bluuebunny/crossref_metadata_2025 huggingface dataset:
Microbial sampling variables and recreational water quality standards.
Authors: Brenniman G R , Rosenberg S H , Northrop R L
Published: November 2008

A study was conducted at two beaches on Lake Erie to evaluate the water sampling design for the collection of several microbiological indicator organisms in relation to day, time, and location of collection. The concentrations of these organisms were generally found to vary significantly (P less than 0.05) by the specific time of day and day of weekend that collection took place. However, the concentrations of these organisms did not vary significantly (P greater than 0.05) at various locations in the bathing area. Future studies investigating the health effects of recreational water as related to microbiological variables should be designed to collect water samples at the specific time of day and day of weekend that an individual was exposed. In addition, sampling at various locations in the bathing area should probably be considered for those beaches having poor dispersion of fecal waste sources.
Enhancement of high risk children's utilization of dental services.
Authors: Olson D G , Levy R L , Evans C A , Olson S K
Published: November 2008

One hundred twenty-four children identified as needing care in two elementary schools by a routine department of public health screening were randomly assigned to either a standard treatment group (notification to parents by a form letter) or an experimental group that added personal contact to the standard treatment. Overall, 53 percent of the subjects in the experimental condition who needed treatment at the initial screening had received this treatment at follow-up, while only 12 per cent of the subjects in the control group had received needed treatment.
Underestimation of the role of pneumonia and influenza in causing excess mortality.
Authors: Barker W H , Mullooly J P
Published: November 2008

Underestimation of pneumonia and influenza (P&I) mortality during influenza epidemics was explored in 38 P&U associated deaths among a population of adults during two influenza A (H3N2) epidemics. Pneumonia or influenza was mentioned on 32 (84 per cent) of the death certificates. However, based on rules for assigning cause of death, only nine (24 per cent, SE = 7) and 23 (61 per cent, SE = 8) of the cases would have been included in P&I mortality statistics compiled by the National Center for Health Statistics and the Center for Disease Control, respectively.
A method for determining costs associated with laboratory error.
Authors: Cavenaugh E L
Published: November 2008

A study directed toward developing a method for determining costs associated with laboratory error was developed, relying on panels of physicians to rank frequency of performance and impact of error of various laboratory tests. Cost estimates of error impact were then developed, using cost of error to patient as the basis. Findings indicate that economic costs of laboratory error differ with the test. Probable costs per error can be used to identify tests with the highest costs to patients. These cost-per-error-data, when combined with test volume data and error rates by test, will help pinpoint the tests that should receive priority effort in a laboratory improvement program. The method developed could serve as one basis for developing an effective laboratory improvement program; it could also be used for budget justification and ultimately for program evaluation.
Phased trial of a proven algorithm at a new primary care clinic.
Authors: Christensen-Szalanski J J , Diehr P H , Wood R W , Tompkins R K
Published: November 2008

A previous study showed that a clinical algorithm for respiratory illnesses, consisting of a checklist, a set of instructions (logic), and computer audit/feedback, could reduce costs significantly while maintaining a high quality of care. The results of this study show that the algorithm system, developed and validated at one primary care clinic, can be successfully imported to another primary care clinic. In the present study, the algorithm system significantly improved the completeness of the medical records, reduced the use of medical tests by 20 per cent-75 per cent, and reduced non-provider costs by 36 per cent per patient visit. This study also shows that all three components of the algorithm system appear to be necessary to achieve these improvements and maintain a high quality of medical care. These results suggest that a wider use of the algorithm system for minor acute medical problems is both feasible and useful in providing high-quality cost-effective care that is auditable.
Factors related to utilization of dental services by the elderly.
Authors: Evashwick C , Conrad D , Lee F
Published: November 2008

A household interview survey of 883 persons aged 62 and older residing in Seattle, Washington, asked about a broad range of health care and social service issues, including the need for and use of dental care. The Anderson model of health services utilization was used to identify predisposing, enabling, and need characteristics hypothesized to affect the use of dental services. A path analysis was conducted to distinguish the direct and indirect effects of the variables. The results showed that none of the predisposing variables, including age, was a significant factor in explaining the use of dental services. Education had both direct and indirect positive relationships to use. Having a regular sources of dental care was also an important factor affecting utilization. Neither income nor insurance variables were powerful factors. Need, measured by an index of dental problems and having dentures, was the stronger determinant of dental care use. In general, the model was better at predicting whether or not dental care would be sought by an older person at all (R2 = .27) than in predicting the amount of service used (R2 = .06).
An evaluation of the effectiveness of motor cycle daytime headlight laws.
Authors: Muller A
Published: November 2008

Currently, 17 states mandate the daytime use of motorcycle headlights. The purpose of these laws is to make the motorcyclists more conspicuous and reduce the number of daytime multi-vehicle collisions. The effectiveness of the laws is examined by comparing the proportion of daytime fatal, front, and side-angle collisions between states with and without such laws. The comparison is based on all motorcycle fatalities recorded by NHTSA for the years 1975-80. The analysis shows no statistically significant difference between states with and without such laws, suggesting that daytime headlight laws are ineffective. Several explanations of this negative finding are explored.
Costs of providing dental services to adult mentally retarded: a preliminary report.
Authors: Gotowka T D , Johnson E S , Gotowka C J
Published: November 2008

This study reports on the hourly costs of providing comprehensive dental services to mentally retarded adults in a hospital-based group dental practice. The analysis indicated average total hourly costs of $56.11 for dentist-provided services an $22.25 for dental hygienist-provided services. When compared to the revenues available for program maintenance, a net hourly deficit of $18.82 per dentist hour and $9.89 per dental hygienist hour resulted. The implications of this operating loss on the continued care of this patient population are discussed.
Sex differences in declining cohort death rates from heart disease.
Authors: Patrick C H , Palesch Y Y , Feinleib M , Brody J A
Published: November 2008

We examined cohort mortality from heart disease (HD) at ages 40 and over for White men and women in the United States between 1945 and 1975. For each successive birth cohort from 1886 to 1890 and 1906 to 1910, female HD mortality rates exhibit a continuous decline with parallel slopes which shows no sign of abating in recent years. Among men, cohort HD mortality rates were increasing prior to 1965; since 1965, there has been a reversal of prior trends, i.e., each successive cohort has shown a decrease in HD mortality rates. None of the various hypotheses put forward to explain the recent decline in HD mortality provides a cogent explantation for the differential effects in men and women.
Public Health Implications of Rubella Antibody Levels in California
Authors: Dales Loring G. , Chin James
Published: November 2008

Rubella hemaggluttination inhibition (HI) antibody determinations were performed in 1977 on a sample of California school children and in 1977-1979 on young women who were about to be married or who were pregnant. Among the pupils, 66 per cent reported prior rubella immunization; immunization history was more common in younger pupils. Seventy-seven per cent had detectable antibody, with little trend of greater seropositivity at older ages. Over 86 per cent of those with a written record of immunization had detectable antibody. There was no consistent indication of loss of seropositivity with increasing time since immunization. Children immunized at 12-14 months of age tended to have a lower seropositivity rate than those immunized at older ages. Among young women, the prevalence of detectable antibody was 80-83 per cent. Comparison with data obtained in 1968-1969 indicates that rubella immunization has had a marked impact on antibody levels in children but less impact on levels in teenagers and adults. The pool of rubella-susceptibles entering secondary schools will probably not decrease soon, so that rubella outbreaks may continue in high school and college-age populations. Ultimately, school entry immunization requirements should drastically curtail disease activity. In the interim, programs to immunize teenagers and young adult females must be strengthened. (Am J Public Health 1982; 72:167-172.)
The environmental health matrix: information for use in planning.
Authors: Laessig R E , Urkowitz A G
Published: November 2008

Environmental and Health planners and policy makers would benefit from a presentation of the casual relationships and the use of that information for plan development and priority setting. The concept of the Environmental-Health Matrix provides a simple structure for constructing data base of environmental-health research information. The Matrix is organized so that it can be used by either environmental or health planners. Entries in the cells of the Matrix assess the nature of the research evidence and direct the user to summaries of research findings. The initial application of the Matrix as both a guide for a literature review and a data base for planning is discussed.
Defining legitimate births in Fulton County, Georgia, 1977.
Authors: Benussi G , McCarthy B J , Friedman J S , Elsea W , Morris L
Published: November 2008

In 1977, the parents of 1,043 births recorded for 15 to 19 year old women in Fulton County, Georgia, were classified as married. However, only 36 per cent of these births could be linked with marriage certificates. An analysis of the unlinked birth certificates showed that the overwhelming majority of teenage parents did not appear to be legally married. The absence of a specific statement regarding marital status on birth certificates results in inaccuracies in the reporting of births according to marital status of parents.
Cuban refugee health care: response of the American health care system to the unexpected arrival of 125,000 immigrants.
Authors: Bienia R A , VanDerDecker J D , Bienia B H
Published: November 2008

During the spring of 1980, over 120,000 Cuban refugees emigrated to the United States. Their rapid, unexpected arrival overwhelmed existing health care facilities in south Florida. Government-operated screening centers capable of handling large patient loads were established. Health screening involved a brief history and physical examination and a search for active tuberculosis and venereal disease. Thousands of refugees were processed rapidly and released to waiting relatives and sponsors. Many others, who for social or psychological reasons could not be released. were transferred to holding centers in various parts of the country. US Public Health Service physicians were faced with difficulties whose basic cause could be traced to the boredom of camp life and stresses due to uncertainty regarding the future. Acting out and compliance problems with medical aftermaths were common. About 3,000 refugees remain in custody today.
Comparison of Utilization of Medical Services by Alcoholics and Non-Alcoholics
Authors: Forsythe Alan B. , Griffiths Barbara , Reiff Sidney
Published: November 2008

To determine whether medical costs for alcoholics are higher than those for non-alcoholics, inpatient and outpatient costs for medical services of 191 alcoholics with 191 non-alcoholic matched controls were compared over four years. Results confirm that alcoholics are higher-cost users of medical services than non-alcoholics. (Am J Public Health 1982; 72:600-602.)
Long-term care criteria and standards agreement with professional placement determination.
Authors: Harris J F , Orr M , Allaway N C
Published: November 2008

The decisions made by physician-nurse teams and individual nurse-evaluators following examination of long-term care patients are compared with the results of placement assignment of the same patients obtained by using the New York State Patient Assessment Form (DMS-1), predictor scores, and numerical standard. The descriptors, when applied to long-term care patients and weighted according to intensity, were capable of matching the best judgment of these professionals with a 90 per cent concurrence.
Family planning and abortion: have they affected fertility in Tennessee?
Authors: Atrash H K , Rochat R W , Schulz K F , Allen D T
Published: November 2008

In Tennessee between 1975 and 1978, birth rates among teenagers decreased while they increased among older age groups. This trend was unlike previous years and coincided temporally with the increased availability of legal abortion services in Tennessee and the special efforts to prevent unwanted pregnancies among teenagers. Increased use of family planning services was significantly associated with the drop in the fertility rate for Black teenagers; legal abortion use was significantly associated with the change in the fertility rate for Black females aged 20 years or older.
Cancer control in India: a multinational approach involving the USA and the USSR.
Authors: Sutnick A I , Saunders J F , Puchkov Y I
Published: November 2008

Based on a long-standing cooperation in medicine and public health between the United States and the Soviet Union, and on the potential contributions to be made by scientists from both of these countries, the World Health Organization invited an American-Soviet collaborative team to recommend a cancer control program for the Government of India. The consultants defined the importance of cancer of the cervix uteri and of the oral cavity, which comprise one-half of India's cancer cases, as the basis for a cancer control program. They recommended incorporation of cancer control functions into the organizational structure of the Ministry of Health as well as specific recommendations in education, prevention, and early detection, diagnosis, treatment, and epidemiologic studies. The mission underscores the value of multinational cooperation on health care problems that are faced in common by the United States, the Soviet Union, and other countries of the world. In addition it serves as a basis for international friendship and understanding in the context of mutually productive activities which may provide a benefit for all nations.
Is smoker/nonsmoker segregation effective in reducing passive inhalation among nonsmokers?
Authors: Olshansky S J
Published: November 2008

Using expired carbon monoxide (CO) and a test of coordination as measures of tobacco smoke exposure in a natural environmental setting where smokers and nonsmokers were segregated, results indicate that by comparison to a control group, subjects seated in adjacent smoking/ nonsmoking environments were not only exposed to similar ambient levels of CO, but also show similar physical and physiological reactions to their exposure in the form of coordination test scores, expired CO, and blood carboxyhemoglobin. While the results may not be generalized to other tobacco smoke constituents or other environmental settings, they raise questions about the health benefits of smoker segregation which future research must address.
A closer examination of neonatal mortality rates among the Texas Spanish surname population.
Authors: Powell-Griner E , Streck D
Published: November 2008

Considering the poor socioeconomic status of the Spanish surnamed population in Texas, the Spanish surname neonatal mortality rate seems surprisingly low. During five of the last 10 years, the neonatal mortality rate for Texas Spanish surnamed population was actually lower than for Anglos. It is often suggested that the low Spanish surname neonatal mortality rate is due in part to reporting problems peculiar to the Spanish surname population in Texas. Linked birth and neonatal death records of Texas residents are examined for evidence of underreporting or misreporting of Spanish surnamed neonatal deaths. It is found that discrepancies in coding race on the birth and death records cause a minor deflation of Spanish surname neonatal and infant mortality rates. Indirect evidence indicates that there may be a substantial amount of underreporting of Spanish surname neonatal deaths. This underreporting appears to be associated with the presence of a large number of Mexican nationals misidentified as Texas residents, and the greater reliance upon lay midwives by the Spanish surname population in Texas. Reasons proposed to explain a reluctance to report neonatal deaths include fear of contact with authorities, and fear that a reported death would diminish the value of the birth certificate.
Serologic investigation of an outbreak of hepatitis A in a rural day-care center.
Authors: Gingrich G A , Hadler S C , Elder H A , Ash K O
Published: November 2008

We studied an outbreak of hepatitis A in a day-care center in a rural community where less than 7 per cent of the population possessed anti-HAV. Serotesting for IgM specific antibody to hepatitis A virus identified 78 cases in center attendees, staff, and families. Thirty-five per cent of the center children were seropositive. In children under age three anicteric infection was at least 17 times more frequent than icteric infection, but in older children and adults icterus was a predominant manifestation of the disease. Clinical suspicion should be high in any day-care child with nausea, emesis, diarrhea, or arthralgia. The low incidence of icterus in infected children suggested that outbreak reports reaching public health departments are likely to be incomplete and poorly indicative of outbreak magnitude. The high frequency of intrafamilial transmission and anicteric infection appeared to justify administration of immune serum globulin to household contacts of center children under age three when a day-care outbreak is detected.
Health-specific family coping index for noninstitutional care.
Authors: Choi T , Josten L , Christensen M L
Published: November 2008

We report on attempts to improve the Richmond/Hopkins Family Coping Index. Factor analysis showed that revised operational guidelines for using the index probably contributed to a significantly higher per cent of variance explained by the index (83 per cent versus 59 per cent). Interrater reliability was high (greater than or equal to .97). Correlation between this index and another coping index was also high (.94). Results support the continued use of the Family Coping Index--with new instructions--to assess patient/family coping.
Smoking habits in a hospitalized population: 1970-1980.
Authors: Covey L S , Mushinski M H , Wynder E L
Published: November 2008

The smoking habits of 23,953 hospitalized men and women aged 20 to 80, interviewed in nine United States cities between 1970 and 1980, were examined. Comparisons were made of age-adjusted smoking rates in 1970-1975 vs 1976-1980, stratified by sex, race, and educational level. An overall decrease in smoking exposure between the time periods studied was observed: a decline in rates of current cigarette smokers and an increase in use of cigarettes containing less than or equal to 12 mg tar. Nevertheless, among current smokers, there was no reduction in the proportions of those who smoke 31+ cigarettes daily. An enhancing effect of higher education on rates of smoking cessation and use of cigarettes containing less than or equal to 12 mg tar was observed. In both time periods, proportionately more Black than White men were smokers, although the difference was smaller in college educated groups. These findings point up the limited effectiveness of public health education about smoking in lower socioeconomic groups, and suggest that in the future, lung cancer and other diseases for which smoking is a major factor will be increasingly social class related diseases.
The organization and evaluation of a computer-assisted, centralized immunization registry.
Authors: Loeser H , Zvagulis I , Hercz L , Pless I B
Published: November 2008

The rationale for, and establishment of, a computer-assisted, centralized immunization registry are described. This registry was created to improve the quality and quantity of information regarding immunization status for a defined population receiving primary care from a variety of providers, principally public clinics and private practitioners. An evaluation of the feasibility of the registry after one year's function shows that 93 per cent of eligible providers initially agreed to participate and 73 per cent continue to do so. Their reports have resulted in the creation of 17,500 individual patient files. Of a prospective cohort of newborns, 23 per cent were identified as "high-risk" for overdue immunizations. After one year, the immunization rates in audited groups improved significantly. The direct cost of this registry is less than 65 cents per currently registered child per year.
Regionalization of surgical services.
Authors: Peterson O L , Bloom B S
Published: November 2008

Using data from the Studies on Surgical Services for the United States (SOSSUS), the extent of existing surgical care regionalization was examined in a defined area. Specialist surgeons comprised 55 per cent of all physicians who did operations, but performed nearly three-fourths of all operative work. About one-third of the most complex operations (CRV greater than or equal to 30), more than one-fifth of medium complexity (CRV = 20-29), and 14 per cent of low complexity (CRV less than 20) were obtained out of county of residence. Nearly one-half of all surgical patients at the university hospital were from other counties; but for those obtaining the most complex operations (CRV greater than or equal to 30), three-fourths of them were from other counties. Thus there was a substantial amount of regionalization of surgical care already existing in this area.
Effect of polybrominated biphenyls (PBB) on developmental abilities in young children.
Authors: Schwartz E M , Rae W A
Published: November 2008

Eighteen children, ages 4 to 6 years, with known exposure to polybrominated biphenyls (PBB) in utero and/or through breast milk were administered developmental tests. These same children had exhibited low scores on a partial developmental assessment two years earlier. Current results were compared to normative test data. Findings showed: 1) PBB cohort children are within the normal range in all areas assessed; 2) An inverse relationship is noted between PBB fat level and scores on some developmental tasks. The importance of this finding for later development is unclear and, thus will bear future monitoring.
The Organization of Medical Practice and Primary Care Physician Income
Authors: Wolinsky Fredric D. , Marder William D.
Published: November 2008

This study investigates the effect of the organization of medical practice, e.g., solo, fee-for-service group, or health maintenance organization (HMO) settings, on primary care physicians' net incomes. Using pooled data on 2,372 primary care physicians, multivariate regression analysis is used to adjust physicians' 1979 net incomes for differences in medical specialty, workload, sex, and experience before estimating the effects of the organization of medical practice. Among HMO physicians, only those in staff model HMOs were found to have significantly lower net incomes than their fee-for-service group practice counterparts. Accordingly, there is little evidence to support the popular belief that physicians practicing in HMOs consistently earn less than their fee-for-service counterparts. (Am J Public Health 1983; 73:379-383.)
Pennsylvania's domiciliary care experiment: II. Cost-benefit implications.
Authors: Ruchlin H S , Morris J N
Published: November 2008

A pilot program based on the substitution of domiciliary care for traditional institutional care was established by the Commonwealth of Pennsylvania to provide community-based care for individuals who could no longer live independently (aging, mentally retarded, mentally ill). To ascertain the cost saving potential of this program, 190 participants and a comparable pool of non-participants were followed for an average 10-month follow-up period. Within each subgroup, participants were disaggregated into two categories: those residing in a community setting at pretest, and those residing in an institutional setting. An analysis of medical care and social support service utilization profiles indicated that program savings exceeded program cost for five of the six study subsamples; the one exception was the mental retardation cohort residing in a community setting at pretest. Net savings were greatest for the three subsamples residing in an institutional setting at pretest. For all the subsamples, over 90 per cent of the program saving stemmed from a lower use of institutional placements.
Paraquat and marijuana: epidemiologic risk assessment.
Authors: Landrigan P J , Powell K E , James L M , Taylor P R
Published: November 2008

In March 1978, 13 (21 per cent) of 61 marijuana samples from the southwestern United States were found to be contaminated with the herbicide paraquat, a pulmonary toxin, in concentrations from 3 to 2,264 parts per million. The source of the contamination was an aerial spraying program in Mexico, supported indirectly by United States funds. To evaluate US exposure, a nationwide survey of the paraquat content of confiscated marijuana was conducted. The survey found 33 (3.6 per cent) of 910 marijuana specimens to contain detectable paraquat. In states adjacent to Mexico (Census Region VI), 23 (12.8 per cent) of 180 specimens were contaminated. Combustion testing indicated that approximately 0.2 per cent of paraquat on marijuana passes into smoke. From these data, we projected that 100-200 marijuana smokers in Census Region VI would be exposed by inhalation to 500 micrograms or more of paraquat per year, a dose judged to represent a health hazard; nationally, between 150 and 300 smokers were projected to have such exposure. Another 6,000 persons in Region VI and 9,000 nationally were projected to be at risk of exposure to between 100 and 499 micrograms of paraquat annually. The risk of paraquat exposure was greatest among those smokers who make one large purchase of marijuana per year. No clinical cases of paraquat poisoning were recognized among marijuana smokers during these studies, but no systematic national search for such cases was undertaken.
Cesarean section delivery rates: United States, 1981.
Authors: Placek P J , Taffel S , Moien M
Published: November 2008

The rate of cesarean section delivery in the United States has risen from 4.5 per 100 deliveries in 1965 to 17.9 in 1981. The rate is highest in the Northeast, in hospitals of 500 beds or more, in proprietary hospitals, for Blue Cross as a source of payment, and for mothers aged 35 years and over. The rate is lowest in the North Central region, in hospitals with less than 100 beds, in government hospitals, for self-pay patients, and for mothers under 20 years of age.
District nursing: the cost benefits of a population-based practice.
Authors: Dreher M
Published: November 2008

This paper presents some serendipitous findings from an ethnohistorical study of public health nursing in rural New England. In the course of that study, a model of population-based nursing revealed itself that some would condemn as antiquated; it may, however, hold great possibilities for addressing the nation's current and future health problems, particularly health maintenance of the elderly and care of the chronically ill. In keeping with the criteria used to evaluate primary health care, the model is examined for the extent to which it is accessible, available, accountable, acceptable, comprehensive, coordinated, and cost-effective. The policy implications of this model for the organization and financing of community health care are explored.
Changes in the hours worked by physicians, 1970-80.
Authors: Freiman M P , Marder W D
Published: November 2008

The hours worked by physicians are affected by changes in a number of factors, including attitudes towards labor-leisure tradeoffs, the characteristics of the physician workforce, and the level of demand for medical services. This paper analyzes changes in the hours worked per week by office-based physicians over the decade 1970-80. Overall, there has been a statistically significant decline in hours of approximately 3 per cent, or 1.5 hours per week. This decline was fairly uniform across most physician characteristics, although the decline was greater for those in primary care specialties. Female physicians increased their average hours worked, although this increase was not statistically significant. In terms of the delivery of skilled medical services, the decline in total hours was largely offset by an increase in the percentage of total hours devoted to patient care. The question of whether these trends will continue has important implications for the validity of projections of a physician surplus in the near future.
A study of pregnancy outcomes in a maternity center and a tertiary care hospital.
Authors: Baruffi G , Dellinger W S , Stobino D M , Rudolph A , Timmons R Y , Ross A
Published: November 2008

This study compares 796 pregnancy outcomes at a maternity center (BMC) with 804 hospital (TJUH) pregnancy outcomes. The samples of pregnant women from the participating institutions were matched on sociodemographic characteristics; analysis of outcomes was performed controlling for medical-obstetric risk. Differences between the institutions were found mainly among women with low intrapartum risk. For these women, neonatal morbidity and length of infant nursery stay were lower at BMC than at TJUH. The percentage of infants with one-minute Apgar scores less than 7 or requiring resuscitation at birth was greater at BMC, but the percentage of infants with five-minute Apgar scores less than 7 as well as neonatal mortality rates did not differ between the two institutions. The number of women with intrapartum or postpartum fever was too small to permit comparison. The study results suggest that care delivered at BMC is safe with regard to the evaluative criteria used.
Diabetes and renal mortality in the United States.
Authors: Geiss L S , Herman W H , Teutsch S M
Published: November 2008

The risk of renal death is examined in the United States population 15 years of age and older with and without diabetes. The renal mortality rate is 174.6 per 100,000 among people with diabetes and 42.5 per 100,000 among people without diabetes. The relative risk of renal mortality is 4.1 for diabetics, age-adjusted relative risk, 2.6. The risk of renal mortality is highest in young people with diabetes. Rates of renal mortality are higher than previously believed among Whites with diabetes and among women with diabetes.
Childhood injuries in North Carolina: a statewide analysis of hospitalizations and deaths.
Authors: Runyan C W , Kotch J B , Margolis L H , Buescher P A
Published: November 2008

We report the nature and causes of childhood injuries leading to hospitalization or death in North Carolina. Based on an 89 per cent sample of 1980 hospital discharges of children between 0 and 19 years of age, the overall annual rate of trauma-related hospitalizations was 80 per 10,000. The rate varied from 119 per 10,000 for the 15-19 year age group to 56 per 10,000 for children between ages 5 and 9. Hospitalization rates are lower than those reported elsewhere, although death rates, based on a seven-year period, are higher in the data reported here. Potential reasons for these differences are suggested.
Variability among state Crippled Children's Service programs: pluralism thrives.
Authors: Ireys H T , Hauck R J , Perrin J M
Published: November 2008

The authors review the history of the Crippled Children's Service (CCS) program and report results of a survey of state CCS programs conducted in 1981. The results of the survey document extensive variability among state programs in respect to several indices, including numbers of children served, conditions covered, and services provided. With few exceptions, selected organizational, economic and demographic variables fail to correlate significantly with the variation of these indices. The strongest correlation, .40 (p less than .02) is between percentage of children served and program per capita expenditures, suggesting that relatively wealthier programs tend to serve more children. Furthermore, analyses of the survey results show that mean coverage by CCS programs of surgical disorders is significantly greater than mean coverage of medical disorders or behavioral disorders (p less than .001). The findings of this study underscore the considerable influence of historical and leadership variables on the functioning of state CCS programs.
Motorcycle headlight-use laws and fatal motorcycle crashes in the US, 1975-83.
Authors: Zador P L
Published: November 2008

Fatal motorcycle crashes in the United States from 1975 to 1983 were analyzed. In the 14 states that had motorcycle headlight-use laws during the study period, about 600 daytime crashes of the type included in the study were prevented by these laws. This reduction corresponds to a 13 per cent reduction in fatal daytime crashes and to an average reduction of about five fatal crashes per year for each of the 14 states. About 30 states did not have motorcycle daytime headlight laws in effect during the study period. If all of these states had such laws, in an average year, approximately 140 additional fatal motorcycle crashes would have been prevented.
The incidence of duodenal and gastric ulcers in a large health maintenance organization.
Authors: Kurata J H , Honda G D , Frankl H
Published: November 2008

We report the incidence of peptic ulcers (duodenal, pyloric canal, gastric, and combined) verified by radiologic, endoscopic, or surgical evidence in a large Health Maintenance Organization (HMO) in Los Angeles, California. For members age 15 and above, the peptic ulcer incidence rate was 0.86 per 1,000 person-years (p-y) (males 1.10, females 0.63). The male to female sex ratio was 1.7. Two hundred twenty-two duodenal, 17 pyloric canal, 89 gastric, and 21 combined first-time diagnosed ulcer cases were located. For duodenal and pyloric canal ulcer, the incidence rate for members age 15 and above was 0.58 per 1,000 p-y (males 0.76, females 0.40). For gastric ulcer, the incidence rate for members age 15 and above was 0.21 per 1,000 p-y (males 0.23, females 0.18). The combined ulcer rate was 0.05 per 1,000 p-y (males 0.07, females 0.02). Gastric ulcer rates were two times higher in 1980 than in 1977. Peptic ulcer age-specific incidence rates increased with age. Incidence rates were much lower than those reported in previous studies, but the gastric to duodenal ulcer ratio and the age and sex relation to ulcer incidence were similar to those previously reported.
Standards for local public health services: where stand the states?
Authors: Schaefer M , Abrantes A
Published: November 2008

Of the 47 states that participated in a 1983 survey of State Health Departments, 30 were found to have public health standards in place or started. Most states' standards emphasize the range of services to be provided, but substantial variations were found in how standards are formulated, adopted, and used by state and local agencies.
The effects of denturism on denture prices.
Authors: Rosenstein D I , Empey G , Chiodo G T , Phillips D
Published: November 2008

In 1978, the country's first denturism initiative was passed in Oregon, legalizing the independent construction of dentures by non-dentists. The major campaign issue was the effect denturism would have on the cost of dentures. A review of Oregon dental insurance data shows that the costs of dentures, which had been rising at the same rate as other dental services, had a much lower rate of increase after passage of the denturism initiative.
Pursuing longevity: delay vs elimination of degenerative diseases.
Authors: Olshansky S J
Published: November 2008

Using a new model which allows for projection of mortality change resulting from preventive health care measures, prospective changes in longevity for the resident United States population in 1978 were compared with projections of longevity gains occurring under a standard single cause-elimination model. Results indicate that equal or greater gains accrue from the prevention or delay of several major degenerative diseases, than from the complete elimination of some single major degenerative diseases. Observed declines in mortality from 1960 to 1978 have resulted in gains in longevity equivalent to the successful elimination of some major degenerative diseases.
Smoke detector legislation: its effect on owner-occupied homes.
Authors: McLoughlin E , Marchone M , Hanger L , German P S , Baker S P
Published: November 2008

Montgomery County, Maryland was the first major jurisdiction to pass a law requiring smoke detectors in all homes. Smoke detector coverage in the county was evaluated five years after the law's implementation and compared to the coverage in neighboring Fairfax County, Virginia, which has no such law. Firefighters visited 651 randomly selected owner-occupied homes and tested each detector. While a similar percentage of homes in Montgomery and Fairfax counties complied with detector codes (42 per cent vs 44 per cent, respectively), Montgomery County had a significantly lower percentage of homes with no working detectors (17 per cent vs 30 per cent) and with no detectors at all (6 per cent vs 16 per cent). In general, Montgomery County residents complied with what they believed the law required, but lacked knowledge of the law's details. New homes where building codes required detectors and homes where owners assumed that detectors were required by law were likely to have working detectors. Analyses of 12 years of fire data suggest that as a county approaches complete detector coverage, the risk of residential fire deaths decreases. An essentially unenforced law seems to be obeyed because it conforms to community values.
Circumcision in the United States.
Authors: Slaby A R , Drizd T
Published: November 2008

The circumcision status of boys aged 12 through 17 years (born from 1949 to 1958) from a sample cohort of the National Health Examination Survey (NHES) cycle III, conducted from 1966-70, was analyzed. Over three-fourths of the cohort had been circumcised, reflecting circumcision practices in the 1950s. Prevalence of circumcision was more common in Whites, in families with higher income, and higher educated heads of household. Circumcision prevalence was the lowest in the South and highest in the Midwest. More recent national data are not available.
The decline in congenital rubella syndrome in Western Australia: an impact of the school girl vaccination program?
Authors: Stanley F J , Sim M , Wilson G , Worthington S
Published: November 2008

Rubella vaccination became available in 1970 in Australia. In Western Australia (WA), a school girl vaccination program was well established by 1971. Mothers under 26 years of age in 1983 would have been eligible for this program and they constitute 40 per cent of WA births. Data on Congenital Rubella Syndrome (CRS) cases were obtained for years of birth 1968-83 inclusive to ascertain if there had been an impact of the program on the CRS rate. Epidemics of rubella occurred in 1970-71, 1974, and 1979-80. The CRS rate has fallen steadily; it did not rise during the 1979-80 epidemic and was less than one in each year after 1977. All CRS cases born since 1974 were to mothers too old to have been eligible for the program. The data suggest that the vaccination program is effective, but this cannot be proven until data become available on pregnancy terminations.
Planning for community physician services prior to deinstitutionalization of mentally retarded persons.
Authors: Minihan P M
Published: November 2008

This study assessed the need for physician services among a group of institutionalized mentally retarded individuals in anticipation of their transfer to community residential facilities and subsequent management of their care by community-based physicians. The clients' personal physicians in the institution identified every chronic condition which required physician services, and recommended the kind of physician and frequency of visits for the management of each condition. Key informants reviewed these estimates and determined if there were sufficient physicians in their communities to provide this care. Thirty-two per cent of the conditions but only 8 per cent of the clients could be managed by a primary care physician. The most frequently required specialties were neurology, orthopedics, and ophthalmology. While primary care services and many of the necessary specialty services were available in the community to meet the needs of these individuals, several specialties essential to the medical care of this group were not available. These included orthopedics for the multiply-handicapped, neurology including behavioral neurology, and psychiatry. Deinstitutionalization policies which rely solely upon community physician services will lead to inadequate medical care in the community for some mentally retarded individuals. In these situations, alternative approaches to care must be developed.
Lead poisoning: more than a medical problem.
Authors: Schneider D J , Lavenhar M A
Published: November 2008

Medical records of 236 Newark, New Jersey children hospitalized and chelated for lead poisoning in 1977 through 1980 were reviewed to determine whether or not any discernible progress had been made in eradicating the disease since 1972. Results show that the number of treated asymptomatic children, ages 1-6, began to rise after 1976 and was higher in 1980 than in 1972 when the Newark Lead Poisoning Prevention and Control Program first began. Although mean and peak blood lead levels have decreased over the nine-year period since 1972, signaling a lessening of disease severity, the increase in numbers and rates indicates that childhood lead poisoning still exists as an environmental and social problem.
Evidence of a reversal of the breastfeeding decline in Peninsular Malaysia.
Authors: Haaga J G
Published: November 2008

Data from the Malaysian Family Life Survey show an increase in the percentage of infants breastfed, at least initially, from 75 per cent in 1970-74 to 79 per cent in 1975-77. Contrary to what would be expected if Malaysia were following the trends observed in the United States and Western Europe, the increase has occurred among poor and uneducated women as well as among the more fortunate. The increase was especially marked for infants born in hospitals and private clinics, which had very low rates of breastfeeding in the early 1970s. The change may be due partly to a shift in the practices and recommendations of health professionals. Trends in infant feeding practices in Malaysia during the whole period 1950-77 are reviewed. Reasons for thinking the increase in the mid-1970s an artifact of the survey are presented and provisionally rejected. The implications of these findings for child health policy in Malaysia and for theories of infant feeding trends in developing countries are discussed.
The impact of the Mississippi Improved Child Health Project on prenatal care and low birthweight.
Authors: Strobino D M , Chase G A , Kim Y J , Crawley B E , Salim J H , Baruffi G
Published: November 2008

A quasi-experimental, nonequivalent control group design was used to evaluate the Improved Child Health Projects in northwest Mississippi (ICHP1 and ICHP2). Control counties were selected for each project that on average were similar to ICHP counties on racial composition, median family income in 1970 and 1980, and number of births in 1978-79. The study population comprised all resident births in the ICHP and control counties during a pre-ICHP period (1975-78) and the ICHP period (1979-81). The percentage of women with adequate prenatal care rose between the two periods for all counties; the rise was greater for the study than for the control counties for ICHP1; the reverse was found for ICHP2. For both projects, the low birthweight rate remained constant in the pre-ICHP and ICHP periods for the study and control counties. Adjustment for changes in the childbearing characteristics between the two periods did not alter these results. Community involvement in its development and coordination may explain ICHP1's impressive rise in the use of prenatal care.
A survey of Campylobacter and other bacterial contaminants of pre-market chicken and retail poultry and meats, King County, Washington.
Authors: Harris N V , Thompson D , Martin D C , Nolan C M
Published: November 2008

As part of a larger study to determine the flow of Campylobacter and Salmonella from food animals to humans during 1982-83, 1,936 swabs were collected for bacteriologic study from pre-market chickens, retail poultry, and other retail meats as well as from equipment and work surfaces used to process such foods. Of the 297 samples collected in a poultry processing plant, 56.6 per cent were positive for Campylobacter jejuni/coli (CJC), as were 23.1 per cent of the 862 retail chicken, and 17.2 per cent of the 29 retail game hen samples. CJC was found infrequently in retail turkey, pork, and beef samples. Contamination of retail and pre-market chicken with CJC appeared to increase as the week progressed, and in pre-market chicken, later in the day. Less than 5 per cent of the retail samples of poultry, beef, and pork were found to contain Yersinia or Salmonella. However, Salmonella was cultured from 14.8 per cent of the swabs taken from the processing plant with 68 per cent of 44 Salmonellas being isolated concurrently with CJC. Tetracycline resistance which was plasmid-mediated was the most common antibiotic resistance observed, and was carried by 23.8 per cent of all CJC isolates. Overall, 38.8 per cent of all CJC isolates were resistant to ampicillin, erythromycin, streptomycin, or tetracycline, either singly or in combination.
Sex and smoking differences in duodenal ulcer mortality.
Authors: Kurata J H , Elashoff J D , Nogawa A N , Haile B M
Published: November 2008

Data from the US Census Bureau and the National Center for Health Statistics suggest that differences in male and female smoking habits between 1920 and 1980 may have contributed to changes in duodenal ulcer mortality sex ratios. An attributable risk analysis suggests that between 43 per cent and 63 per cent of duodenal ulcer mortality for males results from smoking; the comparable figures for females being between 25 per cent and 50 per cent.