Propensity score matching approach to test the association of income inequality and mortality in Sao Paulo, Brazil

Background Support for the adverse effect of high income inequality on population health has come from studies that focus on larger areas, such as the US states, while studies at smaller geographical areas (eg, neighbourhoods) have found mixed results. Methods We used propensity score matching to examine the relationship between income inequality and mortality rates across 96 neighbourhoods (distritos) of the municipality of Sao Paulo, Brazil. Results Prior to matching, higher income inequality distritos (Gini >= 0.25) had slightly lower overall mortality rates (2.23 per 10 000, 95% CI -23.92 to 19.46) compared to lower income inequality areas (Gini <0.25). After propensity score matching, higher inequality was associated with a statistically significant higher mortality rate (41.58 per 10 000, 95% CI 8.85 to 73.3). Conclusion In Sao Paulo, the more egalitarian communities are among some of the poorest, with the worst health profiles. Propensity score matching was used to avoid inappropriate comparisons between the health status of unequal (but wealthy) neighbourhoods versus equal (but poor) neighbourhoods. Our methods suggest that, with proper accounting of heterogeneity between areas, income inequality is associated with worse population health in Sao Paulo.

An overview of the objectives of and the approaches to propensity score analyses

The assessment of treatment effects from observational studies may be biased with patients not randomly allocated to the experimental or control group. One way to overcome this conceptual shortcoming in the design of such studies is the use of propensity scores to adjust for differences of the characteristics between patients treated with experimental and control interventions. The propensity score is defined as the probability that a patient received the experimental intervention conditional on pre-treatment characteristics at baseline. Here, we review how propensity scores are estimated and how they can help in adjusting the treatment effect for baseline imbalances. We further discuss how to evaluate adequate overlap of baseline characteristics between patient groups, provide guidelines for variable selection and model building in modelling the propensity score, and review different methods of propensity score adjustments. We conclude that propensity analyses may help in evaluating the comparability of patients in observational studies, and may account for more potential confounding factors than conventional covariate adjustment approaches. However, bias due to unmeasured confounding cannot be corrected for.

Trends and outcomes in the use of surgery and radiation for the treatment of locally advanced esophageal cancer: a propensity score adjusted analysis of the surveillance, epidemiology, and end results registry from 1998 to 2008

We examined outcomes and trends in surgery and radiation use for patients with locally advanced esophageal cancer, for whom optimal treatment isn't clear. Trends in surgery and radiation for patients with T1-T3N1M0 squamous cell or adenocarcinoma of the mid or distal esophagus in the Surveillance, Epidemiology, and End Results database from 1998 to 2008 were analyzed using generalized linear models including year as predictor; Surveillance, Epidemiology, and End Results doesn't record chemotherapy data. Local treatment was unimodal if patients had only surgery or radiation and bimodal if they had both. Five-year cancer-specific survival (CSS) and overall survival (OS) were analyzed using propensity-score adjusted Cox proportional-hazard models. Overall 5-year survival for the 3295 patients identified (mean age 65.1 years, standard deviation 11.0) was 18.9% (95% confidence interval: 17.3-20.7). Local treatment was bimodal for 1274 (38.7%) and unimodal for 2021 (61.3%) patients; 1325 (40.2%) had radiation alone and 696 (21.1%) underwent only surgery. The use of bimodal therapy (32.8-42.5%, P = 0.01) and radiation alone (29.3-44.5%, P < 0.001) increased significantly from 1998 to 2008. Bimodal therapy predicted improved CSS (hazard ratios [HR]: 0.68, P < 0.001) and OS (HR: 0.58, P < 0.001) compared with unimodal therapy. For the first 7 months (before survival curve crossing), CSS after radiation therapy alone was similar to surgery alone (HR: 0.86, P = 0.12) while OS was worse for surgery only (HR: 0.70, P = 0.001). However, worse CSS (HR: 1.43, P < 0.001) and OS (HR: 1.46, P < 0.001) after that initial timeframe were found for radiation therapy only. The use of radiation to treat locally advanced mid and distal esophageal cancers increased from 1998 to 2008. Survival was best when both surgery and radiation were used.

The essays : or councils, civil and moral, of Sir Francis Bacon, ... With a table of the colours of good and evil. And a discourse of the wisdom of the ancients. To which is added, The character of Queen Elizabeth

The 'Table of colours' has separate pagination and half-title; 'The wisdom of the ancients,' which is translated by Sir Arthur Gorges, has separate pagination and titlepage p.135 misnumbered 145

A Mea Culpa for The Felix Culpa? A Greater Goods Response to the Problems of Evil and Hell

In this paper I want to develop a particular kind of greater-good response to the problems of evil and hell, one which hence can serve as a backup plan should the free will defense not satisfy. Ultimately, this response will appear to belong to several traditions in theodicy. Like all greater-goods views, this one relies on explaining the existence of evil in terms of the greater goods that come out of it. Among these goods are the greater goods of Incarnation and Atonement, their respective goodness consisting in large part in the higher-order divine good of glorifying God through the display of divine virtue.

The social evil in Chicago: a study of existing conditions with recommendations by the Vice Commission of Chicago, a municipal body appointed by the Mayor and the City Council of the City of Chicago, and submitted as its report to the Mayor and City Council of Chicago

Preface -- Outline of study -- Resolution of appreciation -- Introduction and summary -- Proposed ordinance -- Recommendations -- Existing conditions in Chicago -- The social evil and the saloon -- The social evil and the police -- Sources of supply -- Child protection and education -- Rescue and reform -- The social evil and its medical aspects -- Appendices: Text of revised statutes of Illinois and ordinances of the City of Chicago ; Tables ; Exhibits.

The existence of evil spirits proved; and their agency, particularly in relation to the human race, explained and illustrated.

Mode of access: Internet.

Thoughts and sentiments on the evil and wicked traffic of the slavery and commerce of the human species : humbly submitted to the inhabitants of Great Britain /

Mode of access: Internet.

Much Prefatory Declarations, tending to throw farther Light upon the annesced 2d Ed. of Scriptural Esc amination into the Question of whom and what are the Evil Jenii, of the Objects portrayed by the Apostle St. John.

Mode of access: Internet.

A summons of wakening; or, The evil tendency and danger of speculative philosophy, exemplified in Mr. Leslie's Inquiry into the nature of heat, and Mr. Malthus's Essay on population, and in that speculative system of common law. which is at present administered in these kingdoms. To which is subjoined, a prospetus of an inquiry into the origin of government and law.

Mode of access: Internet.

Cautions to young persons concerning health, containing the general doctrine of dyspepsia and chronic diseases, shewing the evil tendency of the use of tobacco upon young persons, more especially the pernicious effects of smoking cigars, with observations on the use of ardent and vinous spirits.

Public lecture delivered in the chapel at Cambridge, November 20, 1804.

The evil of separation from the Church of England, considered in a series of letters, addressed chiefly to the rev. Peter Roe... with some preliminary observations, an essay, and a concluding address, by the editor.

Mode of access: Internet.

The conflict of good and evil in our day : twelve letters to a missionary /

Photocopy. Ann Arbor, Mich. : University Microfilms International, 1979. -- 22 cm.