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Results for “Community population”

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PubMed1991

A longitudinal study of respiratory symptoms in a community population sample. Correlations with smoking, allergen skin-test reactivity, and serum IgE.

Chronic cough and/or phlegm, wheeze in the absence of colds, and rhinitis attributed to allergies are three of the most common respiratory symptoms encountered in community populations. In this study, we have determined the prevalence of these complaints in a random population sample (n = 1,109) using standardized questionnaires at two points in time, eight years apart. Cross-sectional prevalence and changes in symptom occurrence have been correlated with smoking status, allergen skin test reactivity, and total serum IgE levels. Our objective was to determine the individual and combined influence of these three variables on symptom prevalence. Initially, 19.2 percent of the population admitted to wheeze, 17.9 percent to cough, and 44.1 percent to allergic rhinitis. Cough and wheeze prevalence changed little over the eight-year period, while rhinitis increased 11 percent by the second survey. The occurrence of chronic cough was strongly correlated with smoking, and was not further influenced by either allergen skin reactivity or IgE level. Conversely, rhinitis prevalence was related to skin test reactivity with no additional association with smoking or IgE level. The occurrence of wheeze in the absence of colds was associated with both smoking and allergen skin reactivity. Among smokers, the prevalence was over 30 percent and was similar in both skin test positive (STP) and skin test negative (STN) individuals. However, on both surveys, STP ex-smokers and nonsmokers had significantly more wheeze than those who were STN. While the prevalence of wheeze in STN nonsmokers was low (6.8 percent), an IgE-wheeze relationship was also suggested on the second survey. In addition to these cross-sectional symptom relationships, changes in either smoking status or allergen skin reactivity during the study period were associated with changes in the prevalence of each symptom.

Adult↗

PubMed2004

Vascular disease/risk and late-life depression in a Korean community population.

BACKGROUND: Associations between vascular risk factors and late-life depression are controversial. AIMS: To investigate the association between measures of vascular disease/risk and depression and confounding and effect modification by APOE genotype and cognitive function. METHOD: In a Korean community population aged 65+ (n=732), diagnosis of depression (Geriatric Mental State Schedule) and information on vascular status, disability, APOE genotype and cognitive function were obtained. RESULTS: Previous stroke and lower high-density lipoprotein cholesterol level (but neither hypertension nor diabetes) were significantly associated with depression (independently of disability and cognitive function). These associations were stronger in participants with borderline cognitive impairment, although not to a significant extent. CONCLUSIONS: Except for previous stroke and an atherogenic lipid profile, associations between depression and other common risk factors for cerebrovascular disease were not evident.

Aged↗

PubMed2006

[Analysis of coping strategies of community population in Shenzhen].

OBJECTIVE: To investigate the coping strategies of the community-based population in Shenzhen. METHODS: Totally 5,940 subjects from the communities in Shenzhen were sampled and tested with the Simplified Coping Style questionnaire. RESULTS: The most common coping strategies adopted by the community residents in Shenzhen were "consoling themselves" (33.1%) and "looking at the bright side of things" (31.4%), and the least adopted coping strategy was "relieving distress by smoking, drinking, taking medicine and eating" (57.8%); the strategies left out from their choices were mostly negative strategies. The scores for positive coping strategy factors of community residents in Shenzhen were greater than those of negative ones, with a mean difference of 0.43. The scores of both positive and negative coping strategy factors of these residents were significantly lower than those of general population in other mainland cities (P<0.001), with mean differences of 0.12 and 0.36, respectively. CONCLUSION: The community residents in Shenzhen adopt mostly positive strategies for coping with frustration, which benefit their status of self-rated health.

Adaptation, Psychological↗

PubMed1998

Prognostic value of exercise thallium-201 imaging in a community population.

BACKGROUND: The prognostic value of exercise thallium-201 imaging has been well established in referral patient populations at tertiary care centers, but these results may be influenced by referral bias. METHODS: This study was performed to evaluate the prognostic value of thallium imaging in a community-based population of 446 residents of Olmsted County, Minn. Eleven variables were prospectively selected and tested for their associations with outcome end points. RESULTS: Four variables (age, history of myocardial infarction, number of abnormal thallium segments on the postexercise images, and increased thallium lung uptake) contained the most independent prognostic information. For the end point overall mortality rate, the multivariate chi-square values were 17.2 (p < 0.0001) for age and 20.9 (p < 0.0001) for the number of abnormal thallium segments on the postexercise images. Five-year survival rate for patients older than the median age of 59 years with an abnormal scan was 84% versus 97% for patients < or = 59 years of age with a normal scan. CONCLUSION: Exercise thallium imaging was useful for prognostic purposes in this relatively low-risk community population, confirming the findings of referral population studies.

Adult↗

PubMed1988

Seasonal variation in bronchial reactivity in a community population.

Morbidity and mortality from asthma is increased during the grass-pollen season and during the autumn months in the United Kingdom. It is not apparent why this seasonal variation occurs nor whether the variation in morbidity and mortality is associated with variation in bronchial reactivity. We have measured bronchial reactivity on four occasions during 12 months in 60 subjects selected from a community population in the south of England. All subjects had had a histamine challenge test and skin tests to common antigens as part of a survey of asthma prevalence in March 1984. Further measurements of the provocative dose causing a 20% fall in FEV1 (PD20) were made at the peak of the grass-pollen season in June, at the end of September, and in the following March, and current symptoms of respiratory tract infection (RTI) were assessed on all four occasions. Geometric mean PD20 demonstrated significant seasonal variation between 1.38, 0.82, 0.92, and 1.20 mumol in March, June, September, and March, respectively (p less than 0.02). Relative to March 1984, PD20 was significantly decreased in June and September (p less than 0.005 and p less than 0.02, respectively) but not in March 1985 (p = 0.39). Within subjects atopy was significantly related to decrease in PD20 in September (p less than 0.05) and in March 1985 (p less than 0.025) but not in June (p = 0.40). Change in PD20 between occasions was unrelated to RTI symptoms, age, or smoking status, but it was related to change in baseline FEV1/FVC (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2004

Availability and perceived effectiveness of public health activities in the nation's most populous communities.

OBJECTIVES: We examined the availability and perceived effectiveness of 20 basic public health activities in the communities where most Americans reside. METHODS: A self-administered questionnaire was mailed to the 497 directors of US local health departments serving at least 100 000 residents. RESULTS: On average, two thirds of the 20 public health activities were performed in the local jurisdictions surveyed, and the perceived effectiveness rating averaged 35% of the maximum possible. In multivariate models, availability of public health activities varied significantly according to population size, socioeconomic measures, local health department spending, and presence of local boards of health. CONCLUSIONS: Local public health capacity varies widely across the nation's most populous communities, highlighting the need for targeted improvement efforts.

Efficiency, Organizational↗

PubMed1995

Persistence and new onset of asthma and chronic bronchitis evaluated longitudinally in a community population sample of adults.

BACKGROUND: Some patients with chronic obstructive pulmonary disease may share the clinical characteristics of those with asthma; their disease is sometimes called "asthmatic bronchitis." Whether there is a difference between asthmatics who do and do not develop chronic bronchitis is not yet clear. We investigated whether asthma and chronic bronchitis may share some "allergic" phenotypes and whether asthmatic individuals who develop chronic bronchitis subsequently have steeper declines in lung function. METHODS: Known risk factors for decline in lung function were analyzed in a representative community population of adults followed up longitudinally since 1972 in Tucson, Ariz, in groups with persistent, newly developed, and past diagnoses of asthma and chronic bronchitis. We evaluated contributions of initial level of forced expiratory volume in 1 second (FEV1), reversibility with isoproterenol hydrochloride nebulized aerosol bronchodilator treatment, percentage of blood eosinophils to determine eosinophilia, and IgE level. RESULTS: The concurrence of chronic bronchitis and asthma is associated with a steeper decline in FEV1 than is asthma as the sole diagnosis. Asthmatics (those with persistent asthma with and without chronic bronchitis) had the greatest prevalence of increased reversibility with isoproterenol therapy and with eosinophilia. The prevalence of eosinophilia was also high in those with newly diagnosed chronic bronchitis without asthma; however, this was not the case in those with persistent chronic bronchitis without asthma. Larger bronchodilator responses were related to steeper declines in FEV1, both in persistent asthma and in chronic bronchitis. CONCLUSIONS: Bronchodilator response and eosinophilia are generally believed to be hallmarks of asthma. We show that these characteristics may be present in chronic bronchitis as well. The presence of a large (> 25%) bronchodilator response is associated with a steeper decline in FEV1.

Adult↗

PubMed1988

Depressive symptoms and depressive diagnoses in a community population. Use of a new procedure for analysis of psychiatric classification.

A multivariate classification technique was used to examine whether depressive symptoms and symptoms frequently associated with depressive disorders would cluster into recognizable syndromes that parallel traditional DSM-III psychiatric diagnoses. An analysis was made of all respondents in the Epidemiologic Catchment Area (ECA) project of the Piedmont region of North Carolina who reported suffering from depressive symptoms (n = 406) at the second wave of the ECA study. The analysis identified five profiles of symptoms that adequately described the interrelationships of the symptoms as reported in the population. One profile included a set of symptoms nearly identical to the symptoms associated with the DSM-III classification of major depression. Other depressive syndromes emerged and included a premenstrual syndrome among younger women and a mixed anxiety/depression syndrome. The existence of these other depressive syndromes may explain the present discrepancy in the epidemiologic literature between a high prevalence of depressive symptoms and a low prevalence of traditional depressive diagnoses in community populations.

Adolescent↗

PubMed2005

Cognitive assessment of a representative community population with Parkinson's disease (PD) using the Cambridge Cognitive Assessment-Revised (CAMCOG-R).

BACKGROUND: cognitive decline is well recognised in Parkinson's disease (PD) but the best cognitive assessment tool for use in such patients remains unclear. The 30-point Mini-Mental State Examination (MMSE), while quick and straightforward to use, fails to cover a full range of cognitive domains and is recognised to have a ceiling effect. The Cambridge Cognitive Assessment-Revised (CAMCOG-R) is a cognitive screening tool allowing the assessment of a number of different domains of cognition. It has not previously been used specifically on PD subjects. METHODS: a prevalent community population of 135 PD patients were assessed cognitively using the MMSE. Those scoring 25 or above on the MMSE were subsequently further assessed using CAMCOG-R. Demographic and disease factors including disease duration, symptom severity, anxiety, depression and the presence of hallucinations were recorded for each participant. RESULTS: 31/135 (23%) demonstrated cognitive impairment on the MMSE (score < 25). Ninety-four of the remaining group (10 were excluded) achieved a median total CAMCOG-R score of 89/104. The results were widely distributed. The subjects scored particularly highly in the cognitive domains of orientation, comprehension and perception but relatively poorly at memory and abstract thinking. Significantly poorer scores (P < 0.05) were seen throughout the cognitive domains with increasing age, increasing PD symptom severity and increasing disease duration, but not with the presence of anxiety, depression or hallucinations in the subjects. DISCUSSION: CAMCOG-R was found to be a viable and useful cognitive screening tool for use in PD. A wide range of cognitive ability was demonstrated in subjects who had been assessed previously by the MMSE as not having significant cognitive impairment. The group performed worse in certain cognitive domains than others and those who were older, with more severe PD symptoms and with symptoms for longer, scored less well.

Aged↗

PubMedDate not supplied

Descriptive epidemiology of a depressive syndrome in a Western Canadian community population.

OBJECTIVE: To evaluate cross-sectional associations between depressive episodes and a set of potential biopsychosocial determinants in Calgary, Canada. METHODS: Random digit dialling (RDD) was used to select a sample consisting of 2,542 household residents in Calgary. These subjects were interviewed over the telephone using the Composite International Diagnostic Interview (CIDI) short form for major depression, and a questionnaire evaluating a variety of biopsychosocial variables. RESULTS: The prevalence of major depression was associated with biological (family history of major depression, alcohol consumption, street drug use), psychological (ratings of stress, recent life events) and social factors (social support, marital status, income, level of education). CONCLUSION: This study confirms that major depression is correlated with a diverse set of potential determinants in community populations, and that the impact of these determinants may differ between different populations. Prospective studies will be needed to further investigate these associations.

Adult↗

PubMed2004

[Control effect of health education on body mass index of community population].

OBJECTIVE: To examine the effect of community-based health education and health promotion on body mass index (BMI), overweight and obesity. METHODS: We separately selected 100,000 population in Beijing, Shanghai and Changsha Cities during 1991-2000. Each of the cities was then randomly separated intervention and control community of 500,000 population. In the intervention community various kinds of health education and health promotion had been carried out. The level of knowledge, attitude and behavior (KAB) and body mass index (BMI) were evaluated. RESULTS: The net increases of KAB level and regularly exercising rate in three city and different target population were statistically differences in comparison with baseline survey of 1992, and the net decreases of the BMI, overweight rate and obesity rate of the whole population were statistically differences. CONCLUSION: Health education and health promotion can effectively control the rising of population BMI, and have great meaningful for population preventing from cardio-cerebro-vascular diseases.

Body Mass Index↗

PubMed2001

The incidence of dementia in an Australian community population: the Sydney Older Persons Study.

OBJECTIVES: Limited Australian dementia incidence data are available. This study aimed to identify the incidence of dementia and its subtypes in an Australian community dwelling population. METHOD: A community dwelling sample of 647 subjects aged > or =75 years at recruitment were followed for a mean period of 3.2 years (range 2.6-4.5 years). The incidence of dementia (measured in person years at risk) was identified for different levels of severity of dementia, Alzheimer's disease and vascular dementia. RESULTS: Incidence figures were slightly higher than those previously reported. The incidence of dementia and of Alzheimer's disease increased with age but was not affected by gender. The incidence of vascular dementia was not affected by age. CONCLUSION: This study provides the largest body of data on the incidence of dementia in Australia, indicating a slightly higher incidence of dementia than previous reports. Further Australian data are required to confirm these findings.

Age Distribution↗

PubMed1993

Prevalence of psychiatric disorders in a community population of older adolescents.

In a community study of 386 Caucasian working-class older adolescents, a sizeable proportion met lifetime criteria for selected DSM-III-R diagnoses. Alcohol abuse/dependence had the highest lifetime prevalence rate (32.4%), followed by phobias (22.8%), drug abuse/dependence (9.8%), major depression (9.4%), and, least commonly, post-traumatic stress disorder (6.3%) and obsessive compulsive disorder (2.1%). Significant gender differences were found for major depression, post-traumatic stress disorder, and alcohol abuse/dependence, whereas socioeconomic differences occurred in major depression, phobias, and drug abuse/dependence. Adolescents with specific psychiatric disorders had significantly poorer functioning on measures of behavioral problems, interpersonal problems, self-esteem, and school performance. Results suggest the importance of identifying psychiatric disorder in adolescence, and the need for preventive strategies and prompt treatment.

Adolescent↗

PubMed1997

Life table mortality analysis of parkinsonian signs in a community population of older people.

BACKGROUND: A community based mortality review of individuals with parkinsonism is evaluated by a comparative life table analysis. RESULTS: Individuals with parkinsonism had an increased mortality over a nine year follow up. The presence of a gait disturbance is an additional mortality factor. However, the absence of gait disturbance is a far stronger factor for improved survival in parkinsonism than is the adverse factor of a gait disturbance being present. Bradykinesia, tremor and rigidity had no significant additional mortality effect. CONCLUSIONS: Careful risk selection should lead to a favorable mortality result. Credits can be given to those without gait disturbances and extra debits assessed to those with gait disorders.

Aged↗

PubMed2000

Parametric empirical Bayes estimates of disease prevalence using stratified samples from community populations.

Studies of chronic diseases in a community setting often employ stratified sample designs to enable the study to attain multiple research goals at a reasonable cost. One important goal is estimation of disease prevalence in the whole community and in important subgroups. Some adjustment for the sample design is necessary; if the design has many strata with very disparate sampling fractions, simply upweighting observed stratum prevalences may lead to unstable estimators. We propose a parametric empirical Bayes estimator in the spirit of the work of Efron and Morris, and we compare it to the direct upweighted estimator and a regression-smoothed estimator. Simulation studies in realistic settings suggest that the new estimator performs best, giving estimates with low bias and good precision under a variety of models.

Age Factors↗

PubMed1991

Risk of death from Alzheimer's disease in a community population of older persons.

A random sample of 467 persons over age 65 years from the population of an urban US community, stratified by age, sex, and performance on a brief memory test, underwent clinical evaluation for dementing illness in 1982-1984. Of these persons, 134 had probable Alzheimer's disease, 166 had possible Alzheimer's disease, and 167 had no evidence of Alzheimer's disease. Over a median follow-up period of 4.9 years following evaluation, 165 (35%) died. Overall, persons with probable Alzheimer's disease had a relative risk of death 1.44 (95% confidence interval (Cl) 1.05-1.96) times that of the unaffected. Level of cognitive impairment and the presence of cachexia upon physical examination both strongly and independently modified risk of death. Among those with probable Alzheimer's disease, mortality for those with mild or moderate cognitive impairment and no evidence of cachexia was comparable to that of the unaffected. However, among those with probable Alzheimer's disease and either severe cognitive impairment or cachexia, the risk of death was substantially higher. Persons with probable Alzheimer's disease who had both severe cognitive impairment and clear cachexia had a risk of death 4.60 (95% Cl 1.63-13.1) times that of unaffected persons.

Aged↗

PubMed2006

Immediate and longer term impact of the varicella shortage on children 18 and 24 months of age in a community population.

BACKGROUND: Little is known about the impact of the recent varicella vaccine shortage. To assess the temporal trend in varicella vaccine administration before 18 and 24 months of age in a community cohort of children prior to, during and after the recent varicella vaccine shortage. And to compare the temporal trends in varicella vaccinations to trends of an older, more widely accepted vaccine, the MMR. METHODS: Community population-based birth cohorts were identified who were eligible for the varicella vaccination before, during and after the 2001 to 2002 varicella vaccine shortage. Only children (84% of all) who remained in the community through their second birthday were included. For each child in the cohort, the medical records and immunization registry records from both medical facilities in the county were reviewed to identify the dates and sites for all varicella immunizations given. In addition to varicella immunizations, the dates of all MMR vaccinations were recorded. Additional data abstracted included the child's birth date, gender and dates of any recognized cases of chickenpox up through age 24 months. RESULTS: Of the 2,512 children in the birth cohorts, 50.8% were boys. In the three cohorts combined, 81.1% of the boys and 79.3% of the girls (p = 0.30) received the varicella vaccine by age 24 months. The pre-shortage community rate of varicella immunization was 79.7% by 24 months of age. During the varicella vaccine shortage, the rate of varicella immunization by 24 months fell to 77.2%. Only 6 additional children received a "catch-up" immunization by 36 months of age. In the post shortage period the community 24-month immunization rate rebounded to a level higher than the pre-shortage rate 84.0%. During the almost three years of observation, the MMR immunization rate by age 24 months was constant (87%). CONCLUSION: The varicella shortage was associated with an immediate drop in the 24-month varicella immunizations rate but rebounded quickly to above pre-shortage rates. In this community the only long term impact of the varicella vaccine shortage may be on the small number of children who still had not received catch-up varicella immunizations by 36 months of age.

Age Distribution↗

PubMed1983

General aviation accident rates and pilot community population size: an examination of rural-urban differences.

Most investigations of general aviation accidents involving human factors have emphasized biomedical and psychological concerns, with comparatively few contributions from other disciplines. This study derives from a social science orientation and investigates the relationship between general aviation accident rates and the population size of the involved pilots' communities of residence. After excluding agricultural, air taxi, and commercial helicopter operations, an analysis of 48 Colorado communities reporting at least one 1978 accident-involved pilot revealed a correlation of -0.51 between accident rate per 1,000 pilots and community size. The smallest, and generally most rural, communities produced total and fatal accident rates of respectively 2.55 and 5.36 times greater than those for the largest metropolitan areas. A similar trend characterizes U.S. nationwide general aviation accidents and appears as well for automobile mishaps, thus lending additional support to the present findings. Discriminant analysis of individual-level data for 92 of the accidents revealed that the conventional explanations of airport facilities, terrain, pilot qualifications and exposure, and aircraft complexity failed to exert substantial effects on differences among the categories of accidents grouped by community size. Two alternate explanations are offered which speculate that: 1) the rural-urban accident differential may represent a function of variations in "pilot density," and 2) the observed differences may be attributed to attitudinal differences between rural and urban pilots produced by the former group's exposure to a type of "rural subculture."

Accidents, Aviation↗