bluuebunny/crossref_metadata_2025 huggingface dataset:
Neonatal mortality: an analysis of the recent improvement in the United States.
Authors: Lee K S , Paneth N , Gartner L M , Pearlman M A , Gruss L
Published: November 2008

To test the hypothesis that the recent substantial decline in the United States neonatal mortality rate (20.0/1000 in 1950 to 11.6/1000 in 1975) is associated with improvements in perinatal medical care, we examined this change in relation to the two primary components which determine neonatal mortality: birthweight distribution and birthweight-specific mortality. No improvement in the weight distribution of U.S. live births has occurred during this 25-year period, indicating that the change in neonatal mortality is attributable to improved survival for one or more birthweight groups. Decline in the mortality rate in the first 15 years was slow; three-fourths of the decline in the entire 25-year period occurred since 1965. With the exception of perinatal medical care, factors known to affect survival at a given birthweight have not changed in prevalence in the 25-year period. It is a plausible hypothesis that improved perinatal medical care is a major factor in declining neonatal mortality in the U.S.
A model for the incorporation of alumni-faculty feedback into curriculum planning.
Authors: Clemmer D I , Bertrand W E
Published: November 2008

Recent changes in the scope and nature of public health jobs and the characteristics of public health students prompted the development and testing of a strategy for curriculum planning based on information obtained from alumni and faculty. Identification of job activities viewed as important by both faculty and alumni for the largest number of job groups suggested a management-oriented core curriculum which could be supplemented by skills and knowledge related to the type of job which the student was preparing to enter.
Use of a monthly health review to ascertain illness and injuries.
Authors: Jenkins C D , Kreger B E , Rose R M , Hurst M
Published: November 2008

A Monthly Health Review was developed to monitor symptoms, illnesses and injuries among Air Traffic Controllers. Return rate of the mailed check-list exceeded 90 per cent. Diagnoses were generated from symptom clusters by computer algorithms. Telephone interview by physicians, laboratory analyses for serum pepsinogen I, and analyses of relations between symptom clusters and degree of disability all served to support the validity of the methodology. Such a system can provide inexpensive surveillance of morbidity in suitable populations.
The prevalence of intestinal parasites in Puerto Rican farm workers in western Massachusetts.
Authors: Ortiz J S
Published: November 2008

A parasitic surveillance of farm workers of Puerto Rican background and their children revealed a high prevalence rate (35.5%) of parasites in this population. This high prevalence rate, however, was expected in view of the fact that other researchers have found a high degree of parasitosis in Puerto Rican populations residing on the US mainland. However, the prevalence rate was almost double that reported by Winsberg, et al, for the urban population, thus suggesting a higher degree of exposure to the migrant worker than to his counterpart living in the cities. Two cases of hookworm infections were detected in children born in the United States who had never traveled outside the area, thus confirming that there is ample opportunity for the transmission of pathogenic parasites on farms, and also suggesting that migrant workers must live under poor sanitary conditions.
Measles mortality in the United States 1971-1975.
Authors: Engelhardt S J , Halsey N A , Eddins D L , Hinman A R
Published: November 2008

During 1971-75, an average of 35.4 measles-related deaths were recorded each year; one death for every 1,000 measles cases reported. Measles mortality rate was highest in children under 1 year of age, as was the death-to-case ratio. Mortality rates were higher in non-metropolitan than in metropolitan counties. Measles mortality rates were inversely related to median family income.
A survey of canine toxocariasis and toxocaral soil contamination in Essex County, New Jersey.
Authors: Surgan M H , Colgan K B , Kennett S I , Paffmann J V
Published: November 2008

Toxocara canis eggs were found in the feces of 33 of 246 dogs and in two of 629 soil samples from 32 public parks in Essex County, New Jersey. Stool samples collected from these areas were free of T. canis eggs. The findings suggest that contamination of soil in public parks with T. canis eggs is not an important factor in the transmission of visceral larva migrans in this county.
The incidence and economic costs of cancer, motor vehicle injuries, coronary heart disease, and stroke: a comparative analysis.
Authors: Hartunian N S , Smart C N , Thompson M S
Published: November 2008

The economic impact of disease and injury has most often been calculated by examining the costs associated with the prevalence of the impairments in the reference year. An alternative accounting approach is to assign all disease costs to the year of incidence, an approach which entails present-valuing to the year of incidence both health care expenditures and lost productivity. The incidence approach is the more appropriate for gauging the economic gains achievable through prevention, immediate rehabilitation, and arresting progression. Incidence-based costs have been estimated for the United States in 1975 for cancer, coronary heart disease, motor vehicle injuries, and stroke. A noteworthy finding is the relative economic importance of motor vehicle injuries, which frequently have been overlooked in the ordering of public health expenditure priorities. After cancer, which generated approximately $23.1 billion in present-valued costs in 1975 (discounted at 6 per cent), motor vehicle injuries and coronary heart disease constitute the next most expensive conditions--having generated estimated annual costs of $14.4 billion and $13.7 billion, respectively. Stroke, at $6.5 billion, follows in economic importance.
A breast self-examination program for high school students.
Authors: Carstenson R , O'Grady L F
Published: November 2008

Breast self-examination (BSE) is an important adjunct to the detection of breast cancer at an early stage. High school students were instructed in the importance and methods of BSE. By use of questionnaires, the program was evaluated for interest, acceptability, and compliance. It was found that high school students were not adverse to learning about BSE, found the program acceptable, and maintained some compliance at one year.
Seasonal variation in spontaneous abortions.
Authors: Warren C W , Gold J , Tyler C W , Smith J C , Paris A L
Published: November 2008

Using a national sample of hospital discharges, we found identical seasonal patterns for spontaneous abortions and conceptions but no significant seasonal variation in the rate of spontaneous abortions per 1,000 conceptions. The differences between our findings and those of previous investigators of spontaneous abortion may reflect our more comprehensive definition of spontaneous abortion, our more complete estimate of the monthly number of conceptions, and our more rigorous statistical analysis. The periodic regression analysis (PRA) reported in our study may be useful in other studies that monitor short-term trends.
The concept and measurement of continuity in primary care.
Authors: Rogers J , Curtis P
Published: November 2008

Continuity of care, a stated fundamental principle of family medicine, is reviewed in terms of its philosophy and definitions. A model of continuity in primary medical practice is proposed, consisting of five elements: the provider, consumer, encounter type, knowledge base, and environment of continuity. The elements are measurable, some more easily than others. There is need to define and operationalize the model more accurately in order to evaluate continuity in primary care medicine.
Anti-rabies treatments in New Mexico: impact of a comprehensive consultation-biologics system.
Authors: Mann J M , Burkhart M J , Rollag O J
Published: November 2008

Fewer than 20% of the 30,000 anti-rabies treatments administered in the United States each year are necessary. New Mexico established a comprehensive consultation-biologics program to assist physicians in making appropriate and systematic rabies treatment decisions. In 1978, 32 individuals received anti-rabies treatments as the result of 144 physician consultation requests. Dog and cat exposures accounted for 70 per cent of consultations and 63 per cent of the treatments. A seasonal peak of both consultations and treatments was observed in the summer and early autumn. The cost of biologics was $212 per treatment. Coordinated use of laboratory diagnostic services and animal control resources obviated the need for treatment in over 60 per cent of the 112 consultations not resulting in treatment. Experience in 1978 suggested that the system was probably responsible for a greater than five-fold reduction in the annual rate of anti-rabies treatments in New Mexico. Efficient physician utilization and high acceptability of the program may be attributed to maximization of private sector input into design and implementation of this public health program.
Smoking and chronic respiratory symptoms: prevalence in male and female smokers.
Authors: Liard R , Perdrizet S , Correman J , Bidou S
Published: November 2008

The relationship between respiratory symptoms and smoking habits, according to sex, was studied in 899 adults (average age 39, 55 per cent male) in a Paris industrial medical center. The relative risk of having chronic bronchitis among smokers, compared to nonsmokers, was higher in females (3.3) than in males (1.6). The prevalence of chronic respiratory symptoms, dyspnoea and wheezing was more closely associated with the number of cigarettes smoked per day in females than in males. No confounding factor was found to be responsible for these results.
Cigarette smoking and age at natural menopause.
Authors: Kaufman D W , Slone D , Rosenberg L , Miettinen O S , Shapiro S
Published: November 2008

In a cohort of 656 naturally postmenopausal women who were interviewed at age 60 to 69 years, and was had reached their menopause between the ages of 35 and 59 years, the mean age at menopause declined with increasing number of cigarettes smoked, from 49.4 years of age among women who had never smoked to 47.6 years of age among women who smoked at least 15 cigarettes per day (p less than 0.02). The relationship was not attributable to the onset of menopause inducing women to take up smoking.
Crash involvement of teenaged drivers when driver education is eliminated from high school.
Authors: Robertson L S
Published: November 2008

In 1976, Connecticut eliminated state funding for high school driver education and nine school systems dropped the courses from their high school curricula. This research examined the effect of this action on overall licensure of 16-17 year old drivers in communities that dropped the course to those in similar sized communities that retained the driver education course using local funds. Substantial reductions in the numbers of 16-17 year olds who became licensed occurred in the communities that dropped the course. As a result, the numbers of crashes involving 16-17 year olds resident in such communities were also substantially reduced. The conclusion of previously reported research that high school driver education is a major contributor to earlier licensure and accompanying crash involvement of the 16-17 year old population is supported by this additional evidence.
Reliability of the health hazard appraisal.
Authors: Sacks J J , Krushat W M , Newman J
Published: November 2008

As part of a controlled clinical trial of Health Hazard Appraisal's (HHA) efficacy in stimulating risk reduction, the reliability of the HHA questionnaire was evaluated. Of 203 subjects, only 30 (15%) had no contradictions when comparing the responses of the follow-up with baseline questionnaire. Overall, there was an average of 1.6 contradictions per subject. Failure to control for reliability may account for apparent reduction of risk reported in previous studies of HHA.
Adolescent contraceptive use: comparisons of male and female attitudes and information.
Authors: Freeman E W , Rickels K , Huggins G R , Mudd E H , Garcia C R , Dickens H O
Published: November 2008

Information and attitudes about contraception and pregnancy were assessed with a self-administered questionnaire in a sample of urban Black teenagers. Data were obtained from 607 male and female students in high school health classes and a demographically similar group of 123 never-pregnant teenage women in a family planning clinic who had not attended these classes. Males were less likely to recognize the risk of pregnancy, had less information about contraceptives, and fewer attitudes that supported contraceptive use than females who participated in the same shool health classes. More males than females indicated that school classes had been the main source of contraceptive information. Teenage women in the family planning clinic did not differ from the high school females in attitudes about contraceptives, but the school group had somewhat more contraceptive information. The female school group was more likely to have discussed contraception with parents, obtained more contraception information from their mothers, and discussed contraception more with male friends than the teenagers who requested contraceptives at the family planning clinic.
An index of severity for acute pediatric illness.
Authors: Nelson K G
Published: November 2008

A study population of 1,106 patients presenting to a pediatric emergency room for care of acute non-traumatic illness were prospectively assessed to determine what clinical manifestations and/or functional status indicators predicted the severity of their illnesses. From these data, a "Severity Index" was developed using a 0-1-2 point score for the five most significant predictors to give a maximum score of 10 points. The predictor variables include respiratory effort, skin color, activity, temperature, and ability to play. The index has a predictive accuracy for non-severe illness of 98.7 per cent with only 1.3 per cent false negative predictions. In predicting major illness, a false positive prediction rate of 15.8 per cent was obtained. The index appears valid both across and within diagnostic categories.
Racial differences between linked birth and infant death records in Washington State.
Authors: Frost F , Shy K K
Published: November 2008

The race of infants who died in Washington State 1968-1977 was ascertained by two different methods: 1) race on the death record, and 2) race on the corresponding linked birth record. The second method resulted in substantial increases in the numbers of infant deaths for the nonwhite races: Indian 39 per cent (n = 114/293), Filipino 56 per cent (n = 19/34), Japanese 121 per cent (n = 23/19), and Chinese 117 per cent (n = 14/12). For Indians, the discrepancy between birth and death records was greatest when the age at death was less than seven days (p < 0.01).
Late effects following isoniazid therapy.
Authors: Boice J D , Fraumeni J F
Published: November 2008

Amont 338 women treated in Massachusetts with isoniazid (isonicotinic acid hydrazide = INH) for pulmonary tuberculosis, no excess cancer deaths occurred (8 observed vs 8.3 expected) after 23 years (12.9 mean) of follow-up. There was an excess of cancer deaths (54 vs 35.7) among 1,090 patients who did not receive INH, partly due to radiogenic breast cancer resulting from multiple chest fluoroscopies to monitor pneumothorax. Increased deaths from liver cirrhosis (5 vs 0.8) were observed following INH use, suggesting that chronic as well as acute liver disease complicate this treatment.
Tuberculosis risk for hospital employees: analysis of a five-year tuberculin skin testing program.
Authors: Berman J , Levin M L , Orr S T , Desi L
Published: November 2008

This study of hospital employee tuberculin conversion rates was undertaken in a 516-bed urban general hospital to determine if employment in such a hospital placed employees at risk of infection with tuberculosis. Data collected on the tuberculin status of employees from 1971 through 1976 indicated that the five-year conversion rate for all employees in a hospital-wide testing program was 7.1 per cent. Employees at greatest risk for conversion were non-White, age 46 through 64, in the lowest socioeconomic quintile, and employed in the Laundry, Housekeeping, and Engineering and Maintenance Departments. It was concluded that the higher than expected employee conversion rate was not attributable to exposure to infectious patients, but to a combination of the booster effect in serial tuberculin testing, use of a multiple puncture device for skin tests, and exposure to tuberculosis in the community.
Health beliefs and smoking behavior.
Authors: Weinberger M , Greene J Y , Mamlin J J , Jerin M J
Published: November 2008

Smoking histories and beliefs about smoking were obtained on 120 ex- and current smokers. Ex-smokers view smoking as a serious health problem, did not report having a physician recommend they stop, and feel personally susceptible to its adverse effects. Moderate smokers (0-10/day) also view smoking as serious, but do not see themselves as vulnerable to its adverse effects. The data suggest that certain attitudes can discriminate between groups of current smokers, as well as smokers from ex-smokers.
A thirty-month clinical experience in natural family planning.
Authors: Kambic R , Kambic M , Brixius A M , Miller S
Published: November 2008

A Natural Family Planning service was evaluated at the end of a 30-month developmental phase. There were 444 women taught and 322 method acceptor of which 248 intended to avoid pregnancy. NFP clients were older (mean age 26.9 vs 22.4 and 23.7 for comparison groups), and a larger percentage were married (83.1 per cent vs 23.0 per cent for the comparison group). After one year of use, the unplanned pregnancy rate was 14.4 per cent and the total dropout rate was 37.6 per cent by life table analysis.
Obtaining hospital and physician participation in a case-control study of colon cancer.
Authors: Herrmann N , Amsel J , Lynch E
Published: November 2008

This paper describes efforts to solicit hospital and physician participation for a case-control study of the etiology of colon cancer in the five Pennsylvania counties of the Philadelphia metropolitan area. Forty-seven of the 70 hospitals in this region were eligible for inclusion in the study. Thirty-seven (79%) agreed to participate, 27 of them within six months of initial contact. The median time to approval of participation was three months and the median number of separate contacts was nine. At least five participating hospitals submitted the protocol to their lawyers and nine required that special procedures be developed for release of patient information. Two hundred fourteen of 256 listed attending physicians were eligible for participation; 161 (75%) permitted all patients to be contacted 23 (11%) permitted some patients to be contacted; 30 (14%) refused all patient contact. A significant association between type of specialty and type of permission was found (p approximately .005). Concerns about confidentiality and lack of personal advantage were frequently cited by non-participants. The validity of case-control studies relying on hospital or physician ascertainment of cases is seriously challenged by such lengthy delays and lack of participation which can result in a biased pool of potential cases.
Down's syndrome: percentage reporting on birth certificates and single year maternal age risk rates for Ohio 1970-79: comparison with upstate New York data.
Authors: Huether C A , Gummere G R , Hook E B , Dignan P S , Volodkevich H , Barg M , Ludwig D A , Lamson S H
Published: November 2008

Estimates of single year maternal age risk rates for Down's Syndrome births to White residents of Ohio over the period 1970-79 are reported. The rates were estimated from birth certificate data, which first necessitated estimating the percentage of reporting of Down's Syndrome on Ohio birth certificates. Using data from cytogenetic laboratories within the state, percentages of Down's Syndrome cases reported were found to be 36.5 (319/875) for White and 33.9 (342/1,010) overall. Final single year maternal age risk rates reported here are corrected for underreporting using these figures. They should be useful for genetic counselors and obstetricians. Comparisons of observed, uncorrected single year maternal incidence rates were made within Ohio 1970-74 vs 1975-79, and between Ohio and upstate New York for various time periods using both a hierarchial log-linear model for multiway cross-tabulations and a weighted least squares solution. All comparisons showed excellent agreement, indicating no evidence for temporal or geographic differences and implying that environmental factors are unimportant in determining single year maternal age incidence rates in Down's Syndrome for the time periods and populations studied.
Biosocial effects of urban migration on the development of families and children in Guatemala.
Authors: Bogin B , MacVean R B
Published: November 2008

The relationship between rural to urban migration and child growth and family structure is reported in sample of 302 children from families of low socioeconomic status, living in Guatemala City. The sample was divided into three groups: 1) children of parents born outside the city, 2) children of parents born in the city, and 3) children with one migrant and one city-born parent. Children of migrants to the city were the smallest and significantly shorter than children of migrant city-born parents. Migrant parents also had the largest families; family size correlated negatively with growth in height. Growth in weight followed a pattern similar to height, but no significant differences associated with migration status were found between groups.
Prenatal care and pregnancy outcome in an HMO and general population: a multivariate cohort analysis.
Authors: Quick J D , Greenlick M R , Roghmann K J
Published: November 2008

We studied the use of prenatal care and pregnancy outcome in 4,148 deliveries among members of a well-established health maintenance organization (HMO) and 19,116 births among the 1973-1974 White birth cohort in the Portland, Oregon area. Mothers in the HMO were almost one year older on the average, slightly better educated, and less frequently unmarried, but had virtually identical past pregnancy histories when compared with the general population cohort. HMO members began prenatal care one month later and had three fewer visits than the general population (p less than .01); 78 per cent of the general population and only 64 per cent of HMO members began prenatal care in the first trimester (p less than .01). With maternal risk held constant, low birthweight, neonatal mortality, and infant mortality were 1.5 to 5 times greater with late, less frequent prenatal care than with early, frequent care. Multivariate analysis demonstrated a positive relationship between prenatal care and birthweight. Although this relationship was independent of risk factors recorded on birth certificates, it is not necessarily a causal relationship. Unadjusted prematurity, neonatal and infant mortality rates did not differ between the HMO and general populations. Multivariate analyses indicated that, independent of all maternal risk factors, HMO membership was associated with an increase of 30 grams in the predicted birthweight (P less than .01), but had no effect on mortality. The data suggest that, in Portland, Oregon, pregnancy outcome for HMO members is comparable to that of the general population.
Smoking and weight: the Minnesota Lipid Research Clinic.
Authors: Jacobs D R , Gottenborg S
Published: November 2008

The relationship between smoking and weight was examined in data of Lipid Research Clinic (LRC) Prevalence Study in Richfield, Minnesota. Weight was analyzed according to smoking status, age, and sex, holding constant self-perceived physical activity relative to others of the same age and sex. Our findings confirm that weight differences between smokers of 15-29 cigarettes a day (cig/day) and those who never smoked are noticeable in 20-39 year olds and quite marked in the 40-59 year age group. Ex-smokers are somewhat heavier than those who never smoked while, among smokers, a U-shaped curve exists with those smoking 15-29 cig/day being the lightest class. Height varied little between smoking classes. Daily caloric intake was estimated based on 24-hour dietary recalls and analyzed according to smoking status, sex, and age. The results showed that smokers of 15-29 cig/day generally are consuming at least as many or more calories as those who never smoked yet have lower weight.
Community leadership competencies in the Northeast US: implications for training public health educators.
Authors: Strand G A
Published: November 2008

A survey was conducted to determine leadership competencies as perceived by 679 community residents (urban/rural) in six states of the Northeast United States. Respondents were asked to rate the extent to which it is important for a community leader to use each competency listed in the instrument. A factor analysis reduced the list of 39 competency items examined into nine distinct factors. Alpha internal consistency estimates revealed the strength of correlation among items in each factor. A series of one-way analyses of variance failed to show a significant difference between urban/rural community respondents' scores for each factor. The findings suggest specific leadership competencies which should be emphasized in training experiences. Conceptual competencies were identified as most important (problem delineation, organization, management of change, etc.), followed by human competencies (demeanor, empathy, attitudes) and technical competencies (budgeting, supervision, needs assessment) respectively. Items within each factor have implications for development of specific content areas in a leadership training curriculum for public health educators.
Verbal judgments of Taiwanese family planning field workers about induced abortion.
Authors: Cernada G P , Cernada C C
Published: November 2008

Four hundred female governmental family planning field workers in Taiwan were asked by questionnaire whether women should or should not have an induced abortion under certain circumstances. Major findings were that although most workers were favorable to induced abortion under most circumstances, many were unfavorable when marital status, parity, and contraceptive usage of the woman were considered. Furthermore, cumulative judgment scales were shown to exist which have important implications for program approaches elsewhere.
The impact of the accident at the Three Mile Island on the behavior and well-being of nuclear workers; Part I: perceptions and evaluations, behavioral responses, and work-related attitudes and feelings.
Authors: Kasl S V , Chisholm R F , Eskenazi B
Published: November 2008

In order to assess the impact of the accident at the Three Mile Island (TMI), telephone interviews were conducted six months later with 324 nuclear workers assigned to TMI and 298 workers assigned to a comparison plant at Peach Bottom (PB). Examination of PB-TMI differences, stratified by supervisory status, revealed the following: Part I: TMI workers reported greater exposure to radiation at the time of the accident and felt that their health had been thereby endangered. TMI workers experienced more uncertainty and conflict at the time of the accident. Coping responses such as seeing a doctor, taking drugs, and increasing alcohol consumption were quite infrequent. Leaving the area was more common; however, over 40 per cent of TMI workers wished to leave but did not do so because of work obligations. TMI workers reported much lower job satisfaction and much greater uncertainty about their job future.
High and low surgical rates: risk factors for area residents.
Authors: Roos N P , Roos L L
Published: November 2008

Patterns of surgical practice, the type of operations performed, and risk characteristics of elderly patients brought to surgery are examined in areas with differing surgical rates. This population-based analysis covering Manitoba's 56 rural hospital areas uses discharge claims filed routinely with the provincial Health Services Commission. One and a half times as much surgery was performed in high rate areas (115.2 procedures per 1,000 elderly) as in low rate areas (74.7 procedures/1,000). Since surgical case mix varied little between high and low rate areas, the rate variation means that place of residence strongly influences exposure to major surgical procedures. In similar fashion, the proportion of surgical cases classified as high-risk does not vary with the surgical rate. High risk patients resident in high surgical rate areas are more likely to come to surgery than are their counterparts in low rate areas. Further analyses of nonsurgical hospitalization, of three common elective procedures, and of area characteristics were carried out. The surgical selection process, not characteristics of the population residing in the area, appears to determine the rate at which high and low risk patients come to surgery. Our research clearly suggests that high surgical rates carry with them the risk of excess surgical deaths.
Teaching Poison Prevention to Preschool Children, Their Parents, and Professional Educators through Child Care Centers
Authors: Krenzelok Edward P. , Garber Richard J.
Published: November 2008

A program to teach poison prevention to preschool children in day care centers was designed to teach three basic concepts: where poison is, what poison is, and how to avoid poison. A series of ten slide-cassette presentations and numerous teaching aids were developed for use by the day care center instructor to the children. Over 3,000 children were enrolled in the program. Evaluation shows that poison prevention education can be demonstrated in children less than five years of age. (Am J Public Health 1981;71:750-752.)
The relationship between age of mother and child health and development.
Authors: Rothenberg P B , Varga P E
Published: November 2008

This study investigates the relationship between age of mother and children's health and development at birth and at approximately three years of age. The sample is composed of Black and Hispanic women and their firstborn children who were delivered on the wards of a large New York City hospital in 1975. There were no differences between children of teenage and older mothers in terms of prematurity or birthweight, but the children of younger mothers had higher Apgar scores than those of older mothers. Age of mother was not significantly related to hospitalizations, the need to see a physician regularly, or abnormal weight. Although the number of injurious conditions and the incidence of burns were higher among the children of adolescent mothers, the effect of age of mother was not independent of other factors. The children of teenage mothers scored better than those of older mothers on the total Denver Developmental Screening Test, as well as on the Fine Motor sector. These findings thus suggest that when relevant background characteristics are controlled, children of teenage mothers are as healthy and develop as well as children of older mothers.
The quality of medical care delivered by lay practitioners in a feminist clinic.
Authors: Elhai L S
Published: November 2008

The completion of essential components of patient encounters by lay paramedics in a feminist clinic was compared to that of nurse practitioners in a student health gynecology clinic using explicit criteria for the gynecological annual examination and the examination for vulvo-vaginitis. According to evidence charted in medical records, the lay paramedics conducted patient encounters as well as the nurse practitioners, with the exception that the lay paramedics consulted more frequently.
Rh hemolytic disease of the newborn: using incidence observations to evaluate the use of RH immune globulin.
Authors: Adams M M , Marks J S , Gustafson J , Oakley G P
Published: November 2008

During the 1970s, the crude incidence of Rh hemolytic disease of the newborn (RhHDN) in the United States dropped 65 per cent---from 40.5/10,000 total births in 1970 to 14.3/10,000 total births in 1979. Since the risk of RhHDN is directly associated with birth order, changes both in birth order-specific RhHDN incidence rates and in the birth order distribution would be expected to influence crude RhHDN incidence. Review of birth order-specific incidences ascertained in Connecticut, 1972-1977, shows that incidence was stable for first and second births, whereas it dropped significantly for third and fourth births. Due to the nearly complete use of Rh immune globulin (RhIG) in Connecticut during these years, the drop in these specific rates is best attributed to this prevention strategy. Nationwide, during the 1970s, the annual percentages of fourth and higher order births decreased from 18 per cent to 10 per cent. We estimate that some 30 per cent to 40 per cent of the 1970-1979 drop in the crude rate is attributed to changes in the birth order distribution, whereas 60 per cent to 70 per cent of the drop is attributed to RhIG. However, comparison of pooled incidences for 1972-1974 and 1975-1977 observed in Connecticut for first births and births to 15-19 year olds showed significant increases for both groups in 1975-1977. Further study of specific trends from other areas is needed to confirm these observations. Also needed is investigation of likely causes of sensitization among these teenaged, primiparous women.
Cutaneous inflammation caused by inadvertent intradermal administration of DTP instead of PPD.
Authors: Graham D R , Dan B B , Bertagnoll P , Dixon R E
Published: November 2008

In 1979, 101 adults were skin-tested by a health department to evaluate tuberculin reactivity; of the 96 persons followed, 87 (91 per cent) experienced inflammation marked by swelling, erythema, arm pain, and fever. Five months later, a 5 mm to 10 mm purple macule persisted in 76 persons. The vials of PPD reportedly used for testing had been discarded, but PPD had been stored in the refrigerator with DT and DTP. The mean tetanus antitoxin titer in skin-tested persons was 0.14 units per ml (u/ml) vs 0.08 u/ml in untested control persons (p lesser than 0.03). The mean diphtheria antitoxin titer in skin-tested people was 0.90 u/ml vs 0.16 for controls (p = 10(-5)). The mean pertussis antibody in skin-tested persons was 1:169 vs 1:12 for controls (p = 10(-5)). Intradermal DTP in immune rabbits produced histologically typical Arthus reactions similar to those experienced by the humans. Seven months later, 90 persons received PPD injections. Ten had induration; none experienced persistent reactions. We concluded that the humans initially received DTP instead of PPD.
Children's ability to evaluate television commercial messages for sugared products.
Authors: Lambo A M
Published: November 2008

A study of the ability of 120 children to evaluate the cariogenic potential of products presented in commercial television messages was undertaken. Each child was shown commercials for sugar-containing products. The results indicated: 1) grade-related differences exist in a child's ability to evaluate products; 2) no differences between socioeconomic status groups were found in a child's ability to evaluate products; 3) a weak relationship between the level of dental health knowledge and ability to evaluate the products.
Physician-delivered births in Washington State, 1978: geographic patterns.
Authors: Starzyk P M
Published: November 2008

Linkage of birth certificate and physician survey data was used to analyze characteristics of physicians attending deliveries in Washington State in 1978. This analysis revealed substantial differences in attendant characteristics between rural and urban areas. The more urban areas were characterized by a higher proportion of births delivered by obstetrical specialists and a higher average number of births/physician. These results are briefly discussed in terms of supply and accessibility of physicians in several different rural-urban classifications.
Waterborne Gastroenteritis due to the Norwalk Agent: Clinical and Epidemiologic Investigation
Authors: Wilson Rickey , Anderson Larry J. , Holman Robert C. , Gary G. William , Greenberg Harry B.
Published: November 2008

An outbreak of gastroenteritis occurred at a Pennsylvania summer camp in July 1978. Symptoms included abdominal pain (81 per cent), nausea (72 per cent), and vomiting (53 per cent); upper respiratory infection symptoms occurred in 35 per cent of the campers. Illness was associated with consumption of five or more glasses of water or water-containing beverages. Stool cultures from affected persons were negative for bacterial pathogens; however, a fourfold or greater rise to the Norwalk agent was demonstrated in serum samples of three of three ill persons tested and in none of eight controls (p < .02). Campers ill during the first session who were also present during the second session did not become ill during the second session (p < .001). (Am J Public Health 1982; 72:72-74.)
Perspectives on the past and future of psychiatric epidemiology. The 1981 Rema Lapouse Lecture.
Authors: Dohrenwend B P , Dohrenwend B S
Published: November 2008

Two generations of epidemiological studies of the true prevalence of mental disorders have been conducted since the turn of the century. The first and smaller in number took place prior to World War II and was characterized by the use of records and key informants to define "cases." The second, utilizing the greatly expanded nomenclatures that followed World War II, were based for the most part on personal interviews with all subjects or samples there of in communities all over the world. In total, more than 80 different communities were studied by more than 60 different investigators or teams of investigators in these first and second generation studies. The legacy from these studies comes in two main parts: the first consists of methodological problems centering on the question of how to conceptualize and measure mental disorders independently of treatment status; the second is a set of consistent substantive findings about the amounts of various types of mental disorder, the proportions treated and untreated by members of the mental health professions, and the distribution of the disorders according to gender, rural vs urban location, and social class. Analyses of this legacy from first and second generation studies are presented with a view to developing informed speculations about what might be hoped for in the future, vastly different, third generation of studies in this field.
A survey to evaluate parental consent as public policy for neonatal screening.
Authors: Faden R , Chwalow A J , Holtzman N A , Horn S D
Published: November 2008

Most states currently have laws which result in compulsory neonatal screening practices, despite a widespread consensus that participation in genetic services and programs should be voluntary. In 1976, Maryland adopted a regulation designed to respect parents' rights to refuse neonatal screening by imposing a parental consent requirement. The results of a study designed to evaluate the effects of this regulation are reviewed here. Many health care providers were unaware of the parental consent regulation. However, hospitals were generally in compliance with the technical stipulations of the regulations. There was little evidence that the regulation resulted in additional costs to the health care system, either in terms of hospital staff time or in terms of loss of efficiency in the number of infants screened. Mothers affected by the regulation were largely in favor of being informed about neonatal screening and learned a significant amount of new information from the disclosure process. They were almost evenly divided on whether they favored parental consent.
An attempt to eradicate silicotuberculosis in Ottawa County, Oklahoma.
Authors: Snider D E , Dewberry G , Gretz H
Published: November 2008

In 1974 and 1975, a selective tuberculosis screening program was conducted in a small mining community in Ottawa County, Oklahoma. Former miners, 50 years of age and over, who had abnormal chest radiographs consistent with silicosis or inactive tuberculosis and positive tuberculin skin tests, were offered isoniazid preventive therapy. Since the project ended, morbidity from silicotuberculosis has declined but silicotuberculosis has continued to occur. In this report, we examine the reasons for the failure to eradicate this disease from the community.
Project Burn Prevention: outcome and implications.
Authors: McLoughlin E , Vince C J , Lee A M , Crawford J D
Published: November 2008

Project Burn Prevention was designed and implemented to determine the ability of a public education program to increase awareness about burn hazards and reduce the incidence and severity of burn injuries. Media messages were transmitted to residents of a large metropolitan area; separate school and community interventions were implemented in two demographically similar communities within the Standard Metropolitan Statistical Area (SMSA). A second metropolitan area and two of its communities served as control sites. Messages for specific, high-risk age groups emphasized flame burns because of their severity and scalds because of their frequency. Knowledge gains were demonstrable only as a result of the school program. Neither the school program nor the media campaign reduced burn incidence or severity; the community intervention may have brought about a moderate, temporary reduction in injuries. Multiplicity of messages, brevity of the campaign, and separation of the interventions are among possible reasons for the program's failure to significantly reduce burn injuries. Education for personal responsibility is not sufficient. Product modification and environmental redesign must be instituted through education and legislation for successful control of burn injuries.
Ectopic pregnancy and prior induced abortion.
Authors: Levin A A , Schoenbaum S C , Stubblefield P G , Zimicki S , Monson R R , Ryan K J
Published: November 2008

We compared the prior pregnancy histories of 85 multigravid women with an ectopic pregnancy and 498 multigravid delivery comparison subjects. We found a relationship between the number of prior induced abortions and the risk of ectopic pregnancy: the crude relative risk of ectopic pregnancy was 1.6 for women with one prior induced abortion and 4.0 for women with two or more prior induced abortions; however, use of multivariate techniques to control confounding factors reduced the relative risks to 1.3 (95 per cent confidence interval, 0.6-2.7) and 2.6 (95 per cent confidence interval, 0.9-7.4), respectively. The analysis suggests that induced abortion may be one of several risk factors for ectopic pregnancy, particularly for women who have had abortions plus pelvic inflammatory disease or multiple abortions.
Aspirin and myocardial infarction in young women.
Authors: Rosenberg L , Slone D , Shapiro S , Kaufman D W , Miettinen O S , Stolley P D
Published: November 2008

To assess whether aspirin reduces the risk of a first myocardial infarction (MI) in young women, we evaluated data from a case-control study among women less than 50 years of age without a prior MI: 48 of 551 cases of MI and 67 of 896 hospital controls had taken aspirin regularly for at least 12 weeks immediately before admission. The relative risk estimate was 0.8 upon allowance for confounding factors but it was not statistically significant (95 per cent confidence interval, 0.5-1.4). These data alone do not provide evidence of protection by aspirin against a first infarction in young women.
Emerging patterns of tampon use in the adolescent female: the impact of toxic shock syndrome.
Authors: Irwin C E , Millstein S G
Published: November 2008

From November 1980 through January 1981, we queried 714 post menarchal adolescents (ages 12 to 19) about menstrual product use at menarche (T1), during summer 1980 (T2), at last menstrual period (T3), and about intended product for next menstrual period (T4). The percentage of adolescents reporting use of tampons at each point in time were: T1, 3.1 per cent; T2, 24.1 per cent; T3 (following the media coverage of toxic shock syndrome [TSS]), 19.3 per cent; and T4, 19.5 per cent. Prior to TSS coverage there was a shift toward tampon use in 141 of the 672 subjects who used napkins (21 per cent) and no increase in napkin use. Following media coverage, shifts toward tampon use among napkin users decreased to 2.3 per cent while 32.9 per cent of the 168 summer tampon users (T2) shifted to the use of napkins; reasons for the shift were significantly associated with TSS (p less than .001). Ethnicity (White) was highly associated with reported tampon use. Following TSS coverage, adolescents in all ethnic groups decreased their tampon use at the same rate.
Brand preference and advertising recall in adolescent smokers: some implications for health promotion.
Authors: Chapman S , Fitzgerald B
Published: November 2008

A survey on brand preference and cigarette advertising recall in 1,195 school children was conducted in Sydney, Australia. Four of the 130 available brands accounted for the cigarettes smoked by 78.7 per cent of smokers. Smokers were nearly twice as likely to correctly identify edited cigarette advertisements and slogans than were non-smokers. Brand preference is considered an important descriptor of smoking profiles.
Memory aids in longitudinal health surveys: results from a field experiment.
Authors: Marcus A C
Published: November 2008

The use of memory aids to improve respondent recall is becoming increasingly popular in health surveys. In a one-year field experiment involving over 1,200 respondents, people assigned memory aids reported over 50 per cent more symptom episodes than those not assigned memory aids. Differences in reporting levels were particularly striking during the first six to 12 weeks of the survey, for symptoms related to acute, transitory illness, and among minorities and the lower socioeconomic groups. Respondents assigned memory aids were also more likely to report a doctor contact--especially during the fall/winter months. Among respondent who used their memory aids at least once (N = 252), nearly 35 per cent said they were influenced by the information recorded in their memory aids, and most of those who were influenced said that they became more aware of their health. Ten of these people said that they became more worried or depressed because of the information recorded in their memory aids. This constitutes about a four per cent risk among those people who reported using their memory aids at least once. There was no evidence to suggest that the memory aids influenced perceptions of health status.
Pregnancy outcomes of Indochinese refugees, Santa Clara County, California.
Authors: Davis J M , Goldenring J , McChesney M , Medina A
Published: November 2008

Birth certificates and a sample of hospital obstetric records for Indochinese refugees in Santa Clara County, CA, 1979-1980, were reviewed. Among 542 live births, the overall median birthweight of 3175 gm and 5.7 per cent rate of low birthweight were favorable; it is our impression that the more recent arrivals, especially Cambodians and Laotians, present at greater risk, lacking prenatal care, and have more infants of low birth rate and more pregnancy complications.
Telephone versus in-person surveys of community health status.
Authors: Aneshensel C S , Frerichs R R , Clark V A , Yokopenic P A
Published: November 2008

Reports of physical morbidity are compared among a community sample of Los Angeles County adults (N = 546) randomly assigned to either in-person or telephone interviews. No statistically significant differences were found between the two interview methods for overall assessment of health status, illnesses reported for the previous four months, or reports of hospitalization. A significantly greater proportion of in-person respondents, however, reported the presence of restricted-activity days during the previous two weeks. This difference could not be directly attributed to sociodemographic characteristics or reported physical health status of the two samples.