bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperphagia and Obesity in Female Mice Lacking Tissue Inhibitor of Metalloproteinase-1
Authors: Gerin Isabelle , Louis Gwendolyn W. , Zhang Xuan , Prestwich Tyler C. , Kumar T. Rajendra , Myers Martin G. , MacDougald Ormond A. , Nothnick Warren B.
Published: November 2008

Certain matrix metalloproteinases and their regulators, the tissue inhibitors of metalloproteinases (TIMPs), are involved in development and remodeling of adipose tissue. In studying Timp1 mice, which have a null mutation in Timp1 (Timp1−/−), we observed that females exhibit increased body weight by 3 months of age due to increased total body lipid and adipose tissue. Whereas Timp1−/− mice have increased size and number of adipocytes, they also display increased food intake despite hyperleptinemia, suggesting that alterations in hypothalamic leptin action or responsiveness may underlie their weight gain. Indeed, leptin promotes the expression of Timp1 mRNA in the hypothalamus, and leptin signaling via signal transducer and activator of transcription-3 mediates the expression of hypothalamic Timp1. Furthermore, Timp1−/− mice demonstrate increased food intake and altered expression of certain hypothalamic neuropeptide genes prior to elevated weight gain. Thus, whereas previous data suggested roles for matrix metalloproteinases and TIMPs in the regulation of adipose tissue, these data reveal that Timp1 mRNA is induced by leptin in the hypothalamus and that expression and action of Timp1 contributes to the regulation of feeding and energy balance.
The actin-binding protein Lasp promotes Oskar accumulation at the posterior pole of theDrosophilaembryo
Authors: Suyama Ritsuko , Jenny Andreas , Curado Silvia , Pellis-van Berkel Wendy , Ephrussi Anne
Published: November 2008

During Drosophila oogenesis, oskar mRNA is transported to the posterior pole of the oocyte, where it is locally translated and induces germ-plasm assembly. Oskar protein recruits all of the components necessary for the establishment of posterior embryonic structures and of the germline. Tight localization of Oskar is essential, as its ectopic expression causes severe patterning defects. Here, we show that the Drosophila homolog of mammalian Lasp1 protein, an actin-binding protein previously implicated in cell migration in vertebrate cell culture, contributes to the accumulation of Oskar protein at the posterior pole of the embryo. The reduced number of primordial germ cells in embryos derived from lasp mutant females can be rescued only with a form of Lasp that is capable of interacting with Oskar,revealing the physiological importance of the Lasp-Oskar interaction.
The dark side of competition: How competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self‐harm
Authors: Gilbert Paul , McEwan Kirsten , Bellew Rebecca , Mills Alison , Gale Corinne
Published: November 2008

This study was guided by the social rank theory of depression and aimed to explore the relationship between depression, anxiety, stress and self‐harm with striving to avoid inferiority, feelings of shame and styles of attachment. Participants diagnosed with depression (n=62) completed a series of questionnaires measuring striving to avoid inferiority, fears of missing out, being overlooked and active rejection, attachment, social rank and psychopathologies. Striving to avoid inferiority was significantly linked to social rank variables and anxious attachment. Mediator analyses revealed that the relationship between striving to avoid inferiority and depression was mediated by the social rank variable of external shame, and also anxious attachment. These findings suggest that elevated competitive behaviour can have a ‘dark side’. When people feel insecure in their social environments, it can focus them on a hierarchical view of themselves and others, with a fear of rejection if they feel they have become too inferior or subordinate. This may increase vulnerability to depression, anxiety and stress.
VALUE OF BRILLIANT-GREEN IN ELIMINATING ERRORS DUE TO THE ANAEROBES IN THE PRESUMPTIVE TEST FOR B. COLI
Authors: Muer Theodore C. , Harris Robert L.
Published: November 2008

A well tested method will always be especially a help to health officers for the reason that so many presentations are of matters still in the experimental stage. This brief article is based on a considerable use in practical work and the method may take its place among the pretty well established ones.
STUDIES IN THE CLARIFICATION OF MILK
Authors: Marshall Charles E.
Published: November 2008

These studies were started during the summer of 1914 and have been continued in varying degrees since that time. They were made possible by the De Laval Separator Company of New York City, which established a fund placed in the hands of the Treasurer of the College to meet the expenses incurred.

The firm was desirous of knowing the truth about clarification, so far as it can be determined; accordingly, the work was placed on the usual basis of Experiment Station investigational undertakings with the enjoyment of complete independence. The firm has been a constant source of helpfulness and at no time has it attempted or interfered to influence results or the free publication of the findings.

I make this statement as a due appreciation of the helpfulness, generosity and sympathetic attitude of a commercial firm. If any commercial motive exists, it can be only a desire to have facts and truth as a basis for their procedure and progress in manufacture.
CAUSES OF ARMY REJECTIONS: WHAT HEALTH OFFICERS CAN DO TO REMEDY CONDITIONS
Authors: Keefer Frank R.
Published: November 2008

Colonel Keefer, who advises that every health officer become a member of the A. P. H. A., outlines the story of army rejections and analyzes the causes. Health officers hold the strategic position. They should invoke prevention, get statistics, establish machinery for corrective work and foster and direct public opinion through education.
NEED FOR STANDARDS FOR RECORDING AND CLASSIFYING DEFECTS AND IMPAIRMENTS
Authors: Billings John S.
Published: November 2008

Standardization is one of America's greatest needs, for there are many active agencies that undertake related investigations independent of one another, and overlap and duplicate effort. Out of a very large experience Dr. Billings presents standard forms for records of initial and follow-up physical examinations of industrial employees.
AN EPIDEMIC OF PNEUMONIC PLAGUE
Authors: Kellogg W. H.
Published: November 2008

Dr. Kellogg calls on health authorities to wake from their apathy with reference to plague in California, and instead of restrictive measures to adopt an aggressive warfare. He points out that there is real danger to the country and urges adequate appropriations to exterminate the animal disease carriers while this may be done with certainty.
EPIDEMIOLOGICAL RÔLE OF THE CASE OF CEREBROSPINAL MENINGITIS
Authors: Simmons R. R.
Published: November 2008

That carriers are not the infecting agent in most cases of cerebrospinal meningitis is suggested. It does not seem probable that meningococci are present in the naso-pharynx of premeningococus cases in numbers large enough to be a menace. These findings rest on negative results of swabbings taken shortly before the onset of the disease.
INFANT MORTALITY IN DETROIT
Authors: Palmer George T. , Blakeslee G. Arthur
Published: November 2008

One-fourth of all deaths are among children of less than one year. Babies succumb in large part to causes acting before birth. To prevent such deaths, increasing attention must be paid to prenatal work. Lowest mortality is found among Russian Jews and Italians. Race stocks most in need of prenatal attention are Negroes, Poles, Austrians and native whites.
What Health Officers Can Do to Promote Rat Extermination
Authors: Goldman Edward A.
Published: November 2008

Rats are a civic reproach and a sanitary menace of the first magnitude, not merely an unavoidable economic burden. Health officers everywhere must be active because civilization demands the coöperation of all forces in the removal of the rat menace to health and well-being. This paper outlines well-digested plans for efficient warfare on the rat.
THE VALUE OF THE PUBLIC HEALTH NURSE IN PUBLIC HEALTH AND WELFARE ADMINISTRATION
Authors: Hastings Charles J.
Published: November 2008

The newly developed possibilities of the public health nurse have helped change the aspect of public health administration. Trained, sympathetic women are a force in home health education. They have fields in prenatal work, the preschool age, in school inspection and follow-up and in the industries. Their duties begin with conception and end with the grave.
THE LABORATORY IN THE SERVICE OF THE STATE
Authors: Winslow C.-E. A.
Published: November 2008

Professor Winslow has collected in this paper some very interesting comparative statistics with regard to state health laboratories. The progress of public health laboratories in the United States has indeed been remarkable in the last few years. While we may congratulate ourselves on our advance, it is obvious that in many instances much may yet be done to make laboratory of greater value to the citizens of the state.
HMOs and health education.
Authors: Shapiro I S
Published: November 2008

HMOs, by their stated purpose and nature, have a necessary and central involvement with health education. The specific characteristics of any HMO determine the extent and quality of health education. An HMO has the responsibility to identify its educational objectives, as well as the educational components of any of its other objectives. The more professional the educational guidance, the better it is integrated into the organization, and the greater its financial and administrative support, the more likely will be the success in achieving objectives. In brief, every HMO has the need and potential for a health education effort. The extent and quality of that effort will reflect the mix of administrative philosophy, organizational characteristics, the degree to which professional educators are involved, and the amount and stability of financial support.
The effect of antibiotics on mortality from infectious diseases in Sweden and Finland.
Authors: Hemminki E , Paakkulainen A
Published: November 2008

A study was carried out to determine whether the preexisting decline in mortality rates from infectious diseases accelerated after the introduction of antibiotic and chemotherapeutic drugs. Linear regression curves showed that in Sweden mortality rates declined faster in septicemia, syphilis, and non-memingococcal meningitis after the introduction of these drugs. By contrast, for the ten other infectious diseases studied, (scarlet fever, erysipelas, acute rheumatic fever, puerperal sepsis, meningococcal infection, bronchitis, pneumonia, tuberculosis, typhoid fever, and acute gastroenteritis) no such accelerated decline in mortality could be detected. The findings suggest that antibiotic and chemotherapeutic drugs have not had the dramatic effect of the mortality of infectious diseases popularly attributed to them.
An evaluation of selected federal categorical health programs for the poor.
Authors: Komaroff A L , Duffell P J
Published: November 2008

We examine evidence regarding the impact of several categorical federal health service programs--neighborhood health centers, maternal and infant care projects, and children and youth projects--on access to and quality of health care for the poor. We conclude that, although conclusive evidence of improved access and quality are lacking, suggestive evidence of improved quality exists. It is difficult to utilize legislative objectives as guidelines for evaluating the success of a federal program; it is also difficult to obtain solid data supporting the effectiveness or ineffectiveness of health care in general, and of other government programs. These difficulties are discussed.
Health care and disease prevention through genetic counseling: a regional approach.
Authors: Riccardi V M
Published: November 2008

The Colorado-Wyoming Regional Genetic Counseling Program has demonstrated the feasibility and utility of providing genetic counseling services over a very large area of the Rocky Mountain Region. A basis for preventing genetic and congenital disorders has been established and the patient care provided has been as comprehensive, sophisticated and effective as for any genetic counseling clinic operating in a medical center, with the added advantage of being accessible to a much larger and less financially able patient population. Utilization data and consumer assessment of the values of this service confirm these impressions.
A framework for prevention: changing health-damaging to health-generating life patterns.
Authors: Milio N
Published: November 2008

A set of propositions is offered to provide a frame of reference for proposed strategies to improve healthful behavior by placing personal choice-making in the context of societal option-setting. The health status of populations at a given point in time is seen as a result of customary personal choice-making. These choices in turn are limited by both the perceived and actual options available to individuals, depending on their personal and their community's resources, from which to make choices. Most people, most of the time will make the easiest choices, i.e., will do the things, develop the patterns or life-styles, which seem to cost them less and/or from which they will gain more of what they value in tangible and/or intangible terms.
Applications of a job classification system in occupational epidemiology.
Authors: Gamble J F , Spirtas R , Easter P
Published: November 2008

An occupational preventive medicine program attempts to control exposure so workers experience no detrimental effect on health. In a chemically complex industry, the definition of exposure is difficult because of the many different chemicals used and produced, the many different jobs and processes with qualitatively different exposures, and the movement of workers from job to job. Jobs have therefore been grouped on the basis of process or product into functionally homogeneous categories called occupational titles (OT's). Work experience can now be quantified independent of exposure (or by the dominant toxicants in each OT) and compared to health outcomes. Examples are discussed of the application of OT's to studies of the mortality and morbidity experience in the rubber industry, and the development of dose-response relations.
Interest-group representation and the HSAs: health planning and political theory.
Authors: Vladeck B C
Published: November 2008

Examination of the provisions of the National Health Planning and Resources Development Act, P.L. 93-641, concerning the composition of Health Systems Agencies, which are to be the primary building-blocks of local health planning, suggests that expectations of substantial change may be unrealistic. Specifically, in its provision for representation on the HSAs, Congress appears to have been accepting an implicit theory of pluralist interest-group representation that has long been prevalent in other sectors of public life in the United States, and long subject to significant criticism. Such forms of representation tend to lead to bargaining, log-rolling, and collusive competition among narrowly-defined special interests, with the interests of the broader general public less well-served. The application of this theory to health planning in P.L. 93-641 is examined, and predictions drawn about the implications of this analysis for health planning and health policy in the United States in general.
Health beliefs and smoking patterns in heart patients and their wives: a longitudinal study.
Authors: Croog S H , Richards N P
Published: November 2008

Smoking patterns of 205 male patients were examined over a period of eight years after a primary myocardial infarction. Smoking data from their wives at one year after the heart attack were also examined. A marked, persistent reduction in smoking was found among the men. Smoking patterns of wives remained essentially unchanged. Smoking patterns before the heart attack were not related to demographic variables, except for the associated between smoker-nonsmoker status and social measures. Conceptions of susceptibility, threat, and power of prevention drawn from theoretical models on preventive health behavior were employed for analysis. High proportions of husbands and wives reported belief in smoking as important in the etiology of the heart attack, and in possibilities of prevention. Specific beliefs concerning threat, susceptibility, and prevention were not found to be related to the massive drop in smoking behavior among the men nor to stability in pattern among the wives. Alternative explanations are reviewed.
Fire victims: medical outcomes and demographic characteristics.
Authors: Levine M S , Radford E P
Published: November 2008

The medical outcomes and demographic characteristics of all victims of fires identified by The Baltimore Fire Department during a 14-month period in Baltimore City were studied. Fifty-nine per cent of victims suffered minor injuries, 25 per cent required hospitalization and 16 per cent were fatalities. The majority of survivable injuries were due to burns, while the majority of deaths were due to pulmonary injury and carbon monoxide intoxication. Deaths occurring at the scene of the fire or during the first 24 hours were predominantly due to carbon monoxide. Exposure to fires was more likely to result in deaths in the very young and very old. Evidence from autopsy protocols suggests that alcohol was a contributory factor.
Injuries, crashes, and construction on a superhighway.
Authors: Doege T C , Levy P S
Published: November 2008

Crash and injury-crash rates increased significantly on segments of an Illinois superhighway undergoing major construction, compared to crash rates of preceding years and to crash rates on segments not undergoing construction. Maintaining separation of traffic on segments under construction resulted in smaller increase in injury-crash rates than crossover diversion of traffic from lanes under construction into previously one-way roads.
A computer-based record and clinical monitoring system for ambulatory care.
Authors: McDonald C J , Murray R , Jeris D , Bhargava B , Seeger J , Blevins L
Published: November 2008

The Regenstrief Medical Record system is a computer-based medical record system for ambulatory care which has been in operation since 1973. For each patient served, it contains a core medical record including most objective data (treatment records, lab, x-ray and EKG, etc.) and selected items of subjective data. Its supports the care of patients by presenting the clinical data in clear and compact reports and by reminding the physician about clinical conditions that need corrective action. The generation of these computer reminders is totally controlled by physician authored protocols. Each protocol defines an important clinical condition and the content of the reminder to be triggered when that condition occurs. Physician compliance to the standards implicit in these protocols is improved by this feedback. Patient data are captured by computerized ancillary services, (laboratory and outpatient pharmacy) and by manual techniques. Much of these data are recorded by hand (as marks or numbers) on computer-tailored forms which can be optically read by machine. This system represents a different approach to the difficult problems of efficiently using and maintaining patient records.
Socialization and the human physiologic response to crowding.
Authors: Gruchow H W
Published: November 2008

Cross-sectional data were analyzed for a possible relationship between household densities and physiologic alteration, based on socialization experiences with siblings in an earlier home environment. The measure of household density was persons-per-room and the measure of physiologic alteration was urinary vanillylmandelic acid. The results show an interaction between number-of-sibs and number-of-younger-sibs, with a statistically significant positive correlation between household densities and VMA values for subjects with fewer total sibs and no younger sibs, while a negative correlation was observed for subjects with one or more younger sibs. One possible interpretation of these results is that the physiologic response to crowding in humans is dependent at least in part on the earlier socialization experiences of the individual.
Expired air carbon monoxide and serum thiocyanate as objective measures of cigarette exposure.
Authors: Vogt T M , Selvin S , Widdowson G , Hulley S B
Published: November 2008

Expired air carbon monoxide (CO) and serum thiocyanate (SCN) were used to asses exposure to cigarettes in 139 middle-aged men. Subjects who reported smoking cigarettes generally had CO levels exceeding 8ppm and SCN levels exceeding 100umol/L; non-smokers had lower levels. For both tests the mean concentration among men smoking more than one pack daily was three times that of non-smokers. The is a high correlation between the two tests (r=.571 for smokers), an association that was largely independent of the smaller correlations between either test and reported smoking frequency (r=.476 for CO; r=.479 for SCN). The ability to distinguish between individuals who reported "typical" smoking habits and non-smokers was best when the CO and SCN analyses were used together to take advantage of their separate sources of variance; it was 99 per cent when the two tests were mutually concordant (91 per cent of cases). The CO and SCN measurements allowed 16 individuals who reported light smoking habits to be categorized into high and low presumptive tobacco exposure groups. The two tests are inexpensive and suitable for use in epidemiologic and health care delivery programs.
Lung function in fire fighters, II: a five year follow-up fo retirees.
Authors: Musk A W , Petters J M , Wegman D H
Published: November 2008

In a study of the chronic effects of fire fighting on lung function, 1,768 employees from the Boston Fire Department were examined in 1970. From this cohort, 109 firefighters who retired in the period 1970 to 1975 have been restudied with questionnaire and ventilatory function tests. The observed vulues for pulmonary function when expressed as a per cent of predicted are consistently slightly below 100 per cent. The expected effect of cigarett smoking on lung function was demonstrated. The results suggest thetirement) are important in reducing the effect of fire fighting on subjects who may be adversely affected by the inhalation of combustion products.
Hypertension: effects of social class and racial admixture: the results of a cohort study in the black population of Charleston, South Carolina.
Authors: Keil J E , Tyroler H A , Sandifer S H , Boyle E
Published: November 2008

It has been hypothesized that genetic factors, as manifested by skin color, play in important role in the genesis of hypertension among Blacks. A community-based study was carried out in Charleston Country, South Carolina to test this hypothesis. The results of a ten year follow-up study suggest that social class and age were more consistently associated with the incidence of hypertension and levels of blood pressure. The association of hypertension with skin color was minimal and substantially less than that of social class. The incidence rate of hypertension (larger than or equal to 90 mm Hg) was three to four times greater when the study participants were of low social class than when they had higher social class scores at the beginning of this study. In contrast, the incidence rate was only 1.5 times higher for dark than for lighter skinned men, and the rates were almost identical when social class was comparable. Similar results energed when blood pressure was treated as a continuous variable; blood pressure levels and pressure changes over time were consistently and significantly (p less than .01) higher in those Blacks categorized as low social class, controlling for skin color.
Utilization of former military medical corpsmen in the provision of jail health services.
Authors: King L , Reynolds A , Young Q
Published: November 2008

In an effort to improve the quality of health services within a large urban jail, former military medical corpsmen have been employed as an integral component of a jail health service. Medical corpsmen are responsible for the performance of intake medical evaluations, delivery of prescription medications, triage for physician sick call, and provision of elementary health services on the jail tiers. Utilization of medical corpsmen has been associated with improved rates of medication delivery as well as beneficial effects in relation to tuberculosis and venereal disease control, and a more appropriate utilization of physician services. Effective utilization of medical corpsmen requires cooperation from the correctional staff as well as consistent supervision and support by qualified physicians.
Age-adjusted mortality indexes for small areas: applications to health planning.
Authors: Kleinman J C
Published: November 2008

This study compares four age-adjusted mortality indexes and their standard errors among United States counties using 1969-1971 mortality data. It is shown that the direct and indirect methods of age adjustment give nearly identical results (correlation coefficients over .97). Two other indexes which indirectly adjust for age are then compared with the usual indirect method: one is the relative mortality index and the other an index of productive years of life lost. The three indirect indexes are substantially different in the are groups emphasized. This results in substantial differences in those counties identified as having "excess" mortality. Implications of the results for health planning applications are discussed.
Physicians and non-physician health practitioners: the characteristics of their practices and their relationships.
Authors: Simborg D W , Starfield B H , Horn S D
Published: November 2008

Six primary care practices which utilize both physician and non-physician practitioner types were studied to measure differences between practitioner types in the care of patients. By chart review 1,369 patient-practitioner encounters were examined. Physicians identified less symptoms and signs in their patients and prescribed less non-drug therapies than did non-physicians. Likewise, at follow-up visits, physicians tended to document less follow-up of these types of problems and therapies than non-physicians. When examining the interaction between practitioners, the highest rates of follow-up of all types of problems and therapies were found when the same practitioner saw the patient at two successive visits to the same clinic. When a physician saw a patient following a previous visit to a nurse practitioner, there was a significant drop-off in the follow-up rate of problems and therapies. However, when a nurse practitioner saw the patient following a previous visit to a physician, the drop-off in follow-up rates was not as striking. These findings indicate that the skills of physician and nonphysician practitioners are potentially complementary. However, this potential is not fully exploited, particularly by physicians.
Antibody to Escherichia coli enterotoxin in meat-packing workers.
Authors: Wallace R B , Donta S T
Published: November 2008

Meat-packing plant employees exposed to raw animal products had serological evidence of higher infection rates with heat-labile toxin producing enterotoxigenic Escherichia coli (LT-EEC). In those employees with multiple sera available for study over a ten-year period, a drop in mean anti-LT-EEC titer was observed, suggesting altered ecology of or exposure to the organism during this time. Prospective studies need to be done to determine if meat-packing workers actually experience a greater incidence of LT-EEC-induced diarrheal disease.
Smoking and life expectancy among U.S. veterans.
Authors: Rogot E
Published: November 2008

Life expectancies were estimated for selected groups of smokers, ex-smokers, and nonsmokers based on the results of a 16-year mortality follow-up of 198,820 U.S. veterans. Life expectancy varied inversely with number of cigarettes smoked per day. The most pronounced differences were between nonsmokers and heavy cigarette smokers (40+ per day). These differences in life expectancy were greatest at the younger ages--nearly 9 years at ages 35 and 40. Life expectancies for cigarette smokers varied directly with age began smoking. For all ages, differences in life expectancy between nonsmokers and ex-cigarette smokers who stopped for other than doctor's orders were less than those between nonsmokers and current cigarette smokers. Results in the present study clearly confirmed Hammond's earlier findings.
Informed consent by children and participation in an influenza vaccine trial.
Authors: Lewis C E , Lewis M A , Ifekwunigue M
Published: November 2008

Two hundred thirteen school children, ages six to nine, were presented the opportunity to participate in an experimental trial of swine influenza vaccine. In non-directive question and answer sessions, all groups of children except one composed only of six year olds elicited all relevant information on the details of the trial and the associated risks and benefits. Forty-six per cent of the subjects declined to participate. Letters requiring informed consent of the parents were sent to the homes of the others. Almost 15 per cent of these parents agreed to their children's participation. In this setting, children initiate their own visits to the school nurse practitioner. A significant association was found between volunteering for the study and higher use of services (but not for medical reasons). Younger children and boys, regardless of their patterns of use, were less inclined to volunteer for the experiment.
Overcoming barriers to the employment and utilization of the nurse practitioner.
Authors: Sullivan J A , Dachelet C Z , Sultz H A , Henry M , Carrol H D
Published: November 2008

A national longitudinal cohort study of nurse practitioners and their employers conducted during 1973--1976 provided data on barriers to the development of the nurse practitioner role in primary care. Nearly 90 per cent of the 500 primary care nurse practitioners responding and 75 per cent of the 407 employers responding reported encountering one or more barriers to the role development of the nurse practitioner in their practice setting. Nurse practitioners identified an average of 2.2 barriers and employers identified an average of 1.6 barriers each. Specific barriers identified by 20 per cent or more of the nurse practitioners and employers were legal restrictions, limitations of space and facilities, and resistance from other providers. The data and other evidence suggest that these barriers are not insurmountable and that progress is being made in overcoming these obstacles.
Skin color, ethnicity, and blood pressure II: Detroit whites.
Authors: Harburg E , Gleibermann L , Ozgoren F , Roeper P , Schork M A
Published: November 2008

Census areas in Detroit were ranked for their stress scores based on instability (e.g., crime, marital break up) and socioeconomic status. Four areas were selected for detailed study: 1) high stress, population predominantly black and 2) white, and 3) low stress, population predominantly black and 4) white. A sample was drawn from each area of persons of the predominant race, 25-60 years old, married and living with spouse, and having relatives in the Detroit Area. Nurses interviewed such persons; three blood pressure readings were taken during the first half-hour of medical history, and skin color was rated. While lighter skin color showed a negligible relation to higher blood pressure, a four-category division of European national background based on a skin color cline in Europe from Northern areas to the Mediterranean was significantly associated with a nurse-rating of skin color. The rank order of this four category variable, white ethnicity, was related linearly to both systolic and diastolic blood pressure means. Respondents with parents from Mediterranean countries had the lowest pressures and those from Northern Europe had the highest. The relationship is stronger for women than men. The relationship was independent of nine other control variables including age, overweight, smoking etc., and high and low stress areas, although of greater magnitude for the high than low stress groups. In this article, findings in whites are compared with prior results in blacks. Findings suggest that physiological and biological correlates exist that can be explored profitably by future research.
Effects of social disincentive policies on fertility behavior in Singapore.
Authors: Tan S B , Lee J , Ratnam S S
Published: November 2008

Five social disincentive policies were implemented by the Singapore government in 1973 to augment its fertility reduction program. The policies involve increasing delivery charges in government hospitals, school admission priority for children, maternity leave, priority in allocation of government housing, and income tax relief. In a two-year prospective study, 1,010 married abortees (study group) and 943 married parturients (comparison group) were questioned to determine their awareness and understanding of these policies, and whether the policies influenced their decision concerning their present pregnancies or would influence future decisions. Except for the tax policy, these disincentives were known to a fairly large proportion of the women studied. Knowledge was positively related to education level. Four of the five disincentives have, to varying degrees, influenced the women's decisions concerning their present pregnancies and may do so in future pregnancies. The two most widely known and most influential disincentives are those affecting school admission priority and accouchement fees.
Comparative educational approaches to screening for colorectal cancer.
Authors: Elwood T W , Erickson A , Lieberman S
Published: November 2008

The purpose of the study was to evaluate the public's willingness to perform the do-it-yourself Hemoccult Test for colon-rectum cancer and to assess the relative effectiveness of alternative means of persuading people to do the test. American Cancer Society volunteers in four different part of the country contacted a total of 11,115 members of the American Association of Retired Persons, using five methods that differed in the extent of personal and impersonal contact involved. Other variables such as inclusion of postage and dietary restrictions were studied and cost efficiencies were estimated. The Group Meeting Method was the most effective personal distribution method. The Selective Mail-Out Method was the most effective impersonal method. The return rate was higher when postage was provided. Dietary restrictions did not markedly reduce participation. Including digital examinations did not affect the return rate. The findings suggest that the Hemoccult Test has the potential of reaching a significant proportion of the nation's older population.
Oral contraceptive use: association with frequency of hospitalization and chronic disease risk indicators.
Authors: Hoover R , Bain C , Cole P , MacMahon B
Published: November 2008

A questionnaire was mailed to 97,364 married women, aged 26--50, resident in Greater Boston in 1970, requesting information on lifetime oral contraceptive (OC) use, reproductive history, education, and hospitalization experience in 1969; 65,843 women responded. In 1973 a second questionnaire was mailed to 37,292 of these women, including all OC users and an equal number of non-users matched on age, parity, education, and town of residence. This questionnaire related to use of OCs, other female hormones, and the menopause. OC use was most strongly related to age, with a sixfold increase in use from the oldest women (of whom 10 per cent had used OCs at some time) to the youngest. Use was directly related to education and mobility and inversely related to parity. Reasons for beginning and ceasing use differed for women of different ages and educational attainment. Thus, use of OCs varies with social and reproductive characteristics that are risk indicators for many diseases. OC use was associated with increased risk of hospitalization for thromboembolic disease (risk ratio = 1.5, 95 per cent confidence limits 1.2, 3.2) and for mental illness, hyperthyroidism, hypertension, and cancer of the cervix. OC users were hospitalized for many non-life threatening conditions 20 to 40 per cent more frequently than were non-users.
Impact of a rural preventive care outreach program on children's health.
Authors: Cowen D L , Culley G A , Hochstrasser D L , Briscoe M E , Somes G W
Published: November 2008

A "treatment-control" research design incorporating a modified "tracer disease" methodology for measuring health outcomes has been applied to the evaluation of a rural pediatric outreach preventive health care program in Appalachia. The primary research objective was to assess the general level of effectiveness of the health services provided by the program in preventing and/or reducing illness due to common childhood diseases among children receiving these services, when compared to similar (i.e., "matched") children receiving standard pediatric outpatient care but without such outreach services. The research findings indicate that prevalence rates for the selected tracer diseases were generally comparable among program children and their controls. However, evidence of effective identification and treatment of an increased prevalence of iron deficiency anemia by the program was demonstrated. Comparison of the program and control children on their sociocultural characteristics also suggests that the comparable health outcomes for the two groups may have been achieved in the case of the program children despite their somewhat disadvantaged socioeconomic and environmental circumstances relative to the controls; and apparently with lower outpatient services utilization and lower overall costs.
Selective mass treatment in a venereal disease control program.
Authors: Jaffe H W , Rice D T , Voigt R , Fowler J , St John R K
Published: November 2008

To control syphilis among prostitutes and seasonal farm workers in Fresno County, California, we developed a program of selective mass treatment of prostitutes. From August 1976 to July 1977, 512 women entered the program. Overall, 4.6 per cent of women treated prophylactically for syphilis were actually infected. Compared to cases in the previous year, infectious syphilis cases among prostitutes and seasonal farm workers decreased 51.3 per cent and 26.8 per cent, respectively.
Health costs of air pollution: a study of hospitalization costs.
Authors: Carpenter B H , Chromy J R , Bach W D , LeSourd D A , Gillette D G
Published: November 2008

This study of the hospitalization costs of exposure to air pollution in Allegheny County, Pennsylvania was conducted to determine whether persons exposed to air pollution incurred higher hospital utilization rates and additional costs for treatment. A hospitalization data-base comprising 37,818 total admissions for respiratory, suspect circulatory diseases, and comparison circulatory diseases was tested in a cross-section type analysis for relationships between rates of hospitalization, length of stay, and levels of air quality in the neighborhoods of patients' residence. Air quality was identified using data from 49 monitoring stations. Corrections were made for race, age, sex, smoking habits, median income, and occupation. The results show that hospitalization rates, length of stay, and costs of respiratory and suspect circulatory system diseases were significantly greater among populations residing in the more polluted zones of the County. At average costs for hospitalization in this area in 1972, the total increased cost for the 1.6 million persons in the County was estimated at $9.8 million ($9.1 million for increased hospitalization rates and $0.7 million for increased length of stay). The total health costs resulting from air pollution exposure in this area would be much greater when non-hospitalization costs are also included.
The New York rubella incident: a case for changing hospital policy regarding rubella testing and immunization.
Authors: McLaughlin M C , Gold L H
Published: November 2008

A case of rubella in a male obstetrics-gynecology house staff member exposed 170 staff members and 11 prenatal patients to the clinical disease. Of 163 staff members tested within one week of exposure, 132 (80 per cent) were not susceptibles. Repeat titres three weeks later on 28 susceptibles remained negative. Of the 11 patients exposed, three were susceptible and none seroconverted.
The hidden price tag: participation costs and health planning.
Authors: Cooper T L
Published: November 2008

The citizen participation program of the Los Angeles County Health Systems Agency represents one of the most ambitious efforts at implementing the public involvement provisions of PL 93-641. The first year of this program is discussed and analyzed through a participation costs theoretical framework. Specific costs which are inherent in the organizational design and introduced by the implementation procedures adopted are identified and discussed. Levels of participation after one year of operation are examined and found consistent with the high cost of participation in this program.
Violent death in a metropolitan county: II. Changing patterns in suicides (1959-1974).
Authors: Ford A B , Rushforth N B , Rushforth N , Hirsch C S , Adelson L
Published: November 2008

Suicide rates in Cuyahoga County (metropolitan Cleveland) rose from 10.2 in 1958 to 12.5 per 100,000 populations in 1974 (23 per cent increase) with the greatest rise among nonwhite males (from 5.9 to 13.1, or 122 per cent). Increased rates were observed in both the city (19 per cent increase) and suburbs (35 per cent increase). Rates increased among young non-white and white adults of both sexes aged 15--34 years, but decreased slightly among adults aged 65 years and older. These findings are consistent with national trends. Alcohol was present in the blood of one-fourth of the individuals who were "dead on arrival," and at intoxicating levels in 20 per cent. There were increasing percentages of victims with positive blood alcohol and with intoxicating levels during the study period. White male victims in the city had significantly higher frequencies of such findings than their counterparts in the suburbs. The rates of suicide committed by firearms rose among all race-sex groups, with the greatest increase among city nonwhite males (2.1 to 7.7, or 267 per cent). Suicide by chemical agents (roughly one-half being barbiturates) increased in all groups except city nonwhite males, with the greatest increase among white males and suburban white females. Firearms among males and poisoning among females displaced asphyxia as the leading modes of suicide.
The effect of outreach workers' educational efforts on disadvantaged preschool children's use of preventive services.
Authors: Colombo T J , Freeborn D K , Mullooly J P , Burnham V R
Published: November 2008

A special program of outreach services was implemented to assist a poverty population to appropriately use health services in the Kaiser-Permanente Medical Care Program. A study was conducted to determine the effect of outreach workers' intervention on the use of preventive services by this population. Intially, families were divided into two groups, one with and one without outreach workers. Outreach workers (neighborhood health coordinators) were trained in prevention and health education. They were then assigned to specific subgroups of the poverty population to teach the importance of preventive services and to motivate persons to use these services. This paper focuses on the effect of outreach workers' services on the use of selected preventive care services (immunizations and tine test) by preschool children from poverty families. Preschool children in families with coordinator services had higher use rates for preventive care. The sub-group for which outreach workers were specially trained to focus on preventive procedures for the pre-school group had markedly higher use rates for preventive care. The findings suggest that special intervention programs, using indigenous and nonprofessional outreach workers, can increase preventive service utilization by poverty groups.
Causes of death among laundry and dry cleaning workers.
Authors: Blair A , Decoufle P , Grauman D
Published: November 2008

To make a preliminary determination as to whether a potential health hazard exists for workers exposed to dry cleaning solvents (carbon tetrachloride, trichloroethylene, and tetrachloroethylene), we analyzed the causes of death of 330 deceased laundry and dry cleaning workers by the proportionate mortality method. The increased risk for malignant neoplasms resulted primarily from an excess of lung and cervical cancer and slight excesses of leukemia and liver cancer. Although the number of deaths was small, the increased risk of cancer noted in this investigation underscores the need for additional epidemiologic studies of this occupational group.
Rabies in translocated raccoons.
Authors: Nettles V F , Shaddock J H , Sikes R K , Reyes C R
Published: November 2008

Two raccoons imported from Florida by a North Carolina hunting club were diagnosed as having rabies by fluorescent antibody testing of brain tissue. Although dead on arrival in North Carolina, they could have infected other raccoons in the same shipment which had already been released into the wild. Raccoon rabies has become increasingly important in recent years, but this is the first documented report of rabies presence in hunter-purchased interstate shipments.
Controlling the cost of dental care.
Authors: Bailit H L , Raskin M , Reisine S , Chiriboga D
Published: November 2008

Methods for controlling dental care expenditures are taking on greater importance with the rapid increase in prepaid dental plans. The use of regulatory systems to monitor provider performance are necessary to prevent gross over-utilization but are unlikely to result in net savings of more than five per cent of total gross premiums. Theoretically, prepaid group dental practice (PGDP) may reduce expenditures by changing the mix of services patients receive. The modest estimated savings and the small number of PGDPs presently in operation limit the importance of this alternative for the next five to ten years. If substantial reductions in dental expenditures are to be obtained, it will be necessary to limit dental insurance plans to cover only those services which have demonstrated cost-effectiveness in improving health for the majority of people. The concept that richer benefit plans may have small marginal effects on improving oral health may not be easy for the public to accept but, until they do, expenditures for dental care will be difficult to control.
Causes of fetal and neonatal mortality by race in a selected U.S. population.
Authors: Naeye R
Published: November 2008

In a large prospective study (1959--1966), the perinatal mortality rate for U.S. Whites was 34 deaths per 1000 total births, for Blacks 51/1000, for Puerto Ricans 41/1000, and for Orientals 23/1000. A number of disorders were responsible for these differences. Premature rupture of the fetal membranes occurred 92 per cent more often in Blacks than in Whites, marked placental growth retardation 56 per cent more often, amniotic fluid infections 45 per cent more often, and major congenital malformations 15 per cent more often. Most other disorders were less common in Blacks than in Whites. Stratifying the data by selected factors, such as prepregnancy body weight and antenatal medical care, eliminated or greatly reduced almost all of these interracial differences. The only major unexplained differences remaining were an excess of amniotic fluid infections and major congenital malformations in Blacks, and an excess of abruptio placentae and large placental infarcts in Whites.