Influenza poses a continuing public health threat in epidemic and pandemic seasons. The 1951 influenza epidemic (A/H1N1) caused an unusually high death toll in England; in particular, weekly deaths in Liverpool even surpassed those of the 1918 pandemic. We further quantified the death rate of the 1951 epidemic in 3 countries. In England and Canada, we found that excess death rates from pneumonia and influenza and all causes were substantially higher for the 1951 epidemic than for the 1957 and 1968 pandemics (by > or =50%). The age-specific pattern of deaths in 1951 was consistent with that of other interpandemic seasons; no age shift to younger age groups, reminiscent of pandemics, occurred in the death rate. In contrast to England and Canada, the 1951 epidemic was not particularly severe in the United States. Why this epidemic was so severe in some areas but not others remains unknown and highlights major gaps in our understanding of interpandemic influenza.
OBJECTIVE: A survey was conducted to estimate the acceptability of the controlled drinking goal among treatment services in New South Wales (NSW), Australia, and to compare results with similar surveys carried out elsewhere. METHOD: Of all identified alcohol treatment services (N = 295) in NSW, 179 (61%) responded to a mailed questionnaire with useable returns. RESULTS: Nearly three-quarters of respondents endorsed controlled drinking but half of these reported allocating less than 25% of their clients to this goal. Community-based services and alcohol treatment units were significantly more likely to endorse controlled drinking than were residential or private facilities. Community-based services and alcohol treatment units were also more likely to base the appropriateness of controlled drinking on professional experience and research evidence, whereas residential and private facilities relied more on the disease model or agency policy in making this determination. Respondents with tertiary qualifications were more likely to endorse controlled drinking than those without such qualifications, and these respondents were more likely to be found in community-based services and alcohol treatment units. CONCLUSIONS: The results show widespread support for the controlled drinking goal among NSW alcohol treatment services. This is similar to the reported status of controlled drinking in Britain and Norway and stands in marked contrast to the comparative reluctance of treatment services in North America to endorse the controlled drinking goal.
Human development reportedly includes critical and sensitive periods during which environmental stressors can affect traits that persist throughout life. Controversy remains over which of these periods provides an opportunity for such stressors to affect health and longevity. The elaboration of reproductive biology and its behavioral sequelae during adolescence suggests such a sensitive period, particularly among males. We test the hypothesis that life expectancy at age 20 among males exposed to life-threatening stressors during early adolescence will fall below that among other males. We apply time-series methods to cohort mortality data in France between 1816 and 1919, England and Wales between 1841 and 1919, and Sweden between 1861 and 1919. Our results indicate an inverse association between cohort death rates at ages 10-14 and cohort life expectancy at age 20. Our findings imply that better-informed and more strategic management of the stressors encountered by early adolescents may improve population health.
A comparative study of adolescent reproductive behavior in the 1980s examined difference in pregnancy, birth, and abortion levels among teenagers in developed countries especially in the US, Canada, the UK, France, the Netherlands, and Sweden. Only 6 of 37 countries with total fertility rates 3.5 and per capita income US$2000/year, and at least 1 million people had adolescent birth rates higher than the US (Bulgaria, Cuba, Puerto Rico, Romania, Hungary, and Chile). The US had the highest abortion rate (42/1000) followed by Hungary (27/1000). Thus the US had the highest adolescent pregnancy rate (96/1000) as well as Hungary (96/1000). The 6 country analysis showed that reducing the level of sexual activity among teenagers is not necessarily needed to achieve lower pregnancy rates. For example, Sweden had the highest levels of sexual activity but its pregnancy rate were 33% as high as those of the US. The rates of sexual activity among teenagers in the Netherlands equaled those of the US, but its pregnancy rates were 14% as high as those of the US. All countries had earlier, more extensive, and better contraceptive use among sexually active teenagers than the US which accounted for their lower pregnancy rates. The more realistic acceptance of sexual activity among teenagers and provision of contraceptives in all the countries except the US differed from the societal ambivalence in the US. Thus ambivalence about sexuality and the appropriateness of contraceptive use results in lower contraceptive use and greater adolescent pregnancy rates. US adolescents constantly receive conflicting messages that sex is romantic, thrilling, and arousing but it is also immoral to have premarital sex. Thus adults need to be more candid about sexuality so they can clearly convey to adolescents their expectations for responsible behavior and to provide the information and services needed to make effective use of contraceptives when sexually active.
Child and Adolescent Health Research Unit (CAHRU), Department of PE, Sport and Leisure Studies, University of Edinburgh, St. Leonard's Land, Holyrood Road, EH8 8AQ, Edinburgh, UK. email@example.com
This paper examines the relationship between family structure and smoking among 15-year-old adolescents in seven European countries. It also investigates the association between family structure and a number of known smoking risk factors including family socio-economic status, the adolescent's disposable income, parental smoking and the presence of other smokers in the adolescent's home. Findings are based on 1998 survey data from a cross-national study of health behaviours among children and adolescents. Family structure was found to be significantly associated with smoking among 15-year-olds in all countries, with smoking prevalence lowest among adolescents in intact families and highest among adolescents in stepfamilies. Multivariate analysis showed that several risk factors were associated with higher smoking prevalences in all countries, but that even after these other factors were taken into account, there was an increased likelihood of smoking among adolescents in stepfamilies. Further research is needed to determine the possible reasons for this association.
Aerobic fitness and percent body fat were measured in a sample of 438 male Army recruits between the ages of 17 and 30 prior to the commencement of training. The sample came from all areas of England and Wales. Aerobic fitness, as represented by maximal oxygen uptake (VO2 max), was predicted from the Astrand submaximal bicycle heart rate test. Body fat was predicted from four skinfold measurements. Total group means +/- SD were: age, 19.5 +/- 2.5 years; VO2 max 41.7 +/- 8.3 ml/kg . min; and body fat, 14.5 +/- 4.8% of body weight. VO2 max varied with age, athletic participation and aptitude score. No relationship was found with occupation of parent, prior civilian occupation or smoking severity. When adjusted for methodological differences, VO2 max was slightly below similar Army entrants in Norway and the United States.
A retrospective, comparative review of 100 consecutive new outpatients presenting with hyperthyroidism in Cardiff, South Wales, and in Toronto, Canada, was performed. The aim was to quantify the causes of hyperthyroidism with particular emphasis on the prevalence of viral thyroiditis and "silent" thyroiditis. The proportional morbidity of Graves' disease (approximately 70%) was similar in the two groups. Toxic multinodular goitre and toxic adenoma (Plummers' disease) occurred significantly more frequently in Cardiff (25% v 8%), whereas thyroiditis predominated in Toronto (17% v 1%).
The modal age at onset of the parkinsonian syndrome during the past thrity years is less than a decade higher than it was in the late 19th and early 20th centuries, suggesting that the same disease entity is affecting parkinsonian patients now as then. The evidence points to the existence of two distinct clinical entities: 1) parkinsonism secondary to encephalitis lethargica, which had its greatest influence on the epidemiology of parkinsonism between 1920 and 1945; and 2) classic parkinsonism, which has undergone little change in the past hundred years.
Alaska Medical Library - From: Fortuine, Robert et al. 1993. The Health of the Inuit of North America: A Bibliography from the Earliest Times through 1990. University of Alaska Anchorage. Citation number 396.