Trends in illicit drug use in the United States: conflicting results from national surveys.

Data from several national studies lead to divergent conclusions regarding trends in illicit drug use in the United States. Two major population studies point to a downturn in drug use dating to the late 1970s. However, a study of drug-related deaths and hospital emergency room visits shows increases in these events in recent years. Studies also show drug use, especially cocaine, continuing to increase among criminals. Additionally, drugs were identified as the most important problem facing the nation in a Gallup poll conducted during the summer of 1989. This paper offers some possible explanations for the divergent trends. Most notably, we suggest that methodological differences in the studies being compared, and lags between trends in the general population and certain subgroups, account for most of the variation in the trend estimates. The paper concludes that illicit drug use is decreasing in the United States.     

Trends in alcohol consumption in Spain, Portugal, France and Italy from the 1950s until the 1980s

This paper compares trends in alcohol consumption in Spain, Portugal, France and Italy starting from the beginning of the I9SO's and extending until the 1980's and examines the modernization and internationalization of beverage preferences in these countries. The total consumption of alcohol has declined in Spain, France and Italy and the consumption of wine has shown a declining trend in all the countries studied. The traditional beverage, wine, has in Spain, Portugal and Italy been substituted by a new beverage with lower alcohol content, beer. In France the decline in wine consumption has not been substituted by the use of other alcoholic beverages. No noticeable internationalization in beverage preferences has taken place in Spain, Portugal or Italy, whereas imported beverages have gained some ground in France.     

Trends in hearing impairment in United States adults: the national health interview survey, 1986-1995

BACKGROUND: United States trends in the prevalence of hearing impairment have not been reported. These trends could be rising due to changes in environmental noise exposure; alternatively, rates could be declining via a compression of morbidity hypothesis that has been postulated to be occurring in older adults residing in developed nations. METHODS: The National Health Interview Survey is a continuous multistage area probability survey of the U.S. civilian noninstitutionalized population living at addressed dwellings. Adults within randomly selected households were administered a chronic conditions list that included questions about hearing impairment. Complete data were available on 107,100 white and 17,904 African-American adults aged 18 years and older in survey years 1986-1995. Race-specific rates of hearing impairment were adjusted for age and sample survey design. RESULTS: Annual age-adjusted rates of some hearing impairment ranged from 11.0% to 12.7% in whites and 5.9% to 8.5% in African Americans. Rates of severe bilateral hearing impairment in these race groups were 0.7% to 1.1% and 0.1% to 0.5%, respectively. There was no evidence of change in rates of hearing impairment among participants stratified by race and 10-year age groups. CONCLUSIONS: Reported rates of hearing impairment remained relatively stable in the U.S. noninstitutionalized population from 1986 to 1995. There was no evidence of change in rates in adults grouped into 10-year age groups. Population-based studies designed to include clinical and self-reported measures of hearing impairment are needed to further examine trends in hearing impairment.     

Sodium consumption among hypertensive adults advised to reduce their intake: national health and nutrition examination survey, 1999-2004

J Clin Hypertens (Greenwich). 2012; 14:447–454. ©2012 Wiley Periodicals, Inc. The authors estimated the prevalence of taking action to reduce intake related to actual sodium consumption among 2970 nonpregnant US adults 18 years and older with self‐reported hypertension by using data from the National Health and Nutrition Examination Survey 1999–2004. Adjusted multiple linear regression assessed differences in mean sodium intake by action status. A total of 60.5% of hypertensive adults received advice to reduce sodium intake. Of this group, 83.7% took action to reduce sodium. Action to reduce sodium intake differed significantly by age, race/ethnicity, and use of an antihypertensive. The mean (±standard error) sodium intake among hypertensive adults was 3341±37 mg and differed by sex, age, race/ethnicity, education, and body mass index (P<.05), with the lowest intake among adults aged 65 years and older (2780±48 mg). Mean intake did not differ significantly by action status either overall or by subgroup except for one age category: among patients 65 years and older, mean intake was significantly lower among those who took action (2715±63 mg) than among those who did not (3401±206 mg; P=.0124). Regardless of action, mean intake was well above 1999–2004 recommendations for daily sodium intake and about twice as high as the current recommendation for hypertensive adults (1500 mg).     

Changes in respiratory and allergic symptoms in schoolchildren from 1996 to 2002, results from the ISAAC surveys in Antwerp (Belgium)

Two cross sectional surveys (1995/1996 and 2001/2002) were carried out according to the ISAAC protocol among 6-7 and 13-14 year old schoolchildren in Antwerp, Belgium. A total of 8244 children participated in 1996 and 8159 children in 2002. No significant differences in current prevalence of asthma and asthma medication was found in 6-7 year olds and 13-14 year old girls. Significantly less asthma and asthma medication was reported by 13-14 year old boys in 2002. Symptoms of wheeze had lower occurrence in all groups in 2002, which was significant for older age group. Current prevalence of rash was significantly higher in the 6-7 year olds in 2002. No such increase was found for rash in the older age groups but they reported significantly more rhinitis. No differences were found between urban and suburban Antwerp in either survey. No clear changes in the occurrence of asthma were found for school children in Antwerp while wheeze was reported less in 2002 compared to 1996. Allergic disorders had higher occurrences in schoolchildren in 2002.     

克拉玛依市区1995～1998年肺结核登记病例分析

目的　评价世界银行贷款结核病控制项目成效。方法 根据克拉玛依市区1995～1998年结核病登记报表分析结核病人登记及治疗效果。结果 克拉玛依市区1995～1998年新登记病人中涂阳病人百分比呈下降趋势。外来人口病例逐年上升,少数民族发病人逐年增加,1998年已占总登记病人数的63.5%。结论 克拉玛依市区实施世行贷款结核病控制项目效果显著。     

Defining 'current drinkers' in national surveys: results of the 2000 National Alcohol Survey

Aims The purpose of this study is to determine which respondents of national surveys who report low ‘usual’ past year drinking frequency, are unsure of their drinking frequency or refuse to answer, are misclassified either as ‘current drinkers’ or as ‘ex‐drinkers.’ Design and setting The data are from the 2000 National Alcohol Survey, a national household telephone probability sample of adults in all 50 US States and Washington, DC (n = 7612). Participants A subsample of 1734 respondents who reported drinking ‘less than once a month but at least once a year’, ‘less than once a year’, ‘refused’ and ‘don’t knows’ were also asked if they had consumed a whole drink of any alcoholic beverage in the 12 months using dates to anchor the question. Measurements Five alcohol measures were used to compare groups who changed or did not change their drinking status based on the followup question: volume, mean number of days 5 +, social consequences, dependence symptoms and DSM‐IV. Findings The results indicate that only 4.6% of respondents (n = 349) changed their drinking status, and the percentages were equal in both directions. Women were more likely to change their drinking status and specifically become ex‐drinkers based on the follow‐up question. Respondents who became current drinkers drank significantly at a lower average volume than those who remained current drinkers. The prevalence rates based on the five alcohol measures were not affected by how ‘current drinker’ is defined. Conclusions Adding the follow‐up question is recommended for new alcohol surveys so that fewer respondents are misclassified.     

Trends in the prevalence of infection with mycobacterium tuberculosis in Korea from 1965 to 1995: an analysis of seven surveys by mixture models.

SETTING: Korea. OBJECTIVE: Estimation of the prevalence of tuberculous infection from tuberculin skin test surveys can be difficult if cross-reactions resulting from infection with environmental mycobacteria outweigh reactions resulting from tuberculous infection. Mixture analysis was thus chosen as a novel approach for estimating the prevalence of tuberculous infection in Korea. DESIGN: Seven tuberculin skin test surveys conducted between 1965 and 1995 were analyzed by mixture models, a statistical methodology used either to estimate a prevalence or to classify individuals into predefined homogeneous sub-populations. A Bayesian approach including prior information on component distributions was taken. The final model was selected based on the fit to observed values, and the analysis was therefore stratified by sex and year of survey and included age as a covariate. RESULTS: The results showed a large decrease in tuberculous infection in the population below 30 years of age: among 10- to 14-year-old boys (girls), infection prevalence decreased from 74.5% (67.9%) in 1965 to 16.5% (16.9%) in 1995. Additionally, the mean induration for individuals with tuberculous infection decreased by 2mm between 1965 and 1995, indicating a changing sensitivity of tuberculin over time. CONCLUSIONS: Mixture analysis is a promising approach for determining the prevalence of tuberculous infection in the presence of substantial interference from infection with environmental mycobacteria and changing tuberculin reaction sizes over time.     

Improved hypertension management and control: results from the health survey for England 1998

A survey in 1994 showed that among the 20% of the adult English population who were identified as hypertensive, approximately 30% had their blood pressures controlled to <160 mm Hg systolic and <95 mm Hg diastolic. The 1998 Health Survey for England data update the 1994 findings in light of new thresholds and targets for treatment outlined in recent national and international guidelines. This cross-sectional survey is analyzed to describe the prevalence, awareness, treatment, and control of hypertension in a random, nationally representative sample of 11 529 English adults (>/=16 years) living in noninstitutional households in 1998 and to compare these rates with those from 1994. In 1998, 20% and 37% of adults were hypertensive according to the old (systolic >/=160 mm Hg or diastolic >/=95 mm Hg) and new (systolic >/=140 mm Hg or diastolic >/=90 mm Hg) definitions, respectively. Corresponding values in 1994 were 20% and 38%. Treatment and control rates among hypertensive adults (new definition) improved from 26% to 32% and from 6% to 9%, respectively, although 60% of those on treatment received only 1 antihypertensive drug in both years. Among persons with controlled hypertension, 59% reported having received nonpharmacological advice from their physicians in 1998 compared with 30% in 1994. Rates of hypertension treatment and control have increased significantly (P=0.05 and P<0.01, respectively) since 1994 but remain low by international standards. The 1998 data suggest that improved detection, greater use of nonpharmacological measures, and increased use of >1 antihypertensive agent per patient would produce greater success in achieving target levels. This could lead to major reductions in fatal and nonfatal cardiovascular events.     

Patterns and determinants of alcohol consumption in people aged 75 years and older: results from the MRC trial of assessment and management of older people in the community

BACKGROUND: Very little work on alcohol consumption patterns in older people has been undertaken. As a result, knowledge about the prevalence and characteristics of regular drinkers and heavy drinkers in this age group remains limited. OBJECTIVE: To determine the socio-economic and health characteristics associated with different levels of alcohol intake in older people. DESIGN: Detailed screening of patients in one arm of a cluster randomised trial. SETTING: 53 UK general practices drawn from the Medical Research Council General Practice Research Framework. SUBJECTS: All patients aged 75 and over on the GP lists (excluding those in nursing homes or other long stay care) were invited to participate in the study. Of the 15358 people who received a detailed assessment in the 'universal' arm, 14962 (97%) of these answered questions on alcohol consumption. Of these, 62% were female and the median age was 80.3 years. METHODS: Associations between reported alcohol intake and various socio-economic and health variables were investigated, first in univariate analyses and then controlling for other variables in logistic regression models. RESULTS: 5% of men and 2.5% of women exceeded the Royal College of Physicians, Psychiatrists and General Practitioners' recommended drinking limits of 21 and 14 units a week respectively; 17% of subjects had never had a drink. Women and the very elderly were less likely to be drinkers. Those that drank were more likely to be people who still had a fairly active and sociable lifestyle, and with a better self-perceived health status compared with non-drinkers. Moderate drinkers were also less likely to be severely cognitively impaired compared with non-drinkers: adjusted odds ratio 0.69 (95% CI 0.57, 0.85); but more likely to report symptoms of anxiety: 1.31 (1.07, 1.61). CONCLUSIONS: Our results suggest that moderate alcohol consumption is associated with relative financial security and good health with the exception of higher levels of anxiety amongst drinkers.     

Leprosy situation in the southeastern region of Madagascar from 1996 to 1998

Leprosy is endemic in Madagascar. The authors report the results of an epidemiologic study performed between 1996 and 1998 in Farafanguna, localized in the South-Eastern of the country. During this period, 217 new cases have been diagnosed. Of the 130 cases included in the study, 69.23% were children aged lower than 15 years and 76.91% suffered from a multibacillary form. More than 50% of the cases belonged to a large family (6 persons or more) and at least one family case was found in more than 60% of cases. These results enhance the severity of the disease in the country and show the presence of multiple risk factors (promiscuity, family cases and multibacillary forms).     

Religion, health, and psychological well-being in older adults: findings from three national surveys.

This study examines the impact of religious involvement on health status and psychological well-being using data on older adults from three national probability surveys: the Myth and Reality of Aging (N = 2,797), the Quality of American Life (N = 1,209), and Americans' Changing Lives (N = 1,669) studies. Constructs are measured by single items and indices that vary across data sets. A proposed theoretical model specifies direct effects of religiosity on health and well-being and indirect effects on well-being through health. Analyses consist of structural-equation modeling of confirmed measurement models using weighted least squares estimation in LISREL 8.03. The model is analyzed first as specified and is then rerun controlling for the effects of six exogenous constructs: age, gender, race, marital status, education, and geographical region. Findings reveal excellent overall fit in all three samples and the presence of statistically significant religious effects, notably positive net effects of organizational religiosity, in all three samples. These results build on those of prior studies based mostly on samples limited regionally or methodologically or to particular racial or ethnic groups. This study also underscores the value of replicated secondary data analysis as a strategy for gerontologists seeking to confirm or examine a given structural model. Finally, an agenda is proposed for future research in this area.     

Comprehensive health status assessment of centenarians: results from the 1999 large health survey of veteran enrollees

BACKGROUND: Information on the health status of centenarians provides a means for understanding the health care needs of this growing population. Therefore, we examined the health status of a national cohort of centenarian veteran enrollees. METHODS: Ninety-three centenarian veteran enrollees returned a complete health history questionnaire, which included questions about sociodemographic information, age-associated conditions, health behaviors, health-related quality of life as measured by the Veterans SF-36, and change in health status. RESULTS: Centenarian veteran enrollees are a group with major impairment across multiple dimensions of health-related quality of life despite having a relatively low prevalence of diseases. They had considerable physical limitations as reflected by their physical health summary scores (26.2 +/- 8.3). However, their mental health was comparatively good (mental health summary score 44.1 +/- 12.5). Compared to younger elderly veterans (ages 85-99), centenarians had a lower prevalence of hypertension, angina or myocardial infarction, diabetes, and chronic low back pain (p <.05). Centenarians had significantly worse physical functioning, role physical, vitality, and social functioning scores than did younger elderly veterans. The two groups did not differ in their general health, bodily pain, role emotional, and mental health scores. Centenarians did not perceive much decline in their physical or mental health during the preceding year. CONCLUSIONS: Centenarian veteran enrollees are a group with a low number of age-associated diseases and good mental health despite substantial physical limitations. These results support future studies of services directed toward improvement of function as opposed to those focused solely on the treatment of diseases.