bluuebunny/crossref_metadata_2025 huggingface dataset:
Comportamento ingestivo de vacas em lactação em diferentes sistemas forrageiros
Authors: Olivo Clair Jorge , Ziech Magnos Fernando , Meinerz Gilmar Roberto , Both José Francisco , Agnolin Carlos Alberto , Vendrame Tiago
Published: December 2008

Estudou-se o comportamento alimentar de vacas da raça Holandesa em lactação mantidas em pastagem de misturas de espécies de capim-elefante (Pennisetum purpureum Schum.), azevém (Lolium multiflorum Lam.) e outras de crescimento espontâneo. Como diferencial destas pastagens, introduziu-se trevo-branco (Trifolium repens L.) ou amendoim forrageiro (Arachis pintoi Krapov. & Greg.). Nos meses de julho, agosto e outubro de 2005, foram feitas avaliações em pastejo utilizando-se em cada uma seis vacas entre o segundo e o quinto mês de lactação, observadas nos períodos de 18 às 6 h e de 8 às 16 h, a cada 10 minutos, por dois observadores. Foram observados o tempo de pastejo nas linhas constituídas por capim-elefante (CE), o tempo de pastejo nas espécies estabelecidas na entrelinha e os tempos de pastejo total (pastejo de CE + entrelinha), ruminação e ócio. Também foram avaliados a massa de forragem inicial, o valor nutritivo da forragem ingerida e as condições climáticas do período. O tempo médio de pastejo na entrelinha foi de 4 horas e 9 minutos para o trevo-branco e de 3 horas e 6 minutos para o amendoim forrageiro. O tempo médio de pastejo do capim-elefante não diferiu entre as misturas com trevo-branco (4 horas e 27 minutos) e com amendoim forrageiro (5 horas e 51 minutos), assim como os tempos de ruminação e ócio, que também não diferiram entre as espécies associadas. A presença de forrageiras de inverno está associada ao maior tempo de consumo de forragem. A presença de espécies de ciclos diferentes possibilitou que os animais equilibrassem a dieta volumosa.
Index properties of a highly weathered old alluvium
Authors: Zhang G. , Germaine J. T. , Whittle A. J. , Ladd C. C.
Published: December 2008

An experimental programme was developed to investigate extensively the variation in the index properties of a highly weathered old alluvium in San Juan, Puerto Rico. Both Atterberg limits and particle size distribution were measured on disturbed samples subjected to increasing degrees of remoulding and different drying conditions. Results revealed that the soil exhibits variable index properties with different sample preparation techniques, owing to the presence of silt-sized aggregates that contain inter-cemented clay platelets consisting of paralleloriented kaolinite and smectite particles. Remoulding mechanically disintegrates the soil aggregates, causing large increases in the clay fraction and plasticity index. In addition to mechanical disintegration induced by shrinking, drying is accompanied with both physico-chemical and chemical reactions, which can either decrease or increase a soil's plasticity. For this soil, the influence of air-drying differs from that of oven-drying. The results are interpreted by linking the index properties to the soil's mineralogy and microstructure and by considering the five forms of water existing in the soil. This investigation demonstrates the importance of the knowledge of mineralogy and microstructure in understanding a soil's engineering properties, and provides rough guidance on sample preparation techniques for measuring index properties of residual soils used in practice.
The influences of iron (III) and lead (II) contaminants on lime-stabilised clay
Authors: Boardman D. I. , Glendinning S. , Rogers C. D. F.
Published: December 2008

This paper represents a continuation of the work published by Boardman et al., who concluded that the mechanisms of lime stabilisation were distinctly different for two clays of different mineralogy: English china clay, for which short-term flocculation is dependent on pH and long-term strength is dominated by the production of calcium aluminate hydrate (CAH); and Wyoming bentonite, for which strength is dominated by short-term flocculation that is only enhanced by high pH, and long-term strength is a function of the production of calcium silicate hydrate (CSH). To investigate further these variations in the lime stabilisation mechanisms, and to assess the effects of contamination on the stabilisation and solidification process, the studies were repeated using the two clay minerals contaminated with 5000 ppm of either Pb2+ or Fe3+ ions prior to the addition of lime. A similar methodology was adopted as in the previous work, in which the time-dependent physico-chemical mechanisms of reactions were studied by comparing the results from chemical batch leaching tests with the undrained shear strengths and Atterberg limits after three different curing periods. The study concluded that contaminants had a large effect on the initiation and development of the lime–clay reactions both during short-term modification and during the longer-term solidification. However, the effects were found to be clay mineral dependent. It was not possible simply to conclude on the general effects of a particular contaminant, its potential effects having to be considered in relation to the dominant clay mineral. The most profound effects were observed in the mineral with pH-dependent charge (typical of clays commonly found in the UK), where both flocculation and mineral dissolution were substantially altered.
A continuum-based model for analysis of laterally loaded piles in layered soils
Authors: Basu D. , Salgado R. , Prezzi M.
Published: December 2008

An analysis is developed to calculate the response of laterally loaded piles in multilayered elastic media. The displacement fields in the analysis are taken to be the products of independent functions that vary in the vertical, radial and circumferential directions. The governing differential equations for the pile deflections in different soil layers are obtained using the principle of minimum potential energy. Solutions for pile deflection are obtained analytically, whereas those for soil displacements are obtained using the one-dimensional finite difference method. The input parameters needed for the analysis are the pile geometry, the soil profile, and the elastic constants of the soil and pile. The method produces results with accuracy comparable with that of a three-dimensional finite element analysis but requires much less computation time. The analysis can be extended to account for soil non-linearity.
Circadian Research in Mothers and Infants: How Many Days of Actigraphy Data Are Needed to Fit Cosinor Parameters?
Authors: Thomas Karen A. , Burr Robert L.
Published: December 2008

Actigraphy is an easily applied approach for assessing activity and circadian patterns in mother–infant dyads. However, timing and duration of actigraphic measurements can affect assessment accuracy. The purpose of this study was to determine the number of days of actigraphy data required to portray circadian rhythm in mothers and their young infants. Continuous actigraphy monitoring was performed in 20 mother–infant pairs over a 4-day period. Cycle mesor, amplitude, acrophase, and R2 were calculated and compared using from 1 to 4 days of data. Parameters based on 4 days of data were correlated with parameters derived from 1 to 3 days of data. There were no differences among mother or infant cosinor parameters except infant acrophase, which stabilized after ≥2 days of data. Acceptable reliability (r > .80) was achieved with ≥2 days of data. It was concluded that a recording period of 2 days adequately depicted circadian rhythm of actigraphy in mothers and infants.
Reliability, Validity, and Health Issues Arising From Questionnaires Used to Measure Psychosocial and Organizational Work Factors (POWFs) Among Hospital Nurses: A Critical Review
Authors: Bonneterre Vincent , Liaudy Sylvette , Chatellier Gilles , Lang Thierry , de Gaudemaris Régis
Published: December 2008

This systematic review assesses the validity of epidemiological questionnaires used to measure psychosocial and organizational work factors (POWFs) in nurses. Of the 632 articles published between 1980 and July 2008 identified in this review, 108 provide some data concerning analysis of the intrinsic characteristics of such instruments (content validity or conceptual basis, reliability, validation of internal construction) and their external validity with respect to health aspects (concurrent validity and predictive validity). Psychometric properties of generalist questionnaires validated among blue collar or white collar workers were also assessed in the nurse population. The Job Content Questionnaire (JCQ), because of its longevity and reputation, was the generalist questionnaire most used among this population. Although its structure often raises questions in the nurse population, its dimensions (mainly the control one) have been shown to be predictive of some health outcomes measured with “objective” indicators concerning absenteeism, injuries, and musculoskeletal disorders. Effort Reward Imbalance (ERI), which has a structure more stable among the nurse population, has shown concurrent validity in terms of intent to leave the nursing profession. No questionnaire specifically designed for nurses can claim to satisfy all of the recommendations in terms of internal validity. Nevertheless, the Practice Environment Scale–Nursing Work Index (PES–NWI) seems to be one of the most promising instruments because of its appropriateness (content validity), its structure, which has a rather good fit (construct validity), its ability to discriminate magnet hospitals like other NWI derivates (discriminant validity), and it has also been associated in cross-sectional studies with health outcomes, especially nurses’ self-assessed mental health but also with patients’ health outcomes objectively assessed (concurrent validity). However, elements for predictive validity are still lacking with NWI derivates. The Discussion provides recommendations for measuring POWFs, encompassing the use of external validated measurements.
Brominated and chlorinated flame retardants in Lake Ontario, Canada, lake trout (Salvelinus namaycush) between 1979 and 2004 and possible influences of food-web changes
Authors: Ismail Nargis , Gewurtz Sarah B. , Pleskach Kerri , Whittle D. Michael , Helm Paul A. , Marvin Chris H. , Tomy Gregg T.
Published: December 2008

Concentrations of non-polybrominated diphenyl ether (PBDE) brominated (hexabromocyclododecane [HBCD], 1,2-bis[2,4,6-tribromophenoxy]ethane [BTBPE], and pentabromoethylbenzene [PEB]) and chlorinated (Dechlorane Plus [DP] as well as short- and medium-chain chlorinated paraffins [SCCP and MCCP, respectively]) flame retardants were evaluated in archived Lake Ontario, Canada, lake trout (Salvelinus namaycush) samples collected between 1979 and 2004. Polybrominated diphenyl ethers also were analyzed to provide a point of reference for comparison to previous studies. Concentrations of the dominant PBDE congeners (BDEs 28, 47, 99, 100, 153, and 154) increased significantly from 1979 until the mid-1990s, then either leveled off or decreased significantly between 1998 and 2004, a result that corresponds to those of previous studies. In contrast, BDE 209 increased approximately fourfold between 1998 and 2004. The temporal trends of the non-PBDE flame retardants varied, with sum (Σ) HBCD and DP showing significant overall decreases; BTBPE, ΣSCP, and ΣMCP showing parabolic trends; and PEB showing no overall change during the study period. Because many of the non-PBDE chemicals may be used as replacements for penta- and octa-BDE mixtures, these results will provide a baseline to evaluate future usage patterns. Possible changes in food-web structure, evaluated through stable nitrogen isotopes (δ15N), may be influencing our interpretations of contaminant trends in lake trout and are hypothesized to be partially responsible for the observed decrease in concentrations of BDEs 28, 47, 99, 100, 153, and 154 between 1998 and 2004. Retrospective analyses evaluating temporal trends in stable isotope values at the base of the food web, however, are recommended to test this hypothesis further.
Ecological factors regulating mercury contamination of fish from Caddo Lake, Texas, USA
Authors: Chumchal Matthew M. , Hambright K. David
Published: December 2008

Most studies examining the influence of ecological characteristics offish on Hg concentration in fish tissues have focused on a few variables and been conducted in northern ecosystems. We examined how total length (TL), age, food-web position (estimated using δ13C and δ15N), and habitat were related to total Hg concentrations in 10 species of fish from Caddo Lake, a subtropical reservoir located on the border of Texas and Louisiana, USA. We observed biomagnification in the Caddo Lake fish assemblage, and the enrichment factors (the slope of the relationship between δ15N and total Hg concentration) in the two habitats were 0.19 and 0.24, similar to those found in other studies. Although trophic position was the best predictor of total Hg concentration between species, age and TL were the best predictors of total Hg concentration within species. Unlike studies conducted in deep lakes, δ13C values of fish tissue, a measure of the extent to which fish feed in food webs based on pelagic or littoral primary production, was not a good predictor of total Hg concentration in Caddo Lake fish. Total Hg concentrations in fish were elevated in forested-wetland habitats relative to open-water habitats. Data collected in the present study indicate that more Hg likely was available for incorporation into the base of the food web in the forested-wetland habitat than in the open-water habitat. Our results help to clarify the relationship between ecological characteristics of fish and Hg concentration in fish tissue and can be used by researchers as well as public and environmental health officials when designing Hg monitoring studies.
Effect of an STD/HIV Behavioral Intervention on Women's Use of the Female Condom
Authors: Van Devanter Nancy , Gonzales Virginia , Merzel Cheryl , Parikh Nina S. , Celantano David , Greenberg Judith
Published: December 2008

Objectives. This study assessed the effectiveness of a sexually transmitted disease (STD)/HIV behavior change intervention in increasing women's use of the female condom.

Methods. A total of 604 women at high risk for STDs and HIV in New York City, Baltimore, Md, and Seattle, Wash, enrolled in a randomized controlled trial of a small-group, skills-training intervention that included information and skills training in the use of the female condom.

Results. In a logistic regression, the strongest predictors of use were exposure to the intervention (odds ratio [OR] = 5.5; 95% confidence interval [CI] = 2.8, 10.7), intention to use the female condom in the future (OR = 4.5; 95% CI = 2.4, 8.5), having asked a partner to use a condom in the past 30 days (OR = 2.3; 95% CI = 1.3, 3.9), and confidence in asking a partner to use a condom (OR = 1.9; 95% CI = 1.1, 3.5).

Conclusions. Clinicians counseling women in the use of the female condom need to provide information, demonstrate its correct use with their clients, and provide an opportunity for their clients to practice skills themselves.
Impact of Targeted Programs on Health Systems: A Case Study of the Polio Eradication Initiative
Authors: Loevinsohn Benjamin , Aylward Bruce , Steinglass Robert , Ogden Ellyn , Goodman Tracey , Melgaard Bjorn
Published: December 2008

The results of 2 large field studies on the impact of the polio eradication initiative on health systems and 3 supplementary reports were presented at a December 1999 meeting convened by the World Health Organization.

All of these studies concluded that positive synergies exist between polio eradication and health systems but that these synergies have not been vigorously exploited. The eradication of polio has probably improved health systems worldwide by broadening distribution of vitamin A supplements, improving cooperation among enterovirus laboratories, and facilitating linkages between health workers and their communities. The results of these studies also show that eliminating polio did not cause a diminution of funding for immunization against other illnesses. Relatively little is known about the opportunity costs of polio eradication.

Improved planning in disease eradication initiatives can minimize disruptions in the delivery of other services. Future initiatives should include indicators and baseline data for monitoring effects on health systems development.
Beauty and the Beast: Results of the Rhode Island Smokefree Shop Initiative
Authors: Linnan Laura A. , Emmons Karen M. , Abrams David B.
Published: December 2008

Licensed hairdressing facilities are prevalent in communities nationwide and represent a unique and promising channel for delivering public health interventions. The Rhode Island Smokefree Shop Initiative tested the feasibility of using these facilities to deliver smoking policy interventions statewide. A statewide survey of hairdressing facilities was followed by interventions targeted to the readiness level (high/low) of respondents to adopt smoke-free policies.
Geographic Socioeconomic Status, Race, and Advanced-Stage Breast Cancer in New York City
Authors: Merkin Sharon Stein , Stevenson Lori , Powe Neil
Published: December 2008

Objectives. This study examined the association between a residential area's socioeconomic status (SES), race, and advanced-stage breast cancer in New York City.

Methods. The cross-sectional study design used breast cancer information for 37 921 cases diagnosed in New York City from 1986 to 1995. Residential education and income levels were based on the 1990 census and ascribed to each case by zip code. Associations between race, area SES, and advanced-stage breast cancer stage, and the interaction between race and SES, were evaluated in bivariate and multivariate analyses.

Results. After adjusting for age and year at diagnosis, living in areas with lower levels of education and income increased the odds of presenting with advanced-stage breast cancer by 50% for Black women and by 75% for White women. No significant qualitative interaction was present between area SES and race.

Conclusions. This study confirmed independent racial and socioeconomic differences in the risk of advanced-stage breast cancer in a large and diverse population. The results emphasize the need to improve screening practices and clinical treatment in both high-risk populations and high-risk geographic areas.
Ages at Initiation of Cigarette Smoking and Quit Attempts Among Women: A Generation Effect
Authors: Morabia Alfredo , Costanza Michael C. , Bernstein Martine S. , Rielle Jean-Charles
Published: December 2008

Objectives. This study sought to determine whether the age at initiation of regular cigarette smoking and the likelihood of quitting smoking through age 35 differ among women from younger versus older generations.

Methods. Annual population-based, random surveys (total of 3676 female residents of Geneva, Switzerland, aged 35–74 years) were conducted from 1992 to 1998.

Results. Women younger than 55 years were more likely to be past or current smokers, began smoking earlier (median age < 20 years), and smoked more cigarettes per day than older women, yet attempted to quit smoking more often before age 35 (log-rank P < .001).

Conclusions. Young female smokers have a higher propensity to quit smoking compared with older women. Encouraging young smokers to quit—in addition to preventing nonsmokers from starting—may be an important facet of reducing cigarette smoking prevalence among adolescents.
Adequacy of Treatment for Serious Mental Illness in the United States
Authors: Wang Philip S. , Demler Olga , Kessler Ronald C.
Published: December 2008

Objectives. The purpose of this study was to assess the prevalence and correlates of treatment for serious mental illness.

Methods. Data were derived from the National Comorbidity Survey, a cross-sectional, nationally representative household survey assessing the presence and correlates of mental disorders and treatments. Crude and adjusted likelihoods of receiving treatment for serious mental illness in the previous 12 months were calculated.

Results. Forty percent of respondents with serious mental illness had received treatment in the previous year. Of those receiving treatment, 38.9% received care that could be considered at least minimally adequate, resulting in 15.3% of all respondents with serious mental illness receiving minimally adequate treatment. Predictors of not receiving minimally adequate treatment included being a young adult or an African American, residing in the South, being diagnosed as having a psychotic disorder, and being treated in the general medical sector.

Conclusions. Inadequate treatment of serious mental illness is an enormous public health problem. Public policies and cost-effective interventions are needed to improve both access to treatment and quality of treatment.
A Randomized Trial of Chiropractic Manipulation and Mobilization for Patients With Neck Pain: Clinical Outcomes From the UCLA Neck-Pain Study
Authors: Hurwitz Eric L. , Morgenstern Hal , Harber Philip , Kominski Gerald F. , Yu Fei , Adams Alan H.
Published: December 2008

Objectives. This study compared the relative effectiveness of cervical spine manipulation and mobilization for neck pain.

Methods. Neck-pain patients were randomized to the following conditions: manipulation with or without heat, manipulation with or without electrical muscle stimulation, mobilization with or without heat, and mobilization with or without electrical muscle stimulation.

Results. Of 960 eligible patients, 336 enrolled in the study. Mean reductions in pain and disability were similar in the manipulation and mobilization groups through 6 months.

Conclusions. Cervical spine manipulation and mobilization yield comparable clinical outcomes.
Community-Oriented Primary Care: A Path to Community Development
Authors: Geiger H. Jack
Published: December 2008

Although community development and social change are not explicit goals of community-oriented primary care (COPC), they are implicit in COPC’s emphasis on community organization and local participation with health professionals in the assessment of health problems. These goals are also implicit in the shared understanding of health problems’ social, physical, and economic causes and in the design of COPC interventions.

In the mid-1960s, a community health center in the Mississippi Delta created programs designed to move beyond narrowly focused disease-specific interventions and address some of the root causes of community morbidity and mortality.

Drawing on the skills of the community itself, a selfsustaining process of health-related social change was initiated. A key program involved the provision of educational opportunities.
The Burden of Infectious Disease Among Inmates of and Releasees From US Correctional Facilities, 1997
Authors: Hammett Theodore M. , Harmon Mary Patricia , Rhodes William
Published: December 2008

Objectives. This study developed national estimates of the burden of selected infectious diseases among correctional inmates and releasees during 1997.

Methods. Data from surveys, surveillance, and other reports were synthesized to develop these estimates.

Results. During 1997, 20% to 26% of all people living with HIV in the United States, 29% to 43% of all those infected with the hepatitis C virus, and 40% of all those who had tuberculosis disease in that year passed through a correctional facility.

Conclusions. Correctional facilities are critical settings for the efficient delivery of prevention and treatment interventions for infectious diseases. Such interventions stand to benefit not only inmates, their families, and partners, but also the public health of the communities to which inmates return.
Will Screening Mammography in the East Do More Harm than Good?
Authors: Leung Gabriel M. , Lam Tai-Hing , Thach Thuan Q. , Hedley Anthony J.
Published: December 2008

Objectives. We sought to systematically review the evidence for population-based mammography as applied to a Chinese population.

Methods. Primary reports for meta-analysis were identified by a search of MEDLINE and the Cochrane Library. Outcome measures included breast cancer–related mortality, the number needed to be screened to prevent 1 death, and the positive predictive value of mammography.

Results. Pooled relative risk for breast cancer–related death in the screened group was 0.80 (95% confidence interval = 0.71, 0.90). Applied to Hong Kong, this figure translates into a number needed to screen of 1 302 healthy women screened annually for 10 years to prevent 1 death. Conclusions. Evidence is insufficient to justify population-based breast cancer screening by mammography for women in Hong Kong and other Asian populations with low breast cancer prevalence.
Adverse Effects of US Jail and Prison Policies on the Health and Well-Being of Women of Color
Authors: Freudenberg Nicholas
Published: December 2008

In the past few decades, US policies have led to an unprecedented increase in the number of people behind bars. While more men than women are incarcerated, the rate of increase for women has been higher.

Evidence of the negative impact of incarceration on the health of women of color suggests strategies to reduce these adverse effects. Correctional policies contribute to disparities in health between White women and women of color, providing a public health rationale for policy change.

Specific roles for health professionals include becoming involved in alliances addressing alternatives to incarceration, creating programs that address the needs of women in correctional facilities, and identifying the pathways by which correctional policies damage health.
Expanding Harm Reduction Services Through a Wound and Abscess Clinic
Authors: Grau Lauretta E. , Arevalo Silvia , Catchpool Christopher , Heimer Robert
Published: December 2008

A wound and abscess clinic, held concurrently with a syringe exchange, provided economical treatment and aftercare for injection-associated soft tissue infections. During 20 two-hour clinic sessions, 173 treatment episodes were logged, and the visit cost was estimated at $5 per patient.

Increased patient–clinician interactions provided opportunities beyond those afforded by the syringe exchange for patients to obtain resources and referrals to services such as HIV counseling and testing, medical care, and drug treatment.

Distribution of cards advertising the clinic was substantially less effective than word of mouth in increasing community awareness of the clinic.
Vodka and Violence: Alcohol Consumption and Homicide Rates in Russia
Authors: Pridemore William Alex
Published: December 2008

In Russia, rates of alcohol consumption and homicide are among the highest in the world, and already-high levels increased dramatically after the breakup of the Soviet Union. Rates of both, however, vary greatly among Russia’s 89 regions.

We took advantage of newly available vital statistics and socioeconomic data to examine the regional covariation of drinking and lethal violence. Log-log models were employed to estimate the impact of alcohol consumption on regional homicide rates, controlling for structural factors thought to influence the spatial distribution of homicide rates. Results revealed a positive and significant relationship between alcohol consumption and homicide, with a 1% increase in regional consumption of alcohol associated with an approximately 0.25% increase in homicide rates.

In Russia, higher regional rates of alcohol consumption are associated with higher rates of homicide.
Condom Use as a Function of Time in New and Established Adolescent Sexual Relationships
Authors: Fortenberry J. Dennis , Tu Wanzhu , Harezlak Jaroslaw , Katz Barry P. , Orr Donald P.
Published: December 2008

Objectives. This study sought to describe condom use over time in new and established adolescent relationships.

Methods. The outcome variable was time (in days) until first unprotected coital event. Analyses involved comparisons of Kaplan–Meier survival curves and Cox proportional hazards models.

Results. Survival functions for the 2 relationship groups were significantly different. However, by 21 days the curves had converged: 43% of new and 41% of established relationships involved no unprotected coital events. Time to first unprotected coital event was significantly longer in new than in established relationships.

Conclusions. Prolongation of condom use in ongoing relationships may be a useful intervention to prevent sexually transmitted diseases.
Childhood Sexual Abuse and Risk Behaviors Among Men at High Risk for HIV Infection
Authors: DiIorio Colleen , Hartwell Tyler , Hansen Nellie
Published: December 2008

Objectives. This study examined the association between unwanted sexual activity during childhood and risky behaviors among a sample of predominantly African American and Hispanic men.

Methods. Data were obtained from baseline interviews completed by 2676 men enrolled in a multisite HIV prevention trial.

Results. Approximately 25% of the men reported unwanted or uninvited sexual activity before 13 years of age, with Hispanic men more likely than African American men to report unwanted sexual activity during childhood. Men with a history of unwanted sexual activity during childhood were more likely to report unwanted sexual activity since age 13, the buying and selling of sex, problems with alcohol, and drug use. Men who reported unwanted sexual activity during childhood also reported a significantly greater frequency of unprotected sexual acts and more partners.

Conclusions. Among men at high risk for HIV infection, unwanted sexual activity during childhood is more widespread than previously described and can increase the risk of participating in harmful health practices during adulthood, including risky sexual behaviors.
Poverty, Family Process, and the Mental Health of Immigrant Children in Canada
Authors: Beiser Morton , Hou Feng , Hyman Ilene , Tousignant Michel
Published: December 2008

Objectives. This study examined the differential effects of poverty on the mental health of foreign-born children, Canadian-born children of immigrant parents, and children of nonimmigrant parents.

Methods. Secondary analysis of data from a national Canadian study of children between 4 and 11 years of age was conducted.

Results. Compared with their receiving-society counterparts, foreign-born children were more than twice as likely to live in poor families, but they had lower levels of emotional and behavioral problems. The effect of poverty on children's mental health among long-term immigrant and receiving-society families was indirect and primarily mediated by single-parent status, ineffective parenting, parental depression, and family dysfunction. In comparison, the mental health effect of poverty among foreign-born children could not be explained by the disadvantages that poor families often suffer.

Conclusions. Poverty may represent a transient and inevitable part of the resettlement process for new immigrant families. For long-stay immigrant and receiving-society families, however, poverty probably is not part of an unfolding process; instead, it is the nadir of a cycle of disadvantage.
Prevalence of Medication Treatment for Attention Deficit–Hyperactivity Disorder Among Elementary School Children in Johnston County, North Carolina
Authors: Rowland Andrew S. , Umbach David M. , Stallone Lil , Naftel A. Jack , Bohlig E. Michael , Sandler Dale P.
Published: December 2008

Objectives. This study estimated the prevalence of medication treatment for attention deficit–hyperactivity disorder (ADHD) among elementary school children in a North Carolina county.

Methods. Parents of 7333 children in grades 1 through 5 in 17 public elementary schools were asked whether their child had ever been given a diagnosis of ADHD by a psychologist or physician and whether their child was currently taking medication to treat ADHD. Parents of 6099 children (83%) responded.

Results. By parental report, 607 children (10%) had been given an ADHD diagnosis and 434 (7%) were receiving ADHD medication treatment. Seventy-one % of the diagnosed children were receiving medication. Treatment rates varied by sex, race/ethnicity, and grade.

Conclusions. If treatment patterns observed in this study are representative, the public health impact of ADHD may be underestimated. (Am J Public Health. 2002;92:231–234)
Classroom-Based Surveys of Adolescent Risk-Taking Behaviors: Reducing the Bias of Absenteeism
Authors: Guttmacher Sally , Weitzman Beth C. , Kapadia Farzana , Weinberg Sharon L.
Published: December 2008

Objectives. This investigation examined the effectiveness of intensive efforts to include frequently absent students in order to reduce bias in classroom-based studies.

Methods. Grade 10 students in 13 New York City high schools (n = 2049) completed selfadministered confidential surveys in 4 different phases: a 1-day classroom capture, a 1-day follow-up, and 2 separate 1-week follow-ups. Financial incentives were offered, along with opportunities for out-of-classroom participation.

Results. Findings showed that frequently absent students engaged in more risk behaviors than those who were rarely absent. Intensive efforts to locate and survey chronically absent students did not, however, significantly alter estimates of risk behavior. Weighting the data for individual absences marginally improved the estimates.

Conclusions. This study showed that intensive efforts to capture absent students in classroom-based investigations are not warranted by the small improvements produced in regard to risk behavior estimates.
Expressive Freedom and Tobacco Advertising: A Canadian Perspective
Authors: Manfredi Christopher P.
Published: December 2008

In 1989, Canada enacted the Tobacco Products Control Act (TPCA), which prohibited tobacco advertising, required health warnings on tobacco packaging, and restricted promotional activities. Canada's tobacco companies challenged the TPCA's constitutionality, arguing that it infringed on freedom of expression. Although it seemed likely that the Canadian Supreme Court would uphold the legislation, in 1995 the court declared the impugned provisions to be unconstitutional. The decision is testimony to the constraining force of liberalism on tobacco regulation, but it is also evidence of the power of political will. While the Canadian government could have used the decision to justify withdrawing from further confrontations with powerful commercial interests, it chose instead to enact new tobacco control legislation in 1997.
Impact of Highly Active Antiretroviral Treatment on HIV Seroincidence Among Men Who Have Sex With Men: San Francisco
Authors: Katz Mitchell H. , Schwarcz Sandra K. , Kellogg Timothy A. , Klausner Jeffrey D. , Dilley James W. , Gibson Steven , McFarland William
Published: December 2008

Objectives. This study assessed the countervailing effects on HIV incidence of highly active antiretroviral treatment (HAART) among San Francisco men who have sex with men (MSM).

Methods. Behavioral risk was determined on the basis of responses to cross-sectional community interviews. HIV incidence was assessed through application of an enzyme-linked immunoassay testing strategy.

Results. Use of HAART among MSM living with AIDS increased from 4% in 1995 to 54% in 1999. The percentage of MSM who reported both unprotected anal intercourse and multiple sexual partners increased from 24% in 1994 to 45% in 1999. The annual HIV incidence rate increased from 2.1% in 1996 to 4.2% in 1999 among MSM who sought anonymous HIV testing, and the rate was high (5.3%) but stable in a blinded survey of MSM seeking sexually transmitted disease services.

Conclusions. Any decrease in per contact risk of HIV transmission due to HAART use appears to have been counterbalanced or overwhelmed by increases in the number of unsafe sexual episodes. (Am J Public Health. 2002;92:388–394)
No Care for the Caregivers: Declining Health Insurance Coverage for Health Care Personnel and Their Children, 1988–1998
Authors: Case Brady G. S. , Himmelstein David U. , Woolhandler Steffie
Published: December 2008

Objectives. This study examined trends in health insurance coverage for health care workers and their children between 1988 and 1998.

Methods. We analyzed data from the annual March supplements of the Current Population Survey (CPS), a Census Bureau survey that collects information about health insurance from a nationally representative sample of noninstitutionalized US residents.

Results. Of the health care personnel younger than 65 years, 1.36 million (90% confidence interval [CI] = 1.28 million, 1.45 million) were uninsured in 1998, up 83.4% from 1988; the proportion uninsured rose from 8.4% (90% CI = 7.8%, 9.1%) to 12.2% (90% CI = 11.5%, 12.9%). Declining coverage rates in the growing private-sector health care workforce—and declining health employment in the public sector, which provided health insurance benefits to more of its workers—accounted for the increases. Households with a health care worker included 1.12 million (90% CI = 1.05 million, 1.20 million) uninsured children, accounting for 10.1% (90% CI = 9.5%, 10.8%) of all uninsured children in the United States.

Conclusions. Health care personnel are losing health insurance coverage more rapidly than are other workers. Increasingly, the health care sector is consigning its own workers and their children to the ranks of the uninsured.
Effect of Racial/Ethnic Misclassification of American Indians and Alaskan Natives on Washington State Death Certificates, 1989–1997
Authors: Stehr-Green Paul , Bettles James , Robertson L. Dee
Published: December 2008

Objectives. This study examined effects of racial/ethnic misclassification of American Indians and Alaskan natives on Washington State death certificates.

Methods. Probabilistic record linkage were used to match the 1989–1997 state death files to the Northwest Tribal Registry.

Results. We identified matches for 2819 decedents, including 414 (14.7%) who had been misclassified as non–American Indians and Alaskan natives on the death certificates. The likelihood of being correctly classified increased 3-fold for each higher level of American Indian and Alaskan native ancestry (odds ratio = 2.88; 95% confidence interval [CI] = 2.51, 3.30) and decreased by 6.9% per calendar year (95% CI = 2.0, 11.5).

Conclusions. Systematic biases on death certificates in Washington State persist. Methods to reduce misclassification can improve data quality and enhance efforts to measure and reduce racial/ethnic health disparities. (Am J Public Health. 2002;92:443–444)
Moving Forward: Addressing the Health of Asian American and Pacific Islander Women
Authors: Ro Marguerite
Published: December 2008

Little is known about the health of Asian American and Pacific Islander (AAPI) women, a rapidly growing population marked by diverse sociodemographic characteristics, health needs, and access to and use of health services.

This commentary provides broad recommendations for research, program development, and policy development based on the first-ever White House Initiative report on AAPIs. These recommendations address the issues of data, access, civil rights, community capacity, and the need to recognize ethnic subgroups among the AAPI population.

Reflecting on the events of the past year, the recommendations provide direction for public health to address the health and well-being of AAPI women.
Intimate Partner Violence and Women of Color: A Call for Innovations
Authors: Lee Roberta K. , Thompson Vetta L. Sanders , Mechanic Mindy B.
Published: December 2008

In this commentary, we focus on violence against women of color. Although African American women experience higher rates of intimate partner homicide than White women, the cumulative rates for nonfatal intimate partner violence are similar and do not vary between urban and rural locations (though access to services may vary by location).

Much of the research about intimate partner violence is based on women with low socioeconomic status and on interventions that were developed by and for White women. Current primary prevention strategies focus on violence that is perpetrated by strangers rather than their primary perpetrators—intimate partners.

We recommend the development and rigorous evaluation of prevention strategies that incorporate the views of women of color and attention to primary prevention.
Impact of Breast Cancer on African American Women: Priority Areas for Research in the Next Decade
Authors: Jones Lovell A. , Chilton Janice A.
Published: December 2008

Despite all the gains that have been made in the area of breast cancer research, African American women suffer disproportionately from the effects of the disease. Breast cancer is the second leading cause of cancer death among African American women, exceeded only by lung cancer.

Improvements in cancer incidence, mortality, and survival rates among populations are undoubtedly the outcome of quality research. Therefore, there is a need to identify and discuss issues regarding breast cancer among African American women and to determine whether these issues should be a part of the nation's breast cancer research agenda.

This commentary summarizes the results of the Summit Meeting Evaluating Research on Breast Cancer in African American Women, which was held September 8–11, 2000, in Washington, DC. Listed are priority areas and some of the questions that fueled this 2-day discussion among 130 participants, including health advocates, cancer survivors, and experts representing various areas of cancer research.
Cardiovascular Disease Among Women Residing in Rural America: Epidemiology, Explanations, and Challenges
Authors: Taylor Herman A. , Hughes Gail D. , Garrison Robert J.
Published: December 2008

Many believe that the United States has entered a “Golden Age” of cardiovascular health and medicine. Pharmacological and technological advances have indeed produced an era of declining mortality rates from cardiovascular diseases for the nation as a whole. However, there remain areas of challenge.

Cardiovascular disease (CVD) is still by far the leading cause of death and disability in the United States, and it is the leading killer of US women. Perhaps the single most notable feature of the CVD epidemic in the United States is the substantial difference in morbidity and mortality that exists between White women and women of color, with a disproportionate share of suffering borne by minority women. Unexplained regional variations also cloud the otherwise notable progress of the last 30 years, and many rural areas appear to be uniquely affected by cardiovascular disease.

This commentary reviews the evidence that the CVD epidemic disproportionately burdens women of color who reside in rural areas, itemizes and provides a logical framework for explaining this burden, and suggests approaches to solving this vexing public health problem.
Heterogeneity of Health Disparities Among African American, Hispanic, and Asian American Women: Unrecognized Influences of Sexual Orientation
Authors: Mays Vickie M. , Yancey Antronette K. , Cochran Susan D. , Weber Mark , Fielding Jonathan E.
Published: December 2008

Objectives. This study compared health indicators among self-identified lesbians/bisexual women and heterosexual women residing in Los Angeles County.

Methods. Respondents were English-speaking Hispanic, African American, and Asian American women. Health status, behavioral risks, access barriers, and indicators of health care were assessed.

Results. Prevalence rates of chronic health conditions were similar among women in the 3 racial/ethnic groups. However, lesbians and bisexual women evidenced higher behavioral risks and lower rates of preventive care than heterosexual women.

Conclusions. Among racial/ethnic minority women, minority sexual orientation is associated with increased health risks. The effects of sexual minority status need to be considered in addressing health disparities affecting this population.
Early Adult Characteristics and Mortality Among Inner-City African American Women
Authors: Astone Nan Marie , Ensminger Margaret , Juon Hee Soon
Published: December 2008

Objectives. This study examined predictors of longevity in a cohort of inner-city African American women.

Methods. Data were derived from a cohort study of inner-city African American mothers whose median age in 1966 was 31 years. Analyses involved single-decrement life tables and pooled logistic regression.

Results. Giving birth for the first time before age 25 and having at least a high school education predicted longevity in this sample. Effects of later age at first delivery in terms of mortality risk were stronger after 55 years and, especially, after 70 years.

Conclusions. The findings offer support for Geronimus's weathering hypothesis. Predictors of longevity among African Americans may be distinct from predictors for the population as a whole.
McKeown and the Idea That Social Conditions Are Fundamental Causes of Disease
Authors: Link Bruce G. , Phelan Jo C.
Published: December 2008

In an accompanying commentary, Colgrove indicates that McKeown's thesis—that dramatic reductions in mortality over the past 2 centuries were due to improved socioeconomic conditions rather than to medical or public health interventions—has been “overturned” and his theory “discredited.”

McKeown sought to explain a very prominent trend in population health and did so with a strong emphasis on the importance of basic social and economic conditions. If Colgrove is right about the McKeown thesis, social epidemiology is left with a gaping hole in its explanatory repertoire and a challenge to a cherished principle about the importance of social factors in health.

We return to the trend McKeown focused upon—post-McKeown and post-Colgrove—to indicate how and why social conditions must continue to be seen as fundamental causes of disease.
Housing and Health: Time Again for Public Health Action
Authors: Krieger James , Higgins Donna L.
Published: December 2008

Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, public health departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing “Healthy Homes” programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for public health to create healthier homes by confronting substandard housing.
Heat Wave Morbidity and Mortality, Milwaukee, Wis, 1999 vs 1995: An Improved Response?
Authors: Weisskopf Marc G. , Anderson Henry A. , Foldy Seth , Hanrahan Lawrence P. , Blair Kathleen , Török Thomas J. , Rumm Peter D.
Published: December 2008

Objectives. This study examined whether differences in heat alone, as opposed to public health interventions or other factors, accounted for the reduction in heat-related deaths and paramedic emergency medical service (EMS) runs between 1995 and 1999 during 2 heat waves occurring in Milwaukee, Wis.

Methods. Two previously described prediction models were adapted to compare expected and observed heat-related morbidity and mortality in 1999 based on the city's 1995 experience.

Results. Both models showed that heat-related deaths and EMS runs in 1999 were at least 49% lower than levels predicted by the 1995 relation between heat and heat-related deaths or EMS runs.

Conclusions. Reductions in heat-related morbidity and mortality in 1999 were not attributable to differences in heat levels alone. Changes in public health preparedness and response may also have contributed to these reductions.