Prevalence of antibody to hepatitis A and polioviruses in an unimmunized urban population.

A large group of sera collected in 1954-1955 from people living in the metropolitan area of Melbourne, Australia, was tested for neutralizing antibody to polioviruses 1,2 and 3 and for antibody to hepatitis A virus by solid phase radioimmunoassay. The age-specific prevalence of antibody to each virus was remarkable similar, being highest in the elderly and in persons of low socioeconomic status. Antibody to each virus was acquired early in life, with more than half the population showing evidence of infection by the age of 15 years.     

Transitions between community and nursing home residence in an urban elderly population

Over the course of a three year observation and study period, some 6% of a representative community residing urban elderly population were admitted to nursing homes. Nearly half of this group were still living in nursing homes at the end of this observation period. One third had died after entering the nursing home, and the remaining people had returned to their own homes in the community. These three groups had significantly different mean lengths of stay in nursing homes; nearly two years for those whose stays were more permanent, 50 days for those whose stays were short-term, and 153 days on average for those who died following admission.At baseline, the three groups also tended to have different patterns of health, functional and social characteristics. The short term stayers and those who died following admission to a nursing home differed from respondents who did not enter nursing homes—primarily in terms of prior living arrangements and levels of social support. The permanent stayers differed from the two other nursing home sub-groups, and from community residents, in that they tended to be older and more functionally and mentally impaired. However, at baseline they appeared at less risk to expire than those people who later died following admission to nursing homes.Clinical and research implications based on these findings are discussed.Howard R. Kelman, Ph.D. is Director, and Cynthia Thomas, Ph.D. is Senior Research Associate, Division of Health Services Organization and Policy, Department of Epidemiology and Social Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York 10467This work was supported by grants PO1 AGO3424 and RO1 AGO8125 from the National Institute on Aging     

Prevalence of mammography use in a nursing home population

A cross-sectional study was performed to estimate the utilization of screening mammography in a nursing home population. Included in the study were 139 women over 50 years of age who had been residing in a skilled nursing home in Connecticut for at least 1 year. Charts were reviewed to estimate screening mammography and chest x-ray examination use. Functional status of each subject was assessed by supervisory nurses using set criteria. One of the 139 subjects had received a mammogram, whereas 129 subjects (93%) had received chest x-ray examinations. Average length of stay in the nursing home was 6.5 years. No association was noted between functional status and use of mammography. It was concluded that in this clinical setting mammography appears to be underutilized as a screening test for breast cancer. The comparative data on chest x-ray examination use suggest strategies that may be useful in increasing compliance with current screening recommendations for mammography in the institutional setting.     

Prevalence of workplace exacerbation of asthma symptoms in an urban working population of asthmatics

OBJECTIVES: We used an interviewer-administered questionnaire to investigate workplace exacerbation of asthma symptoms (WEAS) among low-income, minority, working asthmatics admitted Bellevue Hospital Center in New York City from 2001 to 2002. We hypothesized that a high prevalence of WEAS would be found in this population among all jobs held and a subset of individual occupational classifications. MEASUREMENTS AND MAIN RESULTS: Of 301 subjects, 51% reported WEAS in their current or most recent job; 71% reported WEAS in any job. Prevalences (95% confidence intervals) of WEAS in common job classifications were 61% (49-73%) in janitorial jobs, 50% (33-67%) in garment and textile manufacturing jobs, and 38% (23-55%) in construction jobs. CONCLUSION: WEAS is prevalent in this urban minority population.     

Hypertension followup in an urban black population.

In a 5-year period, 215 black hypertensives were identified at a neighborhood primary care center that offered free services to residents of a low-income housing project. The mean length of followup for the group was about 34 months, and 183 persons were followed for more than 1 year. Their mean age was 56 years; there were 34 men and 181 women in the group. Fifty-six percent of the 215 persons had a history of hypertension when they came to the center. Three types of outcome measures were examined in this study: (a) compliance, in terms of continued activity in the clinic; (b) lower blood pressure, preferably in the normal range; and (c) development of complications of hypertension. Sixty-seven percent of those alive and still residing in the area were continuing in the program; 37% achieved normotension and an added 21% had improved blood pressure readings. There was no statistical difference in the occurrence of hypertensive complications by initial severity of the hypertension or by how well the blood pressure was controlled. The 75 obese women in the group had more severe hypertension, more new complications, and were less likely to achieve normotension than the 106 nonobese women. These relationships were statistically significant.     

Definition and prevalence of sedentarism in an urban population.

OBJECTIVES: The present study sought to formulate a precise definition of sedentarism and to identify activities performed by active people that could serve as effective preventive goals. METHODS: A population-based sample of 919 residents of Geneva, Switzerland, aged 35 to 74 years, completed a 24-hour recall. Sedentary people were defined as those expending less than 10% of their daily energy in the performance of moderate- and high-intensity activities (at least 4 times the basal metabolism rate). RESULTS: The rates of sedentarism were 79.5% in men and 87.2% in women. Among sedentary and active men, average daily energy expenditures were 2600 kcal (95% confidence interval [CI] = 2552, 2648) and 3226 kcal (95% CI = 3110, 3346), respectively; the corresponding averages for women were 2092 kcal (95% CI = 2064, 2120) and 2356 kcal (95% CI = 2274, 2440). The main moderate- and high-intensity activities among active people were sports (tennis, gymnastics, skiing), walking, climbing stairs, gardening, and (for men only) occupational activities. CONCLUSIONS: The definition of sedentarism outlined in this article can be reproduced in other populations, allows comparisons across studies, and provides preventive guidelines in that the activities most frequently performed by active people are the ones most likely to be adopted by their sedentary peers.     

The paucity of breast-feeding in an urban clinic population.

The lack of breast-feeding among mother-infant dyads utilizing public sector clinics in Los Angeles is presented in this brief study. Whereas the middle and educated classes have begun a resurgence of breast-feeding, this renaissance is missing among the poor. Awareness, health education (by peer advocates), early intervention and reassurance by all levels of health providers is suggested to prevent the dissolution of the lactation bond among the population least apt to breast-feed.     

Seroimmunity to polioviruses in an urban population of Italy.

In a seroepidemiological survey on immunity to polioviruses, carried out in Rome, neutralizing antibodies were titrated on 602 serum samples collected from individuals aged from 6 months to 88 years. The geometric mean titres were 25.24, 25.92, and 18.12 for poliovirus types 1, 2, and 3, respectively. The number of seronegative results for each virus strain was very low (≤1.5%). The immune status of the study population could therefore be considered satisfactory. The distribution of antibody reactivity in different age groups was similar for poliovirus types 1 and 3, while for type 2 a significant difference in titres was found between adults and children.     

Injury prevention awareness in an urban Native American population.

The injury-related mortality rate for Native American children between the ages of 1 and 4 years is nearly three times that of the same age group in the general population. To assess injury prevention awareness in urban Native American families, we administered 39 age-appropriate questions from the Framingham Safety Survey to 50 Native American families and 100 other families and developed an answer scoring system to analyze and compare survey responses. Survey responses revealed that Native American families are less likely to keep small objects, household products, and medicines out of the reach of their children and to possess and understand the use of ipecac. Although urban Native-American families appear to be less aware of ingestion prevention practices than other urban families, these and other deficiencies in injury prevention awareness are more likely the result of factors related to their low-income status than to culturally based practices.     

无锡市城区社区自然人群糖尿病及其患病风险现况

目的了解无锡市城市社区自然人群糖尿病及其患病风险现状。方法采用多阶段整群随机抽样法抽取无锡市城区社区20岁以上居民13 575人进行现况调查。结果无锡市城区社区20岁以上自然人群糖尿病和空腹血糖受损现患率分别为6.27%和1.77%;年龄、糖尿病家族史、超重或肥胖、高血压、血脂异常为该地区糖尿病的危险因素;超重或肥胖、高血压、血脂异常的暴露率在男性中分别为38.89%,40.54%和48.27%,女性中分别为33.43%,31.62%和42.72%;人群中至少具有上述一项危险因素的个体占86.71%,具有高度、中度糖尿病综合患病风险的个体在人群中占25.22%。结论无锡市城市社区人群糖尿病及其患病风险处于较高水平,需大力加强糖尿病与其他慢性非传染性疾病的预防和控制。     

Hypertension and salt intake in an urban population

OBJECTIVE: To evaluate the salt intake and urinary Na+/K+ ratio in a randomized sample from an ethnically mixed urban population. METHODS: A randomized residential sample of 2,268 individuals aged 25-64 in Vit ria, ES, was selected, of whom 1,663 (73.3%) reported to the hospital for standardized tests. Salt, Na+ and K+ intake was estimated from 12-hour urine excretion (7 p.m. to 7 a.m.) and from the monthly salt consumption at home reported in the interview. Clinic arterial pressure was measured twice under standard conditions by two trained investigators, using mercury sphygmomanometry. The Student t and Tukey tests were utilized for statistical analysis. RESULTS: Urinary Na+ excretion was higher in men and individuals of lower socioeconomic level (P<0.000). No difference between ethnic groups was observed. K+ excretion was unrelated to socioeconomic level and ethnicity, but was significantly higher among men (25 18 vs. 22 18 mEq/12h; P=0.002). Positive linear correlation was observed between urinary Na+ excretion and systolic (r=0.15) and diastolic (r=0.19) arterial pressure. Hypertensive individuals showed higher urinary Na+ excretion and Na+/K+ ratio than normotensive individuals. Reported salt intake was around 50% of the intake estimated from 12-hour urine collection (around 45% of 24-hour urinary excretion). CONCLUSIONS: Salt intake is strongly influenced by socioeconomic level and may partially explain the higher prevalence of hypertension in lower socioeconomic classes.