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PubMedDate not supplied

Do waste incinerators induce adverse respiratory effects? An air quality and epidemiological study of six communities.

The purpose of the study presented here was to simultaneously measure air quality and respiratory function and symptoms in populations living in the neighborhood of waste incinerators and to estimate the contribution of incinerator emissions to the particulate air mass in these neighborhoods. We studied the residents of three communities having, respectively, a biomedical and a municipal incinerator, and a liquid hazardous waste-burning industrial furnace. We compared results with three matched-comparison communities. We did not detect differences in concentrations of particulate matter among any of the three pairs of study communities. Average fine particulate (PM2.5) concentrations measured for 35 days varied across study communities from 16 to 32 micrograms/m3. Within the same community, daily concentrations of fine particulates varied by as much as eightfold, from 10 to 80 micrograms/m3, and were nearly identical within each pair of communities. Direct measurements of air quality and estimates based on a chemical mass balance receptor model showed that incinerator emissions did not have a major or even a modest impact on routinely monitored air pollutants. A onetime baseline descriptive survey (n = 6963) did not reveal consistent community differences in the prevalence of chronic or acute respiratory symptoms between incinerator and comparison communities, nor did we see a difference in baseline lung function tests or in the average peak expiratory flow rate measured over a period of 35 days. Based on this analysis of the first year of our study, we conclude that we have no evidence to reject the null hypothesis of no acute or chronic respiratory effects associated with residence in any of the three incinerator communities.

Adolescent↗
PubMed1993

Impact of a breast cancer screening community intervention.

BACKGROUND: Efforts to detect breast cancer in its early stages are necessary to reduce breast cancer-associated mortality. This study evaluated the impact of a multicomponent intervention implemented between 1987 and 1990 to increase a community's utilization of breast cancer screening by women over 50 years of age. METHODS: The study used a pretest/post-test two-community design, with one community assigned as the intervention community and the other as the comparison. The intervention consisted of a comprehensive physician involvement component and a community education effort. To assess the overall impact of the interventions, we measured women's participation in screening via random digit dial telephone surveys at three time points, each approximately 18 months apart. RESULTS: Over the course of the study, there were dramatic improvements in breast cancer screening participation in both communities. However, the intervention city showed more improvement in selected variables than did the comparison community in the early phases of the project between baseline and midpoint. These included increased advice by physicians to have mammograms, increased awareness that screening is necessary in the absence of symptoms, increased awareness that many women over 50 have mammograms, decreased perception of barriers to clinical breast exam, and an increase in the proportion of women having a clinical breast exam. In addition, significantly fewer women in the intervention city than in the comparison city reported never having had a mammogram at midpoint. CONCLUSIONS: The findings demonstrate limited impact of a community intervention during a period of increasing adoption of mammography screening, in part, due to this rapidly rising secular trend. Additionally, increased activities in the comparison community were documented. Therefore, as incidence of screening increases, targeted activities aimed at population subgroups are warranted, and evaluation designs need to include multiple comparison groups or broader geographic random samples.

Aged↗
PubMed1995

Aetiology of community-acquired pneumonia: a prospective study among adults requiring admission to hospital.

BACKGROUND: The prevalence of microorganisms causing community-acquired pneumonia in patients who required admission to hospital was investigated and the percentage of cases whose aetiology remained unknown due to the study design and logistical problems estimated. METHODS: Between January 1991 and April 1993 all patients with community-acquired pneumonia admitted to six hospitals were included in the study. Aetiological diagnosis, categorised as definite, probable and possible, was based on the results of routine microbiological and serological tests. RESULTS: Three hundred and thirty four patients with a median age of 65 (range 17-92) years were enrolled in the study. The diagnosis of community-acquired pneumonia was definite in 108 cases, and probable or possible in 73 and 27 cases, respectively, including dual infections. Streptococcus pneumoniae was the predominant pathogen (27%) followed by viruses and Haemophilus influenzae (both about 8%) and Mycoplasma pneumoniae (6%). Chlamydia spp (3%) and Legionella pneumophila (2%) were less frequently detected. No diagnosis was made in 45% of the cases. With adjustment for anti-microbial therapy before admission and for other logistical considerations, it is estimated that the aetiology could have been ascertained in 65% of the cases. CONCLUSIONS: Streptococcus pneumoniae is the most frequently detected cause of community-acquired pneumonia. The inability to detect a micro-organism results mainly from the use of routine diagnostic tests and, to a lesser extent, from logistical problems or the use of antibiotics before admission.

Adolescent↗
PubMed1990

Amyotrophic lateral sclerosis. A case-control study following detection of a cluster in a small Wisconsin community.

From 1975 to 1983, six cases of amyotrophic lateral sclerosis (ALS) were diagnosed in long-term residents of Two Rivers, Wis; the probability that this occurred due to chance was less than .05. To investigate potential risk factors for ALS, we conducted a case-control study using two control subjects matched to each case patient for age, gender, and duration of residence in Two Rivers. Physical trauma, the frequent consumption of freshly caught Lake Michigan fish, and a family history of cancer were reported more often by case patients than control subjects. These findings support previous studies proposing a role for trauma in ALS pathogenesis and suggest that the causative role of diet should be further explored. Continued surveillance for and epidemiologic investigation of ALS clusters with subsequent retrospective analysis may provide clues concerning the cause of ALS.

Amyotrophic Lateral Sclerosis↗
PubMedDate not supplied

Detection and treatment of hypercholesterolemia in a biethnic community, 1979-1985.

Although hypercholesterolemia has been recognized as a risk factor for coronary heart disease (CHD) for decades, only in recent years have clinical trials definitively shown the efficacy of lowering serum cholesterol to prevent the occurrence or worsening of CHD. In 1985, an NIH consensus conference published guidelines for the diagnosis and treatment of hypercholesterolemia. Prior to 1985, physicians and lay people alike were not yet convinced of the necessity to know one's cholesterol level, nor did they know what levels should be treated. In a community-based survey of cardiovascular risk factors, known as the San Antonio Heart Study, in which 1,932 Mexican-Americans (MAs) and 1,133 non-Hispanic whites (NHWs) were examined between 1979 and 1985, the authors found that only 36/501 MAs (7%) and 54/312 NHWs (17%) in the moderate- or high-risk categories were aware that their cholesterols were high. Of the total number aware, including those whose cholesterol levels were in the low-risk range, only 23/97 MAs (24%) and 29/108 NHWs (27%) were receiving dietary or drug treatment. Of those being treated, only 9/23 MAs (39%) and 12/29 NHWs (41%) were effectively controlled. Mexican-Americans were less likely to be aware of their hypercholesterolemia than non-Hispanic whites, but both ethnic groups had low levels of treatment.

Adult↗
PubMed1998

A comparison of oral fluid and serum for the detection of rubella-specific antibodies in a community study in Addis Ababa, Ethiopia.

OBJECTIVE: To assess the utility of oral fluid compared with serum for the determination of age-prevalence of rubella-specific antibodies in an urban African community setting. METHOD: Paired serum and oral fluid samples were collected from 439 individuals aged 0-49 years in Addis Ababa, Ethiopia, as part of a larger seroepidemiological survey in 1994. Oral fluid was sampled using a simple sponge device that was well accepted by subjects of all ages; venous blood was collected by Vacutainer system. We measured rubella-specific antibodies in serum by the Radial Haemolysis (RH) test, supported by two confirmatory assays, and in oral fluid by IgG antibody-capture radioimmunoassay (GACRIA). RESULTS: Sensitivity and specificity of oral fluid results compared to serum were 89% and 76%, respectively. Sensitivity declined from 96% in age group 0-19 years to 90% in age group 20-29 and 78% in age group 30-49. Specificity was 86% in 0-9 year olds contrasting with 61% in older groups (10-49 years). The positive predictive value of an oral fluid sample was high in all age groups (range 92-100%), while the negative predictive value declined from > or =80% in those aged <10 years to <10% in those aged > or =30 years. Serum confirmatory tests suggested a proportion of false serum RH negatives, increasing with age, indicating a need to standardize serum as well as oral fluid tests. CONCLUSION: In the community setting of a developing country, oral fluid surveys could be useful to estimate age-prevalence of rubella immunity and identify rubella-susceptible children for follow-up. Further work is required to simplify assays and sample processing, improve assay sensitivity and estimate assay specificity more precisely, and compare and standardise collection methods suitable for surveillance of a variety of childhood viral infections.

Adolescent↗
PubMed1985

Prevalence, detection, and control of hypertension in a biethnic community. The San Antonio Heart Study.

A survey was carried out on a random sample of 1,288 Mexican Americans and 929 Anglos living in three socially distinct neighborhoods in San Antonio, Texas. Hypertension was defined as diastolic blood pressure greater than or equal to 95 mmHg or currently taking antihypertensive medication. Overall age-adjusted prevalence rates of hypertension were similar for Mexican-American and Anglo men (10.0 and 9.8%, respectively); for women, the Mexican-American rate was slightly lower than that for Anglos (7.8 and 9.7%, respectively). After adjustment for obesity differences, Mexican Americans have a tendency toward lower hypertension rates than Anglos of the same socioeconomic level. Only among women was a decline in the prevalence of hypertension with increasing socioeconomic status observed. Mexican Americans have a higher proportion of newly diagnosed hypertension, and, among previously diagnosed cases, a lower proportion are on antihypertensive medication than Anglos. The rates of hypertension control found in this survey are among the highest reported in the United States at the community level. Despite this, Mexican Americans still lag somewhat behind Anglos of the same socioeconomic level in awareness, treatment, and degree of hypertension control, suggesting the possibility of sociocultural barriers to adequate medical care.

Adult↗
PubMed1979

Detection of cervical and breast cancer: a community-based pilot study.

Pilot screening clinics were conducted in two Los Angeles County health districts where cervical cancer incidence and mortality rates were high. Results are of interest because they provide information on planning and operating community-based clinics in low-income areas where there are women who are unlikely to seek or are ineligible for available health services.

Adult↗
PubMed2004

Conflicts versus analytical redundancy relations: a comparative analysis of the model based diagnosis approach from the artificial intelligence and automatic control perspectives.

Two distinct and parallel research communities have been working along the lines of the model-based diagnosis approach: the fault detection and isolation (FDI) community and the diagnostic (DX) community that have evolved in the fields of automatic control and artificial intelligence, respectively. This paper clarifies and links the concepts and assumptions that underlie the FDI analytical redundancy approach and the DX consistency-based logical approach. A formal framework is proposed in order to compare the two approaches and the theoretical proof of their equivalence together with the necessary and sufficient conditions is provided.

Algorithms↗
PubMed2005

Detection of plot-level changes in ectomycorrhizal communities across years in an old-growth mixed-conifer forest.

Understanding spatial and temporal patterns present in ectomycorrhizal fungal community structure is critical to understanding both the scale and duration of the potential impact these fungi have on the plant community. While recent studies consider the spatial structure of ectomycorrhizal communities, few studies consider how this changes over time. Ectomycorrhizal root biomass and the similarity of community composition were measured at scales up to 20 cm replicated in nine plots and over 3 yr. Soil cores were additionally stratified into three depths. Annual occurrence of the dominant ectomycorrhizal species was constant at larger spatial scales but varied more across years at a fine spatial scale. Turnover of ectomycorrhizal species between years was observed frequently at scales < 20 cm. The ectomycorrhizal community within a plot was more similar across years than it was to other plots sampled in the same year. Our results demonstrate the dynamic nature of the ectomycorrhizal community even in the absence of large-scale disturbances. The potential role of root turnover and drought stress is discussed.

Biomass↗
PubMed2001

Molecular detection of Mycoplasma pneumoniae in adults with community-acquired pneumonia requiring hospitalization.

Mycoplasma pneumoniae infection was diagnosed in 18 (12.5%) of 144 adults hospitalized with community-acquired pneumonia. The infection was demonstrated by PCR in 15 patients and by serology, using two methods, in 10 patients. The mean age of the 8 patients with positive M. pneumoniae PCR and negative serology was significantly higher than that of the 10 patients with positive serology.

Adult↗
PubMed2004

Characterization of Chlamydia trachomatis omp1 genotypes detected in eye swab samples from remote Australian communities.

Chlamydia trachomatis conjunctival samples collected over a 6-month period from individuals with clinical signs of trachoma and located in remote communities in the Australian Northern Territory were differentially characterized according to serovar and variants. The rationale was to gain an understanding of the epidemiology of an apparent increased prevalence of acute trachoma in areas thought to be less conducive to this disease. Characterization was performed through sequencing of a region of the omp1 gene spanning the four variable domains and encoding the major outer membrane protein. Nucleotide and deduced amino acid sequences were genotyped by using a BLAST similarity search and were examined by phylogenetic analyses to illustrate evolutionary relationships between the clinical and GenBank reference strains. The predominant genotype identified corresponded to that of serovar C (87.1%), followed by the genotype corresponding to serovar Ba (12.9%). All nucleotide and amino acid sequences exhibited minor levels of variation with respect to GenBank reference sequences. The omp1 nucleotide sequences of the clinical samples best aligned with those of the conjunctival C. trachomatis reference strains C/TW-3/OT and Ba/Apache-2. All clinical samples (of serovar C) exhibited four or five nucleotide changes compared with C/TW-3/OT, while all serovar Ba samples had one or two nucleotide differences from Ba/Apache-2. Phylogenetic analyses revealed close relationships between these Northern Territory chlamydial samples and the respective reference strains, although the high proportion of sequence variants suggests an evolutionarily distinct C. trachomatis population causing eye infections in Australia. Given that such genotypic information has gone unreported, these findings provide knowledge and a foundation for trachoma-associated C. trachomatis variants circulating in the Northern Territory.

Adolescent↗
PubMed1987

Blood pressure measurement in an Australian population.

A postal survey of a random sample of 1200 persons who lived in the Hunter Region of New South Wales was undertaken in order to determine their experiences of blood pressure measurement and treatment for hypertension. The corrected response rate was 89%. Ninety per cent of the 962 respondents had visited a doctor in the previous year and 69% of them reported a blood pressure measurement at their last visit. Eighty-nine per cent of the 962 respondents reported that they had undergone a blood pressure measurement in the past three years. Although 79% of the respondents reported a blood pressure measurement in the past year, only 59% of men who were aged 45 years or less had experienced such a measurement during that period. Women were more likely than were men to have had their blood pressure measured and to report a knowledge of and treatment for hypertension. As these findings suggest that a large proportion of the population has experienced a blood pressure measurement in the past three years, it appears that most of the hypertension in the community has already been detected. The value of blood pressure screening is questioned, although it would appear that a need remains for an improvement in the detection of hypertension in men under 45 years of age. The prevalence of hypertension in the community remains high in spite of the degree of attention that is paid to it by the medical profession. It is imperative to explore the possibilities for the primary prevention of hypertension.

Adolescent↗