The Latino mortality paradox: a test of the "salmon bias" and healthy migrant hypotheses.
(9/705)
OBJECTIVES: Relative to non-Latino Whites, Latinos have a worse socioeconomic profile but a lower mortality rate, a finding that presents an epidemiologic paradox. This study tested the salmon bias hypothesis that Latinos engage in return migration to their country of origin and are thereby rendered "statistically immortal" and the alternative hypothesis that selection of healthier migrants to the United States accounts for the paradox. METHODS: National Longitudinal Mortality Study data were used to examine mortality rates of the following groups for whom the salmon hypothesis is not feasible: Cubans, who face barriers against return migration; Puerto Ricans, whose deaths in Puerto Rico are recorded in US national statistics; and US-born individuals, who are not subject to either salmon or healthy migrant effects. RESULTS: The sample included 301,718 non-Latino Whites and 17,375 Latino Whites 25 years or older. Cubans and Puerto Ricans had lower mortality than non-Latino Whites. Moreover, US-born Latinos had lower mortality than US-born non-Latino Whites. CONCLUSIONS: Neither the salmon nor the healthy migrant hypothesis explains the pattern of findings. Other factors must be operating to produce the lower mortality. (+info)
The risks for late adolescence of early adolescent marijuana use.
(10/705)
OBJECTIVES: The purpose of this study was to assess the relation of early adolescent marijuana use to late adolescent problem behaviors, drug-related attitudes, drug problems, and sibling and peer problem behavior. METHODS: African American (n = 627) and Puerto Rican (n = 555) youths completed questionnaires in their classrooms initially and were individually interviewed 5 years later. Logistic regression analysis estimated increases in the risk of behaviors or attitudes in late adolescence associated with more frequent marijuana use in early adolescence. RESULTS: Early adolescent marijuana use increased the risk in late adolescence of not graduating from high school; delinquency; having multiple sexual partners; not always using condoms; perceiving drugs as not harmful; having problems with cigarettes, alcohol, and marijuana; and having more friends who exhibit deviant behavior. These relations were maintained with controls for age, sex, ethnicity, and, when available, earlier psychosocial measures. CONCLUSIONS: Early adolescent marijuana use is related to later adolescent problems that limit the acquisition of skills necessary for employment and heighten the risks of contracting HIV and abusing legal and illegal substances. Hence, assessments of and treatments for adolescent marijuana use need to be incorporated in clinical practice. (+info)
A survey of the ethnic and racial distribution in orthopedic residency programs in the United States.
(11/705)
This study examined the racial and ethnic composition of orthopedic training programs in the United States. A questionnaire was mailed in January 1995 to chairpersons at 159 orthopedic programs in the United States. Eighty-nine (56%) responses were received. The distribution of orthopedic residents and fellows was as follows: white non-Hispanic, 84.2%; Asian, 6.6%; African American, 3.6%; Native American, 2.2%; Puerto Rican, 1.2%; Mexican American, 0.8%; and other Hispanic, 1%. African Americans and Hispanics were under-represented in orthopedic training programs compared with their numbers in the general population. The percentage of residents in these two minority groups also were below goals established by the Council on Graduate Medical Education and the US Government's Healthy People 2000 report. In contrast, Native Americans and Asians were overrepresented. If racial balance is to be achieved in orthopedics, new incentives must be created to encourage more African Americans and Hispanics to enter orthopedic residency training programs. (+info)
Hospitalizations for suspected dengue in Puerto Rico, 1991-1995: estimation by capture-recapture methods. The Puerto Rico Association of Epidemiologists.
(12/705)
Capture-recapture estimations compare the results of 2 or more independent surveillance systems for the same event, and by measuring the degree of overlap between them, provide an estimate of the total number of events, and therefore the completeness of ascertainment in each system. The Puerto Rico Department of Health and the Dengue Branch of the Centers for Disease Control and Prevention (CDC) monitor dengue activity in Puerto Rico through 2 distinct surveillance systems: diagnostic specimens from patients with suspected dengue and infection control nurses' reports on patients hospitalized for suspected dengue. The patient listings from these systems were used in a 2-sample, capture-recapture calculation to estimate the total number of persons with suspected dengue hospitalized from 1991 to 1995. The laboratory positivity rate for suspected dengue cases who submitted appropriately timed serum samples in those years ranged from 72.1% to 81.2%. The laboratory-based (diagnostic sample) surveillance system (routinely used to monitor hospitalizations for suspected dengue) detected an average of 1,197 hospitalized cases during non-epidemic years, and 4,329 cases during the epidemic year of 1994. The detection rate of this system averaged 42% of the numbers derived by the capture-recapture method. In non-epidemic years, an estimated average of 2,791 patients (range = 1,553-3,481) was estimated to have been hospitalized with a clinical diagnosis of dengue, compared with 9,479 during 1994. These results demonstrate the under-detection inherent in passive surveillance systems for hospitalized cases of suspected dengue, and illustrate the value of capture-recapture techniques to better estimate the true incidence of hospitalizations for this disease. (+info)
Common occurrence of concurrent infections by multiple dengue virus serotypes.
(13/705)
The co-circulation of all 4 dengue virus serotypes in the same community, common since the 1950s in Southeast Asia, has now become a frequent occurrence in many Caribbean Islands, Mexico, and Central and South America in the past 20 years. As a consequence, the frequency of concurrent infections would be expected to increase in these areas. To assess this, using state of the art technology, we screened viremic serum samples and mosquitoes inoculated with serum samples collected during epidemics involving multiple dengue virus serotypes in Indonesia, Mexico, and Puerto Rico for virus isolation. Of 292 samples tested, 16 (5.5%) were found to contain 2 or more dengue viruses by an indirect immunofluorescence test and/or the reverse transcriptase-polymerase chain reaction. (+info)
Transmission thresholds for dengue in terms of Aedes aegypti pupae per person with discussion of their utility in source reduction efforts.
(14/705)
The expense and ineffectiveness of drift-based insecticide aerosols to control dengue epidemics has led to suppression strategies based on eliminating larval breeding sites. With the notable but short-lived exceptions of Cuba and Singapore, these source reduction efforts have met with little documented success; failure has chiefly been attributed to inadequate participation of the communities involved. The present work attempts to estimate transmission thresholds for dengue based on an easily-derived statistic, the standing crop of Aedes aegypti pupae per person in the environment. We have developed these thresholds for use in the assessment of risk of transmission and to provide targets for the actual degree of suppression required to prevent or eliminate transmission in source reduction programs. The notion of thresholds is based on 2 concepts: the mass action principal-the course of an epidemic is dependent on the rate of contact between susceptible hosts and infectious vectors, and threshold theory-the introduction of a few infectious individuals into a community of susceptible individuals will not give rise to an outbreak unless the density of vectors exceeds a certain critical level. We use validated transmission models to estimate thresholds as a function of levels of pre-existing antibody levels in human populations, ambient air temperatures, and size and frequency of viral introduction. Threshold levels were estimated to range between about 0.5 and 1.5 Ae. aegypti pupae per person for ambient air temperatures of 28 degrees C and initial seroprevalences ranging between 0% to 67%. Surprisingly, the size of the viral introduction used in these studies, ranging between 1 and 12 infectious individuals per year, was not seen to significantly influence the magnitude of the threshold. From a control perspective, these results are not particularly encouraging. The ratio of Ae. aegypti pupae to human density has been observed in limited field studies to range between 0.3 and >60 in 25 sites in dengue-endemic or dengue-susceptible areas in the Caribbean, Central America, and Southeast Asia. If, for purposes of illustration, we assume an initial seroprevalence of 33%, the degree of suppression required to essentially eliminate the possibility of summertime transmission in Puerto Rico, Honduras, and Bangkok, Thailand was estimated to range between 10% and 83%; however in Mexico and Trinidad, reductions of >90% would be required. A clearer picture of the actual magnitude of the reductions required to eliminate the threat of transmission is provided by the ratio of the observed standing crop of Ae. aegypti pupae per person and the threshold. For example, in a site in Mayaguez, Puerto Rico, the ratio of observed and threshold was 1.7, meaning roughly that about 7 of every 17 breeding containers would have to be eliminated. For Reynosa, Mexico, with a ratio of approximately 10, 9 of every 10 containers would have to be eliminated. For sites in Trinidad with ratios averaging approximately 25, the elimination of 24 of every 25 would be required. With the exceptions of Cuba and Singapore, no published reports of sustained source reduction efforts have achieved anything near these levels of reductions in breeding containers. Practical advice on the use of thresholds is provided for operational control projects. (+info)
Haloterrigena thermotolerans sp. nov., a halophilic archaeon from Puerto Rico.
(15/705)
An extremely halophilic Archaeon belonging to the order Halobacteriales was isolated from the solar salterns of Cabo Rojo, Puerto Rico. The organism, designated strain PR5T, is rod-shaped, non-motile and requires at least 12% (w/v) NaCl to grow. The strain is highly thermotolerant: its temperature optimum is 50 degrees C and growth is possible up to 60 degrees C. Polar lipid analysis revealed the presence of the bis-sulfated glycolipid S2-DGD-1 as sole glycolipid and the absence of the glycerol diether analogue of phosphatidylglycerosulfate. Both C20,C20 and C20,C25 core lipids are present. The G+C content of the DNA is 63.3 mol%. According to 16S rDNA sequence data, strain PR5T is closely related to the representatives of the genera Haloterrigena and Natrinema, but on the basis of its phenotypic properties, 16S rDNA sequence and DNA-DNA hybridization studies, strain PR5T cannot be assigned to any of the recognized species within these genera. On the basis of its polar lipid composition, the isolate has been assigned to the genus Haloterrigena. The creation of a new species, Haloterrigena thermotolerans, is therefore proposed to accommodate this isolate. The type strain is strain PR5T (= DSM 11552T = ATCC 700275T). (+info)
Asthma and Latino cultures: different prevalence reported among groups sharing the same environment.
(16/705)
OBJECTIVES: This 1999 study measured asthma prevalence among Latinos of different cultural traditions who live on the same streets and in the same buildings. METHODS: Health promoters from El Puente in North Brooklyn, New York City, surveyed 3015 people in 946 households, asking standard asthma prevalence questions. RESULTS: Some 46% of households identified themselves as Dominican, 42% as Puerto Rican, 6% as other Latino, and 6% as other. Reported asthma period prevalence was 5.3% (93 of 1749) among Dominicans and other Latinos, compared with 13.2% (147 of 1115) among Puerto Ricans (odds ratio = 0.37; 95% confidence interval = 0.28, 0.49), a difference not explained by location (cluster or building), household size, use of home remedies, educational attainment, or country where education was completed. Differences were least detectable among 13- to 24-year-olds of both sexes and sharpest among women aged 45 years and older and girls from birth to 12 years. CONCLUSIONS: Further research on gene-environment interactions is needed among Puerto Ricans and Dominicans, but asthma's associations with low income and unhealthy environment, which more recent immigrants seem better able to withstand, should not be overlooked. (+info)