bluuebunny/crossref_metadata_2025 huggingface dataset:
Milk fat and gastrointestinal illness.
Authors: Koopman J S , Turkisk V J , Monto A S , Thompson F E , Isaacson R E
Published: November 2008

The population of a pediatric practice was followed prospectively and determinants of acute gastrointestinal illness were evaluated in a nested age-matched case-control study. Children over age one taking low fat milk as their only milk source in the three weeks prior to illness had five times the risk of a doctor's visit for acute gastrointestinal illness as did children taking only whole milk during the same time period. This increased risk could not be explained by numerous potentially confounding variables or potential biases. There was no indication that the increased risk differed for rotavirus positive or rotavirus negative illness, or that it varied by children's age.
Race and sex differences in hip fracture incidence.
Authors: Farmer M E , White L R , Brody J A , Bailey K R
Published: November 2008

Incidence rates for hip fracture in the United States were estimated using non-federal hospital discharges from the National Hospital Discharge Survey for the years 1974-1979. Age-specific incidence curves for women and for men showed similar patterns of increase in risk with age, with risks approximately doubling every five years after age 50. Age-specific rates by five-year age groups were compared among the four race-sex groups. No significant differences were observed between Black females, Black males, and White males. In contrast, rates for White females were one and one-half to four times those for Black females after age 40 and were approximately double those for White males after age 50. Analysis based on an independent data source of non-federal hospital discharges in Washington, DC confirmed these relationships. In the Washington study, White women were at twice the risk for hip fracture (controlled for age) compared with Black women and at 2.7 times the risk for hip fracture (controlled for age) compared to White men. No significant differences were observed between Black women and Black men.
Health promotion for educators: impact on health behaviors, satisfaction, and general well-being.
Authors: Blair S N , Collingwood T R , Reynolds R , Smith M , Hagan R D , Sterling C L
Published: November 2008

A random sample of 117 teachers in three treatment schools and one control school participated in a health survey at the beginning and end of the spring semester. Teachers in the treatment schools participated in a 10-week health promotion program which emphasized exercise, stress management, and nutrition. Comparison of pre- and post-survey data indicated that teachers in the treatment schools increased their participation in vigorous exercise, improved their physical fitness, lost weight, lowered their blood pressure, reported a higher level of general well-being, and were better able to handle job stress.
Group A meningococcal disease in skid rows: epidemiology and implications for control.
Authors: Filice G A , Englender S J , Jacobson J A , Jourden J L , Burns D A , Gregory D , Counts G W , Griffiss J M , Fraser D W
Published: November 2008

Interviews conducted during outbreaks of group A meningococcal disease in skid row communities suggested that heavy alcohol use was associated with increased risk of disease. Frequent moving within skid row and from one skid row to another was characteristic of a subpopulation with increased risk of disease and may have facilitated spread within and between skid rows. The observations discussed herein have important implications for control of communicable diseases in and near skid rows.
AIDS surveillance and health education: use of previously described risk factors to identify high-risk homosexuals.
Authors: Valdiserri R O , Brandon W R , Lyter D W
Published: November 2008

Previously defined "risk factors" in homosexuals with Kaposi's sarcoma may not be causative of AIDS (acquired immune deficiency syndrome) but are an important tool in identifying segments of the homosexual population who are at increased risk for the development of AIDS and who may benefit from health education and surveillance efforts. The epidemiologic characteristics of such a group of homosexuals from a low incidence area (Pittsburgh, PA) are examined and several factors which may account for differences in incidence are briefly discussed.
The association between smoking and sexual behavior among teens in US contraceptive clinics.
Authors: Zabin L S
Published: November 2008

A study of teenage women in 32 contraceptive clinics in the United States shows a strong negative relationship between age of first intercourse and the level of cigarette smoking; the association is strong enough to reverse the usual correlation of smoking and age during the teenage years. Preventive, timely contraceptive behavior is also negatively associated to smoking. These findings suggest that interventions could well be designed and located in settings which take this association into account.
Blood pressure in a population of diabetic persons diagnosed after 30 years of age.
Authors: Klein B E , Klein R , Moss S E
Published: November 2008

Blood pressure levels were investigated in a population of diabetic persons who were diagnosed at 30 years of age or older and who received their primary medical care in an 11-county area in Southern Wisconsin. Prevalence of hypertension in these 5,104 persons was compared with prevalence figures from the Health and Nutrition Examination Survey (HANES) population. Diabetic women had a higher prevalence of hypertension until 65 years of age than did women of similar ages in the HANES. The diabetic males had a prevalence of hypertension similar to that of male HANES participants. Mean systolic blood pressures tended to be slightly higher in persons with "poorest" level of glucose control compared to those whose blood glucose was "best" controlled. Persons for whom diuretic agents had been prescribed were as likely to have blood glucose values in the "poorest" levels of control as persons not using diuretics.
The Edgecombe County (NC) High Blood Pressure Control Program: II. Barriers to the use of medical care among hypertensives.
Authors: James S A , Wagner E H , Strogatz D S , Beresford S A , Kleinbaum D G , Williams C A , Cutchin L M , Ibrahim M A
Published: November 2008

As the initial step in a five-year project to improve control of high blood pressure in Edgecombe County, North Carolina, a survey was conducted in 1980 to determine the prevalence of hypertension and to identify factors which might constitute barriers to the use of medical care by hypertensives. This report summarizes the findings for the 539 hypertensives identified through the baseline survey. In general, Black hypertensives reported more access problems than Whites. Within race, however, males and females differed very little on selected measures of potential access to medical care. Among women, lower scores on potential access were strongly associated with being untreated, whereas for men, concerns about the safety of anti-hypertensive drug therapy were associated with being unaware. On a summary measure of the actual use of medical care in response to symptoms, both male and female treated hypertensives scored higher than their untreated counterparts. The implications of these and other findings for community-based blood pressure control activities are discussed.
Northeastern Ohio Trauma Study: II. Injury rates by age, sex, and cause.
Authors: Fife D , Barancik J I , Chatterjee B F
Published: November 2008

Using a 1977 sample of emergency department visits in five northeastern Ohio counties, population-based injury rates are tabulated by age, sex, and cause. Case fatality ratios are estimated by comparing these injury rates with population-based mortality rates for 1976-1978. For all age and sex groups, injuries are a major cause of emergency department visits. Falls, striking, cuts, and motor vehicle crashes are the leading causes of injury. Case fatality ratios for motor vehicle crash injuries are considerably higher than those for non-transport injuries. Injury rates and case fatality ratios for males exceed those for females except among the elderly. With increasing age, injury rates decline but the fraction of injuries leading to hospital admission or to fatality rises sharply.
Notification of workers at high risk: an emerging public health problem.
Authors: Schulte P A , Ringen K
Published: November 2008

During the last two decades, an increasing number of epidemiologic studies have found cohorts of workers to be at high risk of work-related chronic diseases, especially cancers. These studies frequently have led to the broad recognition of occupational hazards and eventually to the prevention of exposures to such hazards. Generally, however, the individual cohort members found to be at high risk have not been notified of study results, and programs of medical intervention or of palliative services directed at these individual workers have not been developed. Recently, the issue of whether or not workers have a right to be notified more directly about known health hazards to which they may have been exposed has emerged as a major, unresolved question in public health policy. Issues of concern include the criteria that should guide notifications; whom, when, and how to notify; and who should pay for notification and follow-up services. This commentary discusses the scientific, ethical, economic, and institutional aspects of worker notification, and describes three new demonstration projects that have provided notification and intervention for workers at high risk of bladder, colon, and lung cancer.
Patient transfers: medical practice as social triage.
Authors: Himmelstein D U , Woolhandler S , Harnly M , Bader M B , Silber R , Backer H D , Jones A A
Published: November 2008

We studied 458 consecutive patient transfers from 14 private hospitals to a public hospital emergency room during a six-month period. The transferred patients were predominantly male, young, and uninsured, and included large numbers of minority group members. We established criteria to identify patients at high risk for adverse effects of transfer and reviewed the clinical records of the 103 patients meeting these criteria. We judged that transfer resulted in substandard care for 33 of these patients, either because they were at risk for life-threatening complications in transit or because urgently needed diagnosis or therapy was delayed. In the community studied, transfer is a common and potentially dangerous medical intervention which appears to reinforce racial and class inequalities of access to medical care.
Assessment of accuracy of the scoliosis school screening examination.
Authors: Viviani G R , Budgell L , Dok C , Tugwell P
Published: November 2008

Fifteen nurses of comparable training examined six children with normal spines, eight with curves between 10 degrees and 20 degrees, and three with curves over 20 degrees. Nurses correctly classified 78 per cent of normal children, 49 per cent of those with curves between 10 degrees and 20 degrees, and 93 per cent of curves over 20 degrees. The accuracy of the nurses' decision to refer or not refer was determined to be 75 per cent. The sensitivity and specificity values were calculated as 74 per cent and 78 per cent, respectively. Kappa statistics were calculated to assess the agreement greater than chance of the nurse with x-ray evidence. Overall, there was significant agreement (K = 0.49; p less than .001).
Fetal loss and work in a waste water treatment plant.
Authors: Morgan R W , Kheifets L , Obrinsky D L , Whorton M D , Foliart D E
Published: November 2008

We investigated pregnancy outcomes in 101 wives of workers employed in a waste water treatment plant (WWTP), and verified fetal losses by hospital records. Paternal work histories were compiled and each of the 210 pregnancies was assigned a paternal exposure category. The relative risk of fetal loss was increased when paternal exposure to the WWTP occurred around the time of conception.
Diet policies of PKU clinics in the United States.
Authors: Schuett V E , Brown E S
Published: November 2008

About two-thirds of 90 clinics treating phenylketonuria (PKU) now recommend indefinite continuation of a low phenylalanine diet as compared to 1978 when fewer than one-fourth had this policy. The percentage of children maintained on diet has increased markedly for six to eight year-olds. Greater conservatism in clinic diet recommendations likely reflects reports of adverse consequences following diet discontinuation and negative individual clinic experiences.
Consumer demand for patient-oriented pharmacy services.
Authors: Carroll N V , Gagnon J P
Published: November 2008

The purpose of this study was to investigate the extent of consumer demand for patient-oriented pharmacy services. Data, collected via a self-administered questionnaire distributed to 300 households, were analyzed using Kruskal's program for additive conjoint analysis. The results indicate substantial consumer demand for making advisory services available on request, moderate demand for provision of patient medication records, and little demand for voluntary provision of advisory services.
Patterns of drug use from adolescence to young adulthood: I. Periods of risk for initiation, continued use, and discontinuation.
Authors: Kandel D B , Logan J A
Published: November 2008

Patterns of initiation, continued use, and decline in drug use are described on the basis of detailed drug histories in a longitudinal cohort representative of former New York State adolescents. In this cohort, the period of major risk for initiation to cigarettes, alcohol, and marijuana, is completed for the most part by age 20, and to illicit drugs other than cocaine by age 21. Those who have not experimented with any of these substances by that age are unlikely to do so thereafter. Initiation into prescribed psychoactive drugs occurs at a later age than for the licit and illicit drugs and continues through the age period covered by the survey. A potential maturational trend in marijuana use in this cohort is apparent with a decline beginning approximately at age 22.5 for most usage patterns. The periods of highest marijuana and alcohol usage decline beginning at ages 20-21 and contrast sharply with cigarettes which exhibit climbing rates of highest use through the end of the surveillance period (age 25). Overall patterns are similar for men and women, with men initiating all drugs at higher rates than women, except for prescribed psychoactives .
Routine pre-exposure rabies prophylaxis: a reassessment.
Authors: Mann J M
Published: November 2008

The rational use of rabies biologics is a difficult challenge. Pre-exposure rabies prophylaxis (PRE-RP) is one important rabies prevention strategy currently recommended by the US Public Health Service for groups considered at high risk of exposure to rabies. However, standard post-exposure rabies prophylaxis (POST-RP) appears equally effective in preventing rabies; PRE-RP still requires a limited vaccination series if a rabies exposure occurs and, at current costs, standard POST-RP may be a less expensive strategy than PRE-RP. For PRE-RP, as with other human rabies prevention strategies, the central problem is to obtain reasonable estimates of actual rabies exposure risks, which provide the rationale for well-designed programs.
National survey on outbreaks associated with whirlpool spas.
Authors: Spitalny K C , Vogt R L , Witherell L E
Published: November 2008

A national survey of state epidemiologists sought information on reported outbreaks of illness associated with non-residential whirlpool spas for the period April 1972-July 1, 1982. Reports were received from 49 states. Of the 74 whirlpool-associated outbreaks reported, 72 were characterized as having patients with papular or pustular rash and two were associated with cases of Pontiac fever.
Coffee consumption and risk of fatal cancers.
Authors: Snowdon D A , Phillips R L
Published: November 2008

In 1960, the coffee consumption habits and other lifestyle characteristics of 23,912 white Seventh-day Adventists were assessed by questionnaire. Between 1960 and 1980, deaths due to cancer were identified. There were positive associations between coffee consumption and fatal colon and bladder cancer. The group consuming two or more cups of coffee per day had an estimated relative risk (RR) of 1.7 for fatal colon cancer and 2.0 for fatal bladder cancer, compared to the group that consumed less than one cup per day (RR = 1.0). These positive associations were apparently not confounded by age, sex, cigarette smoking, or meat consumption habits. In this study, there were no significant or suggestive associations between coffee consumption and fatal pancreatic, breast, and ovarian cancer, or a combined group of all other cancer sites.
Respiratory impairment and symptoms as predictors of early retirement with disability in US underground coal miners.
Authors: Ames R G , Trent R B
Published: November 2008

A five-year prospective study of 1,394 United States underground coal miners was undertaken to study the effects of respiratory impairment on the rate of early retirement with disability (ERD). Using a logistic regression analysis, ERD was found to be related to reported persistent phlegm after adjustment was made for other respiratory symptoms, respiratory function measurements, cigarette smoking, and some demographic characteristics. No prediction of ERD occurred for spirometrically determined measures of respiratory function. The data thus give limited support to the hypothesis that early retirement with disability in underground coal miners can be predicted prospectively by measures of respiratory symptoms.
Factors associated with birthweight: an exploration of the roles of prenatal care and length of gestation.
Authors: Showstack J A , Budetti P P , Minkler D
Published: November 2008

To assess the association with birthweight of prenatal medical care, length of gestation, and other prenatal factors, birth certificate data were studied for babies born in 1978 to mothers who were residents of Alameda or Contra Costa counties, California. Using multiple regression data analytic techniques, adequate prenatal care (defined by the number of prenatal care visits compared to length of gestation and month of start of care) was found to be associated with an increase of 197 grams in average birthweight. This effect was even greater for Black infants and infants of short length of gestation. Adding length of gestation to the equation increased significantly the proportion of the variance in birthweight accounted for. For babies of short gestation (less than or equal to 280 days), the addition of length of gestation was associated with a halving of the association of prenatal care with birthweight. The results suggest that researchers need to take into account the nonlinear relationship between length of gestation and birthweight when assessing factors that affect birthweight.
Longitudinal study of occurrence of diarrheal disease in day care centers.
Authors: Sullivan P , Woodward W E , Pickering L K , DuPont H L
Published: November 2008

Sixty day care centers (DCC) randomly selected from 736 licensed child care facilities in Harris County (Houston), Texas were surveyed for the incidence of diarrhea by periodic visits and weekly telephone calls over two years. A total of 2,708 episodes of diarrhea were reported in 3,800 children under 6 years of age, and 84 cases occurred in center staff. Overall incidence was 0.44 episodes/person/year among children and 0.14 among staff. Attack rates among the 60 DCC ranged from none to 3.64 cases/year in each child. The incidence for children under 36 months of age was 17 times higher than for the older group. Characteristics of DCC associated with higher rates of disease among children were the presence of young, non-bowel trained children, staff who both diapered infants and prepared food on a regular basis, DCC for profit management, and DCC whose only guidelines were provided by the State. The socioeconomic burden associated with DCC disease, its transmission, and control is considerable and needs to be further addressed.
Reinstitution of diet therapy in PKU patients from twenty-two US clinics.
Authors: Schuett V E , Brown E S , Michals K
Published: November 2008

In a nationwide survey we found 72 PKU (phenylketonuria) patients who had terminated diet but later returned to diet. Sixty-one patients resumed diet due to clinical problems. Age at initial diet discontinuation ranged from three to 20 years. The most prevalent problems reported were poor school performance, and mood and/or behavior changes. Following diet reinstitution, only positive changes were noted for 42 patients, no changes for 19 patients, and 11 had one or more negative changes. Improvements and blood phenylalanine levels were not significantly correlated, but only 11 patients maintained levels less than 10 mg/dl. The number of improvements was significantly correlated with length of time on diet (p less than 0.001). After a median of 10 months on diet, 22 patients had again discontinued due to poor diet control, lack of motivation, poor formula tolerance, lack of apparent benefits and/or changes for the worse. Median time on diet for the 50 second-time continuers was two years nine months.
Control definition in case-control studies of ectopic pregnancy.
Authors: Weiss N S , Daling J R , Chow W H
Published: November 2008

In case-control studies of ectopic pregnancy, the optimal sampling frame for control selection is influenced heavily by the hypothesis being tested. The selection of women completing an intrauterine pregnancy, a common choice for a control group in studies to date, is appropriate only if the hypothesis does not relate to exposures that selectively prevent an intrauterine pregnancy (e.g., use of an intrauterine device (IUD) at the time of conception). Even for other exposures, the selection of such women can yield misleading results if the exposure is related to the likelihood of completion of the intrauterine pregnancy. On the other hand, the selection of nonpregnant women as controls, while permitting a valid evaluation of the risk associated with exposure such as the use of an IUD, can introduce a substantial degree of incomparability between cases and controls with regard to other contraceptive practices and their correlates. Whichever of the two sampling frames that is chosen, an appreciation of these potential biases can lead to ways of tailoring the selection of individual controls to minimize the magnitude of the bias.
An analysis of economic costs associated with an outbreak of typhoid fever.
Authors: Shandera W X , Taylor J P , Betz T G , Blake P A
Published: November 2008

We examined the costs of a typhoid fever outbreak caused by exposures to contaminated food over a 47-day period at a restaurant. For the 49 respondents, the patient-related costs (+215,548) were primarily medical expenses (+183,902) and lost income or productivity (+28,603). The estimated patient-related costs for all 80 outbreak-associated cases was +351,920. Had contaminated food continued to be served, the prevention-related costs (+36,500) would have been offset by patient-related costs (+7,488/day) within 5 days.
Public opinion on and potential demand for vasectomy in semi-rural Guatemala.
Authors: Santiso R , Bertrand J T , Pineda M A , Guerra S
Published: November 2008

In this study of 1,600 men aged 25-50 from semi-rural Guatemala, three-fourths had heard of vasectomy. Among these, 54 per cent approved of it. However, the survey reveals a widespread lack of knowledge regarding the procedure, as well as negative perceptions or doubts about its effect on sexual performance, ability to do hard work, health, and manhood. One-fourth of the respondents who knew of vasectomy and who desired no more children expressed interest in having the operation, a finding which raises questions as to the potential (unrecognized) demand for vasectomy in other developing countries.
Contraceptive usage during lactation: analysis of 1973 and 1976 National Survey of Family Growth: I. Age and race.
Authors: Labbok M , Ford K , Gray R H
Published: November 2008

Data from the National Survey of Family Growth are analyzed to estimate the prevalence of contraceptive use during lactation. Approximately 20 per cent of lactating women were sexually active and did not use a method in months two through six, postpartum. Among method users, the largest proportion chose barrier methods but 14 per cent used oral contraceptives in the early postpartum period. Between 1973 and 1976 there was an increase in the percentage of women who utilized a contraceptive method during lactation and a decrease in the per cent using oral contraceptives.
Assessment of salt use at the table: comparison of observed and reported behavior.
Authors: Mittelmark M B , Sternberg B
Published: November 2008

Observations were made of salt added during meals. Nineteen per cent of 211 participants salted before tasting food, 18 per cent salted after tasting, and 2 per cent salted both before and after tasting. Of those who self-reported "never" to salt food before tasting, 6 per cent were observed to do so. Of those who reported never to salt after tasting, 3 per cent did so. Results support the conclusion that self-reported abstinence from use of table salt is strongly correlated with actual behavior.
Using computers to identify complications after surgery.
Authors: Roos L L , Cageorge S M , Austen E , Lohr K N
Published: November 2008

We used the Health Services Commission data from Manitoba, Canada to identify complications resulting from hysterectomy, cholecystectomy, and prostatectomy which led to hospital readmissions. For each procedure, two specialists independently judged whether the readmissions were for surgery-related complications on the basis of liberally interpreted literature guidelines. Then, each pair of physicians met to resolve differences; only complications agreed upon by physicians were retained in our computer-based analysis. The analysis was done in three steps: algorithms were developed using guidelines from the literature, physician input, and 1974 hospital claims; these were then modified using 1975 data; finally, the algorithms were tested with 1976 data. The computerized algorithms developed were compared with the clinical decisions of physician panels. The results showed high specificity, sensitivity, and predictive value. Given the increasing availability of routinely collected data bases, the possibilities for inexpensively monitoring the outcomes of different providers and institutions are appealing. More extensive validation and application of the methodology to a greater number of procedures are necessary to implement such a program.
Psychological consequences of infestation of the dwelling unit.
Authors: Zahner G E , Kasl S V , White M , Will J C
Published: November 2008

Interview data from a three-wave panel study of the impact of the residential environment upon the psychological well-being of 337 minority women were used to examine the effects of household infestation upon self-reported depression, phobic anxiety, somatization, hostility, and anomia. The findings of cross-sectional and change analyses over the three waves of data point to a stable relationship between rat infestation and a single dimension of psychological well-being, somatization.
A three-state study of waterborne disease surveillance techniques.
Authors: Harter L , Frost F , Vogt R , Little A A , Hopkins R , Gaspard B , Lippy E C
Published: November 2008

For a two-year period, the states of Colorado, Vermont and Washington tested the effectiveness of ten surveillance methods for identifying waterborne disease. Nine were active surveillance methods, soliciting illness reports; one was passive, relying on voluntary disease reporting. One waterborne disease outbreak was identified through use of the nine active methods, while 14 were reported through the passive surveillance method. The presence of coliform bacteria during routine water testing was not related to illness in the community.
A profile of the self-poisoner in Michigan.
Authors: Bouknight R , Alguire P , Lofgren R , Hoppe R
Published: November 2008

We reviewed the charts of all patients (160) ages 15 and older discharged in 1981 from the four hospitals in Lansing, Michigan with a diagnosis of overdose. Females predominated (65 per cent) and the median age was 27 years. The most common reason for intentional self-poisoning was "significant-other" conflict (54.5 per cent), followed by family conflict and financial problems. Benzodiazepines were most commonly used followed by acetylsalicylic acid and ethanol.
Cigarette smoking and lung cancer in 'Hispanic' whites and other whites in New Mexico.
Authors: Humble C G , Samet J M , Pathak D R , Skipper B J
Published: November 2008

A population-based case-control study of lung cancer was performed in New Mexico to explain the differing patterns of lung cancer occurrence in the state's "Hispanic" Whites and other Whites. From 1980 through 1982, interviews were completed with 521 cases and 769 controls. In the male controls, the prevalence of current and previous cigarette usage was similar in the two ethnic groups, but Hispanics smoked fewer cigarettes daily. In the female controls, a lower percentage of Hispanics had ever smoked and their usual consumption was less than that of other White women. Older Hispanic female smokers had used hand-rolled cigarettes for an average of 8.8 years, whereas other White women of the same age had used this type for less than one-half year. Both stratified and multiple logistic analysis showed comparable risks of lung cancer in Hispanic White and other White smokers. There was no evidence of interaction between ethnicity and cigarette smoking. These analyses imply that the differences in lung cancer incidence between New Mexico's Hispanic Whites and other Whites are largely explained by the patterns of cigarette smoking of these two groups.
Declining perinatal mortality in a region of Finland, 1968-82.
Authors: Piekkala P , Erkkola R , Kero P , Tenovuo A , Sillanpää M
Published: November 2008

Perinatal mortality (PNM) in the catchment area of the University Central Hospital of Turku (UCHT), Finland, was investigated during a 15-year period from 1968 to 1982. During the study period, 82,151 babies were born, there were 531 fetal deaths and 505 cases of early neonatal death. The PNM rate declined during the study period from 17.9 in 1968 to 7.0 in 1982, or from 14.8 to 4.6 when infants weighing less than 1000 grams were excluded. Significant declines occurred in PNM due to maternal illness, placental and umbilical cord complications, other asphyxias and respiratory distress syndrome. We believe the centralization of obstetric and neonatal services for risk cases, the introduction of modern obstetric and neonatal management, and continuing education of personnel at every level of maternity and neonatal care accounted for the decline.
Yield of routine annual laboratory screening in the institutionalized elderly.
Authors: Domoto K , Ben R , Wei J Y , Pass T M , Komaroff A L
Published: November 2008

We examined the yield of a battery of 19 screening laboratory tests performed routinely in 70 functionally intact patients, averaging 82.6 years of age and residing at a chronic care facility. The 70 patients underwent 3,903 screening tests (70 admission batteries and 156 batteries at annual intervals). Twenty per cent of the admission test results and 17 per cent of all subsequent annual test results were "abnormal". "New abnormal" results (previously unknown to the responsible physicians) occurred primarily in five of the 19 screening tests; they were found in 13 per cent of all admission screening tests and in 6 per cent of all annual tests. However, many of the "new abnormalities" were only minimally outside the normal range, and only 26 (0.7 per cent) led to further diagnostic evaluation. Of these 26, only four (0.1 per cent of all tests ordered) led to changes in patient management, none of which benefited the patient in an important way.
Drug product selection: the Florida experience revisited.
Authors: Clouse E H , McCormick W C , Angorn R A , Kimberlin C L , Bradham D D
Published: November 2008

The comparison of drug product selection rates determined approximately one year and four years after passage of Florida's Drug Product Selection (DPS) Law indicates very little change in the product selection and brand interchange behaviors of Florida pharmacists. Lack of adequate guidelines from the state and the liability concerns of pharmacists appeared to limit an expected increase in the state DPS rate.
Epidemiologic evidence and motor vehicle policy making.
Authors: Runyan C W , Earp J A
Published: November 2008

After being randomly assigned to receive policy effectiveness information expressed as attributable benefit, attributable risk, or relative risk, 318 graduate students were asked to indicate their preferences for the current voluntary seat belt use policy, a mandatory seat belt policy, or mandatory passive restraints. A control group received no data. Exposure to effectiveness information (any type) was significantly associated with favoring either mandatory seat belts or passive restraints over the current policy. Those exposed to attributable benefit or risk data were more apt to make proregulatory choices than subjects exposed to relative risk data. Attitudes toward government regulation and specific views about personal freedom and policy effectiveness were also found to be significant predictors of policy preference.
Comparative risks and costs of male and female sterilization.
Authors: Smith G L , Taylor G P , Smith K F
Published: November 2008

Couples who are considering elective sterilization should compare the risks and costs of male and female sterilization procedures as part of the decision process. Morbidity, mortality, failure rates, and short-term costs associated with male and female sterilization procedures were estimated from data available in previous case series. Male sterilization procedures were found to have zero attributable deaths and significantly less major complications when compared to female sterilization procedures. No less than 14 deaths a year can be attributed to female sterilization procedures in the US. Male and female sterilization procedures have efficacy rates that are not significantly different from each other. The short-term costs of female sterilization are 3.0 to 4.1 times that of vasectomy.
Community coverage in a rural, church-based, hypertension screening program in Edgecombe County, North Carolina.
Authors: Strogatz D S , James S A , Elliott D , Ramsey D , Cutchin L M , Ibrahim M A
Published: November 2008

In a rural, church-based hypertension program in Edgecombe County, North Carolina, screening of the congregations was complemented by a community outreach component targeted at 18-60 year old males, a group at higher risk for untreated hypertension. Compared with its estimated frequency in the community, untreated hypertension was as common in the church congregations and somewhat less prevalent than expected among outreach screenees.
Infant formulas and gastrointestinal illness.
Authors: Koopman J S , Turkish V J , Monto A S
Published: November 2008

Infants under age one in a pediatric practice were followed prospectively, and the determinants of acute gastrointestinal illness were evaluated in case-control pairs, matched by birth month. The risk of acute gastrointestinal illness in infants receiving formula was six times greater than in infants receiving breast milk and 2.5 times greater than in infants receiving cow milk. In the second six months of life, infants on formula had 0.38 more gastrointestinal illness episodes per child than infants on cow milk. Episodes without rotavirus or bacterial agents accounted for most of the increased risk of formula. The increased risk could not be explained by iron fortification of the formulas, prescription of non-milk based formulas to high-risk infants, case ascertainment bias, control selection bias, or numerous control factors. Non-antibody anti-infection properties found in cow milk are one possible explanation for these findings.
Cancer risk in adulthood from early life exposure to parents' smoking.
Authors: Sandler D P , Everson R B , Wilcox A J , Browder J P
Published: November 2008

We obtained data on smoking by parents from 438 cancer cases and 470 controls to investigate whether cancer risk in adult life is related to transplacental or childhood exposure to cigarette smoke. Cancer cases were between ages 15 and 59 at time of diagnosis. All sites but basal cell cancer of the skin were included. Cancer risk was increased 50 per cent among offspring of men who smoked. Increased risk associated with father's smoking was not explained by demographic factors, social class, or individual smoking habits, and was not limited to known smoking related sites. Relative risk (RR) estimates associated with father's smoking tended to be greatest for smokers, males, and non-Whites. There was only a slight increase in overall cancer risk associated with maternal smoking. Mother's and father's smoking were both associated with risk for hematopoietic cancers, and a dose-response relationship was seen. The RR for hematopoietic cancers increased from 1.7 when one parent smoked to 4.6 when both parents smoked. Although they should be considered tentative, study findings suggest a long-term hazard from transplacental or childhood passive exposure to cigarette smoke.
Government regulation of occupational safety: underground coal mine accidents 1973-75.
Authors: Boden L I
Published: November 2008

The purpose of this paper is to determine the influence of federal mine safety inspections on underground coal mine accidents. An economic incentives model is developed to relate federal enforcement activities to accident rates. The determinants of accident rates are analyzed for 535 coal mines during the period 1973-75. Estimates based on these data when applied to the model indicate that increasing inspections by 25 per cent would have produced a 13 per cent decline in fatal accidents and an 18 per cent decline in disabling accidents.
Cesarean delivery in northeast region of Brazil, 1978-80.
Authors: Janowitz B , Rodrigues W , Covington D L , Arruda J M , Morris L
Published: November 2008

This study presents information on cesarean section rates for the last baby born to 1,746 women in Northeast Brazil between January 1978 and the date of a 1980 household survey. For hospital deliveries, the c-section rate is 19 per cent. Rates were highest in the major urban areas and lowest in rural areas. Within residence categories, the section rate was related directly to education, early prenatal care, and delivery in private hospitals.
The effects of respondent rules on health survey reports.
Authors: Mathiowetz N A , Groves R M
Published: November 2008

Survey researchers believe that self reports, in general, are more accurate than reports obtained by proxy. This paper focuses on the reassessment of previous self/proxy comparisons and presents findings from a telephone adaptation of the National Health Interview Survey (NHIS) designed to investigate response error associated with self and proxy reports. Unlike previous studies in which the type of report is confounded with characteristics of the population home at the time of the interview, the design of this study (random allocation to self or proxy report) allows comparison of reports from similar populations. The results show that when self response is limited to a randomly selected respondent, the self respondents report fewer health events for themselves versus for others in their household.
Interpersonal violence: patterns in a Danish community.
Authors: Hedeboe J , Charles A V , Nielsen J , Grymer F , Møller B N , Møller-Madson B , Jensen S E
Published: November 2008

We studied all cases of assault with violence (1,639) in a Danish population of 275,000 over a one-year period. Most victims were young men. The incidence rose during evenings, nights and weekends, and assaults were often seen in or around bars and restaurants. Women accounted for 64 per cent of all victims of assault in the home. Influence of alcohol was identified in 43 per cent of all cases. The fist was the most frequent agent of assault; use of firearms was a very rare act of violence but was associated with death in three out of five cases. There were 10 deaths in all.
Biomedical applications of cotinine quantitation in smoking related research.
Authors: Sepkovic D W , Haley N J
Published: November 2008

Two studies were undertaken to assess the variability of cotinine concentrations in different biological fluids and to determine the most desirable fluid to use for specific experimental protocols. For protocols validating smoking cessation, plasma or urinary cotinine determinations provided the most accurate indicators of compliance. In studies where smokers switched from high yield to low yield cigarettes, plasma cotinine determinations were good indicators of smoker behavior. Correct interpretation of smoker status is dependent on the biological fluid selected for cotinine analysis.
Cancer incidence rates among blacks in urban and rural Georgia, 1978-82.
Authors: Greenberg R S , Stevens J A , Whitaker J P
Published: November 2008

The records of the Atlanta Cancer Surveillance Center were reviewed for all incident cases of cancer diagnosed among Black residents of the catchment areas during calendar years 1978 through 1982. The resultant age-adjusted overall cancer incidence rates for urban Blacks were greater than those for rural Blacks. The largest urban excess was found for cancers of the buccal cavity and pharynx. Urban residence also was associated with lung and prostate cancers among males, and pancreatic cancers among females.
Sodium in drinking water in South Carolina.
Authors: Lackland D T , Weinrich M C , Wheeler F C , Shepard D M
Published: November 2008

The potential contribution of drinking water sodium to total consumption and to blood pressure levels is explored in a South Carolina survey. Most (96 per cent) of the population was served by drinking water containing less than 100 mg/l Na (median 14.8 mg/l). For households with water sources containing greater than or equal to 100 mg/l Na, drinking water accounted for approximately 8.5 per cent of total estimated consumption. After adjustment for age, sex, race, body mass index, education, and dietary sodium, a negative association between diastolic blood pressure and drinking water sodium levels was found.
Estimates of C. immitis infection by skin test reactivity in an endemic community.
Authors: Dodge R R , Lebowitz M D , Barbee R , Burrows B
Published: November 2008

This report is a comparison of two delayed hypersensitivity skin test reagents, coccidioidin and Spherulin, available for detection of prior infection by Coccidioides immitis. Coccidioidin proved to be a somewhat more sensitive reagent (33.4 per cent positive, vs 29.6 per cent for Spherulin). This difference persisted in the subjects when grouped by age, sex, exposure history, or history of coccidioidomycosis. Skin test reactivity to both reagents declined with age. Independent of exposure history coccidioidin detected 7.3 per cent of the subjects who were not detected by Spherulin; Spherulin detected prior infection in only 3.5 per cent of the subjects not detected by coccidioidin. These results differ from those of previously reported studies.
Prenatal care and pregnancy outcomes during the recession: the Washington State experience.
Authors: Fisher E S , LoGerfo J P , Daling J R
Published: November 2008

To determine whether changes in prenatal care utilization and adverse pregnancy outcomes occurred among poor residents of Washington State during the recent recession, we examined all births occurring from 1980 to 1983 to women in the poorest census tracts of the three major metropolitan counties in Washington State (N = 15,735). A comparison sample consisted of all births occurring in the highest income census tracts (N = 16,295). Because the impact of the recession was hypothesized to be greatest in 1982, rates in 1982 were compared with rates in 1980. The proportion of births receiving late or no prenatal care increased in both the low-income tracts (6.2 per cent to 8.2 per cent) and the high-income tracts (1.6 per cent to 2.3 per cent). The proportion of low birthweight infants increased only in the low-income tracts (6.3 per cent to 7.4 per cent). The prevalence of maternal anemia (hematocrit less than 30) also increased only in the low-income tracts (0.7 per cent to 1.7 per cent). While we were unable to ascertain the financial status of the individuals who suffered the adverse outcomes, the findings for the low-income census tracts are consistent with the hypothesis that an increase in adverse pregnancy outcomes occurred among the poor in Washington State during the recent recession.
Do the new Metropolitan Life Insurance weight-height tables correctly assess body frame and body fat relationships?
Authors: Himes J H , Bouchard C
Published: November 2008

The 1983 Metropolitan weight-height tables include elbow breadth as a measure of frame size. Such tables assume that frame measures provide an estimate of fat free mass and have little or no associations with body fat. These assumptions were evaluated in 437 Canadian adults for six frame measures by their associations with total body measures of fat and fat free mass. All six frame measures were similarly correlated with fat free mass, even when associations with height were taken into account. Wrist and ankle breadths were not associated with total body fat, while shoulder, elbow, hip, and knee breadths were so associated. Thus wrist and ankle breadths satisfy the assumptions inherent in the frame-weight-height tables better than elbow breadth and the other frame measures investigated.
Drugs, lifestyle, and health: a longitudinal study of urban black youth.
Authors: Brunswick A F , Messeri P
Published: November 2008

The association of drug use with indicators of health status was studied in a representative sample of urban Black youth interviewed first in adolescence and then six to seven later in young adulthood. Seven substances, with interaction terms as appropriate, were tested against a psychophysical health scale and also against a more inclusive general health scale. Both measures of health outcomes yielded similar findings. Earlier inhalants use and, under certain conditions, methadone were linked to health change in males. Heroin had a delayed relationship to females' health. Additionally, methadone was associated with poorer health among young Black women who also were heavy alcohol drinkers. The observed relationships between drug use and health persisted after introducing controls for associated lifestyle factors.
Do the sisters of childbearing teenagers have increased rates of childbearing?
Authors: Friede A , Hogue C J , Doyle L L , Hammerslough C R , Sniezek J E , Arrighi H
Published: November 2008

In 1983, 89,000 children were born to United States women aged less than or equal to 16. To reduce teenage fertility rates, public health workers will need to identify teenagers at elevated risk for childbearing. We tested the hypothesis that the sisters of childbearing teenagers may form such a group. We performed an historical cohort study of 3,767 teenagers aged 12-16 years who were enrolled in Arkansas Aid to Families with Dependent Children (AFDC), 1978-81; they had 247 pregnancies. Multivariable log-linear hazard models were used to control and study age, race, number of AFDC-eligibles per household, and county urbanization and family planning services. Teenagers whose sisters bore children had elevated rate ratios (RR) for childbearing (RR = 1.8; 95% Confidence Limits [CL] = 1.2-2.6), as did Blacks (RR = 3.1; 95% CL = 2.0-4.8), and members of households with more than nine AFDC-eligibles (RR = 1.7; 95% CL = 1.1-2.6). Because they may have elevated childbearing rates, and would be easy to contact, the sisters of pregnant teenagers could form an important target population for family planning efforts.