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PubMed1998

A tobacco and alcohol use profile of San Francisco's Chinese community.

Relatively little is known about Asian American tobacco and alcohol use patterns. This is particularly true of Chinese living in the United States--either U.S.-born or non-U.S.-born Chinese. This article presents data from a research project studying tobacco and alcohol use patterns in San Francisco's Chinese community. Data were secured both from focus groups and a self-report telephone survey of a random sample of 1,808 Chinese residents in San Francisco. This results indicate that the prevalence of both tobacco and alcohol use is lower for San Francisco's Chinese population than for the general population. Moreover, those persons who report smoking tend to be different from those who report consuming alcohol. The study concludes that specific, culturally relevant tobacco and alcohol prevention programs should be designed to better reach this target population.

Adolescent↗
PubMed1991

Blood pressure during pregnancy in Canadian Inuit: community differences related to diet.

OBJECTIVE: To assess a possible relation between the incidence of hypertension during pregnancy and the consumption of fatty acids found in fish and sea mammals. DESIGN: Retrospective survey of pregnancy-induced hypertension; prospective diet survey. SETTING: Inuit women from seven communities in the Keewatin region of the Northwest Territories. PATIENTS: All women from Arviat (formerly Eskimo Point), Baker Lake, Chesterfield Inlet, Coral Harbour, Repulse Bay, Sanikiluaq and Whale Cove who gave birth between Sept. 1, 1984, and Aug. 31, 1987. MAIN OUTCOME MEASURES: All blood pressure measurements recorded during the pregnancy, incidence of pregnancy-induced hypertension in the seven communities, harvest of country food (food obtained from the land or sea rather than bought in a store) for six of the communities, self-reported consumption of fish, sea mammals and terrestrial mammals by a subgroup of the subjects and levels of phospholipid fatty acids in cord serum samples from a subgroup of the infants. MAIN RESULTS: Significantly lower mean diastolic blood pressure values during the last 6 hours of pregnancy were noted for the women from the three communities with a higher consumption of fish and sea mammals (78.2 [95% confidence limits (CL) 76.6 and 79.9] mm Hg) than for those from the four communities with a lower consumption of such food (81.5 [95% CL 80.1 and 82.9] mm Hg) (p less than 0.005). The relation between community diet type and blood pressure was independent of other factors. Correspondingly, the women from communities with a lower consumption of marine food were 2.6 times more likely to be hypertensive during the pregnancy than those from communities with a higher consumption of marine food (p less than 0.007). Parity (p less than 0.05) and prepregnancy weight (p less than 0.005) were also significantly associated with pregnancy-induced hypertension; however, the relation between hypertension and community diet type remained significant in logistic regression analysis (odds ratio 2.56, p = 0.03). The differences between the community groups were substantiated by the results of the diet survey, the levels of eicosapentaenoic acid (EPA) in the cord serum phospholipids and the harvest data. CONCLUSIONS: Increased consumption of fish may be beneficial for women at risk for hypertension during pregnancy. A prospective randomized trial of fish or EPA supplementation during pregnancy is warranted.

Animals↗
PubMed2005

Disadvantaged but different: variation among deprived communities in relation to child and family well-being.

BACKGROUND: Disadvantaged communities are increasingly the target for interventions. Sure Start was launched in England in 1999 to tackle child poverty and improve child and family services, with Sure Start Local Programmes (SSLPs) targeted at relatively small areas of marked deprivation. However, they are located in a range of different types of communities where they may provide services to very different resident populations. They are all disadvantaged but underlying that label there are specific patterns of variability, relevant for service provision. To evaluate the implementation, impact, and cost-effectiveness of SSLPs, or other area-based initiatives, it is important to consider ways in which they can be grouped meaningfully according to these patterns. METHOD: Data were collected from administrative databases to describe SSLPs in terms of demography, deprivation, and aspects of child and family functioning and grouped using cluster analysis. RESULTS: Five different 'types' of SSLP community were identified, based on their socio-demographic and economic characteristics; typified by more, less or average deprivation in relation to all SSLPs, and in terms of the proportion of ethnic minority families resident in the areas. The groups differ in terms of community measures of child health, educational attainment, school disorder and child welfare and their prediction from demographic community characteristics. CONCLUSIONS: The groupings have implications for service delivery and the evaluation of area-based initiatives.

Adolescent↗
PubMed1998

Individual host variations in tick infestations of cattle in a resource-poor community.

Relative resistance levels of cattle against tick infestations in the communal grazing area of Botshabelo in the south-eastern Free State were determined. The objective was to establish whether differences in resistance can be exploited to contribute to tick control methods used by small-scale farmers in resource-poor environments. Ten cows (Bos taurus crosses) between the ages of 18 months and four years were used and tick counts were conducted once a month over a period of 12 months to compare their total tick burdens. Tick burdens of the various animals were compared mutually as well as with the mean tick burden of the group as a whole. Tick numbers varied throughout the year on all individuals but some animals consistently tended to have either higher or lower numbers than the mean of the group. Tick burdens on cattle classified as having a relatively low resistance to tick infestations increased eleven-fold from January to June 1996 compared to a six-fold increase on cattle categorized as belonging to the high resistance group. Twenty-eight percent of the cattle in the total study group carried 50% of the ticks collected (60,079). It is recommended that farmers in the region visually assess B. decoloratus burdens, the most abundant tick species, and sell or cull the most susceptible animals first in their normal program of utilization of the animals. This should eventually result in the direct improvement of the overall tick resistance of their cattle herds.

Analysis of Variance↗
PubMed2003

Relating parasite communities to host environmental conditions using phylogenetic tools.

There are many tools available for analysing parasite communities, either based on the proportions or presence/absence of species. These analyses rely on phylogenetic distances, and analyses of actual characters (e.g. species). The phylogenetic analysis (Wanger parsimony) was compared to a cluster analysis (UPGMA) and correspondence analyses of two real helminth communities in sheep (one farm and with repeated sampling along time) or goats (several farms, each sampled once). The cladograms obtained using Wagner parsimony provided a clearer structuring of the helminth communities than classical analyses. The homogeneous groups of parasite communities on goat farms were significantly related (Fisher' exact test) to the environmental characteristics. The evolution along time pattern of change in the sheep infection of sheep was not the same for in all the animals, and two groups of communities could be distinguished in the last lamb cohorts. Phylogenetic analyses provide an effective performing tool to for interpreting the change in evolution of helminth communities with environmental conditions.

Animals↗
PubMedDate not supplied

Barriers to immunization in a relatively affluent community.

BACKGROUND: Although Healthy People 2000 calls for the complete immunization of at least 90% of children by age 20 months, few communities can claim such success. We wanted to determine the parent-reported barriers associated with underimmunization of infants in a relatively affluent midwestern population. METHODS: We undertook a case-control study of a population-based sample of parents and guardians of children who were either fully immunized or underimmunized at 20 months of age in Olmsted County, Minn. RESULTS: In this study, 596 of 1,216 parents (46%) of both immunized and underimmunized children participated. Of these participants, 281 (47%) reported barriers to immunizations, but only 15 (3%) reported major barriers. Whereas the most commonly reported barriers were barriers of inconvenience (waiting too long, inconvenient office hours), only delays caused by a sick child, fear of reactions, trouble remembering an appointment, not knowing when the next shot was due, and transportation problems were significantly associated with underimmunization when controlling for demographic factors. Fear of reactions, sick child delays, and not knowing when the next shot was due had the highest attributable risk for underimmunization. Taken together, parent-reported barriers and demographic factors explained less than 30% of the underimmunization status of children. Parents' most common recommendations for improving immunization status were the use of a recall or reminder system and a single unified schedule for immunizations. CONCLUSIONS: In this relatively affluent community, barriers to immunization were commonly reported but few (fear of reactions, sick child delays, and not knowing when the next shot was due) were associated with underimmunization. The types of barriers reported were similar to those reported in other communities, but unlike many populations studied, cost was not reported as an important barrier.

Case-Control Studies↗
PubMed1999

Change in cognitive function in older persons from a community population: relation to age and Alzheimer disease.

OBJECTIVE: To examine change in cognitive function in older persons sampled from a community population, and its relation to age and Alzheimer disease. DESIGN: Prospective cohort study with an average of 3.5 years of follow-up. SETTING: East Boston, Mass--a geographically defined, urban, working-class community. PARTICIPANTS: A stratified, random sample of persons 65 years and older underwent uniform, structured clinical evaluation for Alzheimer disease. The 388 persons (89.2% of those eligible) who completed at least 1 annual follow-up evaluation were studied: 97 had Alzheimer disease at baseline; 95 developed Alzheimer disease during the study; and 196 were unaffected. OUTCOME MEASURES: Eight cognitive performance tests were administered, then converted to population-weighted z scores and averaged to create a composite summary measure of cognitive function. Initial level of and change in this score were the outcome measures. RESULTS: In the population as a whole, many persons experienced a decline in cognitive performance, and age was related to both initial level and rate of decline. Analyses were conducted in 3 subgroups: persons with Alzheimer disease at baseline, those who developed Alzheimer disease during the study, and those who remained unaffected. In both Alzheimer disease subgroups, substantial cognitive decline was observed, but neither initial level nor rate of decline was related to age. In unaffected persons, little cognitive decline was evident, and there was a small, inverse association of age with initial level of cognitive function. CONCLUSION: In a general population sample, there was little evidence of cognitive decline during a 3.5-year period among persons who remained free of Alzheimer disease.

Aged↗
PubMed2002

Frequency of negative coronary arteriographic findings in patients with chest pain is related to community practice patterns.

OBJECTIVE: To determine factors contributing to the relatively high frequency and variability (10% to 30%) of finding no significant coronary disease by coronary angiography in patients with chest pain. STUDY DESIGN: Retrospective, comparative analysis of practice patterns at 3 southeastern Michigan hospitals and a composite sample from New York State. PATIENTS AND METHODS: Medical records for 7668 patients were reviewed to determine the frequency of negative coronary arteriographic findings in patients undergoing chest pain evaluation. A private practice allopathic community hospital with interventional cardiologists and a private practice osteopathic community hospital with diagnostic facilities (DiagCommunity) were compared with a university hospital with full-time salaried interventional cardiologists and a sample of 17 New York hospitals. RESULTS: Of the 7668 coronary angiograms at all centers, 39.7% were performed to assess patients with stable chest pain. There was no significant obstruction found in 16.5%, and the frequency was not different between the Michigan (17.8%+/-3.8%) and New York (14.2%) hospitals. The DiagCommunity had the highest proportion (22%; P < .001 vs others). On review of the negative coronary arteriographic findings, normal or near normal coronary arteriographic findings were infrequent (range, 2.4%-6.6%) but higher in the DiagCommunity (6.6% vs 2.9%+/-1.6%; P < .0001). CONCLUSIONS: The frequency of finding no significant coronary disease by arteriography in patients with chest pain is similar in southeastern Michigan hospitals and comparable to an established external database. Cardiology self-referral and personal gain does not seem to be a major factor in selection of patients for invasive studies.

Chest Pain↗
PubMed2002

[Structural analysis of users' needs from a community pharmacy related to home care in a suburban area].

OBJECTIVES: To clarify the needs of home care service users needs from a community pharmacy and the functions related to home care in a suburban area. METHODS: A questionnaire on pharmacy services and functions was submitted to 472 home care service users in a suburban area. Gender, age, family status, presence of carers, health condition, home care services being used, prescription and pharmacy utilization status, presence of family pharmacy, and recognition of the need for drug management guidance by home visiting pharmacists were surveyed as well as the users' needs from a community pharmacy and its functions. Using these results, principal component analysis was performed. RESULTS: It was found that the users had a great need for the following services and functions: adequate medication instruction, listening attentively to users, and a good attitude from pharmacists and clerks. Meanwhile, the users' need for home care related services was relatively low, i.e. counseling about home care and welfare services, provision of a home visiting service, and provision of home care supplies. Also, principal component analysis indicated that users' needs consisted of five components, viz, medical services, material supply, convenience, readiness of service provision, and consideration of privacy. Regarding home care related services, counseling about home care and welfare services was related to the medical services; provision of home care supplies was related to the material supply; provision of a home visiting service was related to convenience. CONCLUSIONS: It was shown that users did not clearly recognize a service need for home care services as a new function of community pharmacies. Rather, users recognized the need for home care services connected to these already provided by community pharmacies. Therefore, information provision and education are necessary so that users can clearly understand the details and merits of the home care services which community pharmacies provide.

Aged↗
PubMedDate not supplied

Annual report awards issue. Six hospitals capture annual report competition honors.

The best of the annual reports entered in this year's annual Healthcare Annual Report Contest are included in this issue on pages four through 32. Every entry in this year's competition had something to commend. They were reflective of the talent that assembled them. The editors and panel judges thank you for submitting your entries. The winners are New York Methodist Hospital, Brooklyn, first overall; Children's Hospital of Orange County, Calif., second overall; Woman's Hospital, Baton Rouge, La., first community health; Hackensack University Medical Center, Hackensack, N.J., first year in review; Chesapeake General Hospital, Chesapeake, Va., first community relations; and Osteopathic Health System of Texas, second community relations. The editors thank all the entrants for participating. Remember, the deadline for 1999 entries is July 1, 2000.

Annual Reports as Topic↗
PubMed1981

The short-term outcome of neurotic disorders in the community: the relation of remission to clinical factors and to "neutralizing' life events.

A longitudinal study of neurotic disorder in the community showed that half the cases identified at first interview had remitted one month later. Remission was significantly related to four variables: recency of onset and of peak of the disorders, the occurrence of recent threatening life events and the occurrence of subsequent "neutralizing' life events. A neutralizing event was defined a priori as one which neutralized the impact of an earlier threatening life event or difficulty. One third of all remissions were caused by such an event. Remission of disorder was not significantly related to demographic variables, symptom severity, syndrome type, medical consultation or psychotropic drug prescription. The implications for neurotic disorder in the community are discussed, in particular its relation to life events and the favourable outcome in the absence of treatment.

Adolescent↗
PubMed2004

Communities and hospitals: social capital, community accountability, and service provision in U.S. community hospitals.

OBJECTIVES: The study related community social capital to the level of community accountability and provision of community-oriented services in U.S. community hospitals. STUDY SETTING: The sample included 1,383 community hospitals that participated in the 1997 American Hospital Association's (AHA) Hospital Annual and Governance Surveys. DATA SOURCES: (1) The 1997 AHA Annual Hospital Survey, (2) the 1997 AHA Hospital Governance Survey, (3) the DDB Needham Market Facts Survey, (4) the 1996 County Election Data File, and (5) the 1998 Area Resource File. RESEARCH DESIGN: The study used a mix of longitudinal and cross-sectional data. KEY FINDINGS: We identified two distinct indicators of social capital-community participation and voting participation. Community accountability in hospitals was unrelated to either indicator. Hospitals' provision of community-oriented health services was negatively associated with community participation but unrelated with voting participation. The interaction between voting participation and community representation on hospital governance was positively associated with community accountability and provision of community-oriented health services. CONCLUSION: Neither community participation nor voting participation was sufficient to influence hospital behavior. The positive finding associated with the interaction between voting participation and community representation on hospital governance underscored the importance of an active political culture in influencing hospital behavior, without which the installation of community representatives on hospital governance might be more symbolic than actually serving the health concerns of community residents.

Catchment Area, Health↗
PubMed1992

Community activism relating to a cluster of breast cancer.

In 1985, residents of a suburban community in South Florida became concerned when several young women were diagnosed with breast cancer. First as individuals, then through a community-based effort, they attempted to gain attention and action on what they believed to be a cluster of breast cancer. Through their efforts to find out whether some agent or toxic exposure existed in the community that might have caused breast cancer, the women formed a community-based organization. This paper describes the activism of the women to resolve the issue through an epidemiologic study of the breast cancer occurrence in their community. Furthermore, it substantiates the need and role of rational community response in resolving community threats and concerns.

Adult↗
PubMed1976

The structure of heroin communities (in relation to methadone maintenance).

The sociocultural structure of contemporary urban heroin-using communities is delineated using the dimensions "being hooked," "scoring," and "hustling" on "the street." A concentric ring model is constructed with four rings: (innermost) the street dealing network, other criminal hustles, employed addicts, and a peripheral "recruitment" area (outermost). The model is used to define differential intentions toward and responses to methadone maintenance treatment among members of the heroin community.

California↗