Heavy alcohol use as a risk factor for severe outcomes among adults hospitalized with laboratory-confirmed influenza, 2005-2012.

We examined heavy alcohol use as a risk factor for severe influenza (intensive care admission or death) among hospitalized adults. In <65- and ≥65-year-olds, heavy alcohol use increased disease severity [relative risk (RR) 1.34; 95 % confidence interval (CI): 1.04-1.74, and RR 2.47; 95 % CI: 1.69-3.60, respectively]. Influenza vaccination and early, empiric antiviral treatment should be emphasized in this population.

Risk factors for sporadic Shiga toxin-producing Escherichia coli O157 infections in FoodNet sites, 1999-2000.

To monitor risk factors for illness, we conducted a case-control study of sporadic Shiga toxin-producing Escherichia coli O157 (STEC O157) infections in 1999-2000. Laboratory-confirmed cases of STEC O157 infection were identified through active laboratory surveillance in all or part of seven states. Patients and age-matched controls were interviewed by telephone using a standard questionnaire. Information was collected on demographics, clinical illness, and exposures to food, water, and animals in the 7 days before the patient's illness onset. During the 12-month study, 283 patients and 534 controls were enrolled. STEC O157 infection was associated with eating pink hamburgers, drinking untreated surface water, and contact with cattle. Eating produce was inversely associated with infection. Direct or indirect contact with cattle waste continues to be a leading identified source of sporadic STEC O157 infections.

The potential role of an adult mentor in influencing high-risk behaviors in adolescents.

BACKGROUND: While mentorship programs, which connect adolescents with adults to whom they can turn to for help and advice, are proliferating in an attempt to prevent high-risk behaviors in teenagers, there are few data to show that mentorship actually makes a difference. OBJECTIVE: To determine if there is an association between having an adult mentor and high-risk behaviors in adolescents. HYPOTHESIS: Adolescents who have an adult mentor would be less likely to engage in high-risk behaviors than those without an adult mentor. DESIGN: Cross-sectional study. A self-administered, anonymous questionnaire was developed to assess demographics, involvement in risk behaviors, and the prevalence of a mentor in the life of a young person. PARTICIPANTS: A convenience sample of 294 adolescents, seen consecutively (93% of those approached), receiving outpatient medical care. Participants were predominantly female (68%), of mixed race/ethnicity, aged between 12 and 23 years (mean +/- SD age, 16.9 +/- 2.4), and from diverse socioeconomic backgrounds. SETTING: An adolescent health service in a suburban community-based teaching hospital. MAIN OUTCOME MEASURES: Adolescent smoking, alcohol and drug use, sexual practices, and weapon carrying. RESULTS: Adolescents with mentors were significantly less likely to participate in 4 of the 5 measured risk behaviors: ever carrying a weapon (odds ratio, 0.41; P< or =.01), illicit drug use in the past 30 days (odds ratio, 0.44; P< or =.01), smoking more than 5 cigarettes per day (odds ratio, 0.54; P< or =.05), and sex with more than 1 partner in the past 6 months (odds ratio, 0.56; P< or =.05). No significant difference was found with alcohol use (> or =3 drinks in the past 30 days). CONCLUSION: A strong positive relationship was found between adolescents having an adult mentor and decreased participation in 4 of the 5 risk behaviors evaluated.

Growth and nutrition patterns of infants associated with a nutrition education and supplementation programme in Gaza, 1987-92.

Since 1986, the 28 government community health centres providing primary care in Gaza have paid special attention to growth monitoring, nutrition education, and routine vitamin and iron supplementation in infancy. In 1987-88, 1989 and 1992, respectively, the nursing staff in five of these centres monitored the growth and feeding patterns of 2222, 1899, and 1012 children aged up to 15 months. The growth measures of children aged up to 6 months were similar to standard growth charts, but subsequently deficiencies developed in the study children. There were no differences between the patterns for males and females. Infants from upper socioeconomic categories had growth patterns that were closest to the norm, but this was associated with feeding and supplementation differences. There was improvement in the growth and feeding patterns of the 1989 and 1990-92 birth cohorts compared with the 1987-88 group and with the standard. Feeding patterns showed high levels of compliance with nutrition guidance. Growth monitoring, staff and maternal education, and supplementation with vitamins and, especially, iron were associated with marked improvements in feeding patterns and the growth status of children aged 3-15 months.

Age, sex, educational attainment, and race/ethnicity in relation to consumption of specific foods contributing to the atherogenic potential of diet.

BACKGROUND: We examined which specific foods contributed to the atherogenic potential of diet in population segments defined by age, sex, educational attainment, and race/ethnicity. Data from the 1989 New York State Healthy Heart Program baseline survey were analyzed. METHODS: This telephone survey was conducted in eight communities (total population approximately 1.24 million people) in New York State. Response rate was 65.5% (N = 4,179); 3,606 subjects ages 20 to 64 years who reported their level of educational attainment with self-described ethnicity of white (N = 1,935), black (N = 1,035), or Hispanic (N = 636) were retained in the analysis. Diet was assessed using a 17-item food frequency questionnaire which focused on commonly eaten food high in saturated fat and cholesterol. Connor's cholesterol/saturated-fat index was used as a scale of the atherogenic potential of the diet. RESULTS: Eggs, whole milk, cheese, beef, and butter/margarine were the foods contributing most to the cholesterol/saturated-fat index score in all age-, sex-, and race/ethnicity-specific population segments examined, together contributing a total of 52 to 72% of the cholesterol/saturated-fat index score as measured by the 17-item diet questionnaire. CONCLUSIONS: The implication for public health campaigns directed at reducing the atherogenic potential of diet atherogenicity and for primary care practitioners seeking to influence the diet of patients with high blood cholesterol is that substitutions of less atherogenic food choices for these five foods would appear to be appropriate for most adults.

Maternal smoking: greater effect on males, fetal tobacco syndrome?

We tested the recently proposed criteria for a Fetal Tobacco Syndrome (FTS) on a sample of 925 primiparous black women (including 204 smokers) and their neonates. The proposed FTS criteria included proportional growth retardation (ponderal index greater than 2.26, birth weight less than 2,500 g) in term neonates. Only 19 neonates (2%) in our study fulfilled the FTS morphometric criteria, and of these only 8 had smoking mothers. Nonetheless, the negative effect of maternal smoking on fetal growth (birth weight and length) as reported from earlier investigations was clearly evident in our own data (P less than .01). Separate analysis by fetal sex revealed that the negative effect of maternal smoking upon fetal growth is more pronounced among males than females. We concluded that fetal sex should be taken into account in studies of maternal smoking effects. As for evidence for the existence of the FTS, it remains to be proven.

Growth patterns of height and weight among three groups of Samoan preadolescents.

The Samoan population affords an excellent opportunity to study the influences of modernization and migration on growth. Moreover, since Samoan adults in some settings have very high rates of obesity, the childhood precursors to obesity can be studied among Samoans. This study reports the results of a survey of 786 Samoan children between 5.5 and 11.5 years of age living in traditional, modern or migrant situations. It was found that the children from Western Samoa (traditional) were significantly shorter, lighter and lighter for height than their counterparts in American Samoa (modern) and Hawaii (migrant). The major influence on height and weight appears to be modernization (Western versus American Samoa), with migration (American Samoa versus Hawaii) playing only a small incremental role (significant only for weight among boys). The influences of modernization are likely to be exerted through changes in diet and activity among the children. Modernization and migration are associated with obesity among Samoan adults, and this pattern also seems to be established in preadolescents.

Earlier maturation of pregnant black and white adolescents.

A survey was made of the menarcheal age and anthropometry of 1,844 lower income, nulliparous female patients receiving prenatal care. No differences were observed between black and white patients in height and maximum pregnant weight. A significantly earlier mean menarcheal age was observed in adolescents (12 to 16 years) compared with adults (17 to 31 years). Younger adolescents (12 to 14 years) of both races were taller and heavier (prepregnancy) than National Center for Health Statistics standards and had a significantly greater weight-for-height. Menarcheal age and body habitus were consistent with other reports that younger pregnant adolescents tend to be earlier maturers than older pregnant adolescents and adults. Compared with their age-group cohorts (13 to 31 years) in the two-decades-old Collaborative Perinatal Study of the National Institute of Neurological Communicative Disorders and Stroke, these female patients were larger and had greater pregnancy weight gains. These anthropometric findings may reflect the two decades of improvements in social assistance and prenatal care for lower income women.

Maternal sociomedical characteristics and birth weights of firstborns.

Pregnancy outcome and sociomedical characteristics were examined in a sample of 1844 black and white primiparous females who received prenatal care. White females were more frequently married and more likely to live with their husbands than with their parents. Black females were better educated and more interested in obtaining further education. White women smoked significantly more cigarettes. There were no differences in contraceptive use in black and white females. Number of prenatal visits was least frequent among adolescent black females. With the exception of a higher incidence of vaginal infection among black females, there were no significant differences in general health status. There were no differences in birth weights between the firstborns of black and white adolescents, but adult white females had significantly heavier firstborns than blacks. Nonetheless, no differences were found in prevalence of low birth weight-for-gestational neonates between black and white females. Infrequent prenatal visits, maternal diabetes and smoking were the only significant multivariate factors associated with the occurrence of a low birth weight-for-gestational age neonate among the total sample.