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["Household items" : an alternative task to "animals" in the assessment of semantic verbal fluency: a validation study].

INTRODUCTION: The semantic verbal fluency (SVF) is usually evaluated with the task animals in 1 minute . This is a test widely applied in the screening of cognitive impairment. In our best knowledge there are not other alternatives categories for this task validated in our environment (Spanish as mother tongue, Spain). OBJECTIVE: To validate the category households items as an alternative parallel task to animals in the assessment of SVF. PATIENTS AND METHODS: Prospective assessment of two categories (animals and household items) in two groups: normal controls and patients with Alzheimer s disease (AD). RESULTS CONTROL GROUP: n= 22 (13 M, 9 W); age: 73 5 years, education: 12 5 years; MMSE MEC 35: 30 4; Animals : 15 4. Percentile distribution 10th: 11; 50th: 15; 90th: 20; household items : 17 4. Percentile distribution: 10th: 12; 50th: 17; 90th: 22. AD group: n= 24 (9 M, 15 W); age: 74 5 years; education: 11 5 years; MMSE MEC 35: 17 8; Animals : 6 3. Percentile distribution: 10th: 2; 50th: 6; 90th: 9; household items : 6 4. Percentile distribution: 10th: 1; 50th: 6; 90th: 11. It is observed a positive correlation between the two categories (Spearman s Rho: 0.83, p< 0.0001). CONCLUSIONS: Both SVF categories had a similar distribution and a high correlation. This findings demonstrated the validity of the household items as an alternative and parallel form to animals in the assessment of SVF in patients with cognitive impairment or dementia.

Aged↗

Control of transmission with two types of infection.

The effectiveness of a vaccination strategy to control transmission of an infectious disease depends on the way vaccine doses are distributed to individuals in a community of households. Here we show that this dependence is more complicated when acquisition and severity of illness are determined by the size of the infecting dose, as is thought to be the case for measles and varicella. Two alternative formulations for the way vaccination changes an individual's susceptibility and infectivity show that vaccination coverage, the nature of the vaccine response and the distribution of household size also have a big impact on which strategy is more effective. These judgements are made by comparing the post-vaccination reproduction numbers corresponding to different vaccination strategies.

Communicable Diseases↗

Timing of mortality among internally displaced persons due to the tsunami in Sri Lanka: cross sectional household survey.

OBJECTIVE: To describe the distribution of mortality among internally displaced persons during two and a half months after the Indian Ocean tsunami, 2004. DESIGN: Cross sectional household survey with retrospective cohort analysis of mortality. SETTING: Camps for internally displaced persons due to the tsunami in an eastern coastal district of Sri Lanka. PARTICIPANTS: 3533 people from 859 households accommodated in 13 camps. MAIN OUTCOME MEASURES: All cause death and number of missing people. RESULTS: 446 deaths and 11 missing people were reported after the 2004 tsunami, of which most (99%) occurred on the day of the tsunami or within three days thereafter. No deaths were reported for the two and a half month period starting one week after the tsunami. CONCLUSIONS: Most mortality after the 2004 tsunami occurred within the first few days of the disaster and was low in the study area.

Disasters↗

Microbial quality of water supply to an urban community in Trinidad.

A microbiological study was conducted to determine the quality of the water supply to an urban community in San Fernando proper in south Trinidad using total coliforms and thermotolerant coliforms as indicators of water pollution. The membrane filter technique was used to detect total coliforms and thermotolerant coliforms on endo agar and MFc agar, respectively. The residual chlorine levels in water from the reservoir, from standpipes along the distribution line, and from households were determined with a commercial test kit. Of a total of 104 drinking water samples obtained from households, 84 (80.8%), 56 (53.8%), and 70 (67.3%) tested positive for total coliforms, thermotolerant coliforms, and Escherichia coli, respectively. The difference was statistically significant (P < 0.05, chi2). Of the 81 water samples collected from the Water and Sewerage Authority (WASA) main supply to households, 38 (46.9%), 13 (16.0%), and 27 (33.3%) were contaminated by total coliforms, thermotolerant coliforms, and E. coli, respectively, and the difference was statistically significant (P < 0.05, chi2). Eight (20.5%) of 39 water samples from standpipes along the distribution line tested positive for total coliforms, compared with 4 (10.3%) samples testing positive for thermotolerant coliforms. All five samples of treated water obtained from the reservoir tested negative for coliforms. There was a significant difference (P = 0.004) in the mean residual chlorine levels in water from the reservoir, water from standpipes, and water from households. Similarly, as the level of residual chlorine decreased, there was a statistically significant (P = 0.004) increase in the prevalence of total coliforms in water from 0.0% (treated reservoir water) to 15.2% (standpipe) to 53.5% (household mains) to 80.0% (household drinking water). There was also a statistically significant difference (P < 0.001, chi2) in the prevalence of total coliforms in drinking water and in water from the WASA main supply to households. Of the 105 E. coli strains tested, 7 (6.7%), 16 (15.2%), and 22 (21.0%) were mucoid, hemolytic, and non-sorbitol fermenters, respectively. It was concluded that the high degree of contamination of drinking water in households poses a health hazard to consumers.

Anti-Bacterial Agents↗

A chain-binomial model for intra-household spread of Mycobacterium tuberculosis in a low socio-economic setting in Pakistan.

A simulation study using Greenwood's chain-binomial model was carried out to elucidate the spread and control of Mycobacterium tuberculosis among the household contacts of infectious pulmonary tuberculosis (TB) patients. Based on the observed data, the maximum-likelihood estimates (+/-S.E.) of chain-binomial probabilities of intra-household M. tuberculosis transmission from an index case in 3-person and 4-person households were 0.313+/-0.008 and 0.325+/-0.009 respectively. The chi2 goodness-of-fit test of observed and simulated mean expected frequencies of cases revealed good fit for 3-person (P=0.979) and 4-person (P=0.546) households. With the assumption of varying risk of M. tuberculosis transmission across the households under beta-distribution, goodness-of-fit tests of observed and mean simulated expected frequencies revealed the inadequacy of Greenwood's chain-binomial model both for 3-person (P=0.0185) and 4-person (P<0.001) households. Simulated M. tuberculosis control strategy comprising efficient diagnosis, segregation and prompt antibiotic therapy of index pulmonary TB patients showed a substantial reduction of new cases among the household contacts in both household sizes. In conclusion, segregation coupled with prompt antibiotic therapy of the index case, chemoprophylaxis of M. tuberculosis-exposed household contacts, and the assessment of household environmental risks to devise and implement an educational programme may help reduce the TB burden in this and similar settings.

Family Characteristics↗

Prevention of secondary transmission of pertussis in households with early use of erythromycin.

To examine the effectiveness of erythromycin therapy and prophylaxis for pertussis, 17 households with one secondary case or more were compared with 20 households without secondary cases following a community-wide pertussis outbreak in Maricopa County, Arizona, in 1988. There were no significant differences between the two household groups in age distribution of members, size, crowding, race, proportion of children aged 7 months to 18 years with three or more diphtheria and tetanus toxoids and pertussis vaccine doses, or in the age distribution, vaccination status, or medical care of patients with primary cases. However, median intervals from onset of illness in primary cases to initiation of erythromycin therapy (for cases) and prophylaxis (for contacts) were 11 and 16 days, respectively, in households without secondary spread, vs 21 and 22 days, respectively, in households with secondary spread. These results provide additional evidence that erythromycin is effective in the medical management of pertussis and should be initiated promptly to minimize secondary spread.

Adolescent↗

Evaluation of three smoke detector promotion programs.

CONTEXT: Seventy percent of U.S. residential fire deaths occur in homes without a working smoke detector. To help prevent residential fire deaths, many programs have distributed or installed detectors in unprotected homes. Because persons receiving a detector may not install it and because detector batteries require annual replacement, the enduring effectiveness of these programs may be questioned. OBJECTIVE: We evaluated the long-term functional status of smoke detectors distributed to high-risk households in eight areas of Minnesota, Cherokee County (North Carolina), and Oklahoma City (Oklahoma). DESIGN: Cross-sectional. SETTING: Home visits were made to check the detectors that were distributed 3 to 4 years earlier. PARTICIPANTS: Randomly selected households from the three detector promotion programs. MAIN OUT-COME MEASURE: At least one working smoke detector. RESULTS: Participation rates ranged from 72% to 82%. The percentage of evaluation households with at least one working detector ranged from 58% in Oklahoma to 73% in North Carolina. In 76% of households with nonworking detectors, the batteries were either missing or disconnected. When batteries in nonworking detectors were replaced, 83% of the detectors regained function. CONCLUSIONS: Future programs should consider distributing detectors that do not require annual battery changes or find effective ways to ensure that batteries are routinely replaced. Programs should also provide each household with the number of detectors needed to meet the most current recommended standard of the National Fire Protection Agency. The evaluation's participation rates support the practicality of unannounced home visits to evaluate home injury prevention programs in high-risk groups.

Accident Prevention↗

Lassa virus activity in Guinea: distribution of human antiviral antibody defined using enzyme-linked immunosorbent assay with recombinant antigen.

More than 3,100 households in 27 selected villages distributed in the main geographic regions of Guinea were surveyed for the presence of Lassa virus-specific IgG antibodies (LVA), using an enzyme-linked immunosorbent assay (ELISA) with Lassa virus nucleocapsid protein expressed in insect cells infected with a recombinant baculovirus as antigen. The highest prevalence of LVA (25-55%) was found among inhabitants of tropical secondary forest (areas near Gueckedou, Yomou, and Lola) and guinea savannah (Faranah and Kindia areas), near the southern frontiers with Sierra Leone and Liberia. A much lower prevalence (4-7%) was found among inhabitants of mountainous (Pita, Labe, and Mali) and coastal (Boffa, Boké) areas. We found no discernible differences in LVA prevalence between males and females or among various age groups. Testing of 406 hospital staff members of the eight central hospitals in these areas for LVA revealed a similar distribution of seropositivity among hospitals in various prefectures. The highest prevalence of LVA in hospital staff (29-40%) was in the Gueckedou and Lola hospitals. Sera of LVA-positive persons were tested via Western blot analysis. Antibodies bound predominantly to NP and GP2 proteins.

Adolescent↗

Urban poverty and health in developing countries: household and neighborhood effects.

In the United States and other high-income countries, there is intense scholarly and programmatic interest in the effects of household and neighborhood living standards on health. Yet few studies of developing-country cities have explored these issues. We investigated whether the health of urban women and children in poor countries is influenced by both household and neighborhood standards of living. Using data from the urban samples of 85 Demographic and Health Surveys and modeling living standards using factor-analytic MIMIC methods, we found that the neighborhoods of relatively poor households are more heterogeneous than is often asserted. Our results indicated that poor urban households do not tend to live in uniformly poor neighborhoods: about 1 in 10 of a poor household's neighbors is relatively affluent, belonging to the upper quartile of the urban distribution of living standards. Do household and neighborhood living standards influence health? Using multivariate models, we found that household living standards are closely associated with three health measures: unmet need for modern contraception, attendance of a trained health care provider at childbirth, and young children's height for age. Neighborhood living standards exert a significant additional influence in many of the surveys we examined, especially for birth attendance.

Data Collection↗

Willingness to pay for praziquantel treatment in a hyperendemic community of Ogun State, Nigeria.

BACKGROUND: Schistosomiasis is highly endemic in Nigeria. However, very little is known about the usage and social marketing of praziquantel in the control of schistosomiasis in endemic communities and on the persons willingness to pay for the drug to support its extensive use and thus aid control efforts in Nigeria. OBJECTIVE: The study examined the willingness of people in a hyperendemic community, to pay for treatment with praziquantel before and after provision of the drug, with a view to assess the feasibility of achieving widespread coverage. METHODS: Data were collected through focus group discussions among household heads and other adult family members and through the use of a questionnaire to survey household heads in Imala-Odo, a community hyperendemic for schistosomiasis, in southwest Nigeria. The main outcome measure was the respondents' willingness to pay for schistosomiasis treatment. RESULTS: The results showed that in contrast to the 92.3% of respondents who expressed willingness to buy the drug in the preintervention study, only 46.5% actually purchased the drug during intervention for the treatment of their infected household members. The respondents' level of education, occupation, and income influenced their willingness to pay (P<.05). Statistical tests showed that those willing to pay for treatment had a higher income score than those unwilling to do so. Most respondents preferred their community head and reliable persons chosen by the community as convenient outlets for drug distribution. The number of household members respondents were willing to treat increased from 4 to 6 at N320.00 (US $2.52) in the preintervention and postintervention phases, respectively. Gender factor was found to influence the respondents' perceived average treatment cost; the females wanted N300.00 (US $2.36) against N100.00 (US $0.79) among the males. CONCLUSION: Efforts need to be made and sustained to ensure that all families can afford to praziquantel drug to achieve the ultimate goal of controlling the infection in endemic communities of Nigeria.

Adolescent↗

Serum total and fractionated cholesterol distribution and prevalence of hypercholesterolemia in urban and rural communities in Saudi Arabia.

Hypercholesterolemia is recognized as an independent risk factor for cardiovascular diseases. Data on serum total cholesterol concentration distribution from Saudi Arabia are scarce. We have conducted a cross sectional, national, epidemiological randomized household survey to study the distribution of serum total cholesterol (TCC), low density lipoprotein (LDL) and high density lipoprotein (HDL) concentrations, total cholesterol/high density lipoprotein (CH/HDL) ratio and prevalence of hypercholesterolemia (HC) among subjects aged 25-64 years in urban and rural communities of Saudi Arabia. The sample was 2924 Saudi subjects which was adjusted in accordance with the national population distribution with respect to age, gender, regional and residency, urban vs. rural population distribution. Height and weight were measured with calculation of body mass index (BMI). Blood samples were drawn and assayed for total cholesterol, triglyceride, high density lipoprotein concentration and calculation of low density lipoprotein concentration. The mean of BMI was significantly higher among female subjects and significantly higher among urban subjects. The prevalence of obesity was higher among female subjects and higher, however, not significant, among urban subjects. Mean serum TCC was higher among rural subjects. Mean serum LDL concentration was higher among female subjects and higher among urban subjects. Mean serum HDL concentration was lower among female subjects and lower among urban subjects. Mean CH/HDL ratio was higher among female subjects and higher for urban subjects. Female and male subjects living in rural communities had the highest and lowest percentages of subjects with high concentrations of LDL, respectively. Female and male subjects, living in rural communities had the highest and lowest percentages of subjects with low concentration of HDL, respectively. Male and female subjects living in rural communities had the highest and lowest percentages of studied subjects with a high CH/HDL ratio. The age-adjusted prevalence of HC (5.2-6.2 mmol/l) was equal among all the four groups. The prevalence of HC (> 6.2 mmol/l) was significantly higher among rural male subjects, compared with their counterparts in urban areas, while it was equal among female subjects. There was an increase in age-specific prevalence of HC (> 6.2 mmol/l) with maximum prevalence achieved at an age of 56-64 years for urban subjects, while it was achieved a decade earlier for rural subjects. The prevalence of HC, in general, was higher among rural male and urban female subjects. In conclusion, among Saudi subjects, means of total, fractionated cholesterol concentration, CH/HDL ratio > 6.5 and prevalence of obesity were higher among urban female subjects. The prevalence of HC, whether > 5.2 or > 6.2 mmol/l was higher among rural subjects. The difference, however, reached significance among female subjects. There is a need to study the possible underlying factors for the increase in prevalence of HC among rural subjects with special emphasis on the food components and nutritional habits of rural communities in Saudi Arabia. There is also a need to establish a control program throughout the country with the aim of halting the upward trend in incidence of CVD through control of modifiable risk factor such as obesity and hypercholesterolemia.

Adult↗

Statistical procedures for estimating the community probability of illness in family studies: rhinovirus and influenza.

A statistical method is presented for determining acquisition rates of illness from community sources of infection and for distinguishing among viruses which are associated with different epidemic seasons. The new method consists of a computationally simple procedure for estimating the community transmission parameter and the standard error of the estimator. This method, as well as a previously developed maximum likelihood procedure, is applied to illness data as a means for distinguishing among broad patterns of illness acquisition. The periods evaluated are the rhinovirus, influenza A and influenza B seasons in Tecumseh, Michigan, for the years 1976-1980. Tecumseh households are stratified into exposure groups depending on age-group composition. Estimates are found for the risk differences of illness acquired from the community for households with different age-group distributions. Analysis of the Tecumseh data reveals that members of households with children are more apt than members of households without children to acquire illness associated with rhinovirus, influenza A and influenza B from the community. Members of households with just preschool children (and adults) are more apt than members of households with just school children (and adults) to acquire illness associated with rhinovirus and influenza B from the community. In contrast, members of households with just preschool children (and adults) are just as likely as members of households with just school children (and adults) to acquire illnesses associated with influenza A from the community.

Adolescent↗

Interactive effects of natural and human disturbances on vegetation dynamics across landscapes.

Accurate measures of human effects on landscape processes require consideration of both the direct impacts from human activities and the indirect consequences of the interactions between humans and the landscape. This is particularly evident in systems experiencing regular natural disturbances such as in the mountainous areas of southwestern China, where the remaining population of giant pandas (Ailuropoda melanoleuca) is supported. Here the spatiotemporal patterns of human impacts, forests, and bamboo episodic die-offs combine to determine the distribution of panda habitat. To study the complex interactions of humans and landscapes, we developed an integrated spatiotemporally explicit model of household activities, natural vegetation dynamics, and their impacts on panda habitat. Using this model we examined the direct consequences of local fuelwood collection and household creation on areas of critical giant panda habitat and the indirect impacts when coupled with vegetation dynamics. Through simulations, we found that over the next 30 years household impacts would result in the loss of up to 30% of the habitat relied on by pandas during past bamboo die-offs. The accumulation and spatial distribution of household impacts would also have a considerable indirect influence on the spatial distribution of understory bamboo. While human impacts influence both bamboo die-off and regeneration, over 19% of pre-existing low-elevation bamboo habitat may be lost following an episodic die-off depending on the severity of the impacts and timing of the die-offs. Our study showed not only the importance of the spatial distribution of direct household impacts on habitat, but also the far-reaching effects of the indirect interactions between humans and the landscapes they are modifying.

Animals↗

Evaluation of a scheme for the pre-distribution of stable iodine (potassium iodate) to the civilian population residing within the immediate countermeasures zone of a nuclear submarine construction facility.

BACKGROUND: The Barrow-in-Furness stable iodine (potassium iodate) tablet pre-distribution scheme was the first of its kind to be introduced to protect the population living around a fixed site nuclear facility in the United Kingdom. Pre-distribution schemes have attracted critical comment principally because the certainty of availability of potassium iodate tablets was unknown. This study aimed to establish the reliability of such a scheme. METHOD: A structured interviewer-administered survey of a random sample of households served by the pre-distribution scheme was carried out using a standardized questionnaire. RESULTS: The ability of this scheme to provide stable iodine protection declined from 100 per cent to 60 per cent coverage over a period of two years for the designed worst-case demand (the ability to supply stable iodine tablets to all household residents normally living within the pre-distribution scheme zone). CONCLUSIONS: Pre-distribution has value in areas where evacuation to a centre where stable iodine tablets are available or post-accident distribution to sheltering households is difficult. The value of such a scheme must be calculated against a predictable decline in its effectiveness. In implementing such a scheme it should be noted that this decline in coverage can be reduced by calculating the frequency with which tablet packs are redistributed to take account of this factor.

Disaster Planning↗

Comparative analysis of population age-sex distribution from sample and complete enumeration: 1970 and 1980 census data.

"This paper will attempt to analyze the degree of distortion introduced by sampling, if any, on the age and sex distribution of the population based on the information taken [in the 1970 census] from the sample households. Specifically, the 1970 age and sex distribution of the Philippine population based on the 5-percent sample households will be compared with that obtained from the information supplied by all households, i.e., the actual age and sex distribution of the Philippines....Findings...suggest a failure of the estimation procedures used in past censuses to correct errors attributable to sampling. In particular, the type of sampling error highlighted in this paper is the distortion introduced by sampling in age-sex distribution."

Age Distribution↗