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Assessing hearing problems within a community survey.

Community surveys are increasingly being used as a method of collecting health and lifestyle data. This report describes the use of a simple question on hearing difficulties within such a survey. A systematic sample of 2.5% of the electoral register of the four Parliamentary constituencies of Cardiff, Wales, was drawn. Of the 5145 individuals in the sample, 83% responded. Age and social class explained much of the variability in reported hearing difficulties. A recent fall and cigarette consumption were associated with hearing problems, but the contribution of alcohol consumption while potentially important did not reach statistical significance. This self-administered community survey provided hearing data which are consistent with other specialized studies and is a viable route for the assessment of community needs.

Activities of Daily Living

Physical and mental incapacity in elderly white persons in Cape Town. A community survey.

A community survey of 150 Whites persons over the age of 60 years living in the community in Cape Town showed that incapacity due to physical illness or impairment of function is present to some degree in 33%. Cognitive defects were present in 12%, poor social contacts in 19%, and lack of social and emotional support in 10%. Financial problems (12%) and unsatisfactory housing (3%) were the main material problems. Notwithstanding the above, it appeared that most elderly persons were managing adequately and that 58% were satisfied with their life circumstances.

Aged

Shoulder disorders in the elderly: a community survey.

A community survey of identifiable symptomatic shoulder disorders in a sample of 644 elderly people over age 70 (318 male and 326 female) revealed a prevalence of 21%. Shoulder disorders were more common in women (25%, versus 17% in men). Approximately 70% of the cases of shoulder pain involved the rotator cuff. Fewer than 40% of the subjects sought medical attention for these symptoms. Increased medical awareness is needed, since the elderly often do not volunteer information about such symptoms.

Aged

Prevalence and characteristics of women who have had a hysterectomy in a community survey.

A community survey of 8,896 households was undertaken in the Hunter region of New South Wales to assess women's health status. Consent was gained from 5,781 of the 6,361 eligible women between 18 and 69 years of age. The prevalence of hysterectomy in this sample was 16.9%, with 34.2% of women in their fifties having had a hysterectomy. Most hysterectomies (75%) were performed on women between the ages of 30 and 49 years. The demographic variables of parent's country of birth, educational level and employment status predicted recent hysterectomies after controlling for the effect of age.

Adolescent

Psychiatric disorder and gynaecological symptoms in middle aged women: a community survey.

In a community survey 521 women aged 35-59 were selected at random from all patients registered in two groups practices. They were interviewed at home and assessed by means of standardised psychiatric measures and detailed gynaecological inquiry. Levels of psychiatric morbidity were found to be within the expected range for such a sample. Both psychiatric morbidity and the personality dimension of neuroticism were significantly associated with gynaecological symptoms, including dysmenorrhoea and premenstrual tension, some symptoms of excessive menstruation, and flushes and sweats but not disappearance of menstruation for over six months. Current psychiatric state was significantly associated with recent adverse life events and with indices of psychiatric vulnerability (neuroticism and previous psychiatric history), suggesting possible aetiological links with gynaecological symptoms. The findings of this study have implications for the management of gynaecological complaints in general practice.

Adult

Complaints of cognitive decline in the elderly: a comparison of reports by subjects and informants in a community survey.

In a community survey, subjects and their informants were asked the same questions about memory and intellectual decline in the subjects. Subjects and informants both commonly reported cognitive decline, although in most cases the decline was not seen as interfering with daily life. However, when responses from subjects and informants were cross-tabulated, agreement was found to be poor. For subjects, reports of cognitive decline were correlated with anxiety and depression symptoms and with trait neuroticism. Subjects' reports were uncorrelated with age and only weakly correlated with cognitive test performance, indicating little validity. By contrast, informants' reports were correlated with the subjects' cognitive test performance and age, but also with the informants' own anxiety and depression symptoms. Although informants' reports have validity, they may also be contaminated by the informants' affective state.

Aged

Pi MZ phenotype and an increased prevalence of reported psoriasis in a community survey.

In a community survey of 953 adults we identified 40 who reported having had psoriasis. Eight of these cases were subsequently documented from physicians' records. alpha 1-Antitrypsin (alpha 1-AT) phenotyping identified 35 MZ individuals, 4 (11.4%) of whom reported psoriasis. Among the 918 non-MZ individuals 36 (3.9%) reported psoriasis, yielding a relative incidence of 3.2 (p less than 0.05). This is consistent with previous reports suggesting an association between moderate alpha 1-AT deficiency and psoriasis.

Adolescent

Nutritional status of children in Alexandra township. Clinic-based data and a community survey.

A community-based survey of the nutritional status of children aged 12-23 months was conducted. A cluster sampling technique was used. The weight and height of 426 children were measured. Compared with clinic-based growth-monitoring data, which showed that 5.5% of the children were below the 3rd percentile of weight for age, this survey revealed that 17.7% of boys and 9.3% of girls were below the 3rd percentile of weight for age. This may indicate that the health centre is not reaching those in greatest need. In respect of height for age, 44.3% of boys and 44.1% of girls were below the 3rd percentile while less than 4% of boys and girls were below the 3rd percentile of weight for height; this indicated a high percentage of stunting but no acute malnutrition. Growth monitoring may be an important component of a child health programme. However, unless growth is measured accurately and appropriate action implemented, growth monitoring alone is of little value. Thus before continuing with the programme of growth monitoring, the Alexandra Health Centre should ensure that health workers are adequately trained and that appropriate interventions are implemented to reduce the risks associated with children who fail to gain weight at the expected rate. Once implemented, a regular evaluation of all aspects should be undertaken.

Anthropometry

Fatal ischaemic heart disease in Belfast: a comparison of two community surveys.

Data from two community surveys in Belfast were used to compare all deaths attributed to ischaemic heart disease during two one-year periods (1965/66 and 1981/82). There was an increase in mortality in men of all ages from 3.3 to 4.4 per 1,000 population (33%) and in women from 1.6 to 3.1 per 1,000 population (94%). Only in men aged less than 70 years was the mortality rate unchanged (2.2 per 1,000 population). The proportion of deaths in persons whose fatal attack began outside the hospital was virtually unchanged (65% in 1965/66 compared with 69% in 1981/82). Survival time was markedly decreased in the later survey, as were delay times in initiating medical care. The increase in mortality probably is due to an increase in the incidence of acute myocardial infarction. The introduction of mobile coronary care in Belfast in 1965 seems to have had equal effects in reducing mortality inside and outside hospital.

Adult

Characteristics of nonresponders in a community survey of the elderly.

OBJECTIVE: To identify predictors of nonresponse in a community survey of cognitive status in the elderly. DESIGN: Cross-sectional community survey with two stages of recruitment: an initial, less-intensive method, followed by a more aggressive approach that included face-to-face contact. Characteristics of initial nonresponders and responders were compared. SETTING: A close-knit rural community with higher than usual proportions of elderly, especially the very old. Subjects were interviewed in their homes. Collateral informants were subsequently interviewed by telephone. PARTICIPANTS: Utah heads of household aged 75 and older who resided in a noninstitutionalized setting. MEASUREMENTS: Mini-Mental State Examination (MMSE), Dementia Questionnaire, and an autobiographical risk factor and family history questionnaire provided measures for all independent variables. The dependent variable was status as initial responders or initial nonresponders. RESULTS: An initial participation rate of 63% was achieved, but a final rate of 93% was achieved when initial nonresponders were contacted later face-to-face. MMSE score was significantly related to responder status when analyzed alone (beta = -.19, P = 0.02) and remained a significant predictor after adjusting for education and whether born in Cache County (beta = -.16, P = 0.041) or current drinking, diabetes, or "other" health problems (beta = -.18, P = 0.028). After controlling for the informant report of subject's problems with activities of daily living, MMSE score fell just below statistical significance (beta = -.16, P = 0.079). CONCLUSIONS: Nonresponders in community surveys of the elderly appear to be disproportionately cognitively impaired. The increase in participation rates achieved after more persistent recruitment suggests that many initial nonresponders can still be recruited if intensive methods are used.

Activities of Daily Living

Community surveys of the prevalence of childhood psychiatric disorders: a review.

16 major community surveys designed to measure the prevalence of emotional and behavioral conditions of childhood are reviewed. The present state of the art of community surveys, including definitions of deviance, instruments, and methodologies used as well as potential correlates of disorders studied, are discussed. Among the directions outlined for further research are to focus on a categorical approach; to study a broad age range of children, including preschoolers; to use, when possible, existing instruments; and to measure correlates of disorder, service use, and invulnerability.

Affective Symptoms

The Camberwell Community Survey: a summary of results.

The Camberwell Community Survey was carried out during 1978 and 1979 on a random sample of the population of Camberwell in south London. This is an inner city area with high deprivation indices. 800 members of the community and a random sample of 74 out-patients with affective symptoms were interviewed using the Present State Examination (PSE) and Life Events and Difficulties Schedule (LEDS) of Brown and Harris. The survey has resulted in many publications. The present paper summarises its aims, methods and results.

Adult

A comparison of efficacy of the key informant and community survey methods in the identification of childhood disability in Jamaica.

A comparison of the efficacy of the key informant and the community survey methods for identifying children with disability was carried out in the Jamaican component of an international epidemiological study of childhood disability. Approximately 130 key informants were exposed to a 2-day workshop giving information on signs of disability, aspects of the project, and available services. Questionnaires were given to enable the informants to refer children and they were reminded 6 months later. In the survey method, eight community workers completed a house-to-house survey of all families and administered the 10-question screen with probes on 5475 children, 2 to 9 years old. Seventeen referrals were made by the key informants; of these, two were found to have disabilities. Of the 821 children who tested positive on the 10-question screen in the house-to-house survey, 193 had disabilities. We concluded that the key informant method would not be a satisfactory way of identifying cases of childhood disability.

Child

Modifiable cardiac risk factors of smoking, elevated serum cholesterol and hypertension: a community survey.

This descriptive study assessed the prevalence, perceptions and practices of community residents concerning three risk factors most commonly associated with coronary heart disease: smoking behaviour, hypertension and elevated blood cholesterol/dietary factors. One thousand questionnaires were randomly mailed to residents with a response rate of 48.1%. Results indicated that residents identify smoking and dietary factors as major risks for the development of heart disease. Although the prevalence of hypertension and the frequency of blood pressure screening was similar to other provincial and community surveys that investigated cardiac behaviours, differences were found with the prevalence of smoking behaviour, the frequency of blood cholesterol screening, and knowledge and practices of dietary behaviour. As a result of the study, target groups have been identified and programs have been recommended to meet community needs.

Adolescent

Epidemiology of hypertension in a north Indian population. Based on rural-urban community surveys.

The epidemiology of hypertension was studied on the basis of total community surveys in defined urban (mostly non-agricultural) and rural (agricultural) populations of Haryana, using WHO criteria. A total of 4,068 subjects, comprising 95% of the eligible populations, were examined. Hypertension was found to be almost twice as common in the urban (64.3/1,000) as in the rural group (35.7/1,000). The prevalence of hypertension as well as the mean pressures were greater in men than in women in the 3rd and 4th decades, after which the pattern was reversed in all the subsequent age groups. The regression lines intersected at approximately 45 years of age. However, there was no appreciable sex difference in either group in the overall prevalence of hypertension. The mean systolic and diastolic pressures rose significantly with increasing age. These were generally lower in rural than in urban subjects and there was a difference of almost one decade group. Only one out of every four hypertensives detected during the survey was aware of his disease, and even among these three-fourths were either untreated or inadequately controlled. The lower prevalence of hypertension was associated with lesser mean pressures in the rural community, and both these observations are ascribed to a much larger proportion of rural people (compared to city dwellers) being thinner in size, engaging in hard physical activity, and belonging to a lower socio-economic group. The data have also been compared with other studies from India and abroad and the possible reasons for the observed differences discussed.

Adult

Community survey profiles hospital's image, helps set goals.

A well-designed and executed community survey has helped a hospital to clarify its role, determine service needs, establish short-range and long-range goals and planning directions, and improve communication with its publics.

Community-Institutional Relations

Health and social status of elderly Asians: a community survey.

A sample based on general practices was the starting point for a community survey of Asians aged 65 years and over to describe: family structure and social contact; aspects of lifestyle; language and communication; capacity for self care; and knowledge about and use of services. A total of 726 (95% of those approached) old people were interviewed in their own languages. Almost all had been born in India, mainly in Gujarat or the Punjab, but most had come to Britain via east Africa. Over half of the over 75s were not fully independent in basic activities of daily living, and a fifth were occasionally or often incontinent of urine, though these levels of incapacity were little different from those found in the indigenous elderly. Few elderly Asians were aware of social services, such as meals on wheels, home helps, social workers, and particularly chiropody. Language also excluded them: 37% of men and only 2% of women could speak English. Moreover, two thirds of elderly Asian women were illiterate in all languages. Health education initiatives directed at these people must understand these cultural and language barriers and perhaps use alternative methods, such as Asian radio programmes and home videos, in providing information on health and welfare services.

Aged

A community survey of psychotropic drug consumption in South Verona: prevalence and associated variables.

A cross-sectional community survey was undertaken to investigate the pattern of psychotropic drug consumption in 453 community residents of South Verona. Overall, 15.0% of the subjects were taking psychotropics (benzodiazepines 13.5%, antidepressants 2.2%, neuroleptics 1.1%). Prevalence was higher in females (20.0%), in those over 45 years (25%), in high General Health Questionnaire (GHQ) scorers (26.2%), and in subjects with physical ill-health (27.0%), with social problems (20.0%), with distressing events (22.0%) and with alcohol abuse (32.3%). Logistic regression analysis showed that age, sex, GHQ score, physical ill-health and life events were all significantly and independently associated with psychotropic drug consumption.

Adolescent