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Objectives: We examined whether social networks had a protective association with incidence of dementia among elderly women., Methods: We prospectively studied 2249 members of a health maintenance organization who were 78 years or older, were classified as free of dementia in 2001, and had completed at least 1 follow-up interview in 2002 through 2005. We used the Telephone Interview for Cognitive Status-modified, the Telephone Dementia Questionnaire, and medical record review to assess cognitive status. We used the Lubben Social Network Scale-6 to assess social network. We estimated hazard ratios for incident dementia with Cox proportional hazards models, adjusting for age at entry, education, hormone use, cognitive status scores, and health conditions., Results: We identified 268 incident cases of dementia during follow-up. Compared with women with smaller social networks, the adjusted hazard ratio for incident dementia in women with larger social networks was 0.74 (95% confidence interval=0.57, 0.97)., Conclusions: Our findings suggest that larger social networks have a protective influence on cognitive function among elderly women. Future studies should explore which aspects of social networks are associated with dementia risk and maintenance of cognitive health.

Objectives: The influx of Southeast Asians into the United States allows for the study of this special population and contributes to a broader understanding of reproductive health., Methods: We used information on birth certificates to identify 1937 Hmong children born 1985 through 1988 in California, and we compared birthweight and reproductive factors as related to these children with the same factors as related to 3776 White, non-Hispanic children born in the same period., Results: Mean birthweight among Hmong children (3311 g) was significantly lower (P less than .05) than among White children (3452 g), but the proportion of births under 1500 g was higher for Whites. Hmong women were of much higher parity and were more likely to deliver at both a young (less than 18 years) and an old (greater than 40 years) maternal age. At every age and every parity, however, Hmong women had cesarean sections at one-half to one-tenth the rate of White women., Conclusions: Despite a high proportion of births at high parity and advanced maternal age, Hmong women gave birth to very low-birthweight babies at essentially the same rates as White women. Their lower cesarean section rates, however, deserve further attention.

Background: Successful programs to help pregnant women quit smoking have been developed and evaluated, but formal smoking cessation programs are not a part of care at most prenatal sites. The cost of such programs may be an issue. Considering the costs of adverse maternal and infant outcomes resulting from smoking, we estimated there would be an amount of money a prenatal program could invest in smoking cessation and still "break even" economically., Methods: A model was developed and published data, along with 1989 hospital charge data, were used to arrive at a break-even point for smoking cessation programs in pregnancy., Results: Using overall United States data, we arrived at a break-even cost of $32 per pregnant woman. When these data were varied to fit specific US populations, the break-even costs varied from $10 to $237, with the incidence of preterm low birth weight having the most impact on the cost., Conclusions: It may be advisable to invest greater amounts of money in a prenatal smoking cessation program for some populations. However, for every population there is an amount that can be invested while still breaking even.

The incidence of toxic shock syndrome in women members of a large prepaid medical care program in Northern California was 1.5 cases per 100,000 in a period after removal of tampons containing polyacrylate rayon and reductions in tampon absorbency. This rate was lower, but not significantly lower, than the rate of 2.2 per 100,000 in the prior interval. It was higher, but not significantly higher, than the rate of 0.4 per 100,000 in the era before "superabsorbent" materials were introduced into tampons. The incidence in men has been stable at about 0.1 cases per 100,000 for the 15-year period from 1972 though 1987.

In a population-based case-control study, we assessed the relation between cocaine use and the risk of low birth weight in Alameda County, California, excluding women who used heroin and/or methadone during pregnancy. After adjustment for confounders, the relative risk of low birth weight in users of cocaine throughout pregnancy was 4.0 (95% CI = 1.8, 8.9). Cocaine use was estimated to account for 10 percent of cases of low birth weight in Black women in Alameda County.

In the setting of a prepaid medical care plan, self-administered questionnaires were an accurate source of information on smoking habits and the standard against which the physiologic measures of smoking, serum thiocyanate, and expired carbon monoxide, must be judged. Questionnaire responses were internally consistent and highly reproducible. In contrast, the physiologic measures had low overall sensitivity as tests of current tobacco exposure (0.72). Their sensitivity was improved by utilizing the self-reported information.

The duration per week of exposure to others' tobacco smoke in different locations was tabulated from the questionnaire responses of 37,881 non-smokers and ex-smokers who received multiphasic health checkups in 1979 and 1980. Altogether 63.3 per cent of subjects reported some exposure, 34.5 per cent were exposed at least 10 hours per week, and 15.9 per cent at least 40 hours per week. Duration of exposure per week was weakly correlated with serum thiocyanate level in a small test group. Exposure was strongly related to age with a peak of 78.2 per cent in the twenties decade and an accelerating decline thereafter to 13.9 per cent in those age 80 and over. Sex and race were related to passive smoking only to a relatively small degree. Persons reporting longer exposures were more apt to report greater use of alcohol and marijuana, exposure to occupational hazards, and being currently not married. Lack of college education was most frequent among those denying exposure but was directly related to exposure duration among those reporting some passive smoking. Studies of the health effects of passive smoking should take into account these associated factors. Although the reported passive smoking of married persons was strongly related to their spouses' habits, categorization by spouses' smoking resulted in considerable misclassification.

The California Automated Mortality Linkage System (CAMLIS), established in 1981 to facilitate the conduct of follow-up studies in the State of California, employs a combination of deterministic and probabilistic linkage decision criteria to perform the death clearance function. The system was evaluated against four traditional death clearance procedures and the performance of each procedure measured in terms of measures of sensitivity and specificity. Only one procedure was associated with a specificity lower than 0.99; for that one, the specificity was 0.93. There was much greater fluctuation in the observed sensitivity levels. In one of the procedures, CAMLIS demonstrated a sensitivity of 0.97 versus 0.79 for the Social Security Administration. A comparison against the National Death Index (NDI) produced sensitivities of 0.89 for CAMLIS and 0.94 for the NDI. An assessment of manual search procedures using a file of Japanese names produced a CAMLIS sensitivity measure of 0.92 compared with 0.93 for the manual search. Another manual search procedure using microfiche copies of the state death index produced a CAMLIS sensitivity of 0.97; in this evaluation, the sensitivity of the manual search was defined as 1.0. Another measure of performance of a death clearance procedure is its predictive value in identifying a person who has died; CAMLIS generated predictive values in these evaluations that ranged from 0.93 through 0.99, contrasted with the NDI value of 0.59.

Using questionnaire information provided by 4.385 vasectomized and 13,155 matched, non-vasectomized men, we found no significant differences between them for a large number of symptoms and diseases, including those of the cardiovascular system. After taking into account differences in their martial status, past smoking habits, and physical activity at work, significant statistical associations of vasectomy with joint pain or swelling, back trouble, and a history of kidney or bladder infection persisted. Our data are inconsistent with the occurrence of large increases in the risks of many important diseases in vasectomized humans.

A case-control study of low birthweight among residents of high risk areas of Alameda County was conducted in 1983. The relation of 13 variables to low birthweight was assessed using a multiple logistic regression analysis. A six-fold increase in the risk of low birthweight was found in association with financial problems during the current pregnancy, controlling for differences in race, certain poor health habits, complications of pregnancy, and several other factors between cases and controls.