Spinal cord injury: facts and figures at a glance.
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Age Distribution↗
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Prevalence of current and chronic pain and their influences upon work and healthcare-seeking: a population study.
OBJECTIVE: To investigate the prevalence of current and chronic pain and their relationship to pain intensity, sex, age, income, employment status, citizenship, marital status, urban residence, occupational activity, and healthcare-seeking based on a representative sample from a Swedish county. METHODS: A cross-sectional survey using a postal questionnaire was sent to a representative sample (n = 9952) of the target population (284,073 people, age 18-74 yrs) in a county (Ostergötland) in southern Sweden. A questionnaire was mailed and followed by 2 postal reminders if necessary. RESULTS: The participation rate was 76.7% (n = 7637); nonparticipants were on average younger, male, and earned less money. The overall point prevalence of pain was 48.9%. The corresponding one-month period prevalence was 63.0%, and pain on several occasions during the previous 3 months was reported by 61.3% of participants. The prevalence of chronic pain (pain > 3 months) was 53.7%. Female sex, age, and sick leave/early retirement were generally of significant importance in the regressions of pain. No sex factor was found in the regressions of pain frequency and pain intensity. Chronic pain especially frequent and intensive pain showed clear associations with healthcare-seeking and occupational activity. CONCLUSION: High prevalence of current pain (48.9%) and chronic pain (53.7%) were found in this community-based study. Being female, older, and on sick leave or early retirement were generally of significant importance in the regressions of pain. Chronic pain showed clear associations with healthcare-seeking and occupational activity, indicating considerable socioeconomic costs.
Acute Disease↗
Chronic health problems stymie efforts to improve economic status of certain public housing residents.
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Black or African American↗
Summary health statistics for U.S. children: National Health Interview Survey, 2000.
OBJECTIVES: This report presents statistics from the 2000 National Health Interview Survey on selected health measures for children under 18 years of age, classified by sex, age, race, Hispanic origin, family structure, parent's education, family income, poverty status, health insurance coverage, residence, region, and health status. The topics covered are asthma, allergies, learning disability, Attention Deficit Hyperactivity Disorder (ADHD), prescription medication, respondent-assessed health status, school-loss days, usual place of health care, time since last contact with a health care professional, unmet dental need, time since last dental contact, and selected measures of health care access. SOURCE OF DATA: The NHIS is a multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the National Center for Health Statistics, Centers for Disease Control and Prevention, and is representative of the civilian noninstitutionalized population of the United States. Data are collected during face-to-face interviews with adults present at the interview. Information about children is collected for one randomly selected child per family in face-to-face interviews with an adult proxy respondent familiar with the child's health. SELECTED HIGHLIGHTS: In 2000 most U.S. children under 18 years of age enjoyed excellent or very good health (83%). However, 12% had no health insurance coverage, and 6% had no usual place of health care. Twelve percent of children had ever been diagnosed with asthma. Eight percent of children 3-17 years of age had a learning disability, and 7% of children in this age group had ADHD. Lastly, 11% of children in single-mother families had two or more visits to an emergency room in the past year compared with 6% in two-parent families.
Absenteeism↗
Summary health statistics for U.S. children: National Health Interview Survey, 2001.
OBJECTIVES: This report presents statistics from the 2001 National Health Interview Survey (NHIS) on selected health measures for children under 18 years of age, classified by sex, age, race, Hispanic origin, family structure, parent's education, family income, poverty status, health insurance coverage, residence, region, and health status. The topics covered are asthma, allergies, learning disability, Attention Deficit Hyperactivity Disorder (ADHD), prescription medication, respondent-assessed health status, school-loss days, usual place of health care, time since last contact with a health care professional, unmet dental need, time since last dental contact, and selected measures of health care access. SOURCE OF DATA: The NHIS is a multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the Centers for Disease Control and Prevention, National Center for Health Statistics, and is representative of the civilian noninstitutionalized population of the United States. Data are collected during face-to-face interviews with adults present at the interview. Information about children is collected for one randomly selected child per family in face-to-face interviews with an adult proxy respondent familiar with the child's health. SELECTED HIGHLIGHTS: In 2001, most U.S. children under 18 years of age enjoyed excellent or very good health (84%). However, 10% had no health insurance coverage, and 5% had no usual place of health care. Thirteen percent of children had ever been diagnosed with asthma. Eight percent of children 3-17 years of age had a learning disability, and 6% of children had ADHD. Lastly, 11% of children in single-mother families had two or more visits to an emergency room in the past year compared with 6% of children in two-parent families.
Adolescent↗
Summary health statistics for U.S. adults: National Health Interview Survey, 2002.
OBJECTIVES: This report presents health statistics from the 2002 National Health Interview Survey (NHIS) for the civilian noninstitutionalized adult population, classified by sex, age, race and Hispanic origin, education, income, poverty status, health insurance coverage, marital status, place of residence, and region of residence for chronic condition prevalence, health status, functional limitations, health care access and utilization, health behaviors, and human immunodeficiency virus testing. The presentation of percentages and percent distributions in both age-adjusted and unadjusted versions is new this year. SOURCE OF DATA: The NHIS is a household, multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2002, data were collected for 31,044 adults for the Sample Adult questionnaire. The conditional response rate was 84.4%, and the final response rate was 74.4%. The health information for adults in this report was obtained from one randomly selected adult per family. HIGHLIGHTS: In 2002, 62% of adults 18 years of age or over reported excellent or very good health. Fifty-nine percent of adults never participated in any type of vigorous leisure-time physical activity, and 14% of adults did not have a usual place of health care. Eleven percent of adults had been told by a doctor or health professional that they had heart disease, and 21% had been told on two or more visits that they had hypertension. Twenty-two percent of all adults were current smokers, and 23% were former smokers. Based on their body mass index, 35% of adults were overweight, and 23% were obese.
Adolescent↗
[Factors affecting regularity of counseling and/or medication in schizophrenics in an outpatient setting].
The author investigated a number of factors which affect regularity of counseling and/or medication in schizophrenics in an out-patient setting. A hundred and forty eight schizophrenic out-patients at a psychiatric hospital in Yamagata were examined over a period of three years. The factors consisted of age, sex, family setting, profession, place of residence, financial status, utilization of the aftercare system, insight about their illness and attitude towards drug therapy. Most of the patients maintained good levels in the regularity of counseling and/or medication and their attitude towards therapy was unchanged throughout the course. On the other hand, there is a statistically significant difference between the regularity of counseling and/or medication one month before readmission and at other times. Good levels in regularity is associated with such factors as being male, being single, working conditions, financial status, insight about their illness, positive attitude towards drug therapy and utilization of aftercare system. We had great difficulty in improving the regularity of counseling and/or medication among those schizophrenic patients. But intensive intervention such as enrolling in a day care system could have a favourable effect on the regularity of counseling and/or medication. It may be of benefit in the future to promote further development of such support systems.
Ambulatory Care↗
Urinary incontinence in the nursing home: resident characteristics and prevalence of drug treatment.
OBJECTIVES: To provide a descriptive overview of the elderly, nursing home patient population with urinary incontinence (UI). METHODS: This study was a descriptive, cross-sectional database analysis (2002-2003) examining UI prevalence, demographic and clinical characteristics of UI patients, and UI pharmacotherapy prevalence in the nursing home setting. RESULTS: Of the 29 645 eligible subjects, 8995 experienced some level of UI at the time the minimum data set (MDS) was completed (30%). Compared with continent residents, a greater percentage of incontinent residents were older, white women and had a longer length of stay. Incontinent residents also had more indicators of frailty than those who were continent; they were more impaired on activities of daily living and cognitive performance scale scores, were hospitalized more frequently, and had more urinary tract infections, pressure ulcers, and depression. More incontinent residents were using pads/briefs and had bladder retraining and scheduled toileting. Only 8.7% of those residents rated as having the most severe level of incontinence (MDS level 4) were being treated with pharmacotherapy. Of the 8995 residents with a UI rating of 1 to 4, only 8% (n = 731) had pharmacotherapy. CONCLUSION: There is a high prevalence of UI among nursing home residents and having this condition is negatively correlated with measures of resident health status and healthcare utilization. A variety of interventions are used in this setting to treat UI, and use of pharmacologic therapy appears to be quite low. Appropriate use of interventional strategies that may include drug treatment for UI in the nursing home may reduce the substantial personal and cost burdens associated with this condition. However, clinicians may need population-specific scientific evidence in determining which nursing home patients will benefit most from pharmacotherapy.
Aged↗
Prevalence of tetanus immunity in the Kocaeli Region, Turkey.
We assessed the antibody levels and risk factors for tetanus in an adult population in the Kocaeli Region of Turkey. In 595 individuals over 20 years of age, serum concentrations of anti-tetanus antibodies were detected by enzyme-linked immunosorbent assay and a brief questionnaire was administered. The overall immunity rate was approximately 80% and there was a progressive decline in protection with increasing age. Antibody levels were significantly higher in educated people (80.1%), in employed people (90.3%), in those under 40 years of age (95.0%) and in those who stated that they had received a previous tetanus vaccination (87.9%). There was no association between antibody level and sex, residence, socioeconomic status, military status or history of injury. These data indicate that a vigorous post-injury prophylaxy with antitoxin and antisera should be put into practice, especially for older people, and that immunization programs applied every 10 years must be strengthened.
Adult↗
Sociodemographic factors and age at natural menopause in Shiraz, Islamic Republic of Iran.
With increasing life expectancy, menopause is an increasingly important aspect of women's health. We recorded the age at natural menopause among women in a population-based cross-sectional study in Shiraz, Islamic Republic of Iran, in summer 2000. Interviews with 948 randomly selected menopausal women showed the mean (standard deviation) age at menopause was 48.3 (5.3) years (95% CI: 48.0-48.6), median 49 years. The sociodemographic and health behaviour factors that were significantly related to early mean age of menopause were: never married (44.7 years), low income level (47.4 years), low social class (45.8 years), tobacco use (47.9 years) and non-consanguineous husband (48.1 years).
Age Distribution↗
[Exposure to risk factors of Chilean children according to life status of the community of residence].
An instrument based in ten family health and well being indicators is presented to classify 334 counties in Chile. The Factors' or Vectors' Analysis (included in the S.A.S. packages of computational programs) has been used to assess the main associations among the indicators. In this case two vectors or factors represent 66% of the total variance. The results can be presented in three complementary ways. The first is "Z" score of each of the two factors that were built using either socio-economical or bio-medical variables; i.e. factor "SEC" (Socio-economical) and factor "BIO" (Bio-medical). These results can be represented in graphical coordinates. The second way is Suma Scale, which is built by adding the product of each of the ten regression coefficients--representing the association between the variables in the 334 counties--multiplied by the specific value of each variable in each county. It is postulated that the ranking obtained by this scale indicates the growing vulnerability of the counties. This scale does not include the measure of the amount of population at risk in each country. The third way is Percentage Scale. This scale considers the amount of children affected.
Child↗
[Autopsy: reflection of intrahospital mortality].
Autopsies have long been viewed as a biased source of information with regard to the mortality statistics that prevail in the hospital and community. This bias could be of either a demographic or clinical nature. Our objective was to define the autopsy characteristics from the National Cancer Institute of Mexico and determine how representative they were of hospital mortality. Age, sex, place of residence, socioeconomic status, and tumor location were obtained from the Hospital Mortality Registry (1985 and 1987). During these two years, 451 deaths were registered; in 290 of these cases (64.3%), an autopsy was performed. Discrepancies of 9.8 percent were found between autopsy diagnosis and mortality registry data. Our results indicate that autopsy examinations effectively reflect total hospital mortality, and represent a useful tool for epidemiological cancer studies in Mexico. Furthermore, we believe that mortality statistics should be based on autopsy results.
Adolescent↗
Epidemic dengue 1 in Brazil, 1986: evaluation of a clinically based dengue surveillance system.
In the last 15 years, dengue fever has emerged as a major health problem in tropical America. Prevention and control of epidemic disease are enhanced by the rapid identification of new or increased dengue activity. Most surveillance systems, however, identify cases by clinical case reports and, therefore, lack the sensitivity needed for early detection. During the 1986 dengue 1 epidemic in Rio de Janeiro, Brazil, the authors evaluated the usefulness of a clinical case definition by comparing it with laboratory-confirmed infection status of residents in two cities. The case definition had a sensitivity of 64% and a false-positive rate of 57%. Thus, for every 100 laboratory-confirmed dengue infections, 230 cases were reported. Both infected and noninfected residents who used medical services and who lived in the city with the highest transmission were more likely to meet the case definition. Thus, factors unrelated to actual infection influenced the sensitivity. With the use of stepwise logistic regression, the authors analyzed combinations of patient symptoms and produced nine new hypothetical case definitions. However, none of the new definitions had a false-positive rate lower than 38%. This study emphasizes the need for laboratory-based dengue surveillance systems.
Adolescent↗
[Treatment needs on the increase. Dental status in present and future residents of retirement homes].
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Aged↗
Low-level fetal lead exposure effect on neurobehavioral development in early infancy.
A prospective method was used in this study to assess the effects of fetal lead exposure on neurodevelopmental status in 3- and 6-month old infants. At their first prenatal medical appointments, 305 lower socioeconomic status women residing in predesignated lead-hazardous areas of Cincinnati were recruited. Lead was measured in whole blood in both the mother and fetal-placental unit (prenatal and cord) and the neonate (ten days and 3 months). All blood lead levels were less than 30 micrograms/dL. Infant development was assessed with the Bayley scales at 3 and 6 months of age. Multiple regression analyses which treated perinatal health factors such as birth weight and gestation as confounders indicated an independent, inverse relationship between both prenatal and neonatal blood lead levels and performance on the Bayley Mental Developmental Index at both ages. Male infants and infants from the poorest families appeared to be especially sensitive to these psychoteratogenic influences. Further study using a structural equations approach indicated that neurobehavioral deficits were partly mediated by lead-related reductions in birth weight and gestation.
Age Factors↗
[Epidemiologic study of patients seen at a regional urology service during a year].
An epidemiologic study was performed on all patients seen at the Urology Service of a regional hospital of the National Health Service over a one-year period. The study evaluated the number of patients according to sex, age, where they resided, civil status, diagnosis, and surgical treatment they may have received. Few studies of a similar nature, mainly Japanese, have been reported in the literature.
Adolescent↗
The cholesterol/saturated fat index of the food supply and nutrient intake in an Israeli community compared with the general population.
The average annual death rate from--as well as incidence of--myocardial infarction in the kibbutzim of the Upper Galilee, Northern Israel, is twice that of the general Israeli population. Since dietary habits probably have a role in the etiology of this chronic disease, we compared the food supply in two kibbutzim with the average Israeli consumption. Food supply and a sample of nutrient intake were computed and calculated per person. Energy, protein, and fat (including cholesterol and saturated fat) consumption in the kibbutzim was higher than the average Israeli intake. Similarly, the cholesterol/saturated fat index was 1.4 and 2.8 times higher in kibbutz A and 1.3 and 2.6 times higher in kibbutz B than the average for the Israeli population and the recommended value, respectively. These findings may explain the high morbidity and mortality related to ischemic heart disease found in the kibbutzim.
Cholesterol, Dietary↗
Evaluation of a mass measles immunisation campaign in a rapidly growing peri-urban area.
A mass measles immunisation campaign, with a target coverage rate of 85-90%, was launched in Khayelitsha, a rapidly growing urban township in the Cape Town area. Cross-sectional surveys of the measles immunisation status of resident 6-23-month-old infants were conducted immediately before, immediately after, and approximately 2 months after the campaign in order to determine the effectiveness of a mass campaign in boosting coverage in an area with a high influx rate. Immunisation coverage rates were 55% in the first survey, 76% in the second, and 72% in the third. In the first survey, coverage rates for children born in Cape Town were 1.4 times higher than those born elsewhere. This trend continued throughout the survey. Duration of stay in Cape Town also influenced coverage, with rates for the recently arrived children being considerably lower than those for the more established Cape Town residents. The influx rate between the second and third survey (over the Christmas period) was 9.1% per month. Failure to reach the targeted rate is attributed to the influx rate, campaign design and implementation, and factors related to child and career mobility. Alternative immunisation strategies, with social awareness playing a key role, are being urgently investigated.
Cross-Sectional Studies↗