Objectives:To determine whether infants of parents whose primary language is not English are less likely to receive recommended preventive care than infants of parents whose primary language is English.Study design:We...Objectives:To determine whether infants of parents whose primary language is not English are less likely to receive recommended preventive care than infants of parents whose primary language is English.Study design:We conducted a retro spective cohort study of all 38,793 1-year-old Medicaid-enrolled infants born in Washington state between January 1,1999 and September 30,2000.The main ex posure was self-reported primary language of parents.Using multivariate regres sion,we estimated the relative risk of receiving appropriate and timely receipt of preventive care visits in the first year as recommended by the American Acad emy of Pediatrics and Washington state Medicaid.Results:Fewer than 1 in 6(15.4%)infants received all 6 recommended preventive care visits in their first ye ar of life.Infants of parents whose primary language was not English were half as likely to receive all recommended preventive care visits compared with infant s of parents whose primary language was English(adjusted relative risk = 0.53;95%confidence interval = 0.49 to 0.58).This disparity was seen in white,Hispa nic,and African-American infants,but not in Asian-American infants.Conclusions:Disparities based on primary language exist in receipt of recommended pediatric preventive care in white,Hispanic,and African-American infants enrolled in Medicaid.展开更多
The objective of this study was to determine the effect of environmental stresses on the cytotoxicity of Shiga toxin-producing Escherichia coli (STEC). STEC O157:H7 and six non-O157 STEC strains (O26:H11, O103:H1, O10...The objective of this study was to determine the effect of environmental stresses on the cytotoxicity of Shiga toxin-producing Escherichia coli (STEC). STEC O157:H7 and six non-O157 STEC strains (O26:H11, O103:H1, O104:H4, O111:NM, O121:NM, and O145:NM) were subjected to osmotic (aw 0.95-0.98), acid (pH 4-7), and chlorine (1-5 ppm) stresses. After stress treatments, bacterial populations, expression of virulence-associated genes, and Vero-cytotoxicity were determined. Among the strains, O145:NM survived at aw 0.97 longer than other serotypes, while O111:NM was significantly more sensitive to osmotic stress. At pH 4, O103:H1 was more resistant to the stress, while O26:H11 and O111:NM had significantly less growth. For 2 ppm chlorine stress, O26:H11, O103:H1, and O145:NM had higher populations (>3 log) than other strains. Stressed strains showed a significant increase in relative gene expression levels of stx1, stx2, and eae in O103:H1, O104:H4, and O145:NM than non-stressed control. Additionally, significantly higher Vero-cytotoxicity, as indicated by lactate dehydrogenase assay, of stressed O26:H11, O103:H1, O104:H4, and O145:NM was observed. The results suggest that the growth and cytotoxicity of selected pathogenic E. coli may be enhanced after being exposed to environmental stresses.展开更多
文摘Objectives:To determine whether infants of parents whose primary language is not English are less likely to receive recommended preventive care than infants of parents whose primary language is English.Study design:We conducted a retro spective cohort study of all 38,793 1-year-old Medicaid-enrolled infants born in Washington state between January 1,1999 and September 30,2000.The main ex posure was self-reported primary language of parents.Using multivariate regres sion,we estimated the relative risk of receiving appropriate and timely receipt of preventive care visits in the first year as recommended by the American Acad emy of Pediatrics and Washington state Medicaid.Results:Fewer than 1 in 6(15.4%)infants received all 6 recommended preventive care visits in their first ye ar of life.Infants of parents whose primary language was not English were half as likely to receive all recommended preventive care visits compared with infant s of parents whose primary language was English(adjusted relative risk = 0.53;95%confidence interval = 0.49 to 0.58).This disparity was seen in white,Hispa nic,and African-American infants,but not in Asian-American infants.Conclusions:Disparities based on primary language exist in receipt of recommended pediatric preventive care in white,Hispanic,and African-American infants enrolled in Medicaid.
文摘The objective of this study was to determine the effect of environmental stresses on the cytotoxicity of Shiga toxin-producing Escherichia coli (STEC). STEC O157:H7 and six non-O157 STEC strains (O26:H11, O103:H1, O104:H4, O111:NM, O121:NM, and O145:NM) were subjected to osmotic (aw 0.95-0.98), acid (pH 4-7), and chlorine (1-5 ppm) stresses. After stress treatments, bacterial populations, expression of virulence-associated genes, and Vero-cytotoxicity were determined. Among the strains, O145:NM survived at aw 0.97 longer than other serotypes, while O111:NM was significantly more sensitive to osmotic stress. At pH 4, O103:H1 was more resistant to the stress, while O26:H11 and O111:NM had significantly less growth. For 2 ppm chlorine stress, O26:H11, O103:H1, and O145:NM had higher populations (>3 log) than other strains. Stressed strains showed a significant increase in relative gene expression levels of stx1, stx2, and eae in O103:H1, O104:H4, and O145:NM than non-stressed control. Additionally, significantly higher Vero-cytotoxicity, as indicated by lactate dehydrogenase assay, of stressed O26:H11, O103:H1, O104:H4, and O145:NM was observed. The results suggest that the growth and cytotoxicity of selected pathogenic E. coli may be enhanced after being exposed to environmental stresses.
