Residential mobility and urban-rural residence within life stages related to health risk and chronic disease in Tecumseh, Michigan

Residential history, diagnosis of three chronic diseases, five clinical measurements and histories of smoking and drinking were obtained from a sample of 615 women and 529 men, aged 35-69, randomly selected from respondents of the Tecumseh Community Health Study. Two measures of residential mobility and one of urban-rural residence, during early life stages and over the entire lifetime, were related to subsequent adult health traits. Greater residential mobility, particularly in childhood but also in later life, was significantly associated with greater prevalence of hypertension and higher mean diastolic blood pressure in older persons. Greater duration of urban residence was associated with greater prevalence of chronic bronchitis. Both residential traits were associated with greater prevalence of CHD, and with behavior patterns, namely cigarette smoking and drinking, that are risk factors for certain chronic diseases.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/24112/1/0000369.pd

Does interhospital transfer improve outcome of acute myocardial infarction? A propensity score analysis from the Cardiovascular Cooperative Project

<p>Abstract</p> <p>Background</p> <p>Many patients suffering acute myocardial infarction (AMI) are transferred from one hospital to another during their hospitalization. There is little information about the outcomes related to interhospital transfer. The purpose of this study was to compare processes and outcomes of AMI care among patients undergoing interhospital transfer with special attention to the impact on mortality in rural hospitals.</p> <p>Methods</p> <p>National sample of Medicare patients in the Cooperative Cardiovascular Study (n = 184,295). Retrospective structured medical record review of AMI hospitalizations. Descriptive study using a retrospective propensity score analysis of clinical and administrative data for 184,295 Medicare patients admitted with clinically confirmed AMI to 4,765 hospitals between February 1994 and July 1995. Main outcome measure included: 30-day mortality, administration of aspirin, beta-blockers, ACE-inhibitors, and thrombolytic therapy.</p> <p>Results</p> <p>Overall, 51,530 (28%) patients underwent interhospital transfer. Transferred patients were significantly younger, less critically ill, and had lower comorbidity than non-transferred patients. After propensity-matching, patients who underwent interhospital transfer had better quality of care anlower mortality than non-transferred patients. Patients cared for in a rural hospital had similar mortality as patients cared for in an urban hospital.</p> <p>Conclusion</p> <p>Transferred patients were vastly different than non-transferred patients. However, even after a rigorous propensity-score analysis, transferred patients had lower mortality than non-transferred patients. Mortality was similar in rural and urban hospitals. Identifying patients who derive the greatest benefit from transfer may help physicians faced with the complex decision of whether to transfer a patient suffering an acute MI.</p

Ground-water hydrology and simulation of five remediation alternatives for an area affected by uranium-mill effluent near Cañon City, Colorado /

Includes bibliographical references (p. 88-89).Mode of access: Internet

Base flow of 10 south-shore streams, Long Island, New York, 1976-85, and the effects of urbanization on base flow and flow duration /

Shipping list no.: 92-0595-P.Includes bibliographical references (p. 33-34).Mode of access: Internet

Probability of detecting atrazine/desethyl-atrazine and elevated concentrations of nitrate in ground water in Colorado /

Includes bibliographical references (p. 33-35).Mode of access: Internet

Determination of instream metal loads using tracer-injection and synoptic-sampling techniques, Wightman Fork, southwestern Colorado, July 1999 /

Shipping list no.: 2002-0066-P.Includes bibliographical references (p. 20-21).Mode of access: Internet