bluuebunny/crossref_metadata_2025 huggingface dataset:
2. Two Cases of Death Due to Plastic Bag Suffocation
Authors: Nadesan Kasinathan , Beng Ong Beng
Published: January 2017

Deaths due to plastic bag suffocation or plastic bag asphyxia are not reported in Malaysia. In the West many suicides by plastic bag asphyxia, particularly in the elderly and those who are chronically and terminally ill, have been reported. Accidental deaths too are not uncommon in the West, both among small children who play with shopping bags and adolescents who are solvent abusers. Another well-known but not so common form of accidental death from plastic bag asphyxia is sexual asphyxia, which is mostly seen among adult males. Homicide by plastic bag asphyxia too is reported in the West and the victims are invariably infants or adults who are frail or terminally ill and who cannot struggle. Two deaths due to plastic bag asphyxia are presented. Both the autopsies were performed at the University Hospital Mortuary, Kuala Lumpur. Both victims were 50-year old married Chinese males. One death was diagnosed as suicide and the other as sexual asphyxia. Sexual asphyxia is generally believed to be a problem associated exclusively with the West. Specific autopsy findings are often absent in deaths due to plastic bag asphyxia and therefore such deaths could be missed when some interested parties have altered the scene and most importantly have removed the plastic bag. A visit to the scene of death is invariably useful.
Knowledge and Experience of Young People regarding Drug Abuse between 1969 and 1974
Authors: Wright J. D.
Published: January 2017

A trend survey was carried out by anonymous questionnaire, with an additional 10 per cent interview sample, of the knowledge and experience of drug abuse among fourth-year pupils in three Wolverhampton secondary schools in 1969 and 1974, with additional reference to a smaller survey in 1968.

The survey shows the range of drugs known to the groups, their contact with drugs and drug takers, their sources of information about drugs and the reasons given for taking drugs. Changes between the earlier and later surveys are discussed.

The findings suggest that between 1969 and 1974:

There was a decrease in interest in and a continued ignorance of drugs; An increasing minority were in contact with drugs; That amphetamines and LSD (lysergic acid diethylamide) were less, and sedatives more, available; That parties and public houses had become more, and coffee bars less, important as sources of supply; That these young people, who are predominantly not drug takers and not in contact with drugs, consider that social and situational pressures are more important than mental or personality stress as the reasons for drug taking. The implications of these findings are discussed.
Shoplifting, Depression and an Unusual Intracranial Lesion (A Case Report)
Authors: Chiswick Derek
Published: January 2017

A case is reported of shoplifting occurring in a depressive illness of suicidal intensity. In addition, there was present an unusually large intracranial lesion, the differential diagnosis of which is discussed, although its exact nature remains uncertain.
Stress and Police in Kansas
Authors: Brock Deon , Klaus Suzanne , Harbour Lisa , Nash Tammy
Published: January 2017

This study examines law enforcement-related stress for the officers of one county in southwestern Kansas. The authors intend to uncover the potential sources of officer and/or family stress and identify how this might impact on overall family life/harmony. We intend to discover which independent variables (shift work, crowd control, press problems, etc.) exhibit the strongest relationship with the officer's perception of stress and his/her perception of its association with family stress. All officers of all law enforcement agencies of the county will be provided a survey.
Policing Child Pornography on the Internet — In the Netherlands
Authors: Stol W.Ph. (Wouter)
Published: January 2017

Since crime on the internet does not adhere to national boundaries, police forces must acquaint themselves with the law enforcement situation in other countries. This article provides the reader with information about the Netherlands. Dutch attitudes towards child pornography will be discussed, as well as Dutch legislation, the organisational structure of the police, the division of labour between police units, and problems Dutch police encounter while combating child pornography on the internet. The Dutch police are confronted with two major problems. First, police officers know too little about the digital sides of contemporary police work, including the more technological facets as well as sociological and criminological characteristics of virtual communities. Secondly, the police must establish new formal as well as informal collaborations on both a national and international level, since internet crime does not fit into existing law-enforcement structures.
Respect for a Victim's Privacy during Police Procedure
Authors: Ghazvini Mohammad Farajiha
Published: January 2017

Privacy has been an important element in the protection of civil liberties, used by religious and political dissenters to censor state action and maintain a sphere of freedom of action by restraining the powers of the state vis-à-vis the individual. Many countries expressly protect rights of privacy in their constitutions. However, there is a concrete quality about the concept of privacy not least in the language of everyday life which takes for granted personal, internal worlds. Our relationships with others rest on the recognition of those, and of our own private identity.
Effective Police Administration: Criminal Investigations in Japan
Authors: Masakatsu Okabe
Published: January 2017

Japan has maintained a very low crime rate and a correspondingly high clearance rate for a long time, but recently the circumstances surrounding criminal investigation have been changing remarkably. In order to compare criminal investigations among the developed countries, it will be very informative to consider the situation in Japan.

This article gives a brief introduction to the conditions for, and characteristics of, police criminal investigations in Japan. The first part explains the background to investigations, for example limited legal competence, the cooperative attitude of citizens and changing circumstances in recent times (the increase in the number of offences, new demands from the public and victim support). In the second part, the characteristics of police criminal investigations are noted, that is organised investigations, forensic investigations and countermeasures under the new criminal situation.
First at the Scene
Authors: Ostler R. D.
Published: January 2017

The importance of minute observation is a classical point in criminal investigation. The following article illustrates it afresh.
The Moors Murders
Authors: Benfield A.
Published: January 2017

So many sensational accounts of the Moors Murders have appeared since 1965 that our readers will welcome this plain statement of the facts in the case by a senior officer who was principally concerned in its investigation.
Civilianization in Kent
Authors: Pullinger W. T. C.
Published: January 2017

In our last issue, Mr. Dewhirst set out the case for civilianization. The following article by the senior police officer who was in charge of administration in Kent prior to his own post being civilianized, explains how the change-over was made.
Hypnosis — Its Use and Limitations in Police and Criminal Investigations
Authors: Jaffe J. R.
Published: January 2017

Following the article by Mr. Sam Napier in Issue No. 1/80, we now present the professional viewpoint based on the writer's regular lectures to (i) The Chief Officers Seminar, Greater Manchester Police and (ii) The Detective Training Course. Merseyside Police.
Politics, Reform and the Early-Nineteenth-Century Reports on the Committees on the Police of the Metropolis
Authors: Terrill Richard J.
Published: January 2017

The second of Professor Terrill's articles continues his concept of the early history of the police service in its broad political context. It makes an interesting comparison with the approach in Mr. T. A. Critchley's “History of the Police in England and Wales 900-1966”.
Dr. Who in Almonbury?
Authors: Beck Howard M.
Published: January 2017

Passers-by travelling through the sleepy village of Almonbury, just outside Huddersfield, could be excused for believing that the local residents were having a visitation from the BBC's time-travelling eccentric. For, standing at the corner of a front garden in Northgate, the main thoroughfare through the village, is what seems to be Dr. Who's “Tardis”. To all outward appearances a casualty of incorrectly locked-in co-ordinates, it stands uncomfortably jammed between the garden and a high stone wall. However, things are not what they seem, and with time travel a long way in the future, despite advances in space flight, it is merely one of the last remaining police boxes in West Yorkshire.
Science of the Investigation of Crime
Authors: Kind Stuart S.
Published: January 2017

English text of a lecture delivered in French at the Institute of Police Science, Lausanne, Switzerland to an audience of police officers, lawyers, doctors and scientists.
Maternity Rights for Policewomen within the E.C.
Authors: Dene Elizabeth
Published: January 2017

In recent years there has been a substantial increase in the number of women police officers, with the same powers and authority as their male colleagues and of the number of women seeking employment within the service. However, despite such changes, the percentage of premature resignations from the police remains higher amongst female than male officers. Police managers acknowledge that such losses are expensive for the service, both in cash terms and loss of experience, thus motivated steps are now being taken to enable women more easily to combine police career and family, for example part-time work, career breaks, job-share etc. However, the availability of such schemes is far from widespread and most are still ‘pilot schemes’. In an attempt to understand why so many policewomen resign prematurely, this article reviews the range of maternity provisions within the E.C. for policewomen.
The Massachusetts HIV, Hepatitis, Addiction Services Integration (HHASI) Experience: Responding to the Comprehensive Needs of Individuals with Co-Occurring Risks and Conditions
Authors: Hoffman Heidi L. , Castro-Donlan Carolyn A. , Johnson Victoria M. , Church Daniel R.
Published: January 2017

Categorical funding mechanisms traditionally used to fund public health programs are a challenge to providers serving individuals with complex needs that often span multiple service areas. Integration—a formalized, collaborative process among service systems— responds to the challenge by decreasing fragmentation of care and improving coordination. In 2000, the Massachusetts Department of Public Health (MDPH) received a one-year planning grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to evaluate opportunities for integrating HIV/AIDS programs and substance abuse treatment programs. The project was later expanded to include viral hepatitis programming. Outcomes include the development of a strategic plan, joint procurement initiatives, and an ongoing commitment to sustain inter-bureau integration efforts, even in the face of substantial budget reductions. Integrated approaches can promote greater efficiency, improving communication and coordination among clients, providers, and government funding agencies.
An Invisible Barrier to Integrating HIV Primary Care with Harm Reduction Services: Philosophical Clashes between the Harm Reduction and Medical Models
Authors: Heller Daliah , McCoy Kate , Cunningham Chinazo
Published: January 2017

Overall AIDS mortality in the United States has declined in recent years, but declines have not been consistent across all populations. Due to an array of barriers to care, minorities and poor people who are active substance users have not benefited as others have from advances in the treatment of HIV disease. One way to address this problem is to integrate HIV primary care into harm reduction programs that already effectively serve this population. Such collaborations, however, are difficult to initiate and sustain. Philosophical differences between the medical model and the harm reduction model, which often remain invisible to the parties involved, underlie these difficulties. This article addresses the issue by describing a partnership in the Bronx, NY, between CitiWide Harm Reduction Inc. (CitiWideHR) and the Montefiore Medical Center. It focuses specifically on the sources of philosophical differences between models, and briefly assesses the potential for successful collaborations of this sort.
Intergenerational Health Disparities: Socioeconomic Status, Women's Health Conditions, and Child Behavior Problems
Authors: Kahn Robert S. , Wilson Kathryn , Wise Paul H.
Published: January 2017

Objective.

Relatively little is known about the intergenerational mechanisms that lead to social disparities in child health. We examined whether the association between low socioeconomic status (SES) and child behavior problems is mediated by maternal health conditions and behavior.

Methods.

Prospective cohort data (1979–1998) on 2,677 children and their mothers were obtained from the National Longitudinal Survey of Youth. SES, the Child Behavior Problems Index (BPI), and maternal smoking, depressive symptoms, and alcohol use before, during, and after pregnancy were examined.

Results.

Lower income and lower maternal education were associated with increased child BPI scores. Adjustment for maternal smoking, depressive symptoms, and alcohol use attenuated the associations between SES and child BPI by 26% to 49%. These maternal health conditions often occurred together, persisted over time, and were associated with the mother's own childhood SES and pre-pregnancy health.

Conclusions.

Social disparities in women's health conditions may help shape the likelihood of behavior problems in the subsequent generation. Improved public health programs and services for disadvantaged women across the lifecourse may not only address their own urgent health needs, but reduce social disparities in the health and well-being of their children.
Trends in Maternal and Infant Health in Poor Urban Neighborhoods: Good News from the 1990s, but Challenges Remain
Authors: Howell Embry M. , Pettit Kathryn L. S. , Kingsley G. Thomas
Published: January 2017

Objectives.

During the 1990s, numerous public policy changes occurred that may have affected the health of mothers and infants in low-income neighborhoods. This article examines trends in key maternal and child health indicators to determine whether disparities between high-poverty neighborhoods and other neighborhoods have declined.

Methods.

Using neighborhood-level vital statistics and U.S. Census data, we categorized “neighborhoods” (Census tracts) as being high poverty (greater than 30% of population below the federal poverty level in 1990) or not. We compared trends in four key indicators—births to teenagers, late prenatal care, low birthweight; and infant mortality—over the 1990s among high-poverty and other neighborhoods in Cuyahoga County, Ohio; Denver, Colorado; Marion County, Indiana; and Oakland, California.

Results.

In all four metropolitan areas, trends in high-poverty neighborhoods were more favorable than in other neighborhoods. The most consistently positive trend was the reduction in the rate of teen births. The metropolitan areas with the most intensive programs to improve maternal and child health—Cuyahoga County and Oakland—saw the most consistent improvement across all indicators. Still, great disparities between high-poverty and other neighborhoods remain, and only Oakland shows promise of achieving some of the Healthy People 2010 maternal and child health goals in its high-poverty neighborhoods.

Conclusions.

While there has been a reduction in maternal and infant health disparities between high-poverty and other neighborhoods, much work remains to eliminate disparities and achieve the 2010 goals. Small area data are useful in isolating the neighborhoods that should be targeted. Experience from the 1990s suggests that a combination of several intensive interventions can be effective at reducing disparities.
Disparities in Access to Care and Satisfaction among U.S. Children: The Roles of Race/Ethnicity and Poverty Status
Authors: Shi Leiyu , Stevens Gregory D.
Published: January 2017

Objectives.

The study assessed the progress made toward reducing racial and ethnic disparities in access to health care among U.S. children between 1996 and 2000.

Methods.

Data are from the Household Component of the 1996 and 2000 Medical Expenditure Panel Survey. Bivariate associations of combinations of race/ethnicity and poverty status groups were examined with four measures of access to health care and a single measure of satisfaction. Logistic regression was used to examine the association of race/ethnicity with access, controlling for sociodemographic factors associated with access to care. To highlight the role of income, we present models with and without controlling for poverty status.

Results.

Racial and ethnic minority children experience significant deficits in accessing medical care compared with whites. Asians, Hispanics, and blacks were less likely than whites to have a usual source of care, health professional or doctor visit, and dental visit in the past year. Asians were more likely than whites to be dissatisfied with the quality of medical care in 2000 (but not 1996), while blacks and Hispanics were more likely than whites to be dissatisfied with the quality of medical care in 1996 (but not in 2000). Both before and after controlling for health insurance coverage, poverty status, health status, and several other factors associated with access to care, these disparities in access to care persisted between 1996 and 2000.

Conclusions.

Continued monitoring of racial and ethnic differences is necessary in light of the persistence of racial/ethnic and socioeconomic disparities in access to care. Given national goals to achieve equity in health care and eliminate racial/ethnic disparities in health, greater attention needs to be paid to the interplay of race/ethnicity factors and poverty status in influencing access.
Poverty Experience, Race, and Child Health
Authors: Malat Jennifer , Oh Hyun Joo , Hamilton Mary Ann
Published: January 2017

Objectives.

Studies that examine children's poverty and health at one point in time do not account for some children experiencing poverty briefly and others living in poverty for much of their lives. The objective of this study was to determine how duration of poverty and child race are related to child health.

Methods.

To assess these relationships, we analyzed data from the Panel Study of Income Dynamics and its Child Development Supplement. Ordinary least squares regression was used to estimate bivariate and multivariate models predicting caregiver-rated child health. The regression models assessed the statistical effect of the proportion of childhood in poverty and child race on child health, controlling for child sex, age, parental education, whether the household includes two parents, and family poverty in the last year.

Results.

Increasing proportion of childhood in poverty is associated with worse health status. In addition, African American children are more likely than white children to have lower-rated health status. The analysis does not support the hypothesis that poverty more strongly affects the health of African American children.

Conclusions.

Increasing exposure to family poverty negatively affects child health. Future research would benefit from more studies that utilize longitudinal measures of childhood poverty. We suggest that public policies to reduce childhood poverty exposure would improve child health.
Overweight in Southeastern Pennsylvania Children: 2002 Household Health Survey Data
Authors: Rappaport Elizabeth B. , Robbins Jessica M.
Published: January 2017

Objective.

The authors sought to estimate the prevalence of overweight and risk for overweight and to examine relationships between body mass index (BMI) and socioeconomic and demographic characteristics among children in Philadelphia and four neighboring counties.

Methods.

Data from the 2002 Philadelphia Health Management Corporation Household Health Survey was examined.

Results.

Of 2,621 children aged 2 to 17 years, 36% were overweight or at risk for overweight and 23% were overweight. Prevalences of overweight and at risk for overweight were higher among younger children than among older children and adolescents. African American, Hispanic, and Asian children had higher prevalences than non-Hispanic white children. Childhood overweight was positively associated with household poverty, lower educational status, and higher BMI in the adult survey respondents.

Conclusions.

The observed inverse relationship between age and the prevalence of overweight among Southeastern Pennsylvania children and adolescents differs from previous reports of the prevalence of overweight in samples of U.S. children and adolescents. The high prevalence of overweight among children aged 2 to 9 years should focus attention on improving nutrition and increasing opportunities for physical activity and exercise among preschool and early school-age children.
Enrollment of Racial/Ethnic Minorities in NIAID-Funded Networks of HIV Vaccine Trials in the United States, 1988 to 2002
Authors: Djomand Gaston , Katzman Joanna , diTommaso Dante , Hudgens Michael G. , Counts George W. , Koblin Beryl A. , Sullivan Patrick S.
Published: January 2017

Objective.

The purpose of this study was to analyze enrollment of racial/ethnic minorities in Phase I and Phase II HIV vaccine trials in the U.S. conducted by National Institute of Allergy and Infectious Diseases (NIAID)-funded networks from 1988 to 2002.

Methods.

A centralized database was searched for all NIAID-funded networks of HIV vaccine trial enrollment data in the U.S. from 1988 through 2002. The authors reviewed data from Phase I or Phase II preventive HIV vaccine trials that included HIV-1 uninfected participants at low to moderate or high risk for HIV infection based on self-reported risk behaviors. Of 66 identified trials, 55 (52 Phase I, 3 Phase II) met selection criteria and were used for analyses. Investigators extracted data on participant demographics using statistical software.

Results.

A total of 3,731 volunteers enrolled in U.S. NIAID-funded network HIV vaccine trials from 1988 to 2002. Racial/ethnic minority participants represented 17% of the overall enrollment. By pooling data across all NIAID-funded networks from 1988 to 2002, the proportion of racial/ethnic minority participants was significantly greater (Fisher's exact test p-value <0.001) in Phase II trials (278/1,061 or 26%) than in Phase I trials (347/2,670 or 13%). By generalized estimating equations, the proportion of minorities in Phase I trials increased over time ( p=0.017), indicating a significant increase in racial/ethnic minority participants from 1988 to 2002.

Conclusions.

There has been a gradual increase in racial/ethnic minority participation in NIAID-funded network HIV vaccine trials in the U.S. since 1988. In the light of recent efficacy trial results, it is essential to continue to increase the enrollment of diverse populations in HIV vaccine research.
Socioeconomic Status and Breastfeeding Initiation among California Mothers
Authors: Heck Katherine E. , Braveman Paula , Cubbin Catherine , Chávez Gilberto F. , Kiely John L.
Published: January 2017

Objectives.

To examine multiple dimensions of socioeconomic status and breastfeeding among a large, random sample of ethnically diverse women.

Methods.

This study used logistic regression analysis to examine the influence of a range of socioeconomic factors on the chances of ever breastfeeding among a stratified random sample of 10,519 women delivering live births in California for 1999 through 2001. Measures of socioeconomic status included family income as a percentage of the federal poverty level, maternal education, paternal education, maternal occupation, and paternal occupation.

Results.

Consistent with previous research, there was a marked socioeconomic gradient in breastfeeding. Women with higher family incomes, those who had or whose partners had higher education levels, and women who had or whose partners had professional or executive occupations were more likely than their counterparts to breastfeed. After adjustment for many potential confounders, maternal and paternal education remained positively associated with breastfeeding, while income and occupation were no longer significant. Compared with other racial or ethnic groups, foreign-born Latina women were the most likely to breastfeed.

Conclusions.

The significant association of maternal and paternal education with breastfeeding, even after adjustment for income, occupation, and many other factors, suggests that social policies affecting educational attainment may be important factors in breastfeeding. Breastfeeding rates may be influenced by health education specifically or by more general levels of schooling among mothers and their partners. The continuing importance of racial/ethnic differences after adjustment for socioeconomic factors could reflect unmeasured socioeconomic effects, cultural differences, and/or policies in Latin American countries.
Weather and the Transmission of Bacillary Dysentery in Jinan, Northern China: A Time-Series Analysis
Authors: Zhang Ying , Bi Peng , Hiller Janet E.
Published: January 2017

Objectives.

This article aims to quantify the relationship between weather variations and bacillary dysentery in Jinan, a city in northern China with a temperate climate, to reach a better understanding of the effect of weather variations on enteric infections.

Methods.

The weather variables and number of cases of bacillary dysentery during the period 1987–2000 has been studied on a monthly basis. The Spearman correlation between each weather variable and dysentery cases was conducted. Seasonal autoregressive integrated moving average (SARIMA) models were used to perform the regression analyses.

Results.

Maximum temperature (one-month lag), minimum temperature (one-month lag), rainfall (one-month lag), relative humidity (without lag), and air pressure (one-month lag) were all significantly correlated with the number of dysentery cases in Jinan. After controlling for the seasonality, lag time, and long-term trend, the SARIMA model suggested that a 1°C rise in maximum temperature might relate to more than 10% (95% confidence interval 10.19, 12.69) increase in the cases of bacillary dysentery in this city.

Conclusions.

Weather variations have already affected the transmission of bacillary dysentery in China. Temperatures could be used as a predictor of the number of dysentery cases in a temperate city in northern China. Public health interventions should be undertaken at this stage to adapt and mitigate the possible consequences of climate change in the future.
HIV-M. Leprae Interaction: Can HAART Modify the Course of Leprosy?
Authors: Sarno Euzenir Nunes , Illarramendi Ximena , Nery José A. Costa , Sales Anna M. , Gutierrez-Galhardo Maria C. , Penna Maria L. Fernandes , Sampaio Elizabeth Pereira , Kaplan Gilla
Published: January 2017

It has been speculated that, as seen in tuberculosis, human immunodeficiency virus (HIV) and Mycobacterium leprae (M. leprae) co-infection may exacerbate the pathogenesis of leprosy lesions and/or lead to increased susceptibility to leprosy. However, to date, HIV infection has not appeared to increase susceptibility to leprosy. In contrast, initiation of antiretroviral treatment (ART) has been reported to be associated with anecdotal activation of M. leprae infection and exacerbation of existing leprosy lesions.

To determine whether ART is associated with worsening of the manifestations of leprosy, a cohort of leprosy patients recruited between 1996 and 2006 at the Oswaldo Cruz Foundation (FIOCRUZ) Leprosy Outpatient Clinic in Rio de Janeiro, Brazil, was studied longitudinally. ART treatment of HIV/leprosy co-infection was associated with the tuberculoid type, paucibacillary disease, and lower bacillary loads. CD4 lymphocyte counts were higher among HIV/leprosy patients at the time of leprosy diagnosis, while viral loads were lower compared with the time of HIV diagnosis. The conclusion was that ART and immune reconstitution were critical factors driving the development and/or clinical appearance of leprosy lesions.
Education for the Public Health Profession: A New Look at the Roemer Proposal
Authors: Gebbie Kristine M. , Potter Margaret A. , Quill Beth , Tilson Hugh
Published: January 2017

Demands for a high level of professionalism in public health practice, and concomitant strengthening of public health education to match 21st-century community challenges provide an opportunity to reconsider the current paradigm for professional degrees in public health. In this article, we consider whether the currently typical public health education meets the requirements of a professional education, examine the current state of public health education, and provide a rationale for renewed emphasis on the doctor of public health (DrPH) degree. We also present one potential three-year DrPH curriculum to stimulate further discussion, while acknowledging the multiple challenges that face any school of public health moving to implement such an education.
Public Health and Social Work: Training Dual Professionals for the Contemporary Workplace
Authors: Ruth Betty J. , Sisco Sarah , Wyatt Jamie , Bethke Christina , Bachman Sara S. , Piper Tinka Markham
Published: January 2017

Objectives.

The emergence of new, complex social health concerns demands that the public health field strengthen its capacity to respond. Academic institutions are vital to improving the public health infrastructure. Collaborative and transdisciplinary practice competencies are increasingly viewed as key components of public health training. The social work profession, with its longstanding involvement in public health and emphasis on ecological approaches, has been a partner in many transdisciplinary community-based efforts. The more than 20 dual-degree programs in public health and social work currently offered reflect this collaborative history. This study represents an exploratory effort to evaluate the impact of these programs on the fields of public health and social work.

Methods.

This study explored motivations, perspectives, and experiences of 41 graduates from four master of social work/master of public health (MSW/MPH) programs. Four focus groups were conducted using traditional qualitative methods during 2004.

Results.

Findings suggest that MSW/MPH alumni self-selected into dual programs because of their interest in the missions, ethics, and practices of both professions. Participants highlighted the challenges and opportunities of dual professionalism, including the struggle to better define public health social work in the workplace.

Conclusions.

Implications for academic public health focus on how schools can improve MSW/MPH programs to promote transdisciplinary collaboration. Increased recognition, better coordination, and greater emphasis on marketing to prospective employers were suggested. A national evaluation of MSW/MPH graduates could strengthen the roles and contributions of public health social work to the public health infrastructure. A conceptual framework, potentially based on developmental theory, could guide this evaluation of the MSW/MPH training experience.
Using a Web-Based Simulation as a Problem-Based Learning Experience: Perceived and Actual Performance of Undergraduate Public Health Students
Authors: Spinello Elio F. , Fischbach Ronald
Published: January 2017

Objectives.

This study investigated the use of a Web-based community health simulation as a problem-based learning (PBL) experience for undergraduate students majoring in public health. The study sought to determine whether students who participated in the online simulation achieved differences in academic and attitudinal outcomes compared with students who participated in a traditional PBL exercise.

Methods.

Using a nonexperimental comparative design, 21 undergraduate students enrolled in a health-behavior course were each randomly assigned to one of four workgroups. Each workgroup was randomly assigned the semester-long simulation project or the traditional PBL exercise. Survey instruments were used to measure students' attitudes toward the course, their perceptions of the learning community, and perceptions of their own cognitive learning. Content analysis of final essay exams and group reports was used to identify differences in academic outcomes and students' level of conceptual understanding of health-behavior theory.

Results.

Findings indicated that students participating in the simulation produced higher mean final exam scores compared with students participating in the traditional PBL ( p=50.03). Students in the simulation group also outperformed students in the traditional group with respect to their understanding of health-behavior theory ( p=50.04). Students in the simulation group, however, rated their own level of cognitive learning lower than did students in the traditional group ( p=50.03).

Conclusions.

By bridging time and distance constraints of the traditional classroom setting, an online simulation may be an effective PBL approach for public health students. Recommendations include further research using a larger sample to explore students' perceptions of learning when participating in simulated real-world activities. Additional research focusing on possible differences between actual and perceived learning relative to PBL methods and student workgroup dynamics is also recommended.
Challenges and Priorities for Surveillance of Stillbirths: A Report on Two Workshops
Authors: Duke C. Wes , Correa Adolfo , Romitti Paul A. , Martin Joyce , Kirby Russell S.
Published: January 2017

Stillbirths, those with and without birth defects, are an important public health topic. The National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention conducted two workshops during April and July 2005. Both workshops explored the challenges of conducting surveillance of stillbirths. Workshop participants considered an approach that added the surveillance of stillbirths, those with and without birth defects, as part of existing population-based birth defects surveillance programs in Iowa and Atlanta. The workshops addressed three key aspects for expanding birth defects programs to conduct active, population-based surveillance on stillbirths: ( 1) case identification and ascertainment, ( 2) data collection, and ( 3) data use and project evaluation. Participants included experts in pediatrics, obstetrics, epidemiology, maternal-fetal medicine, perinatology and pediatric pathology, midwifery, as well as practicing clinicians and pathologists. Expanding existing birth defects surveillance programs to include information of stillbirths could potentially enhance the data available on fetal death reports and also could benefit such programs by improving the ascertainment of birth defects.
The Challenge of Infant Mortality: Have We Reached a Plateau?
Authors: MacDorman Marian F. , Mathews T.J.
Published: January 2017

Objectives.

Infant mortality is a major indicator of the health of a nation. We analyzed recent patterns and trends in U.S. infant mortality, with an emphasis on two of the greatest challenges: ( 1) persistent racial and ethnic disparities and ( 2) the impact of preterm and low birthweight delivery.

Methods.

Data from the national linked birth/infant death datasets were used to compute infant mortality rates per 100,000 live births by cause of death (COD), and per 1,000 live births for all other variables. Infant mortality rates and other measures of infant health were analyzed and compared. Leading and preterm-related CODs, and international comparisons of infant mortality rates were also examined.

Results.

Despite the rapid decline in infant mortality during the 20th century, the U.S. infant mortality rate did not decline from 2000 to 2005, and declined only marginally in 2006. Racial and ethnic disparities in infant mortality have persisted and increased, as have the percentages of preterm and low birthweight deliveries. After decades of improvement, the infant mortality rate for very low birthweight infants remained unchanged from 2000 to 2005. Infant mortality rates from congenital malformations and sudden infant death syndrome declined; however, rates for preterm-related CODs increased. The U.S. international ranking in infant mortality fell from 12th place in 1960 to 30th place in 2005.

Conclusions.

Infant mortality is a complex and multifactorial problem that has proved resistant to intervention efforts. Continued increases in preterm and low birthweight delivery present major challenges to further improvement in the infant mortality rate.
Lack of Follow-up of Prostate-Specific Antigen Test Results
Authors: McFall Stephanie L. , Smith David W.
Published: January 2017

Objectives.

We obtained population estimates of the prevalence of lack of diagnostic follow-up after an abnormal prostate-specific antigen (PSA) result and assessed the role of sociodemographic, access, and risk perception factors on follow-up of abnormal tests.

Methods.

We used data from the 2000 National Health Interview Survey cancer control supplement. For 3,310 men aged 40 or older with a PSA test, 463 men reported an abnormal PSA test. Outcomes were abnormal PSA and lack of diagnostic follow-up in the latter group. Covariates for logistic regression included sociodemographic variables (age, race/ethnicity, and education), access to care (health insurance and usual source), and risk of cancer (family history and perceived risk). Survey analysis procedures accounted for the complex survey design.

Results.

Abnormal PSA results were associated with age, family history, and perceived risk of cancer. Approximately 15% of men with abnormal PSA tests reported no follow-up. The estimated number was 423,549 (95% confidence interval [CI] 317,755, 529,343). No follow-up was more likely in Hispanic men (odds ratio [OR] = 2.21, 95% CI 1.04, 4.70) and men without insurance (OR=6.56, 95% CI 2.02, 21.29), but less likely in men with a family history of prostate cancer or higher perceived risk of cancer.

Conclusions.

Substantial numbers of men had no follow-up of abnormal PSA tests. Primary care physicians should assess continuity of care following abnormal PSA results. Data about prostate cancer screening and follow-up are needed to support clinical and policy decisions.
Family Planning Provider Referral, Facilitation Behavior, and Patient Follow-up for Abnormal Pap Smears
Authors: Felix Holly C. , Bronstein Janet , Bursac Zoran , Stewart M. Kathryn , Foushee H. Russell , Klapow Joshua
Published: January 2017

Objectives.

Family planning (FP) clinics are important access points for cervical cancer screening and referrals for follow-up care for abnormal Papanicolaou (Pap) smears for a substantial number of U.S. women. Because little is known about referral and facilitation practices in these clinics or client action based on referrals, we sought to determine FP provider referral and facilitation practices when seeing FP clients with abnormal Pap smear results, and FP client follow-up for abnormal Pap smears due to FP provider referrals.

Methods.

We conducted a mail survey of Medicaid-enrolled FP providers in Arkansas and Alabama, and conducted a telephone survey with a sample of FP clients of those providers responding to the provider survey.

Results.

Major provider factors associated with referral included rural location, health department and clinic institutional setting, large Title X practice/clinic size, and high FP clinic focus. Major factors associated with facilitation included rural location, non-physician specialty, health department and clinic institutional setting, and small Title X clinic size. Of women reporting abnormal results, 62.4% reported follow-up care. Of those who received follow-up care, 40.0% received some care and a referral from their FP provider. A major factor associated with clients seeking follow-up care was being told by their FP provider where to go for follow-up care. Age was a major factor associated with clients actually obtaining follow-up care.

Conclusions.

Where follow-up care is not available at the FP site, referrals are critical and are a major factor associated with whether women seek care for the condition. Interventions to increase follow-up rates should focus on provider and system features, rather than clients.
Community Effectiveness of Public Water Fluoridation in Reducing Children's Dental Disease
Authors: Armfield Jason Mathew
Published: January 2017

Objectives.

Water fluoridation is one of the most effective public health programs of the past century. However, efforts to extend water fluoridation into currently non-fluoridated areas are often thwarted. Despite considerable evidence regarding the effectiveness of water fluoridation at an individual level, published national community-based studies are rare. This study compared children's decay experience and prevalence between areas with and without water fluoridation in Australia.

Methods.

Oral health data were obtained from clinical examinations of 128,990 5- to 15-year-old children attending for a regular visit with their respective Australian state or territory School Dental Service in 2002. Water fluoridation status, residence remoteness, and socioeconomic status (SES) were obtained for each child's recorded residential postcode area.

Results.

Children from every age group had greater caries prevalence and more caries experience in areas with negligible fluoride concentrations in the water (<0.3 parts per million [ppm]) than in optimally fluoridated areas (≥0.7 ppm). Controlling for child age, residential location, and SES, deciduous and permanent caries experience was 28.7% and 31.6% higher, respectively, in low-fluoride areas compared with optimally fluoridated areas. The odds ratios for higher caries prevalence in areas with negligible fluoride compared with optimal fluoride were 1.34 (95% confidence interval [CI] 1.29, 1.39) and 1.24 (95% CI 1.21, 1.28) in the deciduous and permanent dentitions, respectively.

Conclusions.

This study demonstrates the continued community effectiveness of water fluoridation and provides support for the extension of this important oral health intervention to populations currently without access to fluoridated water.
A Review of Legislation Restricting the Intersection of Firearms and Alcohol in the U.S.
Authors: Carr Brendan G. , Porat Gali , Wiebe Douglas J. , Branas Charles C.
Published: January 2017

Objectives.

In the United States, injury is a leading cause of alcohol-related death, and alcohol use is the leading risk factor for injury. We reviewed state and federal legislation regulating the intersection of alcohol and fi earms.

Methods.

We examined the current criminal codes of all 50 states and the District of Columbia using the databases Westlaw and LexisNexis to review restrictions on fi earm use while intoxicated.

Results.

We found three types of laws in 26 states that restrict fi earm use by intoxicated people: sales or transfers are restricted in six states, carrying of concealed weapons is restricted in four states, and possession or discharge of a fi earm while intoxicated is restricted in 20 states.

Conclusions.

Regulation of the carrying and use of fi earms by acutely intoxicated individuals may represent a public health opportunity to reduce fi earm-related injury.
Understanding Recent Changes in Suicide Rates among the Middle-Aged: Period or Cohort Effects?
Authors: Phillips Julie A. , Robin Ashley V. , Nugent Colleen N. , Idler Ellen L.
Published: January 2017

Objective.

We examined trends in suicide rates for U.S. residents aged 40 to 59 years from 1979 to 2005 and explored alternative explanations for the notable increase in such deaths from 1999 to 2005.

Methods.

We obtained information on suicide deaths from the National Center for Health Statistics and population data from the U.S. Census Bureau. Age- and gender-specific suicide rates were computed and trends therein analyzed using linear regression techniques.

Results.

Following a period of stability or decline, suicide rates have climbed since 1988 for males aged 40–49 years, and since 1999 for females aged 40–59 years and males aged 50–59 years. A crossover in rates for 40- to 49-year-old vs. 50- to 59-year-old males and females occurred in the early 1990s, and the younger groups now have higher suicide rates. The post-1999 increase has been particularly dramatic for those who are unmarried and those without a college degree.

Conclusions.

The timing of the post-1999 increase coincides with the complete replacement of the U.S. population's middle-age strata by the postwar baby boom cohorts, whose youngest members turned 40 years of age by 2005. These cohorts, born between 1945 and 1964, also had notably high suicide rates during their adolescent years. Cohort replacement may explain the crossover in rates among the younger and older middle-aged groups. However, there is evidence for a period effect operating between 1999 and 2005, one that was apparently specific to less-protected members of the baby boom cohort.
Racial/Ethnic Differences in the Association between Obesity and Major Depressive Disorder: Findings from the Comprehensive Psychiatric Epidemiology Surveys
Authors: Gavin Amelia R. , Rue Tessa , Takeuchi David
Published: January 2017

Objectives.

This study examined whether the association between obesity and 12-month prevalence of major depressive disorder (MDD) varied according to racial/ethnic status and nativity in representative national samples of black, Latino, Asian, and non-Hispanic white people.

Methods.

We used data from the Comprehensive Psychiatric Epidemiology Surveys.

Results.

In analyses by gender, obesity was associated with an elevated risk of MDD among non-Hispanic white women (adjusted odds ratio [AOR] =1.73; 95% confidence interval [CI] 1.27, 2.35; p=0.001). Formal test for interaction revealed significant variation by race present between non- Hispanic white women and black, Latin, and Asian women. No significant differences were evident among men. In analyses by nativity, the association between obesity and MDD was significant among U.S.-born non-Hispanic white women (AOR=1.62; 95% CI 1.16, 2.27; p=0.001) and U.S.-born black women (AOR=1.29; 95% CI 1.01, 1.66; p=0.041). Significant interactions were present among U.S.-born white and black women, Latin women, and Asian women. No significant interactions were evident among foreign-born women. Similarly, no significant differences were present among native-born or foreign-born men.

Conclusions.

The findings suggest that the association between obesity and MDD varies according to racial/ethnic status and nativity. Understanding the link between obesity and depression may be imperative to designing interventions to address body weight maintenance and reduction strategies among women.