Cohabiting Family Members Research Articles

Breast Cancer Provider Interval Length in Fukushima, Japan, After the 2011 Triple Disaster: A Long-Term Retrospective Study

BackgroundMinimizing the interval from symptom onset to treatment commencement is essential for a favorable outcome among breast cancer (BC) patients. This study examined whether provider interval (time elapsed from first consultation to treatment initiation) lengthened among BC patients after Japan’s 2011 earthquake, tsunami, and nuclear disaster in Fukushima. Factors associated with the length of postdisaster interval and whether the interval was associated with BC stage were also investigated. Patients and MethodsSo-so District (study site) was an area damaged by the 2011 disasters. Data of all BC patients who made their first medical consultation and received initial treatment at the core medical institutions in the area 5 years before or after the disaster were extracted from patient medical records. We used several regression approaches to fulfill our study objectives. ResultsWe included 263 (140 predisaster and 123 postdisaster) patients. After adjustment for covariates, the interval did not significantly change after the disaster compared to before the disaster. Those with 4 or 5 cohabiting family members experienced a shorter interval after the disaster than those with 0 or 1 cohabiting family members (relative length, 0.47; 95% confidence interval, 0.28-0.78). Those with an interval of > 60 days had lower odds of stage III or IV cancer after the disaster than those with an interval of < 30 days (odds ratio, 0.09; 95% confidence interval, 0.01-0.84). ConclusionOverall, provider interval did not lengthen after the disaster. However, those with fewer cohabiting family members might have experienced a longer total interval. Cancer stage may not necessarily reflect the influence of interval on patient outcome.

Demographic and Socioeconomic Factors for Renouncing Further Active Therapy for Patients with Brain Metastasis of Non-Small Cell Lung Cancer.

BackgroundAs patients with brain metastasis (BM) of non-small cell lung cancer (NSCLC) have dismal prognosis, some of them decide to discontinue further treatment for BM. The objective of this study was to determine factors for renouncing further active therapy in patients with BM of NSCLC, focusing on their demographic and socioeconomic status.MethodsMedical records of 105 patients with radiological diagnosis of BM of NSCLC for the recent 11 years at authors' institution were retrospectively reviewed. Clinical features as well as demographic and socioeconomic characteristics such as marriage status, cohabiting family members, religious affiliations, educational background, and economic responsibility were reviewed.ResultsMedian overall survival (OS) was 13.84 (95% CI: 10.26–17.42) years in 67 patients (group A) who underwent active treatment (radiotherapy and/or chemotherapy) and 4.76 (95% CI: 3.12–6.41) years in 38 patients (group B) who renounced active treatment. Less patients were unmarried (p=0.046), more cohabitating family members (p=0.008), and economically independent (p=0.014) in group A than those in group B. Similarly, the unmarried, and none cohabitating family members had short OS (5.17 and 7.38 years, respectively). In multivariate analysis for predisposing factors of OS in these patients, the following demographic and socioeconomic factors had independent significance: marriage status and cohabitating family members.ConclusionThis study suggests that demographic and socioeconomic status as well as clinical factors could influence the decision of further active treatment and prognosis of patients with BM of NSCLC.

Public knowledge, attitudes and willingness regarding bystander cardiopulmonary resuscitation: A nationwide survey in Taiwan

A low bystander cardiopulmonary resuscitation (CPR) rate is one of the factors associated with low cardiac arrest survival. This study aimed to assess knowledge, attitudes, and willingness towards performing CPR and the barriers for implementation of bystander-initiated CPR. Telephone interviews were conducted using an author-designed and validated structured questionnaire in Taiwan. After obtaining a stratified random sample from the census, the results were weighted to match population data. The factors affecting bystander-initiated CPR were analysed using logistic regression. Of the 1073 respondents, half of them stated that they knew how to perform CPR correctly, although 86.7% indicated a willingness to perform CPR on strangers. The barriers to CPR performance reported by the respondents included fear of legal consequences (44%) and concern about harming patients (36.5%). Most participants expressed a willingness to attend only an hour-long CPR course. Respondents who were less likely to indicate a willingness to perform CPR were female, healthcare providers, those who had no cohabiting family members older than 65 years, those who had a history of a stroke, and those who expressed a negative attitude toward CPR. The expressed willingness to perform bystander CPR was high if the respondents possessed the required skills. Attempts should be made to recruit potential bystanders for CPR courses or education, targeting those respondent subgroups less likely to express willingness to perform CPR. The reason for lower bystander CPR willingness among healthcare providers deserves further investigation.

A New Influenza-Tracking Smartphone App (Flu-Report) Based on a Self-Administered Questionnaire: Cross-Sectional Study.

BackgroundInfluenza infections can spread rapidly, and influenza outbreaks are a major public health concern worldwide. Early detection of signs of an influenza pandemic is important to prevent global outbreaks. Development of information and communications technologies for influenza surveillance, including participatory surveillance systems involving lay users, has recently increased. Many of these systems can estimate influenza activity faster than the conventional influenza surveillance systems. Unfortunately, few of these influenza-tracking systems are available in Japan.ObjectiveThis study aimed to evaluate the flu-tracking ability of Flu-Report, a new influenza-tracking mobile phone app that uses a self-administered questionnaire for the early detection of influenza activity.MethodsFlu-Report was used to collect influenza-related information (ie, dates on which influenza infections were diagnosed) from November 2016 to March 2017. Participants were adult volunteers from throughout Japan, who also provided information about their cohabiting family members. The utility of Flu-Report was evaluated by comparison with the conventional influenza surveillance information and basic information from an existing large-scale influenza-tracking system (an automatic surveillance system based on electronic records of prescription drug purchases).ResultsInformation was obtained through Flu-Report for approximately 10,094 volunteers. In total, 2134 participants were aged <20 years, 6958 were aged 20-59 years, and 1002 were aged ≥60 years. Between November 2016 and March 2017, 347 participants reported they had influenza or an influenza-like illness in the 2016 season. Flu-Report-derived influenza infection time series data displayed a good correlation with basic information obtained from the existing influenza surveillance system (rho, ρ=.65, P=.001). However, the influenza morbidity ratio for our participants was approximately 25% of the mean influenza morbidity ratio for the Japanese population. The Flu-Report influenza morbidity ratio was 5.06% (108/2134) among those aged <20 years, 3.16% (220/6958) among those aged 20-59 years, and 0.59% (6/1002) among those aged ≥60 years. In contrast, influenza morbidity ratios for Japanese individuals aged <20 years, 20-59 years, and ≥60 years were recently estimated at 31.97% to 37.90%, 8.16% to 9.07%, and 2.71% to 4.39%, respectively.ConclusionsFlu-Report supports easy access to near real-time information about influenza activity via the accumulation of self-administered questionnaires. However, Flu-Report users may be influenced by selection bias, which is a common issue associated with surveillance using information and communications technologies. Despite this, Flu-Report has the potential to provide basic data that could help detect influenza outbreaks.

Biogeography and environmental conditions shape bacteriophage-bacteria networks across the human microbiome.

Viruses and bacteria are critical components of the human microbiome and play important roles in health and disease. Most previous work has relied on studying bacteria and viruses independently, thereby reducing them to two separate communities. Such approaches are unable to capture how these microbial communities interact, such as through processes that maintain community robustness or allow phage-host populations to co-evolve. We implemented a network-based analytical approach to describe phage-bacteria network diversity throughout the human body. We built these community networks using a machine learning algorithm to predict which phages could infect which bacteria in a given microbiome. Our algorithm was applied to paired viral and bacterial metagenomic sequence sets from three previously published human cohorts. We organized the predicted interactions into networks that allowed us to evaluate phage-bacteria connectedness across the human body. We observed evidence that gut and skin network structures were person-specific and not conserved among cohabitating family members. High-fat diets appeared to be associated with less connected networks. Network structure differed between skin sites, with those exposed to the external environment being less connected and likely more susceptible to network degradation by microbial extinction events. This study quantified and contrasted the diversity of virome-microbiome networks across the human body and illustrated how environmental factors may influence phage-bacteria interactive dynamics. This work provides a baseline for future studies to better understand system perturbations, such as disease states, through ecological networks.

Socioeconomic differences in self- and family awareness of viral hepatitis status among carriers of hepatitis B or C in rural Korea

Hepatitis is the most important cause of hepatocellular carcinoma in Korea. This study evaluated the socioeconomic differences in self- and family awareness of hepatitis status among hepatitis B and C carriers and their cohabitants in rural Korea. In total, 5,017 randomly selected rural residents participated in a seroepidemiologic and questionnaire survey. We found 326 hepatitis B surface antigen carriers or hepatitis C antibody carriers and 310 family members cohabiting with members of this group. Among the hepatitis B carriers and their family members, 48.1% were aware of their own status and 36.7% were aware of their cohabitant's hepatitis status, respectively. Only 28.1% of the hepatitis C carriers were aware of their own status, and only 23.3% of their cohabiting family members knew about their family member's hepatitis C status. A multivariate analysis including health-related factors, such as alcohol consumption, family history of liver disease, and recent acupuncture history, found that self-awareness was significantly lower in the older group and significantly higher in the more educated and higher-income groups. Family awareness was also increased in those working in salaried jobs. Socioeconomic disparities in awareness of hepatitis status were found among hepatitis carriers and their families.

Bariatric Surgery Patients and Their Families: Health, Physical Activity, and Social Support.

This study evaluated the social environment of bariatric surgery patients in the preoperative period. Forty bariatric surgery patients (mean = 46.2 ± 11.2years), 35 adult cohabitating family members (mean = 45.2 ± 12.7years), and 15 cohabitating children (mean = 11.5 ± 3.6years) were recruited from a large rural medical center. Adult participants (patients and family members) completed height, weight, body composition, blood draws, and physical activity assessments (accelerometry), as well as eating behavior and social support inventories before the patient underwent bariatric surgery. Child participants completed demographic, height, and weight assessment only. Over 90% of adult family members were overweight or obese (body mass index (BMI) ≥ 25kg/m2, as were 50% of children (BMI percentile ≥ 85%). More than one third (37.1%) of family members met the criteria for moderate to severe insulin resistance. Physical activity measured by accelerometry was moderately correlated between the patient and adult family members (r = 0.46, p = 0.023). Bariatric surgery patients reported high levels of social support from their family members on multiple social support measures. Many family members of bariatric surgery patients also lived with obesity and related comorbidities, and demonstrate high sedentary behavior. However, patients reported high levels of support from family members, including support in following a healthy diet and engaging in physical activity. Engaging families in behavior change may help bariatric surgery patients and their families to become healthier.

Potential factors, including activities of daily living, influencing home discharge for patients with putaminal haemorrhage.

BackgroundConvalescent rehabilitation wards assist stroke patients in acquiring skills for activities of daily living to increase the likelihood of home discharge. However, an improvement in activities of daily living does not necessarily imply that patients are discharged home. We investigated the characteristics of patients with putaminal haemorrhage who are discharged home following convalescence in rehabilitation wards.MethodsThe sample comprised 89 patients (58 men and 31 women) with putaminal haemorrhage hospitalised in the convalescent rehabilitation ward of our hospital between August 2012 and July 2013. Their age ranged from 29 to 88 years (61.9 ± 11.9 years). The lesion occurred on the right side in 48 and on the left in 41 patients. The mean period from onset to hospitalisation in the convalescent rehabilitation ward was 30.8 ± 17.2 days, and the mean hospitalisation period was 70.7 ± 31.8 days. We examined age, sex, haematoma volume, duration from onset to hospitalisation, neurological symptoms, cognitive function, functional independence measure, number of cohabitating family members and whether the patient lived alone before stroke, and the relationship among these factors and discharge destination (home or facility/hospital) was assessed.ResultsThe discharge destination was home for 71 and a facility or hospital for 18 patients. Differences were observed in age, haematoma volume, neurological symptoms, cognitive function, functional independence measure score on admission and discharge, number of cohabitating family members and whether the patient lived alone before stroke for patients discharged home. Patients who required long-term care and were discharged home were more likely to be living with family members who were present during daytime. Home discharge was possible if functional independence measure score was ≥70 at the time of discharge for motor items and ≥24 for cognitive items, even if a patient lived alone before stroke.ConclusionsAlthough the presence of cohabitating family members was important, the factor most strongly influencing home discharge was the patient’s activities of daily living status at the time of discharge. For patients who lived alone before stroke, physical and cognitive functions must be maintained for them to be discharged home after rehabilitation.

Secondary Exposure of Family Members to Cyclophosphamide After Chemotherapy of Outpatients With Cancer: A Pilot Study.

To measure the total amount of cyclophosphamide (CPA) excreted in the urine of patients with cancer and their cohabitating family members seven days after CPA administration. Biological monitoring. . Home setting with outpatients receiving chemo-therapy. 8 patients administered CPA, 10 cohabitating family members, and 10 control participants. During the first seven days after CPA administration, urine samples were collected from the participants. The samples were analyzed for the unchanged form of CPA using gas chromatography in tandem with mass spectroscopy. CPA levels . CPA was detected in 112 of 276 patient urine samples. The last sample containing detectable CPA levels was collected after more than 48 hours in 63% of the patients, with a maximum length of five days post-treatment. In addition, 243 urine samples were collected from family members, and CPA was detected in the samples of five family members (17-252 ng per member). CPA was not detected in any control participants. These findings indicate that family members in close contact with patients receiving CPA are at high risk for drug exposure as many as seven days post-treatment . Nurses should educate patients and their family members about preventing exposure to antineoplastic drugs in the home setting.

Gastric bypass may promote weight loss in overweight partners.

Following bariatric surgery, patients are expected to implement diet and lifestyle changes that may be imitated by cohabitating family members. We hypothesize that cohabitating family members will lose weight and improve their eating behavior within 1 year after surgery. In this observational prospective study, family members of patients who had gastric bypass surgery (88 partners, 20 children ≥18 years old, and 25 children between 12 and 17 years old) were repeatedly assessed. Family members were asked to assess their weight and height before and 3, 6, and 12 months following bariatric surgery, and they filled out the Dutch Eating Behavior Questionnaire. Between baseline and 1 year following surgery, 49 partners of patients who underwent gastric bypass surgery (66.2%) lost weight, 6 (8.1%) remained stable, and 19 (25.7%) gained weight. Body mass index of partners (P = .002), particularly of overweight partners (P < .001)-but not children-showed a small, significant decrease over time. No significant changes in eating behavior among partners or children were found. The study indicates that gastric bypass surgery may have a ripple effect, with body weight in partners of patients decreasing over time. However, there is considerable variation in the postoperative weight loss of partners.

Alcohol consumption and health status of family members: health impacts without ingestion

Over several decades, many cohort studies from the medical epidemiology literature have observed that compared with abstainers, moderate drinkers experience lower risk for a range of diseases. It was very difficult to separate the hypothesised physiological protective effect of moderate drinking from its well-correlated confounders in observational study settings. To investigate the association between current alcohol consumption levels of randomly selected family members and the current self-reported health status of other members living within the same family, using a large-scale representative general population survey. Poisson regression models of the association between randomly selected key respondent alcohol consumption and health status of cohabiting family members using data from the 2008, 2009 and 2010 National Health Interview Surveys. Self-reported alcohol consumption of randomly selected key participants and self-reported health status of adult and child (parent reported) family members living in the same household were measured and compared. After controlling for a large range of commonly reported confounders, inverse associations were evident between light and moderate alcohol consumption of key participants and the prevalence of adverse health status among their family members, including children. The superior health status attributed to family members of light and moderate drinkers is highly likely to be spurious and due to residual confounding rather than physiologically protective effects of alcohol. Unaccounted for confounding is likely to underpin apparent 'protective effects' due to moderate drinking commonly reported from observational studies of all-cause mortality, heart disease, stroke and other chronic diseases.

P2‐336: Social isolation and quality of life in Alzheimer's dementia patients with Parkinson's disease

Background: Caring for someonewith dementia has been strongly linked to negative outcomes for caregivers such as burden or distress.However, little is known about whether Mild Cognitive Impairment (MCI) can also be linked to negative outcomes for co-habiting familymembers.Moreover, risk factors of poorpsychologicalwell-beingarenotwell established for this group.Examination of family supporters before they assume caregiving responsibilities may assist in identification of those vulnerable to psychological distress. Methods: We aimed to investigate the prevalence and predictors of psychological distress over time in co-habiting relatives of elders with and without MCI. Data from a large, population-based longitudinal study of people aged 70 to 90without dementia at baselinewere collected at baseline and after two years as regards participants’ socio-demographics, cognition, function and behavior, and family members’ psychological distress as measured by the Kessler Psychological Distress Scale (K10). On the K10, scores of 20 out of 50 indicate significant psychological distress. Linear regression analysis with K10 change scores as dependent variable was performed.Results:Of 1037 participants recruited, 327 (32%) had co-habiting family members who provided information about them. At baseline MCI prevalence in this subsample was 33%. Dementia incidence in participants with MCI in the two years following baseline was 2.8%. Rates of family members’ psychological distress were low at baseline and at 2-year follow-up (4.6 and 6.4%, respectively). After controlling for baseline K10 scores, worsening psychological distress was associated with family members’ greater physical disability at 2-year follow-up (b 1⁄4 -.0461, P<.001) as well as worse functional (ADLs) and cognitive (language) performance of the older person at baseline (b 1⁄4 -.162, P1⁄4 .004 and b1⁄4 -.123, P1⁄4 .023, respectively). The overall model accounted for 43% of variance (adjusted R 2.429).Conclusions:Characteristics of older people and their family members or a change thereof may influence family member’s psychological well-being over time. Longitudinal analyses of factors that contribute most toworsening of psychological distress in caring family members will allow identification of risk factors and of family members prone to negative outcomes from early in their caregiving career and provide opportunity for early intervention.

P2‐335: To what extent does cognitive and functional decline in older persons affect the psychological well‐being of cohabiting family members?

P2‐335: To what extent does cognitive and functional decline in older persons affect the psychological well‐being of cohabiting family members?

Risk factors for delusion of theft in patients with Alzheimer's disease showing mild Dementia in Japan

The mechanism underlying delusion in Alzheimer's disease patients has not been fully clarified; however, the occurrence of delusion is a critical issue for dementia patients and their caregivers. In Japan, delusion of theft is the most frequent delusion in AD patients. We examined the risk factors for delusion of theft in AD patients showing mild dementia. Fifty-six AD patients were administered HDS-R, MMSE and COGNISTAT, including the ‘speech sample’, to assess their neuropsychological and social cognitive functions. The age, years of education, presence of cohabiting family members and premorbid personality traits were obtained from family members. About 25.0% of AD patients showed delusion of theft (D-group), and 75% did not (non-D-group). About 33.3% of female patients and 5.9% of male patients were included in the D-group (p < 0.05). About 13.6% of patients who were cohabiting with family members and 66.7% of patients who were living alone were included in the D-group (p < 0.05). About 35.1% of patients who had a neurotic personality and 5.3% of patients who did not were included in the D-group (p < 0.05). There were no significant differences in scores on HDS-R, MMSE and COGNISTAT sub-scales, except for ‘speech sample’, between the two groups. In the ‘speech sample’, 38.7% of patients who understood a relationship between two boys and 12.0% of patients who did not were included in the D-group (p < 0.05). These results indicated that delusion of theft in AD patients was related to female gender, absence of cohabiting family members, neurotic personality and retained social cognitive function.

Concordance Rates of Allergen Sensitization Amongst Family Members at an Inner City Asthma Center

RATIONALE: Environmental and genetic factors are thought to play a role in allergen sensitization. This study was to determine if there is increased concordance rates of allergen sensitization among the adult and pediatric patients treated at our inner city Asthma Center who are cohabitating family members.

United Kingdom: Sisters and inheritance tax

Joyce and Sybil Burden are two sisters who have lived together since birth and currently occupy a UK farmhouse. When one of them dies the other will face a large inheritance tax bill and will have to sell the house to meet the cost. The sisters, Joyce, aged 88, and Sybil, aged 80, want the law changed so that cohabiting siblings have the same rights as married couples, which exempts the surviving half from inheritance duty. After the Civil Partnership Act 2004 granted the same rights to gay and lesbian couples as applied to married couples but not to cohabiting family members, they decided to act. The sisters’ situation is relevant to the use of trusts for holding shared accommodation. Their case was due to be heard before the European Court of Human Rights in Strasbourg on 12 September 2006. Julian Washington, private client partner with Mayfair law firm, Forsters LLP, commenting on the situation, writes: This issue was raised during the passage of the civil partnership legislation through Parliament. A number of opposition peers tried to amend the Civil Partnership Bill (as it then was) in the House of Lords to extend the privileged tax treatment of civil partners and spouses to carers and other relatives who live together. The ‘elderly spinster sisters’ is the oft-quoted exemplar of cohabitants who do not qualify for any special tax treatment and who, as a result, may face difficulties when one of them dies. The House of Lords amendments were rightly voted out of the Civil Partnership Bill (because this is a quiet different issue from the legal recognition of same-sex relationships) but, at the time, the Government said it would look at the position of cohabitants like the Burden sisters. In fact, on 31st May the Law Commission published its consultation paper ‘Cohabitation: The Financial Consequences of Relationship Breakdown’. This paper specifically excludes blood relatives and carers, concentrating on the position of what are colloquially known as ‘common law’ spouses. In other words, there are no signs of any progress for people like Joyce and Sybil Burden. The only comfort for them may be that the existing law allows inheritance tax attributable to houses and land to be paid in ten annual instalments (plus interest). By contrast, the tax attributable to other assets has to be paid at the time of probate.

Victims of sexual offences: Medicolegal examinations in emergency settings

The aim of the study was to present some data concerning the examinations of victims of sexual offences in emergency settings conducted by medicolegal examiners of the Lisbon Department of the National Institute of Legal Medicine (NILM) over a two-year period (2002–2003). The study was based on 352 alleged victims of sexual offences referred by investigating police authorities and physicians working at hospital emergency rooms. Examination records were reviewed and data collected according to the extended medicolegal protocol adopted by NILM, which includes sociodemographic variables, and medical and laboratory findings. The results show that examinations in emergency settings represented about 43% of the total examinations of victims of sexual offences, 44% of them being performed at hospital emergency rooms. Victims’ ages ranged from a minimum of 93 days to a maximum of 86 years. The mean age was 17.5 years. Females represented about 92% with a large over-representation of those aged from 0 to 19 years (61% of the total). Victims were mainly girls of school age (36%) or under 6 years old (25%). Offenders were male, referred to mainly, as acquaintances/neighbours (32%), friends (24%) or cohabiting family members (20%), a large majority belonging to the victim’s social or family circle (85%). Of the examinations requested as “urgent cases” only 61% were reported as having occurred within 72 h prior to the examination. Traumatic lesions on the whole body were found in only 28% of the cases, while findings on the genitalia and/or the anus were present in 31%. Medical and laboratory findings were in accordance with some sort of sexual offence in 34% of the cases. Our findings show the great heterogeneity of the victims, with a high proportion of children as well as the interplay between examination requests in emergency settings and the need to define more accurate criteria and proceedings for legal authorities and physicians who are usually the first line of intervention before specialists in legal medicine.

Concurrence between subject and proxy ratings of quality of life for people with and without intellectual disabilities

The purpose of this investigation was to examine concurrence between subjects' self-reported quality of life (QOL) and assessments of their QOL made by proxies who were either a first degree relative, or were acting in a supportive role similar to that of a family member. Two studies were conducted. The first study, using ComQol-A4 (Cummins, 1993), examined the degree of concurrence between nondisabled subjects' QOL and ratings made on their behalf by proxies who were either a parent or a sibling (N = 78 subject/proxy pairs). The second study utilised ComQol-ID4 (Cummins, 1993), and examined agreement between QOL ratings made by subjects with mild intellectual disability and proxies who were either parents or support workers (N = 24 subject/proxy pairs). In both studies the effects on agreement of variables including subject/proxy living arrangements, gender similarity, and proxy gender and empathy were examined. In contrast to previous research utilising non-standardised approaches to QOL assessment, results from both studies indicated overall a high degree of subject/proxy concurrence. Overestimation or underestimation of ratings by proxies was minimal. These findings endorse the use of standardised approaches such as ComQol for proxy-based measures of QOL. Also, none of the factors investigated directly affected agreement between subject/proxy QOL reports. If standardised approaches to QOL are employed, and if proxies are selected on the basis of close and regular contact, it does not seem to matter if they are male or female, cohabiting family members or non-cohabiting support workers.

Current prevalence of hepatitis B, A and C in a healthy Spanish population. A seroepidemiological study

A seroepidemiological study was carried out in order to determine the prevalence of markers of viral hepatitis infection in employees of five health-care companies and their cohabiting family members. Each participating family unit was required to fill out a questionnaire, in which, among other data, the employee was requested to indicate his or her job category. Markers of hepatitis B infection (anti-HBs, anti-HBc or HBsAg) were observed in 11.7% (58/497) of all subjects. When employees and family members were analysed according to the employee's job category, significant differences were found between "staff" (3%) and "administrative personnel" (13.3%; p less than 0.01) or "factory workers" (16.9%; p less than 0.01). Of 489 individuals tested for the presence of anti-HAV and anti-HCV, 59.1% and 0.6% respectively, were positive. There was a correlation between the prevalence of anti-HAV and age; a large proportion of the subjects under the age of 30 years had no evidence of prior HAV infection.