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The authors analyzed temporal variations in asthma hospital admissions for New Jersey children (0-14 years of age) over a 3-year period. Significant spikes in children's asthma hospital admissions occurred during late September and early October of each of the 3 years of the study. The authors report on an in-depth analysis of the fall peak periods, in an effort to determine whether there was an association between children's asthma hospital admissions and environmental variables. Hospital admission peaks occurred approximately 3 weeks after school started and before heating systems were turned on in New Jersey public schools. They also preceded the point at which schools begin to report increased absences that are due to infectious illnesses. An examination of environmental variables showed only weed pollen as a statistically significant predictor of children's asthma hospital admissions during the fall peaks (p < .001). The counseling of parents about children's exposure to pollen and possible ways to reduce such exposure should be part of the asthma management protocols for children living in high-pollen environments. KEY WORDS: air pollution, asthma, children, ozone, pollen, Seasonal variations in asthma have been widely documented. (1-5) Fleming et al (4) found that, in England, there was a peak in asthma hospital admissions during late September for children [...]

Imagine that a parent wakes up one morning and finds his/her child having a fever. The parent is likely to call a pediatrician for instructions about how to handle the […]

A screening program identified children with poorly managed asthma or respiratory dysfunction. Children in grades 2-5 in all Passaic, New Jersey, schools were eligible for screening with questionnaires and a biometric test. Those with risk factors or failed biometric screening were referred to primary care providers. Of the 6,579 eligible children, 3,657 (56%) had parental questionnaires returned and 3,834 (58%) were biometrically screened. Over the 4-yr study period, 6-22% of children were previously diagnosed with asthma. Approximately 20% of children demonstrated peak flow measures Key words: childhood asthma, Hispanic populations, respiratory dysfunction, school-based screening, ASTHMA affects more than 5% of the American population, about 15 million people and nearly 7% of children < 18 yr. (1-3) Unlike many illnesses that have shown dramatic declines [...]

An investigation on mortality rates of frail people under 75 years of age suggests that those belonging to the 'young-old' category are more susceptible to death due to exposure, while White females succumb to hunger death at an average age of 80.7 years. In the case of males, younger, nonmetropolitan individuals are more susceptible to hunger death. These studies imply the need for voluntary intervention of caregivers in cases of insufficient self-care in older individuals possessing higher risk for exposure and hunger deaths.

More than 100 academic and private-sector researchers, government officials, politicians, and public health practitioners met to discuss issues regarding children's environmental health. Of special concern were the lack of toxicological data on many chemicals, the paucity of studies of children's exposure to these chemicals, and our limited understanding of pediatric toxicology. The increased incidence of childhood cancers and asthma were also of concern, as was our lack of understanding of how exposures to multiple environmental chemicals in low doses may influence child growth and development, disrupt endocrine function, and stimulate development of chronic diseases. An agenda for basic research, education and outreach, and policy and program development was created, with a goal of moving children's environmental health issues forward in a logical and thoughtful manner., MORTALITY RATES for children in the 1-4-y age range fell from 63.9/100,000 in 1980 to 38.5/100,000 in 1996. Rates for children aged 5-14 y fell from 30.6/100,000 to 21.9/100,000 for [...]

The Passaic Asthma Reduction Effort (PARÉ) used an asthma symptom and household exposure factor questionnaire to screen 4634 elementary school children over a 4-year period in Passaic, New Jersey. During the first year, an additional 240 preschool children were also screened. Overall, 16% of the school children were reported by their parents to have been diagnosed with asthma. In all, 30% of responding families claimed to have at least one family member diagnosed with asthma and this was five times more likely if the target child had asthma. Exposures consistently associated with childhood asthma diagnosis included environmental tobacco smoke (ETS), presence of dampness/mold, roaches, and furry pets in the home. Diagnosis of asthma was primarily associated with all six symptoms used in the PARÉ questionnaire, and secondarily with environmental factors. Puerto Rican and black children had the highest asthma prevalence (26% and 33%), while Mexican children had the lowest (7%). Use of medications and school absenteeism among asthmatic children were associated with wheeze and night cough, but not with any specific environmental exposure. Increased school absenteeism by children undiagnosed with asthma was associated with ETS and dampness/mold in the home. Differences in asthma diagnosis and absenteeism in response to environmental factors were found across ethnic subgroups. Getting asthmatic children on medical management protocols and providing families with education about environmental risk reduction should aid in reducing morbidity in this ethnically complex population. Such coordinated efforts offer the promise of reducing school absenteeism.Journal of Exposure Analysis and Environmental Epidemiology (2003) 13, 169–176. doi:10.1038/sj.jea.7500266

Background. Primary care physicians (PCPs) are expected to play a central role in assessing cancer risk. This study was designed to evaluate how accurately PCPs would triage individuals at increased risk for cancer when presented with clinical vignettes. Methods. Surveys evaluated practice demographics, attitudes, and responses to clinical scenarios. Answers were compared with guidelines and graded for consistency with the risk assessment. Results. PCPs were inaccurate in assessing risk (p < 0.0001) and inconsistent in recommending screening (p < 0.001). Older physicians were more consistent (p < 0.02). No attitudinal bias was identified. Conclusion. Continuing education of PCPs is important for cancer-risk assessment and management.

Objective:To assess the actual state of oral and maxillofacial radiology departments in US and Canadian dental schools against the ideal characteristics defined by the American Academy of Oral and Maxillofacial Radiology (AAOMR) 1997 position paper. Study Design:Cross-sectional survey of all 65 US and Canadian dental schools. Results:Sixty-four surveys were returned (98%). At most schools, oral and maxillofacial radiology (OMR) was an identifiable division of a department, established policies, and had operational authority for radiographic practices in the primary radiology clinic. The majority of full-time faculty (72%) had formal training in OMR; the majority of part-time faculty (86%) did not. Full-time faculty spent approximately 60% of their time teaching, with the remainder of their time divided among research and scholarship, faculty practice, and service. Routine x-ray equipment was universally available; advanced imaging technologies were not. OMR faculty involvement in the interpretation of radiographs varied across diseases and conditions. Most published scholarship (85%+) was produced by full-time faculty. Average output was 1 paper per person per year, but a relatively small cadre of OMR faculty generated most papers. Conclusions:In some attributes, the status of OMR closely approximated the ideal characteristics established in the AAOMR report. Among the remaining attributes, bridging the difference between the actual and the ideal will be the challenge for the next 5 years. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:101-8)

Senior citizens were surveyed at 11 senior centers in two states to determine their use of fast food restaurants for food and socialization purposes. Six and 11 percent of respondents in New Jersey and Texas, respectively, eat in fast food restaurants at least once a week. One-fifth of respondents in both states frequent fast food restaurants so they do not have to cook. One-quarter of respondents cited economics as the reason for fast food restaurant patronage. The study provided evidence that seniors patronize fast food restaurants in large numbers, have strong reasons for doing so, and their patronage and motivations do not differ geographically.

Southern-born black and white Americans suffered severe economic deprivations during the first half of the twentieth century. We hypothesized that these conditions increased their risks of dying from cancer, diabetes, heart and cerebrovascular diseases. Mortality files for the years 1979 to 1991 for the United States and a specially constructed US Census population file were used to calculate age-specific and age-adjusted death rates for black and white males and females by region of birth and region of residence at time of death. Death rates of Southern-born populations were compared to the death rates of populations born in the Northeast, Midwest and West. The Southern-born effect was manifested in higher death rates from cancer, diabetes, heart and cerebrovascular diseases for both black and white populations. The Southern-born effect is larger than black/white differences for cancer and of similar magnitude for heart and cerebrovascular diseases. Follow-up investigations are needed to isolate key elements of the Southernborn effect that can be addressed through interventions.

Analysis of black American death rates by region of birth and region of residence showed that southern-born blacks had the highest mortality rates and western-born blacks the lowest mortality rates. Blacks born in the northeast, midwest, and outside the US had rates intermediate between southern and western-born black rates. Blacks born in one region and who died in another had age-specific and age-adjusted mortality rates similar to their region of birth rather than their region of residence.