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PubMed1997

Antipoliomyelitis immunity status in a cohort of young men drafted into military service, residing in the suburban Milan area.

The aim of this study was to verify the antipolio immune status of a cohort of eighteen year-olds residing in the suburban Milan area for whom vaccination histories were available. Seropositivity (titres of neutralizing antibodies > or = 1:8) for the three virus serotypes was detected in 89.2% of the 530 subjects tested, whereas simultaneous seronegativity for all three polioviruses was found for only 0.6% of the subjects.

Adolescent↗

PubMed2005

A typology of groups at risk of HIV/STI in a gold mining town in north-western Tanzania.

Mining communities with migrant populations are high-risk locations for human immunodeficiency virus (HIV)/sexually transmitted infection transmission in Sub-Saharan Africa. Interventions presupposing certain groups to be at high risk, such as those working exclusively as commercial sex workers, may divert attention from other high-risk groups. Qualitative research was conducted in a small town adjacent to a large-scale commercial gold mine in north-western Tanzania. Objectives were to identify populations at high risk of HIV and suggest suitable behavioural interventions by gaining an understanding of sexual behaviour patterns in the town. Rapid assessment procedures were employed comprising participant observation, informal questioning and in-depth interviews. Epidemiological categories of "core", "bridging" and "general" populations may not be adequate to the understanding of risk. Many types of women were found to receive payment for sex, distinguished by permanency of residence, age, relationship status, accommodation and income-earning activity. Paying for sex and having multiple partners was common among most men. The town was a high-risk environment as a result of the economic opportunities available there (in contrast to the poverty of surrounding areas), which were often accessed by offering sex in exchange for money or gifts. In this environment, the potential for spread of HIV infection between sub-populations was high and identification of distinct high- and low-risk groups not possible. However, the methodology enabled the identification of different social circumstances of risk, such as residential arrangements, employment status and venues for recreation, associated with different types of people. Targeted interventions may be oriented to specific circumstances in order to address risk practices in a culturally appropriate manner. It is useful to think of risk environments rather than attributing risk to types of people, and to target interventions to these environments. The methodology also enabled an approach to interventions sensitive to different circumstances associated with risk within the town while identifying structural factors affecting risk at the level of the town as a whole.

Age Factors↗

PubMed1995

The health status and health needs of Chinese population in Glasgow.

This cross sectional study explored the health problems and health needs in the local Chinese community in Glasgow. Several data collection methods have been used in this study, including face-to-face and telephone structured interviews, postal and hand delivered questionnaires. A total of 800 questionnaires were processed, and 493 were completed, giving an overall response rate 61.6%. The results from the present survey indicated that the health status of Chinese residents in Glasgow is poorer than that of the local population. The most important findings of the study is that the Chinese community in Glasgow underuse health services, and unmet health needs exist in the community. The main barrier to effective use of present health services and benefit from the health promotion and health education programmes is language difficulties. Following discussion with the local community, options for improving the health services for the Chinese community in Glasgow were obtained. The findings of the study have implications for health service purchaser/providers of health care to the Chinese population generally in Scotland.

Adolescent↗

PubMed1996

Should amenorrhoea be necessary for the diagnosis of anorexia nervosa? Evidence from a Canadian community sample.

BACKGROUND: This study compares the characteristics of women with anorexia nervosa with those of women who have all the diagnostic features of that disorder except amenorrhoea. METHOD: The study uses data from a large community epidemiological survey of the mental health status of household residents in Ontario, Canada. A multi-stage stratified sampling design generated a sample of 4285 females aged 15-64. DSM-III-R diagnoses were made using the Composite International Diagnostic interview. RESULTS: Eighty-four out of 4285 female respondents met full or partial-syndrome criteria for anorexia nervosa. Comparison of these two groups revealed few statistically significant differences in terms of demographics, psychiatric comorbidity, family history or early experiences. CONCLUSIONS: Amenorrhoea did not discriminate between women with anorexia nervosa and women with all the features except amenorrhoea across a number of relevant variables. The authors question the utility of amenorrhoea as a diagnostic criterion.

Adolescent↗

PubMed1989

Effects of road traffic noise on prevalence of hypertension in men: results of the Luebeck Blood Pressure Study.

Within the Luebeck Blood Pressure Study - a cross-sectional study of 2,315 Luebeck citizens, aged 30-69 years, response 83.3% - the association between blood pressure and exposure to road traffic noise at home was investigated. Road traffic noise was grouped as HIGH and LOW exposure, hypertension was defined as either SBP greater than or equal to 160 mm Hg and/or DBP greater than or equal to 95 mm Hg and/or on antihypertensive medication. A comparison of the crude prevalence of hypertension showed an increase of prevalence for men from 25.5% in the LOW to 31.1% in the HIGH exposure group (odds ratio: 1.32; 90% CI: 1.03-1.69), which was statistically significant at the alpha-level of 0.1. After univariate analyses the variables age, BMI, alcohol consumption, years of education, duration of residence, and employment status were considered as possible confounders or effect modifiers. A logistic regression model was fitted by using a backward stepping procedure. Prevalence were adjusted by using this logistic regression model. Differences between adjusted prevalences in LOW and HIGH exposure groups were similar to the crude differences. The odds ratio computed by the coefficients of this model was also similar to the corresponding odds ratio above. To validate the model we simultaneously stratified the remaining variable of the final model and combined the resulting odds ratios by Mantel-Haenzel. The results were again similar. According to the results of this study a positive association between exposure to road traffic noise and prevalence of hypertension in men is probable.

Adult↗

PubMed1989

Mortality and social class in Sweden--exploring a new epidemiological tool.

Total mortality, mortality from coronary heart disease (CHD), cerebrovascular disease, and other causes of death, were examined for three social groups and ten socio-economic groups in Sweden. The study included all subjects born in the country between 1896 and 1940 who were economically active in 1960-1.9 million men and 0.7 million women. Information on social and socio-economic status, and other social and demographic characteristics, was obtained from the 1960 Census. Information on cause-specific mortality during the period 1961-68 was obtained from a record linkage with the Cause of Death Registry. The analyses were based on 112,469 deaths and 21 million person years at risk. Information on smoking habits was obtained from a sample of 55,000 from the Census population. CHD mortality for women was high among manual workers, SMR = 110 (95% confidence limits 104-117), and low among non-manual workers, SMR = 84 (78-91). CNS-vascular mortality for women was also high among manual workers, SMR = 107 (110-115), and low among non-manual workers, SMR = 89 (82-97). Heavy smoking was more common among non-manual workers in both sexes, which may have contributed to a reverse social class gradient among men, with non-manual male workers being at higher risk for CHD than manual male workers. Farmers (and agricultural workers) generally had a low mortality. Other self-employed men and women had a high total mortality, a high mortality from CHD and CNS-vascular disease--and a high proportion of heavy smokers. There remain differences in mortality between social and socio-economic groups which cannot be explained by smoking habits, age, gender, urbanization, region of residence and martial status.

Adult↗

PubMed1996

Place of death correlated to sociodemographic factors. A study of 203 patients dying of cancer in a rural Swedish county in 1990.

The purpose of this study was to ascertain where patients with malignant disease died and to establish whether such factors as age, sex, marital status, place of residence, diagnosis and interval between diagnosis and death bore any relation to the place of death. All medical records of 203 patients who died in one particular Swedish county in 1990 of cancers of the GI tract, the urogenital organs, the breast, the skin and the thyroid were analysed. Of all 203 patients, 25 (12%) died at home, 49 (24%) in nursing homes and 129 (64%) in hospital. The proportion of home deaths was significantly smaller when the interval from diagnosis to death was less than one month. Death in a nursing home, compared with death in a hospital, was more usual among patients older than 80 years, among those living more than 40 km from the hospital and among those from areas where the local health care centre had a nursing home attached.

Adult↗

PubMed2000

Dietary carotenoids and risk of gastric cancer: a case-control study in Uruguay.

In the period 1997-1999, 120 incident and histologically verified cases of stomach cancer were frequency matched on age, sex, residence and urban/rural status with 360 controls in order to study the role of diet in gastric cancer in Uruguay. Our attention was focused on the role of carotenoids in gastric carcinogenesis, after controlling for major confounders. According to the results, vitamin A, alpha-carotene and lycopene were associated with strong inverse relationships with stomach cancer (OR of stomach cancer for high alpha-carotene intake 0.34, 95% CI 0.17-0.65). Joint exposure to high intakes of alpha-carotene and vitamin C intakes were associated with a strong reduction in risk (OR 0.11, 95% CI 0.03-0.36). It was also suggested that high lycopene intake explained most of the reduction in risk of gastric cancer associated with vegetable intake, whereas no such effect was observed for fruit intake.

Adult↗

PubMed2004

How neighborhoods and physical functioning are related: the roles of neighborhood socioeconomic status, perceived neighborhood strain, and individual health risk factors.

BACKGROUND: Increasing attention is being paid to the impact of neighborhood residence on individual health status. PURPOSE: This study examined pathways through which low neighborhood socioeconomic status (SES) and associated subjective neighborhood characteristics may be associated with self-reported physical functioning. METHODS: A sample of 658 adults responded to a questionnaire survey sent to residents of lower and higher SES neighborhoods. Measures of neighborhood social cohesion and problems were obtained and individual deprivation, social integration, sense of control, and financial strain were assessed with standard measures. Physical functioning was assessed with the MOS 36-item Short Form health survey. RESULTS: Structural equation modeling analyses showed that living in a lower socioeconomic neighborhood was associated with greater perceived neighborhood strain, which, in turn, was associated with poorer physical functioning. Lower neighborhood SES and greater perceived neighborhood strain were associated with poorer physical functioning of individuals through less social integration, less perceived control, and greater financial strain. Individual deprivation was also related to less social integration, less perceived control, and greater financial strain. CONCLUSIONS: Neighborhood SES and associated perceptions of neighborhoods are associated with physical functioning to some extent through the shaping of the social and psychological experiences of individuals living within them.

Adolescent↗

PubMed2003

Oxidation of ER resident proteins upon oxidative stress: effects of altering cellular redox/antioxidant status and implications for protein maturation.

Previous work showed that from all cellular proteins, the endoplasmic reticulum (ER) resident proteins are most sensitive to oxidative stress [hydrogen peroxide (H(2)O(2))], as determined using the oxidation-sensitive, membrane-permeable, acetylTyrFluo probe. Because of the importance of these proteins in proper cellular functioning, we studied (a) whether modifying the cellular redox state/antioxidant status alters the susceptibility of those proteins toward H(2)O(2) oxidative stress and (b) whether H(2)O(2) affects ER function with regard to protein folding. The cellular redox and/or antioxidative capacity was modified in several ways. Lowering the capacity increased H(2)O(2)-induced protein oxidation, and increasing the capacity lowered H(2)O(2)-induced protein oxidation. The effect of H(2)O(2) on ER-related protein maturation was investigated, using the maturation of the low-density lipoprotein receptor as a model. Its maturation was not affected at low concentrations of H(2)O(2) (< or = 400 micro M), which do result in oxidation of ER resident proteins. Maturation was slowed down or reversibly inhibited at higher concentrations of H(2)O(2) (1.5-2.0 mM). These results might be caused by several events, including oxidation of the low-density lipoprotein receptor itself or ER resident proteins resulting in decreased folding (capacity). Alternatively, oxidation of cytosolic proteins involved in ER Golgi transport might attenuate transport and maturation. Clearly, the mechanism(s) responsible for the impairment of maturation need further investigation.

Animals↗

PubMed2006

Worker productivity and outpatient service use after the September 11th attacks: results from the New York City terrorism outcome study.

BACKGROUND: Research has shown that the terrorist attacks in New York City (NYC) on September 11, 2001 had an impact on the psychological status of area residents. Since a major goal of many terrorist attacks is to also adversely affect local socioeconomic activities, the long-term impact of exposure to terrorist attacks on productivity and outpatient service utilization among workers in NYC is assessed. METHODS: The impact of the World Trade Center disaster (WTCD) among 1,167 workers in NYC is examined using a prospective cohort design. The study included measures of WTCD exposures, stressful life events, other traumatic events, post-traumatic stress disorder (PTSD), and depression, assessed at 1 year and 2 years post-disaster. RESULTS: Bivariate analyses suggest that exposure to WTCD events is associated with high productivity loss at baseline, but not consistently at follow-up. Both PTSD and depression are associated with lower quality workdays at baseline and follow-up, but depression is more consistently associated with high work loss and medical service use. In multivariate analyses, WTCD exposure is associated with productivity loss at baseline, but less consistently at follow-up. At baseline, depression and history of traumatic events are associated with lower quality workdays and negative life events with greater workdays lost. Multivariate analyses at follow-up indicated that experiencing negative life events is associated with higher workdays lost and lower quality workdays and that PTSD is associated with lower quality workdays. Similar regression models suggested that increased outpatient service use is associated with depression and lifetime traumatic events at baseline and with negative life events at follow-up. CONCLUSION: This study suggests that while the WTCD had an impact on worker productivity within the first year after the attack, this did not generally persist, especially after controlling for baseline status. Having PTSD or experiencing stressful life events at follow-up, however, is associated with lower quality workdays, even after controlling for baseline status.

Adult↗

PubMed2006

Contamination status of arsenic and other trace elements in drinking water and residents from Tarkwa, a historic mining township in Ghana.

This study was conducted to assess the contamination status of 22 trace elements, especially As in water and residents in Tarkwa, a historic mining town in Ghana. Drinking water and human urine samples were collected from Tarkwa in addition to control samples taken from Accra, the capital of Ghana in March, 2004. Concentrations of As and Mn in some drinking water samples from Tarkwa were found above the WHO drinking water guidelines posing a potential health risk for the people. A potential health risk of As and Mn is a concern for the people consuming the contaminated water in this area. No significant difference of As concentrations in human urine between mining town (Tarkwa) and control site (Accra) was observed. Although As concentrations in drinking water in Tarkwa were low, urinary As levels were comparable to those reported in highly As-affected areas in the world. These results suggest the presence of other sources of As contamination in Ghana. This is the first study on multi-elemental contamination in drinking water and human from a mining town in Ghana.

Arsenic↗

PubMedDate not supplied

Birth weight, maternal age, and education: new observations from Connecticut and Virginia.

It has been well established that increased maternal education, income, and social status contribute to increased birth weight, as well as reduced risk for low or very low birth weight offspring. However, there remains controversy about the mechanism(s) for this effect, as well as the interactions between these factors, maternal age, and race. Presented here is the analysis of a large, recent sample of over 20,000 consecutive live births in 12 hospitals, about half in Connecticut and half in Virginia, including a maternal population that is educationally and racially diverse. Although information on potentially relevant details such as prenatal care, smoking, occupation, and neighborhood is lacking the data set, there is sufficient information to explore the previously noted strong effect of maternal education on birth weight, as well as the large racial difference in outcome at every educational level after adjustment for the effects of age, marital status, state of residence, and gender of the offspring. However, this relationship was not monotonic, and there were differences in the effect between the white and black families, with black women showing a linear and consistent benefit from education across the range, while whites show a sharp benefit from completion of primary education, less from subsequent schooling. A surprising result was the apparent negative impact of very advanced education (>16 years), with lowered birth weights and higher risk of low birth weight offspring in the women with post-college training. The data also shed some addition light on the effect of age and birth weight. Whites show established improvement in birth outcome to about age 30, with slight decline thereafter, whereas in blacks there was progressive decline in birth weight with rising age starting in adolescence, as previously demonstrated by Geronimus. An additional unexpected observation was a sizable difference between births in Connecticut (larger, fewer low birth weight) than Virginia, correcting for all other covariates. It is hypothesized that this may reflect differences in services used, prenatal care in particular given similarities in smoking rates and other predictors. Because of the non-representativeness of and the limited information available in the present study, the conclusions should be taken as hypotheses for further research rather than definitive.

Adolescent↗

PubMedDate not supplied

Propranolol for disruptive behaviors in nursing home residents with probable or possible Alzheimer disease: a placebo-controlled study.

OBJECTIVE: Enhanced behavioral responsiveness to central nervous system (CNS) norepinephrine (NE) in Alzheimer disease (AD) may contribute to the pathophysiology of disruptive behaviors such as aggression, uncooperativeness with necessary care, irritability, and pressured pacing. We evaluated the efficacy of the beta-adrenergic antagonist propranolol for treatment-resistant disruptive behaviors and overall behavioral status in nursing home residents with probable or possible AD. METHODS: Thirty-one subjects (age 85 +/- 8 [SD]) with probable or possible AD and persistent disruptive behaviors that interfered with necessary care were randomized to propranolol (n = 17) or placebo (n = 14) in a double-blind study. Stable doses of previously prescribed psychotropics were maintained at pre-study dose during the study. Following a propranolol or placebo dose titration period of up to 9 days (per a dosing algorithm), subjects were maintained on maximum achieved dose for 6 weeks. Primary outcome measures were the Neuropsychiatric Inventory (NPI) and the Clinical Global Impression of Change (CGIC). RESULTS: Propranolol augmentation (mean achieved dose 106 +/- 38 mg/d) was significantly more effective than placebo for improving overall behavioral status on the total NPI score and CGIC. Improvement in individual NPI items within propranolol subjects was significant only for "agitation/aggression" and "anxiety," and reached borderline statistical significance favoring propranolol over placebo only for "agitation/aggression." Pressured pacing and irritability did not appear responsive to propranolol. In propranolol subjects rated "moderately improved" or "markedly improved" on the CGIC at the end of the double-blind study phase, improvement of overall behavioral status had diminished substantially after 6 months of open-label propranolol treatment. CONCLUSION: Short-term propranolol augmentation treatment appeared modestly effective and well tolerated for overall behavioral status in nursing home residents with probable or possible AD complicated by disruptive behaviors. Propranolol may be helpful specifically for aggression and uncooperativeness (the behaviors assessed by the NPI "agitation/aggressiveness" item). However, the usefulness of propranolol in this very old and frail population was limited by the high frequency of relative contraindications to beta-adrenergic antagonist treatment and diminution of initial behavioral improvements over time.

Adrenergic beta-Antagonists↗

PubMed2002

Age-related association of small intestinal mucosal enteropathy with nutritional status in rural Gambian children.

Small bowel enteropathy (assessed by the lactulose (L) : mannitol (M) permeability test) is a major factor in infant growth faltering and malnutrition in The Gambia. However, little is known about its persistence and nutritional effect beyond 2 years of age. This was addressed by two cross-sectional studies of intestinal permeability and nutritional status in 162 residents, aged 2-60 years, living in three villages in rural Gambia. L:M ratio was found to be highest in the youngest children and although there was a significant improvement with age (P<0.0001), values were always greater than the range found in UK counterparts. M recovery (mean value 5.68 (se 0.12) %) was at all times between one-third and one-half of expected UK values and showed no improvement with age. Gut barrier function, assessed by L uptake, improved with age (P<0.001) and fell within the UK normal range beyond age 10 years. Both the L:M permeability ratio and L recovery were significantly associated with height-for-age z-scores and -0.22 respectively, P<0.001), a relationship that persisted throughout childhood and into adulthood. Change in height-for-age z-score between the two visits was also related to the L:M ratio P=0.018). The close within-subject correlation of permeability variabilities between the two visits suggests a long-term persistence of enteropathy within individuals. It appears that the small bowel enteropathy previously described in Gambian infants persists through to adulthood. Although the lesion improves with age, the relationship between attained height and L:M permeability raises the possibility that enteropathy may continue to limit growth throughout childhood and puberty.

Adolescent↗

PubMed2002

Caries experience in existing and new nursing home residents in Adelaide, Australia.

OBJECTIVES: The Adelaide Dental Study of Nursing Homes was instigated to provide comprehensive information concerning oral disease experience, incidence and increments in a random sample of those older South Australians residing in Adelaide nursing homes. METHODS: This paper presents caries experience results for existing and new nursing home residents, and caries incidence and increments for existing residents, from dental inspections conducted at the baseline and one-year data collections. RESULTS: The residents in this study were very functionally dependent, medically compromised, cognitively impaired and behaviourally difficult older adults, the great majority of whom had moderate to severe cognitive impairment. Residents gave their carers many complex and challenging behavioural problems during oral hygiene care provision. Existing and new residents had similar dental history, oral hygiene, and sociodemographic characteristics, and similar cognitive, medical, functional, and nutritional status. Oral disease experience was high in both existing and new residents. There were no significant differences between existing and new residents for their dentate status, tooth status, coronal caries experience, or root caries experience, with the exceptions that new residents had significantly greater mean number of teeth, more filled coronal and root surfaces, and also new residents had significantly fewer decayed retained roots. Large numbers of tooth surfaces were covered in plaque and debris that negated more precise assessment of caries. The existing residents had caries increments on both coronal (2.5 surfaces) and root surfaces (1.0 surfaces) over the one-year period. Coronal caries incidence was 64% and root caries incidence was 49% of existing residents. CONCLUSIONS: Oral disease experience was high in both existing and new residents. There were few significant differences between existing and new residents' oral health status. New residents were being admitted to nursing homes with a compromised oral health status. Coronal and root caries increments and incidence were high for existing residents over the one-year period.

Activities of Daily Living↗

PubMed2006

Colorectal cancer stage at diagnosis by socioeconomic and urban/rural status in California, 1988-2000.

BACKGROUND: Rural residence has been associated with increased risk of late stage cancer diagnosis, but it is unknown if this is related to lower socioeconomic status (SES) of rural residents or to other factors. This study examined the impacts of SES and urban/rural status on colorectal cancer (CRC) stage at diagnosis in California. METHODS: Cases of CRC among persons >or=50 years of age diagnosed from 1988-2000 were obtained from the California Cancer Registry. A composite census based SES measure was used in the analysis, and the RUCA (Rural Urban Commuting Areas) classification scheme was used to categorize the residence at diagnosis as urban, large town, or small town. Multivariate logistic regression was used to examine the association between SES, urban/rural status, and late stage at diagnosis. RESULTS: In multivariate models, SES had the strongest association with stage at diagnosis among individuals living in urban areas. As SES level increased, odds of late stage at diagnosis decreased. Individuals in the highest SES category had lower odds of being diagnosed at late stage when compared with those in the lowest SES category (O.R. = 0.91, 95% C.I. = 0.87, 0.94). For individuals who lived in large towns and small rural towns, SES was not significantly associated with stage at diagnosis. We found no significant differences in stage at diagnosis by urban/rural status within SES categories. CONCLUSIONS: These data suggest that the relationship between SES and the risk of late stage colorectal cancer varies among rural and urban populations. Further research into the factors that influence access to and utilization of colorectal cancer screening in rural areas is needed.

Aged↗

PubMed2002

Elderly Canadians residing in long-term care hospitals: Part I. Medical and dental status.

BACKGROUND: Oral diseases and conditions have been identified as a significant problem for elderly residents of long-term care (LTC) hospitals in developed countries, yet little recent information is available for the Canadian population. OBJECTIVE: To describe the medical, dietary, oral microbial, oral hygiene and dental status of elderly Canadians living in LTC hospitals in Vancouver and surrounding communities. METHODS: A sample of 369 elderly dentate hospital residents (mean age 83.9 years, 281 women [76.2%]) were examined, and their medical status and medications, oral status and type of hospital were documented. Oral hygiene practices and diet (specifically intake of refined carbohydrates) were evaluated. Subjects with xerostomia and subjects taking medications with hyposalivary side effects were identified, and salivary Streptococcus mutans and Lactobacillus were cultured. RESULTS: The mean plaque index was 1.3; men had a higher plaque index than women and residents of extended care hospitals had a higher plaque index than those in intermediate care hospitals. The mean bacterial score per millilitre of saliva was 9.7 105 colony-forming units (CFU) for Streptococcus mutans and 1.6 105 CFU for Lactobacillus. On average, each subject had 6.3 sound teeth, and 9.3 teeth had been restored. CONCLUSIONS: Although almost half of the subjects had visited a dental office in their community within the past 5 years, the elderly hospital residents in this study had few remaining teeth and suffered from poor oral hygiene. Prevention strategies (such as diet, oral hygiene and antimicrobial agents) rather than dental interventions (such as restorations and extractions) alone may be needed to control oral diseases in this susceptible population.

Aged↗