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Several studies have attributed the prevalence of low back pain (LBP) in helicopter pilots mainly to poor posture in-flight and whole-body vibration, with the latter hypothesis particularly related to a cyclic response of the erector spine (ES) muscle to vibration. This work aims to determine if helicopter vibration and the pilot's normal posture during flight have significant effects on the electromyogram (EMG) of the ES muscle. The bilateral surface EMG of the ES muscle at the L3 level was collected in 10 young pilots before and during a short flight in UH-50 helicopters. The vibration was monitored by a triaxial accelerometer fixed to the pilots' seat. Prior to the flight, the EMG was recorded for relaxed seated and standing postures with 0 degrees (P0) and 35 degrees (P35) of trunk flexion. The effect of the posture during the flight was tested by comparing left and right EMG (normalized with respect to P35). The in-flight muscle stress was evaluated by histograms of EMG activity, and compared to P0 values. Only one pilot in ten showed significant (p<0.05) correlation between the vibration and the EMG over cycles of vibration, and no consistent causal effect was found. The pilots' posture did not show significant asymmetric muscular activity, and low EMG levels were observed during most of the duration of the flight. The results do not provide evidence that LBP in helicopter pilots is caused by ES muscle stress in the conditions studied.

Background: Assessment of vaccination coverage is an important component of the U.S. vaccination program and is primarily measured by the National Immunization Survey (NIS)., Methods: The 1999 NIS is a nationally representative sample of children aged 19 to 35 months, verified by provider records, that is conducted to obtain estimates of vaccination coverage rates. Coverage estimates are calculated for the nation, states, and selected urban areas for recommended vaccines and selected vaccine series., Results: Coverage estimates are presented by a variety of demographic and healthcare-related factors: overall, by poverty status, race/ethnicity, selected milestone ages, participation in WIC, level of urbanicity, provider participation in VFC, and by provider facility type. In 1999, national coverage estimates were high for most vaccines and among most demographic groups. State and urban-area level estimates varied.

Objective: This article reviews four surveys methodologies that have been used over the past 40 years to assess immunization rates in young children in the United States. These methods include three national surveys: (1) United States Immunization Survey (1959-1985), which was first a household and then a telephone survey; (2) National Health Interview Survey (1991-present), which interviews people in their homes; and (3) National Immunization Survey (1994-present), a random-digit-dialing telephone survey. In addition, a series of retrospective school record surveys that used standard sampling and assessment methodologies were conducted nationally during 4 school years September 1990-May 1991., Methods: Federal publications, National Immunization Conference proceedings, and Centers for Disease Control and Prevention (CDC) internal reports regarding national immunization surveys were reviewed. The methodology used in each survey is presented, and selected examples of previously tabulated results are presented., Conclusions: The assessment of immunization coverage in American preschool children requires ongoing commitment and survey expertise. Over the past 40 years the CDC's efforts to determine vaccination coverage in young children has evolved from the comparatively simple United States Immunization Survey to the current National Immunization Survey that utilizes sophisticated statistical and survey techniques to obtain the most-accurate results yet available.

Introduction: We evaluated an intervention program for Mexican-American women to increase Pap smear and mammography screening., Methods: The three-year intervention included the presentation of role models in the media and reinforcement by peer volunteers. We used a two-community (intervention and comparison) pre-post test design. Activities were targeted to a mainly Spanish-speaking, poverty-level, immigrant population. Pre- and postintervention screening rates were based on independent random samples of Mexican-American women 40 years and older., Results: Women reported a 6% absolute increase in Pap smear use similar to the 7% increase in the comparison community. Both communities experienced large but similar increases in recent mammography use (17% and 19%). Adjusting for differences in demographic factors, intervention and comparison changes remained identical., Conclusions: Our peer intervention failed to accelerate the secular trend in cancer screening low-income Mexican-American women. Likely, promotional activities were too diffuse and the comparison community was contaminated with similar interventions. Strong social and market forces make it difficult to measure the effect of a specialized intervention on cancer screening rates.

Introduction: Although recent studies have documented the low participation level of Hispanic women in cancer screening, few have examined their predisposing knowledge and attitudes concerning cancer. We documented the knowledge and fears concerning cancer of an older population of Mexican-American women and how these factors relate to screening behavior and sociodemographic characteristics., Methods: The data are from baseline surveys conducted before the start of a community cancer awareness and prevention program. Nine hundred twenty-three Mexican-American women were interviewed in-person about their knowledge, attitudes, and Pap smear and mammogram screening practices., Results: Knowledge and attitude about cancer varied with age, education, type of health insurance, ability to speak English, and place of birth. Women 65 years of age and older were least knowledgeable of cancer-detection methods and screening guidelines. Those with only Medicare or Medicaid knew far less even compared to uninsured women. Women who did not speak English well were more likely not to know the cancer signs and symptoms, risk factors, and screening guidelines. Women who had knowledge of guidelines and detection methods were more likely to have had a recent screening. Older Mexican-American women with more fatalistic and fearful attitudes toward cancer were less likely to have had a recent Pap smear., Conclusions: The low screening participation among Mexican-American women may be due to their limited awareness and knowledge about breast and cervical cancer screening examinations. Our study highlights the need for wide-scale cancer screening interventions consistent with Mexican-American beliefs.

Introduction: To meet the national goal of 90% immunization levels in 2 year olds, both the public and private sectors must achieve optimal standards for immunization delivery. This study investigated differences in characteristics of children receiving immunizations from public and private providers and assessed parental attitudes about prevention, perception of barriers, and attitudes about vaccines., Methods: Data are from a 1994 statewide household survey of 3,813 parents of children between the ages of 3 and 24 months. Information on the percentage of children up-to-date for recommended diphtheria and tetanus toxoids, pertussis, oral polio, measles, mumps, and rubella vaccines was based on parent-held immunization records (72%) and parental recall., Results: The percentage of children up-to-date for their immunizations was higher for those attending public clinics (59.8%) than those at private offices (53.8%). Users of the public system were more likely to be Hispanic, not to have graduated from high school, to be < or = 100% of poverty, never married, and unemployed. These parents also were significantly more likely to wonder about the safety and efficacy of vaccines and to have their child's immunization record. Multiple logistic regression showed that possession of an immunization record accounted for differences in immunization levels., Conclusions: Public clinics can achieve immunization levels in their pediatric clients comparable to those for children in the private health sector. Levels in both public and private sectors are well below 90% and need to be improved.