bluuebunny/crossref_metadata_2025 huggingface dataset:
Chlamydial LPS and high-sensitivity CRP levels in serum are associated with an elevated body mass index in patients with cardiovascular disease
Authors: Lajunen Taina , Vikatmaa Pirkka , Bloigu Aini , Ikonen Tuija , Lepäntalo Mauri , Pussinen Pirkko J. , Saikku Pekka , Leinonen Maija
Published: November 2008

Objective: Seropositivity for Chlamydia pneumoniae has been associated with an elevated body mass index (BMI). Our aim was to study if serum chlamydial lipopolysaccharide (cLPS), C. pneumoniae antibodies and high-sensitivity C-reactive protein (hsCRP) levels are associated with BMI

Patients and Methods : The study population consisted of 174 patients with symptomatic carotid stenosis, abdominal aortic aneurysm or occlusive aortic disease. Information on BMI, diabetes, smoking, hypercholesterolemia, and statin medication was available. Serum C. pneumoniae IgG and IgA antibodies, cLPS, hsCRP and total endotoxin activity (totLPS) were measured.

Results: BMI correlated with cLPS ( r = 0.197; P < 0.01) and with hsCRP (ρ = 0.195; P < 0.01); in addition, there was a positive correlation between cLPS and hsCRP (ρ = 0.499; P < 0.01). A trend of an increasing proportion of C. pneumoniae IgG positivity (titre ≥ 64; P = 0.018) and higher serum cLPS ( P = 0.01) and hsCRP ( P = 0.01) concentrations was observed across the BMI groups (BMI ≤ 24.9 kg/m2, BMI = 25.0—29.9 kg/m2, and BMI ≥ 30.0 kg/m2). Among the three BMI groups, 24.6%, 38.8%, and 48.3% were C. pneumoniae IgG-positive and the median (IQR) cLPS concentrations (ng/ml) of the groups were: 92.6 (50.8—167.0), 128.9 (76.4—163.9), and 146.4 (105.8—175.8), respectively. The median (IQR) hsCRP (mg/l) concentrations of the groups were: 1.70 (0.70—3.05) 1.70 (0.80—5.20), and 3.40 (1.45—8.55), respectively. These associations remained statistically significant in a multivariate analysis.

Conclusions: Elevated serum cLPS levels were associated with an elevated BMI. This is a novel finding and it strengthens the link between chlamydial infection and obesity. A lack of association between totLPS and BMI suggests that the association between infection and an elevated BMI may be specific to certain pathogens.
Invited review: Deterioration of the immune system after trauma: signals and cellular mechanisms
Authors: Flohé Stefanie B. , Flohé Sascha , Schade F. Ulrich
Published: November 2008

Multiple trauma leads to a deterioration of the immune system. On the one hand, hyperinflammation mediates remote organ damage and may lead to multi-organ failure. On the other hand, immunosuppression develops and promotes an enhanced risk to acquire infectious complications after trauma. The mechanisms that underlie these opposing consequences of trauma are not yet completely understood. There is increasing evidence that endogenous danger signals that derive from destroyed tissues play a role in trauma-induced immune dysfunction. Here, we give an overview on the common animal models that are used to investigate trauma-induced pathology, potential signals and cellular mechanisms that support the imbalance between inflammation and counter-regulation after trauma.
Reaching Land's End: new social practices in the pilgrimage to Santiago de Compostela
Authors: Herrero Nieves
Published: November 2008

Since the 1980s, there has been a steady recovery of the Jacobean pilgrimage involving thousands of people travelling on foot along the routes followed by medieval pilgrims who made the journey to Santiago de Compostela. The aim of this article is to explore the global and local variables
that intervene in this revival, as well as the range of social groups and actors that provide the institutional framework for the ritual practices of the pilgrims. This article analyses the secular transformation of the Jacobean pilgrimage paying particular attention to the extension of the
Pilgrim's Way to Cape Finisterre, where the transformation reaches its maximum expression and pilgrims ritualise the achievement of their goal in the contemplation of the sun setting over the Atlantic Ocean at Land's End.
Vorsicht,heiß! Eine interdisziplinäre Instant-Verständigung über Schönheit und Ästhetik Beware, hot! An interdisciplinary »instant conversation« on beauty and aesthetics
Authors: Burmester Michael , Kaiser Karin
Published: November 2008

Missverständnisse und Perspektivwechsel begleiten die interdisziplinäre Beschäftigung von Usability Professionals und DesignerInnen mit der Ästhetik.Wir inszenieren daher ein Pausen-Gespräch, das versucht, einige dieser Missverständnisse aufzuklären und die unterschiedlichen Perspektiven deutlich zu machen. Dabei trifft das Gestalten von Artefakten auf deren Evaluation, die Ästhetik als die Wissenschaft vom sinnlich Wahrnehmbaren auf das Interesse am Nutzerurteil im Sinne von »schön oder hässlich«, holistische Modelle begegnen reduktionistischen. »Etwas schön machen« löst keine Designaufgabe – dennoch sind Ästhetik und Schönheit für Nutzererleben und Produkt essentiell.
Von der Immaterialisation des Materiellen zur Materialisation im Immateriellen From the immaterialization of the material to materialization in the immaterial
Authors: Platz Axel
Published: November 2008

Bevor der Bildschirm zum Inbegriff des User Interface wurde, als es noch vielfältig Bedienfelder mit mechanischen Bedienelementen gab, war deren Gestaltung geprägt vom Bestreben, sie ihrer Plastizität zu berauben und in die Fläche zu bannen, ja die ganze Bedieneinheit in radikaler Reduktion zu entmaterialisieren und so die Vision der Bedienoberfläche real werden zu lassen. Seit aber diese absolute Flächigkeit in der Glasscheibe des Monitors endlich gegeben ist, frönen die graphischen Oberflächen der tiefenräumlichen Illusion und imitieren mechanische Bedienelemente aller Art. Die Kunst der Gestaltung reduziert sich auf die Kunstfertigkeit der Darstellung – das Design ist zu sehr mit sich selbst befasst, als dass noch eine Symbiose mit Usability gelingen kann.
HEALTH HAZARDS OF NON-POISONOUS DUSTS—A RÉSUMÉ OF SOME RECENT INVESTIGATIONS
Authors: Hayhurst Emery R.
Published: November 2008

Five million workers are subject to industrial dust hazards in this country. The risk to them may be decreased if what is becoming known is utilized. A scientific basis for estimating maximum amounts permissible is near at hand, while the body defenses are becoming better understood.
METHODS OF PLAGUE CONTROL
Authors: Simpson Friench
Published: November 2008

If we are economically and efficiently to ward off plague we must rid ourselves of the rat. This demands coördination of effort, management, organization and funds. Rat destruction and rat-proofing are preventive measures that fortunately do not involve financial loss, while they will eliminate the dangerous rodent from the homes and environment of men.
DRAINAGE AS AN ANTI-MALARIA MEASURE
Authors: LePrince J. A.
Published: November 2008

This author argues the necessity of liberal interpretation of laws. The Health Officer can then be able to use prevention at malarial sources beyond his borders. He urges co-operation of the health officer in drainage plannings and suggests value of permanent improvements, following, of course, study of local conditions.
PRIVY SYMPOSIUM. II
Authors: Ferrell John A.
Published: November 2008

Passing from construction to disease relations, two maladies are here considered in connection with the privy. Dr. Ferrell discusses hookworm and gives a few rules that can eliminate the link of soil pollution. Dr. Smith presents results in typhoid and asserts that the sanitary privy, properly maintained can be an important factor in its control.
WHAT SHOULD BE DONE IN THE CONTROL OF DEGENERATIVE DISEASES?
Authors: Crum Frederick S.
Published: November 2008

Dr. Crum's six lines of attack are: bettered scientific methods in infant and pre-school care; extension of school hygiene, medical inspection and physical training, more intensive health education of the people and the extension of industrial sanitation and industrial hygiene.
STUDIES ON MALARIA CONTROL
Authors: Bass C. C.
Published: November 2008

Nine-tenths of the malaria would be gone in ten years if the doctors could only cure all the cases they treat. Intensive survey and follow-up can effect like results. This is no idle story, for in Sunflower County, Miss., in 1918, malaria was reduced ninety percent.
AFRICAN ABORIGINAL THERAPY
Authors: Sheppard Philip A. E.
Published: November 2008

No other man in America has so complete a knowledge of the aborigines of South Africa as Dr. Sheppard. For twenty-one years he spent his vacations in their kraals. He is a blood-brother in two tribes, and a chief, and sits on his own mat at tribal councils. His picture of their aboriginal therapy is unique.
CAUSES OF TYPHOID FEVER IN MASSACHUSETTS
Authors: O'Donnell George T.
Published: November 2008

To decrease its typhoid Massachusetts needs now to prevent contacts, use prophylaxis, and educate its citizens in personal hygiene. Municipal water supplies are practically safe. Flies, food (milk excepted), privies and sewage are together only a small factor in spreading the disease. The human contact factor is the one that must be controlled.
RELATION OF SCHOOL AND SPECIAL FEEDING TO DEFECTIVE NUTRITION
Authors: Gebhart John C.
Published: November 2008

This author sets forth the futility of attacking undernourishment principally as a school problem. Experience both in this country and in England shows that school meals are merely palliative if unaccompanied by measures to raise permanently home standards of food and hygiene. The school measures must be fitted into the larger social machinery for dealing with the defect.
COMMON-SENSE VERSUS CUSTOM IN THE APPOINTMENT OF HEALTH OFFICIALS
Authors: Larner Herbert B.
Published: November 2008

Once on a time only a minister was deemed fit to be president of a college; more recently only a doctor has been thought competent to be a health officer. Both situations have changed. The college selects the business man of broad vision, while the fitness of the trained engineer for health officer is fast becoming evident.
COMPARATIVE STUDIES OF DIPHTHERIA CULTURES OF LOEFFLER'S MEDIUM WITH THE ORIGINAL SWABS TRANSPORTED BY MAIL
Authors: Young C. C. , Crooks Minna
Published: November 2008

Swabs and cultures prove to be of equal value for diphtheria diagnosis while swabs may give evidence of other infections. This paper tells of an experiment in routine work lasting a year. It shows swabs to be less costly, never dry through storage, and better for surveys. The paper emphasizes the need of rural branch laboratories.
SPECIAL OBJECTIVES OF PHYSICAL EDUCATION WITH RELATIONSHIPS TO PUBLIC HEALTH
Authors: Hetherington Clark W.
Published: November 2008

Most children have no homes, says Mr. Hethrington. Child life and home life have been sacrificed to industry. The home has become a dressing room and refreshment center. Old home functions are shifted to the school. Physical education is one of these, so recently in its new place that it needs interpretation.
FUNCTIONS AND RELATIONSHIPS OF BUREAUS OF CHILD HYGIENE AND BUREAUS OF PUBLIC HEALTH NURSING IN STATE BOARDS OF HEALTH
Authors: Marriner Jessie L.
Published: November 2008

Does the organization of a child hygiene bureau mean the absorption of every function of a state board of health and an application of the same to children under fifteen, in other words, the creation of a health department for children within the regular state board of health? The writer of this article thinks it should not involve this and suggests a plan to avoid duplication.
SOME RELATION BETWEEN OUR HEALTH AND OUR ENVIRONMENT
Authors: Walker Watson Frank
Published: November 2008

“It is not too much to say that an adequate solution of the housing question is the foundation of all social progress. Health, and housing, are indissolubly connected. If this country is to be the country which we desire, a great offensive must be taken against disease and crime, and the first point at which the attack must be delivered is the ugly, unhealthy, overcrowded house, in the mean street, which we all of us know too well.

“If a healthy race is to be reared it can be reared only in healthy homes. If infant mortality is to be reduced, and tuberculosis to be stamped out, the first essential is the improvement of housing conditions; if drink and crime are to be successfully combated, sanitary houses must be provided. If `unrest' is to be converted to contentment, the provisions of good housing may prove one of the most potent agencies in that conversion.”
THE CONTROL OF COMMUNICABLE DISEASES IN SCHOOLS
Authors: Baker S. Josephine
Published: November 2008

Dr. Josephine Baker, as director of one of the most important bureaus in the New York City Department of Health, has become one of the country's best known women health workers. Her experience in the matter of which this paper treats has naturally been very extensive.
SIX MONTHS OF THE HARRISON ACT
Authors: Terry C. E.
Published: November 2008

Public health officials, the medical profession generally, pharmacists, lawyers, legislators and the public have all watched with interest the working of the Harrison Act, by means of which the federal government has taken part in the effort to control the narcotic drug traffic. In Doctor Terry's city, special efforts have been made in this respect.
PSYCHIATRIC CLINICS IN THE SCHOOLS
Authors: MacCurdy John T.
Published: November 2008

The purpose of this important paper by Doctor MacCurdy is to point out why psychiatric clinics in the schools may offer reasonable hope of reducing insanity in the later life of the pupils. And since it is undoubtedly true that the next problem of public health administration will be concerned with mental disorders, where better to begin than with the school child?
REGISTRATION OF MENTAL DISORDERS
Authors: Rosanoff A. J.
Published: November 2008

Doctor Rosanoff in this excellent paper presents, for our consideration, facts which in the future must yield the coöperation between the psychiatrist and the public health official.
THE HEALTH OF DEPARTMENT STORE WOMEN IN NEW YORK CITY
Authors: Mann Kristine
Published: November 2008

Doctor Mann's paper not only presents the specific problem indicated in the title, but also deals with some problems which are sure to command an increasing amount of attention on the part of health administrators, particularly the relationship between wages and health.
THE RELATIONSHIP OF IMPAIRED PHYSICAL CONDITION TO ACCIDENTS
Authors: Farnum C. G.
Published: November 2008

Doctor Farnum points out the value of coöperation between medical and safety departments with an object of fitting the man to the job for which he is physically fit, a means of reducing accidents. This paper tells what one company has done.
THE PLACE OF NUISANCES IN THE LAW
Authors: Feezer Lester W.
Published: November 2008

Mr. Feezer, a member of the bar, has been practicing health rather than law and through his association with the Massachusetts and New York State Departments of Health, is well qualified to interpret this difficult phase of the health problem. In this article he places nuisances in their proper position and explains the most effective methods with which to accomplish their abatement.
THE EXPERIENCE OF NEW YORK CITY IN GRADING MARKET MILK
Authors: Brown Lucius P.
Published: November 2008

In a remarkably clear and lucid style, Mr. Brown states the manner in which the largest city in the country has dealt with the problem of controlling its milk supply. While the essentials of the system are few, their execution is a big task. Read what Mr. Brown has to say about it.
OTHER FACTORS IN INFANT MORTALITY THAN THE MILK SUPPLY AND THEIR CONTROL
Authors: Meigs Grace L.
Published: November 2008

Dr. Meigs is connected with the Children's Bureau of the U. S. Department of Labor. In this paper she reviews some of the methods of attack which have been employed with success in dealing with the infant mortality problem.
THE EFFICIENCY OF VENEREAL CLINICS
Authors: Platt Philip S.
Published: November 2008

One million, two hundred and fifty thousand individuals were treated in one hundred and twenty-two clinics in New York City in 1913 for venereal disease, yet in most of these clinics one could not determine the results of such treatment. Mr. Platt in this paper criticizes the filing systems in general use in these clinics and suggests a remedy in the form of a cross indexing by diseases.
Extramedical factors in the decision to hospitalize medical patients.
Authors: Mushlin A I , Appel F A
Published: November 2008

This study assesses the importance of extramedical factors in the decision to hospitalize medical patients. Residents in a municipal hospital's emergency room completed a questionnaire on 252 consecutive patients at the time of admission. Extramedical factors contributed to the admission decision in 54 patients (21 percent); for twenty of these patients (8 percent of total) extramedical factors were the primary reason for admission. Factors noted most frequently related to patient behavior, such as being unlikely to follow instructions, and to home situations, such as social isolation. For 16 percent of the admissions, physicians felt that treatment outside the hospital was possible if realistic alternatives existed. Results suggest that extramedical factors are important contributors to the need for hospitalization. Attempts to develop quality assurance criteria, such as in utilization review or admission certification, must take such factors into account.
Hepatitis B antigen and antibody in the U.S. Army: prevalence in health care personnel.
Authors: Segal H E , Llewellyn C H , Irwin G , Bancroft W H , Boe G P , Balaban D J
Published: November 2008

The prevalence of Hepatitis B surface antigen (HB(S)Ag) and antibody (anti-HB(S)) seropositivity and the association of seropositivity with demographic, personal health, and professional experiences were studied in a cohort of Army Medical Department officer personnel. Serologic evidence of Hepatitis B infection was found in 5.0 per cent of personnel and was associated with age, sex, place of birth, history of hepatitis, history of blood transfusion, and previous overseas assignments. Seropositivity rates were higher for patient care oriented officer personnel, especially for those in surgical specialties, and rose with increasing professional experience. These data present a composite of risk factors operative in the acquisition of Hepatitis B seropositivity and identify a cohort for prospective study.
Irritating effects on man of air pollution due to cigarette smoke.
Authors: Weber A , Jermini C , Grandjean E
Published: November 2008

Sixty subjects were exposed to cigaretts smoke produced by a smoking machine in a climatic chamber. The irritating effects were recorded by questionnaire and related to concentrations of CO, formaldehyde, and acroleine. The eyes are most sensitive to these irritants, followed by the nose. Annoyance about air quality, and the desire to open the window or to leave the room proved to be other useful measures of sensitivity. With smoke produced by 10 cigarettes/30 m3 acroleine reaches 0.1 ppm, the threshold limit value for industries; simultaneously, CO and formaldehyde exceed the clean air standards for outdoor air. At this exposure level. 9 per cent of the subjects show a strong or very strong eye irritation, while 78 per cent "wish to leave the room." The most important of the measured irritants seems to be acroleine.
Dental visits by income and race in ten urban and two rural areas.
Authors: Okada L M , Sparer G
Published: November 2008

Household surveys in 12 low income areas found large differences in dental visit rates after control for income and race. The dental visit rate for Red Hook (NYC) exceeded the national rate whereas in seven of the areas the rate was below national averages by 40 per cent or more. The ranges in dental visit rate for low income Blacks was from two-thirds the national rate (in two areas of the South) to two to three times greater than the comparable national rate (in three areas of the Northeast). Lesser but nevertheless large variations among area dental visit rates existed for other race and income groups.
Statutory authorizations for the work of local health departments.
Authors: Miller C A , Gilbert B , Warren D G , Brooks E F , DeFriese G H , Jain S C , Kavaler F
Published: November 2008

A study of public health statutes of the 50 states identifies 44 specific services or functions that are assigned to local health departments by all or some of the states. Authorizations are most commonly assigned conjointly both to local and state health departments; exceptions are identified. Data suggest striking inconsistencies between what local health departments are authorized to perform and the services they actually render with regard to a selected group of programs that involve personal health services. The full scope of authorizations for local health departments is not revealed by examination of public health statutes. For this reason, among others, development of up-to-date health codes for all states would be beneficial.
Morbidity and growth of infants and young children in a rural Mexican village.
Authors: Condon-Paoloni D , Cravioto J , Johnston F E , De Licardie E R , Scholl T O
Published: November 2008

The relationship between childhood illnesses and growth increments in length and weight was investigated in a 13-month birth cohort of rural Mexican children. Increments in length and weight for each year from birth to three years were related to high and low frequencies of reported time ill during the same period. Seventy-two of the 276 children had already been characterized as exhibiting "growth failure" relative to other members of the cohorts, and this was considered as a separate factor in the study. We found that upper and lower respiratory infection did not affect incremental gain in height or weight. A high frequency of diarrheal infection was found to reduce weight gain, although gain in height was not affected. Relative to the total sample, the average child with a high frequency of diarrhea achieved only 95 per cent of expected body weight age three; a chidl with both growth failure and high diarrheal frequency reached only 90 per cent of expected body weight at age three.
Sexual knowledge, attitudes, and practice of Israeli adolescents.
Authors: Lancet M , Modan B , Kavenaki S , Antonovski H , Shoham I
Published: November 2008

A study of 4,976 high-school students in Israel, representative of this age group for the entire country except for 13 percent who attend religious schools, revealed that about one-third of the boys aged 14-15 and almost one-half of those in the 16-17 age category have had sexual intercourse. The respective figures for girls are 6 percent and 16 percent. Age at onset of sexual activity was found to be higher and the level of knowledge about the same as in reports from the Western world. Students of Oriental origin, as well as those considering themselves religious or traditional tended to be less active sexually, more conservative in their attitudes, and less knowledgeable. In contrast, students of both sexes residing in kibbutzim were found to be more active sexually and more knowledgeable. A double standard for girls was accepted, especially among the female respondents, except in the kibbutzim. A subgroup of girls highly sexually active, in contrast to their own attitudes, has been identified, and possible reasons for this discordance discussed. As sexual activity among teenagers is becoming more prevalent, comprehensive and early sex education school programs should be encouraged.
Physician behavior as a determinant of utilization patterns: the case of abortion.
Authors: Nathanson C A , Becker M H
Published: November 2008

Health services utilization may be influenced by the structure of the health system and the behavior of health professionals as well as by the actions of individual patients. This research examines the responses of obstetricians toward women seeking abortion. The population for this study includes all obstetrician-gynecologists with any private practice in Maryland during 1975 (473). Each responding physician (443) was presented with a case history vignette describing, in a telephone interview, a woman who is pregnant and considering an abortion. The sociodemographic characteristics of the woman were systematically varied to determine effects of patient attributes on physicians' patient management decisions. Decisions to refer the patient or to participate personally in her care were found to be associated most strongly with the patients' financial resources. Three hundred and twelve obstetricians returned a mail questionnaire, probing their own attitudes and characteristics. Physicians' liberal or conservative attitudes toward expansion of reproductive health care services and their level of disturbance by the abortion procedure were also influential in these patient management decisions. Simultaneous examination of both patient and physician characteristics indicated that the former had the greater weight in accounting for referral decisions.
Socioeconomic differentials in selected causes of death.
Authors: Yeracaris C A , Kim J H
Published: November 2008

The areal approach utilized in mortality analysis for cities in the past is argued to be fruitful for suburban mortality analysis as well. Through factor analysis of four Census Tract indicators, weighted scores were computed and socioeconomic groups were constructed for each central city and each suburban area for three selected metropolitan areas: Birmingham, AL, Buffalo, NY, and Indianapolis, IN. Mortality rates from Heart Diseases, Malignant Neoplasms, and All Other Causes of death were found to be inversely associated with socioeconomic status in both the central cities and the suburban communities of these selected metropolitan areas. Evidence points to increasing socioeconomic differentials between 1960 and 1970 especially for males for the central cities and for suburban rings in spite of reductions in mortality during this period.
The incidence of sudden infant death syndrome in North Carolina's cities and counties: 1972--1974.
Authors: Blok J H
Published: November 2008

Between January 1, 1972 and December 31, 1974, 534 Sudden Infant Death Syndrome cases were reported in North Carolina. All but the out-of-state cases were mapped by county and city locations to determine if urban or rural cases predominated. The mapping was also undertaken to see if significant spatial variabilities could be detected between the county and city populations of infants at risk. The state had an overall SIDS rate of 2.06 per thousand live births. The mapping revealed that counties had a range from zero to a high of 6.6 and that cities with populations of over 10,000 had SIDS rates which ranged from zero to a high of 10.6. The proportions of SIDS cases occurring in either urban or rural locations roughly approximated the distribution of the state's population, with neither location accounting for disproportionately more cases. The larger cities, however, reported more cases than did their suburbs and the immediately surrounding rural areas. The largest and smallest cities, when grouped accordingly, had the lowest urban SIDS rates. The summary SIDS rates for whites was 1.23 per thousant live births, for blacks it was 3.75, and for Indians it was 6.56 per thousand live births.
Health status indices and access to medical care.
Authors: Andersen R
Published: November 2008

This paper examines the uses of some health status indices in measuring equity of access to medical care. Empirical examples are provided using data from national surveys of the U.S. population conducted from 1964 through 1976. A simple indicator, mean number of physician visits, suggests that between 1963 and 1976 the poor improved their position relative to the rest of the population and, indeed, currently enjoy the highest level of access. However, a second measure, the use-disability ratio indicates that the poor may still receive less care relative to their need. A third measure, the symptoms-response ratio suggests how norms of appropriate behavior might be incorporated into an access measure.
An international look at school-based children's dental services.
Authors: Dunning J M , Dunning N
Published: November 2008

School-based dental clinics, when well-managed, can bring good quality care to children where they normally congregate, thus avoiding many of the problems found where children must be taken to private offices out of school hours. Both capital and running expenses for primary care can be substantially reduced. Utilization figures for school-based dental services now reach 98 per cent of eligible children in New Zealand, where dental nurses do simple operative dentistry including cavity preparation and fillings. Australia, where a modified New Zealand plan has been expanding for about 12 years, is moving rapidly to attain similar utilization. In Sweden, 95 per cent of the school-age population is reported to receive school-managed dental service through a government program. In the United States, however, it is commonly reported that less than one-half the school-age population receives good periodic dental care.
Identification and evaluation of competencies of public health nutritionists.
Authors: Sims L S
Published: November 2008

The Delphi Technique was used to elicit a number of essential competencies expected of the "entry-level" public health nutritionist from members of Graduate Faculties of Programs in Public Health Nutrition. Questionnaires composed of "competency statements" were constructed from these responses and sent to practitioners in public health nutrition. The questionnaire requested evaluation of the "necessity" of each competency. Responses served as the basis for "factor analysis" procedures, employed to obtain clusters of competency functions expected of the nutritionist. From the 109 competency items originally identified, 17 competency scales were derived from the factor analysis. A ranking from both faculties and practitioners revealed that both groups highly rated competencies to communicate, to counsel and deal with clients/patients, and to interpret scientific data in "lay language." Less important in the ranking were competencies which dealt with administrative abilities, program planning, legislative activism, and consumer advocacy. These findings have cimplications for the practitioner in public health nutrition as well as for academic groups who must plan and evaluate curricula in public health nutrition and in other fields of public health.
Smoking cessation program: baseline carbon monoxide and serum thiocyanate levels as predictors of outcome.
Authors: Vogt T M , Selvin S , Billings J H
Published: November 2008

One hundred and sixty-two smokers who participated in an aggressive smoking cessation program underwent analysis of expired air carbon monoxide (CO) and serum thiocyanate (SCN) at entry and one year later. Persons who failed to quit smoking had higher baseline CO and SCN and smoked more cigarettes per day than did those who succeeded in quitting. The use of CO, SCN, number of cigarettes smoked, age, and blood pressure at baseline permitted accurate classification of over 70 per cent of the subjects into groups which would succeed and fail in their effort to quit smoking. Persons who failed to quit reduced the reported number of cigaretts smoked per day by one-third, but there was no corresponding reduction in CO and SCN, suggesting that self-reporting of a reduction in the number of cigarettes smoked may not lead to a corresponding decline in exposure.
The effect of infant death on subsequent fertility in Korea and the role of family planning.
Authors: Park C B , Han S H , Choe M K
Published: November 2008

This paper studies the effect of infant death on subsequent fertility in a developing country, examining spacing of children and additional births following the survival or death of the preceding infant. The material is provided by the 1971 National Fertility Survey of Korea, 23,635 retrospective birth records of 6,285 women. The findings suggest that prior to the introduction of a national family planning program, the influence of infant death was limited to the biological effect resulting from a shortened lactational period. Since fertility regulation methods have been made available throughout the country, motivational effects to replace the lost child appeared to emerge. The proportion of excess births attributable to infant deaths has increased in recent years. However, because of the lowered infant mortality, the overall impact of infant death on the national fertility level appears to be small.
The effects of changes in smoking habits on coronary heart disease mortality.
Authors: Kleinman J C , Feldman J J , Monk M A
Published: November 2008

Coronary heart disease (CHD) mortality declined by about 20 per cent between 1965 and 1976. During the same period there were substantial decreases in the proportion of adults who smoked based on data from the National Health Interview Survey (HIS). This study examines the extent to which changes in smoking can account for the decrease in CHD mortality for men and women aged 35-64 years. By applying US smoking levels (estimated from HIS) to data from four epidemiologic studies on the relative risk of CHD death by amount smoked, we obtain estimates of the portion of the decline in CHD mortality attributable to changes in smoking. Smoking changes among women were not generally consistent with declines in CHD mortality. For men, the estimated impact of smoking on CHD mortality varied considerably depending upon which study was used to estimate the relative risk by amount smoked.
Roles for non-physicians in fertility regulation: an international overview of legal obstacles and solutions.
Authors: Paxman J M
Published: November 2008

For more than a decade the roles of non-physicians in fertility regulation have been expanding. The article discusses the relationship between law and the expansion of those roles. The laws and regulations which effect these roles fall into three basic categories: those controlling the medical and other health-related professions, those regulating drugs and devices, and those affecting specific fertility regulation services. These in turn may either inhibit or facilitate the expansion of roles for non-physicians. Where legal barriers arise, and no feasible legal solution is developed, expansion of roles is difficult, if not impossible, as the law invariably reflects the prevailing views on who should provide fertility regulation services. In many countries, however, as roles have been changing, the law has been changing too in a way which affords legal protection to non-physicians. The emphasis to date has been on permitting them to assume expanded roles in the provision of contraceptives. Non-physicians are authorized to prescribe the Pill in at least 10 countries and to re-supply the Pill after prescription in seven others. Non-physicians are permitted to insert IUDs in at least 10 countries. Pilot projects are presently testing the feasibility of permitting non-physicians to perform sterilizations and early abortions. The law has an impact, for good or ill, on all of these arrangements.
Hypertension control in a rural biracial community: successes and failures of primary care.
Authors: Wagner E H , Slome C , Carroll C L , Warner J T , Pittman A W , Pickard C G , Williams B O , Cornoni-Huntley J C
Published: November 2008

Through a total community survey and a medical record review, we examined hypertension awareness, treatment, and control in a biracial rural community rich in primary care resources. The overall prevalence of hypertension among the 2,939 respondents was 20.5 per cent; 82 per cent of hypertensives were aware of their condition; 68 per cent were on treatment; and 55 per cent were under control. Comparison of data sources revealed discrepancies and misconceptions about diagnosis and treatment. Nearly one-third of the population reported a history of hypertension despite the fact that most of them were untreated and were normotensive. Conversely, one-third of "undetected" hypertensives had notation of the diagnosis in their medical records. Discontinuation of treatment accounted for over one-half of aware but untreated hypertension. Misconceptions about therapy contributed to failures of control in the treated group. These findings suggest that difficulties in the transmission of information about hypertension contribute importantly to failures of control.
The paucity of breast-feeding in an urban clinic population.
Authors: Magnus P D , Galindo S
Published: November 2008

The lack of breast-feeding among mother-infant dyads utilizing public sector clinics in Los Angeles is presented in this brief study. Whereas the middle and educated classes have begun a resurgence of breast-feeding, this renaissance is missing among the poor. Awareness, health education (by peer advocates), early intervention and reassurance by all levels of health providers is suggested to prevent the dissolution of the lactation bond among the population least apt to breast-feed.
Changing house staff attitudes toward nurse practitioners during their residency training.
Authors: Weinberger M , Greene J Y , Mamlin J J
Published: November 2008

This study examines the hypothesis that increased physician contact with nurse practitioners (NPs) during residency training would ecourage positive house staff attitudes. House staff expectations of and attitudes toward NPs were assessed at three points during the residency. Data indicated a more positive evaluation of NPs by house staff later in the residency program, as shown by: 1) physician expectations and valuation of NPs, 2) attitudes concerning future employment of NPs, and 3) the extent and capacity of NP utilization by residents.
Does chiropractic utilization substitute for less available medical services?
Authors: Yesalis C E , Wallace R B , Fisher W P , Tokheim R
Published: November 2008

In Muscatine, Iowa, a medically underserved rural area, a cohort study of health care utilization was made before and after a significant increase in medical manpower. There was a slight increase, rather than a decrease, in the use of chiropractic services associated with the growth in the physician manpower pool. The level of access to physician services was not a significant predictor of chiropractice utilization.
Symptomatology in head and neck cancer: a quantitative review of 385 cases.
Authors: Kaufman S , Grabau J C , Loré J M
Published: November 2008

Symptom durations in head and neck cancer patients analyzed as a function of tumor stage suggest a reversal of the "common sense" notion that patients with early disease generally present with a shorter symptomatic period. A possible explanation is that variation in stage at diagnosis is primarily due to intrinsic differences in tumor aggressiveness rather than patient delay. This would imply that early detection programs may be incapable of realizing the potential for improved survival commonly ascribed to them.
Deinstitutionalized mentally retarded hepatitis-B surface antigen carriers in public school classes: a descriptive study.
Authors: Bakal C W , Marr J S , Novick L F , Millner E S , Goldman W D , Pitkin O E
Published: November 2008

Twenty-seven of 33 formerly institutionalized retarded HBsAg carriers exhibited behaviors which might facilitate viral transmission in classrooms where they had been placed with retarded susceptibles. Classroom conditions included lack of handwashing facilities and frequent failure to inform staff of the presence of such carriers in their classes. A serological survey of classroom contacts showed that 91% of never-institutionalized students, 86% of staff, and 18% of formerly-institutionalized students had no antibody to HBsAg. Caution should be taken to protect teachers and students from infection with hepatitis-B in such classrooms.
American Nurse-Midwifery Practice in 1976-1977: Reflections of 50 years of Growth and Development
Authors: Rooks Judith Bourne , Fischman Susan H.
Published: November 2008

Nurse-Midwifery was introduced into the United States in 1925 as a means of meeting the maternal and infant care needs of specific rural and urban poor populations. Four studies of US nurse-midwives conducted between 1963 and 1977 describe recent changes and practice in the profession. Approximately 1,000 nurse-midwives employed in the US responded to a questionnaire in late 1976; about 650 of them were in clinical practice. Of those in practice, two-thirds had graduated as nurse-midwives during the prior six years. At least 90 per cent of them provided prenatal care and family planning, and 85 per cent managed labor and delivery and performed postpartum physical examinations. Working collaboratively with physicians, most nurse-midwives manage the care of prenatal patients with some complications. However, relatively few manage multiple gestation or breech deliveries. The 78 per cent of clinical nurse-midwives who provide gynecologic care to non-pregnant women are likely to diagnose gynecologic conditions and treat common problems such as vaginal infections, gonorrhea, condylomata, and lower urinary tract infections. Those who work in small communities are more likely to assume greater responsibility for complicated deliveries and for care of the newborn from birth through infancy. (Am J Puiblic Health 1980; 70:990-996.)
The risk of hip fracture in postmenopausal females with or without estrogen drug exposure.
Authors: Johnson R E , Specht E E
Published: November 2008

This study estimated the risk of hip fracture among postmenopausal females with and without estrogen drug exposure. The Kaiser-Permanente Medical Care Program in Portland, Oregon served as the setting and medical records the source of data. A retrospective case-control method that matched each female member hospitalized with a hip fracture (N = 168) between 1965-1975 with two control female members hospitalized for reasons other than a hip fracture was used. The estrogen exposure rate of cases was 29.2 per cent and of controls 36.0 per cent. The risk of hip fracture was reduced with postmenopausal and prefracture estrogen exposure (RML = 0.72, 95 per cent CL: 0.48-1.09). However, the number of cases was sufficient only to detect a reduction in risk of about 50 per cent or greater. A possible protective effect from estrogens was also suggested with oral estrogen exposure and with longer lengths of estrogen exposure.
High blood pressure diagnosis and treatment: consensus recommendations vs actual practice.
Authors: Thomson G E , Alderman M H , Wassertheil-Smoller S , Rafter J G , Samet R
Published: November 2008

Diagnostic and treatment practices of institutional facilities treating high blood pressure in New York City were surveyed by mail in 1978. Respondents were adhering to the treatment recommendations of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. Ninety-two per cent of respondents reported 90-104 mm Hg as the diastolic blood pressure level at which drug therapy was initiated, indicating a more aggressive approach than was warranted by the information available at the time of the survey.
Skin color and education effects on blood pressure.
Authors: Keil J E , Sandifer S H , Loadholt C B , Boyle E
Published: November 2008

This study reports that education effects but not skin color effects were associated with blood pressure and the incidence of hypertension in a cohort of Black females in Charleston, South Carolina, observed over the period 1960-1975. The authors suggest that skin color may be a secondary (non-causal) associate of blood pressure in Blacks.
Quality Assessment by Process and Outcome Methods: Evaluation of Emergency Room Care of Asthmatic Adults
Authors: Mates Susan , Sidel Victor W.
Published: November 2008

Weighted process criteria based on chart review and weighted outcome criteria based on telephone interview were used to assess the quality of care for adult patients with asthma in the emergency rooms of a municipal and a voluntary hospital which share medical personnel. Process scores were highly correlated with 24-hour outcome scores at both hospitals but not with 7-day outcome scores. Our findings suggest that appropriate weighted process and outcome criteria are valid and useful methods for quality assessment, and underline the importance of choice of an appropriate “time window” for assessment of outcome. In addition, these assessment methods provide important “feedback” information for those providing care in the emergency room. (Am J Public Health 1981;71:687-693)
Fluoridation: strategies for success.
Authors: Isman R
Published: November 2008

Of 19 referenda on community water fluoridation held in the first six months of 1980, 17 were defeated. Among the postulated reasons are a growing distrust of government and the health establishment. The public remains largely ignorant of the purpose and benefits of fluoridation. The emotionalism surrounding the issue has made it difficult to generate public support outside of the health professions. Opponents have also learned to fight fluoridation with increasingly sophisticated techniques. Some of the strategies used in recent successful campaigns in Oakland, California, and Portland, Oregon are described; recommendations that can be applied to communities considering fluoridation include careful wording of ballot measures so they are unequivocally clear and simple; timing ballot measures with elections likely to draw the largest voter turnout; broadening the base of political and financial support; using a figurehead if possible; and making maximum use of the media.
Modifying dog litter in urban communities.
Authors: Jason L A , Zolik E S
Published: November 2008

Dog litter not only damages the esthetic quality of a community but also poses a serious health problem. The present paper summarizes a series of projects which were designed to ameliorate this litter problem. Two studies indicated that surrounding specific target areas with posts connected by string effectively eliminated dog droppings. Two other studies, which focused on prompting dog owners to pick up their dogs' droppings, also brought about considerable reductions in dog litter.
Occurrence of enteroviruses in community swimming pools.
Authors: Keswick B H , Gerba C P , Goyal S M
Published: November 2008

Municipal swimming pools and wading pools were examined for the presence of human enteric viruses using a portable virus concentrator at the site to concentrate viruses from 100-gallon to 500-gallon samples. Ten of 14 samples contained viruses; three of these were positive for virus in the presence of residual free chlorine. Enteroviruses were isolated from two pools which exceeded the 0.4 ppm free residual chlorine standard. This study appears to be supportive of recent evidence that indicates a higher incidence of enterovirus infection among bathers. All seven wading pool samples contained virus. Coxsackieviruses B3 and B4, poliovirus 1, and echovirus 7 were isolated. Total coliform bacteria were not adequate indicators of the presence of virus, as six of the samples were positive for virus but negative for coliforms. Total plate counts appeared to provide a better indication of the sanitary quality of the pool water, but viruses could still be detected in samples that met currently recommended bacterial levels. It is possible that swimming and wading pools may serve as a means of transmission of enteroviral disease, especially in children, during summer months.
Physicians and nurse practitioners: do they provide equivalent health care?
Authors: Ramsay J A , McKenzie J K , Fish D G
Published: November 2008

Data from 40 patients attending a hypertension clinic staffed by physicians were compared to data from 40 patients attending a hypertension clinic staffed by nurses over a period of 15 months. Nurses appeared to have more success in handling obesity and to achieve somewhat better control of hypertension. Attrition rate was 50 per cent, but particularly high in patients not receiving medication in the physician clinic. There were no differences in appointment keeping.