bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of martensite reorientation in the fretting behaviour of nickel titanium shape memory alloy
Authors: Qian L , Sun Q , Zhou Z
Published: November 2008

In this study, fretting tests of a GCr15 steel ball against a nickel titanium (NiTi) shape memory alloy plate (NiTi/GCr15) are performed on a horizontal servo-hydraulic fretting machine. It is found that the martensite reorientation plays an important role in the fretting behaviour of NiTi. Similar to that in a cyclic torsion test, the shear-induced martensite reorientation deformation of NiTi is reversible in tangential fretting, where the material undergoes a cyclic shear process. With an increase in the number of fretting cycles, the additional tangential displacement due to the martensite reorientation deformation in NiTi reaches its peak value at about 50–100 cycles after the initial increase, and finally decreases to a constant value after 1000 cycles. As a result, the martensite reorientation in fretting increases the elastic-accommodation ability of NiTi/GCr15 pairs, and further expands the partial slip regime of NiTi/GCr15 pairs. In addition, similar to the martensite phase transition in NiTi, the martensite reorientation in NiTi exhibits a strong shielding effect to decrease the contact stress of NiTi/GCr15 pairs and improve the wear resistance of NiTi.
Tribo-characterization of natural fibre-reinforced polymer composite material
Authors: El-Tayeb N S M
Published: November 2008

In this study, low-cost polymeric composite materials using sugarcane fibre-reinforced polyester (SCRP) with two forms of fibre reinforcement – chopped fibres (C-SCRP) and unidirectional fibres – were developed and evaluated. Interfacial adhesion between single sugarcane fibre (SSCF) and polyester, tensile properties of SSCF, and mechanical and tribological performance of SCRP composites were determined. Despite a good degree of interfacial adhesion between the SSCF and matrix, the tensile strength of the C-SCRP composite was lower compared with that of neat polyester. However, the compressive strength of the composite improved by about 37 per cent, whereas tensile and compressive moduli improved by 132 and 17 per cent, respectively. In addition, wear tests revealed that the SCRP composite is a promising material for adhesive wear applications.
A methodology for online wear debris morphology and composition analysis
Authors: Khan M A , Starr A G , Cooper D
Published: November 2008

Online or inline detection of basic debris features, i.e. size, quantity, size distribution, shape, and compositions simultaneously with real time diagnostics is one of the possible ways to perform wear debris analysis with high reliability. At present many techniques and sensors are available that can perform near real time detection and diagnostics for debris quantitative features. But to perform real time detection and diagnostics for features like shape and composition still requires a reliable technical concept.

In this article a new technique for online wear debris shape and composition analysis is described. The developed technique is a combination of hardware and software based on imaging technology for shape and composition detection. Rule-based algorithms are used to perform near real time debris analysis diagnostics. An experimental study is also presented that shows the possible potential of the developed technique on real applications.
Das graphematische Wort (im Deutschen): Eine erste Annäherung
Authors: Fuhrhop Nanna
Published: November 2008

In the field of phonology, the concept of ‘word’ has been well-defined in contemporary linguistics. In morphology and syntax, the different existing theories provide a basis for establishing a ‘word’ as well. In graphematics, too, establishing a concept for ‘word’ might appear simple: A graphematic word is the segment sequence between two spaces. But what does this segment-sequence look like? The essay addresses this question in three steps. It begins by discussing the graphematic syllable. It then explains the principle of writing complex words. In German, this may be the prototypical part of graphematic words. For the non-prototypical part, acronyms, abbreviations, punctuation (hyphen, apostrophe, word-level period) and numbers are discussed. The final section is devoted to the interaction between the different concepts of words (phonological, morphological, syntactic and graphematical), and shows that the graphematic word in German is especially determined by morphological and syntactic features.
Discovering Terroir in the Wines of Alsace
Authors: nesto bill
Published: November 2008

Alsace vineyards are complex in subsoil type. The author proposes that the characteristics of the subsoil are the most indelible aspect of terroir. Many Alsace wine producers use sustainable, biologic, and biodynamic farming practices in order to best transfer flavors that could be attributed to subsoil type. Both the traditional and modern vinification and maturation methods of Alsace producers interfere minimally with the transfer of subsoil flavor to wine flavor. Hence, Alsace wine is the ideal locus to sense and understand ““terroir”” in wine. The author examines whether and how subsoil flavor can be sensed in wine flavor. In particular, he assesses what could account for ““mineral”” smells and tastes in wine. Most Alsace wines are composed of one grape variety. Until recently all Grand Cru wines had to be composed of only one of the four varietals: Riesling, Gewurztraminer, Pinot Gris, and Muscat d'Alsace. Recent changes in wine legislation allow other vine varieties or blends of varieties in Grand Cru wines. The author examines the relationship of these legal changes to the terroir issue and to the marketability of Alsace wine. The author substantiates his theses by comparing and contrasting the opinions of various Alsace winemakers whom he interviewed in November of 2007.
Automated Analysis of Body Movement in Emotionally Expressive Piano Performances
Authors: Castellano Ginevra , Mortillaro Marcello , Camurri Antonio , Volpe Gualtiero , Scherer Klaus
Published: November 2008

EMOTIONAL EXPRESSION IN MUSIC PERFORMANCE includes important cues arising from the body movement of the musician. This movement is related to both the musical score execution and the emotional intention conveyed. In this experiment, a pianist was asked to play the same excerpt with different emotionally expressive intentions. The aim was to verify whether different expressions could be distinguished based on movement by trying to determine which motion cues were most emotion-sensitive. Analyses were performed via an automated system capable of detecting the temporal profiles of two motion cues: the quantity of motion of the upper body and the velocity of head movements. Results showed that both were sensitive to emotional expression, especially the velocity of head movements. Further, some features conveying information about movement temporal dynamics varied among expressive conditions allowing emotion discrimination. These results are in line with recent theories that underlie the dynamic nature of emotional expression.
Eye Movements and Music Reading: Where Do We Look Next?
Authors: Madell Jaime , Hébert Sylvie
Published: November 2008

IN CONTRAST TO SIMILAR RESEARCH IN TEXT reading, research in the eye movements used to read music is relatively undeveloped. Though simpler measures such as the eye-hand span and perceptual span have been evaluated by numerous scholars, more complex phenomena such as context effects have yet to receive proper attention; this is largely the result of a lack of both focus on fine-grained structural properties (i.e., interval size, tonal-harmonic expectation) and a pool of hypotheses and paradigms informed by current models of music perception and cognition. To encourage further, more sophisticated research in eye movements and music reading, the present review discusses recent developments in the field and uses relevant conclusions to build a conceptual springboard for future research.
PRINCIPLES OF ADMINSTRATIVE CONTROL OF COMMUNICABLE DISEASES IN LARGE CITIES
Authors: Billings John S.
Published: November 2008

Doctor Billings discusses in this paper some of the subjects which must always be taken into consideration in controlling the communicable disease situation in any community—among these are the following: Registration, Recognition, Termination, Hospitalization, School Exclusion, Disinfection—and the Education and Instruction of Profession and Public.
THE USE OF THE UNEMPLOYED IN THE FIELD OF SANITATION
Authors: McCrudden James F.
Published: November 2008

Unemployment and under employment are topics that the average health officer pays little attention to. No one will deny the significance of unemployment when considered solely from the public health point of view. Men and women who are out of work or who are only working part time necessarily are unable to buy proper food and shelter which are so essential for their physical well being. Mr. McCrudden, in this paper, tells in an interesting manner how a number of unemployed men were given work through the Health Department of the City of Philadelphia. Not only did they benefit themselves but the work they did was a direct benefit to the entire community. This is a subject that health officials generally might well give more attention to.
Objective criteria for evaluating occupational health programs.
Authors: Webb S B
Published: November 2008

An objective scoring system is proposed as a single and flexible method of evaluating occupational health programs to appraise the extent to which existing programs approach a basic standard of excellence as defined by a theoretical model based on published and professionally acceptable guidelines and standards. This proposed system emphasizes the importance of an interdependent relationship between four program components: (1) guiding philosophy and policy; (2) organizational structure; (3) resources; (4) occupational health services, and it stresses the importance of long range health commitments to employee health status in contrasts to short range health commitments aimed primarily at an economic payoff to a sponsoring agency, institution, or company. The proposed evaluation scheme should enable self-evaluation by individual programs. Additionally, programs can utilize this evaluative tool to examine their influence on such important questions as employee hospital utilization and other specific elements of employee health in an objective, relatively simple manner.
Carbon monoxide in school buses.
Authors: Johnson C J , Moran J , Pekich R
Published: November 2008

Following an incident in which eight children became ill from carbon monoxide in a school bus, an investigation was made of CO levels in school buses in the Seattle area. The procedure selected for the evaluation was to test a large number of buses at a nearby ski resort. On the day selected for the sampling, over 200 buses arrived, bringing school children from a number of school districts in the Seattle are for skiing lessons. As they arrived, 33 buses were checked immediately to determine in-transit levels of CO. Four of the 33 buses had CO levels in excess of Environmental Protection Agency maximum allowable concentrations for an 8-hr exposure. As the buses sat idling in the parking lot, 65 of them were tested--during the lunch hour when the students returned to the buses to have their lunch and to rest. Two buses had nearly 3 times the concentration of CO permitted by the EPA for a 1-hr exposure. A total of seven buses (10 per cent) had concentrations of CO not permitted by the EPA for more than a 1-hr period. Altogether there were 24 buses (36 per cent) that had levels of CO in excess of EPA standards for an 8-hr exposure. As a result of these determinations and other observations a number of recommendations were made to reduce the hazard of exposure to carbon monoxide in school buses.
Rural medical care: an experimental delivery system.
Authors: Reid R A , Eberle B J , Gonzales L , Quenk N L , Oseasohn R
Published: November 2008

The experimental medical care delivery system has been operational since February, 1969. An average of over 200 patient visits per month were managed at the clinic during the past year. The average visit cost is $23.00, which is competitive with cost rates at neighborhood health centers. The average time per patient visit has been approximately 1 hr and 20 min. Of persons using the clinic, the largest number are women of childbearing age. Elderly patients have visited the clinic most frequently. Illness problems have accounted for the majority of patient visits. The program represents a cooperative effort between a rural community and a university to solve a problem of national interest. The implementation of this program has provided the opportunity to operationalize the family nurse practitioner concept in a system of medical care delivery. The feasibility of providing high quality medical care in a rural community by extending medical resources concentrated in an urban area has been demonstrated. This type of delivery system does provide a viable alternative for extending medical care to rural communities. A clinic manned by paramedical personnel offers the urban medical center along with concerned physicians the opportunity to extend their resources to rural areas which have been unable to attract and retain physicians.
Lead poisoning among migrant children in New York State.
Authors: Smith P J , Nelson D M , Stewart R E
Published: November 2008

Potentially hazardous painted surfaces were found in 40% of 166 dwelling units surveyed in 97 upstate New York migrant labor camps, a figure substantially lower than comparable surveys in upstate New York high risk urban areas. Blood samples obtained from 79 migrant children in 1972 revealed only one child with blood lead level above 40 mug per 100 ml as compared to a 21.6% yield from 5,733 high risk urban area children. A second screening program in 1974 yielded only three children of 190 tested with proven blood lead levels above 40 mug per 100 ml, although seven additional children with possible elevations were lost to follow-up.
An evaluation of three techniques improving immunization levels in elementary schools.
Authors: Vernon T M , Conner J S , Shaw B S , Lampe J M , Doster M E
Published: November 2008

Three techniques for improving immunization levels among school-age children were tested and then compared for most effective use of school nurses' time. Method A involved reviewing school immunization records, specifically inviting immunization-deficient children to a school-based clinic, with some follow-up to achieve good response. Method B involved sending out permission slips for a school-based clinic to all students without additional investment of nursing time. Method C involved a health education program encouraging parents to have their children immunized on their own. Using an average of 38 hours of school nurse time, Method A succeeded significantly better then Method B in immunizing more immunization-deficient children and raising immunization levels , while giving fewer unnecessary immunizations. Method C did not produce significant improvement of immunization levels.
Ambulatory care for chronic conditions in an inner-city elderly population.
Authors: German P S , Skinner E Z , Shapiro S
Published: November 2008

Factors affecting the extent to which individuals aged 65 and over living in inner-city households received health care for three chronic conditions (high blood pressure, heart trouble, arthritis) are examined. These factors are age, sex, living arrangements, and the presence of more than one chronic condition. Indicators of receiving care are having seen a health care provider within the previous six months and being on medication for the condition. A more detailed scrutiny of care received for high blood pressure is undertaken as well. This analysis is part of a larger study investigating health care of groups within East Baltimore who utilize different systems of care, focusing on a hospital outpatient department and a new HMO. Data were obtained from 1455 household interviews among three sample populations: enrolees in an HMO, public housing project residents, and the general community. The findings indicate that high proportions of the elderly who report having these conditions also report receiving care for them. For people with high blood pressure, the majority are receiving care and being given self-care instructions, and high proportions report compliance with instructions.
A Bayesian approach to health project estimation.
Authors: Chasse J D
Published: November 2008

This paper illustrates how a Bayesian statistical approach was used to estimate the outcomes of the National Tuberculosis Program in India. Such an estimate, it is argued, is necessary for a proper judgement about a project's social usefulness. The process of medical care delivery is reduced to a set of conditioned probabilities. The numbers are estimated using as source material medical records, the results of medical research, and the opinion of experts. Bayesian methods of estimation are used and their value is discussed. The final discussion contains a brief treatment of the role of project analysis in public decision making. The place of Bayesian methods in project analysis is briefly illustrated, demonstrating their operational value in the field of public health decision making.
The effects of measurement errors on some multivariate procedures.
Authors: Fleiss J L , Shrout P E
Published: November 2008

The effects of random errors of measurement on a variety of basic multivariate procedures are discussed. For some procedures, the effect is one of attenuation (i.e., simply reducing the estimated strength of association). For others, the effect may be to alter the apparent direction of association. Some proposed solutions to the problems caused by errors of measurement are presented, and areas requiring further research are pointed out.
An integrated approach to tuberculosis care in the Commonwealth of Pennsylvania.
Authors: Riehl E D , Berenznicki G , Rogers G , Reza R , Eagan J
Published: November 2008

A significant economization of taxpayers resources (+5.5 million per year) is the result of a major restructuring of the tuberculosis control program in the Commonwealth of Pennsylvania. Concomitantly improved patient management has accelerated the decline in the incidence of tuberculosis while maintaining recommended federal performance standards. The reasons for the success in obtaining this high degree of efficiency are discussed.
Evaluation of a screening program for heart disease.
Authors: Matanoski G M , Henderson M M , Stine O C , Courpas C , Hepner R , Walker S
Published: November 2008

An evaluation of the effectiveness of a screening program using the Phono Cardio Scan to detect heart disease in 18,872 Baltimore (Meryland) elementary school children indicated that few cases were discovered and only one child medical treatment instituted as a result of the program. Most of the children referred to a cardiologist had known disease. There was considerable variability in performance both of the machine and of the three center which were involved in the program. The sensitivity of the machine may have been low as reported in some other studies.
Pro Bono Publico--a century later.
Authors: Greene S B , Salber E J
Published: November 2008

From the introduction of Pro Bono Publico smoking tobacco in Durham, NC a century ago, the production of tobacco products has become a vital part of the state's economy. How this may relate to the smoking behavior, and consequently to the health of its residents is assessed from smoking patterns of adult residents of a rural area of Durham County. Male smoking rates are considerably higher than U.S. estimates whereas female rates are lower. The national trend of increasing incidence of lung cancer can be expected to continue in North Carolina and may be even greater due to the high rate of smoking.
Considerations in the design of mental health benefits under National Health Insurance.
Authors: Mechanic D
Published: November 2008

The existing insurance coverage for mental health benefits provides incentives for hospital as compared with community care and reinforces a medical approach to psychological disability. Moreover, the structure of benefits favors the affluent as compared with the disadvantaged and provides little assistance for the community integration of the chronic mental patient. In considering mental health benefits under National Health Insurance we must be careful to avoid reinforcing these patterns. It is suggested that NHI include a mental health resource development fund intended for building a stronger network of community mental health care and that the pattern of insurance benefits under NHI be consistent with developing psychiatric services on a capitation basis.
Primary health care in an academic medical center.
Authors: Thacker S B , Salber E J , Osborne C , Muhlbaier L H
Published: November 2008

In 1975-76 a one-year longitudinal study of the delivery of primary care services was carried out at all ambulatory institutional facilities in Durham County, North Carolina and in 47 of 50 community private practices covering the broad fields of surgery (including urology and orthopedics), medicine, pediatrics, and ob/gyn. The present paper focuses on the private and public clinics of Duke University Medical Center. Data were analyzed to document differentials in sociodemographic characteristics of patients attending these two systems of care. Results showed that patients attending the private clinics are predominantly white and covered by private insurance, while patients attending the public clinics are predominantly black and heavily dependent on Medicaid coverage. The potentially detrimental effects of a two-class system of care on the health of patients, as well as on the education of students, is discussed in the context of a scant medical literature on this subject.
Welfare status, illness and subjective health definition.
Authors: Prince E O
Published: November 2008

The self-defined health status of welfare recipients hospitalized for illness during the preceding year was compared to that of persons not on welfare but hospitalized for illness during the same period. Data were derived from a systematic probability sample of household residents of the Harlem Hospital inpatient district population surveyed July 1967-June 1970. Welfare recipient respondents were more likely to perceive their health as fair/poor than were persons not on welfare. This difference persisted when the data were analyzed by sex, age, reported levels and type of illness, hospital days and number of stays, and current usual activity; usual activity was a major explanatory variable but only partially accounted for the relationship. It has been hypothesized that in achievement-oriented societies, illness may be used as justification for a culturally-induced sense of personal failure to fulfill socially prescribed role obligations. The data are consistent with this hypothesis.
The prevalence of clinically treated diabetes among Zuni reservation residents.
Authors: Long T P
Published: November 2008

At least one-fourth of the over 45 aged population of the Zuni Indian reservation have diabetes. The true prevalence may be higher since an unknown number of Zunis had no blood sugar measurements during 1975-76 and therefore no opportunity for diagnosis. The high prevalence of diabetes among the Zunis has not been previously documented. It is similar to that found in the well-studied Pima Indians and much higher than that in a carefully examined large white population.
Utilization of prepaid dental health care by students in health professional schools.
Authors: Legler D W , Hughes M L , Bradley E L
Published: November 2008

Utilization of prepaid dental health care was studied, involving health professional students in an open panel program at the University of Alabama Medical Center. Major barriers to treatment were eliminated and optimal conditions for utilization established. Annual utilization ranged from 44-61 per cent during the period extending from 1969-70 to 1975-76. The majority of enrollees treated sought care from the Student Dental Health Plan (SDHP) clinic, rather than from private practitioners. Thirteen per cent of recent graduates presented for treatment at least once each year during their tenure as students, 57 per cent sought care in more than one year, and 24 per cent did not seek care at all. It was concluded that factors other than cost, accessibility, and educational level operate to prevent total utilization of prepaid dental health care in a young adult age group.
Implications of rubella susceptibility in young adults.
Authors: Chappell J A , Taylor M A
Published: November 2008

Rubella history and antibody titre were determined for 457 medical, graduate, and physician assistant students. Eighteen per cent were estimated at risk for rubella. There were no male-female differences. Health-profession students did not differ in rubella immune status from the general population. History was not helpful in assessing immune status. Approximately one-half of persons with low antibody titres had considered themselves immune, while one-half with moderate to high antibody titres had considered themselves at risk. Less than one-half of students with low antibody titres available themselves of immunization which was recommended and offered. With a high percentage of adult females at risk for rubella even in a health-motivated population and with poor follow-up on recommended immunization, current immunization practices must be improved if congenital rubella syndrome is to be further reduced. Mass inoculation of school age males and prepubertal school age females without prior determination of rubella antibody titres is suggested as a cost-effective means of decreasing incidence of congenital rubella syndrome.
Cost-effectiveness evaluation of a home visiting triage program for family planning in Turkey.
Authors: Bertera R L , Green L W
Published: November 2008

Graduate Turkish midwives were trained in triage rules for determining family planning home visit frequency based on risk of couples. In a sample of 542 couples followed for six months, modern contraceptive use increased 22 per cent among high-risk and about 15 per cent among moderate- and low-risk couples. After making assumptions about the fecundity, contraceptive success, and pregnancy complications, the estimated average cost per complication averted was $61 for high-risk, $177 for moderate-risk and $526 for low-risk couples.
A performance comparison: USMG-FMG house staff physicians.
Authors: Saywell R W , Studnicki J , Bean J A , Ludke R L
Published: November 2008

To determine whether differences exist in the performance of United States Medical Graduate (USMG) and Foreign Medical Graduate (FMG) House Staff physicians, inpatient hospital audits evaluating individual physician performance on patient histories and physical examinations were conducted in 14 Maryland and Pennsylvania non-federal, short-term hospitals. A total of 3,204 medical records were abstracted from eight diagnostic categories for 898 house staff physicians, 556 of which were USMGs and 342 were FMGs. The results from these audits indicate that while there is evidence of a strong hospital/type of physician interaction for many of the diagnoses, there was no significant overall difference in performance of USMG and FMG house staff physicians. The largest and most consistent differences in physician performance were associated with hospital characteristics, not physician characteristics.
Ambulatory medical care in the People's Republic of China: an exploratory study.
Authors: Mechanic D , Kleinman A
Published: November 2008

One hundred thirty-eight persons in varying outpatient settings in the People's Republic of China were interviewed briefly. Hospital outpatient utilization appeared to reflect not only severity of illness, but also patients' attitudes and beliefs, illness behavior patterns, and convenience, modifying the formal system of care to some extent. Traditional clinics in commune and county hospitals were typically used to treat psychiatric disorders (defined as physical conditions), chronic illness, and other conditions for which Western medicine offers only symptomatic treatment.
Regional resource allocations for home care: an experiment.
Authors: Shapiro E
Published: November 2008

Decentralized health service delivery responsive to the needs of local populations implies allocating program funds to regions on the basis of predetermined criteria that can facilitate effective planning and budgeting. In 1974, the Manitoba Continuing Care Program attempted to develop a formula for regional allocations for health care services. Four methods were assessed; their strengths and weaknesses are briefly discussed.
Migrant health revisited: a model for statewide health planning and services.
Authors: Barnett S E , Gillespie J , Call R L
Published: November 2008

Since the migrant farmworker family is a marginal issue among competing priorities for public health services, the logical strategy ought to be the pooling of limited resources at the state and local level to provide maximum benefit for the dollar and the client. A program planning model in inter-agency migrant health services delivery has been developed in Colorado. The model includes tangible evidence of cooperation by front-line service agencies. A task force approach for joint agency programming was initiated at state and local levels, and a structure for accountability was established which was carried out with performance contracts.
School-based measles outbreaks: correlation of age at immunization with risk of disease.
Authors: Judelsohn R G , Fleissner M L , O'Mara D J
Published: November 2008

During the Spring of 1978, students with a history of previous measles vaccination accounted for over three-forths of 203 cases of measles in a metropolitan county. Seventy cases occurred in two schools where 99% of the students were vaccinated. We analyzed countywide data to determine past patterns of measles vaccination, including outbreak control and vaccination update clinics. We also examined records of children from the two schools to assess the relationship between disease incidence and age at vaccination. When susceptibility was determined by trained health workers rather than by parents, fewer doses of measles vaccine were estimated to be needed. The majority of cases occurred among children 5 to 9 years old. Attack rates were higher for children vaccinated at 12 months of age or younger than for those vaccinated at 13 months of age or older. There were no significant differences in attack rates among children vaccinated at 13 months of age or older. These findings support recommendations for delaying routine measles vaccination until after 12 months of age and suggest that, during outbreaks, all children vaccinated prior to 13 months of age be revaccinated.
Height, weight and skinfold thickness of Michigan adults.
Authors: Moffatt R J , Sady S P , Owen G M
Published: November 2008

Height, weight, and selected skinfold measurements were taken on 544 Michigan males and 557 females age 18 and over. Mean body weight showed a tendency to increase with age for both sexes up to age 64 while mean height progressively decreased from its maximum at age 18-24 years. Between ages 18 and 64 years, mean triceps skinfold thickness of men increased 10 per cent, female triceps skinfolds 50 per cent. Mean subscapular skinfold values rose consistently with age for both sexes. Comparison of these findings with those from earlier national studies suggest that Michigan adults are heavier and fatter but no taller than other US adults.
Shigella surveillance in a large metropolitan area: assessment of a passive reporting system.
Authors: Kimball A M , Thacker S B , Levy M E
Published: November 2008

A passive disease report card (DRC) surveillance system failed to detect an epidemic of diarrheal disease caused by a newly identified drug-resistant strain of Shigella sonnei. The DRC system inaccurately described both the population at risk and the geographic location of cases. Specific limitations of the DRC system, including problems of underreporting and ascertainment bias, were complicated by the absence of timely data analysis and feedback to providers.
Mortality surveillance in collaborative trials.
Authors: Cutter G , Heyden S , Kasteler J , Kraus J F , Lee E S , Shipley T , Stromer M
Published: November 2008

The Hypertension Detection and Follow-Up Program (HDFP) carried out two pilot surveillances covering the enumerated population to test procedures to be used in assessing the ability of the program to influence life expectancy in the total population. A rigorously sequenced pilot survey of 2,611 households was conducted and carefully monitored through two mailings, telephone contacts, home visits, and communication with "contact" persons. The response rates at each stage varied among the 13 centers. Overall, there was a 42.7% yield from the first mailing; 42.5% of those receiving a second mailing was completed; 78.0% for telephone 61.3% for the home visits and 55.2% from the "contact" persons. Overall, 97.4% of all persons had vital status ascertained. The second phase relaxed the rigorous sequential survey requirements and reduced the reporting requirements from every ten days to monthly. Overall, 93.3% were successfully ascertained. Reduced survey structure, slightly increased mobility (from 12% to 13%), increased workload from 200 to 400 households per center, and a longer time interval between initial enumeration and the mortality ascertainment are among the reasons for performance decline.
Sedating drugs and automobile accidents leading to hospitalization.
Authors: Jick H , Hunter J R , Dinan B J , Madsen S , Stergachis A
Published: November 2008

The use of central nervous system depressant drugs among 244 people hospitalized for injuries suffered in an automobile accident was similar for drivers presumed at fault for the accident compared with other drivers and passengers. It was only slightly higher in the three groups than it was in the population at large. The absence of an important association in this population might be related to the warnings given to people filling prescriptions for these drugs.
Single-site localization of rabies virus: impact on laboratory reporting policy.
Authors: Maserang D L , Leffingwell L
Published: November 2008

Information accumulated by our rabies laboratory during 1977-1979 was retrospectively analyzed for patterns of rabies localization in brain. Of the 1,730 specimens reported positive during that period, 37 were positive at a single site, 27 involving only the cerebellum. Therefore, we recommend that those laboratories which offer the fluorescent rabies antibody test (FRA) examine both cerebellum and hippocampus. Definitive reports based on the FRA should be offered only when both sites have been shown negative for viral particles, or when a positive result is unquestionable.
Occupational health in Cuba.
Authors: Gomez M R
Published: November 2008

Health and safety regulation, training, and research were practically non-existent in Cuba before the Revolution in 1959. Since that time important advances have been made. Specialized inspectors, occupational physicians, and other such personnel are now trained in Cuba. An Occupational Health Institute, founded in 1976, provides training and specialized technical services, and conducts research. In 1978, a far reaching "Work Safety and Health Law" was enacted which defines the rights and responsibility of government agencies, workplace administrators, unions, and workers. Comprehensive control of toxic substances in workplaces, still at an early stage, is likely to increase in light of the new law, the growing availability of qualified personnel, and the mounting concern of public health authorities with the increasingly "developed" health profile of the population.
Nurse practitioner and physician adherence to standing orders criteria for consultation or referral.
Authors: Watkins L O , Wagner E H
Published: November 2008

The degree to which nurse-practitioners (NPs) and physicians (MDs) follow the mutually agreed-upon rules for their practice and the effects of any deviations are unknown. This study assessed whether NPs adhered to consultation/referral (C/R) criteria in NP standing orders for hypertension, whether MDs adhered to the task-delegation intent expressed in standing orders, and the relationship between adherence and blood-pressure (BP) control. A sample of 161 patients from a practice of five MDs and four NPs in a rural primary care clinic was studied over 16 months. Patient characteristics associated with provider non-adherence were identified by discriminant analysis. NPs failed to obtain consultation or referral for 22 of 66 patients (33 per cent) with conditions requiring C/R. MDs retained 17 of the 43 patients (40 per cent) without C/R conditions. NP non-adherence was associated with care by a single NP, presence of few non-hypertension problems, and need for dietary alteration (p less than .05). MD non-adherence was associated with males and presence of severe non-hypertensive disease (p less than .005). Diastolic BP control (less than or equal to 90 mm Hg) was similar in NP patient groups without C/R conditions, retained by NPs despite C/R conditions and shared with MDs by C/R. Control in the shared group was better than in the MD-treated group with C/R conditions (p less than .025). Although in this setting NPs frequently did not adhere to C/R criteria for hypertension, this did not affect acceptable BP control.
Blood lead levels among high-risk children, Detroit, Michigan.
Authors: Talbott E O , Burgess R A , Murphy P A , Kuller L H
Published: November 2008

Since 1972, a federally funded lead screening program has been operational in Detroit, Michigan. Blood lead screening data (27,430 initial tests on Black children less than or equal to 6 years) were assigned by census tract of child's residence to one of the 15 socioeconomically similar areas in geographic proximity to one another. Higher blood lead levels were associated with lower education, lower income, and increased proportion of single parent families. This emphasizes the need to continue screening efforts in lower socioeconomic areas with older housing.
Child abuse in Georgia: a method to evaluate risk factors and reporting bias.
Authors: Jason J , Andereck N D , Marks J , Tyler C W
Published: November 2008

From July 1975 through December 1979, the Georgia Department of Protective Services Central Registry recorded population-based data on confirmed, non-confirmable, and ruled-out child abuse reports. We propose that reporting biases are reflected in the differential characteristics of confirmed and ruled-out reports of child abuse. Characteristics, households, or groups equally or more prevalent in the latter category cannot necessarily be considered associated with increased risk of child abuse, even if they are represented in the confirmed abuse population more than in the general public. Important examples of factors or categories for which an association was suggested in other studies but which are not supported by this analysis are: urban residence, teenage motherhood, infancy, and mothers and other female perpetrators. These are conditions or categories associated with greater surveillance; therefore, risk assessment is not possible using the data in this registry. Certain households do appear to be at increased risk for child abuse. These include large families, families without a biological mother or biological father, and families ever needing Aid to Families with Dependent Children (AFDC). This increased risk, however, is slight. Improved surveillance requires identification of reporting biases. A comparison of confirmed and ruled-out reports is an inexpensive and system-specific step toward achieving this aim.
A Preliminary Study on Dressing Patterns and Incidence of Candidiasis
Authors: Elegbe Isaac A. , Botu Modupe
Published: November 2008

The incidence of candidiasis in two groups of voluntary participants wearing tight and loose fitted dresses was investigated by both microscopic and cultural techniques for a period of two months. Two-thirds of the positives by stain and culture were recovered from those wearing tight clothing (P < 0.05). The findings suggest that tight clothing can predispose the wearer to candidiasis, an organism that can cause vaginitis. (Am J Public Health 1982; 72:176-177.)
Demographic trends in tubal sterilization: United States, 1970-1978.
Authors: DeStefano F , Greenspan J R , Ory H W , Peterson H B , Maze J M , Smith J C
Published: November 2008

In the period 1970-1977, an estimated 4,236,000 women 15-44 years of age had tubal sterilization operations in United States hospitals. Both the number and the rate of tubal sterilizations increased each year from 1970-1977, but in 1978 both declined. Tubal sterilization rates for Black women were higher than for White women. Black women also tended to be younger at the time of tubal sterilization. For the nation as a whole, the mean age at the time of tubal sterilization remained constant at about 30 with the youngest age group having the highest proportion of never-married women.
Identifying the health risks from very low-dose sparsely ionizing radiation.
Authors: Dreyer N A , Friedlander E
Published: November 2008

The health risks from low-dose sparsely ionizing (low-LET) radiation have been the subject of continued debate. At present, quantitative estimates of risk are extremely uncertain due to the controversy surrounding both the dosimetry for A-bomb survivor data and the choice of mathematical models for extrapolating risk from high to low doses. Nevertheless, much can be learned about the nature of the health risks by reviewing the epidemiologic literature. We present a summary of diseases which have been associated with low-LET radiation (less than 1000 rad) in at least two independent studies, according to the mean cumulative organ dose at which the disease was observed. At organ doses of less than or equal to 50 rad, the only diseases that have been reported consistently are thyroid cancer, salivary gland tumors, and leukemia. The first two diseases were observed in association with x-ray epilation of the scalp for tinea capitis, a therapy which is no longer employed. On the other hand, leukemia has been observed repeatedly to occur at cumulative doses of greater than or equal to 30 rad low-LET radiation.
Institutional Change in Delivery of Dental Services: A Marketing Perspective
Authors: Capon Noel
Published: November 2008

The recent appearance and growth of new delivery systems for dental services is examined from a marketing perspective. Analysis reveals that the growth of low priced, high throughput operations is consistent not only with marketing principles, but with the development of American retail institutions in general. Options for independent dentists in the face of this new competitive environment are discussed. (Am J Public Health 1982; 72:679-683.)
Community health planning from an interorganizational perspective.
Authors: Cohen P D
Published: November 2008

Planning agencies do not have control over health care resources in the community. Resources are concentrated in a number of provider organizations, associations, and government agencies, which have common goals as well as a diversity of individual objectives, and therefore enter into networks of relationships to accomplish their overlapping service missions. Interorganizational research shows that it is important to enhance the interdependence and benefits of cooperation between organizations and at the same time maintain the identity and distinctive qualities of each organization. Thus, in addition to the important role to provide information for decisions, planners have a role to manage the interdependencies and identities among organizations in the health system. Research shows that in situations where only methods, data, and analysis were emphasized by health planners, they had less impact on community decisions than in situations where planners also emphasized the development of the interorganizational system of decision-making. In a neutral position with respect to competing forces, planners can more effectively use their leverage from their information processing role and from their regulatory powers to facilitate the balancing of interorganizational interests and to enhance cooperative benefits to the community.
A Comparison of Height, Weight, and Triceps Skinfold Thickness of Children Ages 5-12 in Michigan (1978), Forsyth County North Carolina (1978), and HANES I (1971-1974)
Authors: Diseker Robert A. , Michielutte Robert , Ureda John R. , Schey Harry M. , Corbett Wayne
Published: November 2008

Height, weight, and triceps skinfold measurements were made on 1,668 Forsyth County, North Carolina students ages 5-12 during 1978. These data were compared to a representative sample of Michigan children taken during the same year and to their United States counterparts in HANES I (1971-74). The North Carolina children more closely resembled their US counterparts than did the Michigan group, casting doubt on the secular trend toward heavier children suggested by the Michigan researchers. (Am J Public Health 1982; 72:730-733.)
Differences in dental experiences, practices, and beliefs of inner-city and suburban adolescents.
Authors: Cipes M H , Kegeles S S , Lund A K , Otradovec C L
Published: November 2008

Inner-city and suburban students' dental experiences, current practices, beliefs, and compliance with two school-based preventive programs were examined. Striking differences were found in the students' dental experiences, practices, and beliefs, but few in their compliance. These findings challenge the notion that inner-city students are poor compliers and suggest ways in which practitioners and public health officials might utilize the differing practices of these populations to plan preventive programs for adolescents.
Public money, private control: a case study of hospital financing in Oakland and Berkeley, California.
Authors: Woolhandler S , Himmelstein D U , Silber R , Harnly M , Bader M , Jones A A
Published: November 2008

Government support of public and private hospitals in Oakland and Berkeley, California was investigated. The private hospitals received government subsidies amounting to at least 60 per cent of their total revenues. The dollar amount of the subsidies to private hospitals was four and one-half times greater than government expenditures on the public hospital. In Oakland and Berkeley, as in many cities, public medical services have been reduced while both government health expenditures and private hospital revenues have increased sharply. The private hospitals, although all nominally non-profit, exhibit revenue maximizing behavior which results in socially unjust and medically irrational resource allocation. Funds might be found for public hospitals and clinics, and resources allocated more justly and rationally, if government expenditures in the private sector were brought under greater public scrutiny and control.