Refining The Grain: Using Resident-Based Walkability Audits To Better Understand Walkable Urban Form.

Researchers use measures of street connectivity to assess neighborhood walkability and many studies show a relationship between neighborhood design and walking activity. Yet, the core of those connectivity measures are based on constructs designed for analyzing automobile mobility - the street network - not pedestrian movement. This paper examines the effect of a finer grained characterization of street connectivity and illustrates the idea using parent ratings of street and intersection walkability for children throughout a suburban school district in Oregon. Several policy and practice recommendations are presented, including a discussion that extends Michael Southworth's (1993; 2005) foundational representation of streets and the walkable city using a refined, more pedestrian-centered approach to visualizing connectivity and walkable urban form.

Prevalence and prediction of overweight and obesity among elementary school students.

BACKGROUND: The high rates of childhood overweight and obesity in the United States have generated interest in schools as sites for monitoring body mass index (BMI) information. This study established baseline values for a 5-year longitudinal assessment of BMI of elementary school children and examined variation across the schools, because little is known about factors that affect the distribution of overweight and obesity within school districts. METHODS: Height and weight measurements were collected on 2317 elementary school children in 1 school district. BMI was calculated using the Centers for Disease Control and Prevention's NutStat program. Child characteristics included gender, age, eligibility for free and reduced lunch (proxy for socioeconomic status [SES]), school, grade, and ethnicity/race. Children were grouped into 2 BMI categories, <85th percentile or ≥85th percentile (overweight/obesity). Logistic regression was used to examine potential predictors of overweight/obesity. RESULTS: Prevalence of ≥85th percentile was 30.9%, 34.4%, 35.3%, 36.4%, 37.1%, and 44.5% for K-5, respectively. Prevalence of ≥85th percentile was highest among Hispanic children. Ethnicity was the strongest predictor of inclusion in the ≥85th percentile category followed by grade and free and reduced lunch eligibility. CONCLUSION: The data are consistent with the prevalence of overweight/obesity among American children and Hispanic children in particular. District prevalence of overweight/obesity is higher than available state statistics. Most of the BMI variation is accounted for by ethnicity, SES, and grade. The grade effect and high prevalence of overweight/obesity provide a rationale for BMI screening retention at the schools.

VIH y vulnerabilidad: una comparación de tres grupos en Cali, Colombia / HIV and vulnerability: a comparison of three groups in Cali, Colombia

OBJETIVO: determinar las características socio-demográficas, comportamientos de riesgo para VIH/Sida y presencia de VIH en tres grupos de participantes de diferentes grupos socio-económicos en Cali. METODOLOGIA: entre 2005 y 2007, Durante campañas de búsqueda activa focal integral de VIH, 4055 participantes dieron voluntariamente su consentimiento informado, respondieron un cuestionario estructurado, recibieron asesoría de VIH pre-prueba y post-prueba, así como prueba para diagnóstico presuntivo de VIH. Los participantes fueron agrupados en tres categorías: personas de bajo nivel socio-económico, baja escolaridad y alto desempleo (N1=1217); trabajadores empleados con escolaridad técnica-superior y de estrato medio-alto (N2=899); y estudiantes de universidades de carácter privado, de estrato medio-alto (N3=1939). Se determinaron características socio-demográficas, comportamientos sexuales y auto percepción de conocimientos sobre VIH. Análisis estadístico: uso de Chi-Cuadrado y prueba de muestras independientes t-student, significancia<0.05 e intervalos de confianza al 95%. RESULTADOS: prevalencia global de VIH 0.62%; para el grupo N1 la prevalencia fue 1.97%, mayor que en los otros grupos (p<0.0001). CONCLUSIONES: una alta prevalencia de VIH en el grupo N1 fue evidente, junto con una historia previa más frecuente de Enfermedad de Transmisión Sexual (ETS) y pobre auto-percepción de conocimientos sobre VIH, destacando la necesidad de fortalecer las estrategias de prevención y tamizaje de ETS y VIH dirigidas a este grupo.

OBJECTIVE: to identify socio-demographical characteristics and risk behaviors for HIV /Aids and HIV status in three groups of participants from different socio-economic background in Cali. METHODOLOGY: between 2005 and 2007, an active surveillance campaigns was done and included 4055 voluntary participants who gave informed consent, answered a structured questionnaire, and received pre- and post-test counseling and HIV testing. The participants were grouped in three categories: a total of 1217 from low socio-economic status (lse), with low education and high unemployment (N1), 899 employed workers with technical-professional schooling and upper-middle socio-economic status (N2), and 1939 students of private universities and upper-middle socio-economic status (N3). Socio-demographic characteristics, sexual behaviors and HIV knowledge self-perception were assessed. Statistical analyses: Chi Square, and independent T tests with significance <0.05, 95% confidence intervals. RESULTS: overall prevalence of HIV was 0.62%; in the N1 group prevalence was 1.97%, significantly higher than in the other two groups, (p<0.0001). CONCLUSIONS: a higher prevalence of HIV in the N1 (lse) group was evident, along with a more frequent history of previous Sexual Transmision Disease (std), and poorer self-perception of HIV knowledge, highlighting the need to strengthen std and HIV prevention and testing strategies targeting this group.

Inter-atrial conduction time shortens after blood pressure control in hypertensive patients with left ventricular hypertrophy.

UNLABELLED: Assuming that blood pressure control could induce a shortening of the inter-atrial conduction time and prevent atrial fibrillation occurrence, we studied the inter-atrial conduction time in hypertensive patients with left ventricular hypertrophy. METHODS: Sixty-eight (26 male) 58.34+/-8.08-year-old patient participated in the study. All were in sinus rhythm and had abnormal blood pressure (163+/-18/95+/-9 mm Hg). Their cardiac mass index was increased (151+/-43 g/m(2) SC) and their left atrial dimension was normal (3.67+/-0.54 cm). The inter-atrial conduction time was measured in the echocardiogram from the beginning of the electrocardiographic P wave to the beginning of the A wave in the mitral Doppler signal and was corrected for heart rate. Heart rhythm disturbances were monitored clinically and by means of a Holter. Most patients were treated with angiotensin antagonists. RESULTS: It was found that arterial blood pressure decreased significantly after treatment and that the P-A interval was significantly reduced (71.4+/-14.5 vs. 63.9+/-11.5 ms). During the follow-up, no patient complained of arrhythmia symptoms or exhibited atrial fibrillation in the Holter recording. CONCLUSION: In this selected group of patients with hypertensive heart disease (left ventricular hypertrophy), an effective blood pressure control was accompanied by a significant decrease in the inter-atrial conduction time. It is possible that these effects prevent atrial fibrillation.