A survey of stool culturing practices for vibrio species at clinical laboratories in Gulf Coast states

Non-cholera Vibrio infections are an important public health problem. Non-cholera Vibrio species usually cause sporadic infections, often in coastal states, and have also caused several recent nationwide outbreaks of gastroenteritis in the United States. We report a survey of laboratory stool culturing practices for Vibrio among randomly selected clinical laboratories in Gulf Coast states (Alabama, Florida, Louisiana, Mississippi, and Texas). Interviews conducted with the microbiology supervisors of 201 clinical laboratories found that 164 (82%) received stool specimens for culture. Of these, 102 (62%) of 164 processed stool specimens on site, and 20 (20%) of these 102 laboratories cultured all stool specimens for Vibrio, indicating that at least 34,463 (22%) of 152, 797 stool specimens were cultured for Vibrio. This survey suggests that despite an increased incidence of non-cholera Vibrio infections in Gulf Coast states, a low percentage of clinical laboratories routinely screen all stool specimens, and fewer than 25% of stool specimens collected are routinely screened for non-cholera Vibrio.

Surveillance for five health risks among older adults--United States, 1993-1997

PROBLEM/CONDITION

Overweight, drinking and driving, inadequate fruit and vegetable consumption, physical inactivity, and smoking are associated with the leading causes of morbidity and mortality among older adults (i.e., persons aged > or =65 years) in the United States.

REPORTING PERIOD

This report presents data from the Behavioral Risk Factor Surveillance System (BRFSS) for 1994-1997 and from the National Health Interview Survey (NHIS) for 1993-1995.

DESCRIPTION OF SYSTEMS

BRFSS and NHIS are maintained by CDC and have been used for surveillance purposes. Each survey is administered annually and includes questions about health risks and health behaviors from a representative sample of the U.S. civilian, noninstitutionalized population. The NHIS is designed to provide national estimates and the BRFSS, state estimates.

RESULTS

Prevalences of overweight, drinking and driving, inadequate fruit and vegetable consumption, and smoking decreased with increasing age among older adults in the United States; physical inactivity was the only health risk that increased with increasing age. Sex and race were differentially associated with all five health risks.

INTERPRETATION

Specific subgroups of older adults are at risk for being overweight, drinking and driving, inadequate fruit and vegetable consumption, physical inactivity, and smoking. These health risks varied by age, race, residential state, and socioeconomic status and highlight the heterogeneous nature of older adults.

PUBLIC HEALTH ACTION

Surveillance for health risks among older adults provides information to help identify effective interventions for the growing population of older adults in the United States.

An informational versus monetary incentive in increasing physicians' response rates

This study examined return rates for a cancer prevention survey by pediatricians in relation to an informational booklet versus a monetary incentive in the first of a three-wave mailing. Of the 300 surveys sent which included an informational booklet incentive, 189 (64%) were returned. Of the 300 surveys sent which included a $1.00 incentive 227 (79%) were returned, indicating the $1.00 incentive was more effective than the informational incentive in increasing return rates in this sample of physicians.

College women's perceptions regarding resistance to sexual assault

College women's perceptions about resistance to sexual assault were examined. Twenty-one percent of the 334 women surveyed stated that they had been sexually assaulted. The vast majority of participants had changed their lifestyles to prevent a sexual assault. Less than 1 woman in 5 of those surveyed had taken a self-defense class. Participants believed that resisting sexual assault by a stranger with a weapon was more likely than resisting an unarmed attacker to increase their chances of being physically harmed, raped, or murdered. Twenty-two percent of the participants said they were "very likely" to resist sexual assault by a stranger with a weapon; 52% would resist a stranger without a weapon. The findings indicate the need for an increase in the number of women taking self-defense classes and a revision in women's perceptions about resisting sexual assault.

Sun protection counseling by pediatricians

OBJECTIVE

To establish a national baseline regarding pediatricians' sun protection counseling perceptions and behaviors.

INTERVENTIONS

A survey was mailed to a random sample of 600 pediatricians selected from the 1996 American Academy of Pediatrics Directory using a 3-wave mailing technique to maximize the response rate. The 3-wave mailing resulted in 414 returned surveys of 583 surveys (17 surveys were nondeliverable) (a 71% response rate).

RESULTS

Most (60%) of the pediatricians lacked formal training on how to counsel parents and children about sun protection. Approximately 3 (78%) of 4 indicated that not enough time was spent in their residency program on how to educate parents and children about sun protection. Greater than half (60%) of the respondents indicated that they usually (47%) or always (13%) counseled about sun protection. Seventy-seven percent of the respondents indicated that pediatricians have a professional responsibility to counsel parents and children about sun protection.

CONCLUSIONS

The results of this investigation suggest that most pediatricians surveyed believed that they had a professional responsibility to counsel about sun protection and that such counseling would be effective in decreasing skin cancer and the number of sunburns. Although most had not had training on sun protection counseling in their residency program, 6 of 10 indicated that they usually or always counseled about sun protection. Sun protection counseling training in residency programs can potentially extend pediatricians' knowledge of skin cancer and the importance of a broad spectrum of preventive measures, as well as increase their ability to counsel about such measures.

Perceptions of cervical cancer and Pap smear screening behavior by women's sexual orientation

This study examined 330 adult females' perceptions and practices regarding cervical cancer by sexual orientation. Ninety-four percent of respondents were unable to correctly identify all 5 risk factors associated with increased risk for cervical cancer (smoking, sexual intercourse with men, multiple male sexual partners, sexual intercourse before age 16, and having genital warts) regardless of sexual orientation. Furthermore, 20% were not able to identify any of the 5 risk factors for cervical cancer. Lesbians perceived themselves to be less susceptible to cervical cancer than heterosexuals or bisexuals even though 79% of lesbians had sexual intercourse with a male. Eight percent of the respondents believed that most women who develop cervical cancer die from the disease. The main barriers identified by non-regular Pap screeners (N = 127) were: no health insurance (33%), forgetting to get a pap test (32%), and not liking to get a Pap test (31%). Three-fourths (75%) have had a Pap test within the last 2 years and planned to continue having them on a regular basis. The results of this survey indicate that there is considerable room for improvement in knowledge, perceptions, and practices of all women, regardless of sexual orientation, regarding cervical cancer.