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PubMed1992

Occurrence of Staphylococcus intermedius on the hair and skin of normal dogs.

Aerobic bacterial populations were studied on the distal hair coat and at the skin surface of the shoulder, rump and abdomen of 10 healthy dogs. Coagulase negative staphylococci (CNS) were more frequently isolated from the hair than the skin at the shoulder and rump. There was no difference in the isolation rate of coagulase positive staphylococci (CPS) (Staphylococcus intermedius) between the hair and skin. Total skin counts were greatest on the abdomen whereas CNS counts from the hair were least at this site. There were no differences between CPS counts at the three sites on either hair or skin. The populations on the relatively unfavourable microenvironment of the distal hair may represent contamination rather than colonisation. The low populations of CPS at the skin surface also indicate contamination or transient colonisation rather than true resident status.

Abdomen↗
PubMed2006

The impact of community risks and resources on adolescent risky behavior and health care expenditures.

PURPOSE: To examine a nested model that predicts adolescent risky behavior, health care use, and health care expenditures from individual characteristics, such as age and gender, and community characteristics such as social capital and community-level risky behavior rates. METHODS: Claims and encounter data were used to classify adolescents enrolled in Florida's Healthy Kids Program into two groups: those who engaged in risky behavior (ARB) and those who did not (NRB). Hierarchical linear modeling techniques were used to predict the odds of risky behavior, the odds of health care use, and health care expenditures based on individual and community characteristics. RESULTS: ARB consumed significantly more health care services than NRB, and their higher use and charges were attributable not only to individual level factors (i.e., age, gender, presence of special health care need, metropolitan residence status), but also to community level factors (i.e., social capital, risky behavior rates, violence, and ethnic/racial composition) as well. In particular, community investment in social capital predicted lower levels of risky behavior as well as lower health care expenditures. CONCLUSIONS: This information is important in terms of policy efforts at providing health care for this vulnerable group of individuals, as well as in developing prevention and intervention programs that can be delivered through the health care system and via links to community supports.

Adolescent↗
PubMed1999

Vaccine injury compensation programs worldwide.

Approximately a dozen countries provide some form of compensation for injuries (or deaths) following vaccination. More than anything else, they were instituted in the belief governments have a special responsibility to those injured by properly manufactured and administered vaccines used in public health programs. Administratively, most are managed through the national government, including decisions on eligibility for and amount of compensation. Eligibility may depend on the recipient's age, citizenship or residency status, category of vaccine (e.g., recommended, compulsory), the location it is administered (public vs private ambulatory setting), or satisfying certain time frames for filing a claim. Since few vaccine-related injuries have a clinical or laboratory marker, proving actual causation is difficult. Causation decisions are usually based on the balance of probabilities standard of more likely than not. All countries require that the effects be long lasting (e.g., greater than 6 months), and nearly all provide coverage for medical costs, disability pensions, and death benefits, while noneconomic damages (pain and suffering) are included much less frequently. Funding is generally from the national treasury, with some programs receiving support from lower governmental entities or vaccine manufacturers. After nearly 4 decades of operation, vaccine injury compensation program appears to be an increasingly accepted component of immunization programs today. While we have a much better understanding of their statutory purpose, frame work, process and outcome, there is much more to be learned. Future research should focus on vaccine compensation programs and (1) decision-making at the administrative level; (2) the utilization of outcome indicators in order to gauge effectiveness, including immunization acceptance; (3) the knowledge and attitudes of the public and medical community in host countries; and (4) the overall perspective of vaccine manufacturers. Insight into these and other areas will no doubt aid other countries as they consider implementing programs of their own.

Humans↗
PubMed2002

Prevalence and correlates of erectile dysfunction in a population-based study in Belgium.

OBJECTIVES: This study aims to estimate the prevalence of erectile dysfunction (ED) in the male population of Belgium, and to study its correlation with education, the international prostate symptom scale (IPSS), sexual activity, depression, body mass index, alcohol, smoking, easiness to discuss ED with a doctor, current health index, physical activity, hypertension, diabetes, cardiovascular disease, professional status, residence and whether or not the respondent lives alone. METHODS: An age-stratified random sample of the male population aged 40-70 years of Ghent and Charleroi was interviewed in the home by a trained, experienced male nurse, using a structured interview that included the international index of erectile function (IIEF) and the IPSS. ED was classified by the subjects' self-reported confidence to achieve and maintain an erection. RESULTS: In total, 799 men were interviewed, with a participation rate of 38.0%. The overall age-adjusted prevalence of ED was 10.1% severe, 24.7% moderate, 26.6% mild, and 38.7% reported no ED. Age and the absence of sexual activity over the last 4 weeks were the strongest correlates of ED. Other strong correlates were four or more health complaints, depression, a high score for the IPSS and absence of physical activity. DISCUSSION: The prevalence of ED in Belgium is comparable with the results of other population-based studies for severe and moderate ED. Sexual inactivity over the last four weeks is a strong correlate of ED, and should make the clinician think of a possible problem of ED.

Adult↗
PubMed2003

Perception of risk of HIV/AIDS and sexual behaviour in Kenya.

The association between perception of risk of HIV infection and sexual behaviour remains poorly understood, although perception of risk is considered to be the first stage towards behavioural change from risk-taking to safer behaviour. Using data from the 1998 Kenya Demographic and Health Survey, logistic regression models were fitted to examine the direction and the strength of the association between perceived risk of HIV/AIDS and risky sexual behaviour in the last 12 months before the survey. The findings indicate a strong positive association between perceived risk of HIV/AIDS and risky sexual behaviour for both women and men. Controlling for sociodemographic, sexual exposure and knowledge factors such as age, marital status, education, work status, residence, ethnicity, source of AIDS information, specific knowledge of AIDS, and condom use to avoid AIDS did not change the direction of the association, but altered its strength slightly. Young and unmarried women and men were more likely than older and married ones to report risky sexual behaviour. Ethnicity was significantly associated with risky sexual behaviour, suggesting a need to identify the contextual and social factors that influence behaviour among Kenyan people.

Acquired Immunodeficiency Syndrome↗
PubMed2000

The human immunodeficiency virus-infected traveler.

As the number of travelers from industrialized countries who are infected with human immunodeficiency virus (HIV) increases as a consequence of the clinical benefits of highly active antiretroviral therapy (HAART), updated prophylactic knowledge is needed. Vaccine prophylaxis must balance the safety and immunogenicity of vaccines with the estimated risk of acquiring the disease. Further research is needed on antimalarial chemoprophylaxis for travelers who are HAART recipients, because of possible pharmacokinetic interactions. Safe sex practices must be adopted to avoid both spreading of the infection in the host country and superinfection with different HIV strains. Most individuals infected with HIV may travel safely, even though the infectious risk has been reported to be higher for patients with advanced infections than for the general population. These patients are also less likely to produce an effective immune response to vaccines. Migrants and refugees from poor countries are also at risk of acquiring HIV infection. Their legal-residency status may often prevent their access to adequate health services, thus necessitating urgent public health actions.

AIDS-Related Opportunistic Infections↗
PubMed1997

Risk factors associated with permanent access-site infections in chronic hemodialysis patients.

OBJECTIVE: To determine the epidemiological risk factors associated with permanent access-site (PAS) infection in a population of chronic hemodialysis patients. DESIGN: Retrospective cohort analysis. SETTING: Hemodialysis unit of a 400-bed Department of Veterans' Affairs hospital. RESULTS: A cohort of 94 males (1,316 patient months) was studied. Fifty-one PAS infections in 31 patients were observed. Six patients had two PAS infections, four patients had three infections, and two patients had four infections. Twenty-nine of the 31 patients with PAS infections were bacteremic at least once. Univariate analysis identified seven factors significantly associated with PAS infection in this population: location of PAS other than forearm, type of vascular access (polytetrafluoroethylene [PTFE] versus endogenous arteriovenous [AV] fistula), limited ambulatory status, residence in a nursing home, bacterial infection at a distant site, number of access-site revisions, and number of hospitalizations. In a logistic regression analysis, only graft type and number of PTFE graft revisions were associated independently with PAS infection. The odds ratio for PAS infection in PTFE grafts compared to endogenous AV fistula was 7.8; the odds ratio for PAS infection with each PTFE graft revision was 1.5. CONCLUSIONS: PAS infections were associated independently with the type of graft and the number of PTFE graft surgical revisions.

Adult↗
PubMed2002

Behavioral change in persons with dementia: relationships with mental and physical health of caregivers.

The purpose of this study was to examine the effects that changes in behavioral and psychological symptoms of dementia of persons with Alzheimer's disease have on their caregivers' mental health and physical health. The research design was a prospective, longitudinal follow-up study conducted in a major medical center and in participants' homes. Longitudinal analysis linking change in behavior to caregiver outcomes was based on 64 cases. Care recipients were assessed at the time of diagnosis with the Mini-Mental State Examination (MMSE). To provide information on the care recipient's behaviors, caregivers participated in an interview with the Modified Neuropsychiatric Inventory at diagnosis and at follow-up. Caregivers also completed a battery of established instruments to measure stress appraisal, mental health, and perceptions of their physical health at follow-up. Results showed that increases in problem behaviors among persons living with dementia, along with residence status, were significant predictors of caregivers' mental health and also their physical health. However, these relationships were mediated through stress appraisal. Variables such as MMSE score of the person with dementia, number of years caregiving, relationship status, and education level were not significant predictors of caregivers' health when behavior change was in the model.

Adaptation, Psychological↗
PubMed2004

Effect of sodium arsenite on peripheral lymphocytes in vitro: individual susceptibility among a population exposed to arsenic through the drinking water.

Arsenic (As) contamination in ground water has affected more than 19 countries. Approximately 36 million people in the Bengal delta alone are exposed to this toxicant via drinking water (>50 microg/l) and are at potential health risk. Chronic ingestion of As via drinking water is associated with occurrence of skin lesions, cancer and other arsenic-induced diseases in West Bengal, India. An in vitro cytogenetic study was performed utilizing chromosomal aberrations (CA) in lymphocytes treated with sodium arsenite (0-5 microM) in six symptomatic (having arsenic-related skin lesions) individuals, six age- and sex-matched As-exposed asymptomatic (no arsenic-related skin lesions) individuals and six control individuals with similar socio-economic status residing in non-affected districts of West Bengal with no evidence of As exposure. The mean As content in nails and hair was 9.61 and 5.23 microg/g in symptomatic, 3.48 and 2.17 microg/g in asymptomatic and 0.42 and 0.33 microg/g in the control individuals, respectively. The main aim of our study was to determine whether genotoxic effects differed in the lymphocytes of the control (no exposure to arsenic), asymptomatic and symptomatic individuals after in vitro treatment with sodium arsenite. Although both the exposed groups had chronic exposure to As through the drinking water, individuals with skin lesions accumulated more As in their nails and hair and excreted less in urine (127.80 versus 164.15 microg/l). The results show that sodium arsenite induced a significantly higher percentage of aberrant cells in the lymphocytes of control individuals than in the lymphocytes of both the exposed groups. Within the two exposed groups As induced higher incidences of CA in the symptomatic than the asymptomatic individuals. These results suggest that asymptomatic individuals have relatively lower sensitivity and susceptibility to induction of genetic damage by As compared with the symptomatic individuals.

Adult↗
PubMed1999

The challenge of inner-city asthma.

Racial and ethnic minorities of low socioeconomic status residing in urban environments currently referred to as inner cities appear to represent a population that is disproportionately at high risk for asthma morbidity and mortality. Epidemiologic studies suggest that key risk factors contributing to asthma morbidity within the inner city include social demography, the physical environment (indoor and outdoor), and health care access and quality. This epidemiologic literature has helped to define opportunities for successful intervention strategies in these high-risk populations. Studies of the effectiveness of community-based and health system-based interventions with specific focus on inner-city populations are beginning to emerge in the literature.

Asthma↗
PubMed1986

Epilepsy in the elderly: prognosis.

251 patients were admitted with seizures after the age of 60 years to the county hospital of Frederiksberg during the period 1979-1983, 163 had not received anti-epileptic treatment prior to admission, of these 151 had been admitted with their first seizure, 88 had established epilepsy at the time of admission. Of patients not previously treated and observed for at least 12 months, 62% remained seizure-free throughout the study, while 47% with established epilepsy were seizure-free. Of those not previously treated, 72% entered remission within the first year with a slight increase during the subsequent years. The first year was crucial in determining the long-term prognosis. Compared to previous studies on the prognosis of epilepsy it seems that prognosis in the elderly is as good or even better. Measurement of S-drug-levels at the time of seizure recurrence suggests that suboptimal treatment and poor compliance are important factors, thus indicating the need for regular control and monitoring of S-drug-levels. The presence of paroxysmal activity in the EEG was significantly correlated to seizure recurrence. Thirty-three patients entered nursing homes during the study period. Deterioration in residence status was correlated to degree of dementia and to the presence of focal neurological signs but not to age or to the severity of epilepsy.

Age Factors↗
PubMed1998

Determinants of the quality of life of rural families.

Drawing from human ecology theory, the purpose of this study was to examine socioeconomic-demographic determinants of the quality of life of rural families. In the study, computer-aided telephone interviewing via random digit dialing procedures were used to collect data in the spring of 1996. The participants included 510 rural (both farm and nonfarm) respondents. Quality of life was measured by five subscales: finances; home, family, and friends; household; community; and environment. The results of the regression analyses indicated that the independent variables--gender, race, marital status, employment status, residence, age, family income, and household size, differentially affected the quality of life subscales. Among the independent variables, household size--not a commonly used determinant in quality of life studies--was the most important predictor of subjective well-being. The findings of this study lend support for the dimensional, rather than global, measurement of subjective well-being.

Adult↗
PubMed2003

Women brothel workers and occupational health risks.

STUDY OBJECTIVES: This study examined working conditions, reported morbidity, symptoms of post-traumatic stress disorder (PTSD) and depression and their relation to an index of occupational health risk among women working in brothels in Israel. DESIGN: Personal structured interviews with a scale of occupational risk that included seven self report items reflecting past and present morbidity and symptoms. PARTICIPANTS AND SETTING: A purposive sample of 55 women in three cities in Israel, between the ages of 18-38. MAIN RESULTS: Most (82%) women were trafficked into Israel to work illegally in prostitution, effectively deriving them of access to discretionary health care. A third of the sample (32%) had a high score (between 3 to 6) on the index of occupational risk factors. A high score was not related to recent physician or gynaecological visits and was more common among illegal workers than those with residence status. A set of regression analyses showed that the most significant predictors of reporting a high level of occupational risk symptoms were starting sex work at an early age, the number of hours worked in a day, a history of suicide attempts and PTSD symptoms. CONCLUSIONS: High occupational risk was found to be unrelated to recent physician or gynaecological visits, indicating that these visits were most probably controlled by the brothel owners and not by medical need as perceived by the women themselves. Furthermore, occupational risk factors were associated with some of the working and background conditions reported by women brothel workers. There is an urgent need for medical care for this high risk group.

Adolescent↗
PubMed2003

Legal, financial, and ethical ambiguities for Mexican American families: caring for children with chronic conditions.

The author reports findings from a study about experiences of 17 Mexican American families caring for children with serious chronic conditions. Legal, financial, and ethical ambiguities arose when parents' desire to provide necessary care for their children and providers' professional commitment to offer this care conflicted with United States laws, including welfare reform initiatives, requiring providers to determine eligibility before providing care to immigrants and to report undocumented care seekers to authorities. Families frequently felt intimidated because health care systems are complex, and legal residency status often varied among family members. Findings imply that official policy and education of family members should aim to assure that children with chronic conditions receive needed services without relying on providers to enforce immigration laws.

Caregivers↗
PubMed1997

Anxiety, depression and PTSD in asylum-seekers: assocations with pre-migration trauma and post-migration stressors.

BACKGROUND: Research into the mental health of refugees has burgeoned in recent times, but there is a dearth of studies focusing specifically on the factors associated with psychiatric distress in asylum-seekers who have not been accorded residency status. METHOD: Forty consecutive asylum-seekers attending a community resource centre in Sydney, Australia, were interviewed using structured instruments and questionnaires. RESULTS: Anxiety scores were associated with female gender, poverty, and conflict with immigration officials, while loneliness and boredom were linked with both anxiety and depression. Thirty subjects (79%) had experienced a traumatic event such as witnessing killings, being assaulted, or suffering torture and captivity, and 14 subjects (37%) met full criteria for PTSD. A diagnosis of PTSD was associated with greater exposure to pre-migration trauma, delays in processing refugee applications, difficulties in dealing with immigration officials, obstacles to employment, racial discrimination, and loneliness and boredom. CONCLUSIONS: Although based on correlational data derived from'a convenient' sample, our findings raise the possibility that current procedures for dealing with asylum-seekers may contribute to high levels of stress and psychiatric symptoms in those who have been previously traumatised.

Adult↗
PubMed2002

Review, deliberation, and voting: a study of selection decisions in a medical school admission committee.

BACKGROUND: Medical school admission committees differ in their decision-making procedures. Some assign ratings to groups of application materials to devise rank order acceptance lists, whereas others deliberate and vote on each separate application. PURPOSE: This study examined what the screening review and deliberative processes contribute to decision making in a medical school admission committee. METHODS: We reviewed records of admission committee members' preliminary votes on applicants after initial screening, final votes after committee deliberation, and written comments regarding issues of concern influencing their votes cast. Descriptive univariate and bivariate analyses are presented. RESULTS: Approximately one in five votes cast after initial screening was changed following committee deliberation, resulting in majority vote shifts in roughly 10% of cases containing votes by the same committee members at both time periods. Factors cited as influencing vote changes (in declining order of frequency) included Medical College Admission Test scores, medical experience, comparison with other applicants, grades, letters of evaluation, interviews, individual attributes, residency status, service experience, expressed desire of committee members to discuss the applicant at the meeting, American Medical College Application Service personal statement, and diversity. CONCLUSIONS: Admission committee members' voting behaviors appear to be influenced by the deliberative process. Future studies should explore the extent to which committee group dynamics influences decision making and the relative contribution of particular academic and nonacademic factors to vote-changing behavior.

College Admission Test↗
PubMed2000

Older women's organization of friendship support networks: an African American-white American comparison.

Research of friendship in older people's lives has recently extended to examine the impact of social structural factors. This study compared the friendship support networks of a small sample of older African and White American women for influences of ethnicity. The comparison used a matched-pair sample which controlled for age, marital status, residence type, and disability. Examination of data from the women's diagrams and descriptions of current informal support networks and friendship life histories indicates ethnic differences in four related areas of friendship network organization: size, composition, recruitment strategies, and opportunities for support exchanges. Implications for research and practice are considered.

Black or African American↗
PubMed1980

Alternate roles for the elderly: an example from a Midwestern retirement community.

Increasing numbers of individuals are surviving to retirement age in relatively good health. With the loss of the work role and other roles typically associated with middle age, they are faced with the dilemma of the "roleless role," an absence of well-articulated, age-appropriate expectations and standards of behavior by which to structure everyday life. Recent anthropological, sociological, and psychological studies indicate the possibility of the development of alternate roles and age-appropriate normative systems in age-homogeneous environments. An example of one such alternate behavioral system is provided from data collected on a small retirement community in the Midwest. A normative system seems to have developed in which personal qualities such as trust, friendliness, and concern for others are more highly valued than former achievements or occupational status. Residents most frequently cited as having made a good adjustment to aging were not necessarily those who were most active, but rather those individuals who showed a determination to "keep going," lacked self-pity, kept mentally alert and aware, were willing to help others, and showed a sense of responsibility to the community. Various roles were developed and were expected to be assumed by incoming residents: alternate "work roles," represented by committee memberships and volunteer activity; "family roles," represented by the supportive or helping relations adopted toward other residents; and leisure-type roles. These behavioral standards and expectations helped to structure the relationships and everyday life of residents within the community.

Aged↗