Modeling of the Temporal Patterns of Fluoxetine Prescriptions and Suicide Rates in the United States

BACKGROUND: To study the potential association of antidepressant use and suicide at a population level, we analyzed the associations between suicide rates and dispensing of the prototypic SSRI antidepressant fluoxetine in the United States during the period 1960–2002. METHODS AND FINDINGS: Sources of data included Centers of Disease Control and US Census Bureau age-adjusted suicide rates since 1960 and numbers of fluoxetine sales in the US, since its introduction in 1988. We conducted statistical analysis of age-adjusted population data and prescription numbers. Suicide rates fluctuated between 12.2 and 13.7 per 100,000 for the entire population from the early 1960s until 1988. Since then, suicide rates have gradually declined, with the lowest value of 10.4 per 100,000 in 2000. This steady decline is significantly associated with increased numbers of fluoxetine prescriptions dispensed from 2,469,000 in 1988 to 33,320,000 in 2002 (r(s) = −0.92; p < 0.001). Mathematical modeling of what suicide rates would have been during the 1988–2002 period based on pre-1988 data indicates that since the introduction of fluoxetine in 1988 through 2002 there has been a cumulative decrease in expected suicide mortality of 33,600 individuals (posterior median, 95% Bayesian credible interval 22,400–45,000). CONCLUSIONS: The introduction of SSRIs in 1988 has been temporally associated with a substantial reduction in the number of suicides. This effect may have been more apparent in the female population, whom we postulate might have particularly benefited from SSRI treatment. While these types of data cannot lead to conclusions on causality, we suggest here that in the context of untreated depression being the major cause of suicide, antidepressant treatment could have had a contributory role in the reduction of suicide rates in the period 1988–2002

Carbon stored in human settlements: the conterminous United States

Urban areas are home to more than half of the world's people, responsible for >70% of anthropogenic release of carbon dioxide and 76% of wood used for industrial purposes. By 2050 the proportion of the urban population is expected to increase to 70% worldwide. Despite fast rates of change and potential value for mitigation of carbon dioxide emissions, the organic carbon storage in human settlements has not been well quantified. Here, we show that human settlements can store as much carbon per unit area (23–42 kg C m −2 urban areas and 7–16 kg C m −2 exurban areas) as tropical forests, which have the highest carbon density of natural ecosystems (4–25 kg C m −2 ). By the year 2000 carbon storage attributed to human settlements of the conterminous United States was 18 Pg of carbon or 10% of its total land carbon storage. Sixty-four percent of this carbon was attributed to soil, 20% to vegetation, 11% to landfills, and 5% to buildings. To offset rising urban emissions of carbon, regional and national governments should consider how to protect or even to increase carbon storage of human-dominated landscapes. Rigorous studies addressing carbon budgets of human settlements and vulnerability of their carbon storage are needed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75157/1/j.1365-2486.2009.02002.x.pd

Single parenting: Interventions in the transitional stage

Following divorce or separation, many mother-headed families need to mourn losses, including reduced economic resources. They need to reestablish family rituals, confront such issues as time management and structural changes that can result in scapegoating or over-reliance on a parental child. Normalizing difficulties associated with parenting is important because single parents tend to internalize societal attribution of family difficulties to inadequate family structure rather than developmental stages, limited economic resources, and negative expectations about the capacity of women to head families.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44289/1/10591_2004_Article_BF00891869.pd

Accounting for the Change in Income Disparities between US Central Cities and their Suburbs from 1980 to 1990

Develops a method that uses cluster analysis to group central cities in the United States. Selection of the candidate cluster solutions; Median characteristics of the clusters; Stressed central cities; Healthy central cities

Diasporas and democratization in the post-communist world

If diaspora communities are socialized with democratic values in Western societies, they could be expected to be sympathetic to the democratization of their home countries. However, there is a high degree of variation in their behavior. Contrary to the predominant understanding in the literature that diasporas act in exclusively nationalist ways, this article argues that they do engage with the democratization of their home countries. Various challenges to the sovereignty of their homelands explain whether diasporas involve with procedural or liberal aspects of democratization. Drawing evidence from the activities of the Ukrainian, Serbian, Albanian and Armenian diasporas after the end of communism, I argue that unless diasporas are linked to home countries that enjoy both international legal and domestic sovereignty, they will involve only with procedural aspects of democratization. Diasporas filter international pressure to democratize post-communist societies by utilizing democratic procedures to advance unresolved nationalist goals

Planning for a statewide network of dementia assessment services: A survey of geriatric assessment services in Michigan

All 38 geriatric assessment service units identified in Michigan were surveyed and responded as a component of planning a statewide network of diagnostic and assessment services for patients with dementia. Most units were outpatient (71 percent), urban (71 percent), and hospital-based (82 percent). Some provided primarily geropsychiatric services (21 percent), while the rest provided general geriatric services. The staff included physicians (95 percent), nurses (100 percent), social workers (95 percent) and other professionals (SO percent) such as nutritionists, neuro psychologists or clinical pharmacists. Assessments performed by most units included physical (92 percent), psychosocial (95 percent), functional (95 percent), neurological (71 percent) mental (95 percent), and financial (89 percent). Patient referral sources were most frequently self/family, followed by physician, community agencies, and community mental health. Reasons for referral were most often confusion! memory loss, followed by behavior change, caregiver stress, depression, and evaluation for placement. Most patients seen were between 65 and 84 years of age (72 percent), lived within 25 miles of the unit (87 percent), and had dementia (62 percent). Urban sites assessed significantly more persons per month (19 percent) than non-urban sites (4 percent). Community-based services spent significantly more time per month on geriatric assessments (68 hours) than did hospital-based services (26 hours). These survey results will aid the development of a statewide network of dementia diagnostic and assessment services.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67004/2/10.1177_153331759200700606.pd

An exploratory approach for enhancing vertical and horizontal equity tests for ad valorem property tax valuations using geographically weighted regression

Purpose: The purpose of this study is to enhance the estimation of vertical and horizontal inequity within property valuation. Property taxation is a crucial source of finance for local government around the world – based on a presumptive tax base underpinned by estimates of property value, inaccurate real estate valuations used for such ad valorem or value-based property tax calculations potentially lead to a variety of costs, both financial and other, for tax payers and governments alike. More common are increased costs in time, staff and, in some cases, legal fees. Some governments are even bound by acceptability thresholds to promote fairness, equitability and overall government accountability with respect to valuation. Design/methodology/approach: There exist a number of vertical inequity measurements that have undergone academic testing and scrutiny within the property tax industry since the 1970s. While these approaches have proved successful in detecting horizontal and vertical inequity, one recurring disadvantage pertains to measurement error/omitted variable bias, stemming largely from a failure to accurately account for location. A natural progression within property tax research is the application of a more spatially local weighted modelling approach to examine vertical and horizontal inequity. This research, therefore, specifies a geographically weighted regression (GWR) methodology to detect and measure vertical inequity in property valuations. Findings: The findings show the efficacy of using more applied spatial approaches for vertical tax estimation and indeed the limitations of employing conditional mean estimates coupled with delineated boundaries for assessing property tax inequity. The GWR model findings highlight the more fluctuating nature of vertical inequity across the Belfast market for the apartment sector both in a progressive and regressive sense and at different magnitudes. Moreover, the results reveal spatial clustering in the effects and are indicative of systematic inequities related to location inferring that spatial (horizontal) tax inequities are not random. The findings further show increased GWR model predictability overall. Originality/value: This research adds to the existing literature base for evaluating both vertical and horizontal inequity in value-based property taxation at the intra-neighbourhood level. This is accomplished by modifying the Birch–Sunderman approach by transforming the traditional OLS model architecture to a GWR model, thereby allowing coefficient estimates of inequity to vary not only across a jurisdiction, but also at a more local level, while incorporating property characteristic variables. This arguably allows assessors to identify specific geographical areas of concern, saving them money, time and resources on identifying, addressing and correcting for inequity

Oral Health Knowledge and Sources of Information Among Elementary Schoolchildren

The dental health knowledge and sources of health information of 848 elementary schoolchildren (aged 9–12) in southwestern Michigan were assessed. Demographic parameters (education level, percent below poverty level, median income level) of the area were similar to state and national averages. The children were found to have some knowledge of caries and periodontal disease prevention, yet basic misconceptions were evident. More than one-third of the children thought that plaque should only be removed by a dentist. While 75 percent of the subjects knew that fluoride protected teeth from decay, only 4 percent of the children identified fluoridated water as the best source of this preventive agent. Knowledge of pit and fissure sealants was limited. Extent of correct dental knowledge was not related to age, sex, or mean DMFS scores. Children who answered the most questions correctly named parents and family as their source of information; dentist's office was the second most frequently mentioned source. Findings suggest a need to correct basic misinformation about dental health and to inform children about current efficacious preventive agents.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66129/1/j.1752-7325.1989.tb02019.x.pd