Preventing cardiovascular disease through community-based risk reduction: the Bootheel Heart Health Project.

OBJECTIVES: The purpose of this study was to determine whether a community-based risk reduction project affected behavioral risk factors for cardiovascular disease. METHODS: Community-based activities (e.g., exercise groups, healthy cooking demonstrations, blood pressure and cholesterol screenings, and cardiovascular disease education) were conducted in six southeastern Missouri counties. Evaluation involved population-based, cross-sectional samples of adult residents of the state and the intervention region. Weighted prevalence estimates were calculated for self-reported physical inactivity, cigarette smoking, consumption of fruits and vegetables, overweight, and cholesterol screening. RESULTS: Physical inactivity decreased within the intervention region, that is, in communities where heart health coalitions were developed and among respondents who were aware of these coalitions. In addition, the prevalence rates for reports of cholesterol screening within the past 2 years were higher for respondents in areas with coalitions and among persons who were aware of the coalitions. CONCLUSIONS: Even with modest resources, community-based interventions show promise in reducing self-reported risk for cardiovascular disease within a relatively brief period.

The role of data-driven planning and coalition development in preventing cardiovascular disease.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States. Effective programs for the prevention and control of CVD need to include data-based planning and evaluation at the State and local levels. The authors describe the development of data-driven planning and intervention strategies in Missouri. Statewide planning activities have resulted in the formation of an advisory committee and development of a State plan, a resource directory, and training courses. Analysis of mortality data revealed an unusual concentration of CVD deaths in the southeast portion of the State. Local coalitions are being developed in each of six counties in this region to reduce the prevalence of CVD risk factors. A regional behavioral risk factor survey of 1,006 adults identified key risk factors that will be addressed by the coalitions. These data suggested that physical inactivity, obesity, and hypertension are especially acute problems in the area. Key components of the local coalition development included providing localized data and obtaining the strong commitment of the local health departments. Expanded use of chronic disease surveillance data for planning and evaluation will increase the probability that localities, States, and the nation will achieve Year 2000 Health Objectives. The data-based planning process is described as a possible model for use by other States and localities.

Population biology of hookworms in west Bengal: analysis of numbers of infective larvae recovered from damp pads applied to the soil surface at defaecation sites.

The aims of this study were to analyze the seasonal distribution of infective larvae on the soil surface, to determine whether numbers of infective larvae near faeces were related to the faecal egg count of individuals, and to relate the distribution of larvae to environmental characteristics. Larvae were recovered from damp pads, applied to the soil surface in an annulus around fresh, identified stools of individuals who were participating in a larger epidemiological study. This provided an estimate of exposure to infection at the time of defaecation. Transmission was restricted to the rainy season and large aggregations of larvae were encountered earlier rather than later in the rainy season. Frequency distributions for the number of larvae extracted from each pad showed a high degree of aggregation, with most monthly counts showing good fits to the negative binomial probability distribution. Despite variations in monthly sampling means, the degree of aggregation in the population of larvae was remarkably stable over the 18 month sampling period (k of negative binomial = 0.01 to 0.08). Estimates of the degree of aggregation of the parasites in the human population were also available, and comparisons suggest that the infective larvae were much more aggregated than the parasitic stages. There was no relationship between the mean daily egg output of individuals and the number of larvae which developed and were recovered from the soil surface near the faeces. Thus, people who contribute large numbers of eggs to the environment are not necessarily those who are the greatest source of infection for others.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrested development in human hookworm infections: an adaptation to a seasonally unfavorable external environment.

Contrary to general belief, larvae of Ancylostoma duodenale do not always develop directly to adulthood upon invasion of man. In West Bengal, India, arrested development appears to be a seasonal phenomenon which results in (i) reduction of egg output wasted in seeding an inhospitable environment and (ii) a marked increase in eggs entering the environment just before the monsoon begins.