How best to use antibiotics in chronic bronchitis.
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Anti-Bacterial Agents↗
Biomedical subjects
I B Tager
Publications and source records attributed to I B Tager.
Risk estimates for chronic bronchitis in smokers: a study of male-female differences.
Data from a study of chronic bronchitis and obstructive airway disease prevalence in an urban population were used to obtain estimates of the risk of these diseases in smokers and to detail the effect of cigarette smoking on the observed male: female ratio of these diseases. Standard questionnaires and measures of pulmonary function were used. Eighty-two per cent of the observed prevalence of chronic bronchitis could be attributed to cigarette smoking, and 66% of the over-all population rate was attributed to smoking. Both men and women showed a linear increase in chronic bronchitis prevalence with increased smoking. The risk of chronic bronchitis was greater for men than women in all smoking categories, but no differences in decrease in pulmonary function could be observed. Data from comparable studies were assessed and were shown to corroborate the observation that men appear to be at a greater risk for chronic bronchitis, but less clearly so for obstructive airway disease. This excess risk does not appear to be due to a difference in cigarette consumption.
Adolescent↗
Household aggregation of pulmonary function and chronic bronchitis.
Persons from 148 randomly selected households in an urban community were screened in their homes using a modified British Medical Research Council respiratory disease questionnaire and a portable spirometer. Analysis showed a significant tendency for chronic bronchitis to aggregate within households. Significant aggregation was observed for 1-sec forced expiratory volume, when measured as the per cent of the predicted value or as a score calculated from the data. The 1-sec forced expiratory volume was significantly correlated between siblings, but less clearly so between spouses. Correlation of 1-sec forced expiratory volume between mother and child appeared to be confounded by maternal smoking habits, an effect most notable between mothers and male offspring. The 1-sec forced expiratory volume of fathers was significantly correlated with that of their children, especially female children, an effect that appeared to be independent of smoking habits.
Adolescent↗
Prevalence of gram-negative rods in the normal pharyngeal flora.
We obtained throat cultures from 100 randomly selected people free from any chronic upper or lower respiratory disease who did not work in a hospital and who had not experienced any acute illness or received any antibacterial therapy in the 4 weeks preceding culture. Eighteen percent harbored either a species of Enterobacteriaceae or Pseudomonas aeruginosa in their pharynx. In all cases, colony counts were low, the majority being detected in broth media selective for Gram-negative rods. There were no clear-cut age or sex distributions of Gram-negative pharyngeal carriage. These data imply that, in at least some cases, isolation of Gram-negative rods from sputum of untreated patients may be a normal finding, and that in some patients with pulmonary infection, the pretreatment, upper respiratory tract flora may serve as the source of subsequent superinfection with Gram-negative rods.
Acinetobacter↗
Mammography and clinical breast examination among Korean American women in two California counties.
BACKGROUND: Mammography and clinical breast examination (CBE) are underutilized, especially by women from some racial/ethnic minorities. Few published studies of screening practices or correlates for these subgroups exist. METHODS: A population-based telephone survey of 1,090 Korean Americans living in two California counties was conducted. To produce population estimates of mammography and CBE testing, we adjusted frequencies to account for different selection probabilities. Multivariable logistic regression was performed to determine independent correlates of testing. RESULTS: Only 34% [95% confidence intervals (CI) 30%, 39%] of Korean American women age 50 and older were estimated to have had a mammogram in the past 2 years. Only 32% (95% CI 28%, 37%) had had a CBE in the past 2 years. The strongest independent correlate of testing was having a regular medical checkup [odds ratio (OR) for mammogram = 9.21, 95% CI 3.98, 21.35; OR for CBE = 11.58, 95% CI 4.71, 28.46]. CONCLUSIONS: These estimates are lower than the Healthy People 2000 objectives as well as published estimates for other populations in the United States. Planning and implementing tailored programs to improve screening are best done using a community-sensitive approach, which, because racial/ethnic subgroups are growing, will assume increasing public health importance.
Aged↗
Surveillance techniques for respiratory illness.
The data presented represent a pilot study to determine the most efficient method of detecting the frequency and severity of respiratory illnesses in a defined population of children. Home surveillance telephone calls, parent-completed diaries, and monitoring of school absence lists were used. Detailed questionnaires were used to investigate reported illnesses. No one method of surveillance provided accurate estimates of respiratory morbidity in young children, and physicians' records were not reliable enough to be used as the sole source for data validation. Use of multiple sources for surveillance, however, provided illness rates comparable to those obtained in other community surveillance programs.
Child↗
Rationale and methods for a statewide, prospective surveillance system for the identification and prevention of nosocomial infections.
Review of current methods of surveillance for nosocomial infection indicates that prospective surveillance of patients on a daily basis is the most accurate and valid method. In this paper, we detail such a method. Samples of hospitalized patients for surveillance are based on a fixed period of observation in each patient-care area. Data are collected on a detailed, standardized daily log that emphasize the recording of primary clinical data. Such a system is practical and is acceptable to infection control practitioners. Representative samples of patients are obtained. The utility of such a system for identifying preventable risk factors for the development and evaluation of programs of prevention is being tested in 12 acute-care hospitals in Rhode Island.
Cross Infection↗
Correlates of cigarette smoking among Korean American adults in Alameda County, California.
OBJECTIVE: To estimate the prevalence of cigarette smoking and to determine the sociodemographic correlates of smoking among Korean American adults in Alameda County, California, 1994-1995. METHOD: Korean surname-based telephone survey; contingency table and multinomial logistic regression analyses. FINDINGS: Almost 39% of Korean American men and 6% of Korean American women were current smokers. Among Korean American men those who attended religious activities less than monthly had nearly three times the odds of being current smokers, and those who did not speak English well had 2 1/2 times the odds of being current smokers as compared to never smokers. Those 18 to 24 years of age had more than 8 1/2 times the odds, and those who attended religious activities less than monthly had more than 3 1/2 times the odds of being current smokers as compared to former smokers. Among Korean American women those who were not married had more than 3 times the odds of being current smokers, and those who attended religious activities less than monthly had 22 times the odds of being current smokers as compared to never smokers. Those who attended religious activities less than monthly had almost 8 times the odds of being current smokers as compared to former smokers. CONCLUSIONS: This study increases our understanding about the prevalence and correlates of cigarette smoking among Korean Americans and can contribute to the development of effective smoking cessation and prevention strategies in this understudied population.
Adult↗
Statistical methods for the analysis of the association between bronchial responsiveness and pulmonary function changes.
An autoregressive model for the analysis of longitudinal data was applied in the context of investigating the effect of bronchial responsiveness on the growth of pulmonary function in children. In the model used, the correlation between pulmonary function values within an individual decreases exponentially as the time between visits increases. The model incorporates both fixed and time-dependent covariates in a unified fashion and does not require complete data in all visits for each individual. Furthermore, the change in pulmonary function is not assumed to be linear over time. Using response to cold air data as a measure of bronchial responsiveness, we found that children who responded to cold air have a slower rate of growth in pulmonary function. In addition, the data suggested that the effect of cigarette smoking may be greater as the response to cold air increases. Extensions of the autoregressive approach to other correlation structures and to the case of unequidistant observations are discussed.
Adolescent↗
Reliability of lifetime residential history and activity measures as elements of cumulative ambient ozone exposure assessment.
UNLABELLED: Assessment of long-term effects of lifetime ambient oxidant pollution relies on ecological exposure assignment. Given the characteristics of ozone exposure profiles, with daily and seasonal peaks and clearly lower indoor concentrations, exposure misclassification is of considerable concern. This study considered residential location, time spent outdoors, and outdoors activity as major determinants of "effective" lifetime ozone exposure. Given the lack of a valid "gold standard" for these measures, we evaluated the repeatability of the retrospective assessment of these factors. METHODS: A convenience sample of 175 college students raised in California participated in the study, designed as test-retest 5-7 days apart. Lifetime residential history and outdoors activity ("moderate" and "heavy") for each residence were extensively evaluated on both visits. RESULTS: Although reliability of residential location decreased considerably with increasing number of lifetime residences, assigned lifetime ambient ozone concentrations from the nearest monitor yielded highly reliable cumulative values (intraclass correlation = 0.99). "Doers" of both "moderate" and "heavy" activity could be identified reliably (kappa = 0.83 and 0.93, respectively). Derived "hours per month" were reasonably correlated across visits (r = 0.73 for "moderate," 0.64 for "heavy") with 27% and 36% of the variance between visits, respectively. Reporting errors increased with increasing levels of activity. CONCLUSIONS: Among students 17-21 years old, lifetime residential location could be repeatedly assessed. The overall performance of the set of activity questions was reasonably reliable and compares well with other measures used in epidemiology, such as blood pressure or dietary intake. Such questionnaires may be useful tools in reducing misclassification of lifetime exposure to ambient oxidants.
Adolescent↗
"Health is strength": a research collaboration involving Korean Americans in Alameda County.
INTRODUCTION: This is a preliminary report from a research collaboration between Asian Health Services (community health center); Koreans in Alameda County, California; and the University of California at Berkeley School of Public Health. This five-year Centers for Disease Control and Prevention project supports a collaborative community intervention to improve breast and cervical cancer screening behavior among Korean women. METHODS: A Korean Community Advisory Board and Korean-American staff were recruited, and community sensitive research (CSR) and participatory action research (PAR) principles were applied: (1) building community infrastructure for sustainable action, (2) cultural appropriateness, (3) assuring responsiveness to community needs, and (4) a prevention focus that would assist health care providers. We conducted a population-based telephone survey on 676 Korean adults (272 men and 404 women). RESULTS: The collaborative process yielded (1) a high response rate (79%), (2) baseline health information on Korean Americans, (3) broadening of the original research topic, (4) survey responses that will guide intervention design, (5) culturally competent strategies, and (6) expanded Korean-American Community capacity for local action. CONCLUSIONS: Research collaboration between universities, community-based organizations, and ethnic communities can yield high-quality research. CSR and PAR approaches help break through cultural barriers in otherwise "hard to reach" API sub-populations. Determinants of success include sharing common goals; trust, honesty, and integrity; shared decision making; mutual respect of each partner's expertise; cultural sensitivity and cultural competence; flexibility, good communication, and mutual learning; and continuity of partners. Actively engaging members of the study population in the research process builds community capacity, thus laying the foundation for future projects that improve health status.
Adult↗