Lifestyle Interview Research Articles

The heterogeneity of subjective cognitive decline: A data‐driven approach on a population‐based sample

AbstractBackgroundSubjective Cognitive Decline (SCD) has been largely studied as a risk condition for cognitive decline, mainly in memory clinics or research settings. SCD samples are highly heterogeneous, including both individuals with early Alzheimer’s disease and others with psychological vulnerabilities and/or physical comorbidity. Aims: identify distinct SCD subgroups in a population‐based sample of cognitively normal (CN) older adults; explore cross‐sectional differences among SCD subgroups and controls (noSCD); investigate the effect of SCD status on 8‐year cognitive changes.MethodThe InveCe.Ab population‐based study (NCT01345110) enrolled people aged 70‐74 years residing in Abbiategrasso (Milan). Participants underwent multidimensional assessment (blood sampling, lifestyle interview, medical and neuropsychological assessment) at baseline (Nov 2009‐Jan 2011) and after 2, 4 and 8 years. CN participants at baseline completing at least 60% of neuropsychological assessment were included in the present investigation. Those reporting any cognitive complaints to the geriatrician were classified as SCD. Hierarchical cluster analysis was conducted in SCD including 9 relevant variables: education, depressive symptoms, cardiovascular risk, comorbidity, subjective cognitive complaints (numbers) and 4 neuropsychological scores measuring memory, executive functions, visuospatial abilities and language respectively. Cross‐sectional differences among the SCD subgroups identified and noSCD were performed using Kruskal‐Wallis test. Longitudinal cognitive changes according to baseline SCD status (noSCD, SCD subgroups) were estimated using linear mixed models, adjusted for age and education.ResultTwo clusters were identified in SCD. Table 1 shows cross‐sectional results. SCD1 (N=141), compared to SCD2 and CN, were less educated, have higher comorbidities, depressive symptoms and SCD complaints. SCD1 showed lower performances on executive and visuospatial functions, while SCD2, despite being healthier and more educated, showed reduced episodic memory. At longitudinal analysis, all cognitive functions declined due to aging (Time; p<.001). SCD2 displayed a steeper worsening on executive function (Group*Time; p<.001).ConclusionThe presence of SCD at the population level could be informative of future cognitive decline when reported by individuals with higher education. Future studies are needed to clarify the meaning of this condition in the aged population, in order to identify early those at increased risk of actual cognitive decline.

A Model of an Integrative Approach to Breast Cancer Patients.

Background:Breast cancer (BC) survivors have physical and psychological needs that require convincing responses by health care providers. The quality of life issue and clinical unmet needs are among the main reasons pushing a number of patients toward “natural” therapies that are often misleading and alternative to mainstream cancer care. Integrative Oncology (IO) tries to respond to many of those needs, by combining lifestyle counseling, body-mind activities, and complementary evidence-informed therapies with anticancer standard treatments.Methods:In our model at Fondazione Policlinico Gemelli (FPG), every woman diagnosed with a BC waiting for surgery or candidate to neoadjuvant chemotherapy undergoes a preliminary psycho-oncological distress evaluation and a brief lifestyle interview. Anthropometric measurements, body composition analysis, and individual levels of physical activity are recorded. Patients are given evidence based recommendations about the advisable diet and physical activity in a prehabilitation setting. A physician provides patients with information about integrative care plans to treat symptoms related to the disease or its treatments. Therapeutic approaches include acupuncture, mindfulness-based protocols, qigong, massage therapy, and classes of music/art therapy.Results:Between September 2018 and February 2020, the Center for Integrative Oncology at FPG has carried out 1249 lifestyle counseling sessions, 1780 acupuncture treatments, 1340 physiotherapy sessions, 3261 psycho-oncological consultations, 218 herbal medicine counseling sessions. Moreover, 90 BC patients completed the mindfulness based stress reduction (MBSR) protocol and 970 patients participated in qigong, art therapy, and music therapy classes.Conclusions:Our integrative approach aims to achieve a person-centered medicine by improving symptoms management, adherence to oncological protocols, and eventually overall quality of life.

Effects of Lutein Supplementation in Japanese Patients with Unilateral Age-Related Macular Degeneration: The Sakai Lutein Study

This prospective randomized double-masked study investigated the effects of 20 mg lutein supplementation with two different capsules (beeswax or glycerol fatty acid esters) for 6 months on the fellow eyes of 39 Japanese patients with unilateral age-related macular degeneration, and assessed the factors associated with baseline plasma lutein concentration via lifestyle interviews. Macular pigment optical density (MPOD), determined with the two-wavelength autofluorescence method, increased over time in the beeswax group (ANOVA, p = 0.0451), although the increase from 3 months to 6 months was only marginally significant. No significant increase was observed in the glycerol fatty acid esters group (ANOVA, p = 0.7396). Plasma lutein concentrations significantly increased at 3 and 6 months from baseline in both groups (both p < 0.01). In a multiple regression model, age was negatively associated with higher plasma lutein concentration (p = 0.0305), while consumption of green vegetables was positively associated with baseline plasma lutein concentration (p = 0.0322). In conclusion, a significant increase in MPOD was not fully confirmed with 6 months intake duration despite a significant increase in plasma lutein concentrations. Consumption of green vegetable was confirmed to be associated with plasma lutein concentration after adjusting for other potential factors including age.

P2‐594: ESTIMATE OF CASES ATTRIBUTABLE TO MODIFIABLE RISK FACTORS FOR DEMENTIA WITHIN A POPULATION‐BASED SAMPLE IN ITALY: THE INVECE.AB STUDY

Preventing dementia onset is one of the global public health priorities. Around 30-35% of dementia cases could be attributable to modifiable risk factors (i.e. low education, hypertension, obesity, smoking, depression, physical inactivity, diabetes, hearing loss, social isolation/loneliness), which may be the targets for large-scale primary prevention initiative (Norton et al., Lancet Neurol 2014; Livingston et al., Lancet 2017). However, these estimates relied on secondary data from review and meta-analysis and did not consider the concurrent effect of relevant non-modifiable factors, such as age and ApoE4. The present study aimed to estimate the portion of dementia incident cases potentially attributable to known modifiable risk factors within a population-based prospective cohort, controlling for age and ApoE4. Preliminary findings at 4-year follow-up are shown. The InveCe.Ab study (ClinicalTrials.gov, NCT01345110) enrolled people aged 70–74 years residing in Abbiategrasso (Milan). Participants underwent blood sampling, lifestyle interview, medical and neuropsychological assessment at baseline (Nov 2009-Jan 2011) and after 2 and 4 years. Cases with complete baseline neuropsychological and medical evaluation and without a dementia diagnosis (N=1267), attending at least one follow-up visit (N=1095) were included. Logistic regression models were performed on STATA14 to evaluate the association between each modifiable risk factors and cumulative incidence of dementia at 4-year, with age and ApoE4 as covariates. After model estimation, the population attributable fraction (PAF) for each modifiable risk factor was calculated. Panel 1 detailed the risk factors considered. During the follow-up period, 58 participants developed dementia (5.3%). Results are reported in Table 1. Briefly, older participants and e4 carriers showed a 2-fold increased risk of incident dementia. Among the modifiable risk factors, only physical inactivity significantly increased the risk of incident dementia (OR=2.22) controlling for age and ApoE4 status.

M33 - DEPRESSION PROBLEMS AMONG TURKISH TWINS

Background In this study, we investigate factors affecting depressive behavior among adult Turkish twins living in the Kirikkale and Ankara regions of Turkey. Twins administered a health and lifestyle interview which included questions about smoking, alcohol and drug use, depression, demographics and factors possibly affecting behavior problems. Main focus was on binary variable pointing to depressive problems. Methods We assessed 309 twin pairs (339 males and 279 females) aged between 15 and 45 years living in the Kirikkale and Ankara regions of Turkey. We analyzed the data using descriptive statistics, t-tests, chi-square tests, and bivariate and multivariate clustered logistic regression. In addition, we fit Structural Equation Models (SEM) to determine contributions of latent genetic and environmental factors to depression in this sample. Results 256 participants (43.9%) were identified as having depressive problems, of which 45.3% were males and 54.7% were females. Mean for depression was significantly higher in males than in females (p=0.0001). Our study showed that gender, presence of a twin with depression in the family, age, marital status, and daily sports activities all played a significant role in depressive behavior among twins. The twin analysis suggested that genetic factors play significant role on the liability to depressive problems. Discussion Significant differences in the presence of depression in women versus men are observed for the Turkish population. We find that having a twin with depression plays a significant role in depression problems among Turkish twins. This study will enable us to better understand genetic and environmental influences on behavioral outcomes across diverse cultures.

Smoking Habits are Strongly Associated With Colorectal Polyps in a Population-based Case-control Study.

The goal of this study is to test the association between lifetime smoking habits and colorectal polyps of different classifications. Smoking is an established risk factor for several cancers, including colorectal cancer. However, the association between lifetime smoking habits including intensity, duration, and cessation, and premalignant colorectal polyps is yet to be established. A case-control study among 828 consecutive subjects aged 40 to 70 years, undergoing screening or diagnostic colonoscopy. Exclusion criteria were: medically treated diabetes, colectomy, and belonging to colorectal cancer high risk group. Polyps were stratified according to histology (serrated or adenomatous polyp) and location. All participants underwent anthropometric measurements and a structured medical and lifestyle interview. Current-smoking was more strongly associated with increased odds for distal rather than proximal polyps [odds ratio (OR), 4.00; 95% confidence interval (CI), 2.40-6.68 and OR, 2.52; 95% CI, 1.46-4.36, respectively], with serrated-polyps rather than adenomas (OR, 6.36; 95% CI, 2.77-14.57 and OR, 3.01; 1.90-4.74, respectively). All levels of smoking intensity (daily cigarettes) were associated with colorectal polyps. A dose-response association was seen between smoking duration and colorectal polyps. Smoking duration of ≥20 years was strongly associated with distal polyps (OR, 4.01; 95% CI, 1.62-9.84), independently of potential confounders, smoking intensity and years since smoking cessation. All associations were stronger for distal serrated polyps. Smoking duration is associated with colorectal plyps, independently of other potential confounders, smoking intensity, and cessation. The association is stronger with distal rather than proximal polyps, and with serrated polyps rather than adenomas.

Cardiovascular prevention in 50-year-old adults: an Italian intervention study.

Cardio50 is a project of active risk identification and cardiovascular prevention implemented in an Italian cohort of healthy people aged 50. A total of 3127 individuals were invited for a screening visit with lifestyle interview and registration of BMI, blood pressure (BP), glucose, cholesterol and classified into groups: A (normal), B (abnormal lifestyle, normal parameters), C (at least one abnormal parameter). People in group C were offered a free blood test and a specialistic medical visit to investigate the suspect of hypertension, dyslipidemia or dysglycemia. Those in groups B and C were scheduled for a follow-up visit after 4-6 months and finally readdressed to the general practitioner. A total of 2325 invited individuals attended the screening visit: 18% were classified in group A, 32% in B, 42% in C, 8% met exclusion criteria and were not classifiable. In group C, 86% attended to the cardiologist visit, 76% had dyslipidemia, 35% hypertension, 1% diabetes, 14% impaired fasting glycemia, 19% obesity, 21% metabolic syndrome; 21% were smokers, 11% at risk of alcoholism. At follow-up, we appreciated a decrease in BP in group C individuals. After lifestyle intervention, physical activity increased, whereas metabolic syndrome, impaired fasting glucose and risky drinking decreased. The current project is coherent with modern strategies based on multifactorial actions. After the intervention, we observed an early reduction in BP and some improvements in lifestyle. This simple and low-technology program allowed us to detect and treat large numbers of individuals at high risk for cardiovascular events.

Distinct Metabolic Profiles are Associated with Colorectal Adenomas and Serrated Polyps.

Prevention of colorectal cancer (CRC) by colonoscopy is recommended according to age and personal/familial history. Metabolic alterations are associated with colorectal adenomas, but data are scarce regarding serrated polyps and advanced polyps. The aim of this study was to evaluate the association between metabolic alterations and colorectal polyp type and advanced polyps. A case-control study was conducted among consecutive subjects, 40 to 70 years old, who underwent screening/diagnostic colonoscopy from 2010 to 2015. Subjects who were treated for diabetes, who had a family/personal history of CRC, and who were at high risk for CRC were excluded. Participants underwent anthropometric, laboratory, and ultrasonographic evaluations and a medical and lifestyle interview. Polyps were histologically classified as adenomatous or serrated polyps and divided into advanced and non-advanced categories. The study included 828 participants (58.4 ± 6.6 years, 50.4% men). Abdominal obesity (odds ratio [OR] = 1.67, 95% CI: 1.20-2.30), hypertension (OR = 1.47, 95% CI: 1.03-2.09), and a high glycosylated hemoglobin percentage (HbA1c%) (OR = 1.57, 95% CI: 1.06-2.34) were independently associated with colorectal adenomas, whereas a high triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio was independently associated with serrated polyps (OR = 2.31, 95% CI: 1.32-4.03). A combination of three metabolic alterations was strongly associated with colorectal polyps. Abdominal obesity, hypertension, and a high HbA1c% are independently associated with adenomas, whereas a high TG/HDL ratio is associated with serrated polyps. These parameters are easily accessible in clinical practice and may help define high-risk groups for CRC.

Study of chronic pain and its associated risk factors among Japanese industry workers: the Quality of Working Life Influenced by Chronic pain (QWLIC) study.

This study was performed to identify the prevalence, influence, and risk factors associated with chronic pain among Japanese industry workers. We investigated 2,544 participants working at a manufacturing company A, a manufacturing company B, and 16 branch shops of a retail chain company C. The participants responded to self-administered questionnaires related to pain. Furthermore, data obtained from the lifestyle interview sheet of an annual health screening examination and those obtained from the questionnaires were merged. We analyzed the association between lifestyles, psychosocial factors, and chronic pain. Age- and sex-adjusted odds ratios were calculated with a 95% confidence interval using the logistic regression model. Of 2,544 participants, 1,914 (1,224 men and 690 women) completed the questionnaire, and the response rate was 75.2%. The prevalence of chronic pain over 3 months was 42.7% and that of chronic pain with work disability was 11.3%. A higher proportion of obesity, smoking habit, insomnia, psychological stress, depressive state, workaholic nature, low social support from supervisors and coworkers, high job demand, low job control, and job dissatisfaction was observed in workers with chronic pain than in workers without pain. Several risk factors of chronic pain in Japanese industry workers were found. Obesity, smoking habits, sleep disorders, workplace environment, and mental state should be taken into account as risk factors associated with chronic pain issues and general occupational health.

Risk factors influencing smoking behavior: a Turkish twin study.

In this study, we introduce the first twin study in Turkey, focusing on smoking behavior, and laying the foundation to register all twins born in Turkey for research purposes. Using Turkish twins will contribute to our understanding of health problems in the context of cultural differences. We assessed 309 twin pairs (339 males and 279 females) aged between 15 and 45 years living in the Kırıkkale and Ankara regions of Turkey, and administered a health and lifestyle interview that included questions about smoking status and smoking history. We analyzed the data using descriptive statistics, t-tests, chi-square tests, and bivariate and multivariate clustered logistic regression. In addition, we fit bivariate Structural Equation Models (SEM) to determine contributions of latent genetic and environmental factors to smoking outcomes in this sample. One hundred seventy-eight participants (28.8%) were identified as smokers, smoking every day for a month or longer, of whom 79.2% were males and 20.8% were females. Mean values for number of cigarettes per day and the Fagerstrom Test of Nicotine Dependence (FTND; Fagerstrom, 1978) score were higher in males than in females, and age of onset was earlier in males. There was a significant positive correlation between the FTND score and number of cigarettes smoked per day, and a significant negative correlation between both variables and age at onset of smoking. Our study showed that gender, presence of a smoking twin in the family, age, alcohol use, marital status, daily sports activities, and feeling moody all played a significant role in smoking behavior among twins. The twin analysis suggested that 79.5% of the liability to FTND was influenced by genetic factors and 20.5% by unique environment, while familial resemblance for smoking initiation was best explained by common environmental factors. Marked differences in the prevalence of smoking behavior in men versus women were observed for the Turkish population. Genetic analyses showed that common environmental factors primarily contributed to smoking initiation, while genetic factors explained a greater proportion of variance in liability to nicotine dependence. Our study shows higher heritability estimate of the FTND scores and higher shared environmental influence on smoking initiation for both males and females than reported in previous studies.

Obesity and diet awareness among Polish children and adolescents in small towns and villages.

In addition to genetic predispositions and environmental factors, healthy lifestyle education is very important for children and adolescents. The purpose of this research was to estimate the number of overweight and obese children and adolescents from small towns and villages and to find out an association between health awareness in children and the risk of becoming overweight or obese. The research was conducted in 1,515 healthy children aged 6-18 years from small towns and villages in Poland. Overweight was diagnosed when BMI for age and sex was over the 90th percentile; obesity--when it was over the 95th percentile. The study consisted of a lifestyle interview and anthropometrical measurements. The lifestyle interview was conducted with the use of an anonymous questionnaire form and included questions about food frequency, diet habits and physical activity. The research was analysed using the SAS System for Windows, release 8.02. Overweight status was diagnosed in 9.0% and obesity in 5.1% of respondents. Excess body mass was statistically more frequently diagnosed in girls than in boys aged 14-18 years. Girls of this age group significantly more frequently chose wholemeal bread, smoked sausages, meat and poultry as products that are believed to keep them fit. Older children substantially more often indicated that stress, smoking cigarettes, consuming fatty meat, sweets, being obese, and a lack of physical activity are factors that damage health. Boys spent more time in front of a computer or TV than girls; in the older group of children, the phenomenon even intensified. Awareness of healthy lifestyle behaviour is not sufficient to maintain optimal body mass. Knowledge about proper eating habits is better among girls than among boys, especially in the older age groups. However, in older groups, there was less physical activity due to spending more time in front of TV or the computer. High percentage of obese/overweight children and insufficient knowledge of nutrition may consequently result in increased risk of cardio-vascular diseases in adult population.

Prenatal methamphetamine exposure and neurodevelopmental outcomes in children from 1 to 3 years

BackgroundDespite the evidence that women world-wide are using methamphetamine (MA) during pregnancy little is known about the neurodevelopment of their children. DesignThe controlled, prospective longitudinal New Zealand (NZ) Infant Development, Environment and Lifestyle (IDEAL) study was carried out in Auckland, NZ. Participants were 103 children exposed to MA prenatally and 107 who were not exposed. The Mental Developmental Index (MDI) and the Psychomotor Developmental Index (PDI) of the Bayley Scales of Infant Development, Second Edition (BSID-II) measured cognitive and motor performances at ages 1, 2 and 3, and the Peabody Developmental Motor Scale, Second Edition (PDMS-II) measured gross and fine motor performances at 1 and 3. Measures of the child's environment included the Home Observation of Measurement of the Environment and the Maternal Lifestyle Interview. The Substance Use Inventory measured maternal drug use. ResultsAfter controlling for other drug use and contextual factors, prenatal MA exposure was associated with poorer motor performance at 1 and 2years on the BSID-II. No differences were observed for cognitive development (MDI). Relative to non-MA exposed children, longitudinal scores on the PDI and the gross motor scale of the PDMS-2 were 4.3 and 3.2 points lower, respectively. Being male and of Maori descent predicted lower cognitive scores (MDI) and being male predicted lower fine motor scores (PDMS-2). ConclusionsPrenatal exposure to MA was associated with delayed gross motor development over the first 3years, but not with cognitive development. However, being male and of Maori descent were both associated with poorer cognitive outcomes. Males in general did more poorly on tasks related to fine motor development.

Golestan cohort study of oesophageal cancer: feasibility and first results

To investigate the incidence of oesophageal cancer (EC) in the Golestan province of North-East Iran, we invited 1349 rural and urban inhabitants of Golestan province aged 35–80 to undergo extensive lifestyle interviews and to provide biological samples. The interview was repeated on a subset of 130 participants to assess reliability of questionnaire and medical information. Temperature at which tea was consumed was measured on two occasions by 110 subjects. Samples of rice, wheat and sorghum were tested for fumonisin contamination. An active follow-up was carried out after 6 and 12 months. A total of 1057 subjects (610 women and 447 men) participated in this feasibility study (78.4% participation rate). Cigarette smoking, opium and alcohol use were reported by 163 (13.8%), 93 (8.8%) and 39 (3.7%) subjects, respectively. Tobacco smoking was correlated with urinary cotinine (κ=0.74). Most questionnaire data had κ >0.7 in repeat measurements; tea temperature measurement was reliable (κ=0.71). No fumonisins were detected in the samples analysed. During the follow-up six subjects were lost (0.6%), two subjects developed EC (one dead, one alive); in all, 13 subjects died (with cause of death known for 11, 84.6%). Conducting a cohort study in Golestan is feasible with reliable information obtained for suspected risk factors; participants can be followed up for EC incidence and mortality.

Are MRI White Matter Lesions Clinically Significant in the ‘Old-Old’? Evidence from the Sydney Older Persons Study

Background: The number of individuals aged over 80 years is the fastest increasing group in developed countries. White matter lesions (WML) observed on magnetic resonance imaging (MRI) have uncertain clinical significance, particularly in the old. Objectives: To determine the prevalence of periventricular and deep WML in survivors of an original cohort of randomly selected elderly community dwellers, and to examine their associations with clinical markers of vascular and extrapyramidal disorders of ageing, as well as quantitative cognitive measures. Methods: Brain MRI, lifestyle interview, cognitive testing and medical examination were administered to 122 participants from the Sydney Older Persons Study 6-year review (mean age: 85.5 years). Apolipoprotein E (ApoE) genotype was also established. Presence and severity of periventricular and deep WML were ascertained using semi-quantitative rating methods and their relations to the cognitive and clinical variables investigated. Results: Periventricular WML were present in all participants in similar severity for all three regions sampled. In contrast, a gradient of severity was observed for the deep WML: most severe in the parietal region, followed by the frontal and occipital regions, and least severe in the temporal region. Associations with gender or with the ApoE Ε4 allele were non-significant. WML were inconsistently associated with age and cognitive functioning or with the clinical markers of dementia. No frontal specificity emerged. Examination of individual lesion types did not change the general pattern of associations. Supporting evidence for a threshold effect was observed on some measures. Conclusions: WML are extremely common in elderly, non-demented individuals. Unlike in younger individuals, MRI abnormalities may not be evidence of a current pathological process and their importance may change with advancing age.

Helminthiasis and culture change among the Cofán of Ecuador

Blood and fecal samples and lifestyle interviews were obtained in August 1996 from two Cofán villages in Ecuador, Dureno and Zabalo, that are experiencing different degrees of acculturation. Dureno's territory has been divided by roads and encroached upon by oil companies and colonists, whereas Zabalo, 95 km downriver from Dureno, is located in the Cuyabeno Fauna Reserve, a protected area. This study examines how culture change affects the prevalence of parasitic infections. Fecal samples were examined for helminth eggs to determine helminthiasis in each village sample. Seventy-four samples were collected (Dureno n = 50; Zabalo n = 24), representing 20% of the population in each village. Hemoglobin (Hb) levels and eosinophil counts were determined for all adult participants (Dureno n = 39; Zabalo n = 13). Microscopic examination of prepared samples revealed ova from two parasitic nematodes: roundworm (Ascaris lumbercoides) and hookworm (Ancylostoma duodenale or Necator americanus). Roundworm and hookworm infections were higher in Dureno (44% positive) compared to Zabalo (17% positive), with infected adults from both villages showing eosinophilia. Hb levels were not significantly correlated with the prevalence of helminth infections. It appears that the transmission and prevalence of parasitic infections within each community is associated with the interaction of biological, cultural, and environmental factors. Am. J. Hum. Biol. 12:465–477, 2000. © 2000 Wiley-Liss, Inc.

Helminthiasis and culture change among the Cofán of Ecuador.

Blood and fecal samples and lifestyle interviews were obtained in August 1996 from two Cofán villages in Ecuador, Dureno and Zabalo, that are experiencing different degrees of acculturation. Dureno's territory has been divided by roads and encroached upon by oil companies and colonists, whereas Zabalo, 95 km downriver from Dureno, is located in the Cuyabeno Fauna Reserve, a protected area. This study examines how culture change affects the prevalence of parasitic infections. Fecal samples were examined for helminth eggs to determine helminthiasis in each village sample. Seventy-four samples were collected (Dureno n = 50; Zabalo n = 24), representing 20% of the population in each village. Hemoglobin (Hb) levels and eosinophil counts were determined for all adult participants (Dureno n = 39; Zabalo n = 13). Microscopic examination of prepared samples revealed ova from two parasitic nematodes: roundworm (Ascaris lumbercoides) and hookworm (Ancylostoma duodenale or Necator americanus). Roundworm and hookworm infections were higher in Dureno (44% positive) compared to Zabalo (17% positive), with infected adults from both villages showing eosinophilia. Hb levels were not significantly correlated with the prevalence of helminth infections. It appears that the transmission and prevalence of parasitic infections within each community is associated with the interaction of biological, cultural, and environmental factors. Am. J. Hum. Biol. 12:465-477, 2000. Copyright 2000 Wiley-Liss, Inc.

Risk profile of homeless pregnant adolescents and youth

Pregnant homeless young women have special service needs. This article examines those needs by comparing the risk profiles of 55 pregnant homeless youths and 85 pregnant youths who live with their families. These young women were seen in a primary health care clinic and underwent extensive lifestyle interviews during their physical examinations. Clinical social workers provided social services and follow-up. The homeless pregnant youths were younger, primarily white, and from outside Los Angeles County. They were more likely to be diagnosed as depressed, to have previously attempted suicide, to have histories of sexual and physical abuse, and to be diagnosed as drug abusing. Review of pregnancy outcomes showed the difficulty of serving homeless pregnant youth and the lack of services for them. Following this study, the clinic instituted new monitoring procedures and established a team case management approach to serving homeless pregnant teens and youths.

Minimal Risk of Transmission of AIDS-Associated Retrovirus Infection by Oral-Genital Contact

To the Editor.— The San Francisco Men's Health Study is a prospective study of a population-based random sample of single men 25 to 54 years of age residing in the 19 census tracts of San Francisco with the highest incidence of acquired immunodeficiency syndrome (AIDS). One thousand thirty-five eligible men were recruited. Participants visit the study clinic at six-month intervals, where they undergo a detailed medical and life-style interview and physical examination and provide specimens for laboratorystudy. Serological testing for AIDS-associated retrovirus (ARV) is performed on the cohort using the indirect fluorescent antibody technique. 1,2 Between June 1984 and January 1985 at the time of the first clinic visit, 214 exclusively heterosexual men were found to be uniformly seronegative for antibodies to ARV and will not be considered further in this communication. At that time, the overall seropositivity rate for the remaining 821 homosexual and/or bisexual men was 48.4%.