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Smith L.V.,University of California at Los Angeles | Simon P.,University of California at Los Angeles | Cummings P.L.,Office of Senior Health | Kuo T.,Office of Senior Health | Kuo T.,University of California at Los Angeles
Public Health Nutrition | Year: 2010

Objective The present study examines the receptivity to and potential effects of menu labelling on food choices of low-income and minority individuals - a group often at disproportionate risk for preventable, lifestyle-related health conditions (e.g. obesity, diabetes and CVD).Design We conducted a cross-sectional survey to examine the knowledge, attitudes and potential response to menu labelling in an urban public health clinic population. Setting United States.Subjects A total of 639 clinic patients were recruited in the waiting rooms of six, large public health centres in Los Angeles County (2007-2008). These centres provide services to a largely uninsured or under-insured, low-income, Latino and African-American population.Results Among those approached and who met eligibility criteria, 88% completed the survey. Of the 639 respondents, 55% were overweight or obese based on self-reported heights and weights; 74% reported visiting a fast food restaurant at least once in the past year, including 22% at least once a week; 93% thought that calorie information was important; and 86% thought that restaurants should be required to post calorie information on their menu boards. In multivariate analyses, respondents who were obese, female, Latino and supportive of calorie postings were more likely than others to report that they would choose food and beverages with lower calories as a result of menu labelling.Conclusions These findings suggest that clinic patients are receptive to this population-based strategy and that they would be inclined to change their food selections in response to menu labelling. © 2009 The Authors.


Cummings P.L.,Office of Senior Health | Sorvillo F.,Office of Health Assessment and Epidemiology | Sorvillo F.,University of California at Los Angeles | Kuo T.,Office of Senior Health | Kuo T.,University of California at Los Angeles
Journal of the American Geriatrics Society | Year: 2012

Objectives To update and examine Alzheimer's disease-related mortality trends according to age, sex, race and ethnicity, geography, and other case characteristics for a 10-year period. Design Trend and comparative analyses of the U.S. multiple-cause-of-death records for 1999 to 2008. Setting United States. Participants Participants were decedents with Alzheimer's disease (AD) coded as underlying or associated cause of death; decedents with other forms of dementia or cognitive disorder were excluded. Measurements Case frequency, age-specific death rates, and crude and age-adjusted mortality rates were estimated for all AD decedents from the sampled period. Measures of AD mortality burden were compared with those of other leading causes of death (e.g., diabetes mellitus, stroke). Results From 1999 to 2008, 879,281 AD-related deaths were identified. The age-adjusted mortality rate for AD increased from 45.3 per 100,000 population (95% confidence interval (CI) = 45.0-45.7) in 1999 to 50.0 per 100,000 population (95% CI = 49.7-50.3) in 2008. The average age at death was 85.9. Differences in AD-related deaths varied according to sex, race and ethnicity, and geography. The number of AD-related deaths and age-specific mortality for persons aged 85 and older (n = 532,338, 1,096.6 per 100,000 population) were comparable with those from the same age group who died from diabetes mellitus (n = 488,593, 1,006.5 per 100,000 population). Conclusion The burden of AD-related mortality was substantial for the period 1999 to 2008. This burden is expected to grow rapidly as the baby boomer generation ages. Findings from this study may have important implications for present and future planning in medicine, social services, public policy, and public health. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.


Cummings P.L.,Office of Senior Health | Sorvillo F.,University of California at Los Angeles | Kuo T.,Office of Senior Health | Kuo T.,University of California at Los Angeles
Foodborne Pathogens and Disease | Year: 2010

Despite the recognition of nontyphoidal Salmonella as an important foodborne infection, few data exist on salmonellosis as a cause of death in the United States. To provide a quantitative assessment of the burden of Salmonella-related mortality in the United States, we examined national multiple-cause-of-death data for the years 1990-2006. Crude and age-standardized rates of salmonellosis mortality and 95% confidence intervals (CI) were computed for race, sex, age, state of residence, and year. A matched case-control analysis, using non-Salmonella deaths as controls, was conducted to determine whether certain diseases were more likely to be listed as comorbid conditions for Salmonella-related death. Salmonellosis was reported as an underlying or associated cause of death among 1316 persons, with an average annual age-adjusted mortality rate of 0.03 per 100,000 person-years. Salmonellosis mortality rates were higher among blacks and Asian/Pacific Islanders with an age-adjusted rate ratio of 2.61 (95% CI, 2.43-2.81) and 2.48 (95% CI, 2.30-2.67), respectively. Rates were also higher in males with an age-adjusted rate ratio of 1.84 (95% CI, 1.68-2.03). The highest frequency of deaths occurred among adults age 75-84 (n=329; 25% of all cases). A declining trend in salmonellosis-related deaths was observed over the study period. Several comorbid conditions were associated with Salmonella deaths, including HIV and connective tissue disorders, with matched odds ratios of 7.44 (95% CI, 5.04-10.97) and 3.69 (95% CI, 1.88-7.25), respectively. Despite declining trends, salmonellosis continues to be an important cause of preventable death especially among selected subgroups, underscoring the need for expanded prevention efforts. Copyright 2010, Mary Ann Liebert, Inc.


Jeffrey J.,University of California at Los Angeles | Dumont R.A.,University of California at Los Angeles | Kim G.Y.,Office of Senior Health | Kuo T.,University of California at Los Angeles | Kuo T.,Office of Senior Health
Family Medicine | Year: 2011

BACKGROUND AND OBJECTIVES: The present study reviewed the published literature to examine the effects of international health electives (IHEs) on medical student learning and career choice. METHODS: A systematic literature review was conducted to identify key English-language articles on IHEs, using PubMed journal databases for the period 1990-2009. Article inclusion for this review was vetted by a rigorous evaluation of each article's study methods, content, and data quality. Pooled or aggregate information from 11 key articles, including information on type and duration of IHE, study and comparison group characteristics, and measured outcomes such as self-reported changes in cultural competency, clinical skills, and specialty choice, were extracted and summarized. RESULTS: Findings suggest that having IHE experiences contributed to a more well-rounded training for medical students; students reported being more culturally competent and were more likely to choose a primary care specialty and/or a public service career. CONCLUSIONS: Although IHE experiences appear to have educational benefits, the quality and availability of these electives vary by institution. Barriers to ensuring that students attain a safe and rich experience include the lack of consistent categorical funding, safety concerns when traveling, and limited faculty experience and resources to support and guide students during their rotations abroad.


PubMed | Office of Senior Health
Type: Journal Article | Journal: Foodborne pathogens and disease | Year: 2010

Despite the recognition of nontyphoidal Salmonella as an important foodborne infection, few data exist on salmonellosis as a cause of death in the United States. To provide a quantitative assessment of the burden of Salmonella-related mortality in the United States, we examined national multiple-cause-of-death data for the years 1990-2006. Crude and age-standardized rates of salmonellosis mortality and 95% confidence intervals (CI) were computed for race, sex, age, state of residence, and year. A matched case-control analysis, using non-Salmonella deaths as controls, was conducted to determine whether certain diseases were more likely to be listed as comorbid conditions for Salmonella-related death. Salmonellosis was reported as an underlying or associated cause of death among 1316 persons, with an average annual age-adjusted mortality rate of 0.03 per 100,000 person-years. Salmonellosis mortality rates were higher among blacks and Asian/Pacific Islanders with an age-adjusted rate ratio of 2.61 (95% CI, 2.43-2.81) and 2.48 (95% CI, 2.30-2.67), respectively. Rates were also higher in males with an age-adjusted rate ratio of 1.84 (95% CI, 1.68-2.03). The highest frequency of deaths occurred among adults age 75-84 (n = 329; 25% of all cases). A declining trend in salmonellosis-related deaths was observed over the study period. Several comorbid conditions were associated with Salmonella deaths, including HIV and connective tissue disorders, with matched odds ratios of 7.44 (95% CI, 5.04-10.97) and 3.69 (95% CI, 1.88-7.25), respectively. Despite declining trends, salmonellosis continues to be an important cause of preventable death especially among selected subgroups, underscoring the need for expanded prevention efforts.

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