Deaths due to dementia: An analysis of multiple-cause-of-death data.

This study analyzes multiple-cause-of-death information from over 113,000 death certificates of Canadians aged 65+ and identifies causes that are significantly likely and significantly unlikely to combine with dementia to cause death. For dementia as a mentioned cause and as the underlying cause of death, frequencies and rates of death were calculated. Dementia was mentioned on death certificates 2.4 times as often as it occurred as the underlying cause of death. Among the causes least associated with dementia were some cancers, chronic respiratory diseases and rheumatoid arthritis. Causes of death that rarely occur with dementia should be further investigated in terms of their potential role in preventing or delaying the onset of dementia. In particular, further study of the role of anti-inflammatory drugs and nicotine in reducing the risk of dementia is indicated. Causes positively associated with dementia largely reflect the physical deterioration it confers.

Falling short of Pap test guidelines.

OBJECTIVES: This article examines the associations between women's characteristics and getting or not getting a Pap test. DATA SOURCE: The data are from the 1994/95 National Population Health Survey (NPHS) conducted by Statistics Canada. ANALYTICAL TECHNIQUES: Multivariate logistic regressions were used to determine the odds of women not complying with Pap test guidelines, that is, of never having had a Pap test, and among women who had had one, of not having done so in the last three years. MAIN RESULTS: One in four women aged 18 to 69 had either never had a Pap test or had not had one in the three years before the NPHS. Notably, older women--who are at the greatest risk for cervical cancer--are less compliant with screening guidelines than younger women. Other characteristics of women with high odds of never having had a Pap test are: being single, being a resident of Quebec, having immigrated to Canada, having less than a secondary school education, not being in the highest income group and having had no sex partners in the previous year.

Surgical rates in subprovincial areas across Canada: rankings of 39 procedures in order of variation.

OBJECTIVE: To rank 39 surgical procedures in order of variation of inpatient surgical rates, according to a new index of variation and to test the hypothesis that there is greater variation for primarily discretionary operations than for primarily non-discretionary operations. DESIGN: A population-based retrospective cohort study. SETTING: Nine provinces (99.19% of Canada's population). PARTICIPANTS: All hospital inpatients who underwent any of 39 types of surgery and were separated from hospital between Apr. 1, 1988 and Mar. 31, 1990 (the most recent time period for which Canada-wide data were available at the subprovincial level analysed). MAIN OUTCOME MEASURE: Rankings of the 39 procedures according to the index of variation, calculated from inpatient surgery rates in 255 census divisions across Canada. RESULTS: The 13 procedures with the greatest variation were all primarily discretionary. Thirteen of the 14 procedures with the lowest variation were primarily non-discretionary. All but one of the procedures whose degree of discretion was deemed intermediate were in the middle third of the rankings. CONCLUSIONS: The greatest variation is found in primarily discretionary operations. Further investigation should be focused on identified geographical locations where rates for operations that are primarily discretionary are unusually high or low, and particularly on those operations for which there is disagreement regarding the indications for surgery.

High and low surgical procedure rates in census divisions across Canada.

This paper identifies outliers (unusually high or low values) among rates of 39 surgical procedures in 255 Canadian census divisions. Surgery rates for the two-year period from April 1988 through March 1990 were standardized for age and sex, and then "normalized" to adjust for differences in census division population sizes. Among the 39 procedures, a total of 402 outlying census division rates were found, of which 48 were deemed to be very high, 254 high, 79 low, and 21 very low. The results are presented for individual procedures, by province, and for the 16 census divisions in which medical schools and their associated teaching hospitals are located.

Apparent nitrogen digestibility data: AACC-ASTM collaborative study.

Apparent nitrogen digestibility data were obtained from 4 laboratories for 6 protein sources and 2 diet levels, 6 and 10% protein, after a 2-day adaptation period during the AACC-ASTM protein efficiency ratio (PER) and net protein ratio (NPR) collaborative studies. For 5 protein sources fed as 10% of the diet, the interlaboratory variation as measured by coefficient of variation (CV) values was low (1.5-3.5%), indicating high precision of the method. Wheat flour (6% protein diet) had the highest variation and, therefore, the lowest precision (CV of 7.10%). The interlaboratory variation (CV value) for 3 of the 4 laboratories was considerably lower, less than half that for the 4 laboratories. An analysis of variance of apparent nitrogen digestibility data indicated significant (P less than 0.05) effects for the 4-laboratory group due to laboratories and protein diets at both 10 and 6% protein levels, and for the 3-laboratory group at the 10% protein level. The 3-laboratory ANOVA for the 6% diets indicated a significant effect (P less than 0.05) due to diet only.

Induction of Flavonoid Synthesizing Enzymes by Light in Etiolated Pea (Pisum sativum cv. Midfreezer) Seedlings.

Etiolated pea (Pisum sativum cv. Midfreezer) seedlings respond to illumination with white light by changes in the activity of phenylpropanoid and flavonoid synthesizing enzymes. Unlike in cell cultures, changes in enzyme activity in pea seedlings are not concerted. Phenylalanine ammonia-lyase (EC 4.3.1.5) activity peaked approximately 18 hours after onset of illumination. The phenylacetate path did not interfere with the measurement of phenylalanine ammonia-lyase activity. Activity of cinnamic acid 4-hydroxylase (EC 1.14.13.11) showed an early peak after 8 hours illumination, declined thereafter sharply, then gradually increased during the remainder of the experiment. Activities of chalcone synthase and UDP glucose:flavonol 3-O-glucosyltransferase (EC 2.4.1.91) increased steadily and reached a plateau after approximately 70 hours illumination time. Activity of 4-hydroxycinnamate:coenzyme A ligase (EC 6.2.1.12) remained relatively unchanged, whereas that of chalcone isomerase (EC 5.5.1.6) declined steadily during the course of the experiment. The relative in vitro enzyme activities suggest that the rate-limiting step for the phenylpropanoid path is the cinnamic acid 4-hydroxylase, that of the flavonoid pathway is the chalcone synthase. Integration of enzyme activity curves, however, show that only the curve deriving from phenylanine ammonia-lyase activity matches closely the production of the flavonol glycosides.