Trends in state-specific prevalence of overweight and underweight in 2- through 4-year-old children from low-income families from 1989 through 2000

OBJECTIVES: To document overweight and underweight state-specific prevalence and examine trends among 2- through 4-year-old children from low-income families. METHODS: State-specific and overall overweight and underweight prevalence for 1989, 1994, and 2000 and trend analyses during the study period are documented. Overweight was defined as a sex-specific body mass index (BMI) for age in the 95th percentile or higher and underweight as a sex-specific BMI for age in less than the fifth percentile on the 2000 Centers for Disease Control and Prevention (CDC) growth charts. These analyses are based on one randomly selected record per child per year for 30 states consistently participating in the CDC Pediatric Nutrition Surveillance System in 1989, 1994, and 2000. Prevalence in 1989 and 1994 is adjusted to state-specific age and race/ethnicity distribution of the population in 2000. Overweight and underweight prevalence were categorized as 5% or less, more than 5% to 10%, more than 10% to 15%, more than 15% to 20%, and more than 20%. RESULTS: The number of states that reported overweight prevalence of more than 10% increased from 11 in 1989 to 28 in 2000. Underweight decreased during the study period: 9 states in 1989 and 23 states in 2000 had a prevalence of 5% or less. No geographic predominance was apparent. Trend analyses showed significant increases in overweight in 30 states (P < .01) and decreases in underweight in 26 states (P < .05). CONCLUSIONS: Overweight is increasing and underweight is decreasing in our study population. We need to expand prevention and intervention efforts to reverse the rising trend of overweight in the United States.     

Influenza vaccination by race among disabled community dwelling older women

Disabled older adults have been shown to be at risk for underutilization of some preventive services relative to able-bodied individuals. The Women's Health and Aging Study surveyed female Medicare enrollees in Baltimore, Maryland, who were among the most disabled community-dwelling women at the start of the study. Longitudinal survey data from the study were used to test for the existence or emergence of racial variation in influenza vaccination rates, for which racial variation has been shown in the general population. The primary analysis, using data on the same women before and after Medicare flu shot coverage began, suggested that influenza vaccination rates increased after Medicare coverage began and that there was no difference by race. A secondary analysis using data on women who were interviewed only after Medicare flu shot coverage began showed some racial variation, although the difference may have been larger prior to coverage. The utilization rate did not approach the Healthy People 2010 target.     

Parental reporting of smelly urine and urinary tract infection

Background: Parents often report that young children have "smelly urine" or a particular urinary odour. There is little evidence that these observations are relevant to the diagnosis of urinary tract infection (UTI). Aims: To determine whether parental reporting of smelly urine is of any relevance to the diagnosis of UTI in children less than 6 years of age. Methods: Parents whose children were having urine collected as part of their admission to a large district hospital were given a simple questionnaire to complete regarding the current smell of their child‘s urine. Parents were asked whether their child‘s urine smelled different from usual or had a particular smell. Microscopy and culture results of the child‘s urine were compared to their parent‘s questionnaire answers to see if there was a association between parental reporting of a different or particular urine smell and a diagnosis of UTI. Results: One hundred and ten questionnaires and urine samples were obtained. Fifty two per cent of parents thought that their child‘s urine smelled different from usual or had a particular smell. Only 6.4% of children were diagnosed as having a UTI. There was no statistically significant association between parental reporting of abnormal urine smell and diagnosis of UTI. Conclusion: In determining whether a young child has a UTI, asking parents about urine smell is unlikely to be of benefit.     

Parental reporting of smelly urine and urinary tract infection.

BACKGROUND: Parents often report that young children have "smelly urine" or a particular urinary odour. There is little evidence that these observations are relevant to the diagnosis of urinary tract infection (UTI). AIMS: To determine whether parental reporting of smelly urine is of any relevance to the diagnosis of UTI in children less than 6 years of age. METHODS: Parents whose children were having urine collected as part of their admission to a large district hospital were given a simple questionnaire to complete regarding the current smell of their child's urine. Parents were asked whether their child's urine smelled different from usual or had a particular smell. Microscopy and culture results of the child's urine were compared to their parent's questionnaire answers to see if there was a association between parental reporting of a different or particular urine smell and a diagnosis of UTI. RESULTS: One hundred and ten questionnaires and urine samples were obtained. Fifty two per cent of parents thought that their child's urine smelled different from usual or had a particular smell. Only 6.4% of children were diagnosed as having a UTI. There was no statistically significant association between parental reporting of abnormal urine smell and diagnosis of UTI. CONCLUSION: In determining whether a young child has a UTI, asking parents about urine smell is unlikely to be of benefit.