The seasonal and chronological distributions of birth dates of 820 patients with congenital hypothyroidism due to thyroid dysgenesis were analysed in eight areas in the world. The incidence had some seasonal variations in certain areas. These observations suggest that some environmental factors cause this disease.
Because of the beneficial effect of estrogens on the risk of cardiovascular disease and osteoporosis in postmenopausal women, the factors which influence endogenous postmenopausal estrogen levels are of substantial importance. The major source of postmenopausal estrogen is the aromatization of androgens to estrogens. Because alcohol is reported to increase aromatization rates, the relationship between serum estradiol and moderate alcohol consumption was examined in a group of 128 healthy Pittsburgh postmenopausal women, and a significant direct association was found. In order to address the generalizability of this finding, 3 comparable study populations of healthy postmenopausal women were recruited: 62 in Copenhagen, 34 in Lisbon and 20 in Madrid. Although no association was detected in the Madrid study sample, in both the Copenhagen and Lisbon study populations, not only were estradiol levels significantly increased in alcohol users as compared to abstainers, but also estradiol levels were significantly correlated with total weekly drinks consumed. Based on these findings in study samples of healthy postmenopausal women from Pittsburgh, Copenhagen and Lisbon, we conclude that the increase in estradiol levels seen with moderate alcoholic beverage consumption is not an isolated finding and speculate that moderate alcohol consumption by healthy postmenopausal women may have beneficial effects.
The factor analytic model of the practitioner-oriented opinions about people (OAP) was tested with a population of gerontological practitioners (N =558). A confirmatory factor analysis was performed to ascertain the degree-of-fit between these data and the published OAP factor model. After results supported the hypothesis that the two samples differed, a second factor analysis was designed to yield estimates of communalities by a least squares multiple regression technique. This analysis eliminated nine items not warranting inclusion in the instrument, redistributed the factors, and brought out a completely new factor. Finally, to test the hypothesis that attitudes toward aging and the aged are uncorrelated, a third analysis was performed in which the six scales of the oblique solution were refactored. The resulting higher order dimensions tended to support this hypothesis.
To understand the causes of low childhood immunization rates, physicians were interviewed about their knowledge, attitudes, and self-reported immunization practices.
Trained interviewers conducted a standardized telephone survey of physicians. A random sample of Pennsylvania family physicians, pediatricians, and general practitioners younger than 65 years of age who were in office-based practices was selected from the combined listings of the American Medical Association and American Osteopathic Association. Physicians seeing > or = 5 patients per week under age 6 years, seeing a total of > or = 15 patients per week, and having > or = 50% primary care patients were eligible. Of 383 eligible physicians, 70% (268) responded. The questionnaire was designed using the Health Belief Model, immunization barriers, and input from practitioners in primary care, pediatric infectious disease, maternal/ child health, and preventive medicine.
Respondents were more likely to refer to public vaccine clinics those children without insurance (P 90%) respondents thought that vaccine efficacy was high and that the likelihood of serious side effects was low. However, only 37% gave estimates that corresponded with the literature regarding the likelihood of an infant with pertussis to need hospitalization. Many respondents used invalid vaccine contraindications; for instance, 37% would not administer MMR to a boy whose mother was pregnant. Many respondents (21%) would not administer four vaccines simultaneously.
If the Healthy People 2000 goal to eliminate indigenous cases of measles is to be achieved, free vaccine supplies and increased provider education are needed.
The occurrence of brachmesophalangia-V (BMP-V) in 2,012 individuals from five samples of children of different ethnic backgrounds was determined using two indices. Frequencies of BMP-V were analyzed for three variants: BMP-V alone, BMP-V with clinodactyly, and BMP-V with a cone-shaped epiphysis. The two indices used to identify BMP-V indicated highest relative frequencies among Mexican children, moderate frequencies among children of European ancestry (Pennsylvania White, Canadian, West German), and lower frequencies in Pennsylvania Black children. Index 1, based on the ratio of the width to the length of the fifth mid-phalanx, consistently produced higher frequencies than Index 2, based on the ratio of the length of the fifth to the length of the fourth mid-phalanges. Index 1 was also more selective of BMP-alone, while Index 2 selected primarily BMP-V with clinodactyly and/or cone-shaped epiphyses. The differences between indices were largely due to the fact that Index 1, which basically defines shape, selected both the shortest and/or widest mid-phalanges, while Index 2 related actual length differences. It is suggested that Index 2 provided a more suitable criterion of BMP-V in comparative studies, due to possible population differences in phalangeal shape.