bluuebunny/crossref_metadata_2025 huggingface dataset:
Disability determinations for adults with mental disorders: Social Security Administration vs independent judgments.
Authors: Okpaku S O , Sibulkin A E , Schenzler C
Published: November 2008

OBJECTIVES. Disability determinations made by the Disability Determination Service for Social Security Administration (SSA) disability claims due to mental impairment were compared with the independent judgments of a team of mental health workers. The decisions of the Service and the team's agreement with those decisions were predicted from a set of explanatory variables. METHODS. One hundred fifty-eight adult applicants for or beneficiaries of SSA benefit programs participated. The team used SSA disability criteria to judge disability based on in-depth interviews. RESULTS. Team members voted yes, no, or maybe regarding approval for disability. Of the cases approved by the team, 89% were actually allowed by the Disability Determination Service. However, the team could not reach a yes or no decision for almost half of the subjects, contributing to a total agreement with the Service on only 40% of the cases. CONCLUSIONS. Sufficient evidence exists to question the reliability of SSA disability determinations for mental disorders. Although the Disability Determination Service decision for mental impairments can be predicted above chance, a direct test of the reliability of such determinations should be conducted, with particular attention to the effect of the quality of the medical information.
Preventing disability and falls in older adults: a population-based randomized trial.
Authors: Wagner E H , LaCroix A Z , Grothaus L , Leveille S G , Hecht J A , Artz K , Odle K , Buchner D M
Published: November 2008

OBJECTIVES. Because preventing disability and falls in older adults is a national priority, a randomized controlled trial was conducted to test a multicomponent intervention program. METHODS. From a random sample of health maintenance organization (HMO) enrollees 65 years and older, 1559 ambulatory seniors were randomized to one of three groups: a nurse assessment visit and follow-up interventions targeting risk factors for disability and falls (group 1, n = 635); a general health promotion nurse visit (group 2, n = 317); and usual care (group 3, n = 607). Data collection consisted of a baseline and two annual follow-up surveys. RESULTS. After 1 year, group 1 subjects reported a significantly lower incidence of declining functional status and a significantly lower incidence of falls than group 3 subjects. Group 2 subjects had intermediate levels of most outcomes. After 2 years of follow-up, the differences narrowed. CONCLUSIONS. The results suggest that a modest, one-time prevention program appeared to confer short-term health benefits on ambulatory HMO enrollees, although benefits diminished by the second year of follow-up. The mechanisms by which the intervention may have improved outcomes require further investigation.
Weight control practices in adults: results of a multistate telephone survey.
Authors: Serdula M K , Williamson D F , Anda R F , Levy A , Heaton A , Byers T
Published: November 2008

In this study, data collected in 1989 in a random-digit dialing telephone survey of 60,590 adults in 38 states and the District of Columbia were analyzed. Approximately 38% of women and 24% of men reported that they were currently trying to lose weight. Methods reported were counting calories (24% of women, 14% of men), participating in organized weight loss programs (10%, 3%), taking special supplements (10%, 7%), taking diet pills (4%, 2%), and fasting for 24 hours or longer (5%, 5%). Among both sexes, only half of those trying to lose weight reported using the recommended method of caloric restriction combined with physical activity.
Acanthosis Nigricans among Native Americans: an indicator of high diabetes risk.
Authors: Stuart C A , Smith M M , Gilkison C R , Shaheb S , Stahn R M
Published: November 2008

Prevalence of the skin lesion acanthosis nigricans was determined in two tribal communities in Texas and Nebraska. Thirty-eight percent of the Alabama-Coushatta tribe of Texas had acanthosis nigricans. Nineteen percent of Omaha and Winnebago tribal children had the skin lesion; the youngest children had the least acanthosis nigricans. Among weight-matched Alabama-Coushatta, fasting insulin concentrations were twofold higher in subjects with the lesion. It was concluded that acanthosis nigricans is highly prevalent among Native Americans and that its presence suggests insulin resistance. Thus, it may identify those with the highest risk for non-insulin-dependent diabetes mellitus in this population.
Risk factors for hip fracture in US men aged 40 through 75 years.
Authors: Hemenway D , Azrael D R , Rimm E B , Feskanich D , Willett W C
Published: November 2008

Relatively few studies have examined risk factors for hip fracture among men. This study analyzes data from the Health Professionals Follow-up Study, a prospective study of approximately 50,000 men who were between the ages of 40 and 75 years in 1986. Body mass index, smoking status, and alcohol consumption were not associated with hip fracture in this population. However, age and height were related to hip fracture. Men who were 65 and older had a significantly higher risk of sustaining a hip fracture than younger adults. Men 6 feet or taller were more than twice as likely to sustain a hip fracture as those under 5 feet, 9 inches.
The US prevalence of self-reported carpal tunnel syndrome: 1988 National Health Interview Survey data.
Authors: Tanaka S , Wild D K , Seligman P J , Behrens V , Cameron L , Putz-Anderson V
Published: November 2008

To estimate the prevalence of carpal tunnel syndrome among US adults, data from the Occupational Health Supplement of the 1988 National Health Interview Survey were analyzed. Based on a sample of 44,233 households (response rate, 91.5%), an estimated 1.55% (2.65 million) of 170 million adults self-reported carpal tunnel syndrome in 1988. Females and Whites had a higher prevalence of self-reporting carpal tunnel syndrome than males and non-Whites, respectively. Among 127 million adults who worked during the 12 months before the survey, 0.53% (0.68 million) reported that their "prolonged" hand discomfort was called carpal tunnel syndrome by a health care provider.
Sexually transmitted diseases: a neglected public health priority.
Authors: Yankauer A
Published: November 2008

Sexually transmitted diseases remain uncontrolled although millions of cases occur annually in the United States. The advent of acquired immunodeficiency syndrome (AIDS), which is also a sexually transmitted disease, has not altered this situation. The major portion of federal funding for sexually transmitted diseases is allocated to a search for an AIDS vaccine or cure. State health department funding for sexually transmitted diseases, although only a small fraction of the $1.3 billion AIDS research budget of the National Institutes of Health, is largely consumed by AIDS. A single adequately funded sexually transmitted disease control program that applies well-established public health principles for the control of communicable diseases would make sense. However, a consensus to develop and support such a program does not exist in the United States.
The effects of HIV/AIDS intervention groups for high-risk women in urban clinics.
Authors: Kelly J A , Murphy D A , Washington C D , Wilson T S , Koob J J , Davis D R , Ledezma G , Davantes B
Published: November 2008

OBJECTIVE. This study reports the results of a behavior change intervention offered to women at high risk for human immunodeficiency virus (HIV) infection seen in an urban primary health care clinic. METHODS. Participants were 197 women randomly assigned to either an HIV/acquired immunodeficiency syndrome (AIDS) risk reduction group or a comparison group. Women in the HIV/AIDS intervention group attended five group sessions focusing on risk education; skills training in condom use, sexual assertiveness, problem solving, and risk trigger self-management; and peer support for change efforts. Women in the comparison group attended sessions on health topics unrelated to AIDS. RESULTS. At the 3-month follow-up, women in the HIV/AIDS intervention group had increased in sexual communication and negotiation skills. Unprotected sexual intercourse had declined significantly and condom use had increased from 26% to 56% of all intercourse occasions. Women in the comparison group showed no change. CONCLUSIONS. Socially disadvantaged women can be assisted in reducing their risk of contracting HIV infection. Risk reduction behavior change interventions should be offered routinely in primary health care clinics serving low-income and high-risk patients.
A national surveillance system for newly acquired HIV infection in Australia. National HIV Surveillance Committee.
Authors: McDonald A M , Gertig D M , Crofts N , Kaldor J M
Published: November 2008

OBJECTIVES. The purpose of this study was to describe the establishment of a national surveillance system for newly acquired human immunodeficiency virus (HIV) infection and present the first 3 years' results. METHODS. All new cases of diagnosed HIV infection were reported to the national HIV surveillance center through state and territory health authorities. Information sought on each case included evidence of whether the infection had been newly acquired, defined by the diagnosis of HIV seroconversion illness or by the report of a negative or indeterminate HIV antibody test result occurring within the 12 months prior to diagnosis of infection. RESULTS. Of 3602 reported cases of HIV infection in adults and adolescents newly diagnosed in Australia between 1991 and 1993, 11.4% were identified as newly acquired. The majority (85%) of cases of newly diagnosed HIV infection occurred among men who reported homosexual contact, and 15% of these cases were identified as newly acquired. Average age at diagnosis was 31 years for cases of newly acquired infection and 34 years for other cases. CONCLUSIONS. Surveillance for newly acquired HIV infection has been established at a national level in Australia and provides valuable information for planning primary HIV prevention programs.
Mandatory anonymous HIV surveillance in Denmark: the first results of a new system.
Authors: Smith E , Rix B A , Melbye M
Published: November 2008

OBJECTIVES. This paper describes the principles and first results of the newly implemented anonymous mandatory human immunodeficiency virus (HIV) reporting system in Denmark. METHODS. The system is based on a serially numbered form that is circulated among the laboratories, the physicians, and the national surveillance unit. All laboratories doing confirmatory tests for HIV antibodies must send a report form along with any positive test results. Before forwarding the form, the laboratory is to fill in the top part with the name and address of the requesting physician and send the back copy to the surveillance unit. The physicians are mandated by law to fill in the form with data on the patient and to keep two copies for their own files before sending the original to the surveillance unit. RESULTS. After a revision of the system, a response rate of 95% was obtained. CONCLUSIONS. We have established an anonymous mandatory HIV surveillance system in Denmark that enables routine evaluation of the completeness of reporting and nonresponding physicians to be reminded of their duty to report. Also, the physicians can act as mediators between patients and researchers; therefore, nested studies can be done without breaking the anonymity of the patient.
HIV infection in homosexual and bisexual men 18 to 29 years of age: the San Francisco Young Men's Health Study.
Authors: Osmond D H , Page K , Wiley J , Garrett K , Sheppard H W , Moss A R , Schrager L , Winkelstein W
Published: November 2008

OBJECTIVES. Recent studies suggest very high human immunodeficiency virus (HIV) infection rates in some populations of younger homosexual men, but these studies may represent only particularly high-risk populations. The current study obtained population-based data on the HIV epidemic in young homosexual/bisexual men. METHODS. A household survey of unmarried men 18 through 29 years of age involved a multistage probability sample of addresses in San Francisco. A follow-up interview and HIV test for men who were HIV negative at baseline were completed; the median follow-up was 8.9 months. RESULTS. Sixty-eight of 380 homosexual/bisexual men (17.9%) tested HIV seropositive. Sixty-three percent of men reported one or more receptive anal intercourse partners in the previous 12 months, and 41% of those men did not use condoms consistently. The HIV seroincidence rate among those seronegative at first study was 2.6% per year. CONCLUSIONS. HIV infection rates in young homosexual men in San Francisco are lower than those in the early 1980s; however, the rate of infection in these men, most of whom became sexually active after awareness of AIDS had become widespread, threatens to continue the epidemic in the younger generation at a level not far below that of a decade ago.
Does the promotion and distribution of condoms increase teen sexual activity? Evidence from an HIV prevention program for Latino youth.
Authors: Sellers D E , McGraw S A , McKinlay J B
Published: November 2008

OBJECTIVES. Opponents of condom availability programs argue that the promotion and distribution of condoms increases adolescent sexual activity. This assertion was tested empirically with data from the evaluation of a human immunodeficiency virus (HIV) prevention program for Latino adolescents. METHODS. The onset of sexual activity, changes in the frequency of sex, and changes in the proportion of respondents with multiple partners were compared for intervention and comparison groups. Multivariate regression analysis was used to assess the effect of the intervention on these outcomes after adjustment for baseline differences between the intervention and comparison groups. RESULTS. Male respondents in the intervention city were less likely than those in the comparison city to initiate first sexual activity (odds ratio [OR] = 0.08). Female respondents in the intervention city were less likely to have multiple partners (OR = 0.06). The program promoting and distributing condoms had no effect on the onset of sexual activity for females, the chances of multiple partners for males, or the frequency of sex for either males or females. CONCLUSIONS. An HIV prevention program that included the promotion and distribution of condoms did not increase sexual activity among the adolescents in this study.
Contraceptive efficacy and acceptability of the female condom.
Authors: Farr G , Gabelnick H , Sturgen K , Dorflinger L
Published: November 2008

OBJECTIVES. The purpose of the study was to determine the contraceptive efficacy of the female condom and to provide data about the device to the US Food and Drug Administration. METHODS. The clinical trial was conducted at six US sites and three sites in Latin America. Eligible subjects were in mutually monogamous relationships and agreed to use the female condom as their only means of contraception for 6 months. RESULTS. A total of 328 subjects contributed to the analysis of contraceptive efficacy. Twenty-two US subjects and 17 Latin American subjects became pregnant, yielding 6-month gross cumulative accidental pregnancy rates of 12.4 and 22.2, respectively. During perfect (consistent and correct) use of the method, the 6-month accidental pregnancy rates were 2.6 and 9.5 for the US and Latin American centers, respectively. There were no serious adverse events related to the use of the method. CONCLUSIONS. The female condom provides contraceptive efficacy in the same range as other barrier methods, particularly when used consistently and correctly, and has the added advantage of helping protect against sexually transmitted diseases.
The consistency of self-reported HIV risk behavior among injection drug users.
Authors: McElrath K , Chitwood D D , Griffin D K , Comerford M
Published: November 2008

OBJECTIVES. Most studies of risk factors for human immunodeficiency virus (HIV) rely heavily on retrospective self-reports. The degree to which these reports provide reliable information has received little research attention. The purpose of this study was to assess the extent to which the reliability of retrospective self-report data is affected over time. METHODS. Data were examined from a longitudinal study of risk behaviors among injection drug users. Structured interviews were administered to 366 injection drug users who were asked to recall behaviors that they had reported 6, 12, or 18 months earlier. RESULTS. Kappa coefficients showed moderate initial memory loss for injection and sexual risk behaviors. After 6 months, time had little effect on the ability of injection drug users to recall injection and sexual risk behaviors. For ordinal measures of risk, subjects who gave different reports over time were most likely to disagree by one response category. CONCLUSIONS. These findings support the use of retrospective self-reports in assessing HIV risk behaviors among injection drug users. Retrospective inquiry is likely to remain an important method for collecting data over time.
The types of drugs used by HIV-infected injection drug users in a multistate surveillance project: implications for intervention.
Authors: Diaz T , Chu S Y , Byers R H , Hersh B S , Conti L , Rietmeijer C A , Mokotoff E , Fann S A , Boyd D , Iglesias L
Published: November 2008

OBJECTIVES. This study sought to describe the drugs used by drug injectors infected with human immunodeficiency virus (HIV) and to determine factors associated with the primary injection drug used. METHODS. A cross-section of persons 18 years of age or older reported with HIV or acquired immunodeficiency syndrome (AIDS) to local health departments in 11 US states and cities was surveyed. RESULTS. Of 4162 persons interviewed, 1147 (28%) reported ever having injected drugs. Of these 1147 injectors, 72% primarily injected a drug other than heroin. However, the types of drugs injected varied notably by place of residence. Heroin was the most commonly injected drug in Detroit (94%) and Connecticut (48%); cocaine was the most common in South Carolina (64%), Atlanta (56%), Delaware (55%), Denver (46%), and Arizona (44%); speedball was most common in Florida (46%); and amphetamines were most common in Washington (56%). Other determinants of the type of drug primarily injected were often similar by region of residence, except for heroin use. Polysubstance abuse was common; 75% injected more than one type of drug, and 85% reported noninjected drug use. CONCLUSIONS. Preventing the further spread of HIV will require more drug abuse treatment programs that go beyond methadone, address polysubstance abuse, and adapt to local correlates of the primary drug used.
Who is Hispanic? Definitions and their consequences.
Authors: Zimmerman R S , Vega W A , Gil A G , Warheit G J , Apospori E , Biafora F
Published: November 2008

What is the appropriate method for classifying Spanish-speaking-origin inhabitants of the United States? This paper presents relevant data from the first wave of a longitudinal study of adolescents in the greater Miami area. As expected, the broadest definition--"up to third generation" Hispanic--identified the largest proportion of the sample as Hispanic, whereas parent self-report placed the smallest proportion into the Hispanic category. When policymakers are concerned about enumerating the entire Hispanic population, a definition broader than self-identification should be used; in estimating prevalence rates, however, the use of self-identification may be adequate.
Commentary: recent reforms in the British National Health Service--lessons for the United States.
Authors: Holland W W , Graham C
Published: November 2008

President Clinton recently announced his reform plan for health care in the United States. The United Kingdom, along with other countries, has already enacted reforms in an effort to overcome the basic problem of having insufficient funds to provide a health service to meet modern demands. This paper briefly describes the recent health reforms in the United Kingdom and highlights some lessons for the United States, which include the need to choose procedures that should be universally provided. Health reforms that involve some fundamental restructuring need to be evaluated everywhere and agreed to by the staff in advance.
Employment status and depressive symptoms in middle-aged women: a longitudinal investigation.
Authors: Bromberger J T , Matthews K A
Published: November 2008

OBJECTIVES. This study investigated the psychological effects of paid employment and nonemployment, cross-sectionally and longitudinally, in 541 middle-aged women. METHODS. Women were seen for an extensive baseline evaluation and were reevaluated in an identical manner 3 years later. They were divided into four "synthetic" cohorts, based upon employment status at these two assessments. RESULTS. At baseline, nonemployed women reported higher levels of depressive symptoms than employed women, with nonemployed women with less education, low support from family and friends, or low marital satisfaction the most symptomatic. Symptoms decreased in women who were nonemployed initially but employed at the later exam; in all other groups, symptoms increased. Unlike the cross-sectional findings, however, the longitudinal findings showed that women who were nonemployed at baseline and had low levels of education, social support, or marital satisfaction did not benefit more from subsequent employment than did their counterparts who had high levels of these factors. CONCLUSIONS. New paid work may have a positive effect on mood for middle-aged women. However, given the contradictions between our cross-sectional and longitudinal results, caution should be exercised in drawing conclusions from cross-sectional studies that likely confound employment status, symptoms, and moderating variables.
Providing medical care to methadone clinic patients: referral vs on-site care.
Authors: Umbricht-Schneiter A , Ginn D H , Pabst K M , Bigelow G E
Published: November 2008

OBJECTIVES. Intravenous drug users are at high risk for medical illness, yet many are medically underserved. Most methadone treatment programs have insufficient resources to provide medical care. The purpose of this study was to test the efficacy of providing medical care at a methadone clinic site vs referral to another site. METHODS. Patients with any of four target medical conditions were randomized into an on-site group offered medical care at the methadone treatment clinic and a referred group offered medical care at a nearby clinic. Entry to treatment and use of medical services were analyzed. RESULTS. Of 161 intravenous drug users evaluated, 75 (47%) had one or more of the target medical conditions. Fifty-one were randomized. In the on-site group (n = 25), 92% received medical treatment; in the referred group (n = 26), only 35% received treatment. CONCLUSIONS. Providing medical care at a methadone treatment program site is more effective than the usual referral procedure and is a valuable public health intervention.
The relationship between mortality and intensity of inpatient alcoholism treatment.
Authors: Bunn J Y , Booth B M , Cook C A , Blow F C , Fortney J C
Published: November 2008

OBJECTIVES. Previous studies have examined mortality in alcoholics receiving extended inpatient alcoholism treatment, but few have investigated less intense treatment. This study examined mortality within 3 years after discharge from varying intensities of inpatient alcoholism treatment. METHODS. Using the computerized database of the Department of Veterans Affairs, we identified men participating in varying intensities of inpatient alcoholism treatment and followed them for 3 years after discharge. Adjusted mortality rates were computed and survival analysis was performed to assess the risk of death, adjusting for factors that may be related to mortality. RESULTS. The death rate was lower for men who completed extended formal inpatient treatment than for those who began, but did not complete, inpatient treatment or those who underwent short detoxification. Differences among the treatment groups remained after age, race, marital status, and disease severity were controlled. CONCLUSIONS. These results suggest that extended formal inpatient alcoholism treatment is associated with a lower risk of death than less intense forms of inpatient treatment.
Completion rates of clients discharged from drug and alcohol treatment programs in Washington State.
Authors: Wickizer T , Maynard C , Atherly A , Frederick M , Koepsell T , Krupski A , Stark K
Published: November 2008

OBJECTIVES. The primary goal of this study was to analyze completion rates of clients in drug and alcohol abuse treatment programs in Washington State and to assess the factors associated with treatment completion. A secondary goal was to examine the utility of a state information system as a source of evaluative data. METHODS. Analyses were conducted of 5827 client records contained in the Washington State Substance Abuse Monitoring System, representing a census of public clients discharged during the last quarter of 1990 from all state-funded alcohol and drug treatment programs in four treatment modalities. Logistic regression was performed to determine the independent predictors of treatment completion. RESULTS. Completion rates were highest for intensive inpatient alcohol treatment (75%) and lowest for intensive outpatient drug programs (18%). Factors associated with treatment completion included screening at a referral assessment center, education, age, ethnicity, and existence of a secondary drug problem. CONCLUSIONS. The fit between clients and treatment programs may be an important factor explaining why some clients complete treatment and others drop out. State client information systems are an important source of data for analyzing treatment completion and other outcomes.
Ethnicity and the use of outpatient mental health services in a national insured population.
Authors: Padgett D K , Patrick C , Burns B J , Schlesinger H J
Published: November 2008

OBJECTIVES. Factors affecting ethnic differences in the use of outpatient mental health services are analyzed in an insured, nonpoor population to determine if lower use by Blacks and Hispanics persists when socioeconomic and other factors are controlled. METHODS. To identify significant predictors of the probability and amount of use, insurance claims data for a population of 1.2 million federal employees insured by Blue Cross/Blue Shield in 1983 were analyzed with the Andersen and Newman model of health service utilization. Logistic and ordinary least squares regression models were estimated for each ethnic group. RESULTS. Blacks and Hispanics had lower probabilities and amounts of use when compared with Whites after controlling for a number of variables. CONCLUSIONS. Since ethnic differences in the use of outpatient mental health services exist even in an insured, nonpoor population, factors other than lower socioeconomic status or insurance coverage--for example, cultural or attitudinal factors and service system barriers--are likely responsible. Such findings have policy implications in the current climate of health care reform to increase access to care for the underserved.
Mental health status as a predictor of morbidity and mortality: a 15-year follow-up of members of a health maintenance organization.
Authors: Vogt T , Pope C , Mullooly J , Hollis J
Published: November 2008

OBJECTIVES. This study sought to relate preexisting depression, worries, affect balance, and mental health symptoms to subsequent risk of morbidity and mortality. METHODS. A random sample of members of a health maintenance organization were interviewed at home in a 1970/71 survey. Baseline psychological measures from that survey were then related to 15-year mortality and first incidence of cancer, heart disease, hypertension, stroke, functional gastrointestinal disease, and hyperimmune diseases. RESULTS. Baseline depression and the Langner Mental Health Index predicted incidence of functional gastrointestinal and hyperimmune diseases. The relationship of the Langner index to hyperimmune diseases was particularly strong; mortality, cancer, heart disease, hypertension, and stroke incidence were not related to that index. Except for affect balance, which was worst in the elderly, indications of psychological dysfunction were strongest in the young. CONCLUSIONS. Psychological indices detected increased risk for functional gastrointestinal and hyperimmune diseases but were not related to mortality risk. Further research is needed to disaggregate relationships of the specific conditions that were included in the hyperimmune group. Functional gastrointestinal disease might be preventable with early attention to depressed persons and to those scoring high on the Langner index.
The prevalence and demographics of pathological gamblers: implications for public health.
Authors: Volberg R A
Published: November 2008

OBJECTIVES. A study of pathological gambling in five states provides information needed to address the public health threat that the expanding availability of legalized gambling poses to at-risk groups in the general population. METHODS. Over the course of this project, epidemiological data were collected to determine the prevalence of probable pathological gambling in the general population in each study state and demographic data were collected from pathological gamblers entering treatment programs in each state. RESULTS. Among the states surveyed, the availability of and involvement in gambling differ significantly, as does the prevalence of pathological gambling. Despite these differences, the demographics of pathological gamblers in these states are similar. Like those in the general population, pathological gamblers entering treatment in each state are similar. However, pathological gamblers entering treatment do not represent the full spectrum of individuals in the general population who experience gambling-related problems. CONCLUSIONS. These findings raise a number of issues, including the potential impacts of continued gambling legalization on the overall rate of gambling problems in the general population and on specific at-risk groups, including women, minorities, and children. They thus have implications for policy and program decisions now being made throughout the United States.
Television beer advertising and drinking knowledge, beliefs, and intentions among schoolchildren.
Authors: Grube J W , Wallack L
Published: November 2008

OBJECTIVES. The relationships between television beer advertising and drinking knowledge, beliefs, and intentions were investigated in a survey of schoolchildren. The research was guided by a theoretical model specifying that awareness of advertising, and not mere exposure, is necessary for it to have an effect on beliefs or behaviors. METHODS. Participants were a random sample of 468 fifth- and sixth-grade schoolchildren from a northern California community. Data were collected in the home with a combination of self-administered questionnaires and structured interviews. RESULTS. Nonrecursive statistical modeling indicated that awareness of television beer advertising was related to more favorable beliefs about drinking, to greater knowledge of beer brands and slogans, and to increased intentions to drink as an adult. The effects of advertising awareness on knowledge, beliefs, and intentions were maintained when the reciprocal effects of beliefs, knowledge, and intentions on awareness were controlled. CONCLUSIONS. The findings suggest that alcohol advertising may predispose young people to drinking. As a result, efforts to prevent drinking and drinking problems among young people should give attention to countering the potential effects of alcohol advertising.
Risk factors for homelessness among schizophrenic men: a case-control study.
Authors: Caton C L , Shrout P E , Eagle P F , Opler L A , Felix A , Dominguez B
Published: November 2008

OBJECTIVES. To identify risk factors for homelessness among the severely mentally ill, we conducted a case-control study of 100 indigent schizophrenic men meeting criteria for literal homelessness and 100 such men with no homeless history. METHODS. Subjects were recruited from shelter, clinic, and inpatient psychiatric programs in Upper Manhattan. Clinical interviewers employed standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use. RESULTS. Homeless subjects showed significantly higher levels of positive symptoms, higher rates of a concurrent diagnosis of drug abuse, and higher rates of antisocial personality disorder. Homeless subjects experienced greater disorganization in family settings from birth to 18 years and less adequate current family support. Fewer homeless subjects than subjects in the never-homeless comparison group had a long-term therapist. These differences remained when demographic variables were adjusted statistically. CONCLUSIONS. Homeless schizophrenic men differed from their domiciled counterparts in all three domains we investigated; family background, nature of illness, and service use history. Findings are discussed in relation to policy and programs for the severely mentally ill.
Enhancing the self-report of alcohol consumption in the community: two questionnaire formats.
Authors: King A C
Published: November 2008

Two questionnaire formats for assessing alcohol consumption in a community sample were compared. Subjects completed the Semi-Quantitative Food Frequency Questionnaire and a questionnaire specifically targeting alcohol use. Across all alcoholic beverages, subjects reported lower consumption on the alcohol questionnaire than on the food frequency questionnaire. The results suggest that food frequency questionnaires may provide a better means for enhancing self-report of alcohol use than questionnaires that target solely alcohol intake.
The frequency and nature of alcohol and tobacco advertising in televised sports, 1990 through 1992.
Authors: Madden P A , Grube J W
Published: November 2008

This study examines the frequency and nature of alcohol and tobacco advertising in a random sample of 166 televised sports events representing 443.7 hours of network programming broadcast from fall 1990 through summer 1992. More commercials appear for alcohol products than for any other beverage. Beer commercials predominate and include images at odds with recommendations from former Surgeon General Koop. The audience is also exposed to alcohol and tobacco advertising through the appearances of stadium signs, other on-site promotions, and verbal or visual brief product sponsorships. Moderation messages and public service announcements are rare.
The illegal sale of cigarettes to US minors: estimates by state.
Authors: Cummings K M , Pechacek T , Shopland D
Published: November 2008

Data available from recent national surveys on the cigarette consumption and purchasing practices of teenage smokers were used to generate state-specific estimates of the number of teenage smokers and cigarette sales to minors. In 1991, approximately 2.7 million teenage cigarette smokers consumed an average of 28.3 million cigarettes per day (516 million packs per year). An estimated 255 million packs of cigarettes were sold illegally to minors in 1991. To make cigarettes and other tobacco products less accessible to minors, policymakers should consider implementing various legislative and economic measures such as banning cigarette vending machines and raising tobacco excise taxes.
Is liquor intoxicating? Scientists, prohibition, and the normalization of drinking.
Authors: Pauly P J
Published: November 2008

The reliance of current advocates of recreational drug legalization on parallels between "drug prohibition" and the repudiated experiment of National Prohibition in the 1920s invites renewed attention to the history of the legalization and normalization of drinking. A new scientific conception of the nature and effects of alcohol formed an important element in both the politics of repeal and the ensuing legitimation of alcohol consumption. The industrial toxicologist Yandell Henderson argued that alcohol should be considered analogous to carbon monoxide--clearly a poison, yet a normal part of civilized life and only problematic above a determinable and manageable exposure threshold. This argument had political force in the early 1930s as part of the contention that beer was not an "intoxicating liquor." It was more broadly persuasive because it was consistent with Americans' experience with industrial poisons, for which exposure levels had been set by toxicologists such as Henderson. This historical perspective illuminates the more recent reassessment of the risks of alcohol consumption. It also challenges the applicability of the model of the normalization of drinking to proposals to legalize cocaine and opiates.
Using CD4 counts to evaluate the stages and epidemiology of HIV infection in South Carolina public clinic patients.
Authors: Luby S , Jones J , Horan J
Published: November 2008

OBJECTIVES. CD4 lymphocyte counts decrease with the duration of human immunodeficiency virus (HIV) infection. We used CD4 counts collected for clinical reasons to evaluate the stage of HIV infection and the epidemiology of recent HIV infections among attendees of South Carolina's public health clinics. METHODS. We measured the CD4 T-lymphocyte counts of persons newly diagnosed with HIV infection April 1989 through June 1990 at South Carolina public health clinics who returned for follow-up. RESULTS. Of 812 newly diagnosed HIV-infected health department patients, 420 (52%) had their CD4 lymphocyte counts measured. Of these 420, 51 (12%) had CD4 counts of < 200, the level below which prophylaxis for pneumocystis pneumonia prolongs survival, and 193 (46%) had CD4 counts of < 500, the level below which zidovudine may prolong disease-free survival. The highest CD4 counts (> or = 900), which are associated with more recent HIV infection, were more common in females. CONCLUSIONS. In South Carolina, almost half of newly reported HIV-infected persons who agreed to CD4 testing at the health department might benefit from immediate drug therapy. Within this population, women may be an emerging risk group that requires specifically directed HIV prevention efforts.
Smokeless tobacco use and increased cardiovascular mortality among Swedish construction workers.
Authors: Bolinder G , Alfredsson L , Englund A , de Faire U
Published: November 2008

OBJECTIVES. Little is known about the risks of cardiovascular disease associated with the use of smokeless tobacco, which produces blood nicotine levels similar to those caused by cigarette smoking. METHODS. Male Swedish construction industry employees (n = 135,036) who attended a health examination were followed by studying cause-specific mortality during a 12-year period. The study population comprised 6297 smokeless tobacco users, 14,983 smokers of fewer than 15 cigarettes per day, 13,518 smokers of 15 or more cigarettes per day, 17,437 ex-smokers, 50,255 "other" tobacco users, and 32,546 nonusers. RESULTS. The age-adjusted relative risk of dying from cardiovascular disease was 1.4 for smokeless tobacco users and 1.9 for smokers of 15 or more cigarettes per day, compared with nonusers. Among men aged 35 through 54 years at the start of follow-up, the relative risk was 2.1 for smokeless tobacco users and 3.2 for smokers. When data were adjusted for body mass index, blood pressure, and history of heart symptoms, the results were essentially unchanged. Cancer mortality was not raised in smokeless tobacco users. CONCLUSIONS. Both smokeless tobacco users and smokers face a higher risk of dying from cardiovascular disease than nonusers. Although the risk is lower for smokeless tobacco users than for smokers, the excess risk gives cause for preventive actions.
Urinary tract infection during pregnancy: its association with maternal morbidity and perinatal outcome.
Authors: Schieve L A , Handler A , Hershow R , Persky V , Davis F
Published: November 2008

OBJECTIVES. The effects of antepartum urinary tract infection on adverse maternal and perinatal outcomes were examined. Antepartum urinary tract infection has been previously implicated as a risk factor for numerous outcomes. METHODS. Crude and multivariable analyses were performed with a perinatal registry cohort of 25,746 mother/infant pairs. RESULTS. Elevated risks were observed for exposure to urinary tract infection and low birthweight, prematurity, preterm low birthweight, premature labor, hypertension/preeclampsia, maternal anemia, and amnionitis. Urinary tract infection was associated with perinatal death only among subjects 20 to 29 years of age. CONCLUSIONS. These findings underscore the importance of antepartum urine screening to identify patients at risk for adverse outcomes.
Air recirculation and sick building syndrome: a blinded crossover trial.
Authors: Jaakkola J J , Tuomaala P , Seppänen O
Published: November 2008

OBJECTIVE. This study tested the hypothesis that recirculated air in mechanically ventilated buildings causes symptoms commonly referred to as the sick building syndrome and perceptions of poor indoor air quality. METHODS. A blinded, four-period crossover trial was carried out in two identical buildings, contrasting 70% return air (index phase) with 0% of return air (reference phase). Each period lasted 1 work-week. The study population comprised 75 workers who had reported symptoms related to the work environment or perceptions of poor indoor air quality. Participants reported their ratings of symptoms, their perceptions, and related information in a daily diary. The outcome criteria included aggregative symptom scores for mucosal irritation, skin reaction, allergic reaction, and general symptoms formed of ratings of component symptoms. Perceptions of unpleasant odor, stuffiness, or dustiness were additional outcome criteria. RESULTS. All 75 participants returned their diaries. For no symptoms did the scores differ between the two phases more than could be expected by chance. Mean rating of unpleasant odor was significantly smaller during the index phase, but mean ratings of dustiness and stuffiness did not differ materially between the two phases. CONCLUSIONS. Our results suggest that 70% recirculated air, when accompanied by an adequate intake of outdoor air, can be used without causing adverse effects.
Pesticide exposures, cholinesterase depression, and symptoms among North Carolina migrant farmworkers.
Authors: Ciesielski S , Loomis D P , Mims S R , Auer A
Published: November 2008

OBJECTIVES. We conducted a clinic-based study of erythrocyte cholinesterase levels, pesticide exposures, and health effects among farmworkers and nonfarmworkers to determine risks for exposure and associated morbidity. METHODS. Two hundred two farmworkers and 42 nonfarmworkers were recruited sequentially at two community health centers. Erythrocyte cholinesterase levels were measured colorimetrically. Questionnaires obtained data on demographics, occupational history, exposures, and symptoms. RESULTS. Cholinesterase levels were significantly lower among farmworkers (30.28 U/g hemoglobin) than among nonfarmworkers (32.3 U/g hemoglobin). Twelve percent of farmworkers, but no nonfarmworkers, had very low levels. Farmworkers applying pesticides also had lower cholinesterase levels. One half of farmworkers reported being sprayed by pesticides and working in fields with an obvious chemical smell. Of reported symptoms, only diarrhea was associated with cholinesterase levels. Reported exposures, however, were strongly associated with symptoms. CONCLUSIONS. Farmworkers reported many pesticide exposures that violate state and federal regulations. Farmworkers had cholinesterase levels significantly lower than those of nonfarmworkers, although only spraying pesticides was associated with very low levels.
Racial differences in rural adults' attitudes toward issues of adolescent sexuality.
Authors: Horner R D , Kolasa K M , Irons T G , Wilson K
Published: November 2008

This study, based on a random sample of adults in a rural North Carolina county, demonstrates racial differences in rural adults' attitudes relating to adolescent sexual issues. Blacks were 50% more likely than Whites to indicate that public schools should provide general health care services, including pregnancy testing and treatment of sexually transmitted diseases, to teenagers; however, they were only half as likely as Whites to approve of sexual experimentation by adolescents. The local community's attitudes must be considered in the implementation of rural adolescent health programs, including acquired immunodeficiency syndrome education.
The prevalence of intrauterine growth retardation in Mexican Americans.
Authors: Balcazar H
Published: November 2008

This study evaluated the prevalence of intrauterine growth retardation in Mexican Americans compared with non-Hispanic Whites in the state of Arizona. Data came from all live birth certificates in 1986 and 1987. Rates of intrauterine growth retardation in Mexican-American and non-Hispanic White infants in Arizona were lower than those in White infants in California. Differences in patterns of the 10th percentile growth distribution curves were observed between infants born in Arizona and those born in California. Compared with non-Hispanic Whites, Mexican Americans had lower adjusted odds ratios for intrauterine growth retardation according to several maternal risk characteristics.
The driver's license list as a population-based sampling frame in Iowa.
Authors: Lynch C F , Logsden-Sackett N , Edwards S L , Cantor K P
Published: November 2008

Driver's license lists are infrequently used for population-based sampling, presumably because of suspicions of poor population coverage. The 1990 Iowa driver's license list was compared with the 1990 census to evaluate coverage by 5-year age group, sex, resident county, and urbanicity. Coverage exceeded 90% among 15- to 74-year-old men and 15- to 64-year-old women, with uniform coverage by county and county urbanicity group in these age ranges. In Iowa, these lists are convenient and cost-effective and appear to be representative for 25- to 64-year-olds. The representativeness of driver lists in regard to other factors and in other geographic regions deserves further evaluation.
Neural tube defects in Jamaica following Hurricane Gilbert.
Authors: Duff E M , Cooper E S
Published: November 2008

An increased incidence of obvious live-birth neural tube defects (i.e., spina bifida cystica and encephalocele) occurred in Jamaica 11 to 18 months after Hurricane Gilbert. The conceptions of the affected babies coincided with a rise in megaloblastic change in sickle cell patients, suggesting a wide-spread drop in dietary folate intake. A detailed history was taken from each of the 17 affected mothers (case subjects) and 51 unaffected mothers (matched control subjects). The case subjects reported a significantly lower mean intake of dietary folate in the periconceptional period (154 micrograms/day) than did the control subjects (254 micrograms/day). The temporary increase in neural tube defects was associated with a diet comparatively low in folate in the periconceptional period, suggesting the dietary level of folate that fails to protect against neural tube defects under natural conditions.
The use of commercial tanning facilities by suburban Minnesota adolescents.
Authors: Oliphant J A , Forster J L , McBride C M
Published: November 2008

In 1991, 1008 suburban St. Paul, Minn, high school students were surveyed via self-administered questionnaire regarding use of commercial tanning facilities, injuries experienced from tanning, use of protective measures while tanning indoors, and knowledge of the risks of tanning. Overall, 34% of the respondents had used commercial tanning facilities. Fifty percent said they had not been warned by tanning facility operators about the risks of tanning indoors, 28% reported not being told to wear goggles, and 17% reported never wearing goggles. The results indicate that these adolescents use commercial tanning services at high rates, and often in ways that increase their risk for a variety of health problems.