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PubMed1994

Correlations among indices of electric and magnetic field exposure in electric utility workers.

Power-frequency electric and magnetic fields are known to exhibit marked temporal variation, yet in the absence of clear biological indications, the most appropriate summary indices for use in epidemiologic studies are unknown. In order to assess the statistical patterns among candidate indices, data on 4383 worker-days for magnetic fields and 2082 worker-days for electric fields collected for the Electric and Magnetic Field Project for Electric Utilities using the EMDEX meter [Bracken (1990): Palo Alto, CA: Electric Power Research Institute] were analyzed. We examined correlations at the individual and job title group levels among indices of exposure to both electric and magnetic fields, including the arithmetic mean, geometric mean, median, 20th and 90th percentiles, time above lower cutoffs of 20 V/m and 0.2 microT, and time above higher cutoffs of 100 V/m and 2.0 microT. For both electric and magnetic fields, the arithmetic mean was highly correlated with the 90th percentile; moderately correlated with the geometric mean, median, and lower and higher cutoff scores; and weakly correlated with the 20th percentile. Electric and magnetic field indices were generally weakly correlated with one another. Rank-order correlation coefficients were consistently greater than product-moment correlation coefficients. Job title group summary scores showed higher correlations among electric field indices and magnetic field indices and between electric and magnetic field indices than was found for individual worker-days, with only the 20th percentile clearly independent of the others. These results suggest that individuals' exposures are adequately characterized by a measure of central tendency for electric and magnetic fields, such as the arithmetic or geometric mean, and an indicator of a lower threshold or cutoff for each field type, such as the 20th percentile or proportion of time above 20 V/m or 0.2 microT. A single measure of central tendency for each type of field appears to be adequate when exposures are assessed at the job title level.

Electricity↗
PubMed1996

Splenic Doppler impedance indices: influence of different portal hemodynamic conditions.

The spleen plays a pivotal role in the pathogenesis and maintenance of portal hypertension. Few data exist about splenic hemodynamics evaluated by duplex sonography in this condition. Twenty-six normal subjects, 207 patients with portal hypertension of various causes, and in different splenoportal hemodynamic conditions, and 31 patients with liver transplantation were evaluated. In each patient the splenic resistive index (RI = peak systolic--end diastolic velocity/peak systolic velocity) and pulsatility index (PI = peak systolic--end diastolic velocity/mean velocity) were measured. In 17 cirrhotic patients, splenic indices were compared with portal hemodynamics as invasively evaluated by hepatic vein catheterization. In the various groups, RI and PI were respectively: normal subjects, 0.51 +/- 0.05 and 0.72 +/- 0.11; cirrhotic patients with hepatopetal portal blood flow (n = 167), 0.64 +/- 0.08 and 1.03 +/- 0.24; cirrhotic patients with hepatofugal portal flow (n = 3), 0.74 +/- 0.08 and 1.27 +/- 0.08; cirrhotic patients with portal vein thrombosis (n = 9), 0.74 +/- 0.08 and 1.36 +/- 0.34; patients with noncirrhotic obstruction of the portal system (n = 7), 0.69 +/- 0.11 and 1.16 +/- 0.28; cirrhotic patients with surgical decompression of splenic vein system (n = 21), 0.54 +/- 0.07 and 0.76 +/- 0.15; patients with liver transplantation (n = 31), 0.50 +/- 0.08 and 0.70 +/- 0.15. Both RI and PI were significantly higher in cirrhotic patients with hepatopetal portal flow compared with controls (P < .0001), and even higher in cirrhotic patients with portal vein thrombosis (P < .004 and P < .001 in comparison with RI and PI values of cirrhotic patients). In patients with noncirrhotic portal vein thrombosis, splenic impedance indices were higher than those in controls (RI and PI P < .0001). Cirrhotic patients who underwent surgery for the therapy of portal hypertension showed splenic impedance indices significantly decreased compared with other cirrhotic patients (RI and PI P < .0001). In patients who underwent liver transplantation, splenic impedance indices were the same as those in controls. In 23 of the 52 patients surgically treated (surgical shunt or liver transplantation), impedance indices were evaluated both before and after surgical treatment. All these patients showed a decrease in splenic impedance indices (RI and PI, P < .0001) after surgical treatment. RI and PI values were higher in patients with large esophageal varices as compared with patients without or with small varices (P < .02 and P < .01). RI and PI values were not related to age, mean arterial pressure, sex, Child-Turcotte-Pugh score, presence of ascites, or cause. A significant correlation was found between splenic impedance indices and portal resistance as evaluated by hepatic vein catheterization (r = .80, P < .001 for RI values; r = .87, P < .001 for PI values). In conclusion, this study shows that splenic impedance indices are increased in cirrhotic patients, and seems to demonstrate that in patients with cirrhosis these indices reflect portal vein blood flow resistance.

Adult↗
PubMed1998

Splenic impedance indices: a useful method to monitor patients after liver transplantation?

Splenic Doppler impedance indices are influenced, in portal hypertensive patients, by the resistance of the portal system. The aim of the study was to verify the usefulness of these indices in evaluating the presence of a pathological increase in portal resistance in patients with complications after liver transplantation. Splenic impedance indices have been evaluated in 46 patients before orthotopic liver transplantation (OLT), and 2 days, 1, 4, 8, and 12 to 18 months after transplantation. The results showed that spleen size slowly decreased after liver transplantation. From a baseline longitudinal diameter value of 18.0+/-3.6 cm (M+/-SD), the decrease was by 0%+/-3%, 8%+/-8%, 13%+/-9%, 15%+/-11%, and 14%+/-11% at 2 days and 1, 4, 8, and 12 to 18 months after liver transplantation. Splenic impedance indices-resistance index = (peak systolic - end diastolic) / peak systolic velocity; pulsatility index = (peak systolic - end diastolic) / mean velocity-which were increased before liver transplantation, showed a rapid decrease to normal values: resistance index: from 0.62+/-0.08 to 0.55+/-0.08 after 2 days, and to 0.49+/-0.09, 0.51+/-0.10, 0.54+/-0.10, 0.55+/-0.11 after 1, 4, 8, 12-18 months; pulsatility index: from 0.96+/-0.21 to 0.82+/-0.17 after 2 days, and to 0.69+/-0.19,0.72+/-0.21, 0.81+/-0.26, 0.84+/-0.26 after 1, 4, 8, and 12 to 18 months. Patients who had a good outcome, without any major complications, showed a clear and steady decrease in splenic impedance indices. On the contrary, patients who had complications affecting portal resistance (e.g., acute rejection, relapse of chronic hepatitis C virus-related hepatitis or cirrhosis, stenosis of portal anasthomosis, portal thrombosis), showed a lack of decrease, or, after an initial decrease, a subsequent re-increase in splenic impedance indices to pathological values. Splenic impedance indices measured in patients with complications were higher than those of patients without complications (P < .0004). Specificity and sensitivity of splenic impedance indices in the evaluation of the presence of complications increasing portal resistance were good. In conclusion, after OLT, splenic impedance indices could be useful aspecific parameters for identifying patients with complications that are able to affect or increase portal resistance.

Adult↗
PubMed1988

Extrapolating global visual field indices from local parameters in the nasal region.

The local mean and the average difference of four pairs of test locations within the 26 degrees visual field, situated above and below the horizontal nasal meridian, were used to predict the global field indices MD and CLV of the Gl glaucoma program. Out of 539 examinations (194 eyes suspected of having glaucoma), the local indices NDIFF (describing asymmetrical behavior around the nasal horizontal meridian), ND0 (the mean defect in the nasal region), and the global indices MD and CLV were calculated. Seven hundred fifty-five examinations (446 normal eyes) served as a control group. First and second examinations of 146 glaucoma suspect eyes were used to calculate the retest reliability scores for the indices in question. When analyzing the glaucoma suspects, the local index NDIFF, together with the local mean defect, ND0, yielded highly reliable estimates of the global indices MD and CLV, with a retest correlation r = 0.86 for NDIFF, and r = 0.96 for ND0. The covariance of NDIFF with CLV was r = 0.67, while the co-variance of MD with ND0 was r = 0.95. The ranges of the local indices ND0 and NDIFF were each classified into 'normal range' and 'range of suspected pathology', in analogy to the normal and pathological ranges of the global field indices. Equivalence of the local indices with the corresponding ranges of MD and CLV was investigated and the results are shown. The establishment of local indices may prove to be a powerful tool in early detection of glaucomatous damage.

Glaucoma↗
PubMed1994

Clinical indicators derived from the patient assessment instrument in the long-stay residents of 69 VA nursing homes.

OBJECTIVES: Previous work has shown that clinical indicators reflecting occurrence of bedsores, behavioral disturbances, and deterioration of activities of daily living (ADLs) can be calculated for the long-stay residents of Veterans Affairs (VA) nursing homes from the standard biannual Patient Assessment Instrument (PAI). The present study aimed to construct national curves for these indicators, against which each facility could in the future compare its own values; and to determine the correlations between the indicator values and selected nursing home characteristics. METHODS: Eight indicators were calculated for the long-stay (more than six months) residents of the 69 VA nursing homes housing 50 or more such patients from the 1992 PAI data. The indicators were: prevalence of bedsores; incidence of bedsores; prevalence of physically aggressive behavior; incidence of aggressive behavior; and frequencies of six-month losses of eating, mobility, transfer, and toileting functions by the initially independent residents. RESULTS: There was a two- to sixfold difference between the most favorable quartile and the least favorable quartile for the eight indicators. Significant correlations across institutions were found between the prevalence and incidence of bedsores, the prevalence and incidence of aggressive behavior, and the frequencies of declines in the four ADLs by the initially independent residents. One or several of the indicators were significantly superior in nursing homes with these characteristics: a smaller size, a slower resident turnover rate, a smaller proportion of residents with nonorganic psychoses, a lower ratio of short-stay to long-stay residents, and a lower ratio of independent to dependent long-stay residents. CONCLUSIONS: These data provide national standards against which each VA nursing home can compare its PAI-derived clinical indicator values. The outcomes measured by these indicators appear to be influenced both by casemix and by environmental factors.

Activities of Daily Living↗
PubMed2004

The impact of the use of multiple risk indicators for fracture on case-finding strategies: a mathematical approach.

The value of bone mineral density (BMD) measurements to stratify fracture probability can be enhanced in a case-finding strategy that combines BMD measurement with independent clinical risk indicators. Putative risk indicators include age and gender, BMI or weight, prior fracture, the use of corticosteroids, and possibly others. The aim of the present study was to develop a mathematical framework to quantify the impact of using combinations of risk indicators with BMD in case finding. Fracture probability can be expressed as a risk gradient, i.e. a relative risk (RR) of fracture per standard deviation (SD) change in BMD. With the addition of other continuous or categorical risk indicators a continuous distribution of risk indicators is obtained that approaches a normal distribution. It is then possible to calculate the risk of individuals compared with the average risk in the population, stratified by age and gender. A risk indicator with a gradient of fracture risk of 2 per SD identified 36% of the population as having a higher than average fracture risk. In individuals so selected, the risk was on average 1.7 times that of the general population. Where, through the combination of several risk indicators, the gradient of risk of the test increased to 4 per SD, a smaller proportion (24%) was identified as having a higher than average risk, but the average risk in this group was 3.1 times that of the population, which is a much better performance. At higher thresholds of risk, similar phenomena were found. We conclude that, whereas the change of the proportion of the population detected to be at high risk is small, the performance of a test is improved when the RR per SD is higher, indicated by the higher average risk in those identified to be at risk. Case-finding strategies that combine clinical risk indicators with BMD have increased efficiency, while having a modest impact on the number of individuals requiring treatment. Therefore, the cost-effectiveness is enhanced.

Absorptiometry, Photon↗
PubMed2003

Assessing anchor damage on coral reefs: a case study in selection of environmental indicators.

Because environmental conservation can remove scarce natural resources from competing uses, it is important to gain support for conservation programs by demonstrating that management actions have been effective in achieving their goals. One way to do this is to show that selected significant environmental variables (indicators) vary between managed and unmanaged areas or change over time following implementation of a management regime. However, identifying indicators that reflect environmental conditions relevant to management practices has proven difficult. This paper focuses on developing a framework for choosing indicators in a coral reef habitat. The framework consisted of three phases: (1) information gathering to identify candidate variables; (2) field-testing candidate variables at sites that differ in intensity of human activity, thus identifying potential indicators; and (3) evaluating potential indicators against a set of feasibility criteria to identify the most useful indicators. To identify indicators suitable to measure the success of a management strategy to reduce anchor damage to a coral reef, 24 candidate variables were identified and evaluated at sites with different intensities of anchoring. In this study, measures that reflected injuries to coral colonies were generally more efficient than traditional measures of coral cover in describing the effects of anchoring. The number of overturned colonies was identified as the single most useful indicator of coral reef condition associated with anchoring intensities. The indicator selection framework developed here has the advantages of being transparent, cost efficient, and readily transferable to other types of human activities and management strategies.

Animals↗
PubMed2007

Defining acceptable levels for ecological indicators: an approach for considering social values.

Ecological indicators can facilitate an adaptive management approach, but only if acceptable levels for those indicators have been defined so that the data collected can be interpreted. Because acceptable levels are an expression of the desired state of the ecosystem, the process of establishing acceptable levels should incorporate not just ecological understanding but also societal values. The goal of this research was to explore an approach for defining acceptable levels of ecological indicators that explicitly considers social perspectives and values. We used a set of eight indicators that were related to issues of concern in the Lake Champlain Basin. Our approach was based on normative theory. Using a stakeholder survey, we measured respondent normative evaluations of varying levels of our indicators. Aggregated social norm curves were used to determine the level at which indicator values shifted from acceptable to unacceptable conditions. For seven of the eight indicators, clear preferences were interpretable from these norm curves. For example, closures of public beaches because of bacterial contamination and days of intense algae bloom went from acceptable to unacceptable at 7-10 days in a summer season. Survey respondents also indicated that the number of fish caught from Lake Champlain that could be safely consumed each month was unacceptably low and the number of streams draining into the lake that were impaired by storm water was unacceptably high. If indicators that translate ecological conditions into social consequences are carefully selected, we believe the normative approach has considerable merit for defining acceptable levels of valued ecological system components.

Data Collection↗
PubMed1998

ENVIRONMENTAL AUDITING: Choosing Indicators of Natural Resource Condition: A Case Study in Arches National Park, Utah, USA

/ Heavy visitor use in many areas of the world have necessitated development of ways to assess visitation impacts. Arches National Park recently completed a Visitor Experience and Resource Protection (VERP) plan. Integral to this plan was developing a method to identify biological indicators that would both measure visitor impacts and response to management actions. The process used in Arches for indicator selection is outlined here as a model applicableto many areas facing similar challenges. The steps were: (1) Vegetation types most used by visitors were identified. Impacted and unimpacted areas in these types were sampled, comparing vegetation and soil factors. (2) Variables found to differ significantly between compared sites were used as potential indicators. (3) Site-specific criteria for indicators were developed, and potential indicators evaluated using these criteria. (4) Chosen indicators were further researched for ecological relevancy. (5) Final indicators were chosen, field tested, and monitoring sites designated. In Arches, indicators were chosen for monitoring annually (soil crust index, soil compaction, number of used social trails and soil aggregate stability) and every five years (vegetation cover and frequency; ground cover; soil chemistry; and plant tissue chemistry).KEY WORDS: Biological indicators; Recreation impacts; Recreation management; Desert soils; Trampling

Journal Article↗
PubMed2005

A pilot ontological model of public health indicators.

UNLABELLED: There are various public health databases in the world aiming to provide data to compare health conditions in different countries. Their data sets are more or less overlapping but data from different databases and different countries are hard to compare due to different definitions and interpretations. Our aim was to create a core ontological model that is able to represent public health indicators. We assumed, that by such representation comparability and quality of data could be improved. METHOD: Three sets of indicators were taken, and a core ontology was built from information objects describing their top level entities. The Protégé ontology editor with RDF backend was used for building the ontology. The used indicator sets were the indicators of the Health for All Database of the World Health Organisation (HFA), the OECD Health Data, and the set of indicators proposed by the European Community Health Indicators (ECHI) European project. Then 19 indicators selected from HFA was represented using the core ontology. Strength and weaknesses of the descriptive capability of the model was studied. RESULT: The drafted core model seems to be useful in representing many of the public health indicators. In some cases it really helps improve comparability. However, some of the semantic details cannot be sufficiently expressed by the used ontology representation language. There is a need of merging other domain ontologies to represent indicators related to other domains, such as economy, social and environmental sciences.

Databases, Factual↗
PubMed2005

A study on symptom profiles of late-life depression: the influence of vascular, degenerative and inflammatory risk-indicators.

BACKGROUND: If specific symptom profiles of depressive disorders in the elderly are related to a specific etiology, this could have implications for everyday clinical practice. We hypothesized that a "motivational" profile, with symptoms such as psychomotor change, loss of interest and loss of energy, could clinically separate patients with predominantly vascular or degenerative risk indicators from patients with inflammatory risk indicators. METHODS: A total of 4051 subjects participated in a study on mental health problems in community-dwelling elderly. Information on psychiatric symptoms, demographic and medical status, previous history and family history was obtained. We distinguished three subgroups according to predominant somatic risk-indicators; vascular, degenerative and inflammatory groups. RESULTS: Motivational symptoms were associated with vascular or degenerative risk-indicators for depression; psychomotor change with both indicators; loss of energy with vascular, though also with the inflammatory indicator, and thinking/concentration disturbance with the degenerative indicator. The so-called mood symptoms of depression, especially thoughts of death, were more strongly related with the inflammatory risk-indicator. Melancholic symptoms like appetite and sleep disturbances were more strongly associated with the inflammatory risk-indicator. LIMITATIONS: Etiological classification was not confirmed by additional investigations such as laboratory findings or MRI brain scans. CONCLUSION: This study showed that in patients with a late-life depression specific symptoms of the depressive disorder may reflect the predominant underlying pathogenic mechanism.

Age of Onset↗
PubMed2006

Comparison of insulin sensitivity assessment indices with euglycemic-hyperinsulinemic clamp data after a dietary and exercise intervention in older adults.

Multiple indices to assess insulin sensitivity calculated from mathematical equations based on fasting blood parameters or oral glucose tolerance data have been developed. Although these indices have frequently been validated using euglycemic-hyperinsulinemic clamp data, the utility of each equation in measuring change in insulin sensitivity over time remains uncertain. We examined change in insulin sensitivity in response to a 12-week diet and exercise intervention in 31 older men and women with impaired glucose tolerance using a euglycemic-hyperinsulinemic clamp and 10 commonly used insulin sensitivity equations. Mean glucose disposal as calculated from clamp data was significantly higher after the intervention compared with baseline (5.92 +/- 0.38 vs 5.18 +/- 0.30 mg . kg fat free mass(-1) . min(-1), P = .013). In contrast, none of the examined indices indicated a significant change in insulin sensitivity over time (all P > .3). A limits of agreement approach to compare insulin sensitivity calculated from each equation with the measure of glucose disposal from the clamp indicated overall imperfect agreement between measures (agreement limits ranged from +/-2.48 to +/-4.23 mg . kg fat free mass(-1) . min(-1)) despite significant bivariate correlations between indices and clamp data. The wide variability in the 95% prediction limits of agreement among equations suggests that these equations vary substantially from a euglycemic-hyperinsulinemic clamp in their ability to assess insulin sensitivity. Despite the observed limited agreement using this statistical approach, changes in several calculated indices were significantly correlated with changes in clamp data, suggesting that these indices may have some utility in tracking improvements in insulin sensitivity. Further research is necessary to examine agreement between indices and clamp data in larger, more heterogeneous populations and in response to other interventions where the magnitude of change in insulin sensitivity may be larger.

Aged↗
PubMed2006

Evaluating the correlation and prediction of trunk fat mass with five anthropometric indices in Chinese females aged 20-40 years.

BACKGROUND AND AIMS: Obesity is a worldwide problem, and excess trunk fat mass (FM(trunk)) has been associated with an increased risk of diseases. The early measurement of FM(trunk) has potential importance to evaluate trunk obesity. We sought to evaluate the correlation and predication of FM(trunk) with five anthropometric indices in Chinese females. METHODS AND RESULTS: A sample of 850 China females aged 20-40 years were recruited and divided into four age groups with a 5-year range in each group. Five anthropometric indices were measured or calculated. FM(trunk) in kg was measured using a dual-energy X-ray absorptiometry scanner. Principal component analysis (PCA) and multiple regression analysis were performed to develop prediction equations. There was an increasing trend of FM(trunk) and five anthropometric indices in successively older age groups. Four formed principal components (PCs) interpreted over 99% of the total variation of five relative anthropometric indices in all age groups. Regression analyses showed that four PCs combined explained a greater variance (R(2)=45.2-81.6%) in FM(trunk) than did each of the five indices alone (R(2)=2.4-72.2%). CONCLUSIONS: Our results suggested that there is an increasing trend of FM(trunk) and five anthropometric indices with aging; that age obviously influences the relationship of FM(trunk) and the anthropometric indices studied; and that the accuracy of predicting the FM(trunk) using five anthropometric indices combined is greater than using the five indices alone.

Absorptiometry, Photon↗
PubMed2005

Determining indications for adult vaccination: patient self-assessment, medical record, or both?

CONTEXT: Eight or more vaccines may be indicated for adults in the United States. Determining if any vaccines are needed requires integrating information on the patient's demographic and behavioral risk factors and health status, the health status of the patient's close contacts, and the patient's immunization history. This process can be time consuming for providers and their staff. We used patient self-assessment as a method of determining which vaccines are indicated for a patient and whether indicated vaccines had been received. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional convenience sample of 300 adults in three family practice settings. Participants completed a self-assessment tool to determine if influenza, pneumococcal, measles, mumps, and rubella (MMR), tetanus, hepatitis A and hepatitis B vaccines were indicated and previously received. A chart audit was then performed to obtain similar information. MAIN OUTCOME MEASURES: Agreement (kappa statistic [< 0.00: poor agreement; 0.00-0.20: slight; 0.21-0.40: fair; 0.41-0.60: moderate; 0.61-0.80: substantial; 0.81-1.00: almost perfect]) between the self-assessment tool and the audit for (1) indicated vaccines and (2) previous receipt of indicated vaccines indicated according to both the assessment form and the audit. RESULTS: Agreement between the self-assessment tool and chart review was substantial or better only for pneumococcal and MMR vaccines (kappa=0.65 and 0.85, respectively). For influenza vaccine, agreement improved (from kappa = 0.56 to kappa = 0.74) when indications attributable to health conditions of family members were excluded. Agreement regarding receipt of vaccines was highest for influenza vaccine (kappa = 0.70). Only 57% of patients correctly recalled tetanus vaccination that were documented in the medical record (kappa = -0.04). Kappa statistics were unreliable for hepatitis A and B vaccines because so few vaccinations had been received. CONCLUSIONS: Discrepancies in agreement regarding indications for vaccines appeared to result from absence of information in the medical record regarding high risk behaviors and family contacts. Lack of agreement regarding vaccines that had been previously been received appeared due to both poor recall and lack of documentation. Combining medical record audit with self-assessment may be the most complete assessment of vaccination status of adults, but requires reconciling disagreements. Electronic medical records and registries that contain information about risk factors and previously administered vaccines may be necessary to overcome some these problems.

Adolescent↗
PubMed1997

AM-loading of fluorescent Ca2+ indicators into intact single fibers of frog muscle.

The AM loading of a number of different fluorescent Ca2+ indicators was compared in intact single fibers of frog muscle. Among the 13 indicators studied, loading rates (the average increase in the fiber concentration of indicator per first 60 min of loading) varied approximately 100-fold, from approximately 3 microM/h to >300 microM/h (16 degrees C). Loading rates were strongly dependent on the molecular weight of the AM compounds, with the rate increasing steeply as molecular weight decreased below approximately 850. Properties of delta F/F (the Ca2(+)-related fluorescence signal observed with fiber stimulation) were also measured in AM-loaded fibers and compared with those previously reported for fibers microinjected with indicator. In general, the time course of delta F/F was very similar with AM-loading and microinjection; however, the amplitude of delta F/F was usually smaller with AM-loading. There was a strong correlation between the rate of indicator loading and the value of the parameter f (the ratio of the amplitude of delta F/F in AM-loaded versus microinjected fibers). For indicators with small loading rates (<10 microM/h, N = 5), f values were generally small (< or =0.4, N = 4); whereas with large loading rates (>100 microM/h, N = 4), f values were large (> or =0.8, N = 4). This suggests that, with any AM indicator, a small concentration may associate nonspecifically with the fiber (either the indicator is incompletely de-esterified or, if completely de-esterified, not located in the myoplasmic compartment). If the loaded concentration is small, the nonspecific indicator will present a significant source of error in the estimation of [Ca2+]i.

Animals↗
PubMed2002

Regrowth and survival of indicator microorganisms on the surfaces of household containers used for the storage of drinking water in rural communities of South Africa.

The present study covered two rural communities of South Africa: Ncera and Ntselamanzi villages. Raw water from Ncera river is used by the community of Ncera village for drinking, while the community of Ntselamanzi receives their drinking water from Alice purification system. Treated water is supplied to the community by a public standpipe system. In rural communities of South Africa, many households use polyethylene (PE) and galvanized steel (GS) containers for the storage of their drinking water. To investigate the regrowth and survival of indicator microorganisms on the surface of household containers during the storage of drinking water, PE and GS slides were suspended in the appropriate household containers for a period of 48 h. This period of 48 h was chosen as the study period because results from the questionnaire indicated that the largest percentage (62%) of households store their water for that length of time. The experiment was performed to test drinking water as it is collected and stored by rural communities. No disinfection of household containers or slides was done during the study period. Attached coliphages (F-RNA (FP) and somatic phage (SP), coliform bacteria (total coliform (TC), presumptive Escherichia coli (EC), Salmonella (Sal) and Clostridium perfringens (CP) were measured during the study period. With the exception of CP, attached indicator microorganisms consisted of TC, presumptive E. coli and Salmonella, somatic and F-RNA coliphages, although the yield (average count) for the last four groups (EC: < 1-3 cfu cm(-2), Sal: < 1-15 cfu cm(-2), FP: < 1-7 pfu cm(-2), SP: < 1-7pfu cm(-2)) was lower than that of TC (3-183 cfu cm(-2)). However, the lowest yield of indicator microorganisms was noted for presumptive E. coli. Whereas the occurrence and survival of TC was noted on the surface of household containers during the entire period of the experimental study, other indicator microorganisms occurred from time to time. The regrowth of indicator microorganisms occurred 48 h after the exposure of slides to both types of test waters. This length of time mostly resulted in the regrowth of TC (with an increase in bacterial counts) while the persistence of other indicator organism groups on the surface of the slides was apparent. A comparison between PE and GS containers showed that more TC (average count) regrew on PE than on GS containers (for river water, PE: from 36 to 55 cfu cm(-2), GS: from 25 to 26 cfu cm(-2); for standpipe water, PE: from 147 to 183 cfu cm(-2), GS from 3 to 4 cfu cm(-2)). This study revealed that both types of household containers supported the growth and survival of indicator microorganisms due to the bad quality of the intake water before storage. The storage of drinking water for 48 h mainly resulted in the regrowth of TC. Nevertheless, the persistence of other indicator microorganisms was observed on the surface of household containers.

Biofilms↗
PubMed2003

Development of sustainability indicators by communities in China: a case study of Chongming County, Shanghai.

Public participation as a means of identifying sustainability indicators for Chongming County, Shanghai, China was evaluated by an international group drawing on established best practice. An initial 'long list' of 86 sustainability indicators, based on previous indicator systems developed in China, was identified. This 'long list' was reduced via consultations with local academics and local-government officers from Shanghai City and Chongming County to a 'short list' of 17 indicators. This short-list was subjected to further community consultation involving 159 local-government officers, teachers, students (aged 12-14 years), farmers and workers. Data from the consultations indicated differences in the understanding of sustainable development among the different sectors. By combining the data from the different sectors it was possible to identify a consensus around 4 core and 7 additional indicators. These are proposed as indicators which could be used to steer local activities directed towards sustainable development. The list of indicators produced by the people of Chongming Island was compared to local indicator systems in Europe. In comparison with European lists the Chongming list was found to have a greater emphasis on economic development but a similar level of concern for environmental matters. This study has special significance as it reports on the implementation of a process involving local resident participation in the process of sustainable development in China.

Adolescent↗
PubMed2001

Area characteristics and individual-level socioeconomic position indicators in three population-based epidemiologic studies.

PURPOSE: There is growing interest in incorporating area indicators into epidemiologic analyses. Using data from the 1990 U.S. Census linked to individual-level data from three epidemiologic studies, we investigated how different area indicators are interrelated, how measures for different sized areas compare, and the relation between area and individual-level social position indicators. METHODS: The interrelations between 13 area indicators of wealth/income, education, occupation, and other socioenvironmental characteristics were investigated using correlation coefficients and factor analyses. The extent to which block-group measures provide information distinct from census tract measures was investigated using intraclass correlation coefficients. Loglinear models were used to investigate associations between area and individual-level indicators. RESULTS: Correlations between area measures were generally in the 0.5--0.8 range. In factor analyses, six indicators of income/wealth, education, and occupation loaded on one factor in most geographic sites. Correlations between block-group and census tract measures were high (correlation coefficients 0.85--0.96). Most of the variability in block-group indicators was between census tracts (intraclass correlation coefficients 0.72--0.92). Although individual-level and area indicators were associated, there was evidence of important heterogeneity in area of residence within individual-level income or education categories. The strength of the association between individual and area measures was similar in the three studies and in whites and blacks, but blacks were much more likely to live in more disadvantaged areas than whites. CONCLUSIONS: Area measures of wealth/income, education, and occupation are moderately to highly correlated. Differences between using census tract or block-group measures in contextual investigations are likely to be relatively small. Area and individual-level indicators are far from perfectly correlated and provide complementary information on living circumstances. Differences in the residential environments of blacks and whites may need to be taken into account in interpreting race differences in epidemiologic studies.

Adult↗