Yersinia enterocolitica gastroenteritis among infants exposed to chitterlings--Chicago, Illinois, 2002.
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During December 2002-January 2003, the Chicago Department of Public Health (CDPH) investigated a cluster of Yersinia enterocolitica infections reported during a 10-week period among nine Chicago infants aged < or =1 year. This report summarizes the investigation of these cases and underscores the continuing risks for enteric infection among infants exposed to chitterlings (i.e., pork intestines), and the need for health-care providers to be aware of Y. enterocolitica as a cause of gastroenteritis, particularly in black children during traditional winter holiday celebrations. (+info)
Comorbid psychiatric disorders in youth in juvenile detention.
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OBJECTIVE: To estimate 6-month prevalence of comorbid psychiatric disorders among juvenile detainees by demographic subgroups (sex, race/ethnicity, and age). DESIGN: Epidemiologic study of juvenile detainees. Master's level clinical research interviewers administered the Diagnostic Interview Schedule for Children Version 2.3 to randomly selected detainees. SETTING: A large temporary detention center for juveniles in Cook County, Illinois (which includes Chicago and surrounding suburbs). PARTICIPANTS: Randomly selected, stratified sample of 1829 African American, non-Hispanic white, and Hispanic youth (1172 males, 657 females, aged 10-18 years) arrested and newly detained. MAIN OUTCOME MEASURE: Diagnostic Interview Schedule for Children. RESULTS: Significantly more females (56.5%) than males (45.9%) met criteria for 2 or more of the following disorders: major depressive, dysthymic, manic, psychotic, panic, separation anxiety, overanxious, generalized anxiety, obsessive-compulsive, attention-deficit/hyperactivity, conduct, oppositional defiant, alcohol, marijuana, and other substance; 17.3% of females and 20.4% of males had only one disorder. We also examined types of disorder: affective, anxiety, substance use, and attention-deficit/hyperactivity or behavioral. The odds of having comorbid disorders were higher than expected by chance for most demographic subgroups, except when base rates of disorders were already high or when cell sizes were small. Nearly 14% of females and 11% of males had both a major mental disorder (psychosis, manic episode, or major depressive episode) and a substance use disorder. Compared with participants with no major mental disorder (the residual category), those with a major mental disorder had significantly greater odds (1.8-4.1) of having substance use disorders. Nearly 30% of females and more than 20% of males with substance use disorders had major mental disorders. Rates of some types of comorbidity were higher among non-Hispanic whites and older adolescents. CONCLUSIONS: Comorbid psychiatric disorders are a major health problem among detained youth. We recommend directions for research and discuss how to improve treatment and reduce health disparities in the juvenile justice and mental health systems. (+info)
Early life conditions and cognitive functioning in later life.
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Early life conditions are related to cognitive development and abilities in childhood and cognitive function in adulthood. However, the association between early life conditions and cognitive change in old age is unknown. The authors examined the relation between socioeconomic position (SEP) and cognitive milieu in childhood and change in cognitive function in a population-based sample of 4,398 community-dwelling adults (62.1% female; 61.7% Black) aged 65 years or older from Chicago, Illinois. Baseline data were collected in 1993-1997. Change in cognitive function was assessed by means of a global cognitive index derived from measures of memory, perceptual speed, and overall cognitive function administered at three in-home assessments between 1993 and 2003, with an average of 5.3 years of follow-up. After results were controlled for age, sex, race, and education, interactions of time with childhood SEP (beta = -0.003, t = -1.0, p = 0.32) and childhood cognitive milieu (beta = -0.0008, t = -0.5, p = 0.62) were nonsignificant, indicating that early life conditions were not related to cognitive change. SEP (beta = 0.034, t = 2.4, p = 0.01) and cognitive milieu (beta = 0.017, t = 2.2, p = 0.03) were associated with absolute level of cognitive function, with better performance being related to higher SEP and a better cognitive milieu. A better SEP and a more stimulating cognitive milieu in childhood have small but significant effects on absolute level of cognitive function; however, they do not seem to protect against cognitive decline in old age. (+info)
Response rates to a questionnaire 26 years after baseline examination with minimal interim participant contact and baseline differences between respondents and nonrespondents.
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Research on response rates to surveys mailed to study participants decades after baseline examination, with minimal interim contact, is limited. This paper documents response rates to a 26-year follow-up survey of surviving participants from a large cohort in Illinois and compares baseline characteristics of nonrespondents and respondents. Mortality follow-up of the Chicago Heart Association Detection Project in Industry 1967-1973 cohort involved minimal or no participant contact since baseline. In 1996, a 26-year follow-up questionnaire was mailed to all surviving participants aged 65 years or older. Current addresses were obtained from the Health Care Financing Administration for 96.5 percent of 12,409 participants in our analyses. Total response rates were 59.8 percent and, for participants for whom Health Care Financing Administration addresses were available, 60.8 percent. A higher response rate was obtained for younger recipients, men, Whites, more-educated persons, nonsmokers, and those with a better cardiovascular risk profile at baseline. A graded negative relation was found between number of cardiovascular risk factors at baseline and response rates obtained in 1996. Use of Health Care Financing Administration records as an additional follow-up method and factors that influence response rates are discussed. In conclusion, long-term follow-up of older surviving participants is feasible if current addresses can be obtained from standardized sources. (+info)
Comparison of health status indicators in chicago: are Black-White disparities worsening?
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OBJECTIVES: This study examined Chicago residents' progress toward the Healthy People 2000 goal of reducing racial disparities in health and compared the results with a recent analysis of US data. METHODS: Non-Hispanic Black-to-non-Hispanic White rate ratios were computed for 14 health status indicators for 1990 and for 1998. RESULTS: Nationally and in Chicago, indicators for both Blacks and Whites improved between 1990 and 1998; however, Whites consistently fared better. Nationally, gaps narrowed on 10 indicators; for Chicago, they widened on 10 indicators. CONCLUSIONS: Nationally, there is apparent progress in reducing Black-White disparities; this is not true for Chicago. Whether failure to reduce racial disparities is unique to Chicago or is common to other urban centers remains an open question with important implications. (+info)
HIV/AIDS Community Health Information System.
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Given changes in the faces of AIDS over the last decade, it is crucial that disparities in health and access to healthcare are addressed. An Internet-based GIS was developed using ESRI's Arc Internet Map Server (Arc IMS) to provide users with a suite of tools to interact with geographic data and conduct spatial analyses related to the characteristics that promote or impede the provision of HIV-related services. Internet Mapping allows those engaged in local decision-making to: (1) geographically visualize information via the Internet; (2) Assess the relationship between the distribution of HIV services and spatially referenced socio-economic data; and (3) generate "what if" scenarios" that may direct the allocation of healthcare resources. (+info)
Newly diagnosed tuberculosis in inner-city Chicago: the pulmonary fellow perspective.
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BACKGROUND: The extent to which pulmonary fellows encounter patients with newly diagnosed tuberculosis during their 3-year training program in large metropolitan areas in the USA where active tuberculosis is still relatively common is uncertain. OBJECTIVES: To characterize clinical encounters of pulmonary fellows with patients with newly diagnosed tuberculosis at a large university-based training program in inner-city Chicago over a 3-year period. METHODS: A retrospective review of medical records of patients with newly diagnosed tuberculosis at the University of Illinois Medical Center at Chicago outpatient clinics (UMC) and the City of Chicago Department of Public Health Uptown Neighborhood Health Center Tuberculosis Clinic (CDPH) between 1999 and 2001 was conducted. A pulmonary fellow encounter rate (PFER) was derived as the average number of patients with newly diagnosed tuberculosis seen by a pulmonary fellow per month over the 3-year study period in each institution. RESULTS: We found that 9 pulmonary fellows diagnosed, treated and followed all 80 patients with newly diagnosed tuberculosis seen at CDPH over the 3-year study period. By contrast, they evaluated only 14 patients with newly diagnosed tuberculosis and followed 2 of them regularly at UMC (p < 0.05). PFER was 2.96 at CDPH and 0.52 at UMC (p < 0.05). Adverse events ascribed to anti-tuberculosis drugs were observed more frequently in patients seen by pulmonary fellows at CDPH than at UMC (p < 0.05). CONCLUSIONS: Pulmonary fellows are more likely to encounter patients with newly diagnosed tuberculosis at a designated tuberculosis clinic than at a university hospital in inner-city Chicago during their 3-year training. (+info)
Developing a group practice comprehensive care education curriculum.
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In fall 2002 the University of Illinois at Chicago College of Dentistry implemented a Group Practice Comprehensive Care Clinical Education Curriculum. The primary responsibility for patient care has shifted in this comprehensive care curriculum from the students to the faculty and staff. Students have a primary responsibility for learning. This competency-based education curriculum utilizes a variety of student evaluation methods including self-evaluation, OSCE, and portfolio to verify competence. Formative evaluation methods are utilized in daily assessment of student performance. On-time graduation rates have increased from 60-70 percent to 96 percent, and regional board first-time pass rates have been maintained at 90+ percent. Overall predoctoral clinical productivity in the first full year of the program has increased by over 300,000 dollars. (+info)