News Release

Preventive Medicine 2003 selected oral, poster abstracts

Summaries of selected presentations

Peer-Reviewed Publication

American College of Preventive Medicine

TITLES/DESCRIPTIONS OF SELECTED NEWSWORTHY ABSTRACTS

SELECTED ORAL PRESENTATIONS

Prevalence of Overweight among Los Angeles County School Children: Results of Statewide Physical Fitness Testing Program--Oral Presentation No. 68927
(N. Lee, Epidemic Intelligence Service, Centers for Disease Control and Prevention, assigned to the Los Angeles Department of Health Services; Presentation scheduled between 3:30 p.m. and 5 p.m., Saturday, February 22, 2003; Bayview Room, Paradise Point Resort.)

Researchers used data from the spring 2001 California Physical Fitness Testing Program to determine the prevalence of overweight among 5th, 7th, and 9th grade students in the Los Angeles County public school system. After analyzing body mass index data from 280,509 students (79.2 percent of available students), they found that, overall, the prevalence of overweight was 20.6 percent for the three age groups, and the risk of overweight was 18.9 percent. The prevalence of overweight was higher among boys (23.7 percent) than among girls (17.4 percent). The percentage rate was inversely related to grade level: 24.6 percent among 5th graders, 19.9 among 7th graders, and 15.7 among 9th graders. The prevalence of overweight was highest among Latinos (25.2 percent), followed by Pacific Islanders (19.9 percent), African Americans (19.3 percent), white persons (13 percent), and Asian Americans (11.9 percent). The investigators concluded that the prevalence of overweight in Los Angeles County public school children far exceeds the "Healthy People 2010" target of 5 percent.

Adverse Events and Deaths Associated with Laboratory Errors at a Hospital--Pennsylvania 2001--Oral Presentation No. 68927
(S. Chang, Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, GA; Presentation scheduled between 3:30 p.m. and 5 p.m., Saturday, February 22, 2003, Bayview Room, Paradise Point Resort.)

Prothrombin time and international normalized ratio (INR) are laboratory measurements that make up blood coagulation reports for patients. In July 2001, personnel at a Pennsylvania hospital recognized falsely low INR reporting levels from their laboratory. Investigators from the Centers for Disease Control and Prevention compared characteristics of patients tested (843) during the period when errors were reported (June 4 – July 25, 2001), with a pre-error period (835 tests) from April 15 to June 3, 2001. The investigators conducted a study in patients who had at least one high INR (greater than 3.0) to determine possible associations between exposure to errors and adverse events. They found that insufficient quality control and incorrect programming of a laboratory computer had generated 2,252 falsely low INR reports during the error period. According to the authors, patients with prothrombin times and INR performed during the seven-week error period were more likely to have bleeding complications. Three deaths were attributable to laboratory errors. The investigators concluded that preventable errors due to inadequate laboratory quality control went unrecognized for 7 weeks leading to adverse events and deaths. They advise laboratories to verify automated calculations. In addition, clinicians should suspect laboratory errors when clinical parameters are "discordant" with prothrombin time and INR results.

An Email-Based Program for Nutrition Intervention--Oral Abstract No. 70821
(G. Block, University of California, Berkeley; Presentation scheduled between 3:30 p.m. and 5 p.m., Saturday, February 22, 2003, Bayview Room, Paradise Point Resort)

This research involved an email-based internet program designed to provide dietary screening followed by individually-tailored information directed at changing dietary behavior. The fully automated 12-week email program of dietary intervention was developed with nutrition messages, tips, and goals. In the first phase, the 84 employee participants at a small worksite were screened by the program to assess their fat and fruit/vegetable/fiber intake. Then participants could choose to work on one of the dietary areas for the 12-week period. Also, as part of the package, weekly emails were tailored to individual life-style characteristics such as frequency of eating and whether there were children in the house, etc. Each email contained health information, tailored tips for improving that person's diet, and small goals to try to achieve the following week. From evaluations completed, the researchers found that 70 percent of the participants had learned something about their eating habits, 83 percent had read at least one-half the emails and would recommend the package to others, and over 50 percent had talked to someone else about improving their diet. At least 83 percent of the participants tried to make changes in their diet, and 90 percent of these persons reported some success. The researchers believe that they have found a very cost-effective way of helping employees and their families improve their dietary behaviors. They believe that such a program would be effective in other types of organizations as well, including possible use with the members of a health maintenance organization.

SELECTED POSTER PRESENTATION ABSTRACTS

A Prospective Study of Body Size Parameters and Risk of Prostate Cancer – Poster Abstract No. 65528
(N. Kojimahara, Division of Preventive Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA; Poster viewing from 7 p.m. to 8:30 p.m. on Thursday, February 20, Foyer outside Bayview Room, Paradise Point Resort.)

Using data from the Physicians Health Study of 22,071 men in the U.S., investigators looked at self-reports from 1,634 prostate cancer patients. They were trying to determine the relationship between body size parameters (height, weight, body mass index), plus age, to the risk of prostate cancer. Three categories of height were examined: less than 70 inches, 70 to 71 inches, and 71 plus inches. Age was stratified to less than 50 years, 50 to 59 years, and over 60. The researchers found that increasing height appeared to be a risk factor for prostate cancer over age 50. In other words, increasing height appeared to raise the risk of prostate cancer, but only over age 50. They wrote: "Statistically significant risk estimates suggest that in older age groups the relationship between height and prostate cancer increases." Moreover, this conclusion did not apply below age 50; also, there was no relationship between either body mass index or weight and risk of prostate cancer in this population.

Trends in Leading Causes of Death in Los Angeles County, 1990 – 2000 – Poster Abstract No. 69227
(L. Rollin-Alamillo, Los Angeles Department of Health Services, Los Angeles, CA; Poster viewing from 7 p.m. to 8:30 p.m. on Thursday, February 20; Foyer outside Bayview Room, Paradise Point Resort.)

Using the California Master Death File for 1990 to 2000, these investigators classified leading cause of death categories based on underlying cause of death. Over the 10-year period, they found that significant declines had taken place in mortality rates for most of the leading causes of County deaths. They found declines of: 77 percent for HIV/AIDS; 45 percent for homicide; 32 percent for suicide; 32 percent for unintentional injuries; 29 percent for cirrhosis; 26 percent for heart disease; 17 percent for stroke; and 15 percent for cancer. During this period, all-cause mortality rates declined by 31 percent in Latinos, 26 percent in Asian/Pacific Islanders, 26 percent in whites, and 17 percent in African Americans. However, during the 10-year period, they saw a significant increase in mortality from diabetes of 53 percent. Age-adjusted diabetes mortality was more than two times higher in African Americans than in white persons, and one and one-half times higher in Latinos. The authors stress the importance of focused primary and secondary prevention efforts, especially against diabetes.

A Population-Based Analysis of Mortality Due to Pneumococcal Disease in California – Poster Abstract No. 70041
(M. Redelings, University of California, Los Angeles; Poster viewing from 7 p.m. to 8:30 p.m., Thursday, February 20, 2003; Foyer outside of Bayview Room, Paradise Point Resort.)

Pneumococcal disease is an important cause of death from pneumococcal pneumonia. A vaccine is available that can protect against most of the common causes of death from this illness. Yet, according to the authors of this study, few population-based studies exist on the actual magnitude of the problem. Consequently, these investigators decided to evaluate the mortality from this illness, along with its California demographic correlates. Using vital records data from the 10-year period between1989 and 1998, they found that the overall mortality rate was just slightly over 2 deaths per 100,000 population. Mortality was elevated in elderly individuals (38.2 deaths per 100,000 population after age 85); infants, 1.10 deaths; African Americans, 2.96 deaths; Native Americans, 2.4 deaths; and males, 2.67 deaths. The majority of the deaths (almost 81 percent) fell into groups at high risk for the disease and who were candidates for vaccination. Mortality was seasonal, reaching a peak in the winter months. A trend of decreasing mortality was observed over the 10-year period. The investigators urged that serious efforts be made to vaccinate individuals from groups at greatest risk of pneumococcal-related death. Also, consideration should be given to pneumococcal immunization for those under age 65.

Attitudes, Perceptions, and Practices in Medical Error Reporting Among Housestaff and Nursing--Poster Abstract No. 70435
(D. Wild, Griffin Hospital; Derby, CT; Poster viewing from 7 p.m. to 8:30 p.m. on Thursday, February 20; Foyer outside of Bayview Room; Paradise Point Resort.)

Medical error reporting is a crucial step in identifying and preventing such problems. Also, housestaff practices are important since behavior learned while a resident is likely to persist during professional practice. These investigators conducted a pilot study to investigate housestaff and nursing personnel's error reporting practices at Griffin Hospital during the academic year from 2001 to 2002. In this survey, 24 residents (96 percent of the group) and 36 nurses (60 percent) responded to the questionnaire. The results showed that only 3 residents, along with 35 nurses, were aware of the existence of the medical error reporting system. Only 3 residents and 26 nurses actually used the system. Residents were more likely than nurses to describe the hospital culture toward medical error reporting as "non-supportive." Both groups reported being uncomfortable talking to patients about medical errors, and few did. Both groups said that they were more likely to report an error if it had serious consequences. Also, residents were more likely than nurses to report errors if they did not like the person who committed the error.

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Preventive Medicine 2003
American College of Preventive Medicine Annual Meeting
February 19 – 23, 2003
Paradise Point Resort
San Diego, California

Contact: Bill Glitz (703) 532-3797/ Jim Augustine (703) 644-6824

From February 19 to 23, please contact us at the press room by calling The Paradise Point Resort at (858) 274-4630 and asking for The Boardroom


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