Hospital's redesigned Web site patient-friendly, comprehensive. Site one-of-a-kind in Twin Cities market area

North Memorial Medical Center, Robbinsdale, Minn., has opened a brightly redesigned Web site. It is patient-friendly and features a different approach to provide healthcare information called "care areas," which are organized by condition, such as heart care, cancer care and childbirth. This approach led to the the site being named North Memorial Online Care Center.     

Telephone survey assessment of household patterns of influenza vaccination, Twin Cities seven county metro area, 2008-2009

Major national surveys do not collect the influenza vaccination status of all household members, thus limiting current understanding of household influenza vaccination patterns. In an early 2009 telephone survey of 800 households in the metropolitan Minneapolis-St Paul area, household respondents reported the age, gender, and 2008-2009 seasonal influenza vaccination status of all household members. After poststratification to adjust for nonresponse, the full household influenza vaccination rate for multiperson households is 35.2%, partial household influenza vaccination rate is 39.9% and the rate of complete household nonvaccination is 24.9%. Full household influenza vaccination is more common in households with an elderly resident, intermediate in households with a child under 5 years of age, and less common in the remaining households. No household members are vaccinated in approximately 10% of multiperson households with either an elderly adult or young child; the corresponding rate in other households is 32.8%. An estimated 51.4% of households with children over 1 year of age have all children vaccinated against influenza; 43.5% of households with children had no children vaccinated against influenza. Households with younger children are more likely to have all children vaccinated and less likely to have no children vaccinated. We believe this is the first study to describe the prevalence of household influenza vaccination patterns. Continued efforts to monitor and increase household vaccination may be a valuable strategy to protect individuals and communities from influenza.     

Traffic accidents in a metropolitan area in Brazil, 1991-2000

A time series study described the trend in motor vehicle accidents from 1991 to 2000, using data from the State Transit Department in Salvador, Bahia State, Brazil. Rates were calculated for total motor vehicle accidents, number of casualties, and standardized mortality based on population and number of vehicles, comparing two periods (1991-1994 and 1995-2000), before and after the adoption of safety measures including compulsory seat belt use and the new National Transit Code (NTC). Vehicle accident and casualty rates were high and showed little variation during the study period. The mortality rate decreased from 25.7/100,000 inhabitants in 1995 to 18.1/100,000 in 1998 and remained stable thereafter. The only significant difference (p < 0.001) was in the mean motor vehicle accident mortality rate before and after the intervention. The case fatality rate decreased from 10.7% (1995) to 7% (2000). Although still representing a major public health problem in this important metropolitan area, the decrease in motor vehicle accident mortality was possibly due to interventions in 1995 and expanded NTC measures in 1998. Greater efforts to change driver and pedestrian behavior could further decrease the high number of accidents and related mortality.     

Ticks in the metropolitan area of Berlin,Germany

A high-resolution city map showing the geographic distribution of 12 tick species (Acari: Argasidae, Ixodidae) that have been recorded from the metropolitan area of Berlin, Germany is presented. A total of 237 tick locations was mapped. These include ten ixodid tick species: Dermacentor reticulatus, Haemaphysalis concinna, Hyalomma rufipes, Ixodes ricinus, Ixodes canisuga, Ixodes hexagonus, Ixodes arboricola, Ixodes frontalis, Ixodes trianguliceps and Rhipicephalus sanguineus sensu lato. The two tick species Hy. rufipes and R. sanguineus s.l. are not endemic to Berlin. Hyalomma rufipes ticks are introduced in Europe with migratory birds from Africa every spring. Rhipicephalus sanguineus s.l. are introduced to Central Europe with dogs that had travelled to or were imported from countries where this tick is endemic. In Germany, they are able to develop and reproduce inside heated buildings. Occurrences of two soft tick species, the pigeon tick Argas reflexus and the short-legged bat tick Carios vespertilionis were also mapped. Other tick species that are likely to be endemic to Berlin and its environs, but for which documented findings or geographical coordinates are lacking, are mentioned. These include the long-legged bat tick I. vespertilionis and the marten tick I. rugicollis documented in Brandenburg, the federal state surrounding Berlin. It can be assumed that if appropriate field studies are carried out, these tick species will also be found in the metropolitan area of Berlin. The high-resolution mapping of all tick species found in a city (like Berlin) forms the basis for further investigations into the impact of climate change and changing land use on ticks and tick-borne diseases, precisely in those habitats where most people will live in the future.     

Temporal analysis of the incidence of meningitis in the Tehran metropolitan area, 1999-2005

Objectives  

The aim of this study was to describe the temporal determinants of meningitis incidence in the population living in the Tehran metropolis.     

Perinatal mortality in the St. Louis metropolitan area

Statistical data in fetal, neonatal, perinatal, and infant mortality were collected from various sources for the St. Louis metropolitan area (St. Louis City and St. Louis County). The overall perinatal mortality rate of 25.8 for the St. Louis metropolitan area in 1973 compares favorably with the national rate of 25.5 in 1973. The prematurity rate at St. Louis City Hospital (SLCH) is almost three times that of St. Mary's Health Center (SMHC), 12.7 in contrast to 4.8. Both the neonatal and perinatal mortality rates at SLCH are about twice the rate of SMHC, neonatal 19.5 versus 7.4 and perinatal 31.7 in contrast to 19.6. Prematurity and its complications still seem to be the leading cause of neonatal mortality. With modern obstetrical and intensive neonatal care, the survival rates for low birth weight infants has improved markedly. The combined survival rates at SLCH and SMHC, 1972 through 1974 for infants weighing 501-1,000 gms 28 percent; 1,001-1,500 gms, 74 percent; 1,501-2,5000 gms, 95.5 percent; and greater than 2,500 gms. 99.7 percent. Recent studies have shown that the long-term prognosis for these low birth weight infants, in terms of neurological or intellectual sequelae is good. Thus, a more aggressive approach to the management of perinatal problems can be expected to yield excellent results.     

Mortality, hospital discharges, and case fatality for pulmonary embolism in the Twin Cities: 1980-1995

Pulmonary embolism (PE) causes substantial morbidity and mortality, but little information is available regarding recent secular trends for PE. This study determined trends for PE in adults ages 30 to 84 years in the Minneapolis-St. Paul metropolitan area from 1980 to 1995. The age-adjusted mortality rate for PE decreased approximately 50% during the study period; the rate ratio (RR) for 1992-95 compared to 1980-83 was 0.41 in men [95% confidence interval (CI) 0.31-0.55] and was 0.60 in women (95% CI 0.46-0.79). The hospital discharge rate for PE also decreased from 1980-83 to 1988-91 (RR 0.69, 95% CI 0.63-0.76 in men; RR 0.72, 95% CI 0.66-0.78 in women), but increased slightly between 1988-91 and 1992-95. The case fatality rate for PE decreased approximately 60% during the period (RR 0.38, 95% CI 0.28-0.51 in men; RR 0.37, 95% CI 0.28-0.50 in women). The PE trends were paralleled by declining hospital discharge rates for phlebitis and thrombophlebitis. These data support a changing natural history or possible improvements in the prevention, diagnosis, and treatment of PE between 1980 and 1995.     

Nutrient intake in a metropolitan area, 1973-74 vs 1980-82: the Minnesota Heart Survey

Trends in dietary intake in the Twin Cities metropolitan area were measured by comparing data from two independent surveys conducted in 1973-74 and 1980-82. Dietary information was collected by 24-h recall and coded by a single coding center. For men reported caloric intake declined significantly and fat, protein, and carbohydrate each declined approximately 6%; changes in reported dietary intake for women were smaller and mostly nonsignificant. Few trends were observed for either sex in nutrient intake relative to energy intake. Changes in mean serum total-cholesterol levels and body mass indices between 1973-74 and 1980-82 were not consistent with the direction of dietary trends. The proportion of subjects whose 24-h intake met five selected US dietary goals was calculated. In 1980-82, less than 15% of persons reached the goals for carbohydrate and fat intake on the day surveyed; the cholesterol-intake goal (less than or equal to 300 mg/d) was met by 39% of men and 64% of women during the 24-h period surveyed.     

Child morbidity in the Kingston metropolitan area, Jamaica 1983

The case reports of all children admitted to public and private hospitals in the Kingston metropolitan area were examined for an analysis, by special areas, of spatial variations in child morbidity. A Poisson probability test was applied in order to determine areas of significant excesses in admission rates and three special areas selected for a child health survey. At the 0.025 significance level 20 of the 72 special areas had significantly higher and three significantly lower levels of admission. The survey confirmed the pattern revealed by hospital admissions and suggested that the children of young, unemployed and single women may be particularly vulnerable.     

Prevalence of chronic bronchitis among US Hispanics from the Hispanic Health and Nutrition Examination Survey, 1982-84.

In the Hispanic Health and Nutrition Examination Survey (HHANES), Puerto Ricans had a higher age-adjusted prevalence of self-reported chronic bronchitis (2.9 percent, 95% CI = 2.2, 3.6) than Mexican Americans (1.7 percent, 95% CI = 1.3, 2.1) or Cubans (1.7 percent, 95% CI = 0.9, 2.5). The prevalence of chronic bronchitis was at least 2 times higher in smokers as compared to nonsmokers among Puerto Ricans and Cubans, but not for Mexican Americans.     

Changes in Spanish surname cancer rates relative to other whites, Denver area, 1969-71 to 1979-81.

Cancer incidence rates for persons of Spanish surname and other Whites in the Denver, Colorado area were derived for two time periods, 1969-71 and 1979-81. The substantial deficits in total cancers for Spanish surname males and females relative to other Whites in 1969-71 diminished considerably for all age groups by 1979-81. The major determinants of this pattern were the rapidly rising Spanish surname rates for cancer of the colon and rectum, lung cancer, kidney cancer, female breast and uterine cancers, and male prostate, bladder, and hematopoietic cancers. There was a convergence of Spanish surname rates toward the other White rates for nearly all sites, regardless of whether other Whites showed increasing, decreasing, or stable rates. Notable exceptions occurred for cervical cancer, which dropped more slowly among persons of Spanish surname than among other Whites, and Spanish surname female stomach cancer rates which rose during the 1970s in contrast to a decrease among other Whites. The overall pattern is consistent with acculturation of persons of Spanish surname towards the majority's lifestyle, suggesting the value of more detailed studies of specific cancer determinants in the Spanish surname population.     

Bathtub-related drownings in the United States, 1979-81.

We analyzed National Center for Health Statistics data on drownings in bathtubs and Consumer Product Safety Commission data on bathtub-related injuries for the years 1979-80 and 1979-81, respectively. Seven hundred ten persons drowned in bathtubs in 1979 and 1980, for a crude mortality rate of 1.6 per million persons per year. Although there was an excess of deaths in the spring, there was no important seasonal trend. Mortality rates in the Pacific and Mountain states were higher than in other states. Persons at the extremes of age were at greatest risk of death, with mortality rates of 5-6 per million per year. Black males aged 20-64 years had substantially elevated mortality rates compared to White males. The prevalence of personal risk indicators varied with age, with a frequent history of being left unattended among children less than 5 years old, a frequent history of seizures among persons 5-39 years old, a frequent history of alcohol or drug use among persons 40-59 years old, and frequent evidence of having fallen among those at least 60 years old. Bathtubs are potentially dangerous, and the prevention of drownings in them can be approached through a combination of passive and active strategies.     

Baylisascaris procyonis in the metropolitan Atlanta area

Baylisascaris procyonis, the raccoon roundworm responsible for fatal larva migrans in humans, has long been thought to be absent from many regions in the southeastern United States. During spring 2002, 11 (22%) of 50 raccoons trapped in DeKalb County, Georgia, had B. procyonis infection. The increasing number of cases highlight this emerging zoonotic infection.     

Homicide surveillance--United States, 1979-1988.

From 1979 through 1988, 217,578 homicides occurred in the United States, an average of greater than 21,000 per year. Homicide rates during this 10-year period were about 1.5 times higher than the rates during the 1950s. The national homicide rate of 10.7/100,000 in 1980 was the highest ever recorded. Homicide occurs disproportionately among young adults. Among the 15- to 34-year age group, homicide is the fourth most common cause of death among white females, the third most common cause among white males, and the most common cause among both black females and black males. In 1988, nearly two-thirds (61%) of homicide victims were killed with a firearm, 75% of these with a handgun. More than half (52%) of homicide victims were killed by a family member or acquaintance, and about one-third (35%) of homicides stemmed from a conflict not associated with another felony. The homicide mortality rate among young black males 15-24 years of age has risen 54% since 1985. Ninety-nine percent of the increase was accounted for by homicides in which the victim was killed with a firearm. The surveillance data summarized in this report should assist public health practitioners, researchers, and policymakers in addressing this important public health problem.