bluuebunny/crossref_metadata_2025 huggingface dataset:
Personality Disorder According to the ICD 9 and DSM III and Their Value in Court Reporting
Authors: Gayford J. J. , Jungalwalla H. N. K.
Published: January 2017

The historical background to classification of personality is briefly reviewed. A more detailed comparative account is given of the ICD 9 (1978) and the DSM III (1980) typological classifications of personality disorders. Their value in court reporting is discussed. A critical evaluation is made of personality typology. The conclusion is that in spite of certain defects they are a useful method of transmitting information and of making prognostications in forensic psychiatry.
Medical Concepts in Psychopathy and Violence
Authors: Weller M. P. I.
Published: January 2017

It is widely assumed that psychopathic behaviour arises from unsatisfactory parenting, but upbringing difficulties are equally apparent in other psychiatric disorders. The poor response to psychological treatments is noteworthy and organic features, of a specific type, have been implicated. The most recent evidence strongly supports earlier findings of a genetic factor. Damage or malfunction of the left temporal lobe of the brain, or of the frontal area, are associated with violent psychopathic behaviour. Dysfunction in these same areas has also been found in schizophrenic patients and there is a genetic relationship between psychopathy and schizophrenia. It is concluded that organic factors probably underpin some psychopathic behaviour, a situation which may affect our attitudes.
The Pathology of Sudden Death in Hypertensive Individuals
Authors: Copeland Arthur R.
Published: January 2017

A study of sudden death in hypertensive individuals was carried out with reference to the case files of the Office of the Medical Examiner of Metropolitan Dade County, Miami, Florida, USA, during 1984. All autopsied cases in which the primary or contributory cause of death included hypertensive cardiovascular disease or its sequelae (e.g. intracerebral haemorrhage) were collected. These autopsied cases were then analysed as to age, race, Hispanic surname, sex, cause of death listed on the death certificate, and alcohol content at autopsy. In addition, the total body height, total body weight, fresh heart weight and fresh kidneys weight were categorized as was the degree of patency of the coronary arteries. Furthermore, past medical history, duration of any illness, and any medication noted at the scene of death were also tabulated. Briefly, these 182 autopsied cases represented approximately half the 422 cases of hypertension examined by this office, and represented 7.2 per cent of autopsies performed in that year. Most cases involved persons over 40 years of age, having a non-Hispanic surname, being white and male, and who died from atherosclerosis and hypertension, hypertension alone, or intracranial haemorrhage, with negative blood alcohol present in 44.5 per cent of the cases studied. The mean heart weight was 504–5 gm (S.D. = 162 gm), the mean right kidney weight was 179.9 gm (S.D. = 52.4 gm) and the mean left-kidney weight was 183.6 gm (S.D. = 59 gm). Histologically, fibrosis of the heart and arteriolonephro-sclerosis or arteriolar sclerosis of the kidneys were frequently seen. Quantitatively, the degree of involvement of atheromatous plaque in the coronary arteries was evenly divided among all degrees of severity. Most cases had a past medical history conducive to developing hypertension for an undocumented amount of time. Medication at the scene of death was absent in 65 per cent of the cases. Furthermore, the blood pressure was not documented in 73.6 per cent of cases. Discussion follows concerning the role of the medical examiner in such cases and the nature of that material not frequently studied by clinicians.
Maternal Filicide in Hong Kong, 1971–85
Authors: Cheung P. T. K.
Published: January 2017

A retrospective study of all mothers charged with killing or attempted killing of their biological children during the period 1971 to May 1985 in Hong Kong was carried out. Adopting d'Orban's (1979) classification of maternal filicides into battering, mentally ill, neonaticide, unwanted child, retaliating and mercy-killing groups, a detailed analysis of offenders, victims, offences and legal dispositions was performed. Marked similarities and little differences are noted when our findings are compared with those of Western researchers. The commonest age group of mothers was 25–29 years. Most mothers were married. Mentally-ill mothers constituted the largest group and they were beset by social and marital problems. The next most common group were battering mothers who had similar violent family backgrounds and a multitude of other social stresses, as did battering mothers in the West. The most dangerous period for the victims appeared to be during the first six months. Methods of assault were similar to those found in the West but throwing the victim out of a high-rise building was also a common method here. Courts were generally lenient towards offenders, as in the West.
A Comparison of Political and Non-Political Murderers in Northern Ireland, 1974–84
Authors: Lyons H. A. , Harbinson H. J.
Published: January 2017

The case records of 106 persons charged with murder and referred to the authors for psychiatric assessment between 1974 and 1984 were examined and a 140-item questionnaire completed. Political murderers were found to be generally more stable than non-political murderers. Significant differences also emerged in the recommendations made by defence and prosecution psychiatrists.
Fronto-Cranial Suspension—An Unusual Form of Hanging
Authors: Crompton M. Rufus
Published: January 2017

This report concerns a case of an extremely unusual form of hanging, and attempts to explain the mechanism of death in such cases, and also its choice.
Paradoxical Undressing and Hypothermia
Authors: Sivaloganathan S.
Published: January 2017

This paper presents a study of the association between hypothermia and paradoxical undressing. Seventy per cent of the cases showed this feature in a series of 20 cases during an eight-year period.
The Blood Alcohol Concentration at Post-Mortem in 175 Fatal Cases of Alcohol Intoxication
Authors: Heatley M K , Crane J
Published: January 2017

The mean blood alcohol concentration (BAC) in 175 fatal cases of acute alcohol intoxication was found to be 355 mg/100 ml. This figure is less than that quoted in many standard textbooks on forensic medicine.

The BAC in fatal cases of acute alcohol intoxication complicated by aspiration was lower than in those cases where there was no evidence of aspiration at autopsy. In those individuals with a previous history of alcohol abuse the BAC causing death was found to be significantly higher than in those without a history of prolonged heavy alcohol consumption suggesting that a degree of tolerance to the effects of alcohol may be induced.
Computer-Assisted Learning in Morbid Anatomy
Authors: Cross Simon S , Laidler Peter
Published: January 2017

This article describes the objectives, design and performance of a computer program which provides a textual simulation of autopsies. The benefits of using this program to teach medical students about the procedures of autopsy diagnosis is discussed. This form of computer-assisted learning is also useful in introducing medical students to correct death certification: a neglected area of medical education.
Accidental Self-Strangulation in a Young Child—A Case Report and Review
Authors: Shepherd R T
Published: January 2017

The accidental self-strangulation of a child of 3 years is described. This is an unusual occurrence and has, in this case, resulted from a particular group of circumstances. The features of the case are presented and asphyxial deaths in youg children are reviewed. The dangers of loose wires, cords or other potential ligatures in or adjacent to sleeping or play areas is emphasized. That a relatively small amount of force is required to asphyxiate a child appears to be confirmed by this case.
Traumatic Sub-Arachnoid Haemorrhage as Part of the NAI Syndrome
Authors: Sivaloganathan S
Published: January 2017

Case of fatal traumatic subarachnoid haemorrhage, as part of non-accidental injury in children is reported. The possible mechanisms are discussed.
Pathological Aspects of Ricin Toxicity in Mammalian Lymph Node and Spleen
Authors: Leek M D , Griffiths G D , Green M A
Published: January 2017

In an earlier study (Griffiths et al., 1987) we demonstrated that two toxic plant proteins, ricin and abrin, bring about apoptotic rather than necrotic cell death in mammalian lymphoid tissues and intestine. Here we expand upon the previous study, and report further observations relating purely to ricin and its pathology in lymph node and spleen. Rats were injected with ricin and killed at time intervals, tissue being excised and examined by light or electron microscopy.

As well as previously reported apoptotic changes in the lymph node, we observed sinusoidal haemorrhage accompanied by erythrophagocytosis and loss of normal structure. With the aid of lymphocyte typing, we noticed a complete relocation of T and B lymphocyte populations, with destruction of B cells.

Follicular centres of the spleen exhibited similar pathology to that seen in lymph nodes, along with loss of lymphocytes in areas adjacent to the central artery of the peri-arteriolar lymphoid sheath (PALS).
Study of Squatting Facet/Extension of Talus in Both Sexes
Authors: Pandey S K , Singh Shamer
Published: January 2017

Extensions of the trochlear surface and facets of the neck tali, i.e. the effects of squatting stress induced bone-remodelling, have been studied in samples from a North Indian population and examined for differences with those from other geographic sectors. Further, size and side of occurrence of the facets and extensions were analysed. Various squatting effects on the talus are found to be more common in this zone in general and in females in particular. The differences are appraised in the sociophysiologic context of life style in the studied population. The study reasonably emphasizes the need for elaboration of impact, that stress induced bone remodelling may have on physical and sports performance especially that of the females and possible preventive and corrective measures.
Infanticide in Scotland
Authors: Marks M N , Kumar R
Published: January 2017

Details from Scottish Office records of all infants under a year who were the victims of homicide in Scotland during 1978–1993 are presented and compared with results from studies of infant homicide in England and Wales. Although Scottish homicide rates in the total population are much higher than those in England and Wales, the annual Scottish infanticide rate (43/million) is remarkably similar to that of England and Wales (45/million). In addition, characteristics of victims and perpetrators are also similar between the two regions. As with England and Wales, in Scotland the younger the infant the greater the risk of becoming the victim of homicide (83% were killed within 6 months of birth); male babies were more frequently killed than female ones; a parent was the most frequent perpetrator (93% of offences); mothers tended to kill neonates but for infants older than a day more fathers than mothers were recorded as the main accused. Mothers and fathers were convicted of similar offences but fathers were less likely to receive non-custodial sentences. Differences in sentencing appeared to be related to either gender-related differences in attributions as to the motivation for the offence, or to the level of violence used against the victim. Offences of mothers were most frequently recorded as being motivated by mental illness, those by fathers as due to rage. Fathers were more likely to have killed by kicking or hitting, mothers by some form of suffocation.
The Effect of the Community Care Act 1990 on Discharge from a Psychogeriatric Unit to Residential and Nursing Homes
Authors: Shah Ajit
Published: January 2017

This study compares the proportion of patients discharged to residential and nursing homes from a psychogeriatric unit and the length of hospital admissions before and after the introduction of the National Health Service and Community Care Act 1990. This Act appeared not to influence the proportion of patients discharged to residential and nursing homes and the length of hospital admission. A year after the introduction of this Act may be too soon to observe an effect as the actual implementation of the Act by the health and social services may take considerable time.
The Psychosocial Characteristics of Juvenile Sexual Offenders Referred to an Adolescent Forensic Service in the UK
Authors: Dolan M , Holloway J , Bailey S , Kroll L
Published: January 2017

Criminal statistics indicate that a high percentage of sexual offences are committed by perpetrators under the age of 18 years. Descriptive data based on a retrospective case note study of 121 juvenile sexual offender referrals to an adolescent forensic unit are presented. The results suggest that adolescents commit an array of offences and present with generalized adjustment difficulties. Conduct disorder was the most common diagnosis, while rates of mental illness were lower than in earlier studies. Abused as opposed to non-abused offenders experienced more dysfunctional upbringings and demonstrated higher rates of personal disturbance. Theoretical and treatment implications are discussed in relation to the available literature on adolescent sexual offending.
Behind Closed Doors
Authors: Sheehan Lindsay , Corrigan Patrick W. , Al-Khouja Maya A. , Lewy Stanley A. , Major Deborah R. , Mead Jessica , Redmon Megghun , Rubey Charles T. , Weber Stephanie
Published: January 2017

Many thousands of families lose a loved one to suicide each year. The stigma experienced by family survivors threatens to further burden families and impede the grieving process. This study used a community-based participatory research process to explore the family stigma of suicide from a social-cognitive perspective. We describe a secondary analysis of qualitative data focusing on stigma directed at bereaved families. Thematic analysis of focus group data ( n = 62) resulted in themes describing stereotypes, prejudice, and discrimination. Bereaved families were viewed as contributing to their loved ones death through abuse, neglect, denial, or failure to provide adequate help. Bereaved families were seen as emotionally strong, victims of the suicide, or as contaminated by their association. Families encounter pressure to keep the suicide a secret and experience withdrawal of support systems. Results suggest needs for evidence-based programs to address both public and internalized stigma experienced by bereaved families.
A Review on Time Perception of Death Row Inmates’ Denials in Their Last Statements in the Context of Forensic Linguistics
Authors: Uysal Basak
Published: January 2017

This study aims to find out the time perception used in the denials in the last statements of 70 death row inmates, who were executed in Texas Huntsville Unit between 1982 and 2016. To accomplish this, the tenses in their last statements were specified, and their distribution was demonstrated on a horizontal timeline. Document analysis, which is one of the qualitative research methods, was utilized as the data collection tool of the study. The main data obtained from the results of the study suggest that the following 429 death row inmates out of 537 used their right for the last statement; however, 108 of them did not state anything. A total of 70 of the 429 death row inmates denied the crimes, of which they were convicted with execution, in their last statements. When the age range is taken into consideration, it is clear that the distribution of simple tenses and the distribution of compound tenses are very close to each other. The simple tense is used the least by the 60 to 70 age-group, whereas it is mostly used by 20 to 30 age-group. Considering their education level in addition to their age range, it is observed that the highest education level is that of the 60 to 70 age-group. The most frequently used tense in the last statements of death row inmates is simple tense; however, simple present tense is used as the most common tense overall. As the timeline progresses toward the future, expectations and affirmation exist in the meaning of the sentences.
Chronic Illness with Complexity
Authors: Hash Joanne , Bodnar-Deren Susan , Leventhal Elaine , Leventhal Howard
Published: January 2017

The present study examines how different chronic illnesses and mental illness comorbidity (chronic illness with complexity [CIC]) associate with components of advance care planning (ACP). We also explore the role self-perceived burden plays in the relationship between illness and ACP. Data were gathered from a cross-sectional survey of 305 elderly participants from the New Jersey End-of-Life study. Participants with diabetes and those with cardiovascular disease (CVD) are less likely, while participants with CIC are more likely, to plan for the end-of-life. Participants with diabetes are less likely to make formal plans, whereas those with CVD are less likely to hold informal discussions. CIC is associated with increased odds of having an advance directive, but no other form of ACP. Self-perceived burden did not appear to be the gateway by which illness groups differentially engaged in ACP. Future research should investigate what aspects of illnesses drive ACP.
Event Centrality and Bereavement Symptomatology: The Moderating Role of Meaning Made
Authors: Bellet Benjamin W. , Neimeyer Robert A. , Berman Jeffrey S.
Published: January 2017

The centrality of a loss to a bereaved individual’s identity is associated with greater symptomatology, whereas meaning made of a loss is associated with positive outcomes. This article examines meaning made as a moderator of the relationship between event centrality and symptomatology. Our sample consisted of 204 bereaved undergraduate university students. Centrality was assessed using the Centrality of Events Scale, meaning made was assessed using the Integration of Stressful Life Experiences Scale, and symptomatology was assessed using the posttraumatic stress disorder Checklist-Civilian and Inventory of Complicated Grief-Revised. Meaning made had a significant moderating effect on the relationship between centrality and both measures of symptomatology. At lower levels of meaning made, centrality had a strong and positive association with symptomatology; at higher levels of meaning made, this association became weaker. These results suggest that meaning made is the key to understanding how centrality affects bereavement outcomes.
Voices We Forget—Danish Students Experience of Returning to School Following Parental Bereavement
Authors: Lytje Martin
Published: January 2017

This study explores how Danish students experience returning to school following parental bereavement. Eighteen focus group interviews with 39 participants aged 9 to 17 years were conducted. All participants had experienced the loss of a primary caregiver. Data collection was divided into two phases. In Phase I, 22 participants from four grief groups were interviewed 4 times over the course of a year. During Phase II, confirmatory focus groups were undertaken with the 17 participants. This article explores findings related to the four themes of initial school response, long-term support, challenges within the class, and academic challenges. The study found that (a) students struggle to reconnect with classmates following the return to school and often feel alone, (b) schools fail to have guidelines in place for what they are allowed to do if becoming sad the class, and (c) schools seem to forget their loss as time passes.
A Model of Transcorporeal Communication: Communication Toward/With/to the Deceased
Authors: DeGroot Jocelyn M.
Published: January 2017

Research indicates that people maintain a connection with deceased loved ones, which can be healthy for the bereaved individuals. To maintain these bonds, people readily admit to communicating with the deceased. Although communication with the deceased shares similarities with traditional models of interpersonal communication, it is distinctly different. Interviews with 20 individuals revealed support for a model of transcorporeal communication, communication to people who do not maintain a physical presence. This communication includes the components of sender, inner representation of the deceased as receiver, message, feedback based on what the sender believes the deceased would say, and a metaphysical element. Implications of transcorporeal communication for griefwork are also discussed.
Throwing Skills
Authors: Ghorbani Saeed , Bund Andreas
Published: January 2017

Traditionally, motor learning scientists have evaluated the process of learning a new motor skill by considering the skill as a whole. Yet, motor skills comprise various phases, and in the motor learning literature, it is not clear whether new learners show similar or different learning across various phases. We provide exploratory data on learning movement phases by novices, using baseball pitching as the learning task. Eight participants (four male, four female, M age = 23.7 years, SD = 2.4) performed five trials each in the pretest followed by three blocks of 10 trials each in the acquisition phase. Finally, two retention tests of five trials were conducted by each participant 10 minutes and seven days after the last acquisition block, respectively. Intra- and interlimb coordination of upper and lower body segments were measured as dependent variables. We found significant differences between the stride phase and the other phases at pretest, during the acquisition phase, and on both retention tests across all kinematic variables. Participants experienced more trouble coordinating the stride phase than the other phases of pitching, perhaps because the stride phase is the only phase in which the participants had to move their upper and lower body parts simultaneously. We discuss implications for motor learning generally.
Understanding Serial Killing: How Important are Notions of Gender?
Authors: Ashburner Elizabeth , Soothill Keith
Published: January 2017

To understand serial killing, we must move beyond the individual and consider background structural and cultural factors. Elliot Leyton's structural approach is seductive but problematic. In analysing serial killing as a cultural phenomenon, Mark Seltzer points to the United States as an information society characterised by ‘wound culture’. However, theorists have largely neglected the area of gender. Serial killing illustrates the nature of gender relations within our culture. Nevertheless, feminist theories and texts tend to focus solely on men murdering women, but such approaches need to be extended to cover the whole spectrum of serial killing, whether it involves heterosexual or homosexual relations, male or female killers. To understand why one individual becomes a serial killer while another will not there is a need to combine sociological and individual approaches. Using Tony Jefferson's concept of subjectivity, which combines social and psychoanalytical influences on human behaviour, is one way forward in trying to explain the phenomenon of serial killing.
Anti-Corruption Reforms in the Police: Current Strategies and Issues
Authors: Moran Jon
Published: January 2017

During the 1990s a number of high-profile corruption cases, involving police officers engaging in serious criminal activity, merged with wider debates on police integrity. This article examines the anti-corruption strategies employed by the Metropolitan Police and Merseyside Police. Some current risk areas of corruption are examined and then the roles of dedicated anti-corruption units, preventive measures and other techniques are discussed. What appears qualitatively different about the current approach of these two services is the internal commitment which is reflected in the operations of a dedicated anti-corruption unit, the development of preventive measures and the recognition that a successful anti-corruption unit should operate in a developing system of overall ‘professional standards’. The latter includes the development of a series of managerial, organisational and procedural systems extending throughout the organisation.
‘You have the right to remain silent’
Authors: Race Leanne , Hogue Todd E
Published: January 2017

Action on Hearing Loss explain that 11 million people within the UK are affected by hearing loss and this is expected to rise to 15.6 million by 2035 (Action on Hearing Loss, 2016). In 2011, a Strategic Command Course publication for Sign Health stated that services for D/deaf people within the criminal justice system needed improving and advised increasing the number of regional Police Link Officer for the Deaf (PLOD) schemes within police forces (Walton et al., 2011). This paper describes a study that used a questionnaire survey to investigate levels of D/deaf awareness amongst Police Crime Commissioners (PCCs) and police officers and their attitudes towards D/deafness, as well as their specific awareness relating to PLOD schemes. The D/deaf community were also surveyed to assess their communication preferences when liaising with the police and their previous experiences of police contact. Eighteen PCCs, 75 police officers and 15 members of the D/deaf community were included in the analysis. Results found a lack of awareness amongst all participants regarding PLOD schemes, differences between communication methods being used and those that are preferred, with only 11% of respondents from the D/deaf community reporting their experience with the police as ‘good’. The study also found a significant correlation between police officer participation in a D/deaf awareness courses and improved attitudes towards D/deafness. It is evident that policies exist to enhance the quality and accessibility of services for D/deaf people, but what remains to be explored is the availability and awareness of existing provisions.
Speaking in Public
Authors: Williams Dorian
Published: January 2017

Speaking in public so often falls to police officers nowadays that we felt our readers would like to have the benefit of the advice of a distinguished practitioner of the art. Mr. Dorian Williams is known to many millions by his television commentaries: he is also known to many thousands of police officers, for he has lectured at the Police College ever since its foundation in 1948 and to police audiences all over the country. He thus writes with a unique familiarity with police needs.
Police Education: Scottish Advance
Authors: Le Cheminant J.
Published: January 2017

Mr. Le Cheminant's article is both an answer to “Maxwell” in our June, 1969, issue and an up-dating of the information given in Inspector McIntosh's article in our May, 1968, issue.
The Age of Crime
Authors: Rollo J.
Published: January 2017

A Scottish police officer gives his conclusions on a piece of criminological research into the records of his force.
The Role of Gallery Ranges
Authors: Busch Ted
Published: January 2017

An American expert, author of a forthcoming book, “Facts, Fads and Fallacies about Shooting Ranges”, contributes his views on firearms training.
Firearm Homicide and Firearm Suicide: Opposite but Equal
Authors: Branas Charles C. , Richmond Therese S. , Schwab C. William
Published: January 2017

Objective.

Homicide and suicide are intentional acts of violence that disproportionately involve firearms. Much more effort has been devoted to the ecological study of homicide; methods that have been developed to better understand and subsequently prevent homicide may be applicable to suicide. The purpose of the present study was to compare the occurrence of firearm homicide and firearm suicide using routine activity theory as a framework for analysis.

Methods.

Detailed mortality data pertaining to decedents, their neighborhoods, and use of firearms were collected from 1994 to 1998 for the counties containing and surrounding three small to medium-sized U.S. cities. Data from a total of 468 neighborhoods that collectively experienced 1,025 intentional deaths from firearms (396 firearm homicides and 629 firearm suicides) were analyzed.

Results.

Firearm homicide was consistently associated with out-of-home, nighttime activity in neighborhoods where many people were likely to be coming and going. In an opposite-but-equal fashion, firearm suicide was consistently associated with in-home, daytime activity in out-of-the-way neighborhoods.

Conclusions.

Firearm homicide and firearm suicide were found to be consistently associated with markers of routine activity in all three cities, albeit in an opposite-but-equal manner. Because firearm suicides very often occur as lonely events in lonely neighborhoods, they may go under-noticed relative to firearm homicides. More awareness and additional public health studies of firearm suicide, in tandem with firearm homicide, should be pursued to better identify individuals and neighborhoods that are at greatest risk of experiencing each event.
Development of Guidelines on Nonoccupational HIV Postexposure Prophylaxis for the State of Rhode Island
Authors: Merchant Roland C. , Mayer Kenneth H. , Browning Carol A.
Published: January 2017

The Brown University AIDS Program and the Rhode Island Department of Health joined with health care practitioners, researchers, and representatives of community-based health, social service, and advocacy organizations to create comprehensive guidelines on nonoccupational HIV postexposure prophylaxis for the state of Rhode Island. These guidelines offer health care practitioners detailed advice on the evaluation and management of blood or body fluid exposures outside the health care setting, e.g., through sexual assault, consensual sex, injecting-drug use, or needlestick injuries. In these circumstances, HIV postexposure prophylaxis serves those for whom primary prevention measures have failed or were impractical or impossible.

The guidelines represent the end product of coordination among private and public, academic and nonacademic, clinician and layperson groups committed to decreasing the incidence of HIV infections in the state of Rhode Island. The guidelines serve as both a resource for health care practitioners and a means of educating them on this method of HIV prevention.
An Innovative Blood Lead Screening Program for Indian Children
Authors: Howell Embry M. , Russette Loretta
Published: January 2017

There is little information on the lead levels of Indian children nationally. In the late 1990s, members of the Chippewa and Cree tribes living on the Rocky Boy Reservation near Box Elder, Montana, were concerned about environmental pollution and how it might be affecting the health of their children. With financial assistance from the Environmental Protection Agency, the tribes designed and implemented an innovative lead screening program for young children. Because most children on the reservation participated in WIC and Head Start, those programs were used to indentify and screen close to 100% of young children on the reservation. The average blood lead level for children ages 1–5 on the Rocky Boy reservation was 2.4μg/dL, which is not significantly different from that of children of the same age nationally.

The project showed that Indian families will participate readily in screening programs that may improve their children's health.
Impact of Health Insurance Status on Vaccination Coverage in Children 19–35 Months Old, United States, 1993–1996
Authors: Zhao Zhen , Mokdad Ali H. , Barker Lawrence
Published: January 2017

Objectives.

To show how health insurance (privately and publicly insured, insured and uninsured) relates to vaccination coverage in children 19–35 months old, and how this can be used to better target public health interventions.

Methods.

The National Health Interview Survey (NHIS) gathers information on the health and health care of the U.S. non-institutionalized population through household interviews. The authors combined immunization and health insurance supplements from the 1993 through 1996 NHIS, and classified children 19–35 months old by their immunization and insurance status. Results were compared using both bivariate and multivariate analyses, and the backwards stepwise selection method was used to build multivariate logistic regression models.

Results.

Uninsured children tended to have lower vaccination coverage than those who had insurance, either private or public. Among those with insurance, publicly insured children had lower vaccination coverage than privately insured children. Backwards stepwise regression retained insurance status, metropolitan statistical area, and education of responsible adult family member as major predictors of immunization. Factors considered but not retained in the final model included child race/ethnicity, family poverty index, and region of country.

Conclusions.

Insurance status was a critical predictor of vaccination coverage for children ages 19–35 months. After controlling for confounders, the uninsured were about 24% less likely to receive all recommended shots than the insured and, among the insured, those with public insurance were about 24% less likely to receive all recommended vaccines than those with private insurance.
Occurrence of Low Birthweight and Preterm Delivery among California Infants before and after Compulsory Food Fortification with Folic Acid
Authors: Shaw Gary M. , Carmichael Suzan L. , Nelson Verne , Selvin Steve , Schaffer Donna M.
Published: January 2017

Objectives.

Studies suggest that folic acid intake influences the occurrence of low birthweight and preterm delivery. Since 1998, there has been compulsory fortification of flour and other grains with folic acid in the U.S. The objective of this study was to investigate the frequencies of low birthweight and preterm delivery after mandatory folic acid fortification among approximately six million California births.

Methods.

The authors investigated prevalences of low birthweight and preterm delivery before and after compulsory fortification among 5,916,630 singleton California live births that occurred from January 1990 through December 2000.

Results.

The unadjusted prevalences of very low birthweight, low birthweight, and preterm delivery did not substantially vary across birth years. That is, substantial decreased prevalences during the fortification period relative to the period preceding it were not observed. However, analyses that simultaneously adjusted for maternal age, parity, race/ethnicity, education, year of birth, and fortification period revealed the following relative risk ratios (RR) and 95% confidence intervals (CI): RR=0.91, CI 0.88, 0.94 for very low birthweight, RR=0.94; 95% CI 0.93, 0.96 for low birthweight, and RR=0.96; 95% CI 0.94, 0.97 for preterm delivery.

Conclusion.

Findings indicate small reductions in prevalences of these outcomes associated with the timing of fortification of the U.S. food supply.
Prostate Cancer Incidence and Mortality Rates and Trends in the United States and Canada
Authors: McDavid Kathleen , Lee Judy , Fulton John P. , Tonita Jon , Thompson Trevor D.
Published: January 2017

Objective.

The purpose of this study was to compare prostate cancer incidence and mortality trends between the United States and Canada over a period of approximately 30 years.

Methods.

Prostate cancer incident cases were chosen from the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Program to estimate rates for the United States white males and from the Canadian Cancer Registry for Canadian men. National vital statistics data were used for prostate cancer mortality rates for both countries, and age-adjusted and age-specific incidence and mortality rates were calculated. Joinpoint analysis was used to identify significant changes in trends over time.

Results.

Canada and the U.S. experienced 3.0% and 2.5% growth in age-adjusted incidence from 1969–90 and 1973–85, respectively. U.S. rates accelerated in the mid- to late 1980s. Similar patterns occurred in Canada with a one-year lag. Annual age-adjusted mortality rates in Canada were increasing 1.4% per year from 1977–93 then fell 2.7% per year from 1993–99. In the U.S., annual age-adjusted mortality rates for white males increased 0.7% from 1969–1987 and 3.0% from 1987–91, then decreased 1.2% and 4.5% during the 1991–94 and 1994–99 periods, respectively.

Conclusions.

Recent incidence patterns observed between the U.S. and Canada suggest a strong relationship to prostate-specific antigen (PSA) test use. Clinical trials are required to determine any effects of PSA test use on prostate cancer and overall mortality.
Team Epi-Aid: Graduate Student Assistance with Urgent Public Health Response
Authors: MacDonald Pia D.M.
Published: January 2017

Team Epi-Aid provides graduate students with practical public health experience through participation in outbreak investigations and other applied projects with state and local health departments in North Carolina. It is an initiative of the North Carolina Center for Public Health Preparedness in the North Carolina Institute for Public Health at the University of North Carolina School of Public Health. The program allows state and local health departments access to volunteers and technical expertise from the university when they need assistance. It requires close collaboration with state and county health departments. Team Epi-Aid provides the opportunity for integrated learning with students and faculty within the departments of the School of Public Health, and through recent expansion, within the schools of Medicine and Pharmacy. Orientations are conducted each semester and formal training is provided as needed. Team Epi-Aid has been popular, with 58 active student participants contributing 1,465 hours of service during the initiative's first 21 months.
Educating Health Professionals to Respond to Bioterrorism
Authors: McKinney W. Paul , Wesley Gina C. , Sprang Mary V. , Troutman Adewale
Published: January 2017

In September 2003, a consortium of bioterrorism and health education experts from the University of Louisville, the University of Kentucky, the Kentucky Department for Public Health, and the Louisville Metro Health Department received funding from the Health Resources and Services Administration (HRSA) to develop a broadly based bioterrorism education program for health professionals in the Commonwealth of Kentucky and the surrounding region. This grant will fund a series of presentations tailored to the needs of professionals in medicine, dentistry, public health, nursing, behavioral medicine, allied health, pharmacy, veterinary medicine, and agriculture, providing coordinated training both on site and through distance learning technology. This article outlines the major grant-funded activities envisioned for the grant years 2003 through 2005, focusing on the use of standardized patients and computerized biosimulators, the transdisciplinary partnerships of the universities involved, and the essential collaboration provided by the state and local health departments.
An Innovation in Partnership among First Responders and Public Health: Bridging the Gap
Authors: Werner Danilea , Wright Kathleen , Thomas Mike , Edgar Mark
Published: January 2017

To properly prepare for and respond to bioterrorism and other urgent public health threats and emergencies, response disciplines must work together in well coordinated efforts to address the preparedness needs of their communities and the nation. Traditional public health workforce and first responder roles have been challenged and new partnerships have emerged, increasing the need for innovative education and training. This article provides a review of an approach the Heartland Center for Public Health Preparedness took to foster these partnerships and increase the provision of competency-based, integrated responder education and training in the St. Louis, MO, metropolitan area.
Partnering for Preparedness: The Project Public Health Ready Experience
Authors: Estrada Librada C. , Fraser Michael R. , Cioffi Joan P. , Sesker DeAnne , Walkner Laurie , Brand Michael W. , Kerby Dave S. , Johnson David L. , Cox Gary , Brewer Lou
Published: January 2017

Effective partnerships between local and state public health agencies and schools of public health have tremendous potential to improve the health of communities nationwide. This article highlights successful collaboration between local public health agencies (LPHA), state health departments, and Academic Centers for Public Health Preparedness (ACPHP) in schools of public health developed through participation in Project Public Health Ready, a program to recognize LPHA emergency preparedness. The project's pilot phase illustrated that LPHAs, state health departments, and ACPHP can effectively work together to improve individual public health worker competency and organizational response capacity in local public health agencies nationwide.
Public Health and Terrorism Preparedness: Cross-Border Issues
Authors: Olson Debra , Leitheiser Aggie , Atchison Christopher , Larson Susan , Homzik Cassandra
Published: January 2017

On December 15, 2003, the Centers for Public Health Preparedness at the University of Minnesota and the University of Iowa convened the “Public Health and Terrorism Preparedness: Cross-Border Issues Roundtable.” The purpose of the roundtable was to gather public health professionals and government agency representatives at the state, provincial, and local levels to identify unmet cross-border emergency preparedness and response needs and develop strategies for addressing these needs. Representatives from six state and local public health departments and three provincial governments were invited to identify cross-border needs and issues using a nominal group process. The result of the roundtable was identification of the needs considered most important and most doable across all the focus groups. The need to collaborate on and exchange plans and protocols among agencies was identified as most important and most doable across all groups. Development of contact protocols and creation and maintenance of a contact database was also considered important and doable for a majority of groups. Other needs ranked important across the majority of groups included specific isolation and quarantine protocols for multi-state responses; a system for rapid and secure exchange of information; specific protocols for sharing human resources across borders, including emergency credentials for physicians and health care workers; and a specific protocol to coordinate Strategic National Stockpile mechanisms across border communities.
Competency Mapping and Analysis for Public Health Preparedness Training Initiatives
Authors: Calhoun Judith G. , Rowney Rosemarie , Eng Emilie , Hoffman Yael
Published: January 2017

Competency-based education and assessment initiatives have been completed in a number of health care and health management professions during the past decade. In addition, several competency specification endeavors have been similarly undertaken in relation to the field of public health, including the development of the Council on Linkages between Academia and Public Health Practice competency model and the initial competency modeling Delphi survey completed by the Association of Schools of Public Health. All of these organizations have subsequently had to address the many challenges and barriers to the dissemination and integration of their models into specific educational and professional development practices. As previously addressed by many researchers in the field of competency modeling and deployment, understanding and acceptance of competency-based systems are formidable goals, often rife with controversy. This article describes the processes undertaken by The University of Michigan Center for Public Health Preparedness to integrate competency-based learning and assessment in educational and training initiatives with its many community partners.
Nevada's Academic-Practice Collaboration: Public Health Preparedness Possibilities outside an Academic Center
Authors: Clements-Nolle Kristen , Ballard-Reisch Deborah S. , Todd Randall L. , Jenkins Tia
Published: January 2017

The Nevada State Health Division developed a local academic-practice partnership with the University of Nevada Reno's Master of Public Health Program to assess the bioterrorism risk communication, information, response, and training needs of professional and public stakeholder groups throughout Nevada. Between October 16, 2002, and April 13, 2004, 22 needs assessment focus groups and 125 key informant interviews were conducted to gather information on the diverse needs of the stakeholders. The themes that emerged from these activities included the need for effective pre-event education and training; a coordinated and responsive public health preparedness infrastructure; honest, accurate, and timely communication in the event of a bioterrorism situation; and appropriate information dissemination methods and technology. The data collected through this needs assessment gave the Nevada State Health Division vital information to plan public health preparedness initiatives. The establishment of local academic-practice partnerships for states without a Centers for Disease Control and Prevention-funded Academic Center for Public Health Preparedness is an effective way for health departments to develop their public health preparedness infrastructure while simultaneously training the future public health workforce.
Does Literacy Mediate the Relationship between Education and Health Outcomes? A Study of a Low-Income Population with Diabetes
Authors: Schillinger Dean , Barton Lauren R. , Karter Andrew J. , Wang Frances , Adler Nancy
Published: January 2017

Objectives.

We sought to determine whether literacy mediates the relationship between education and glycemic control among diabetes patients.

Methods.

We measured educational attainment, literacy using the Short Test of Functional Health Literacy in Adults (s-TOFHLA), and glycemic control (HbA1c) in 395 diabetes patients at a U.S. public hospital. We performed path analysis to compare two competing models to explain glycemic control. The direct effects model estimated how education was related to HbA1c; the mediational model estimated the strength of the direct relationship when the additional pathway from education to literacy to HbA1c was added.

Results.

Both the model with a direct effect of education on HbA1c and the model with literacy as a mediator were supported by good fit to observed data. The mediational model, however, was a significant improvement, with the additional path from literacy to HbA1c reducing the discrepancy from observed data ( p<0.01). After including this path, the direct relationship between education and HbA1c fell to a non-significant threshold.

Conclusions.

In a low-income population with diabetes, literacy mediated the relationship between education and glycemic control. This finding has important implications for both education and health policy.