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PubMed2004

Descriptive epidemiology of pedometer-determined physical activity.

PURPOSE: The dual purposes of this study were: 1) to provide preliminary descriptive epidemiology data representing pedometer-determined physical activity (PA) and 2) to explore sources of intra-individual variability in steps per day. METHODS: All participants (76 males, age = 48.4 +/- 16.3 yr, body mass index (BMI) = 27.1 +/- 5.1 kg x m(-2); 133 females, age = 47.4 +/- 17.5 yr, BMI = 26.9 +/- 5.7 kg x m(-2)) resided in Sumter County, SC, and were recruited by telephone to receive a mailed kit to self-monitor PA for 1 wk. Statistical analyses compared mean steps per day between sexes, races, age groups, education and income levels, and BMI categories. Mean steps per day were also compared between: 1) weekdays versus weekend days, 2) workdays versus nonworkdays, and 3) days of sport/exercise versus no participation. RESULTS: The entire sample took 5931 +/- 3664 steps x d(-1) (males = 7192 +/- 3596 vs females = 5210 +/- 3518 steps x d(-1), t = 7.88, P < 0.0001). Significant differences were also indicated by race, age, education, income, and BMI. In addition, weekdays were significantly higher than weekend days, workdays were higher than nonworkdays, and sport/exercise days were higher than nonsport/exercise days. CONCLUSIONS: The large standard deviations reflect a wide distribution of ambulatory behavior. Regardless, important differences are still evident by demographic characteristics, BMI categories, day of the week, and reported engagement in work or sport/exercise.

Adolescent↗
PubMed2000

[Evaluate of popular knowledge and everyday practices in oral health].

OBJECTIVE: To evaluate the popular knowledge and everyday practices in oral health of public services' users. METHODS: The target population was selected from a stratified sample and included users seeking medical care in health care units in Santa Maria - RS. The data were collected using a semi-structured interview and organized into descriptive categories groups, allowing the distribution in a frequency table. RESULTS: It was verified the predominance of the age group between 21 to 40 years old and females. The socioeconomic pattern is characterized by low schooling and family income. The search for oral diseases control are due to individual awareness of the need of oral hygiene and dental care; fluoride in toothpaste and drinking water and its benefits were not known by the population. CONCLUSIONS: The health programs offered to the population must take into account the knowledge and practices in oral health care to make it possible an improvement of oral health according to their reality. In addition there is a need to promote the collective awareness on health promotion in every level of the society.

Adolescent↗
PubMed2000

Health sector reform in Brazil: a case study of inequity.

Health sector reform in Brazil built the Unified Health System according to a dense body of administrative instruments for organizing decentralized service networks and institutionalizing a complex decision-making arena. This article focuses on the equity in health care services. Equity is defined as a principle governing distributive functions designed to reduce or offset socially unjust inequalities, and it is applied to evaluate the distribution of financial resources and the use of health services. Even though in the Constitution the term "equity" refers to equal opportunity of access for equal needs, the implemented policies have not guaranteed these rights. Underfunding, fiscal stress, and lack of priorities for the sector have contributed to a progressive deterioration of health care services, with continuing regressive tax collection and unequal distribution of financial resources among regions. The data suggest that despite regulatory measures to increase efficiency and reduce inequalities, delivery of health care services remains extremely unequal across the country. People in lower income groups experience more difficulties in getting access to health services. Utilization rates vary greatly by type of service among income groups, positions in the labor market, and levels of education.

Brazil↗
PubMed1998

Pneumococcal carriage in an Alaskan drug-using population.

This study examined the prevalence of pneumococcal carriage rates in an Alaskan drug-using population. Data collection included: (a) The Risk Behavior Assessment, (b) a supplemental smoking questionnaire, and (c) collection and culture of nasal/oropharyngeal specimens for isolation of Streptococcus pneumoniae. The overall carriage rate for S. pneumoniae was 13%. Of seven smoking variables, only hashish smoking within the prior six-month period was significantly associated with pneumococcal carriage. Other carriage indicators in the literature were nonsignificant. Results of the logistic regression indicate that the risk factors for carriage were (a) smoking hashish within the last six months, (b) receiving income from public assistance, and (c) receiving income from a family member or friend.

Adolescent↗
PubMedDate not supplied

Extents of contamination of top milk and their determinants in an urban slum of Varanasi, India.

A community based study to examine the extent of contamination of supplementary milk feeds of 149 children aged 6-24 months was conducted in a semi urban slum of Varanasi, India. Out of 201 children, 149 top milk samples were collected directly from the feeding utensils into a sterile vial and subjected to bacteriological analysis. Overall, 53.7% of milk samples were contaminated by bacteria and among them 16.1% were potentially enteropathogenic in nature. The distribution of pathogens was E. coli (13.4%), Klebsiella spp (5.4%), Enterobacter spp. (5.4%), Pseudomonas aeruginosa (4.7%), Shigella spp. (2.7%) and others (22.1%). The rate of contamination was significantly higher (p < 0.001) in lower income group (73.4%), lower caste (69.6%) and in case of illiterate mothers (69.3%). Bivariate analysis indicated that wherever the afore mentioned parameters of hygiene were adverse, isolation rates increased multifoldely. Multiple logistic regression analysis indicated that the probability of a milk sample being positive for bacterial contamination was higher by 20 times when unclean utensils were used, by 3 times if mothers hands were dirty and by 2.8 time if the mothers were illiterate. The odds of contamination by pathogens was 25.7 times higher if the feeding utensils were dirty.

Animals↗
PubMed2002

Reduced P300 amplitude in a visual recognition task in patients with schizophrenia.

We studied top-down visual processes in schizophrenia by analyzing visual event-related potentials (ERPs) during a gestalt recognition task, after subjects (patients with schizophrenia, n = 10; controls, n = 14) were trained to perceive three different geometrical shapes. Recognition performance of patients was poorer under both the figure and the nonfigure conditions then that of normal controls. ERPs analysis indicated that P300 amplitudes of the patients were significantly smaller than those of controls during correct figure detection trials. Moreover, topographical analysis of the differences in ERPs during the figure vs the nonfigure condition showed an earlier, more positive and more widely distributed P300 in controls than in patients with schizophrenia. Our study supports the misconnection hypothesis of schizophrenia and highlights the difficulty of the patients to refer to previous experience in order to filter incoming information. In a visual recognition task, this misconnection syndrome might induce a failure to integrate information stored in the frontal and prefrontal sites with incoming stimuli.

Adult↗
PubMed1991

An analysis of frequencies of surgical procedures in Canada.

This paper reports preliminary and selected results of an analysis of the frequencies of 36 common surgical procedures in hospitals across Canada during the period April 1985 to March 1987. Age-sex-specific and age-sex-standardized procedure rates were calculated for each procedure for each of 245 Census Divisions (CDs) across Canada, as well as for 338 smaller urban areas (FSAs) within the province of Ontario. Special attention was given to adjusting the rates for differing population sizes of the geographical regions. Procedure rates were computed based on the residence of the patient, not on the location of the hospital. Graphical techniques, analysis of variance, and other statistical techniques were used to identify unusually high or low procedure rates and to determine effects due to differences in age, sex, and geographical region. The relationship of procedure rate to the socio-economic level of a region (as measured by the proportion of low-income individuals in the region) was analyzed.

Canada↗
PubMed1990

[What is cost benefit analysis?].

The practical and theoretical bases of cost-benefit analysis are reviewed systematically with particular emphasis on how an analysis can be carried out in practice. A Danish analysis about introduction of vaccination for mumps, measles and German measles is included as a common example. The great significance of elucidating the socio-economical questions to be answered before commencing an analysis is emphasized. It is therefore recommended that, among other things, as a side-effect of the actual cost-benefit analysis, a cash-analysis and a budget analysis should be carried out to identify the parties involved in the immediate expenses and incomes. This is particularly important in the cases where the same parties have a central position in the decision-making processes concerned in the project. In addition, costs and benefits are frequently distributed differently in time in different ways: Short-term expenses and long-term benefits. In connection with decision-making, this may also involve problems and should, therefore, be elucidated in detail. Similarly, the importance of including many alternatives in the analysis is emphasized and illustrated. In conclusion, it is demonstrated how well the theoretical principles have been followed, the employment and the process which led to the concrete analysis.

Child↗
PubMed1978

Pharmacists voice their concern over patient package inserts.

The annual meetings of the America Pharmaceutical Association and the American Society of Hospital Pharmacists are a time for discussion of issues that currently affect the profession. Two major issues discussed at this year's meetings were the distribution of patient package inserts and the increased numbers of pharmacists graduating from college each year. This report highlights discussion about these two issues and presents excerpts from the inaugural addresses of the incoming presidents.

Attitude of Health Personnel↗
PubMedDate not supplied

[Social services and the pressure to modernize: new needs and developmental trends in care of the elderly].

Demographic and sociostructural changes put pressure on care services for the elderly within the German welfare system: There is a need for facilities and new concepts. This also requires more and flexible domestic services, which are poorly developed in the German social system. Because the German range of care provider types is easy to navigate, there is increased demand for consumer information and recommendations. Considering the domains of care services, which have been widely distributed to the powerful non-profit welfare organizations, the status quo vs. new flexible service will challenge consumers confidence and choice, especially since todays elderly are more active and have more expendable income. The recently instituted "long-term care insurance" encourages, for the first time, competition between nonprofit organizations and commercial providers. Nevertheless, a clearly perceptible "polarization of age" draws attention to persisting challenges to social policy. Therefore, the increasing competition among types of care providers urges for a truly independent quality control, as well as an effective "welfare mix".

Aged↗
PubMed1998

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.

Adult↗
PubMed2000

Health risk and inequitable distribution of liquor stores in African American neighborhood.

In this paper we examine whether the physical availability of alcohol is greater in predominantly African American communities compared to predominantly white communities as indicated by the presence of off premises liquor stores. We investigate the extent to which the income status of the residents of a community mediates the relationship between community racial composition and alcohol availability; and explore whether the intersection of race and class places low income African American communities at increased risk to have such stores located in their communities. Multivariate analytic techniques are used to examine the relationship between community racial composition, median income of neighborhood residents and per capita number of alcohol outlets in 194 census tracts in Baltimore, Maryland. The analysis found that liquor stores are disproportionately located in predominantly black census tracts, even after controlling for census tract socioeconomic status. Census tracts that are both low income and predominantly African American have substantially more liquor stores per capita than other census tracts. Although it is beyond the scope of the present study, our data reveal significant associations between the presence of liquor stores and the risk of health-related social problems in low income neighborhoods. More research needs to be done on the impact of alcohol on the social, psychological, and physiological health of low income urban populations.

Black or African American↗
PubMed1998

Depressive symptoms of Alzheimer caregivers are mainly due to personal rather than patient factors.

OBJECTIVES: To investigate the predictors of caregiver's depressive symptoms in a sample of community-dwelling Alzheimer's patients. DESIGN: A cross-sectional study was conducted in an Alzheimer's unit specifically devoted to the care of demented patients in Brescia Province (Italy). One hundred and three dyads were consecutively recruited between July 1994 and July 1995. Caregivers were sons/daughters (65%) or husbands/wives; mean age was 54.6 +/- 13.2. Alzheimer's patients Mini Mental State Examination score was 11.3 +/- 8.3; patients were equally distributed among disease severity levels. The following variables have been collected: (a) background and context variables (caregiver's age, gender, marital status, education, relationship and cohabitation with the patient, employment status, satisfaction with household income);(b) caregiver's personal resources (health, social relationships and social interactions, formal supports use, assistance and vigilance); (d) primary stressors (patient's age and gender, cognitive status, functional status, frequency of behavioural disturbances). Caregiver's depressive symptoms represented the main outcome measure. RESULTS: Being husband or wife, low self-rated health and caregiving competence, high numbers of hours for assistance and patient's behavioural disturbances and younger age were associated caregiver's depressive symptoms. With multivariate analysis only relationship to the patient, caregiver's health and competence were independent predictors of caregiver's depressive symptoms. CONCLUSION: Factors related to the caregiver--relationship, health and competence--rather than to the patient constitute the main risk factors for caregiver's depressive symptomatology.

Adult↗
PubMed2003

How important are economic factors in choice of medical specialty?

An ongoing debate exists among health care researchers about the mechanism that allocates physicians across medical specialties, and appropriate policy measures to correct imbalances that may arise from time to time. Most researchers believe that choice of residency program by medical school graduates is key to understanding how physicians are distributed across specialties, but there is much disagreement about whether economic or non-economic factors are most influential in determining this choice. We undertake an empirical investigation of two potentially important economic factors: income and leisure. To do so, we specify a two way error component regression model to estimate the effects of expected earnings and available leisure time, and uncertainty of earnings and leisure, on specialty choices of medical residents. Our findings indicate that economic factors are an important influence in the specialty choice process; in particular, medical residents are attracted to specialties that offer the prospect of longer and more certain annual vacations, higher earnings, shorter residency programs, and more certain work schedules. Our results suggest that employment contracts that provide generous annual vacation time and promise regular weekly work schedules may be more effective than increased earnings in correcting the current perceived shortage of primary care physicians.

Career Choice↗
PubMed2006

Dendritic cells interacting mainly with B cells in the lymphoepithelial symbiosis of the human palatine tonsil.

The lymphoepithelial symbiosis (LES) of the human palatine tonsil is composed of spindle- or star-shaped epithelial cells forming a loose meshwork, containing numerous lymphocytes and dendritic cells (DCs). In the present study, we immunohistochemically characterized DCs in the LES (LES-DCs). LES-DCs were phenotypically immature DCs that were S100beta+, fascin-, HLA-DR+, CD1a-, CD80-, CD83-, CD86-, and CD123-. The most characteristic feature of LES-DCs was that they contacted many B cells, which were mostly IgM+ IgD+ resting naive B cells. Langerhans cells (LCs) located in the nonsymbiotic squamous epithelium were immature DCs that were S100beta+, fascin-, and CD1a+ and did not contact lymphocytes. In contrast to LES-DCs, interdigitating dendritic cells (IDCs) in the T zone were mature DCs that were HLA-DR+, CD1a-, fascin+, CD80+, CD83+, and CD86+ and contacted numerous CD4+ T cells. Two subsets of IDC, S100beta+ fascin+ IDC (IDC-1) and S100beta- fascin+ IDC (IDC-2), were identified, and the majority of IDCs are IDC-2. In contrast to IDCs, which were distributed in the T-cell area in groups, LES-DCs were distributed along the crypt as if forming a barrier. These findings suggest that LES-DCs are a novel type of DC playing an important role in the induction of humoral immune response against incoming air- or food-borne pathogenic antigens.

B-Lymphocytes↗
PubMed1993

A comparison of empirical models on determinants of infant mortality: a cross-national study on Africa.

The goal of achieving health for all by the year 2000 has instigated numerous studies on the determinants of health. In this paper, we re-evaluate two models in which infant mortality--across twenty-eight low- and middle-income African states--is explained by socioeconomic, demographic, medical, environmental and political factors. The results indicate that the GNP per capita, school population as a percentage of the population under 19, population density and the percentage of the population with access to health care together explained 80% of the variations in infant mortality in the sample study. Apart from the GNP per capita and the school population as a percentage of the population under 19 which were negative and statistically significant, variables of importance for health policy, e.g. female literacy rate, water supply, food aid, calorie supply, health care expenditure and the degree of urbanization carried a negative sign but were nonsignificant. We interpreted the above thus: a reduction in infant mortality is feasible only with changes on diverse fronts rather than by marginal improvements in a few determining factors. A comparative test of the replicated model and our proposed model has shown that our model produced a better theoretical and statistical fitting than did the replicated model.

Africa↗
PubMed1999

Consumption of foods from the WIC food packages of Chinese prenatal patients on the US west coast.

OBJECTIVE: To assess consumption of foods from food packages provided by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) among 80 Chinese prenatal WIC recipients living in Oakland or San Francisco, Calif. DESIGN: During a single interview, a food frequency questionnaire was used to assess WIC food consumption by the prenatal patients for the period before and after receipt of WIC vouchers. SETTING: The study was conducted at Asian Health Services, Oakland, and the Chinatown Public Health Center of the San Francisco Department of Public Health in California. SUBJECTS: Eighty low-income Chinese prenatal women with limited education and limited ability to speak English, aged 21 to 43 years, with gestational stages of 15 to 38 weeks. STATISTICAL ANALYSES PERFORMED: Descriptive statistics (frequency and percent distribution) were used to report the findings of the study. RESULTS: Subjects reported that before receiving WIC vouchers, milk, eggs, and juice were the only foods in their WIC food package that had been consumed frequently (> 5 times/week) in their daily diet. Other WIC foods, including cheese, peanut butter, dried beans, and hot and cold cereals, were consumed infrequently (0 to 1 time/month). Subjects reported that with the availability of WIC vouchers, milk, eggs, and juice remained frequently consumed with 81% to 100% of monthly supply as the most prevalent reported consumption rate. Dried beans and hot and cold cereals were also consumed frequently. Cheese remained poorly consumed (0% to 20% of the monthly supply). As many as 74 of 80 subjects stated that they had shared foods from their own WIC package, except milk, with their families. The use of any WIC foods provided to other children in the family was not assessed in this study. APPLICATIONS: Data from this study indicate that most WIC foods were well used by Chinese prenatal patients. The most notable exception was cheese, which was poorly consumed. The ready consumption of milk by pregnant Chinese WIC recipients in this study suggests that milk may be readily consumed by these women, even though it is atypical of the Asian diet. The WIC food package for Chinese prenatal patients may be improved by omitting cheese and substituting more milk and/or foods such as tofu and dark green leafy vegetables.

Adult↗

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