Association of socioeconomic status with overall and cause specific mortality in the republic of seychelles : results from a cohort study in the african region

BACKGROUND: Low socioeconomic status (SES) is consistently associated with higher mortality in high income countries. Only few studies have assessed this association in low and middle income countries, mainly because of sparse reliable mortality data. This study explores SES differences in overall and cause-specific mortality in the Seychelles, a rapidly developing small island state in the African region. METHODS: All deaths have been medically certified over more than two decades. SES and other lifestyle-related risk factors were assessed in a total of 3246 participants from three independent population-based surveys conducted in 1989, 1994 and 2004. Vital status was ascertained using linkage with vital statistics. Occupational position was the indicator of SES used in this study and was assessed with the same questions in the three surveys. RESULTS: During a mean follow-up of 15.0 years (range 0-23 years), 523 participants died (overall mortality rate 10.8 per 1000 person-years). The main causes of death were cardiovascular disease (CVD) (219 deaths) and cancer (142 deaths). Participants in the low SES group had a higher mortality risk for overall (HR = 1.80; 95% CI: 1.24-2.62), CVD (HR = 1.95; 1.04-3.65) and non-cancer/non-CVD (HR = 2.14; 1.10-4.16) mortality compared to participants in the high SES group. Cancer mortality also tended to be patterned by SES (HR = 1.44; 0.76-2.75). Major lifestyle-related risk factors (smoking, heavy drinking, obesity, diabetes, hypertension, hypercholesterolemia) explained a small proportion of the associations between low SES and all-cause, CVD, and non-cancer/non-CVD mortality. CONCLUSIONS: In this population-based study assessing social inequalities in mortality in a country of the African region, low SES (as measured by occupational position) was strongly associated with overall, CVD and non-cancer/non-CVD mortality. Our findings support the view that the burden of non-communicable diseases may disproportionally affect people with low SES in low and middle income countries.

Crawford County Fair Association, September 30, 2002

County Audit Report - Fair Association

Page County Landfill Association, June 30, 2001 & June 30, 2002

Other Audit Reports

Page County Landfill Association, June 30, 2003

Other Audit Report

Dubuque County Fair Association, September 30, 2003

County Audit Report - County Fair Association

Page County Landfill Association, Independent Auditor's Reports, Basic Financial Statements and Required Supplementary Information, Schedule of Findings, June 30, 2004

Other Audit Reports - 28E Organizations

Dowel Bar Optimization: Phases I and II, October 2001

America’s roadways are in serious need of repair. According to the American Society of Civil Engineers (ASCE), one-third of the nation’s roads are in poor or mediocre condition. ASCE has estimated that under these circumstances American drivers will sacrifice $5.8 billion and as many as 13,800 fatalities a year from 1999 to 2001 ( 1). A large factor in the deterioration of these roads is a result of how well the steel reinforcement transfers loads across the concrete slabs. Fabricating this reinforcement using a shape conducive to transferring these loads will help to aid in minimizing roadway damage. Load transfer within a series of concrete slabs takes place across the joints. For a typical concrete paved road, these joints are approximately 1/8-inch gaps between two adjacent slabs. Dowel bars are located at these joints and used to transfer load from one slab to its adjacent slabs. As long as the dowel bar is completely surrounded by concrete no problems will occur. However, when the hole starts to oblong a void space is created and difficulties can arise. This void space is formed due to a stress concentration where the dowel contacts the concrete. Over time, the repeated process of traffic traveling over the joint crushes the concrete surrounding the dowel bar and causes a void in the concrete. This void inhibits the dowel’s ability to effectively transfer load across the joint. Furthermore, this void gives water and other particles a place to collect that will eventually corrode and potentially bind or lock the joint so that no thermal expansion is allowed. Once there is no longer load transferred across the joint, the load is transferred to the foundation and differential settlement of the adjacent slabs will occur.

Assessment of Dowel Bar Research, August 2002

This report presents the latest technological gaps in dowel bar research based upon completed and ongoing dowel bar research from across the nation. In order to obtain this collection of information about dowel bars, a search was conducted on a nationwide level. The technological gaps and duplications of the research were then determined. In addition, this report also provides a brief annotated bibliography of all sources used to determine the gaps in technology and knowledge for dowel bar and alternative dowel bar topics as applied to highway pavements.

Report on Special Investigation of the Rural Iowa Waste Management Association for the Period July 1st, 1999 through October 15th, 2004

Other Audit Reports - Special Investigation

Dowel Bar Optimization: Phases I and II, October 2001

America’s roadways are in serious need of repair. According to the American Society of Civil Engineers (ASCE), one-third of the nation’s roads are in poor or mediocre condition (1). ASCE has estimated that under these circumstances American drivers will sacrifice $5.8 billion and as many as 13,800 fatalities a year from 1999 to 2001 ( 1). A large factor in the deterioration of these roads is a result of how well the steel reinforcement transfers loads across the concrete slabs. Fabricating this reinforcement using a shape conducive to transferring these loads will help to aid in minimizing roadway damage. Load transfer within a series of concrete slabs takes place across the joints. For a typical concrete paved road, these joints are approximately 1/8-inch gaps between two adjacent slabs. Dowel bars are located at these joints and used to transfer load from one slab to its adjacent slabs. As long as the dowel bar is completely surrounded by concrete no problems will occur. However, when the hole starts to oblong a void space is created and difficulties can arise. This void space is formed due to a stress concentration where the dowel contacts the concrete. Over time, the repeated process of traffic traveling over the joint crushes the concrete surrounding the dowel bar and causes a void in the concrete. This void inhibits the dowel’s ability to effectively transfer load across the joint. Furthermore, this void gives water and other particles a place to collect that will eventually corrode and potentially bind or lock the joint so that no thermal expansion is allowed. Once there is no longer load transferred across the joint, the load is transferred to the foundation and differential settlement of the adjacent slabs will occur.

Rural Iowa Waste Management Association Independent Auditor's Reports Finanical Statement and Required Supplementary Information Schedule of Findings for the period ending June 30, 2004.

Rural Iowa Waste Management Association Independent Auditor's Reports, Financial Statement, Required Supplementary Information and Schedule of Findings for the Period Ending June 30, 2004.

State of Iowa HIV and AIDS Surveillance Report, September 2005

This quarter, we received reports for 26 HIV diagnoses. So far this year, there have been 79 HIV diagnoses reported, exactly the same as this time last year. Thirty-five percent received concurrent AIDS diagnoses. There were 57 AIDS diagnoses in the first three quarters of 2005, 20% higher than what we saw at this time last year. Nearly half (47%) of these were persons who had been diagnosed with HIV for at least one year (fifteen years for two persons), and the rest received concurrent HIV and AIDS diagnoses. In surveillance news, Illinois, Maine, and Philadelphia have announced that they will begin HIV reporting by name on January 1, 2006. Currently they use code or name-to-code systems to report new diagnoses of HIV. The Centers for Disease Control and Prevention do not accept information from areas that report HIV cases by code, so no national surveillance data are available for HIV diagnoses. For this reason, Ryan White CARE Act funds cannot be appropriated according to the number of persons living with HIV. Instead, funds are distributed according to the number of AIDS cases reported to surveillance systems. These data are not representative of current trends in the epidemic and may be rewarding areas for having poorer health care systems.

Page County Landfill Association, Independent Auditor's Reports, Basic Financial Statements and Required Supplementary Information, Schedule of Findings, June 30, 2005

Other Audit Reports - 28E Organizations

Rural Iowa Waste Management Association, Independent Auditor's Reports, Financial Statement and Required Supplementary Information, Schedule of Findings, June 30, 2005

Other Audit Reports - 28E Organizations

Page County Landfill Association, Independent Auditor's Reports, Basic Financial Statements and Required Supplementary Information, Schedule of Findings, June 30, 2006

Other Audit Reports - 28E Organizations