Average Economic Status Research Articles

Prevalence of elder abuse and its correlated factors in Iranian community-dowelling older adults: a cross-sectional study

BackgroundThe global elderly population is rapidly increasing, with projections estimating that the number of older adults will reach 2.1 billion. Elder abuse, a significant public health issue, leads to serious psychological, physical, and social consequences. Therefore, this study aims to assess the prevalence of elder abuse in Qazvin, Iran, while exploring correlated factors that may act as potential risks or protective factors, especially within the context of post-pandemic COVID-19 conditions.MethodsThis cross-sectional study, conducted from May to October 2024, included 540 older adults aged 60 and above residing in Qazvin city, Iran. Participants were selected using a multi-stage cluster sampling method. Data were collected through face-to-face interviews using a demographic checklist, the General Health Questionnaire, the Advanced Activities of Daily Living Scale, the Mini-Cog Screening Tool, the Multidimensional Scale of Perceived Social Support, and the Short Version of the Domestic Elder Abuse Assessment Questionnaire. Data analysis was performed using one-sided and two- sided chi-square tests, as well as a logistic regression model.ResultsA total of 540 older adults participated in the study, with a mean age of 72.08 ± 8.08 years. The majority of the participants were married (n = 390, 72.2%) and had an average economic status (n = 348,64.4%). Among the participants, 71.1% (n = 384) reported experiencing at least one form of elder abuse within the past year, with psychological abuse (n = 274, 50.7%) and care neglect (n = 269,49.8%) being the most prevalent forms. The results indicated that elder abuse was significantly associated with good and excellent economic status (OR = 0.335, 95% CI: 0.150–0.749), being homemaker (OR = 2.789, 95% CI: 1.252–6.215), and having better mental health (OR = 0.931,95% CI: 0.885–0.980).ConclusionsThis study found a high prevalence of elder abuse in Qazvin city, with economic status, employment status, and mental health identified as key predictors. Based on these findings, further in-depth investigations are needed to explore the underlying causes of elder abuse. Additionally, efforts to clarify statistics and raise community awareness about the dimensions and reporting mechanisms of elder abuse are essential. The development of integrated support services to promote the physical and mental health of older adults and reduce their dependency is strongly recommended.

Nutritional status and dietary habit of COVID-19 patients: A study in a tertiary hospital

Background: Nutritional status has impact on body immune function that is important for controlling disease process and prognosis of the newly emerging Coronavirus Disease 2019 (COVID-19). As no vaccine or specific antiviral treatment is not available for COVID-19, therefore, improvement of nutritional status is important. Adequate and appropriate diet is required for maintaining good nutritional status. There is very few research carried out to evaluate the influence of nutritional status and dietary habit of patients with COVID-19. Objective: To study the nutritional status and dietary habit of COVID-19 patients admitted in a tertiary hospital of Dhaka, Bangladesh and its impact on the severity of the disease COVID-19. Methodology: A cross-sectional study was performed on 384 patients in the Corona unit of Holy Family Red Crescent Hospital during 17th May to 31st December’ 2020. Patients were selected conveniently according to inclusion criteria. COVID-19 patients were categorized as Mild, Moderate and Severe cases according to National Institute of health and latest Public Health Information from Centers for Disease Control (CDC). Direct interviewing of the selected patients with pretested structured questionnaire, data were collected on socio demographic characteristics, nutritional status following Body Mass Index (BMI) grading, daily consumption of different food items in the last 3 months and dietary habits in the last 3 months of these three categories of patients. Written consent of the patient and ethical clearance was obtained prior to data collection. All statistical analyses were performed by using the SPSS software version 21. Result: A total of 384 patients interviewed. Age distribution was Mean ±SD, 42.85±13.82. Male/Female ratio 1.33. Most of them were graduates, 33.1% and 42.9% were Govt. service holders. Monthly family income was Tk 35000 (taka thirty-five thousand) and above in 39.6% cases. Regarding source of infection in these patients, 40.3% and 35.2% from traveling abroad and shopping respectively. Urban dwellers were75% and 25% from rural area. Nutritional status of COVID-19 patients was calculated according to BMI grading. Among all Underweight COVID-19 patients- 90% were Moderate cases. Among all Normal nutritional status COVID- 19 patients we found 37.5%, 41.7% and 20.8% were in mild cases, moderate cases, and severe cases respectively. Regarding Overweight COVID-19 patients we found 46.7% and 32.7% in moderate and in severe cases. Obese 1 were 48.1% in moderate cases and 32.1% in severe cases of COVID-19 patients. On the other hand, all (100%) obese 2 patients were moderate cases. BMI found statistically significant p – 0.002. Regarding food items protein showed statistically significant (p- 0.04). In severe cases having good sun exposure was found in only 19.5% cases. Regarding dietary habit of COVID-19 patients, most of the variables were found statistically significant i,e skipping of their meal (p-0.016), number of meal ( p-0.040), quality of food( p-0.014), taking food according to daily requirement ( p - 0.021) and eating extra salt with food(p-0.029). Conclusion: Considering the result, it can be concluded that COVID-19 patients were mostly middle aged from urban areas with average economic status. Source of infection was from traveling abroad and shopping. Nutritional status of most of Moderate and Severe COVID-19 cases were under weight, obese 1 and obese 2. Concerning diet and dietary habit, protein, skipping of meal, number of meals, variety of food, eating food according to daily requirement and eating extra salt with food significantly associated with the severity of COVID-19. This was a single centered study with a small sample size. A multicenter, larger sample size study recommended for confirming our data and to get an actual view of the nutritional status and dietary habit of COVID19 patients. Northern International Medical College Journal Vol. 13 No. 1-2 July 2021-January 2022, Page 574-580

Association between flaunting behaviors on social media and among the general population in Bangladesh: A cross-sectional study.

The number of social media users is growing with each passing day at full tilt, keeping pace with digitalization and technological advances. Despite several advantages, there are also certain negative aspects to using social networking sites (SNS) for communication, amusement, self-expression, impression management, and other purposes. This study sought to investigate the association between mental health status and flaunting behaviors in social media among the general population in Bangladesh. We conducted this nationwide cross-sectional online survey among 465 people aged between 18 and 60 between October 15, 2021 and January 15, 2022. Following electronic consent, we collected the socio-demographic profiles and psychometric parameters of the respondents. Additionally, we assessed the diverse perspectives on SNS usage and its relationship to the self-reported symptoms of depression and loneliness. The estimated prevalence of loneliness and depressive symptoms were 65.16% (mild: 39.57%, moderate: 16.56%, severe: 9.03%) and 55.49% (mild: 26.67%, moderate: 22.15%, severe: 6.67%), respectively. Key factors associated with flaunting on social media were mental health issues such as depression and loneliness. Several social factors were also considered, such as being young, of the male sex, unmarried, illiterate, a student, urban dwelling, average economic status, nuclear family structure, types of SNSs, checking social media first in the morning, and the use of SNS for gaining popularity. A significant portion of SNS users reported symptoms of mental illness. Current study findings urge for longitudinal studies with larger sample sizes to have a nearly equal distribution of users from each social media platform for in-depth exploration of how user attitudes about SNSs and site usage patterns impact the general public's mental health. We suggest that regulating SNS usage patterns and treatment approaches would improve the situation.

Periodontal Diseases in Pregnant Women in Prenatal Consultation

Background: The relationship between pregnancy and periodontal health had well documented in the literature. Of many studies of periodontal diseases in the Democratic Republic of Congo, no study had evaluated these diseases in pregnant women during Prenatal Consultation (PC). This study aimed to describe the occurrence and clinical profile of periodontal diseases in pregnant women admitted to the PC at the General Military Hospital of BOBILA. Materials and Methods: It is a cross-sectional and analytical study of pregnant women admitted to the PC from August to December 31, 2018, at the General Reference Military Hospital of BOBILA/Kinshasa City. The data were collected through a survey combined with the stomatological interview. Sociodemographic data, clinical and periodontal indices included Oral Hygiene Index Simplified (OHI-S), Bleeding on Probing (BOP), and Periodontal Disease Index (PDI) were assessed. The statistical analyses were carried out using the SPSS version 20.0 software. The Chi-square tests, Student t-test were used to determine differences in the distribution of variables, and the odd Ratio with a confidence interval (IC) at 95% was used to estimate the degree of association. The results were significant at p < 0.05. Results: Of the 105 pregnant women received at the PC, 83 were included in this study. The age group between 20 - 29 was the most represented, with a predominance of stay-at-home mothers (75.9%) and married cases (73.4%), they had an average economic status (56.6%) and a secondary education level (63.8%). Gingival bleeding (44.6%) was the main complaint of the pregnant. Gestational age was a significant factor associated with gum bleeding (p < 0.005). Most of the pregnant had poor oral hygiene, localized gravidities (69.6%) during the third semester. Conclusion: A significant proportion of women had experienced periodontal diseases during the pregnancy period, mostly in the third trimester, and was associated with a gestational age of pregnant women.

Adherence to endocrine therapy and its relation to disease-free survival among breast cancer patients visiting an out-patient clinic at Khartoum Oncology Hospital, Sudan.

Adherence to endocrine therapy provides substantial reduction in breast cancer (BC) relapses and improve survival. Hence, non-adherence remains an under reported issue mainly in developing countries. The aim of this study is to evaluate the adherence to endocrine therapy (tamoxifen [TAM] and aromatase inhibitors [AIs]) among BC patients visiting an out-patient clinic (2015-2016) in Khartoum Oncology Hospital, Sudan. Adherence was assessed using pills count and self-reporting methods. A total of 172 patients were interviewed. Also, records were reviewed for demographic and other cancer characteristics. The patients' mean age at diagnosis was 53 years, with the highest frequency at (41-60) years. Invasive ductal carcinoma 69.2% formed the main pathological diagnosis. T2 tumour size (51.2%) and lymph node involvement (N1) (31.4%) were most evident. Also, the majority of patients were stage III (45.9%) and grade II (48%). The studied women were postmenopausal (49.4%) and premenopausal (47.7%). Regarding hormonal receptors, about 68% were oestrogen (ER)+/progesterone (PR)+ and 23.3% were ER+/PR-. Studying adherence, almost (93%) of the studied group were ≥80% adherent to TAM and AIs. The hormonal therapy persistence mean was 27.2 ± 22.5 months (40-96). While adherence percentage mean was 93.7 ± 13.6% (0%-100%). Also disease-free survival (DFS) mean was 36.3 ± 32.7 months (4-312). Adherence to hormonal therapy and persistence were significantly correlated (P < .000). Also, statistically significant association was found between hormonal therapy adherence (≥80%) and patient poor to average economic status (P = .006), and the marital status "married" (P = .008). A high rate of adherence (93%) to endocrine therapy was estimated in the present study. Also, a positive association was found between the hormonal therapy persistence, and the DFS year's groups (P = .000), and the hormonal therapy types (P = .000). Adherence to hormonal therapy and persistence were significantly correlated (P < .000).

Hubungan Antara Status Ekonomi Dengan Minat Ibu Terhadap Kontrasepsi Tubektomi Di Bpm Ny. Istianah Ernawati Desa Ketapang Tanggulangin Sidoarjo

According the first research in BPM by Mrs. Istianah Ernawati, Amd Keb Ketapang village Tanggulangin-Sidoarjo through the deployment of quotioner, obtained result from 10 respondents there are 2 (20%) respondents with high economic status, 1 (10%) respondent was very interested to use family planning tubektomi, 1 (10%) respondent was interested to use family planning tubektomi. Respondents with average economic status, 2 (20%) respondents, 1 (10%) who was very interested, 1 (10%) who was interested to use family planning Tubektomi. Respondents with under economic status, 6 (60%) respondents, 1 (10%) respondent was interested to use family planning tubektomi, 5 (50%) respondents wasn’t interested to use family planning tubektomi. From research result there are still mary mothers with low economic status who were not interested to tubektomi contraception, it happened because economic status. Analitical research design by cross sectional. Population and sample in research is all mothers who have more than 2 children and mothers age which are more than 35 years old who came to BPM Mrs. Istianah Ernawati, Amd.Keb Ketapang village Tanggulangin-Sidoarjo with the total is 32 respondents. Instrument research used check-list. Data analyzing proccess used Korelasi Spearman Test. The result of Korelasi Spearman Test be obtained rs calculating 0,516 &gt; rs table 0,362 that H0 is refused and H1 is accepted, so there is positive contact between economic status with mothers interest to tubektomi contraception in BPM Mrs. Istianah Ernawati, Amd.Keb Ketapang village Tanggulangin-Sidoarjo in 2015. So more and high economic status mothers and high interested mothers tubektomi contraception.

The delay to the first psychiatry consult in two acute inpatients clinics in Romania

Around 25% of adults experience a mental illness in each year and approximately 60% received no mental health care. There are still long delays between the onset of symptoms and the first psychiatric consult and treatment. Objective: To understand the pathway to care and to determine the delay in seeking help for mental health problems, considering sociodemographic variables in patients admitted in two Romanian acute psychiatric inpatients settings. Methods: Between May-August 2015, WHO's Pathway Encounter Form was applied to 200 individuals, at their first admission, consecutively hospitalized in acute psychiatry clinics from Targu Mures and Craiova, Romania. Results: The profile of the participants in this study was: woman in the sixth decade of life, having an average economic status and without psychiatric history, searching help for depressive symptoms (by themselves or at the advice of the family), mainly to a psychiatrist or a General Practitioner. The average delay from the onset of symptoms to the first psychiatry consult was 16 weeks. Only previous positive personal history for MH problems and current diagnosis had a high statistically significant influence on the moment when subjects of our study decided to access the MH services. Conclusions: A better knowledge and understanding on the factors that influence people to seek help in mental health problems would be useful for improving the future organization of healthcare services and programs.

Family Caregivers Burden and its Related Factors Among Iranian Elderly Psychiatric Patients’ Caregivers

Background: Providing care for an old person with a psychiatric disorder is a long-term and stressful process exerting negative outcomes on the caregivers' physical, psychological, and social health. Objectives: The aim of the study was to determine the burden among family caregivers of psychiatric elderly and its related factors. Methods: This descriptive study was conducted on 200 elderly psychiatric patients via convenient sampling, referring to the zare teaching psychiatric hospital of Sari, Iran. The sampling lasted from June tomid-November, 2015. Twoquestionnaires of demographics (the elderly and caregivers) and Zarit Burden Interview were used to collect the data. The data was analyzed using descriptive and inferential statistics, such as independent t-test, Analysis of Variance (ANOVA) and Scheffe Post Hoc test. Results: The results indicated that the mean of the caregivers' age was 51.24 ± 12.16. Ninety-four percent of the caregivers were married, and 49 had higher diploma education. Sixty-seven percent reported average economic status. The findings showed 68 of caregivers came up with mild to severe burden. According to the demographics, the hours of care per week (P = 0.001) and having other psychiatric patients in the family (P = 0.006) were related to the burden. Conclusions: Significantly high caregivers' burden can overshadow the risk of low quality of care the psychiatric elderly patients and expose their caregivers' psychological health to danger. Thus, it seems that community-oriented interventions are required to reduce the burden and boost long-term quality of care by informal caregivers, such as patients' families. ©2018, Iranian Journal of Psychiatry and Behavioral Sciences.

Family Caregivers’ Attitude toward Long-Term Care of Elderly with Psychiatric Disorders and Associated Factors

Background: Providing care for the elderly with psychiatric disorders is a long-term and stressful process leading to some negative outcomes on the caregivers’ physical, psychological and social health. In addition, it seems that the caregivers’ attitude toward providing long-term cares affects their performance and behavior. Objectives: The current study aimed to outline the caregivers’ attitude toward providing long-term cares for the elderly patients with psychiatric disorders. Patients and Methods: The current descriptive study was conducted on 200 elderly patients with psychiatric disorders, referred to the Zare teaching psychiatric hospital in Sari, Iran. The participants were selected via convenient sampling method. The sampling lasted from June to mid-November in 2015 .Two questionnaires were applied to collect data , the demographics (the elderly and caregivers) and the short form of Klein attitude toward the provision of long-term care scale (ATPLTC scale). The data were analyzed using descriptive and inferential statistics such as independent T-test, ANOVA and Scheffe test. Results: The study results indicated that the mean ± SD age of the caregivers was 51.24 ± 12.16 years. Ninety-four percent of the caregivers were married and the education level in 49% was above high school diploma. Sixty-seven percent of them reported average economic status. The findings showed that 71% of the caregivers had negative attitude toward long-term care giving. There was a significant relationship between caregivers` education level (P = 0.017), other family members with psychiatric disorder (P = 0.036) and the weekly hours caring for the patient (P = 0.032). Conclusions: The caregivers’ negative attitude toward caring for the elderly patients with psychiatric disorders is an alarm for the mental healthcare policy makers and psychiatric/mental health team workers. To promote the mental health among the elderly patients with psychiatric disorders and those of their caregivers, it is necessary to develop family-oriented education, counseling and supportive programs and perform more studies on the issue.

Family Caregivers’ Attitude toward Long-Term Care of Elderly with Psychiatric Disorders and Associated Factors

Background: Providing care for the elderly with psychiatric disorders is a long-term and stressful process leading to some negative outcomes on the caregivers’ physical, psychological and social health. In addition, it seems that the caregivers’ attitude toward providing long-term cares affects their performance and behavior. Objectives: The current study aimed to outline the caregivers’ attitude toward providing long-term cares for the elderly patients with psychiatric disorders. Patients and Methods: The current descriptive study was conducted on 200 elderly patients with psychiatric disorders, referred to the Zare teaching psychiatric hospital in Sari, Iran. The participants were selected via convenient sampling method. The sampling lasted from June to mid-November in 2015 .Two questionnaires were applied to collect data , the demographics (the elderly and caregivers) and the short form of Klein attitude toward the provision of long-term care scale (ATPLTC scale). The data were analyzed using descriptive and inferential statistics such as independent T-test, ANOVA and Scheffe test. Results: The study results indicated that the mean ± SD age of the caregivers was 51.24 ± 12.16 years. Ninety-four percent of the caregivers were married and the education level in 49% was above high school diploma. Sixty-seven percent of them reported average economic status. The findings showed that 71% of the caregivers had negative attitude toward long-term care giving. There was a significant relationship between caregivers` education level (P = 0.017), other family members with psychiatric disorder (P = 0.036) and the weekly hours caring for the patient (P = 0.032). Conclusions: The caregivers’ negative attitude toward caring for the elderly patients with psychiatric disorders is an alarm for the mental healthcare policy makers and psychiatric/mental health team workers. To promote the mental health among the elderly patients with psychiatric disorders and those of their caregivers, it is necessary to develop family-oriented education, counseling and supportive programs and perform more studies on the issue.

Admission Hypothermia Among Neonates Presented to Neonatal Intensive Care Unit

Introduction: In developing countries, thermal protection of the newborn is not properly addressed. Neonates presented to Neonatal intensive care unit (NICU) for admission with various problems are frequently found to be hypothermic. The objective of this study was to determine the incidence and associated risk factors for neonatal hypothermia on admission to NICU. Materials and Methods: This was a prospective observational study carried over a period of three years at Enam Medical College and Hospital (EMCH) among the newborns admitted to NICU. Hypothermia has been defined as axillary temperature &lt;36.5°C (&lt;97.7° F). Temperature was measured at admission. Data were collected regarding perinatal and socio economic factors. Bivariate and multivariate analysis has been done to see the association of risk factors. Result: A total of 2310 babies between 0 and 680 h of age (mean 43± 12 hours) were studied. Thirty four percent (785) of the neonates had hypothermia. Mean gestation was 34±3 weeks and 42.5% were inborn. Significant determinants of neonatal hypothermia at admission included factors like preterm (p=0.03), low birth weight (p=0.005), normal delivery (p=0.012), birth asphyxia (p=0.001) below average socioeconomic status (p=0.001) and long distance (&gt;10 km) travelled by the neonate (p=0.03). Independent variables are resuscitation at birth [p=.001, Odds Ratio (OR), 2.43; Confidence Interval (CI), 1.47 to 4.00], (p=0.001), age less than 24 hours (p=.02; OR 2.25; CI, 1.13 to 4.47), low birth weight (p=0.03; OR,2.0; CI, 1.06 to 3.82), caesarean section(C/S) delivery (p=.006; OR 1.35; CI, 1.18-2.12) and below average economic status (p=0.001; OR, 2.76; CI, 1.56 to 5.90). Conclusion: Incidence of admission hypothermia among neonates in our NICU was 34%. Independent risk factors are resuscitation at birth, very low birth weight, C/S delivery, age less than 24 hours and poor socio-economic condition. Proper thermal care should be provided for neonates both at home and hospitals. DOI: http://dx.doi.org/10.3126/jnps.v33i3.8312 J. Nepal Paediatr. Soc. 2013;33(3):166-171

Social support of Chinese patients with ovarian malignancies during chemotherapy: A cohort questionnaire survey

Social support of Chinese patients with ovarian malignancies during chemotherapy: A cohort questionnaire survey

Geographic aspects of poverty and health in Tanzania: does living in a poor area matter?

Previous studies have consistently found an inverse relationship between household-level poverty and health status. However, what is not well understood is whether and how the average economic status at the community level plays a role in the poverty-health relationship. The purpose of this study is to investigate the concentration of poverty at the community level in Tanzania and its association with the availability and quality of primary health care services, the utilization of services, and health outcomes among household categories defined by wealth scores. A principal component method has been applied to rank households separately by urban/rural location using reported levels of asset ownership and living conditions. The household wealth scores were also used to classify communities into three cluster-types based on the proportion of households belonging to the poorest wealth tercile. On average, all the wealth terciles living in low poverty concentration areas were found to have better health outcomes and service utilization rates than their counterparts living in high poverty concentration clusters. Consistent with the finding is that high poverty concentration areas were further away from facilities offering primary health care than low poverty concentration areas. Moreover, the facilities closest to the high poverty concentration areas had fewer doctors, medical equipment and drugs. Among the high poverty concentration clusters, the 10 communities with the best women's body mass index (BMI) measures were found to have access to facilities with a greater availability of equipment and drugs than the 10 communities with the worst BMI measures. Although this study does not directly measure quality, the characteristics that differentiate high poverty concentration clusters from low poverty concentration clusters point to quality as more important than physical access among the study population.

Health of the Negro1

Health of the Negro¹

Retirement Prospects of the Baby Boom Generation: A Different Perspective

We examine the average economic status of baby boom cohorts as they approach retirement chiefly using data on their life cycle income experience to date. Contrary to popular impression, baby boomers are likely to enter old age in an even better economic position than pre-boom cohorts. Economic and demographic adjustments that they made, such as deferred marriages, reduced childbearing, and increased labor force participation of wives, have compensated for their relatively low wage rates. Potential downside effects of reduced childbearing regarding Social Security and health care prospects are discussed.

How Parents Have Coped: The Effect of Life Cycle Demographic Decisions on the Economic Status of Pre-School Age Children, 1964-87

SINCE THE EARLY 1960S THE DEMOGRAPHIC CIRCUMSTANCES of children under six years old in the United States have changed substantially, with effects on their economic well-being both for better and for worse. Most previous studies of this subject, following Samuel Preston's (1984) lead, have stressed the adverse effect on the poverty rate of children resulting from the breakup of marital and nonmarital unions (Bane, 1986; Dooley, 1989; Duncan et al., 1987; Easterlin, 1987; Espenshade, 1985; Garfinkel and McLanahan, 1986). This article takes a somewhat broader view, complementing and extending previous work. First, it looks at children of all economic statuses, not just those in poverty. Second, in assessing the effect of demographic decisions on children's average economic status, it encompasses a wider range of factors. As potential parents pass from adolescence through the familyforming years, they face decisions about the formation or dissolution of unions, establishment of an independent household, number of children, timing of children, and labor force participation. The concern here is with how this entire set of life cycle demographic decisions in the period 196487 affected the average economic status of pre-school age children. On a priori grounds, the combined effect of these decisions on young children's economic status is uncertain. There is ample documentation of the adverse impact of the growth of single-parent families. Because children in such families are typically worse off than those in two-parent families, a shift from twoto one-parent families would worsen the economic status of children. But other demographic decisions, both of couples and of single

Energy expenditure and consumption of mature, pregnant and lactating women

Energy expenditure and consumption of mature, pregnant and lactating women

Some Aspects of the Negro Market

THE Negro market in America, as far as numbers are concerned, comprises about one tenth of our nation. If developed to the average per capita buying level, this portion of our domestic market would be of greater importance than our entire export market. And the Negro, as a consumer, is forging ahead more rapidly than is the average American citizen. Yet, both in sales and in market research this tenth of our population is relatively neglected. In our market activities we need to set the Negro market off by itself for purposes of study and development, and we must rigorously analyze this market and all its elements in order that it can be built up to its highest potentialities. In this way we shall not only help the Negro tenth of our population, but we shall greatly expand and improve our national market as a whole. Realizing these facts, the Afro-American chain of newspapers, in cooperation with the Urban League, retained the Research Company of America to make a careful study of the Negro market in the northern cities. They wanted much more complete and dependable facts about this market than had previously been collected and analyzed. The tables presented are taken from the study recently conducted and completed by the Research Company of America. These tables represent only a fragment of the many questions asked Negro families in what is believed to be one of the most comprehensive surveys ever conducted among Negroes. This study covered a stratified sample of a carefully selected cross-section, by census tracts, of a minimum of i ,OOO typical Negro homes in each of the following cities: Washington, Baltimore, and Philadelphia-a total of more than 3,00o Negro homes. Only Negro interviewers were used. The original briefing and instruction session lasted 2? hours. Interviewers were given supplemental briefing each day. Adequate emphasis was placed on the importance of the study. Each interviewer was charged with an individual responsibility. Field interviewers were spot-checked regularly and daily to insure accuracy in their reporting. The majority of the field staff was recruited from the student body of Negro universities, with the voluntary collaboration of their faculties who rendered important assistance. Other interviewers were school teachers and social service workers or those engaged in related fields. The Urban League was also extremely helpful and cooperative. These studies were under the constant personal supervision of the author; and most important, no incentive was offered to respondents for their free answers. The average economic status of the Negro families in Washington, D. C., is materially higher than in the other two cities studied. This differentiation among the Negroes is reflected in their buying habits. In Philadelphia, 65 per cent of all Negro families have weekly earnings between $20 and $57.50, but the proportion in the $38-$57.5o group is now generally higher than in the $20-$37.5o group. In Washington, about 30 per cent of families earn $58 or more, as compared with about 25 per cent in Baltimore and about 20 per cent in Philadelphia. On the average, one and one

Pyridoxine Hydrochloride (Vitamin B6) in the Control of Radiation Sickness: Preliminary Report

Since 1934, we have used the protracted fractionated method of deep x-ray therapy in the treatment of practically all types of malignant neoplasms that have been referred to us for treatment. As in most general radiological clinics, carcinomas of the uterine cervix and breast are by far the most frequent types of lesion encountered. From 1934 to 1941, we used the old Drum type of equipment unit, operating at 200 kv.p., 5 ma., 50 cm. distance, 0.5 mm. Cu plus 1.0 mm. Al filter, with an output of 17 r per minute in air, not including back-scatter. During that seven-year period, the control of x-ray sickness was quite a problem. We used face masks (1), nembutal (2), fruit juices (3), good ventilation of therapy rooms (4), and many other measures recommended by various authors, with variable results. In 1941, we installed a modern shock-proof 220-kv.p. unit, operating at 200 kv., 20 ma., 50 cm. distance, and an r output of 50 per minute, with 0.5 mm. Cu plus 1.0 mm. Al filtration. From that time on, radiation sickness ceased to be a major problem unless we increased our daily dose from 300 to 500 or 600 r. It was about this time that we began to administer nicotinic acid (5) and thiamine chloride (6) routinely to patients receiving 200 kv. x-ray therapy. This probably helped to prevent some cases of radiation sickness, but in other instances it was wholly ineffective. It is generally recognized that the larger the daily dose of radiation with a 200-kv. unit, the greater is the possibility of x-ray sickness. The size of the field, the area treated, and the general nutritional state of the patient also play important roles (7). It has been our experience that when two areas of the pelvis or breast are treated, with fields up to 15 × 15 cm. and a daily dosage of 150 r measured in air to each area, severe radiation sickness rarely develops, provided proper attention is given to the patient's general nutritional state (8). Diarrhea practically never occurs under these circumstances. If, however, the epigastric area or right and left hypochondriac regions are treated with 150 r, using 15 × 15 cm. fields, radiation sickness occurs much more frequently and usually requires special attention if therapy is to be continued (see Case 18). Lesions of the extremities can be given large doses of radiation without signs of radiation sickness (see Case 5). In April 1945, we decided to double the daily x-ray dosage of 300 r, so as to give 600 r. In this way we hoped to decrease the time necessary for adequate treatment of cases of carcinoma in the hospital, to make possible a more rapid turnover of cases, and to reduce the hospital expenses proportionately. Economics plays an important part in the management of any type of malignant disease, especially among people whose average economic status is low. Two questions immediately confronted us: (1) How could we control the x-ray sickness that we felt would most probably develop?