A note on infantile pellagra

There occurs largely in tropical Africa and tropical America an acute and fatal disease which commonly attacks infants in the first few years of life. It is called by a different name in almost every country. It is frequently seen shortly after weaning. It is characterized by oedema, crazy-pavement skin, diarrhoea, cheilosis and stomatitis, generalized pallor of the skin and pale, straight, scanty hair. Neurological changes may occur but are slight and are terminal. Microcytic or macrocytic anaemia and steatorrhoea are variable features. It is almost certainly due to multiple deficiency defects, the major ones being those of nicotinic acid, riboflavin and protein, the latter producing a marked nutritional oedema. All other known deficiencies of vitamins, iron and the extrinsic factor of Castle have been described in some of the cases. Possibly as yet the main deficiency is not known. Intercurrent disease is common and is frequently the cause of death and of suspected failure of treatment by dietetic measures; bronchopneumonia, heavy malarial infection, anaemia and helminthiasis all occur. It is not known if the pellagra is the primary cause of the disease or if faulty methods of weaning and other gastro-intestinal disturbance lead to secondary pellagra, or if other infections, e.g., malaria, precipitate the vitamin deficiencies. It appears to have clear relationship with a deficiency of the vitamin B₂ complex, and can best be called by the time-honoured name of pellagra, since this name has for centuries described the various clinical states which characterize in all their complexity a deficiency of the vitamin B₂ complex. Some have thought that the oedema is due to beriberi, but there is no evidence in favour of this, and injections of the pure B₁ vitamin do not decrease the oedema. Those who do not accept this view may refer to the disease as kwashiorkor or the Proctor-Williams's disease.     

A note on interrater agreement

We investigate the properties of a measure of interrater agreement originally proposed by Rogot and Goldberg. Unlike commonly used measures, this measure not only adjusts for chance agreement, but it also standardizes for both perfect agreement as well as for perfect disagreement. Further, one can also use this measure to assess category specific conditional agreement, and thus apply it to situations with missing main diagonal data. We provide an asymptotic method for inference with this measure.     

A note on cost-value analysis

We discuss 'cost-value analysis', a method for health care resource allocation suggested by Nord et al. (Nord E et al. Incorporating societal concerns for fairness in numerical valuations of health programmes. Health Econ 1999; 8: 25-39). Some difficulties and issues for future research are pointed out.     

A mark-release-recapture experiment with Culex tritaeniorhynchus Giles

A mark-release-recapture experiment with the progeny of wild collected Culex tritaeniorhynchus was conducted at the village of Khokhar near Lahore, Pakistan, during June–July 1976, the onset of the monsoon. Recapture rates for each of three releases ranged from a low of 0·19% for males to a high of 0·58% for females. Male and female recaptures were well correlated with the dispersion patterns of the unmarked adults which suggested that the released adults selected similar resting habitats as the wild population. The direction of dispersal appeared random and marked, unfed females were captured biting buffaloes at the most distant collection site, 1·22 km from the release point. The initial gonotrophic cycle of the released females was completed six to eight days after emergence. The last marked female and male specimens were collected 13 and 15 days after the day of release, respectively. Released virgin females were all inseminated by the second night. The modified Lincoln index and Jackson's positive method (based on an eight-day sampling sequence) provided relatively similar estimates of population size which were considered realistic. Jackson's negative method, based on a three-day recapture chain, provided a substantial underestimate of survivorship and thus an underestimate of population size.     

Use of a modified Marchand cage to study mating and swarming behavior in Culex tarsalis, with reference to colonization

Selective pressures in laboratory rearing may account for the poor field mating of laboratory reared Culex tarsalis males. Previous studies of swarming behavior of field collected Cx. tarsalis had to be done in the field since such adults did not exhibit normal swarming in cages. Field collected individuals did not swarm normally nor mate effectively in cages. Normal swarming behavior by field collected mosquitoes, subsequent mating, and insemination were observed in a cage modified from a design by Marchand (1985). The use of such a cage could reduce one type of selective mating pressure involved in the colonization of mosquito species.     

A note on schooling and obesity

The effect of schooling on the odds that an individual is obese is estimated. Particular attention is given to the possible endogeneity effect of schooling. Empirical results show that schooling has a relatively substantial negative effect on the odds that an individual is obese. The simulations generally suggest that the odds of being obese significantly decreases after 12 years of schooling for various gender, age, and ethnic population groups.     

A note on prevention versus cure

The aim of this study is to test if the general Swedish population prefers saving lives through prevention or acute care. A trade-off question of a choice between saving lives through prevention or acute care was administered in a Swedish population sample. Based on the answers we estimate the median number of lives saved in acute care that is judged equivalent to saving one life through prevention. According to the results 1.2-1.4 lives saved in acute care is judged equivalent to saving one life through prevention. Thus our results indicate that lives saved through prevention and cure are given about the same value by the median respondent. Individuals seem to focus on the size of the health benefits rather than whether the health benefits are achieved through prevention or cure.     

A methodological note on location-allocation models

Three conditions render the use of standard methodologies inappropriate in solving location-allocation problems. This paper presents one alternative method for assigning an emergency aircraft to one of three hospitals in northern Chile when standard approaches are not suitable. Graph analyses and the demographic potential measures are used in the case presented. The main advantages of this alternative approach are its computational ease and the use of more than one method.     

A note of thanks

European Journal of Epidemiology -