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Ecology of Capillaria hepatica (Bancroft 1893) (Nematoda). 1; Dynamics of infection among Norway rat populations of the Baltimore Zoo, Baltimore, Maryland.

Seventy-five per cent of 845 Norway rats examined in the Baltimore Zoo for Capillaria hepatica were infected. Nearly all adult rats and 65% of juveniles were infected. Only 8% of 299 infected rats were heavily infected. The prevalence and intensity of infection increased with the size of the host. There were no seasonal differences in infection rates among adults, but juveniles collected during spring had higher infection rates than those collected during winter. Prevalence of C. hepatica infection varied from one place to another. No correlation between infection rate, vegetative cover, soil type, monthly rainfall, mean daily temperature, or food habits of rats was found. The dynamics of rat populations are perhaps the most important factors in the maintenance and dynamics of C. hepatica infections. Rapid population turnover contributes to the rapid release of a great number of eggs into the environment and high recruitment rates provide sufficient numbers of susceptible hosts for the parasite to complete its cycle.

Animals

The public's view of physicians' assistants and nurse practitioners: a survey of Baltimore urban residents.

This study of public attitudes toward physicians' assistants and nurse practitioners finds that the public regards the two groups of health workers as remarkably similar. A telephone survey of 2,583 households in the Baltimore, Maryland, metropolitan area indicates that about half the population have heard of a PA or NP, though only 4 per cent report receiving care from such workers. In this urban sample, respondents accepted the principle that important medical care functions can be delegated, as long as the PA or NP is considered assistant to the physician. The public reported more acceptance of tasks performed by nurse practitioners than by physicians' assistants, though the differences are small.

Attitude

A case with both hemoglobins C and N-Baltimore.

Hemoglobins C and N-Baltimore were detected in a 75-year-old black man. Although mild anemia and abnormal erythrocyte morphology resembling thalassemia were present, detection of this combination of hemoglobins at an advanced age suggests that it does not limit normal activities.

Aged

The animal bite epidemic in Baltimore, Maryland: review and update.

In 1972 in Baltimore, a peak of 7,436 reported animal bites (8/1,000 population) was reached. The bite rate for the most susceptible age group (5-14) was 19 per 1,000 population. By 1976, only 5,092 bites were reported, 5.8 per 1,000 total population, and 12.3 per 1,000 population 5-14 years of age. The decline in the number and rates of animal bites is believed due in large measure to the actions taken by the Bureau of Animal Control: education and publicity, increased fees and penalties, and enforcement of the new laws and regulations.

Adolescent

Training public school teachers in population dynamics: An evaluation of the urban life-population education workshops in Baltimore.

Nine population education workshops were held for city school teachers in Baltimore, Maryland during the 1972-73 academic year. The original program schedule was modified two times, at the end of the third workshop and the sixth. Each change resulted in fewer formal presentations, more teacher discussions and greater teacher involvement in the workshop program. From the ideas generated by the workshops, curriculum units suitable for elementary and secondary school students were produced. An evaluation of the program showed that teachers' knowledge of selected demographic concepts and facts increased between the pre-workshop period and the post-workshop period. The changes were greater in the later workshops. The changes in knowledge were statistically significant. While there was some regression to pre-test levels, the teachers retained a substantiol portion of the knowledge they received when measured a second time after the workshop. High school teachers showed greater effective changes in knowledge than lower grade teachers. However, interest in population education appears to be wide-spread among all teachers including lower grade teachers. It is suggested that in the future, programs in population education consider conducting separate workshops for teachers of the same or similar grade level.

Curriculum

The oral health of adults in the Baltimore SMSA study area.

This study, carried out in the region including Baltimore, Maryland, USA followed the pattern previously reported in the studies in Australia, New Zealand, Norway, Germany and Japan (Int. dent. J. 1976, 26, 317). In this area dental care is provided predominantly by payment of fees for service in private practice. Details are given of the oral health status in terms of caries, periodontal disease and loss of teeth for a group of 1142 adults aged between 35 and 45. Using the WHO stepwise regression analysis the significance of the previously reported predictors for each of the variables examined was determined. Finally a comparison is made between the present findings and those from an earlier National Health Survey carried out between 1960 and 1962. This suggests that while the caries situation may have improved over the past fifteen years, periodontal disease and loss of teeth have increased.

Adult

Experience of a sickle cell screening program in Baltimore.

The hemoglobinopathies constitute a major medical problem in the black community of Baltimore. A sickle cell service should be designed to discover, educate, and, if necessary, treat. Screening is sound preventive medicine and may serve to introduce the patient to the concept of continuing medical surveillance. The prevention of serious complications in patients with the more severe types of hemoglobinopathy should be a basic goal in the program.

Adolescent

Automated multiphasic health testing. Diagnostic and testing results obtained at the Health Evaluation Center. Public Health Service Hospital, Baltimore.

The results of automated multiphasic health testing (AMHT) were evaluated with special attention to diagnoses made by physicians and to false positive results, as well as to laboratory test results. The study population consisted of 1,157 patients at the Health Evaluation Center of the Public Health Service Hospital in Baltimore. Although 95 percent of the patients had at least one newly diagnosed disease or condition., the percentage dropped to 78 percent when dental abnormalities were excluded and to 70 percent when dental, vision, and hearing abnormalities were excluded. Abnormal laboratory test results were observed for 98 percent of the patients, and 36 percent had at least one false positive test result. The study results indicated that AMHT is a highly productive method for comprehensive medical testing with a variety of uses other than mass screening. The productive diagnostic yield combined witha high percentage of false positive results dictate the need for careful planning for followup care, strict attention to quality control, and excellent communication between the AMHT center and the practicing physician.

Adolescent

Control of a measles outbreak in an elementary school. Baltimore County, Md. 1975.

Between April 18 and May 20, 1975, 16 cases of measles occurred in pupils in an elementary school in Baltimore County, Md., and 1 case occurred in a sibling at a junior high school. Measles was serologically confirmed in 16 of these pupils. Attack rates were determined by grade and by vaccine status. The measles attack rate was 2.1 percent for the 377 children who had been given measles vaccine at 1 year of age or later. The rates were 27.8 percent (13 times higher) for those vaccinated at less than 10 months of age and 20.0 percent (10 times higher) for those with no definite history of vaccine. The higher attack rates for children who were vaccinated only before 10 months of age supports the 1972 recommendation of the Public Health Service Advisory Committee on Immunization Practices that children vaccinated before this age need to be revaccinated with live measles virus vaccine to assure full protection. The finding that 2 of 10 children with a history of measles became ill during the outbreak suggests that such histories are not a totally reliable indicator of immunity. Containment of the outbreak was attributed to the high level of immunity in the community and prompt initiation of control measures.

Adolescent

LRC Coronary Prevention Trial: Baltimore.

Intense, initial efforts to enroll 250 individuals in the Coronary Prevention Trial at Johns Hopkins University through referrals from private physicians and from commercial laboratories were largely unsuccessful. Not until a mass-screening effort was initiated in the community were we able to contact sufficient nunbers of potential study candidates. The time needed to acquire the trial candidates was 2.5 times as long as our original estimate, and 35,000 individuals were tested in the process.

Cholesterol

Occupational exposures to cyanide in Baltimore fire fighters.

A group of 479 fire fighters were investigated for routine exposure to hydrogen cyanide in the fire atmosphere using measurements of serum thiocyanate (SCN-). Our findings indicate that fire fighters were exposed to levels of hydrogen cyanide sufficient to raise their mean serum thiocyanate (SCN-) levels above that of controls. This elevation of serum SCN- occurred independently of smoking habits. Exposure to cyanide occurred much less frequently than previously studied exposures to carbon monoxide. Difficulties of correlating acute symptoms and the effectiveness of mask use with serum thiocyanate are discussed.

Air Pollutants