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PubMedDate not supplied

Respiratory function as measured by peak expiratory flow rate and PM10: six communities study.

This Six Communities Study conducted at six communities in southwestern North Carolina investigates the respiratory health status of residents whose households are located near an incinerator. This diary study makes it possible to estimate the daily variation of pulmonary function measured as peak expiratory flow rate (PEFR) related to 24-h mean PM10 levels, which were observed at each monitoring station placed in the six study communities, as a surrogate exposure measure of outdoor air pollution. Observations of PEFR among participants in each community were analyzed to determine how they varied according to the degree of exposure to ambient pollutants as well as to other cofactors including, sex, age, respiratory hypersensitivity, hours spent outdoors within the area of the selected community, and surrogate measures for indoor air pollution exposure (vacuum use and experience of air irritants at work). The findings revealed that respiratory hypersensitivity status is a predictor of declining PEFR. PM10 concentrations measured in each study area did not seem to be related to the variations of respiratory health as measured by PEFR. This study did not show any difference in respiratory health between subjects of an incinerator community and those of its comparison community. Even though this community-based study with free-living subjects shows negative findings on the relationship between respiratory health and PM10, it is worth noting that these findings must be interpreted cautiously because exposure estimation based on monitoring of ambient air likely results in misclassification of true exposure levels.

Adolescent↗
PubMed1996

Patterns of HIV/AIDS in Zimbabwe: implications for health education.

Current patterns of HIV/AIDS in Zimbabwe are examined using national surveillance data reflecting four main variables: age, gender, marital status, and residence. The data show that the distribution of cases by age and gender is consistent with the literature on the rest of sub-Sahara Africa. Distribution of cases by age is bimodal with incidence highest among sexually active young adults (20-39 years) and the very young (0-4 years), and the male-to-female ratio is nearly 1:1 among adults. However, among adolescents 15-19, the incidence among females is six times greater than their male counterparts. The data also show that married persons have the highest rate of HIV infection (51%), greater than single persons (34%). These patterns highlight the significance of heterosexual and perinatal transmission. These data suggest a need for expanded HIV testing, counseling, and education across gender and marital status in order to detect HIV infection earlier in the spectrum of the disease. Promotion of monogamy and proper condom use should be a major focus of the empowerment process. Further recommendations are provided for planning, implementation, evaluation, and coordination of a comprehensive national prevention strategy.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Farming and mortality from non-Hodgkin's lymphoma: a case-control study.

A case-control study of non-Hodgkin's lymphoma (NHL) and its subtypes among males was conducted using computerized mortality listings from the State of Wisconsin for the years 1968-1974. Age, year of death, race, county of usual residence, marital status, and usual occupation were abstracted for the 774 records of male deaths due to NHL and a matched series of deaths due to other causes. The frequency of farming occupation among NHL cases was compared to the frequency among controls, and odds ratios (OR) were calculated. Farming was more common among cases than among controls (OR = 1.22). The association of NHL with farming occupation was greater among decedents under 65 years of age (OR = 1.7) than among those who were older. The younger decedents were at higher risk of reticulum-cell sarcoma (OR = 2.7) than of other cell types. The strength of the association increased over the 9-year study period. County levels of selected agricultural characteristics were used as surrogate measures of farming exposures in residence counties of farmers and were summarized by factor analysis. Major findings were of elevated risk among younger farmers for reticulum-cell sarcoma in counties high in summary measures of general agricultural activity (OR = 3.2), of small grain acreage and acres treated with insecticides (OR = 6.6), and of wheat acreage (OR = 4.4). Given the limitations of the data, further investigation of non-Hodgkin's lymphoma in farmers is warranted.

Age Factors↗
PubMed1994

The Influence of Obesity on the Self-Reported Health Status of Chamorros and other Residents of Guam.

PURPOSE OF THE PAPER. We report on an analysis of the relationship of obesity to self-assessments of physical health for a probability sample of Guam's indigenous (Chamorro) and resident populations. Further, we examine whether Guam's populations fit a Western model, in terms of viewing obesity as an unhealthy condition. As background for our analysis, we review the literature on (1) the relationship between obesity and chronic noninfectious diseases; (2) social and behavioral associations of obesity; and (3) the reliability of self-assessed physical health and measures of obesity. METHODS. The data analyzed were taken from a Behavioral Risk Factor Survery (BRFS) conducted on Guam in 1991. We employed various standard univariate (chi-square analysis, ANOVA) and multivariate (OLS regression and logisitic regression analusis) statistical procedures in exploring our data and testing hypotheses on the correlates and associations of self-reported health and obesity. PRINCIPAL FINDINGS. Controlling for ethnicity, age, gender, marital and socioeconomic status, we found that obesity and being Chamorro was associated significantly with low assessments of physical health and that income was a signifcant predictor of higher self-assessments. A small sample of Micronesians, with a slightly greater level of obesity than the Chamorros, did not show the same tendency towards lower self-evaluation of their health. This probably reflects their lesser degree of internalizaition of Western ideas about obesity, appearance and health. When controlling for self-assessments of physical health, obesity was also shown to be related significantly with dieting by Chamorro women but was not a significant predictor of their increased participation in physical exercise. Young males were significantly more likely to report participation in physical exercise regardless of their weight or ethnicity. CONCLUSIONS. We hypothesize that historical (acculturative) changes to the diet and life ways of Chamorros, together with a likely genetic predisposition to store fat, has led to the relatively high levels of obesity seen on Guam today. Because of internalization of Western ideals about obesity and appearance, and increased community awareness of the health perils of obesity, Chamorros are at a public health crossroads. Effective health interventions must reckon with powerful genetic and cultural cross-currents. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS. Colleagues are encouraged to examine the effects of ethnicity and acculturation on the health attitudes, behaviors, and status of other Pacific Islander and Asian populations. The creation of such a comparative data base will service APIA health interventions. KEY WORDS. Guam, Chamorros, Asian Pacific Islander Americans, survey, obesity, self-evaluated health status, socioeconomic status, cross-cultural comparisons.

Journal Article↗
PubMed2005

Patients with gallstones develop gallbladder cancer at an earlier age.

Significant proportions of Indian patients with gallbladder cancer are young. Multiple risk factors for gallbladder cancer are recognized among Indian patients. The effect of these risk factors on the age of development of gallbladder cancer is not known. We conducted a study to determine the influence of risk factors on the age at diagnosis of patients with gallbladder cancer and to assess the interactions between these risk factors. Patients with gallbladder cancer from two tertiary care institutions during the period 1994-2001 were prospectively studied. An ultrasound examination was done to look for the presence of gallstones. The influence of gender, gallstones, socio-economic status, smoking, residence in rural areas and in the Gangetic belt on the age at presentation was analysed using univariate analysis, logistic and linear regression analyses. The mean age of the 121 patients studied was 55+/-11.7 (SD) years. There were 51 (42%) patients aged less than 50 years. The younger patients (age < or =50 years) were more likely to have gallstones (88 versus 66%; P=0.008) and to have come from a lower socio-economic background (88 versus 71%; P=0.02) in comparison with older patients. However, there was no effect of the other risk factors. The independent determinants for younger age of patients with gallbladder cancer on logistic regression analysis were gallstones [odds ratio (OR) 4, 95% confidence interval (CI) 1.5-11; P=0.006] and lower socio-economic status (OR 3.1, 95% CI 1.1-8.6; P=0.03). On linear regression analysis, age at presentation was lowered by 5.6 years if there were associated gallstones. The mean age of patients with these two risk factors was significantly lower than that of those with one risk factor or no risk factor (52+/-12 years versus 57+/-11 years versus 61+/-9 years; P=0.007). In conclusion, the presence of gallstones and lower socio-economic status were both independently associated with a younger age at diagnosis of gallbladder cancer and their effect was additive.

Adult↗
PubMed2003

Humor coping, health status, and life satisfaction among older adults residing in assisted living facilities.

The present study examined the relationships between humor coping, health status, and life satisfaction among older residents of assisted living facilities. A structural equation model with latent variables was specified for the three variables. Health status was expected to directly affect humor coping and life satisfaction. Humor coping was hypothesized to have a direct association with life satisfaction and indirectly affect the relationship between health status and life satisfaction. Participants completed the Multidimensional Functional Assessment Questionnaire, Coping Humor Scale, and Life Satisfaction Index A. The relationships between health status and humor coping and health status and life satisfaction were statistically significant. Both the direct association of humor coping on life satisfaction and the intervening role between health status and life satisfaction were not supported. Humor as a coping strategy seems to be available to older adults who are in better health.

Adaptation, Psychological↗
PubMed1995

Vitamin B-12 status of long-term adherents of a strict uncooked vegan diet ("living food diet") is compromised.

The present study examined the vitamin B-12 status in long-term adherents of a strict uncooked vegan diet called the "living food diet." The study was comprised of two parts. In the cross-sectional part, the data on serum vitamin B-12 concentrations and dietary intakes in 21 (1 male, 20 females) long-term adherents (mean 5.2 y, range 0.7-14) of the "living food diet" were compared with those of 21 omnivorous controls matched for sex, age, social status and residence. In the longitudinal part of the study, food consumption data were collected and blood samples were taken from nine "living food eaters" (1 male, 8 females) on two occasions 2 y apart. The cross-sectional study revealed significantly (P < 0.001, paired t test) lower serum vitamin B-12 concentrations in the vegans (mean 193 pmol/L, range 35-408) compared with their matched omnivorous controls (311, 131-482). In the vegan group, total vitamin B-12 intake correlated significantly (r = 0.63, P < 0.01) with serum vitamin B-12 concentration. The vegans consuming Nori and/or Chlorella seaweeds (n = 16) had serum vitamin B-12 concentrations twice as high as those not using these seaweeds (n = 5) (mean 221 pmol/L, range 75-408, vs. 105, 35-252, P = 0.025). In the longitudinal study, six of nine vegans showed slow, but consistent deterioration of vitamin B-12 status over a 2-y observation period. On the basis of these results we conclude that some seaweeds consumed in large amounts can supply adequate amounts of bioavailable vitamin B-12.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2026

Development and Validation of a Predictive Model for Identification of Cognitive Impairment Risk in Older Adults with Subjective Cognitive Decline&#xff1a;A Longitudinal Study.

BACKGROUND: Subjective cognitive decline (SCD) is a transitional state between objective cognitive impairment and cognitively intact mental status, providing a critical window for implementing preventive interventions to delay objective cognitive decline. AIMS: We aimed to develop a predictive model for SCD progression in older adults with mild cognitive impairment (MCI). This model will facilitate the identification of risk factors and establishment of targeted interventions for community-based SCD management. METHODS: Data from the China Health and Retirement Longitudinal Study (CHARLS) was utilized in this study, extracting 18 indicators. Potential predictors selected through univariate Cox regression and LASSO regression analyses were sequentially incorporated into a multivariable Cox regression model. A nomogram was constructed to establish a predictive model. Model validation encompassed Area Under Curve (AUC) metrics for discriminative capacity, complemented by quantitative assessments using calibration curve analysis for precision verification and decision curve analysis (DCA) for clinical utility evaluation. RESULTS: A total of 1099 older adults with SCD were included in the final analysis, of whom 114 (10.3%) developed MCI. Multivariable Cox regression identified residence, marital status, educational level, social participation, gait speed, and baseline cognitive function. The model demonstrated time-dependent AUC values of 0.885, 0.830, 0.839, and 0.836 in the training set when evaluating discriminative capacity at 2-, 4-, 7-, and 9-year, respectively. The predictive model showed excellent predictive ability according to AUC, calibration curve, and DCA. CONCLUSIONS: A predictive model was created to estimate the risk of developing MCI in older individuals with SCD, offering clinician-actionable intervention benchmarks for preventive care.

Humans↗
PubMed1989

Improving Medicare payments to HMOs: urban core versus suburban ring.

This article considers improvements in the location adjustment now used in Medicare's payment formula to HMOs. Average Medicare expenditure increases with metropolitan area population size and is higher in the urban core of a metropolitan area than in the suburbs. Input prices rather than the health or poverty status of residents appear to be the major cause of these patterns. At present Medicare payment to HMOs varies by county and is proportionate to Medicare fee-for-service expenditures there. The article suggests modifying the current payment, which depends on the county unit, by having one payment rate for the core of each metropolitan area and another for the ring. In areas where HMO penetration is large, payment should be based on Medicare expenditures in areas with similar characteristics, such as population size and wages. Because these proposals are incremental, they are politically feasible.

Catchment Area, Health↗
PubMed2003

Oral health status of children and adolescents by rural residence, United States.

CONTEXT: The limited information available on the oral health status of rural children in the United States makes it difficult to devise policy strategies to address perceived problems. PURPOSE: To document the oral health status and dental care utilization of US children by place of residence, METHODS: Data from National Health Interview Surveys for 1995, 1997, and 1998, and from the third National Health and Nutrition Examination Survey (1988-1994) were analyzed. FINDINGS: Children residing in rural areas were more likely to be uninsured for dental care than were children from urban areas (41.1% versus 34.7%). A greater percentage of rural than urban children reported unmet dental needs (7.5% versus 5.6%); there was no difference in self-reported poor dental status. Urban children were more likely than rural children to have visited the dentist in the past year (73.6% versus 69.9%) and were also more likely to be regular users of dental care (61.7% versus 51.4%). Differences in percentage of rural and urban children with caries lesions and caries experience were not significant. CONCLUSIONS: Children residing in rural areas have less access to and utilization of dental care compared to children residing in urban areas. Moreover, poor rural children display less utilization of dental services than poor urban children. Differences in the sum of decayed and filled primary teeth and the sum of decayed, missing, and filled permanent teeth were not significant.

Adolescent↗
PubMed1995

Antioxidant status in long-term adherents to a strict uncooked vegan diet.

Antioxidant status was investigated in 20 Finnish middle-aged female vegans and in one male vegan who were following a strict, uncooked vegan diet ("living food diet"), by means of a dietary survey and biochemical measurements (blood concentrations of vitamins C and E and beta-carotene, and the activities of the zinc/copper-dependent superoxide dismutase and selenium-dependent glutathione peroxidase). Values were compared with those of omnivores matched for sex, age, social status, and residence. Antioxidant supplementation was used by 4 of 20 female vegans and by 11 of 20 control subjects. Based on dietary records, the vegans had significantly higher intakes of beta-carotene, vitamin E, vitamin C, and copper, and a significantly lower intake of selenium than the omnivorous control subjects. The calculated dietary antioxidant intakes by the vegans, expressed as percentages of the US recommended dietary allowances, were as follows: 305% of vitamin C, 247% of vitamin A, 313% of vitamin E, 92% of zinc, 120% of copper, and 49% of selenium. Compared with the omnivores, the vegans had significantly higher blood concentrations of beta-carotene, vitamin C, and vitamin E, as well as higher erythrocyte superoxide dismutase activity. These differences were also seen in pairs who were using no antioxidant supplements. The present data indicate that the "living food diet" provides significantly more dietary antioxidants than does the cooked, omnivorous diet, and that the long-term adherents to this diet have a better antioxidant status than do omnivorous control subjects.

Adult↗
PubMed2001

Clinical characterization of depressive mixed state in bipolar-I patients: Pisa-San Diego collaboration.

BACKGROUND: Although mixed states were classically described as various concomitant admixtures of depression and mania, the official current definitions in both DSM-IV and ICD-10 tend to restrict the concept to manic patients with full syndromal depression. Recent research has actually shown that mania with few depressive symptoms constitutes the most prevalent clinical presentation of mixed or dysphoric mania. Major depressive patients with few concomitant manic symptoms are not officially recognized within the current nosology. In this paper we attempt to delineate the clinical profile of such depressive mixed states in the context of bipolar I disorder. METHODS: In the Pisa day center, we studied 195 bipolar I patients who either met Pisa criteria for bipolar mixed state (n=159) or DSM-III-R criteria for major depressive episode (bipolar major depression or B-MD, n=36). Of the 159 patients identified by Pisa criteria as mixed state, 86 also met the criteria of the DSM-III-R for mixed episode (core mixed state or MS group), while 32 met the DSM III-R criteria for major depressive episode (provisionally defined as depressive mixed states, D-MS); the remaining patients (n=41, 25.7%) with predominatly manic picture were not included in the present comparisons. RESULTS: The three groups (B-MD, MS and D-MS) had close similarities in clinical and sociodemographic characteristics such as age, sex distribution, marital status, schooling, residence, age at onset, age of first treatment, age of first hospitalization, degree of chronicity of the index episode, stressor within the 6 months before the index episode, lifetime suicide attempts and premorbid temperament. First degree family history for bipolar illness and that for other mental disorders was also similar, except for major depression that was more common among the relatives of D-MS. MS and D-MS were further distinguished from B-MD by the fact that the latter followed a more 'cyclic' course with shorter yet greater number of episodes, and which began with a pure depressive episode; by contrast, MS and D-MS had fewer episodes of longer duration, less interepisodic remission, and tended to begin with a mixed episode. Incongruous psychotic features were more common in the two mixed groups compared to B-MD, and the most common features of the D-MS group were agitation, psychotic depression with irritable mood, pressured speech and/or flight of ideas. LIMITATION: It was not feasible to collect information blind to clinical status in patients with severe psychotic mood states. CONCLUSION: These data confirm the existence of psychotic agitated depressive mixed states with flight of ideas, distinct from cyclic retarded pure bipolar depressive states. The recognition of these affective states is clinically important to protect patients from the potentially harmful indiscriminate use of antidepressants and to provide them with the benefits of an anticonvulsant, a short-term neuroleptic, or ECT.

Adult↗
PubMed2004

Circulating levels of the neuropeptide hormone somatostatin may determine hepatic fibrosis in Schistosoma mansoni infections.

The neuropeptide hormone somatostatin reduces fibrosis and Schistosoma-caused clinical morbidity in the rodent model. In our study we aimed to delineate an association between fibrosis and the inability to generate critical levels of endogenous somatostatin in S. mansoni infected subjects. In June 2001, 85 subjects from the district dispensary at Richard Toll in the Medical Region of Saint-Louis, Senegal, were selected. Fifty-seven subjects were infected with S. mansoni of whom 32 were suffering from severe morbidity (SM). Twenty-eight subjects showed an inactive disease status with no evident infection at the actual time of study. All subjects were classified according to age, sex, occupation, height, weight, and parasite eggs per gram. All 85 participated in a water contact and morbidity questionnaire, underwent a clinical examination and donated 5ml of peripheral blood for detecting plasma levels of somatostatin. Ultrasonography detected fibrosis grade in all the subjects. To address whether inherent somatostatin levels determined clinically evident disease severity (epg, hepatomegaly, splenomegaly, hematemesis, ascites), the mean somatostatin values of the inactive disease status group and severe morbidity group were compared. Low somatostatin levels were depicted in subjects with severe morbidity symptoms associated with schistosomiasis as compared to exposed but inactive disease status subjects residing in the same region. Logistic regression analysis indicated that with decreasing somatostatin values the probability of severe morbidity increased with age being a confounding factor. To address whether inherent somatostatin levels determined fibrosis and if this association was significant, plasma somatostatin levels of non-fibrotics (ultrasonographic grading A), and fibrotics (ultrasonographic grading B-E) were compared. In all age groups as well as in adults alone, mean somatostatin levels were higher in the non-fibrotic group as compared to the fibrotics group, the difference being significant. The group B comprised of borderline fibrotic cases, therefore a separate analysis was done between groups A (non-fibrotics) and groups C, D (confirmed fibrotics). Mean somatostatin values were higher in the non-fibrotic group as compared to the fibrotics group, the difference being borderline significant. In schistosomiasis patients, circulating levels of somatostatin by binding to hepatic stellate cells (HSC) may modulate fibrosis. This phenomenon is regulated by age whereas gender and prior treatment have no effect on this association. Host specific somatostatin levels may create a 'preset environment' status that can determine progression to severe fibrosis.

Adolescent↗
PubMed2004

War-related psychological sequelae among emergency department patients in the former Republic of Yugoslavia.

BACKGROUND: Residents of the Republic of Serbia faced civil war and a NATO-led bombing campaign in 1999. We sought to assess the burden of metal health dysfunction among emergency department (ED) patients presenting for care three years post-war in Serbia. METHODS: This study was conducted during July and August 2002 at two sites: a university hospital ED in Belgrade, Serbia and an ED in a remote district hospital serving a Serbian enclave in Laplje Selo, Kosovo. Investigators collected data on a systematic sample of non-acute patients presenting to the ED. All respondents completed a structured questionnaire assessing demographics and symptoms of post-traumatic stress disorder (PTSD) (using the Harvard Trauma Questionnaire), and major depression (using the Center for Epidemiologic Studies Depression Scale). RESULTS: A total of 562 respondents participated (310 in Belgrade, 252 in Laplje Selo); the response rate was 83.8%, 43% were female, and mean age was 37.6 years (SD = 13.4). Overall, 73 (13.0%) participants had symptoms consistent with PTSD, and 272 (49.2%) had symptoms consistent with depression. Sixty-six respondents had both disorders (11.9%). In separate multivariable logistic regression models, predictors of PTSD were refugee status and residence in Laplje Selo, and predictors of depression were older age, current unemployment, and lower social support. CONCLUSIONS: Three years post-war, symptoms of PTSD and major depression in Serbia remained a significant public health concern, particularly among refugees, those suffering subsequent economic instability, and persons living in rural, remote areas.

Adult↗
PubMed1999

Predictive model of coronary heart disease in Egypt (a disease with multiple risk factors).

As a multifactorial disease and with the need of primordial prevention coronary heart disease (CHT), a risk scoring system for the prediction of CHD was devised at Community Medicine Department Ain Shams University, Cairo, EGYPT. In this matched case-control study of 119 cases and 121 age and sex matched controls, current cigarette smoking, lack of siesta, hypertension, diabetes mellitus, low occupational physical activity, hypercholesterolemia, marital status, urban residence, level of education, work index, coffee consumption, positive family history, BMI, elevated W/H ratio, low HDL and elevated TC/HDL were studied for association with CHD. The additive risk scoring system based on the results of conditional multiple logistic regression identified the first six factors with statistical weights of 1, 5, 10, 6, 6, 11, respectively. On back validation receiver operating characteristic (ROC) curve, a total score of 17 was found to be the cut off point above which there was increased risk of CHD. The overall predictive accuracy of this system--equivalent to the area under the ROC curve--was 0.873. Future studies need to assess the risk scoring system in population based studies.

Adult↗
PubMed1993

Lifetime DSM-III-R diagnostic outcomes in the offspring of schizophrenic mothers. Results from the Copenhagen High-Risk Study.

OBJECTIVES: To perform a long-term prospective follow-up of children at high risk for schizophrenia to identify risk factors for the development of this disorder. DESIGN: Prospective follow-up population study of children of schizophrenic mothers and their matched controls from age 15 years to age 42 years, with multiple diagnostic assessments performed by senior clinicians using structured interviews blindly with respect to the group membership of the subject. PARTICIPANTS: Two hundred seven offspring of schizophrenic mothers and 104 control children without schizophrenic parents matched to the index group on age, sex, paternal socioeconomic status, urban/rural residence, and the amount of time spent during childhood in institutional rearing. MAIN OUTCOME MEASURE: The prevalence of the DSM-III-R disorders during the subjects lifetime. RESULTS: A significant aggregation of schizophrenia (16.2%) and other nonaffective, nonorganic psychosis (4.6%), and Cluster A personality disorders (21.3%) occurred among the offspring of schizophrenic mothers compared with the controls (1.9%, 0.9%, and 5%, respectively). No evidence of increased aggregation of (psychotic and nonpsychotic) affective disorders was noted among the offspring of schizophrenics. CONCLUSION: These results coincide with the results of other family studies in demonstrating a significant and specific familial aggregation of schizophrenia and nonpsychotic schizophrenia spectrum disorders among the biological relatives of schizophrenics.

Adolescent↗
PubMed2005

Relation of residency selection factors to subsequent orthopaedic in-training examination performance.

OBJECTIVES: Orthopaedic surgery remains one of the most competitive specialties, with more than a 99% match fill rate in the past several years. An oversupply of qualified applicants leads to intense competition for these residency spots, allowing program directors to be more selective in choosing their future residents. Although many previous studies have documented factors important to program directors in the admission process, less is known about how preselection factors correlate with subsequent performance in a residency program. METHODS: The relation of both demographic and academic factors with subsequent performance on the Orthopaedic In-Training Examination (OITE) were studied. These factors include United States Medical Licensing Examination (USMLE) step I scores, Alpha Omega Alpha (AOA) status, research publications, age entering residency, marital status, and medical school affiliation. RESULTS: In this study, the only statistically significant correlations to OITE scores were USMLE step I performance and marital status. Those residents who had previously scored above 220 on the USMLE step I had higher average OITE scores than those scoring below 220. Residents who were married also had higher average OITE scores. A trend with regard to AOA status also was found, with residents scoring slightly higher on the OITE if they were members of AOA. CONCLUSIONS: Few preresidency variables correlate to success during an orthopaedic residency.

Adult↗
PubMed1992

Health status of the temporarily homeless population and residents of North West Thames region.

OBJECTIVES: To survey the health status of the temporarily homeless population of North West Thames region and make comparisons with regional residents. DESIGN: Direct interview with standardised questionnaires. SETTING: Temporarily homeless people resident in hotels in the London boroughs in the North West Thames region and a random sample of regional residents. SUBJECTS: 137 hotels thought to be providing accommodation to homeless people selected at random from a list of 295. 113 (82%) participated in the study, and 319 (61%) of 522 homeless people approached participated. The study was restricted to adults aged 16 and over selected at random. RESULTS: The homeless population was predominantly female (195/319; 61%), young (229 (72%) aged 16-34), and poor, 54% (172/319) receiving income support. 207 subjects (65%) had dependent children aged 16 and under. Rates of acute illness among homeless people (32 cases; 10%) were similar to those reported by regional residents. The prevalence of longstanding limiting illness (108 cases; 34%) was similar to that for regional residents, but the prevalence of mental morbidity was twice that for the region as a whole (145 cases (45%) v 1485 (18%)). Utilisation of general practitioner services, accident and emergency departments, and inpatient admission was much higher by the homeless population than by regional residents. General practitioner registration rates were above 90% for the homeless sample. CONCLUSIONS: Survey data provide empirical evidence about the nature and characteristics of the temporarily homeless population. The high service utilisation recorded may, in part, have resulted from the higher morbidity in this sample of homeless people. The concentration of homeless people into specific locations may suggest that additional funding should be provided to the district which provides care to this group. However, such funding should not necessarily be used for additional acute care but should be used to purchase appropriate services which meet the health needs of this very young, poor and vulnerable group.

Adolescent↗