Nutrition, physical activity, and quality of life in older adults: summary.

If health-related quality of life--and not longevity--is the key goal for health promotion, then it is captured only partly by the existing mortality and morbidity indexes. Researchers now urge that government agencies and health care providers begin collecting quality-of-life data on the populations they serve. Adding life to years, not years to life, is the current agenda for productive and successful aging.

Cervical spine injuries among submersion victims.

Background: Submersion victims are frequently considered at high risk for cervical spine (C-spine) injury regardless of whether they sustain a traumatic injury. We hypothesized that C-spine injury is unlikely in submersion victims who do not sustain high-impact injuries.

Methods: The study was a cohort study of all people who submerged between January 1974 and July 1996 and received medical care or were seen by the medical examiner in King, Pierce, and Snohomish counties in Washington State.

Genetic taste responses to 6-n-propylthiouracil among adults: a screening tool for epidemiological studies.

Genetically mediated taste responsiveness to 6-n-propylthiouracil (PROP) has been linked to reduced acceptance of some bitter foods. In this community-based study male (n = 364) and female (n = 378) adults enrolled in a self-help dietary intervention trial were screened for PROP taster status. Respondents, aged 18--70 years, were mailed filter papers impregnated with PROP or with aspartame solutions.

Antenatal syphilis in sub-Saharan Africa: missed opportunities for mortality reduction.

Purpose: Between 4-15% of pregnant women are believed to be infected with syphilis in sub-Saharan Africa. Active infection with syphilis in pregnant women results in foetal or infant death or disability for 50-80% of affected pregnancies, and is a major cause of adult morbidity as well. Antenatal syphilis screening is cheap and effective; however, it is often poorly implemented in countries with high syphilis risk.

Local health districts and the public health workforce: a case study of Wyoming and Idaho.

This study of personnel in local health departments (LHDs) focused on two predominantly rural states: Idaho and Wyoming. Although in the same region of the country, the structure of local public health is different in each state. Idaho's regionalized LHDs are relatively autonomous, whereas Wyoming's are county based, with many public health functions retained at the state level.

Genetic polymorphism of dopamine D2 receptors in Parkinson's disease and interactions with cigarette smoking and MAO-B intron 13 polymorphism.

Genetic polymorphisms of dopamine D2 receptors (DRD2) may be susceptibility factors for Parkinson's disease due to their influence on dopamine response and association with cigarette smoking, which is inversely related to risk of Parkinson's disease. Relations of TaqIA and TaqIB DRD2 genotypes with Parkinson's disease were investigated and tested for interactive effects with smoking and the monoamine oxidase B (MAO-B) intron 13 polymorphism previously found to be related to smoking. Study subjects were 152 cases of idiopathic Parkinson's disease and 231 controls.

Engaging colleges and universities as partners in Healthy Communities initiatives.

Colleges and universities have an important role to play in building healthier communities. In many communities, however, these institutions are viewed with mistrust and skepticism, not as partners or assets. Academics often fail to respect and value community resources; they often assume the role of experts when they approach communities, in the context of short-term projects that place a priority on their goals rather than on communities' goals.

Outcome of surgery for thoracic outlet syndrome in Washington state workers' compensation.

Objective: To determine the predictors of outcome of thoracic outlet syndrome (TOS) surgery in a population-based cohort of injured workers.

Methods: All injured workers in the Washington State Workers' Compensation system who received TOS surgery during 1986 to 1991 were identified by computerized bill payment records and validated by medical record review (n = 158). The main outcome measure was work disability status 1 year after surgery.

Tobacco withdrawal signs and symptoms among women with and without a history of depression.

A past history of depression is associated with a decreased likelihood of quitting smoking. Tobacco withdrawal may be a mechanism through which depression history impedes smoking cessation. This research examined the influence of depression history on unmedicated tobacco withdrawal signs (polysomnographic measures of sleep) and symptoms (self-reported urge, negative affect, hunger, and sleep) among women (N= 13).

Public health informatics: a CDC course for public health program managers.

Information science and technology are critical to the modern practice of public health. Yet today's public health professionals generally have no formal training in public health informatics--the application of information science and technology to public health practice and research. Responding to this need, the U.

Dietary factors in Parkinson's disease: the role of food groups and specific foods.

Purpose: The association between self-reported past food intake and Parkinson's disease (PD) was investigated in a case-control study of men and women aged 40-89 years.

Methods: Newly diagnosed idiopathic PD cases were ascertained from neurologists, and from outpatient and pharmacy computerized databases, at the Group Health Cooperative (GHC) clinics in the Puget Sound region of Washington state. Control subjects were chosen from the GHC patient roster and had no reported history of diagnosed neurodegenerative disease.

Information needs in public health and health policy: results of recent studies.

Clearly, much work needs to be done to address the diverse and sometimes unique on-line information needs of public health professionals and health policy analysts. In some cases, there are needs for complex new knowledge bases created via linkages among multiple databases (e.g.

Patient characteristics and practice patterns of physicians using homeopathy.

Background: The use of homeopathy is growing in the United States, but little is known about practice patterns of physicians using homeopathy and the patients who seek homeopathic care.

Materials And Methods: Data for consecutive patient visits to 27 doctors of medicine and doctors of osteopathy using homeopathy in 1992 were collected and compared with the National Ambulatory Medical Care Survey of 1990.

Results: Patients seen by the homeopathic physicians were younger, more affluent, and more likely to present with long-term complaints.

Risk factors for pilot fatalities in general aviation airplane crash landings.

Context: Most pilots survive airplane crash landings in small airplanes. Factors associated with pilot death have not been well studied.

Objective: To identify factors associated with fatalities in general aviation airplane crash landings.

Device evaluation and coverage policy in workers' compensation: examples from Washington State.

Workers' compensation health benefits are broader than general health benefits and include payment for medical and rehabilitation costs, associated indemnity (lost time) costs, and vocational rehabilitation (return-to-work) costs. In addition, cost liability is for the life of the claim (injury), rather than for each plan year. We examined device evaluation and coverage policy in workers' compensation over a 10-year period in Washington State.

Case series and exposure series: the role of studies without controls in providing information about the etiology of injury or disease.

Descriptions of exposure histories in persons with the same injury or illness ("case series"), and descriptions of outcomes in persons with the same exposure ("exposure series"), have the potential to contribute knowledge relevant to disease etiology in some special situations. The case series can be thought of as a primitive form of case-control study--one in which the controls are only implied. Similarly, the exposure series is a rudimentary type of cohort study.

Reliability and validity of medical outcome and patient satisfaction measures among injured workers in Washington State: a pretest.

Several existing measures of medical outcomes and some newly constructed measures of patient satisfaction were tested for reliability and validity on a sample of 100 subjects who had suffered work-related injuries and illnesses in Washington State. Included in the measures of medical outcome were the SF-36 and the upper body mobility subscale of the Health Assessment Questionnaire. The newly constructed measures of patient satisfaction assessed areas such as satisfaction with the attending physician and with access to referrals.

Environmental public health surveillance.

A holistic and collaborative approach needs to be taken in the development of environmental public health surveillance systems. Exposure and hazard surveillance integrated with outcome-based surveillance will blend fragmented strands of data into streams of information. Adequate resources and strong leadership are essential to the creation of such surveillance systems.

Does sharing the cost of a bicycle helmet help promote helmet use?

Objective: To determine whether asking for a $5.00 donation for bicycle helmets, compared with distribution free of charge, would affect helmet use among children receiving helmets and an educational intervention from public health clinics.

Setting: Six public health clinic sites in King County, Washington.

Rapid KABP survey for evaluation of NGO HIV/AIDS prevention projects.

The Johns Hopkins University HAPA Support Program (HSP) provided technical assistance to Save the Children (SC), a U.S.-based nongovernmental organization, to conduct a survey of knowledge, attitudes, beliefs, and practices (KABP) related to AIDS among rural Zimbabweans.

Antibiotics to prevent infection of simple wounds: a meta-analysis of randomized studies.

A meta-analysis was conducted to determine whether prophylactic systemic antibiotics prevent infection in patients with nonbite wounds that are managed in the emergency department (ED). A literature search was performed to identify published, randomized trials of prophylactic antibiotics for nonbite wounds. Blinded review of trial methods was used to select trials that randomly assigned patients to antibiotic or control groups and analyzed results by intention to treat.

The effectiveness of four interventions for the prevention of low back pain.

Objective: Low back pain affects 60% to 80% of US adults at some time during their lives. This review evaluates the effectiveness of four strategies to prevent low back pain for asymptomatic individuals: back and aerobic exercises, education, mechanical supports (corsets), and risk factor modification.

Data Sources: The MEDLINE database was searched for all relevant articles published in English between 1966 and 1993.

Infant injury death in Washington State, 1981 through 1990.

Objective: To measure annual rates of infant injury death in Washington State and identify potential risk factors for infant injury death.

Methods: A population-based case-control study using a linked file of birth and death certificates for the years 1981 through 1990.

Results: The leading causes of infant injury death, per 100,000 live births, were intentional injury (9.

Respiratory infection with Chlamydia pneumoniae in middle-aged and older adult outpatients.

This study was undertaken to characterize the epidemiology and clinical presentation of infection with Chlamydia pneumoniae in a population composed primarily of middle-aged and older adults. Pharyngeal swabs and acute and convalescent phase sera were obtained from outpatients presenting with signs and symptoms of an acute respiratory infection. Sera were examined using the micro-immunofluorescence (MIF) test to detect antibody to Chlamydia pneumoniae and complement fixation tests to detect Mycoplasma pneumoniae, influenza A virus, influenza B virus, respiratory syncytial virus and adenovirus.

Risk factors for distal symmetric neuropathy in NIDDM. The San Luis Valley Diabetes Study.

Objective: To investigate risk factors for distal symmetric (sensory) neuropathy among prevalent cases of non-insulin-dependent diabetes mellitus (NIDDM) in a population-based study in southern Colorado.

Research Design And Methods: Prevalent neuropathy was identified in 77 of 277 people with NIDDM by a standardized history and neurologic examination. Fifteen known or suspected risk factors for neuropathy were determined without knowledge of neuropathy status.