% CI 0.14% to 0.90%) for those aged ≥40 years. Of these, four had an intraocular pressure ≤21 mm Hg, and three had an intraocular pressure >21 mm Hg. Conclusion The prevalence of open-angle glaucoma among indigenous Australians within central Australia was 0.52% for those aged ≥40 years. After adjustment for the age distribution of our sample, this is one-third the prevalence seen among the non-indigenous Australian population and is despite a higher prevalence of ocular parameters considered to be associated with glaucoma

Incidence of visual impairment due to cataract, diabetic retinopathy and trachoma in indigenous Australians within central Australia: the Central Australian Ocular Health Study

Author version made available in accordance with the publisher's policy.Background: To estimate the incidence and causes of visual impairment for the purposes of service provision among the indigenous Australian population within central Australia from its most common causes, namely cataract, diabetic retinopathy and trachoma. Design: Clinic-based cohort study. Participants: One thousand eight hundred eighty four individuals aged =20 years living in one of 30 remote communities within the statistical local area of 'Central Australia'. Methods: From those initially recruited, 608 (32%) participants were reviewed again between 6 months and 3 years (median 2 years). Patients underwent Snellen visual acuity testing and subjective refraction. Following this, an assessment of their anterior and posterior segments was made. Baseline results were compared with those who were reviewed. Main Outcome Measures: The annual incidence rates and causes of visual impairment (vision worse than Snellen visual acuity 6/12 in at least one eye). Results: The incidence of visual impairment in at least one eye was 6.6%, 1.2% and 0.7% per year for cataract, diabetic retinopathy and trachoma, respectively (7.9%, 1.5% and 0.7% per year for those aged =40 years). Advancing age was the main risk factor common to all three. Conclusion: It is important to be mindful not only of the prevalence of disease in a community but also of the rate at which new cases are occurring when allocating resources to address the ocular health needs of this region. Compared with historical data, diabetic retinopathy is emerging as a new and increasing threat to vision in this population.Australian National Health & Medical Research Counci

The Responsiveness of Casino Revenue to the Casino Tax Rate

This paper uses variation in Illinois casino taxes to estimate the elasticity of casino adjusted gross receipts (AGR) with respect to the marginal casino tax rate. Illinois’ shift to a graduated rate schedule initiated increases in the highest marginal tax rate on AGR from 20% to 70% with reversion to a 50% rate. We construct a state-level casino tax rate variable based on the effective marginal rates on AGR at individual casinos, imputing the tax on casino admissions as a proportion of adjusted gross receipts. We find that a 1% increase in this casino tax rate decreases AGR by 0.2%