Geographic distribution of physicians in Portugal

The main goals of this paper are to (1) analyse the inequality in geographic distribution of physicians and its evolution, (2) estimate the determinants of physician density, and (3) assess the importance of competitive and agglomerative forces in location decisions. The analysis of the geographic distribution of physicians is based on the ratio of general practitioners (GPs) and specialists to 1,000 inhabitants. The inequality is measured using Gini indices, coefficients of variation, and physician-to-population ratios. The econometric models were estimated by ordinary least squares. The data used refer to 1996 and 2007. The impact of the growing number of physicians, and therefore potential increased competition, on geographic distribution during the period studied was small. Nonetheless, there is evidence of competitive forces acting on the dynamics of doctor localisation. Geographic disparities in physician density are still high, and appear to be due mainly to geographic income inequality.     

吉林省莱姆病疫源地地理分布

目的了解吉林省莱姆病的疫源地情况。方法按《莱姆病流行病学个案调查表》的内容对吉林省9个地区进行了人群、动物感染率，媒介蜱带菌率，蜱活动规律、消长时间、生存条件等调查；对吉林省莱姆病自然疫源地的分布、地理景观进行分析，对山区、半山区、平原调查的数据进行统计学处理。结果吉林省9个地区35个市县、55个乡镇的3561人群蜱叮咬率为91．00％，2292人群感染率为6．20％；马、牛、羊、狗、野鼠5种动物2499份调查，感染率为22．13％；抓捕的3570媒介蜱带菌率为35．80％。结论吉林省9个地区及旅游景点存在莱姆病疫源地，莱姆病并非属林业型疾病。     

Correction to: Geographic distribution of physicians in Portugal

The European Journal of Health Economics -     

Geographic distribution of Ochlerotatus japonicus in New York State

Tires and other water-holding containers throughout New York State were sampled during 2000 for the presence of immature or adult Ochlerotatus japonicus to determine the geographic distribution of this species. Waste tire stockpiles were one of the primary sites surveyed. Immature or adult Oc. japonicus were confirmed in 18 counties in New York State, including the northernmost recorded occurrence of this species in the United States.     

Geographic distribution of human Blastocystis subtypes in South America

Blastocystis is a cosmopolitan enteric protist colonizing probably more than 1 billion people. This protozoan exhibits genetic diversity and is subdivided into subtypes (STs). The aim of this study was to determine the distribution of Blastocystis STs in symptomatic and asymptomatic human samples from different countries of South America. A total of 346 fecal samples were genotyped by SSU rDNA showing ST1 (28.3%), ST2 (22.2%), ST3 (36.7%), ST4 (2%), ST5 (2.3%), ST6 (2%), ST7 (2.3%), ST8 (0.6%), ST12 (0.9%) and a novel ST (2.7%). These findings update the epidemiology of Blastocystis in South America and expand our knowledge of the phylogeographic differences exhibited by this stramenopile.     

我国男性青年视力低下的地区分布

目的 了解我国青年视力现状及其地域分布特点。方法 采用整群抽样的方法，在全国31个省（市，自治区）选择100个县（区）作为抽样点，对73000名17－21a男性青年的体格状况进行调查。按照视力低于诊断标准，将所有观察对象分为正常，轻度，中度和重度视力低下。采用SPSS11．0软件对不同地区视力低下检出率进行比较。结果 各地区视力低下检出率存在显差异，全国平均检出率为29．5％。华北，华东地区最高，分别为35．3％和32．5％，西北，西南地区最低，分别为25．9％和22．4％。各地区视力低下检出率存在城乡差别和化程度间的差别，城市的视力低下检出率较乡村高，全国城市视力低下检出率平均为36．2％，乡村为25．2％。高中以上化中视力低下检出率较初中以下高。高中以上化全国平均为38．8％。初中以下全国平均为23．8％，视力低下的检出率随年龄增加而增加，并存在种族差异。结论 青少年视力低下检出率存在明显的地工差异。应进一步研究不同地区视力低下与环境，气候，地理等关系。     

Geographic distribution of human immunodeficiency virus markers in parenteral drug abusers.

Drug abuse treatment programs in six regions of the United States collaborated in a study aimed at monitoring trends in the seroprevalence of human immunodeficiency virus (HIV) antibodies. The wide disparities in HIV seroprevalence in the face of similarities in drug using behavior have important implications for prevention. In the New York City area (Harlem, Brooklyn), 61 per cent of samples (N = 280) obtained in late 1986 were positive, up from 50 per cent of samples (N = 585) in early 1985. In Baltimore, Maryland, 29 per cent of samples (N = 184) representing 11 programs were positive. In contrast, samples from programs distant from the Northeast corridor had far lower rates: Denver, Colorado 5 per cent (N = 100); San Antonio, Texas 2 per cent (N = 106); Southern California, 1.5 per cent (N = 413); and Tampa, Florida, 0 per cent (N = 102). Contrary to expectations, there was no corresponding difference in reported lifetime needle sharing experiences, which ranged from 70 per cent in New York to 99 per cent in San Antonio. HIV seropositivity was associated only with geographic location and ethnicity; however, because needle sharing is practiced by parenteral drug abusers in areas where seroprevalence is still relatively low, these areas are potentially vulnerable to the same catastrophic spread seen in the Northeast. A window of opportunity exists where prompt, vigorous, and aggressive efforts at prevention could have major impact.     

Geographic distribution of the Australian primary health workforce in 1996 and 2001

OBJECTIVE: To analyse the geographic distribution of medical and non-medical primary health professions in 2001, and to compare this with 1996. DESIGN AND SETTING: Census data on the number and characteristics of selected health professionals in Australia by remoteness areas (as measured by the Accessibility Remoteness Index of Australia) were obtained from the Australian Bureau of Statistics. MAIN OUTCOME MEASURES: Number of general medical practitioners, allied health professionals and nurses per capita in Australia by remoteness areas in 2001 and 1996. RESULTS: In 2001, the number of general medical practitioners per capita in major cities was significantly higher than the numbers in inner regional areas, outer regional areas, and remote areas. This was also true of the number of allied health professionals per capita. The number of nurses per capita did not show the same pattern. From 1996 to 2001, the number of general medical practitioners per capita showed the largest increase in outer regional areas (10%) and no change in remote areas. The allied health professional workforce per capita increased significantly in all regions, while the nursing workforce per capita showed no significant increases. CONCLUSIONS AND IMPLICATIONS: Supply of all primary health professionals in remote areas remains low, and distribution patterns changed little from 1996 to 2001. The implementation of numerous government health workforce initiatives has coincided with little observable change in geographic distribution of the health workforce up to 2001.     

Implementing feeding guidelines for NICU patients<2000 g results in less variability in nutrition outcomes

BACKGROUND: We devised a consistent approach to instituting and advancing enteral nutrition among neonatal intensive care unit (NICU) patients<2000 g birth weight. We then assessed variability in feeding-related outcomes during a period before (period 1) vs after (period 2) implementing these guidelines. METHODS: Using data from period 1 vs period 2, we statistically compared the equivalence of variance, focusing on certain feeding-related outcomes. Specific outcomes we chose to examine were (1) day of life when the first enteral feedings were given, (2) number of days during the entire hospitalization when no feedings were given, (3) number of days parenteral nutrition (PN) was administered, and (4) day of life when feedings of 80 mL/k/d and 100 kcal/k/d enteral were achieved. RESULTS: Fifty-eight patients<2000 g were admitted to the NICU in period 1, of which 56 survived to discharge home. In period 2, 68 patients<2000 g were admitted and 66 survived to discharge. Demographic features of the patients in periods 1 and 2 did not differ. In both periods, feedings were begun on a median of day 1. However, in period 1 the range was from day 0 to day 24, and in period 2, the range was from day 0 to day 6 (equivalence of variance p<.001). After feedings were initiated, they were withheld for a median of 2 days (range, 0-23) during the remainder of the hospitalization in period 1 vs a median of 1 day (range, 0-12) in period 2 (p<.001). During period 1, PN was used for a median of 10 days (range, 0-72) vs 7 (range, 0-47) in period 2 (p=.001). During period 1, more variability occurred in the day of life when 80 mL/k/d and 100 kcal/k/d were achieved (both p<.001). No differences were seen in necrotizing enterocolitis, intestinal perforation, mortality, or length of hospital stay. CONCLUSIONS: Implementing feeding guidelines was associated with significantly less variability in feeding-related outcomes. We speculate that this is a reflection of better feeding tolerance, which resulted from a more consistent approach to initiating and advancing enteral feedings.     

Geographic distribution modeling and spatial cluster analysis for equine piroplasms in Greece

Maximum entropy ecological niche modeling and spatial scan statistic were utilized to predict the geographic range and to investigate clusters of infections for equine piroplasms in Greece, using the Maxent and SaTScan programs, respectively. The eastern half of the country represented the culminating area with high probabilities (p > 0.75) of presence of equine piroplasms and encompassed most regions with high concentration of equid host populations. The most important environmental factor that contributed to the ecological niche modeling was land cover followed by temperature. Significant clusters (p < 0.0001) were detected for Babesia caballi and Theileria equi infections in North and Central regions of Greece, respectively, which have significant equine populations. Maximum entropy ecological niche modeling and spatial scan statistic have proved to be useful tools for the surveillance of animal diseases.     

妊娠期糖尿病孕妇50g GCT和75g OGTT分布特征的研究

目的:探讨成都市妊娠期糖尿病(gestational d iabetes m ellitus,GDM)孕妇糖筛查(50 g GCT)和糖耐量(75g OGTT)的分布特征。方法:选取2008年9月～2009年6月在四川省妇幼保健院建卡产检的2 514例孕妇进行GCT检查,有妊娠期糖尿病高危因素的孕妇在24周以前进行检查;无高危因素者在24～28周检查;在妊娠中晚期出现体重增长过快、胎儿发育过大、羊水过多等情况的孕妇即使之前GCT试验阴性,也应及时重复GCT检查;GCT异常者3天后行75 g OGTT检查。结果:①成都市GDM发生率为4.97%;不同筛查孕周GCT异常率和GDM阳性率差异有统计学意义,24～28周检出率最高;②成都市GDM 50 g GCT 1 h血糖值呈正态分布,平均值为(9.53±1.47)mmol/L,且随着孕周的增加,50 g GCT 1 h血糖值呈逐渐增高的趋势;③75 g OGTT平均空腹血糖值为(5.03±1.08)mmol/L,1 h血糖值为(11.56±1.36)mmol/L,2 h血糖值为(10.12±1.29)mmol/L,3h血糖值为(7.33±1.15)mmol/L,空腹血糖偏低,而服糖后1 h、2 h、3 h血糖值偏高。结论:①对孕妇常规进行血糖筛查是有必要的,GCT检查最佳筛查孕周为24～28周,有高危因素的孕妇宜初诊时进行检查,对首次血糖筛查结果正常而有高危因素者应在以后的孕周复查以防漏诊。②根据成都市GDM 50 g GCT和75 g OGTT的分布特征,在制定适合我国的GDM标准时,有必要进行不同地域的多中心研究,对现有糖筛查和糖耐量的诊断标准进行确认和调整。     

Human infections with non-O157 Shiga toxin-producing Escherichia coli, Switzerland, 2000-2009

We characterized 97 non-O157 Shiga toxin (stx)-producing Escherichia coli strains isolated from human patients during 2000-2009 from the national reference laboratory in Switzerland. These strains belonged to 40 O:H serotypes; 4 serotypes (O26:H11/H-, O103:H2, O121:H19, and O145:H28/H-) accounted for 46.4% of the strains. Nonbloody diarrhea was reported by 23.2% of the patients, bloody diarrhea by 56.8%. Hemolytic uremic syndrome developed in 40.0% of patients; serotype O26:H11/H- was most often associated with this syndrome. Forty-five (46.4%) strains carried stx2 genes only, 36 strains (37.1%) carried stx1, and 16 (16.5%) strains carried stx1 and stx2. Genes encoding enterohemolysin and intimin were detected in 75.3% and 70.1% of the strains, respectively. Resistance to ≥1 antimicrobial agent was present in 25 isolates. High genetic diversity within strains indicates that non-O157 stx-producing E. coli infections in Switzerland most often occurred as single cases.