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Geospatial analysis of Mediterranean diet adherence in the United States
- Meifang Chen, Thomas Creger, Virginia Howard, Suzanne E Judd, Kathy F Harrington, Kevin R Fontaine
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- Journal:
- Public Health Nutrition / Volume 24 / Issue 10 / July 2021
- Published online by Cambridge University Press:
- 03 August 2020, pp. 2920-2928
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Objective:
The current study aims to describe the Mediterranean diet (MD) adherence across the US regions, and explore the predictive factors of MD adherence among US adults.
Design:Cross-sectional secondary data analysis. MD adherence score (0–9) was calculated using the Block 98 FFQ. Hot spot analysis was conducted to describe the geospatial distribution of MD adherence across the US regions. Logistic regression explored predictors of MD adherence.
Setting:Nationwide community-dwelling residency in the USA.
Participants:Adults aged ≥45 years (n 20 897) who participated in the REasons for Geographic and Racial Differences in Stroke study and completed baseline assessment during January 2003 and October 2007.
Results:The mean of MD adherence score was 4·36 (sd 1·70), and 46·5 % of the sample had high MD adherence (score 5–9). Higher MD adherence clusters were primarily located in the western and northeastern coastal areas of the USA, whereas lower MD adherence clusters were majorly observed in south and east-north-central regions. Being older, black, not a current smoker, having a college degree or above, an annual household income ≥ $US 75K, exercising ≥4 times/week and watching TV/video <4 h/d were each associated with higher odds of high MD adherence.
Conclusions:There were significant geospatial and population disparities in MD adherence across the US regions. Future studies are needed to explore the causes of MD adherence disparities and develop effective interventions for MD promotion in the USA.
Contributors
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- By Rose Teteki Abbey, K. C. Abraham, David Tuesday Adamo, LeRoy H. Aden, Efrain Agosto, Victor Aguilan, Gillian T. W. Ahlgren, Charanjit Kaur AjitSingh, Dorothy B E A Akoto, Giuseppe Alberigo, Daniel E. Albrecht, Ruth Albrecht, Daniel O. Aleshire, Urs Altermatt, Anand Amaladass, Michael Amaladoss, James N. Amanze, Lesley G. Anderson, Thomas C. Anderson, Victor Anderson, Hope S. Antone, María Pilar Aquino, Paula Arai, Victorio Araya Guillén, S. Wesley Ariarajah, Ellen T. Armour, Brett Gregory Armstrong, Atsuhiro Asano, Naim Stifan Ateek, Mahmoud Ayoub, John Alembillah Azumah, Mercedes L. García Bachmann, Irena Backus, J. Wayne Baker, Mieke Bal, Lewis V. Baldwin, William Barbieri, António Barbosa da Silva, David Basinger, Bolaji Olukemi Bateye, Oswald Bayer, Daniel H. Bays, Rosalie Beck, Nancy Elizabeth Bedford, Guy-Thomas Bedouelle, Chorbishop Seely Beggiani, Wolfgang Behringer, Christopher M. Bellitto, Byard Bennett, Harold V. Bennett, Teresa Berger, Miguel A. Bernad, Henley Bernard, Alan E. Bernstein, Jon L. Berquist, Johannes Beutler, Ana María Bidegain, Matthew P. Binkewicz, Jennifer Bird, Joseph Blenkinsopp, Dmytro Bondarenko, Paulo Bonfatti, Riet en Pim Bons-Storm, Jessica A. Boon, Marcus J. Borg, Mark Bosco, Peter C. Bouteneff, François Bovon, William D. Bowman, Paul S. Boyer, David Brakke, Richard E. Brantley, Marcus Braybrooke, Ian Breward, Ênio José da Costa Brito, Jewel Spears Brooker, Johannes Brosseder, Nicholas Canfield Read Brown, Robert F. Brown, Pamela K. Brubaker, Walter Brueggemann, Bishop Colin O. Buchanan, Stanley M. Burgess, Amy Nelson Burnett, J. Patout Burns, David B. Burrell, David Buttrick, James P. Byrd, Lavinia Byrne, Gerado Caetano, Marcos Caldas, Alkiviadis Calivas, William J. Callahan, Salvatore Calomino, Euan K. Cameron, William S. Campbell, Marcelo Ayres Camurça, Daniel F. Caner, Paul E. Capetz, Carlos F. Cardoza-Orlandi, Patrick W. Carey, Barbara Carvill, Hal Cauthron, Subhadra Mitra Channa, Mark D. Chapman, James H. Charlesworth, Kenneth R. Chase, Chen Zemin, Luciano Chianeque, Philip Chia Phin Yin, Francisca H. Chimhanda, Daniel Chiquete, John T. Chirban, Soobin Choi, Robert Choquette, Mita Choudhury, Gerald Christianson, John Chryssavgis, Sejong Chun, Esther Chung-Kim, Charles M. A. Clark, Elizabeth A. Clark, Sathianathan Clarke, Fred Cloud, John B. Cobb, W. Owen Cole, John A Coleman, John J. Collins, Sylvia Collins-Mayo, Paul K. Conkin, Beth A. Conklin, Sean Connolly, Demetrios J. Constantelos, Michael A. Conway, Paula M. Cooey, Austin Cooper, Michael L. Cooper-White, Pamela Cooper-White, L. William Countryman, Sérgio Coutinho, Pamela Couture, Shannon Craigo-Snell, James L. Crenshaw, David Crowner, Humberto Horacio Cucchetti, Lawrence S. Cunningham, Elizabeth Mason Currier, Emmanuel Cutrone, Mary L. Daniel, David D. Daniels, Robert Darden, Rolf Darge, Isaiah Dau, Jeffry C. Davis, Jane Dawson, Valentin Dedji, John W. de Gruchy, Paul DeHart, Wendy J. Deichmann Edwards, Miguel A. De La Torre, George E. Demacopoulos, Thomas de Mayo, Leah DeVun, Beatriz de Vasconcellos Dias, Dennis C. Dickerson, John M. Dillon, Luis Miguel Donatello, Igor Dorfmann-Lazarev, Susanna Drake, Jonathan A. Draper, N. Dreher Martin, Otto Dreydoppel, Angelyn Dries, A. J. Droge, Francis X. D'Sa, Marilyn Dunn, Nicole Wilkinson Duran, Rifaat Ebied, Mark J. Edwards, William H. Edwards, Leonard H. Ehrlich, Nancy L. Eiesland, Martin Elbel, J. Harold Ellens, Stephen Ellingson, Marvin M. Ellison, Robert Ellsberg, Jean Bethke Elshtain, Eldon Jay Epp, Peter C. Erb, Tassilo Erhardt, Maria Erling, Noel Leo Erskine, Gillian R. Evans, Virginia Fabella, Michael A. Fahey, Edward Farley, Margaret A. Farley, Wendy Farley, Robert Fastiggi, Seena Fazel, Duncan S. Ferguson, Helwar Figueroa, Paul Corby Finney, Kyriaki Karidoyanes FitzGerald, Thomas E. FitzGerald, John R. Fitzmier, Marie Therese Flanagan, Sabina Flanagan, Claude Flipo, Ronald B. Flowers, Carole Fontaine, David Ford, Mary Ford, Stephanie A. Ford, Jim Forest, William Franke, Robert M. Franklin, Ruth Franzén, Edward H. Friedman, Samuel Frouisou, Lorelei F. Fuchs, Jojo M. Fung, Inger Furseth, Richard R. Gaillardetz, Brandon Gallaher, China Galland, Mark Galli, Ismael García, Tharscisse Gatwa, Jean-Marie Gaudeul, Luis María Gavilanes del Castillo, Pavel L. Gavrilyuk, Volney P. Gay, Metropolitan Athanasios Geevargis, Kondothra M. George, Mary Gerhart, Simon Gikandi, Maurice Gilbert, Michael J. Gillgannon, Verónica Giménez Beliveau, Terryl Givens, Beth Glazier-McDonald, Philip Gleason, Menghun Goh, Brian Golding, Bishop Hilario M. Gomez, Michelle A. Gonzalez, Donald K. Gorrell, Roy Gottfried, Tamara Grdzelidze, Joel B. Green, Niels Henrik Gregersen, Cristina Grenholm, Herbert Griffiths, Eric W. Gritsch, Erich S. Gruen, Christoffer H. Grundmann, Paul H. Gundani, Jon P. Gunnemann, Petre Guran, Vidar L. Haanes, Jeremiah M. Hackett, Getatchew Haile, Douglas John Hall, Nicholas Hammond, Daphne Hampson, Jehu J. Hanciles, Barry Hankins, Jennifer Haraguchi, Stanley S. Harakas, Anthony John Harding, Conrad L. Harkins, J. William Harmless, Marjory Harper, Amir Harrak, Joel F. Harrington, Mark W. Harris, Susan Ashbrook Harvey, Van A. Harvey, R. Chris Hassel, Jione Havea, Daniel Hawk, Diana L. Hayes, Leslie Hayes, Priscilla Hayner, S. Mark Heim, Simo Heininen, Richard P. Heitzenrater, Eila Helander, David Hempton, Scott H. Hendrix, Jan-Olav Henriksen, Gina Hens-Piazza, Carter Heyward, Nicholas J. Higham, David Hilliard, Norman A. Hjelm, Peter C. Hodgson, Arthur Holder, M. Jan Holton, Dwight N. Hopkins, Ronnie Po-chia Hsia, Po-Ho Huang, James Hudnut-Beumler, Jennifer S. Hughes, Leonard M. Hummel, Mary E. Hunt, Laennec Hurbon, Mark Hutchinson, Susan E. Hylen, Mary Beth Ingham, H. Larry Ingle, Dale T. Irvin, Jon Isaak, Paul John Isaak, Ada María Isasi-Díaz, Hans Raun Iversen, Margaret C. Jacob, Arthur James, Maria Jansdotter-Samuelsson, David Jasper, Werner G. Jeanrond, Renée Jeffery, David Lyle Jeffrey, Theodore W. Jennings, David H. Jensen, Robin Margaret Jensen, David Jobling, Dale A. Johnson, Elizabeth A. Johnson, Maxwell E. Johnson, Sarah Johnson, Mark D. Johnston, F. Stanley Jones, James William Jones, John R. Jones, Alissa Jones Nelson, Inge Jonsson, Jan Joosten, Elizabeth Judd, Mulambya Peggy Kabonde, Robert Kaggwa, Sylvester Kahakwa, Isaac Kalimi, Ogbu U. Kalu, Eunice Kamaara, Wayne C. Kannaday, Musimbi Kanyoro, Veli-Matti Kärkkäinen, Frank Kaufmann, Léon Nguapitshi Kayongo, Richard Kearney, Alice A. Keefe, Ralph Keen, Catherine Keller, Anthony J. Kelly, Karen Kennelly, Kathi Lynn Kern, Fergus Kerr, Edward Kessler, George Kilcourse, Heup Young Kim, Kim Sung-Hae, Kim Yong-Bock, Kim Yung Suk, Richard King, Thomas M. King, Robert M. Kingdon, Ross Kinsler, Hans G. Kippenberg, Cheryl A. Kirk-Duggan, Clifton Kirkpatrick, Leonid Kishkovsky, Nadieszda Kizenko, Jeffrey Klaiber, Hans-Josef Klauck, Sidney Knight, Samuel Kobia, Robert Kolb, Karla Ann Koll, Heikki Kotila, Donald Kraybill, Philip D. W. Krey, Yves Krumenacker, Jeffrey Kah-Jin Kuan, Simanga R. Kumalo, Peter Kuzmic, Simon Shui-Man Kwan, Kwok Pui-lan, André LaCocque, Stephen E. Lahey, John Tsz Pang Lai, Emiel Lamberts, Armando Lampe, Craig Lampe, Beverly J. Lanzetta, Eve LaPlante, Lizette Larson-Miller, Ariel Bybee Laughton, Leonard Lawlor, Bentley Layton, Robin A. Leaver, Karen Lebacqz, Archie Chi Chung Lee, Marilyn J. Legge, Hervé LeGrand, D. L. LeMahieu, Raymond Lemieux, Bill J. Leonard, Ellen M. Leonard, Outi Leppä, Jean Lesaulnier, Nantawan Boonprasat Lewis, Henrietta Leyser, Alexei Lidov, Bernard Lightman, Paul Chang-Ha Lim, Carter Lindberg, Mark R. Lindsay, James R. Linville, James C. Livingston, Ann Loades, David Loades, Jean-Claude Loba-Mkole, Lo Lung Kwong, Wati Longchar, Eleazar López, David W. Lotz, Andrew Louth, Robin W. Lovin, William Luis, Frank D. Macchia, Diarmaid N. J. MacCulloch, Kirk R. MacGregor, Marjory A. MacLean, Donald MacLeod, Tomas S. Maddela, Inge Mager, Laurenti Magesa, David G. Maillu, Fortunato Mallimaci, Philip Mamalakis, Kä Mana, Ukachukwu Chris Manus, Herbert Robinson Marbury, Reuel Norman Marigza, Jacqueline Mariña, Antti Marjanen, Luiz C. L. Marques, Madipoane Masenya (ngwan'a Mphahlele), Caleb J. D. Maskell, Steve Mason, Thomas Massaro, Fernando Matamoros Ponce, András Máté-Tóth, Odair Pedroso Mateus, Dinis Matsolo, Fumitaka Matsuoka, John D'Arcy May, Yelena Mazour-Matusevich, Theodore Mbazumutima, John S. McClure, Christian McConnell, Lee Martin McDonald, Gary B. McGee, Thomas McGowan, Alister E. McGrath, Richard J. McGregor, John A. McGuckin, Maud Burnett McInerney, Elsie Anne McKee, Mary B. McKinley, James F. McMillan, Ernan McMullin, Kathleen E. McVey, M. Douglas Meeks, Monica Jyotsna Melanchthon, Ilie Melniciuc-Puica, Everett Mendoza, Raymond A. Mentzer, William W. Menzies, Ina Merdjanova, Franziska Metzger, Constant J. Mews, Marvin Meyer, Carol Meyers, Vasile Mihoc, Gunner Bjerg Mikkelsen, Maria Inêz de Castro Millen, Clyde Lee Miller, Bonnie J. Miller-McLemore, Alexander Mirkovic, Paul Misner, Nozomu Miyahira, R. W. L. Moberly, Gerald Moede, Aloo Osotsi Mojola, Sunanda Mongia, Rebeca Montemayor, James Moore, Roger E. Moore, Craig E. Morrison O.Carm, Jeffry H. Morrison, Keith Morrison, Wilson J. Moses, Tefetso Henry Mothibe, Mokgethi Motlhabi, Fulata Moyo, Henry Mugabe, Jesse Ndwiga Kanyua Mugambi, Peggy Mulambya-Kabonde, Robert Bruce Mullin, Pamela Mullins Reaves, Saskia Murk Jansen, Heleen L. Murre-Van den Berg, Augustine Musopole, Isaac M. T. Mwase, Philomena Mwaura, Cecilia Nahnfeldt, Anne Nasimiyu Wasike, Carmiña Navia Velasco, Thulani Ndlazi, Alexander Negrov, James B. Nelson, David G. Newcombe, Carol Newsom, Helen J. Nicholson, George W. E. Nickelsburg, Tatyana Nikolskaya, Damayanthi M. A. Niles, Bertil Nilsson, Nyambura Njoroge, Fidelis Nkomazana, Mary Beth Norton, Christian Nottmeier, Sonene Nyawo, Anthère Nzabatsinda, Edward T. Oakes, Gerald O'Collins, Daniel O'Connell, David W. Odell-Scott, Mercy Amba Oduyoye, Kathleen O'Grady, Oyeronke Olajubu, Thomas O'Loughlin, Dennis T. Olson, J. Steven O'Malley, Cephas N. Omenyo, Muriel Orevillo-Montenegro, César Augusto Ornellas Ramos, Agbonkhianmeghe E. Orobator, Kenan B. Osborne, Carolyn Osiek, Javier Otaola Montagne, Douglas F. Ottati, Anna May Say Pa, Irina Paert, Jerry G. Pankhurst, Aristotle Papanikolaou, Samuele F. Pardini, Stefano Parenti, Peter Paris, Sung Bae Park, Cristián G. Parker, Raquel Pastor, Joseph Pathrapankal, Daniel Patte, W. Brown Patterson, Clive Pearson, Keith F. Pecklers, Nancy Cardoso Pereira, David Horace Perkins, Pheme Perkins, Edward N. Peters, Rebecca Todd Peters, Bishop Yeznik Petrossian, Raymond Pfister, Peter C. Phan, Isabel Apawo Phiri, William S. F. Pickering, Derrick G. Pitard, William Elvis Plata, Zlatko Plese, John Plummer, James Newton Poling, Ronald Popivchak, Andrew Porter, Ute Possekel, James M. Powell, Enos Das Pradhan, Devadasan Premnath, Jaime Adrían Prieto Valladares, Anne Primavesi, Randall Prior, María Alicia Puente Lutteroth, Eduardo Guzmão Quadros, Albert Rabil, Laurent William Ramambason, Apolonio M. Ranche, Vololona Randriamanantena Andriamitandrina, Lawrence R. Rast, Paul L. Redditt, Adele Reinhartz, Rolf Rendtorff, Pål Repstad, James N. Rhodes, John K. Riches, Joerg Rieger, Sharon H. Ringe, Sandra Rios, Tyler Roberts, David M. Robinson, James M. Robinson, Joanne Maguire Robinson, Richard A. H. Robinson, Roy R. Robson, Jack B. Rogers, Maria Roginska, Sidney Rooy, Rev. Garnett Roper, Maria José Fontelas Rosado-Nunes, Andrew C. Ross, Stefan Rossbach, François Rossier, John D. Roth, John K. Roth, Phillip Rothwell, Richard E. Rubenstein, Rosemary Radford Ruether, Markku Ruotsila, John E. Rybolt, Risto Saarinen, John Saillant, Juan Sanchez, Wagner Lopes Sanchez, Hugo N. Santos, Gerhard Sauter, Gloria L. Schaab, Sandra M. Schneiders, Quentin J. Schultze, Fernando F. Segovia, Turid Karlsen Seim, Carsten Selch Jensen, Alan P. F. Sell, Frank C. Senn, Kent Davis Sensenig, Damían Setton, Bal Krishna Sharma, Carolyn J. Sharp, Thomas Sheehan, N. Gerald Shenk, Christian Sheppard, Charles Sherlock, Tabona Shoko, Walter B. Shurden, Marguerite Shuster, B. Mark Sietsema, Batara Sihombing, Neil Silberman, Clodomiro Siller, Samuel Silva-Gotay, Heikki Silvet, John K. Simmons, Hagith Sivan, James C. Skedros, Abraham Smith, Ashley A. Smith, Ted A. Smith, Daud Soesilo, Pia Søltoft, Choan-Seng (C. S.) Song, Kathryn Spink, Bryan Spinks, Eric O. Springsted, Nicolas Standaert, Brian Stanley, Glen H. Stassen, Karel Steenbrink, Stephen J. Stein, Andrea Sterk, Gregory E. Sterling, Columba Stewart, Jacques Stewart, Robert B. Stewart, Cynthia Stokes Brown, Ken Stone, Anne Stott, Elizabeth Stuart, Monya Stubbs, Marjorie Hewitt Suchocki, David Kwang-sun Suh, Scott W. Sunquist, Keith Suter, Douglas Sweeney, Charles H. Talbert, Shawqi N. Talia, Elsa Tamez, Joseph B. Tamney, Jonathan Y. Tan, Yak-Hwee Tan, Kathryn Tanner, Feiya Tao, Elizabeth S. Tapia, Aquiline Tarimo, Claire Taylor, Mark Lewis Taylor, Bishop Abba Samuel Wolde Tekestebirhan, Eugene TeSelle, M. Thomas Thangaraj, David R. Thomas, Andrew Thornley, Scott Thumma, Marcelo Timotheo da Costa, George E. “Tink” Tinker, Ola Tjørhom, Karen Jo Torjesen, Iain R. Torrance, Fernando Torres-Londoño, Archbishop Demetrios [Trakatellis], Marit Trelstad, Christine Trevett, Phyllis Trible, Johannes Tromp, Paul Turner, Robert G. Tuttle, Archbishop Desmond Tutu, Peter Tyler, Anders Tyrberg, Justin Ukpong, Javier Ulloa, Camillus Umoh, Kristi Upson-Saia, Martina Urban, Monica Uribe, Elochukwu Eugene Uzukwu, Richard Vaggione, Gabriel Vahanian, Paul Valliere, T. J. Van Bavel, Steven Vanderputten, Peter Van der Veer, Huub Van de Sandt, Louis Van Tongeren, Luke A. Veronis, Noel Villalba, Ramón Vinke, Tim Vivian, David Voas, Elena Volkova, Katharina von Kellenbach, Elina Vuola, Timothy Wadkins, Elaine M. Wainwright, Randi Jones Walker, Dewey D. Wallace, Jerry Walls, Michael J. Walsh, Philip Walters, Janet Walton, Jonathan L. Walton, Wang Xiaochao, Patricia A. Ward, David Harrington Watt, Herold D. Weiss, Laurence L. Welborn, Sharon D. Welch, Timothy Wengert, Traci C. West, Merold Westphal, David Wetherell, Barbara Wheeler, Carolinne White, Jean-Paul Wiest, Frans Wijsen, Terry L. Wilder, Felix Wilfred, Rebecca Wilkin, Daniel H. Williams, D. Newell Williams, Michael A. Williams, Vincent L. Wimbush, Gabriele Winkler, Anders Winroth, Lauri Emílio Wirth, James A. Wiseman, Ebba Witt-Brattström, Teofil Wojciechowski, John Wolffe, Kenman L. Wong, Wong Wai Ching, Linda Woodhead, Wendy M. Wright, Rose Wu, Keith E. Yandell, Gale A. Yee, Viktor Yelensky, Yeo Khiok-Khng, Gustav K. K. Yeung, Angela Yiu, Amos Yong, Yong Ting Jin, You Bin, Youhanna Nessim Youssef, Eliana Yunes, Robert Michael Zaller, Valarie H. Ziegler, Barbara Brown Zikmund, Joyce Ann Zimmerman, Aurora Zlotnik, Zhuo Xinping
- Edited by Daniel Patte, Vanderbilt University, Tennessee
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- The Cambridge Dictionary of Christianity
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- 05 August 2012
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- 20 September 2010, pp xi-xliv
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Contributors
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- By Amelia Evoli, Ami K. Mankodi, Ana Ferreiro, Anders Oldfors, Anne K. Lampe, Anneke J. van der Kooi, Bernard Brais, Bertrand Fontaine, Bjarne Udd, Carina Wallgren-Pettersson, Caroline A. Sewry, Carsten G. Bönnemann, Cecilia Jimenez-Mallebera, Chad Heatwole, Charles A. Thornton, Corrado Angelini, David Hilton-Jones, Doreen Fialho, Duygu Selcen, Edward J. Cupler, Emma Ciafaloni, Enrico Bertini, Eric A. Shoubridge, Eric Logigian, Erin O’Ferrall, Eugenio Mercuri, Franco Taroni, Frank L. Mastaglia, Frederic Relaix, George Karpati, Giovanni Meola, Gisèle Bonne, Hannah R. Briemberg, Hanns Lochmüller, Heinz Jungbluth, Ichizo Nishino, Jenny E. Morgan, John Day, John Vissing, John T. Kissel, Kate Bushby, Leslie Morrison, Maria J. Molnar, Marianne de Visser, Marinos C. Dalakas, Mary Kay Floeter, Mariz Vainzof, Maxwell S. Damian, Michael G. Hanna, Michael Rose, Michael Sinnreich, Michael Swash, Miranda D. Grounds, Mohammed Kian Salajegheh, Nigel G. Laing, Patrick F. Chinnery, Rabi Tawil, Rénald Gilbert, Richard Orrell, Robert C. Griggs, Roberto Massa, Saiju Jacob, Shannon L. Venance, Stefano Di Donato, Stella Mitrani-Rosenbaum, Stephen Gee, Stuart Viegas, Susan C. Brown, Tahseen Mozaffar, Tanja Taivassalo, Valeria A. Sansone, Violeta Mihaylova, Yaacov Anziska, Zohar Argov
- George Karpati, McGill University, Montréal
- Edited by David Hilton-Jones, Kate Bushby, Robert C. Griggs
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- Book:
- Disorders of Voluntary Muscle
- Published online:
- 26 February 2010
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- 21 January 2010, pp vii-x
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Typhoid fever from water desalinized using reverse osmosis
- S. M. Al-Qarawi, H. E. El Bushra, R. E. Fontaine, S. A. Bubshait, N. A. El Tantawy
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- Journal:
- Epidemiology & Infection / Volume 114 / Issue 1 / February 1995
- Published online by Cambridge University Press:
- 15 May 2009, pp. 41-50
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In May 1992, 81 bacteriologically confirmed cases of typhoid fever (TF) were identified in all districts of Tabuk City in northwestern Saudi Arabia. Attack rates (AR) in residential districts ranged from 0·9–10·3 per 10000. Confirmed cases included 9 workers in the city's referral hospital, King Khalid Hospital (AR 140/10000), 2 in families of medical staff, 57 in the community (AR 4·4/10000) and 13 in a local military cantonment (AR 0·8/10000). The outbreak began with the onset of TF in the three areas within 5 days, continued for 7 weeks, and ended 2 weeks after chlorination began. Among water sources, the odds ratio (OR) was highest (2·6; 95% confidence interval [CI] 1·25–5·39) for water purchased from reverse osmosis (RO) plants, especially RO plants supplied by one well (ASUW) (OR = 7·05; 95% CI 2.51–20·7). The aquifer for ASUW lay partially beneath a depression where city sewage collected. Unchlorinated water samples from ASUW 1 month after the outbreak ended yielded coliforms. ASUW probably became contaminated with Salmonella typhi when KKH demand overtaxed the aquifer and drew in surface water. Membranes in RO plants using this unchlorinated well water could then become fouled with S. typhi. RO plants, which are common throughout Saudi Arabia, need close monitoring. WTater for RO must be prechlorinated to prevent microbiologic fouling of the membranes.
Epidemiological investigation of an outbreak of meningococcal meningitis in Makkah (Mecca), Saudi Arabia, 1992
- Y. M. Al-Gahtani, H. E. El Bushra, S. M. Al-Qarawi, A. A. Al-Zubaidi, R. E. Fontaine
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- Journal:
- Epidemiology & Infection / Volume 115 / Issue 3 / December 1995
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- 15 May 2009, pp. 399-409
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During March and April of 1992, the health surveillance system began detecting increasing numbers of cases of meningococcal disease (MCD) in the Islamic holy city of Makkah (Mecca). We identified 102 bacteriologically confirmed cases (CC) and 80 suspected cases (SC) of MCD. Neisseria meningitidis was identified as Group A. III-1 clone. The ratio of male:female cases was 2·9:1. All age groups of males were affected. There was only one case among women aged 10–30; 50% of the adult female cases were 55 or older. The case-fatality ratio (CFR) was 14·7% among CC. Pakistanis, who comprised about one-third of the CC. had a CFR of 26·7%. Fifty-nine percent of CC were religious visitors. CC in residents were most common in persons living near the Holy Mosque (Haram), where the carriage rate reached 86%. A mass vaccination program against MCD was instituted, using AC bivalent meningococcal vaccine (MCV). An abrupt drop, from a mean of 15 CC per week to 2 CC per week (only in visitors), coincided with vaccinating 600000 persons over 2 weeks. Makkah residents who had been vaccinated against MCD were less likely to have contracted MCD (OR = 0·17, 95% CI: 0·06–0·50). MCV was of no significant protective value if it had been administered 5 years before the outbreak. The main reason for not being vaccinated as stated by both cases (71%) and controls (45%) was not knowing about the disease. The age and sex differences probably relate to differences in exposures to crowded conditions. Health education should illuminate the seriousness of the disease and the importance of vaccination.
An outbreak of hepatitis A in recently vaccinated students from ice snacks made from contaminated well water
- L. J. ZHANG, X. J. WANG, J. M. BAI, G. FANG, L. G. LIU, Y. ZHANG, R. E. FONTAINE
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- Journal:
- Epidemiology & Infection / Volume 137 / Issue 3 / March 2009
- Published online by Cambridge University Press:
- 26 September 2008, pp. 428-433
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On 30 May 2006, township S in Sichuan Province, China, reported an outbreak of hepatitis A (HA) in students who had recently received HA vaccine. The concern was raised that the vaccine had caused the outbreak. We attempted to identify the source of infection and mode of transmission. A HA case was defined as onset of jaundice or anorexia since 1 April 2006 with a twofold elevation of alanine aminotransferase (ALT) and anti-HA virus-IgM in a resident of or visitor to the township. Exposures to vaccine and snacks of 90 case-students to those of 107 control-students were compared. Thirty-four per cent of cases ate ice slush compared to 4·7% of controls (OR 4·1), and 51% of cases ate snow cones compared to 17% of controls (OR 8·3). The ice snacks were made with well water. HA virus RNA was detected by reverse transcription–polymerase chain reaction from patients' blood and well water. Untreated well water poses important dangers to the public in areas where piped, potable water is available.
New insight into the generation of ship bow waves
- E. FONTAINE, O. M. FALTINSEN, R. COINTE
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- Journal:
- Journal of Fluid Mechanics / Volume 421 / 25 October 2000
- Published online by Cambridge University Press:
- 02 November 2000, pp. 15-38
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The generation of ship bow waves is studied within the framework of potential flow theory. Assuming the ship bow to be slender, or thin, a pattern of the flow is derived using the method of matched asymptotic expansions. This method leads to the determination of three different zones in which three asymptotic expansions are performed and matched. To first order with respect to the slenderness parameter, the near-field flow appears to be two-dimensional in each transverse plane along the bow. However, it is demonstrated that three-dimensional effects are important in front of the ship and must be taken into account in the composite solution. This leads to a three-dimensional correction to be added to the two-dimensional solution along the ship. The asymptotic approach is then applied to explain the structure of the bow flow in connection with experimental observations and numerical simulations.
Klebsiella Pneumoniae Bloodstream Infections in Neonates in a Hospital in the Kingdom of Saudi Arabia
- Ayman Abdulaziz Al-Rabea, Dale R. Burwen, Mariam A. Fath Eldeen, Robert E. Fontaine, Fred Tenover, William R. Jarvis
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 19 / Issue 9 / September 1998
- Published online by Cambridge University Press:
- 02 January 2015, pp. 674-679
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- September 1998
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Objective:
To identify risk factors for Klebsiella pneumoniae bloodstream infections (BSI) in neonates in a hospital in the Kingdom of Saudi Arabia (KSA).
Design:Two case-control studies among hospitalized neonates during February 15-May 14, 1991, and a procedural and microbiological investigation.
Setting:Hospital A, a maternity and children's hospital in KSA.
Patients:Case patients had a blood culture positive for K pneumoniae after >2 days of hospitalization and had no evidence of a nonblood primary site of infection.
Results:When the 20 case patients were compared with controls, hospitalization in a critical-care unit (odds ratio [OR], 5.5; 95% confidence interval [CI95], 1.20-51.1; P=.03) was identified as a risk factor. When the case patients were compared with a second set of controls matched by critical-care status, receipt of a particular intravenous fluid (D10%/0.2NS; OR, 11.0; CI95, 1.42-85.2; P=.009) or a blood product (OR undefined; P=.04) were identified as risk factors. Infusates were administered via umbilical catheters for most case and control patients (19/20 vs 15/20, P>.05); catheters were manipulated more frequently in patients in criticalcare units. Umbilical catheter tip, skin, or mucus membrane K pneumoniae colonization occurred in 47% and 53% of evaluated case and control patients, respectively. Available K pneumoniae isolates from blood cultures and colonization sites had identical antimicrobial susceptibility patterns. Emphasis on handwashing, careful preparation and administration of infusates, and aseptic technique for catheter insertion, maintenance, and manipulation was temporally associated with resolution of the epidemic.
Conclusions:This outbreak was probably due to infusion therapy practices that led to BSI in nursery patients colonized with K pneumoniae. Both catheter-related infections and extrinsic contamination of infusates may have occurred. Hospital personnel should be aware of their potential to spread nosocomial pathogens from person to person and should implement Centers for Disease Control and Prevention recommendations to decrease nosocomial BSIs.
Observation of a Variable, ZZ Ceti White Dwarf: GD154
- B. Pfeiffer, G. Vauclair, N. Dolez, M. Chevreton, J. R. Fremy, G. Herpe, M. Barstow, S. J. Kleinman, T. K. Watson, J. A. Belmonte, S. O Kepler, A. Kanaan, O. Giovannini, R. E. Nather, D. E. Winget, J. Provencal, J. C. Clemens, P. Bradley, J. Dixson, A. D. Grauer, G. Fontaine, P. Bergeron, F. Wesemael, C. F. Claver, T. Matzeh, E. Leibowitz, P. Moskalik
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- Journal:
- International Astronomical Union Colloquium / Volume 134 / 1993
- Published online by Cambridge University Press:
- 12 April 2016, pp. 201-204
- Print publication:
- 1993
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The ZZ Ceti stars form a class of variable white dwarfs: the hydrogen dominated atmosphere ones, which do pulsate in an instability strip in the effective temperature range 13000K-11500K. We know 22 such ZZ Ceti white dwarfs. Their variations are caused by nonradial g-mode pulsations with periods are in the range 100-1000 seconds.
A subsample of the ZZ Ceti stars shows amplitude variations on time scales of the order of one month. These variations could be driven by nonlinear phenomena.
An Ultraviolet Look at the Blue Edge of the ZZ Ceti Instability Strip
- R. Lamontagne, F. Vesemael, G. Fontaine, G. Vegner, E. P. Nelan
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- Journal:
- International Astronomical Union Colloquium / Volume 114 / 1989
- Published online by Cambridge University Press:
- 12 April 2016, pp. 240-243
- Print publication:
- 1989
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It has already been shown that most, and probably all, of the DA white dwarfs become variable in a narrow temperature range as they cool down (Fontaine et al. 1982). Optical photometry and spectrophotometry has led to several determinations of the boundaries of this instability strip. The strip has been found to cover the range 10300 - 13600 K (McGraw 1979), 10400 - 12100 K (Greenstein 1982), 10000 - 13000 K (Weidemann and Koester 1984) and 11000 - 13000 K (Fontaine et al. 1985). Theoretical calculations show that the location of the blue edge is very sensitive to the efficiency of convection used in the unpertubed models (Winget et al. 1982; Winget and Fontaine 1982; Fontaine, Tassoul, and Wesemael 1984). Also, the sharpness of this boundary depends on the range of stellar mass and thickness of the hydrogen envelope found in ZZ Ceti stars. Recently, Wesemael, Lamontagne, and Fontaine (1986) and Lamontagne, Wesemael, and Fontaine (1987) have obtained and compared ultraviolet observations of several DA white dwarfs, in or near the instability strip, with published model calculations from Nelan and Wegner (1985), hereafter NW, and Koester et al. (1985), hereafter KWZV. They determined the boundaries of the variability region at 11400 - 12500 K or 11700 - 13000 K depending on which grid was used. We present here a reanalysis of these IUE observations with an improved grid of model atmospheres in order to define more precisely the location of the blue edge.
Dispersive X-Ray Synchrotron Studies of Pt-C Multilayers
- B. Rodricks, F. Lamelas, D. Medjahed, W. Dos Passos, R. Smither, E. Ziegler, A. Fontaine, R. Clarke
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- Journal:
- MRS Online Proceedings Library Archive / Volume 143 / 1988
- Published online by Cambridge University Press:
- 21 February 2011, 209
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- 1988
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We demonstrate the simultaneous acquisition of high-resolution x-ray absorption spectra and scattering data, using a combination of energy-dispersive optics and a twodimensional CCD detector. Results are presented on the optical constants of Pt and on the reflectivity of a platinum-carbon multilayer at the LIII absorption edge of Pt.
Resting Metabolic Rate in Monozygotic and Dizygotic Twins
- E. Fontaine, R. Savard, A. Tremblay, J.P. Després, E. Poehlman, C. Bouchard
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- Journal:
- Acta geneticae medicae et gemellologiae: twin research / Volume 34 / Issue 1-2 / April 1985
- Published online by Cambridge University Press:
- 01 August 2014, pp. 41-47
- Print publication:
- April 1985
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In order to study the influence of heredity on resting metabolic rate (RMR), 20 monozygotic and 19 dizygotic male twin pairs aged 20.6 (SD 2.9) and 21.4 (SD 3.1) years, gave their consent to participate in the experiment. Fat free weight (FFW) was estimated from underwater weighing. RMR was measured by indirect calorimetry using an open circuit system. RMR was expressed as kJ · min−1, kJ/m2 · h−1, kJ/kg · h−1 and kJ/kgFFW · h−1. Significant intraclass coefficients were observed in MZ twins for the different expressions of RMR. The values ranged from r = 0.45 (P < 0.05) to r = 0.81 (P < 0.01). However, DZ twins demonstrated lower intraclass coefficients for RMR, with a range from r = 0.21 to r = 0.44. Significant (P < 0.05) DZ resemblance was revealed only when RMR was expressed as kJ · min−1 and kJ/kg · h−1. Results of the present study suggest that variations in RMR may have a genetic component. Implications for human energy balance and body fat are discussed.