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PubMed1995

Students' perceptions of violence in the public schools: the MetLife survey.

PURPOSE: To investigate secondary school students' perceptions of violence in American public schools. METHODS: Subjects included 726 public school students in grades 7 through 12. A two-stage clustered and stratified (by grade level, region, and location) sample design was used to obtain the sample. Each student completed a self-administered survey instrument under the supervision of their teacher. RESULTS: The sample was 54% female and the majority of students were white. One in five students reported living in a neighborhood with a lot or some crime. In the majority of cases, males, students from neighborhoods in which crime was prevalent, and students with low academic achievement were most likely to have committed acts of violence. Almost a third of the boys, 7% of girls, and 40% of those who earned poor grades reported having ever carried a weapon to school. One in ten boys and almost 20% of those who earned poor grades reported threatening a teacher. One in four students reported having ever been a victim of violence at or around school, and 14% were very worried or somewhat worried about being physically attacked or hurt at school. One in four students believed the efforts by their schools to address violence were less than adequate. CONCLUSIONS: Schools cannot ignore the need to create a safe environment by coordinating deterrents to violence through discipline, prevention, and education. Because schools alone cannot eliminate the problem of violence, communities must also be involved by working with the schools to create a safe and nurturing environment which fosters learning.

Adolescent↗
PubMed2006

Rapid separation of serum does not avoid artificially higher matrix metalloproteinase (MMP)-9 levels in serum versus plasma.

OBJECTIVES: To examine whether the time between blood drawing and centrifugation (TBDC) affects the levels of matrix metalloproteinase (MMP)-9 and MMP-2 levels in serum and in plasma samples, and to assess whether there is correlation between MMP-9 and MMP-2 levels in serum and plasma samples. DESIGN AND METHODS: Serum and plasma samples (N=8) were separated from venous blood collected into citrate, heparin, and EDTA tubes, which were either centrifuged immediately or after 5, 10, 20, or 30 min after blood drawing. We assessed the correlation between MMP-9/MMP-2 in serum and citrate, heparin, and plasma samples (N=20), which were assayed for gelatine zymography of MMP-2 and MMP-9. RESULTS: MMPs are released by platelets or leukocytes during platelet activation or sampling process, thus leading to artificially higher MMP-9 levels in serum compared with citrate, heparin, or EDTA plasma samples, independently of TBDC. Citrate and heparin plasma samples had the lowest Pro-MMP-9 and MMP-9 levels, which correlated with each other. Pro-MMP-9 levels in serum correlated with Pro-MMP-9 levels in EDTA or citrate plasma, but not with heparin plasma. While no significant correlations were found between MMP-9 levels in serum and those found in plasma samples, the total MMP-9 levels (Pro-MMP-9+MMP-9) in serum and in plasma samples correlated with each other. No significant differences were found in pro-MMP-2 levels. CONCLUSIONS: These results suggest that the circulating levels of MMP-9 should be assessed in citrate or heparin plasma samples, but not in serum samples because of artificially higher MMP-9 levels in serum, independently of TBDC, and because they do not correlate with the MMP-9 levels in plasma samples.

Citric Acid↗
PubMed2005

Spatial patterns of cadmium and lead deposition on and adjacent to National Park Service lands in the vicinity of Red Dog Mine, Alaska.

Heavy metal escapement associated with ore trucks is known to occur along the DeLong Mountain Regional Transportation System (DMTS) haul road corridor in Cape Krusenstern National Monument, northwest Alaska. Heavy metal concentrations in Hylocomium splendens moss (n = 226) were used in geostatistical models to predict the extent and pattern of atmospheric deposition of Cd and Pb on Monument lands. A stratified grid-based sample design was used with more intensive sampling near mine-related activity areas. Spatial predictions were used to produce maps of concentration patterns, and to estimate the total area in 10 moss concentration categories. Heavy metal levels in moss were highest immediately adjacent to the DMTS haul road (Cd > 24 mg/kg dw; Pb > 900 mg/kg dw). Spatial regression analyses indicated that heavy metal deposition decreased with the log of distance from the DMTS haul road and the DMTS port site. Analysis of subsurface soil suggested that observed patterns of heavy metal deposition reflected in moss were not attributable to subsurface lithology at the sample points. Further, moss Pb concentrations throughout the northern half of the study area were high relative to concentrations previously reported from other Arctic Alaska sites. Collectively, these findings indicate the presence of mine-related heavy metal deposition throughout the northern portion of Cape Krusenstern National Monument. Geospatial analyses suggest that the Pb depositional area extends 25 km north of the haul road to the Kisimilot/Iyikrok hills, and possibly beyond. More study is needed to determine whether higher moss heavy metal concentrations in the northernmost portion of the study area reflect deposition from mining-related activities, weathering from mineralized Pb/Zn outcrops in the broader region, or a combination of the two. South of the DMTS haul road, airborne deposition appears to be constrained by the Tahinichok Mountains. Heavy metal levels continue to diminish south of the mountains, reaching a minimum in the southernmost portion of the study area near the Igichuk Hills (45 km from the haul road). The influence of the mine site was not studied.

Alaska↗
PubMed2001

Use of contraceptive methods in Spain: results of a national survey.

We conducted a personal interview of 2136 Spanish women aged 15 to 49 years with the aim of determining the contraceptive attitudes of this population. A stratified random sampling was performed to select the women who were to be interviewed, and this sampling design ensured adequate representation of the sample in Spain. At the time of the survey, only 1296 of the 2136 women used some type of contraceptive method (60.6%); the most commonly used method was the condom. The major reason given by the 840 women not using contraceptive methods was the absence of sexual intercourse. Nearly 25% of the Spanish women aged 15-49 years reported that they have no sexual relations.

Adolescent↗
PubMed2001

Sequential methods of analysis for genome scans.

As the preceding chapters illustrate, now that whole-genome scan analyses are becoming more common, there is considerable disagreement about the best way to balance between false positives and false negatives (traditionally called type I and type II errors in the statistical parlance). Type I and type II errors can be simultaneously controlled, if we are willing to let the sample size of analysis vary. This is the secret that Wald (1947) discovered in the 1940s that led to the theory of sequential sampling and was the inspiration for Newton Morton in developing the lod score method. We can exploit this idea further and capitalize on an old, but nearly forgotten theory: sequential multiple decision procedures (SMDP) (Bechhoffer, et al., 1968), which generalizes the standard "two-hypotheses" tests to consider multiple alternative hypotheses. Using this theory, we can develop a single, genome-wide test that simultaneously partitions all markers into "signal" and "noise" groups, with tight control over both type I and type II errors (Province, 2000). Conceiving this approach as an analysis tool for fixed sample designs (instead of a true sequential sampling scheme), we can let the data decide at which point we should move from the hypothesis generation phase of a genome scan (where multiple comparisons make the interpretation of p values and significance levels difficult and controversial), to a true hypothesis-testing phase (where the problem of multiple comparisons has been all but eliminated so that p values may be accepted at face value).

Chromosome Mapping↗
PubMed2003

[Incidence and clinical characteristics of maculopapular exanthemas of viral aetiology].

OBJECTIVE: To estimate the incidence of maculo-papular viral exanthemas and to describe the epidemiological and clinical patterns. DESIGN: Observational descriptive study with a sample design. PARTICIPANTS AND SETTING: 154 practitioners from the Castilla y León Sentinel Network with a surveilled population of 23 237 people-year under 15 years old, notified in 2002 the cases of diseases by means of a standard form with the variables and inclusion and exclusion criteria. MAIN MEASUREMENTS: It was included the maculo-papular exanthemas associated to a presumable systemic virus disease in patients under 15 years old. It was excluded the infectious mononucleose, the chickenpox, and other non viral infections or exanthemas. RESULTS: 368 cases were notified which represent a incidence rate of 158.37 cases per 10 000 (95% CI, 142.31-174.42). The incidence was maximum under four years old, more than 350 per 10 000, decreasing significantly in children over this age. Erythema infectiousum presented the highest rate, followed by exanthema subitum. The exanthemas caused by measles or rubella were insignificants. CONCLUSIONS: Childhood exanthematous diseases of presumable viral etiology have an important incidence in primary care, although the majorities are banal and self-limited diseases. Clinical characteristics supported the suspicion diagnosis, which was consistent with the observed epidemiological description and expected presentations of each disease. Although serological analysis could diminish the uncertainly on notification and control of diseases submited to especial programs of vaccination and eradication, they would not improve substantially the diagnosis and treatment of these patients.

Adolescent↗
PubMed2002

Estimating the distribution of usual dietary intake by short-term measurements.

OBJECTIVE: To estimate the habitual dietary intake distribution in a population on the basis of repeated short-term measurements, especially of multiple 24 h diet recalls. METHODS: Six different statistical methods were evaluated and compared. The comparison referred to theoretical assumptions, admitted data transformations, statistical foundations, available software packages, and applications to real data of dietary intake. RESULTS: The Nusser method and a simplified version of it proposed in the paper have proved to be universally applicable methods for estimating the usual intake distribution for food groups and nutrients. Also, the Buck method seemed to be a robust estimation procedure suitable for the description of food consumption data, whereas the other considered methods were only applicable for log-normally distributed intake data or required a comprehensive data simulation. Characteristics of the estimated usual intake distribution were a decreased standard deviation, increased lower percentiles, and decreased upper percentiles compared to the observed sample distribution of individual means. Empirical results concerning total fat and vegetable intake in three different European consumption surveys showed that the estimated percentiles of the usual intake distribution did not depend markedly on the number of sampling days. CONCLUSIONS: Repeated short-term measurements like 24 h diet recalls can be used to describe the habitual dietary intake distribution in food consumption surveys. Recommended is a sampling design of two non-consecutive sampling days. The sampling days of all participants should be selected in such a way that they cover all seasons and days of the week.

Data Interpretation, Statistical↗
PubMed2006

Menopausal symptoms and health problems of women aged 50-65 years in southern Jordan.

OBJECTIVES: To identify menopausal symptoms and health disorders of women aged 50-65 years in under-privileged areas of southern Jordan. METHOD: A multistage, random-sampling design was applied to select a sample of households from three governorates. A total of 143 women were eligible to be included in the analysis. Women were asked about a list of symptoms (somatic, psychological and genitourinary) and about a list of morbidities such as hypertension, diabetes mellitus and urinary tract infection. Ever-screening by mammogram, regular breast self-examination, ever-screening by cervical smear, general medical check-up, physical activity, smoking habit, and ever-receiving information about menopause were also investigated. RESULTS: The median age of onset of natural menopause was 50 years; 77% of women were illiterate, and 59% of the couples were relatives. The most frequently reported somatic symptoms were joint aches/stiffness (89%), bone pains (74%) and paresthesia in the extremities (51%). Hot flushes were experienced by 62% and urinary incontinence by 30%. Almost 62% reported irritability and mood changes, 56% had high blood pressure, and 18% and 14% suffered from urinary tract infection and reproductive tract infection, respectively. Eight percent and 11% reported ever-screening by mammogram and cervical smear, respectively, and 11% reported performing breast self-examination regularly. Regular physical exercise was reported by 8%, and 81% were overweight or obese. One-quarter received information on menopause, and 58% reported the need to know 'everything' about menopause. CONCLUSION: Women in southern Jordan experienced multiple menopause-related symptoms and morbidities. The majority of them did not receive any health education about this phase of life. Preventive health practices and health-promoting behaviors are relatively uncommon. Effective health-care delivery systems responsive to menopausal women's health needs are highly recommended.

Aged↗
PubMed2001

Prevalence and correlates of sunscreen use among US high school students.

Sun exposure during childhood and adolescence increases the risk of skin cancer later in life. To determine the prevalence and correlates of sunscreen use among US high school students, researchers assessed data on sunscreen use, demographic characteristics, and health behaviors obtained from the 1999 Youth Risk Behavior Survey (YRBS). This survey used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9-12 (N = 15,349). Overall, 13.3% (95% confidence interval, +/- 1.3) of students used sunscreen always or most of the time (i.e., frequent use). Frequent sunscreen use was lower among males (8.6%, +/- 1.2) than females (18.1%, +/- 1.9) and among Blacks (4.8%, +/- 1.7) and Hispanics (10.8%, +/- 2.8) than Whites (16.5%, +/- 1.9). Frequent sunscreen use decreased with age. Infrequent use of sunscreen was associated with other risky health behaviors, such as driving after drinking or riding in a car with a drinking driver, smoking cigarettes, being sexually active, and being physically inactive. Results indicate a need for health education interventions addressing sunscreen use that target high school students.

Administration, Cutaneous↗
PubMed2005

Assisted living in rural America: results from a national survey.

CONTEXT: Expanding the availability of long-term care (LTC) services and making them more responsive to consumer preferences is an important goal, particularly for elderly people living in rural areas who tend to be older and have greater functional limitations but less access to the range of LTC options available in metropolitan areas. One option that has been growing in popularity is assisted-living facilities (ALFs). PURPOSE AND METHODS: This paper describes rural ALFs and compares them with metropolitan ALFs. Data were collected using a multistage sample design that yielded a nationally representative sample of ALFs. Telephone interviews were completed with administrators of 1,251 ALFs in 1998. FINDINGS: Nationwide, assisted living was largely administered by private payment, and there was an undersupply in rural areas. Compared with metropolitan ALFs, rural ALFs were smaller and less likely to offer the types of services and accommodations associated with the philosophy of assisted living. They were more likely to offer accommodations with little privacy, and while similar in the services they offered, rural ALFs were less likely to have nurses on staff, particularly licensed practical nurses. Moreover, they were less likely to offer a combination of high services and high privacy. Finally, rural ALFs charged lower prices than urban ALFs; however, the average price was still unaffordable for most elderly rural residents. CONCLUSIONS: These findings suggest that assisted living, as currently structured, will make only a marginal contribution to meeting the needs of frail elders in rural areas.

Aged↗
PubMed2005

Epidemiology of vestibular vertigo: a neurotologic survey of the general population.

OBJECTIVE: The purpose of this study was to determine the prevalence and incidence of vestibular vertigo in the general population and to describe its clinical characteristics and associated factors. METHODS: The neurotologic survey had a two-stage general population sampling design: nationwide modified random digit dialing sampling for participation in the German National Telephone Health Interview Survey 2003 (response rate 52%) with screening of a random sample of 4,869 participants for moderate or severe dizziness or vertigo, followed by detailed neurotologic interviews developed through piloting and validation (n = 1,003, response rate 87%). Diagnostic criteria for vestibular vertigo were rotational vertigo, positional vertigo, or recurrent dizziness with nausea and oscillopsia or imbalance. Vestibular vertigo was detected by our interview with a specificity of 94% and a sensitivity of 84[corrected]% in a concurrent validation study using neurotology clinic diagnoses as an accepted standard (n = 61). RESULTS: The lifetime prevalence of vestibular vertigo was 7.4[corrected]%, the 1-year prevalence was 4.9[corrected]%, and the incidence was 1.4[corrected]%. In 80% of affected individuals, vertigo resulted in a medical consultation, interruption of daily activities, or sick leave. Female sex, age, lower educational level, and various comorbid conditions, including tinnitus, depression, and several cardiovascular diseases and risk factors, were associated with vestibular vertigo in the past year in univariate analysis. In multivariable analysis, only female sex, self-reported depression, tinnitus, hypertension, and dyslipidemia had an independent effect on vestibular vertigo. CONCLUSIONS: Vestibular vertigo is common in the general population, affecting [corrected] 5% of adults in 1 year. The frequency and health care impact of vestibular symptoms at the population level have been underestimated.

Activities of Daily Living↗
PubMed2003

Mercury derived from dental amalgams and neuropsychologic function.

There is widespread concern regarding the safety of silver-mercury amalgam dental restorations, yet little evidence to support their harm or safety. We examined whether mercury dental amalgams are adversely associated with cognitive functioning in a cross-sectional sample of healthy working adults. We studied 550 adults, 30-49 years of age, who were not occupationally exposed to mercury. Participants were representative of employees at a major urban medical center. Each participant underwent a neuropsychologic test battery, a structured questionnaire, a modified dental examination, and collection of blood and urine samples. Mercury exposure was assessed using a) urinary mercury concentration (UHg); b) the total number of amalgam surfaces; and c) the number of occlusal amalgam surfaces. Linear regression analysis was used to estimate associations between each marker of mercury exposure and each neuropsychologic test, adjusting for potential confounding variables. Exposure levels were relatively low. The mean UHg was 1.7 micro g/g creatinine (range, 0.09-17.8); the mean total number of amalgam surfaces was 10.6 (range, 0-46) and the mean number of occlusal amalgam surfaces was 6.1 (range, 0-19). No measure of exposure was significantly associated with the scores on any neuropsychologic test in analyses that adjusted for the sampling design and other covariates. In a sample of healthy working adults, mercury exposure derived from dental amalgam restorations was not associated with any detectable deficits in cognitive or fine motor functioning.

Adult↗
PubMed2005

National estimates of out-of-pocket dental costs for HIV-infected users of medical care.

BACKGROUND: Out-of-pocket costs for U.S. dental care in 1996 were dollar 157 per person at the poverty level and dollar 229 for people with higher incomes. This article examines out-of-pocket expenditures for dental care in HIV-infected patients who took part in the HIV Cost and Services Utilization Study (HCSUS), conducted by a consortium of private and government institutions centered at the RAND Corp. METHODS: The HCSUS used a probability sampling design. The authors used a weighted sample of 2,466 HCSUS respondents to estimate the national population of HIV-infected users of medical care. The patients were asked to report how much they had spent on their dental care in the preceding 12 months, including payments made by them, their family or their friends--but not by insurance companies--for their dental care. RESULTS: In 1996, 135,000 HIV-infected subjects spent dollar 20.5 million on dental care, averaging dollar 152 per user. Whites spent dollar 220, African-Americans dollar 55 and Hispanics dollar 101. People receiving dental care from private dentists spent dollar 232 compared with dollar 7 spent by those who received care in AIDS clinics. CONCLUSIONS: More than one-half of the HIV-infected users of medical care identified private dentists as their source of dental care and spent the vast majority of the dollar 20.5 million. The remaining subjects identified public dental programs as their source of care and had low expenditures. The explanation for these low expenditures is the subsidization of public programs and the likelihood that fewer and less costly services are provided by such programs. PRACTICE IMPLICATIONS: Dentists should be aware of out-of-pocket funds spent by the HIV-infected population in private practices and public programs. Any policy change reducing public funding may result in higher out-of-pocket costs for disadvantaged groups or in increasing disparities in access to dental services.

Adolescent↗
PubMed2001

Adoption as a risk factor for attempted suicide during adolescence.

OBJECTIVE: Depression, impulsivity, and aggression during adolescence have been associated with both adoption and suicidal behavior. Studies of adopted adults suggest that impulsivity, even more than depression, may be an inherited factor that mediates suicidal behavior. However, the association between adoption and adolescent suicide attempts and the mechanisms that might explain it remain unknown. The objective of this study was to determine the following: 1) whether suicide attempts are more common among adolescents who live with adoptive parents rather than biological parents; 2) whether the association is mediated by impulsivity, and 3) whether family connectedness decreases the risk of suicide attempt regardless of adoptive or biological status. METHODS: A secondary analysis of Wave I data from the National Longitudinal Study of Adolescent Health was conducted, which used a school-based, clustered sampling design to identify a nationally representative sample of 7th- to 12th-grade students, with oversampling of underrepresented groups. Of the 90 118 adolescents who completed the National Longitudinal Study of Adolescent Health in-school survey, 17 125 completed the in-home interview and had parents of identified gender who completed separate in-home questionnaire. The subset of adolescents for this study was drawn from the in-home sampling according to the following criteria: 1) adolescent living with adoptive or biological mother at the time of the interview, 2) adolescent had never been separated from mother for more than 6 months, 3) mother was in first marriage at the time of the interview, and 4) the adoptive mother had never been married to the adolescent's biological father. Of the 6577 adolescents in the final study sample, 214 (3.3%) were living with adoptive mothers and 6363 (96.7%) were living with biological mothers. Variables. The primary outcome measured was adolescent report of suicide attempt(s) in the past year. Other variables included in the analyses were sociodemographics characteristics (gender, age, race/ethnicity, family income, parental education), general health (self-rated health, routine examination in the past year, need for medical care in the past year that was not obtained), mental health (depressive symptoms, self-image, trouble relaxing in the past year, bad temper, psychological or emotional counseling in the past year), risk behaviors (cigarettes, alcohol, marijuana, sexual intercourse ever, delinquency, physical fighting in the past year, impulsive decision making), school-related characteristics (grade point average, school connectedness), and family interaction (family connectedness, parental presence, maternal satisfaction with parent-adolescent relationship). Data Analysis. Univariate analyses were used to compare adoptees versus nonadoptees, suicide attempters versus nonsuicide attempters, and adopted suicide attempters versus nonadopted suicide attempters on all variables. Variables that were associated with attempted suicide were entered into a forward stepwise logistic regression procedure, and variables that were associated with the log odds of attempt were retained in the model. The area under the model's receiver operating characteristic curve was calculated as a measure of its overall performance. After the association of adoption with attempted suicide was demonstrated, the potential mediating effect of impulsivity was explored by adding it to the model. The same procedure was followed for any variable that was associated with adoption in the full sample or the subsample of suicide attempters. To determine whether any variable in the model moderated the association between adoption and suicide attempt, the interaction term for that variable x adoption was forced into the model. RESULTS: Adoptees differed significantly from nonadoptees on 4 of 26 variables. They were more likely to have attempted suicide (7.6% vs 3.1%) and to have received psychological or emotional counseling in the past year (16.9% vs 8.2%), and their mothers reported higher parental education and family income. Attempters differed significantly from nonattempters on all variables except for age, race/ethnicity, parental education, family income, and routine examination in the past year. On logistic regression, 9 variables were independently associated with attempted suicide: depression (adjusted odds ratio [AOR]: 3.41), counseling (AOR: 2.83), female gender (AOR: 2.31), cigarette use (AOR: 2.31), delinquency (AOR: 2.17), adoption (AOR: 1.98), low self-image (AOR: 1.78), aggression (AOR: 1.48), and high family connectedness (AOR: 0.60). The receiver operating characteristic curve for the model had an area of 0.834, indicating performance significantly better than chance. The AOR for adoption did not change when parental education, family income, and impulsivity were forced into the model. (ABSTRACT TRUNCATED)

Achievement↗
PubMedDate not supplied

Correlates of bidi use among youth.

OBJECTIVES: To identify characteristics associated with youth bidi use. METHODS: The New Jersey Youth Tobacco Survey is a self-administered school-based survey that uses a 2-stage cluster sample design to obtain a representative statewide sample; 9589 students (grades 7-12) participated. Logistic regression was used to generate an adjusted odds ratio (OR) for current bidi use for each variable, controlling for gender, race, and school grade. RESULTS: Higher odds for current bidi use were noted for black and Hispanic students, users of other tobacco products, and students that perceived bidis as safer than cigarettes. CONCLUSIONS: These results suggest specific groups that should be targeted for intervention.

Adolescent↗
PubMed2003

Evaluation of the Idaho Technology LightCycler PCR for the direct detection of Mycobacterium tuberculosis in respiratory specimens.

SETTING: The rapid detection of Mycobacterium tuberculosis (TB) in clinical samples is an important goal. The LightCycler heralds an advance in thermal cycle technology combining rapid cycle DNA amplification with fluorimetry, eliminating the need to perform amplification and product analysis separately. OBJECTIVES: To evaluate the LightCycler for direct detection of M. tuberculosis complex in respiratory specimens. To evaluate a DNA extraction method based on Chelex 100 resin, heating and ultrasonication for the prevention of endogenous inhibitions in respiratory samples. DESIGN: DNA was extracted from sputum samples using the Chelex method and polymerase chain reaction (PCR) for TB performed with the LightCycler. RESULTS: For 88 sputum samples positive by microscopy and culture for M. tuberculosis, 95% were PCR-positive. None of the five sputum samples that were smear-negative but culture-positive for M. tuberculosis, the 79 culture-negative sputum samples and the 29 sputum samples that were culture-positive for mycobacteria other than TB yielded positive PCR results. PCR inhibitors were not detected in any of the samples. CONCLUSION: The LightCycler proved a simple, reproducible and rapid system, reducing the time to result from weeks (culture) or days (conventional PCR) to hours. The Chelex 100 resin method produced good results for the smear-positive specimens. However, a larger study is required to determine the efficacy of the method with smear-negative specimens and for specimens known to contain endogenous inhibitors.

Fluorometry↗
PubMed2004

Satisfaction with health care for young children.

OBJECTIVES: The aims of this study are to 1) assess parent satisfaction with well-child care for their young child and 2) identify how global satisfaction ratings and parent reports on the processes of care vary with child and family characteristics, health care received, and health system factors. METHODS: The National Survey of Early Childhood Health is a telephone survey that used a stratified random-digit-dial sampling design to achieve a nationally representative sample of 2068 children and 4 to 35 months. Parents provided global ratings of satisfaction with their child's well-child visits (range 0-100) and reported their satisfaction with information provided and the time spent with the provider. A subsample of parents whose child has a particular provider for well-child care (n = 930) also reported their likelihood of recommending their provider. RESULTS: The mean global satisfaction rating is 86.9 (standard error: 6.1). Approximately 94% of parents of young children reported information satisfaction, 88% reported time satisfaction, and 79% would recommend their child's provider. Bivariate analysis shows lower satisfaction for uninsured children but few differences associated with insurance type or health care setting. In multivariate analyses including child and family factors and health system factors, Hispanic, Spanish-speaking mothers of young children have lower odds than non-Hispanic white mothers of reporting information (odds ratio [OR]: 0.32; 95% confidence interval [CI]: 0.13-0.79) and time satisfaction (OR: 0.44; 95% CI: 0.21-0.90). Parents of children who experienced missed or delayed care have lower odds of time satisfaction (OR: 0.27; 95% CI: 0.16-0.46) and have lower global satisfaction. Greater length of well-child visits is consistently associated with greater satisfaction on all 4 measures. CONCLUSION: Although most parents reported relatively high levels of satisfaction with well-child care, shorter length of well-child visits and experiencing missed or delayed care are the 2 factors consistently associated with lower satisfaction using each of the measures. Efforts to improve satisfaction ratings might focus on improving the delivery of well-child care and ensuring that parents get the time they need.

Analysis of Variance↗
PubMedDate not supplied

[The national addictions survey of Mexico].

A probabilistic household survey was made with the following objectives: to estimate the prevalence of consumption of tobacco, alcohol and legal and illegal drugs; to identify attitudes and values, risk factors and problems associated with the consumption of addictive substances in a population from 12 to 65 years old, which resides in the urban areas of Mexico. This survey forms part of the National Health Surveys System, and its sample design is based on the Master Sample Framework of the National Health Surveys System, which gathered information representative of the national population and for seven regions. In the elaboration of the questionnaire indicators proposed by the World Health Organization (WHO), validated for Mexico, were used as well as previous knowledge about the topic. Thirteen thousand and five interviews were made, of which 96.7 per cent were complete and 2.6 per cent were rejected. In the group from 12 to 17 years old, 32 per cent of the men and 23 per cent of the women already consumed alcoholic drinks. The age group with the largest proportion of men who were frequent drinkers is from 30 to 39 years of age, with 36.3 per cent. For women 34.0 per cent of the frequent drinkers were found in the 40 to 49 year age group. It was found that six per cent of the population from 18 to 65 years of age is alcohol dependent, 12.5 per cent of men and less than one per cent of women. The population which smokes reaches 26 per cent of the total, with 38.3 per cent of men and 14.4 per cent of women. Forty two and four per cent of smokers are from 18 to 29 years of age. Among the daily smokers, 17 per cent were considered dependent on cigarettes. Only 4.8 per cent of the population admits having consumed some type of drug on at least one occasion, with the men from 12 to 34 years old being the age group which is most affected by the use of drugs (8.5%). Active users in the last year made up 2.1 per cent and in the last month the proportion of active users was less than one per cent. The most frequently used drug was marihuana (1%), the second used were tranquilizers (0.4%), and the third most frequently used were inhalants (glue, thinner) (0.26%). The most commonly consumed drug by male users was marihuana and by female users the most commonly used drug was stimulants.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗