bluuebunny/crossref_metadata_2025 huggingface dataset:
Seroconversion to human immunodeficiency virus in prison inmates.
Authors: Horsburgh C R , Jarvis J Q , McArther T , Ignacio T , Stock P
Published: November 2008

We evaluated the prevalence and incidence of human immunodeficiency virus (HIV) infection in 3,837 inmates of a state prison system. Ninety-two (2.4 percent) were HIV-seropositive. The highest proportion of HIV-seropositive inmates was found among Blacks (5.4 percent), females, and those 30 years of age or older. HIV-seropositivity of entering inmates was also 2.4 percent and was unchanged over the three years of the study. Seroconversion occurred in two inmates while in prison, a rate of one conversion per 604 person-years, but HIV infection could have occurred before entry. Seroconversion to HIV was rare in inmates in this correctional facility.
Misclassification of childhood homicide on death certificates.
Authors: Lapidus G D , Gregorio D I , Hansen H
Published: November 2008

Suspect classification of homicide deaths of Connecticut residents under 20 years of age was noted for 29 percent of cases examined. Misclassification was attributed to incomplete or erroneous information recorded on the death certificates, rather than errors in the designation of ICD-9 homicide codes. The results have important implications in the interpretation of vital statistics when homicide is listed as the cause of death and underscore the value of record linkage systems.
The growing proportion of female physicians: implications for US physician supply.
Authors: Kletke P R , Marder W D , Silberger A B
Published: November 2008

This study analyzes how the growing proportion of women in the United States physician population will affect the amount and type of physician services available to the US population. Female physicians work fewer hours per week, are slightly less likely to be in patient care, and tend to enter different specialties than male physicians. Female physicians also have higher retirement rates than male physicians, but due to their lower mortality rates, have work lives nearly as long as male physicians. We examined how the changing composition of the physician population will affect the availability of physician services by comparing historical and projected trends for the number of active post-residency physicians with comparable trends for a full-time-equivalent measure of physician supply. The full-time-equivalent measure takes into account the different labor supply behavior of key subpopulations (e.g., women and graduates of US versus foreign medical schools). The results suggest that the changing composition of the physician population will reduce the growth of effective physician supply between 1986 and 2010 but only by four percentage points.
Cryptosporidium infection in Oregon public health clinic patients 1985-88: the value of statewide laboratory surveillance.
Authors: Skeels M R , Sokolow R , Hubbard C V , Andrus J K , Baisch J
Published: November 2008

To evaluate the utility of statewide laboratory Cryptosporidium surveillance, we screened stools from all 5,256 patients evaluated at local health departments for parasitic disease from January 1985 through June 1988. Fifty-seven patients (1.1 percent) were found to have Cryptosporidium. Seasonal peaks in positivity were observed in the spring, summer, and early autumn months. In children, younger age was associated with higher positivity rate of cryptosporidiosis. As a result of these surveillance efforts, Oregon's first known outbreak of cryptosporidiosis was detected and investigated during 1988. Twenty-five persons were infected, including children, parents, and staff associated with two day care centers. The cost of routine screening for Cryptosporidium was $1.13 per specimen in our laboratory, and we consider it useful.
A comparison of alcohol sales data with survey data on self-reported alcohol use in 21 states.
Authors: Smith P F , Remington P L , Williamson D F , Anda R F
Published: November 2008

We used data from 21 states that participated in the 1985 Behavioral Risk Factor Surveillance System to compare state-specific per capita self-reported alcohol consumption and the prevalence of three drinking behaviors with state-specific per capita sales. The correlation coefficient for per capita sales and per capita self-reported consumption for the 21 states was 0.81. Per capita sales were also significantly correlated with the prevalence of self-reported heavier drinking, binge drinking, and drinking and driving; the corresponding correlation coefficients were 0.74, 0.59, and 0.51. These findings suggest that states with higher per capita sales of alcohol also have higher rates of self-reported consumption and drinking patterns suggestive of high-risk behavior.
End state renal disease among Native Americans, 1983-86.
Authors: Newman J M , Marfin A A , Eggers P W , Helgerson S D
Published: November 2008

We used data reported to Medicare from 1983 through 1986 to determine the incidence of end-stage renal disease (ESRD) among Native Americans and Whites in the United States. The 1,075 Native American cases represented an annual incidence, age-adjusted to the White population, of 269 per million, 2.8 times the rate for Whites. Fifty-six percent of Native American cases and 27 percent of the White cases were attributed to diabetes, indicating that ESRD is a major problem. Diabetes control provides the greatest opportunity for prevention.
Mortality from infectious diseases among New Mexico's American Indians, Hispanic whites, and other whites, 1958-87.
Authors: Becker T M , Wiggins C , Peek C , Key C R , Samet J M
Published: November 2008

To examine ethnic differences in infectious disease-related mortality in New Mexico's American Indian, Hispanic White and other White populations, we analyzed vital records data from 1958 to 1987. We found that for most infectious causes, American Indians had the highest mortality rates, followed by Hispanics. The state's minority populations remain at increased risk for infectious disease mortality.
Recurring urinary tract infection: incidence and risk factors.
Authors: Foxman B
Published: November 2008

Urinary tract infection (UTI) is a common infection among young women, with a high recurrence rate. This study documents the six-month incidence of second UTI among a cohort of women with one initial UTI and the factors associated with recurrence. Among the cohort of 113 women, 30 (26.6 percent) experienced at least one culture-confirmed recurrence within the six months following initial infection. The presence of hematuria and urgency as symptoms of initial infection were the strongest predictors of second infection. Behavioral factors associated with initial infection (frequency of sexual intercourse, diaphragm use, and voiding after sexual intercourse) did not distinguish between women who would and would not experience a second UTI during the six-month follow-up period.
Potential for Lyme disease in Maine: deer survey of distribution of Ixodes dammini, the tick vector.
Authors: Smith R P , Rand P W , Lacombe E H
Published: November 2008

A survey of deer brought to tagging stations at 24 sites in Main revealed the presence of the deer tick, Ixodes dammini, on 5.1 percent of deer. Ticks were found almost exclusively on deer from southwest coastal sites in the state. The potential for endemic Lyme disease in coastal Maine merits further study.
AIDS risk behavior patterns among gay men in small southern cities.
Authors: Kelly J A , St Lawrence J S , Brasfield T L , Stevenson L Y , Diaz Y E , Hauth A C
Published: November 2008

Men entering gay bars in three small southern cities were administered questionnaires to assess AIDS (acquired immunodeficiency syndrome) risk knowledge, perceived norms concerning the social acceptability of AIDS risk precautions, and personal sexual behavior. Seventy-seven percent (N = 355) of male patrons completed the measures. While risk knowledge levels were high, respondents did not perceive strong norms favoring risk reduction precautions. Rates of risk behavior were considerably higher than those reported for gay men in large urban epicenters.
Recovery of hepatitis A virus from a water supply responsible for a common source outbreak of hepatitis A.
Authors: Bloch A B , Stramer S L , Smith J D , Margolis H S , Fields H A , McKinley T W , Gerba C P , Maynard J E , Sikes R K
Published: November 2008

An outbreak of hepatitis A occurred in a north Georgia trailer park served by a private well. Of 18 residents who were serosusceptible to hepatitis A virus (HAV), 16 (89%) developed hepatitis A. Well water samples were collected 3 months after illness onset in the index case and 28 days after illness onset in the last trailer park resident. Hepatitis A virus antigen (HAVAg) was detected in the samples by enzyme immunoassay from three of the five cell lines following two 30-day passages and from a fourth cell line following a third passage of 21 days.
A rural outbreak of Legionnaires' disease linked to visiting a retail store.
Authors: Redd S C , Lin F Y , Fields B S , Biscoe J , Plikaytis B B , Powers P , Patel J , Lim B P , Joseph J M , Devadason C
Published: November 2008

Between May 7 and June 7, 1986, 27 residents of a rural county in Maryland developed legionellosis, and two died. Legionella pneumophila serogroup 1 was cultured from the sputum of two patients and identified in lung tissue of a third patient by direct fluorescent antibody staining. An additional 11 patients had four-fold rises in antibody titer to L. pneumophila, and 13 had single titers greater than or equal to 1:256. To determine risk factors for disease, we performed a case-control study. Twelve of 16 case-patients reported visiting store A in the two weeks before onset of illness compared with four of 28 control-patients. A serologic survey of employees showed that employees of store A were 3.63 times more likely than control employees to have titers of antibody to L. pneumophila greater than or equal to 1:256 (95% confidence intervals 0.8, 16.7). Cultures of soil specimens, samples of water from the hot water system of store A and from stagnant ponds near store A collected five weeks after the end of the outbreak were negative for Legionella species. Store A was adjacent to a site of excavation and construction during May 1986, when the community was experiencing an extended drought. This investigation suggests that exposure to excavation and construction activity may be a risk factor for legionellosis.
Epidemiologic and clinical characteristics of persons with serologic evidence of E. canis infection.
Authors: Rohrbach B W , Harkess J R , Ewing S A , Kudlac J , McKee G L , Istre G R
Published: November 2008

The results of a serosurvey of Oklahomans for the presence of antibody to Ehrlichia canis is reported. Paired serum specimens, from patients lacking the serologic criteria for diagnosis of Rocky Mountain spotted fever (RMSF), were tested. A four-fold increase in E. canis-IFA antibody was found in 16/144 (11 percent) of these paired serum samples. Patients with serologic evidence of E. canis infection had a mean age of 34 years, 69 percent were male, and 63 percent lived in a town less than 10,000 population. Signs and symptoms included: fever 94 percent, headache 94 percent, fatigue 94 percent, anorexia 81 percent, nausea 60 percent, and rash 44 percent. When compared to control patients, whose sera were submitted for RMSF testing but did not meet serologic criteria for RMSF or E. canis, case-patients were more likely to have had leukopenia (OR = 4.9, 95 percent Cl = 1.2, 19.0) and tick exposure (OR = 9.5, 95 percent Cl = 1.4, 62.7). The results suggest E. canis, or a closely related agent, is a cause of human illness. Ticks are probable vector.
Self-rated health and mortality in the NHANES-I Epidemiologic Follow-up Study.
Authors: Idler E L , Angel R J
Published: November 2008

The ability of self-rated health status to predict mortality was tested with data from the National Health and Nutrition Examination Survey (NHANES-I) Epidemiologic Follow-Up Study (NHEFS), conducted from 1971-84. The sample consists of adult NHANES-I respondents ages 25-74 years (N = 6,440) for whom data from a comprehensive physical examination at the initial interview and survival status at follow-up are available. Self-rated health consists of the response to the single item, "Would you say your health in general is excellent, very good, good, fair, or poor?" Proportional hazards analyses indicated that, net of its association with medical diagnoses given in the physical examination, demographic factors, and health related behaviors, self-rated health at Time 1 is associated with mortality over the 12-year follow-up period among middle-aged males, but not among elderly males or females of any age.
Screening for chlamydial cervicitis in a sexually active university population.
Authors: Malotte C K , Wiesmeier E , Gelineau K J
Published: November 2008

Enzyme-linked immunoabsorbent assays to detect chlamydial cervicitis were performed on samples from 1,320 sexually active university women. Seventy-five (prevalence 5.7 percent) had positive tests. Demographic, history, symptom, and physical examination variables were insufficient to predict infection accurately. We conclude that screening during routine visits with this population is cost-effective.
Comparison of antineoplastic drug handling policies of hospitals with OSHA guidelines: a pilot study.
Authors: Valanis B , Driscoll K , McNeil V
Published: November 2008

Hospital antineoplastic drug handling policies of 24 hospitals in eight Southwestern Ohio counties were compared with recommendations of the 1986 Occupational Safety and Health Administration (OSHA) guidelines. Although most study facilities where antineoplastics are handled have policies, content varies and is generally less complete than OSHA guidelines, particularly regarding storing, transporting, and disposing of drugs; managing equipment; informing personnel of risk; and surveillance. Recommendations for personal protection concur more closely with OSHA guidelines than do other content areas.
Improving influenza vaccination performance in an HMO setting: the use of computer-generated reminders and peer comparison feedback.
Authors: Barton M B , Schoenbaum S C
Published: November 2008

We evaluated a program for improving influenza immunization performance in a health maintenance organization (HMO). The HMO implemented several interventions successively from 1984-87: a postcard reminder to members at high risk for complications of influenza, a computer-generated reminder to the physician at the time of any primary care visit by high-risk patients, performance feedback to chiefs of service, and, finally, retrospective feedback to each physician comparing his/her performance with that of the other physicians. We examined immunization rates for a group of members older than age 65, a high-risk group under age 65, and a group of diabetic members who had not been subject to the reminders (vs a group who had been covered by the program). Vaccination rates were increased in those diabetic members who received reminders. Nevertheless, among members younger and older than age 65 whose experience was observed over three flu seasons, a significant increase in vaccination rates was not achieved until physician feedback was added to the program. We conclude that each element of the reminder and feedback program has contributed to the overall increase in vaccination rates at the HMO and that effective ongoing influenza immunization programs can be implemented in practice settings with appropriate systems support.
Smoking before, during, and after pregnancy.
Authors: Fingerhut L A , Kleinman J C , Kendrick J S
Published: November 2008

We report the first national data on smoking before, during, and after pregnancy. Estimates are based on the 1986 Linked Telephone Survey that reinterviewed 1,550 White women 20-44 years of age who were respondents to the 1985 National Health Interview Survey. An estimated 39 percent of White women who had smoked before pregnancy quit smoking while pregnant (27 percent when they found out they were pregnant and 12 percent later during pregnancy). Women with less than 12 years of education were five times as likely to smoke and one-fourth as likely to quit as those with 16 or more years of education. Women who smoked more than one pack of cigarettes per day before pregnancy were one-fifth as likely to quit as those smoking less. Of the women who quit, 70 percent resumed smoking within one year of delivery. Of those who relapsed, 67 percent resumed smoking within three months of delivery and 93 percent within six months. There is little evidence of educational differentials in relapse rates. The fact that relapse remains high suggests that while health of the fetus is a strong influence on women's smoking habits, women may be less aware of the effect of passive smoke on the infant.
Information on tar and nicotine yields on cigarette packages.
Authors: Davis R M , Healy P , Hawk S A
Published: November 2008

We examined information on tar and nicotine yields on the packages of 160 cigarette brands, 58 percent of the 275 brands for which tar and nicotine yields were listed in a recent Federal Trade Commission report. The tar yield was indicated on 14 percent, the nicotine yield was indicated on 11 percent. As tar yield increased among brands, the yield was progressively less likely to be shown on the package and was not disclosed on the package of any cigarette yielding 11 mg or more of tar.
Comparative evaluation of American Cancer Society and American Lung Association smoking cessation clinics.
Authors: Lando H A , McGovern P G , Barrios F X , Etringer B D
Published: November 2008

We compared the effectiveness of American Cancer Society, FreshStart, American Lung Association, Freedom from Smoking, and laboratory clinic methods in subjects (N = 1041) from three communities. Three-month follow-up results favored the laboratory method over the two public service approaches on both a prevalence and a sustained abstinence measure. At one-year follow-up, treatment effects for smoking prevalence were no longer significant. However, sustained abstinence results at one-year remained highly significant and favored the more intensive laboratory and Freedom from Smoking clinics over the FreshStart method. FreshStart fared less well than the other interventions both in producing initial quit attempts and in sustaining abstinence among initial quitters. It should be noted, however, that FreshStart requires considerably less facilitator contact than do the other approaches. Unexpected outcome effects occurred for treatment location. Future clinic programs should include a specific target date for quitting and should place more emphasis upon recycling participants who fail to sustain abstinence.
Persistence of anti-HBs among health care personnel immunized with hepatitis B vaccine.
Authors: Pasko M T , Beam T R
Published: November 2008

Health care personnel who received the hepatitis B vaccine (Heptavax-BR, MSD) were followed for persistence of hepatitis B surface antibody (anti-HBs). Response occurred in 135/146 (92.5 percent) vaccinees. Loss of anti-HBs (less than 72 RIA units; 10 S/N) occurred in 35.9 percent during the 36-month surveillance. Stepwise discriminant analysis found age and magnitude of initial antibody level, but not weight-height index, to be predictive of antibody loss over the 36 months. Twenty-four of 27 employees (88.9 percent) who lost anti-HBs responded to a fourth vaccine dose. In contrast, three of eight initial non-responders (37.5 percent) developed antibody after a fourth vaccine dose.
Smoking and consistently high use of medical care among older HMO members.
Authors: Freeborn D K , Mullooly J P , Pope C R , McFarland B H
Published: November 2008

Smoking behavior of consistently high and low users of medical care services were compared in two groups of older health maintenance organization (HMO) members continuously enrolled for five years and a subgroup who were continuously enrolled for 10 years. Smokers and former smokers, combined, were more likely than never-smokers to be consistently high users of ambulatory services (52 percent vs 34 percent in the five-year group, and 45 percent vs 30 percent in the 10-year group).
Increase in condom sales following AIDS education and publicity, United States.
Authors: Moran J S , Janes H R , Peterman T A , Stone K M
Published: November 2008

Data from a national probability sample of drug stores show that condom sales rose from 240 million annually in 1986 to 299 million in 1988. The greatest increase occurred in 1987 after the Surgeon General's report on AIDS was released. Sales of latex condoms with spermicide rose 116 percent. Sales of other types of condoms increased less. These data suggest that Americans are using more condoms and probably more effective condoms in response to AIDS education.
Males' use of public health department family planning services.
Authors: Glasser M
Published: November 2008

Information was obtained from over 200 males visiting a family planning service either to obtain free-of-charge condoms or incidental to accompanying their female partner. The former group was younger and more likely to reside near the health department: over 40 percent of this group used the health department as sole condom source. Both groups indicated willingness to share in costs for male services. Future programs need to more effectively plan public health family planning for these males.
Young children who drown in hot tubs, spas, and whirlpools in California: a 26-year survey.
Authors: Shinaberger C S , Anderson C L , Kraus J F
Published: November 2008

A survey of drownings in hot tubs, spas, and whirlpools in California 1960-85 suggests a person- and site-specific profile. The identified 74 deaths occurred mostly in White children, under two years of age, in Southern California, during the late afternoons, from May through August. From 1967 to 1985, the drowning rate increased tenfold. The deaths were associated with access to the water, lack of supervision, neuromotor handicaps, and entrapment by suction. Educational and environmental control efforts are required to reduce the incidence.
The dramatic increase in the rate of low birthweight in New York City: an aggregate time-series analysis.
Authors: Joyce T
Published: November 2008

This paper uses monthly time-series data from 1968 through 1988 to test whether the observed increase in the incidence of low birthweight in New York City represents a reversal of the downward trend that existed prior to 1984. We find that the trend has shifted for both Whites and Blacks. We estimate that between July 1984 and December 1988 there were 3,110 additional low-birthweight births to Blacks and 1,385 additional low-birthweight births to Whites above what would have been expected had the rate of low birthweight not shifted upwards. The incremental costs of treating these infants in their first year of life is estimated at over $22,000,000 in 1986 dollars.
Secular change in birthweight among southeast Asian immigrants to the United States.
Authors: Li D K , Ni H Y , Schwartz S M , Daling J R
Published: November 2008

We analyzed the Washington State births in 1980-1986 to Southeast Asian parents whose birth place was coded as being outside of the US. The mean birthweight increased from 3188 grams in 1980-81 to 3283 grams in 1986, an annual increment of about 18 grams (95% CI = 11, 25 grams). The prevalence of low birthweight (less than 2500 grams) decreased from 7.2 percent in 1980-81 to 5.4 percent in 1986, an annual reduction of 6.4 percent (95% CI = 1.3, 11.2 percent). In an analysis of information ascertained from the birth certificate, the change of paternal occupational status (from student to employed) was associated with 27 percent of the reduction in the prevalence of low birthweight, independent of maternal age, infant sex, and prior gravidity. A similar temporal change of birthweight during the same period of time was not observed among infants of US-born Asian mothers. Among the women who had two consecutive births from 1984 to 1986, the improvement of birthweight for the second birth compared to the first birth was much greater in infants born to the Southeast Asian mothers than that to White mothers. Our study suggests that living in the United States after immigration from their native countries has had a positive impact on the birthweight of infants born to Southeast Asian immigrants.
Potential exposure and health risks of infants following indoor residential pesticide applications.
Authors: Fenske R A , Black K G , Elkner K P , Lee C L , Methner M M , Soto R
Published: November 2008

Air and surface chlorpyrifos residues were measured for 24 hours following a 0.5 percent Dursban broadcast application for fleas inside a residence. Two of the three treated rooms were ventilated following application. Maximum air concentrations were measured 3-7 hours post-application. Peak concentrations in the infant breathing zone were 94 micrograms/m3 in the nonventilated room and 61 micrograms/m3 in the ventilated room, and were substantially higher than concentrations in the sitting adult breathing zone. Concentrations of approximately 30 micrograms/m3 were detected in the infant breathing zone 24 hours post-application. Surface residues available through wipe sampling were 0.7-1.6 micrograms/cm2 of carpet on the day of application and 0.3-0.5 micrograms/cm2 24 hours post-application. Estimated total absorbed doses for infants were 0.08-0.16 mg/kg on the day of application and 0.04-0.06 mg/kg the day following application, with dermal absorption representing approximately 68 percent of the totals. These doses are 1.2-5.2 times the human No Observable Effect Level (NOEL). Exposures to cholinesterase inhibiting compounds following properly conducted broadcast applications could result in doses at or above the threshold of toxicological response in infants, and should be minimized through appropriate regulatory policy and public education.
Breastfeeding patterns in Puerto Rico.
Authors: Becerra J E , Smith J C
Published: November 2008

In the 1950s, Puerto Rico began an active industrialization program. We used data from the 1982 Puerto Rico Fertility and Family Planning Assessment to describe the trend in the incidence of breastfeeding in Puerto Rico over time and to ascertain some of its determinants. From 1946 through 1982, 5,884 infants were born among this statistically representative sample of reproductive-aged women. The proportion of infants who had ever been breastfed was 59 percent for births before 1960 (mean duration = 7.8 months), dropped to 25 percent for infants born from 1970 to 1974 (mean duration = 4.9), and rose to 38 percent for births delivered from 1980 to 1982 (mean duration = 3.4). Prior breastfeeding experience was an important determinant of breastfeeding a newborn. Infants of mothers who had breastfed a previous baby were 7.3 times more likely to be breastfed (95% confidence interval = 6.6, 8.0) compared with infants of mothers who had not previously breastfed. The 38 percent of infants who were breastfed in Puerto Rico in the early 1980s is below the 74 percent to 97 percent reported in Latin America and below the 54 percent reported in the United States for the same period. This study provides baseline data for any future intervention strategies.
Poison Control Center follow-up of occupational disease.
Authors: Bresnitz E A
Published: November 2008

We followed up 73 of 372 calls to a Regional Poison Control Center (RPCC) that involved workplace disease/exposure(s); most other calls were not made by the workers. An average of 12 additional people per workplace were potentially exposed. Six of the 73 contacted a government agency for investigation of the hazard/illness. Twenty-five percent of callers were still exposed an average of seven months after the original call. The results indicate that poison control centers should develop a public health component to calls about possible workplace poisonings.
Illegal abortion in Mexico: client perceptions.
Authors: de Weiss S P , David H P
Published: November 2008

An exploratory study of the perceptions of 156 abortion clients in Mexico suggests that perceived quality of service was the main reason for choosing physicians while cost and anonymity were the major reasons for choosing nonphysicians. "Too young" was the most often cited reason for pregnancy termination, followed by economic situation and having too many children already. Cost was, on average, equivalent to three to four weeks minimum wage; physicians' charges were about three times higher than those of nonphysicians.
A survey of state Medicaid policies for coverage of abortion and prenatal diagnostic procedures.
Authors: Weiner J , Bernhardt B A
Published: November 2008

In the summer of 1988, we surveyed all states to evaluate access to Medicaid funding for abortion after the diagnosis of an anomalous fetus. All state Medicaid programs covered amniocentesis, and most had expanded coverage to include newer prenatal diagnostic procedures for eligible women. In 29 states, however, abortion coverage was limited to instances when continuation of abortion threatens the life of the mother. Only 13 states paid for a woman on Medicaid to obtain an abortion after diagnosis of an anomalous fetus.
Obstetrical pulmonary embolism mortality, United States, 1970-85.
Authors: Franks A L , Atrash H K , Lawson H W , Colberg K S
Published: November 2008

To investigate pulmonary embolism as a cause of obstetrical death, vital records data from 1970 through 1985 were analyzed. Results showed that the number of obstetrical pulmonary embolism deaths per 100,000 live births declined by 50 percent for both Whites and Blacks. However, Black women maintained more than a 2.5-fold higher risk, and women over age 40 had a ten-fold higher risk of embolism mortality. Thus, although the risk of obstetrical pulmonary embolism death has declined, some subgroups of women remain at higher risk.
Cervix and breast cancer incidence in immigrant Caribbean women.
Authors: Fruchter R G , Nayeri K , Remy J C , Wright C , Feldman J G , Boyce J G , Burnett W S
Published: November 2008

Cervix and breast cancer incidence in 1978-82 was computed for immigrant and United States-born Black women in Brooklyn, New York. Compared to the national SEER (Surveillance, Epidemiology and End Results) rates, US-born and Haitian women had high rates of invasive cervical cancer, while English-speaking Caribbean immigrants had an average rate. However, while US-born women had an average rate of carcinoma in situ of the cervix, both immigrant groups had low rates. Both immigrant groups had low rates of breast cancer, whereas US-born Black women had an average rate.
Unlicensed midwifery practice in Washington state.
Authors: Myers S J , St Clair P A , Gloyd S S , Salzberg P , Myers-Ciecko J
Published: November 2008

We examined the role of unlicensed midwives in Washington State by questioning mothers of infants born out-of-hospital with an unlicensed person in attendance. Only a small proportion of the state's births (0.11 percent) were attended by unlicensed midwives. Unlicensed midwives attended 7 percent of home births, licensed midwives and certified nurse-midwives attended 69 percent. Mothers chose unlicensed midwives because they had religious beliefs in common, or because they were the only providers available who would attend a home birth.
The prime time diet: a content analysis of eating behavior and food messages in television program content and commercials.
Authors: Story M , Faulkner P
Published: November 2008

The purpose of this study was to identify and analyze messages related to food and eating behavior as presented on prime time television (8:00-11:00 pm) both in programming and commercials. Food references occurred an average of 4.8 times per 30 minutes of programming time. Over half (60 percent) of all food references in programs were for low nutrient beverages and sweets. The prime time diet is inconsistent with dietary guidelines for healthy Americans.
A critique of the Harvard Resource-Based Relative Value Scale.
Authors: McMahon L F
Published: November 2008

Physician payment reform has assumed a prominent place in the national health policy debate. A key component in this debate is the Harvard Resource-Based Relative Value Scale (RBRVS). The Harvard research effort relied upon several necessary methodologic assumptions and compromises that must be understood to appreciate the RBRVS's strengths and weaknesses. For example, the Harvard group surveyed too few cases to cover the range of clinical practice in a specialty, had too little input in the selection of cases that were judged to be the same or equivalent between specialties, and used an unproven extrapolation methodology to assign final values for total work to non-surveyed physician services. This methodology led to a number of anomalies in the final RBRVS, such as values for comprehensive services for some specialties that were lower for new than for established patients, and total work values for many new patient office services that were lower for Internal Medicine than for Family Practice, a finding inconsistent with empiric evidence. The Harvard RBRVS represents a significant contribution that increases our understanding of physician practice. The system should not be viewed as a finished product. Further investigation and explanation of the assumptions and anomalies are needed to construct a system that reflects adequately the complexity in physician work.
Designing fee schedules by formulae, politics, and negotiations.
Authors: Glaser W A
Published: November 2008

Fee-for-service cannot be used successfully by organized health insurance without a fee schedule. America first tried to pay doctors under Medicare by an involved formula system without a fee schedule, but the effort has failed. The United States has now commissioned a research project to design a unique fee schedule that will precisely reflect physicians' effort and practice costs and that will represent the prices produced by a perfectly competitively market. The primary goal is the same as that pursued recently by reformers in all countries: viz., narrow the spread in fees and income between surgical and cognitive fields. There are serious technical limitations on this effort, despite the talent of the research team. An additional difficulty lies in the nature of the subject: paying the doctor involves conflicts of interest between payers and all doctors as well as among the medical specialties, and the conflicts cannot be resolved by any formulae calculated by any single research team. Methodological and political compromises will be necessary, in order to adopt a reform. The new method may be just as politically driven, complicated, and disputed as the old one, despite America's pretenses that it prefers free markets and opposes excessive government.
Ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus in New York health care facilities, 1988. The New York MRSA Study Group.
Authors: Budnick L D , Schaefler S
Published: November 2008

The emergence in 1988 of ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus (MRSA) in New York City was studied in nine hospitals and eight nursing homes. Of the 43 hospitalized patients studied, 21 were admitted from home, while nine of the 12 nursing home patients were transferred from a hospital. Twenty-four of the 55 patients had been treated previously with ciprofloxacin, and 26 had an identifiable risk factor for a nosocomial infection. MRSA was a contributing factor in at least five of the 21 deaths. MRSA resistance to ciprofloxacin was detected within three months of the drug's commercial availability, apparently emerged independently at a number of the health care facilities, and has become widespread. If such resistance is found in a health care facility, ciprofloxacin may not be useful as a first line antibiotic.
Infectious disease control in a long-term refugee camp: the role of epidemiologic surveillance and investigation.
Authors: Elias C J , Alexander B H , Sokly T
Published: November 2008

This report demonstrates the role of epidemiologic surveillance and investigation in the control of infectious diseases in a long-term refugee camp. The applications of simple epidemiologic methods in a refugee camp on the Thai-Cambodian border are described for a one-year period. The development of a Health Information Office facilitated the collection of demographic and vital statistics data, administration of a disease surveillance system, regular monitoring of hospital and outpatient discharge diagnoses, and investigation of disease outbreaks. This office also organized community health education campaigns and disease control efforts. Examples of specific disease investigations are provided to demonstrate the utility of epidemiologic surveillance in the control of infectious disease. We conclude that simple epidemiologic methods play an important role in health planning in long-term refugee camps.
Physician breach of patient confidentiality among individuals with human immunodeficiency virus (HIV) infection: patterns of decision.
Authors: Schwartzbaum J A , Wheat J R , Norton R W
Published: November 2008

To determine whether the sex, race, or sexual preference of a patient infected with immunodeficiency virus (HIV) influences a physician's decision to breach patient confidentiality, Tennessee primary care physicians were mailed a questionnaire containing a case study in which an HIV-infected patient presented a risk to a third party. Eight different descriptions of the sex, race, and sexual preference of the hypothetical patient were distributed randomly among the physicians, one description to each physician. The physicians were asked to decide whether to maintain confidentiality, notify the health department, or inform the patient's partner. Responses of 199 White male physicians were analyzed using an unconditional saturated logistic regression model. The odds ratios for these physicians saying they would send the patient's antibody status to the health department extend from 18.4 (95 percent confidence interval: 1.3, 260.1) for Black homosexual males to .5 (95 percent CI: 0, 11.5) for White homosexual females. The odds ratios for White male physicians saying they would inform the patient's partner range from 7.5 (95 percent CI: .8, 69.2) for Black heterosexual males to 1.0 (reference category) for Black homosexual females. The results suggest that when physicians decide to protect a third party by breaching an HIV-infected patient's confidentiality, their decision may be influenced in some cases by the race, sex, and sexual preference of the patient.
The increasing frequency of heterosexually acquired AIDS in the United States, 1983-88.
Authors: Holmes K K , Karon J M , Kreiss J
Published: November 2008

Of 88,510 cases of acquired immunodeficiency syndrome (AIDS) reported in adults in the United States from 1983 through 1988, the percentage attributed to reported heterosexual contact with persons known to be infected or at increased risk of infection with human immunodeficiency virus (HIV) has increased steadily from 0.9 percent in the first quarter of 1983 to 4.0 percent in the fourth quarter of 1988, from 0.1 (in 1983) to 1.4 percent (in 1988) among men, and from 13 (in 1983) to 28 percent (in 1988) among women. Among women, the cumulative incidence of AIDS attributable to heterosexual contact per million population is over 11 times greater for Blacks and Hispanics than for Whites. Among men, this incidence is over 10 times greater for Blacks and four times greater for Hispanics than for Whites. The pattern of distribution of heterosexually acquired AIDS parallels the distribution of other heterosexually transmitted diseases, which are also more frequent in Black and Hispanic inner-city populations. Drug use, exchange of sex for drugs or money, and early onset of sexual activity in adolescents are increasingly associated with heterosexually transmitted infections and are likely to be very important in heterosexual transmission of HIV in inner-city US populations.
Serious poisonings among older adults: a study of hospitalization and mortality rates in Massachusetts 1983-85.
Authors: Woolf A , Fish S , Azzara C , Dean D
Published: November 2008

We analyzed poisoning-related hospitalization and mortality rates among older adults living in Massachusetts during 1983-85. While poisoning-related hospitalization rates of individuals greater than or equal to 60 years were near the state average, death rates for men greater than or equal to 70 years and for women over 60 were higher than those of younger individuals. Medications and carbon monoxide were commonly implicated agents in these poisoning deaths. Older adults are more vulnerable to death from a poisoning than are younger age groups.
Changes in ambulatory surgery utilization 1983-88: a community-based analysis.
Authors: Lagoe R J , Milliren J H
Published: November 2008

Changes in ambulatory surgery utilization in the metropolitan area of Syracuse, New York 1983-88 were identified. Total ambulatory surgery utilization rose from 12,479 to 24, 643 procedures. Approximately 69 percent of the increase was generated by freestanding surgery centers. Operations responsible for the largest additional volumes included lens procedures, certain cervical procedures, hernias, and excision of skin and breast lesions.
Swaddling and acute respiratory infections.
Authors: Yurdakok K , Yavuz T , Taylor C E
Published: November 2008

In Turkey and China the ancient practice of swaddling is still commonly practiced. Both countries have extremely high rates of pneumonia, especially during the neonatal period. Preliminary evidence on the possibility that swaddling may interfere with normal respiratory function and thereby predispose to pneumonia was gathered in a teaching health center in Ankara. Babies who had been swaddled for at least three months were four times more likely to have developed pneumonia (confirmed radiologically) and upper respiratory infections than babies who were unswaddled. These preliminary findings were highly significant and are being followed up by further studies.
Elevated blood lead in California adults, 1987: results of a statewide surveillance program based on laboratory reports.
Authors: Maizlish N , Rudolph L , Sutton P , Jones J R , Kizer K W
Published: November 2008

California medical laboratories that test for blood lead are required to report results exceeding 1.21 mumols/L (25 micrograms/dl). Between April and December 1987, the California Department of Health Services received 3,077 blood lead reports from 34 laboratories for 1,293 civilian, non-institutionalized adults. Approximately 1 percent of all reports exceeded 3.87 mumols/L (80 micrograms/dl), 7 percent exceeded 2.42 mumols/L (50 micrograms/dl), and 21 percent exceeded 1.93 mumols/L (40 micrograms/dl). Individuals tested were overwhelmingly male (94 percent), disproportionately Hispanic surnamed (44 percent), and most often residents of Los Angeles County (81 percent). Workers in lead smelting, battery manufacturing, and brass foundries accounted for nearly 80 percent of reports. Construction, radiator repair, pottery and ceramics manufacturing, and gun firing ranges accounted for the remainder. All adults with reports of greater than or equal to 2.90 mumols/L who were contacted reported on occupational exposure. Approximately half were not in routine medical monitoring programs. Despite OSHA standards, elevated blood lead with the potential for serious acute and chronic lead poisoning in California adults remains a significant public health and major occupational health concern.
Recent time trends in uterine cancer.
Authors: Persky V , Davis F , Barrett R , Ruby E , Sailer C , Levy P
Published: November 2008

Recent trends in corpus uterine cancer incidence rates were explored using 1979-86 data from the Surveillance and End Results Program (SEER); recent trends in hospitalizations for corpus uterine cancer were explored using 1979-86 data from National Hospital Discharge Surveys (NHDS); and recent trends in exogenous hormone use were delineated using data from the 1980, 1981, and 1985 National Ambulatory Medical Care Surveys (NAMCS). Uterine cancer incidence rates using SEER data have continued to decline since 1979. An acceleration in the decline since 1983-84 is suggested in all women and in women with intact uteri ages 45-64. Hospitalizations for uterine cancer have also declined since 1979, with a marked acceleration in the decline since 1983-84 for all women and for women ages 40-79 has increased 22 percent and use of unopposed exogenous estrogens in women of similar age has increased 7 percent, while use of exogenous progesterones have shown much more substantial increases of approximately 700 percent. Possible relationships between trends in exogenous hormone use and incidence rates of corpus uterine cancer are discussed.
The present and the future of AIDS and tuberculosis in Illinois.
Authors: Coté T R , Nelson M R , Anderson S P , Martin R J
Published: November 2008

The relation between the acquired immune deficiency syndrome (AIDS) and tuberculosis (TB) was examined by matching the Illinois AIDS and TB registries. The match group was examined and compared with patients with only one disease by race, method of human immunodeficiency virus (HIV) transmission, site of tuberculous disease, radiographic findings, and results of Mantoux tests. The time of TB diagnosis was centrally distributed around the time of AIDS diagnosis; from this, it was determined that 4.1 percent of AIDS patients develop active TB. Projections for future AIDS cases were made by fitting a polynomial model to historical data. These projections were then used to predict the future impact of AIDS-related TB upon state TB rates. The rise in TB rates call for special efforts to minimize this impact.
The relationship of smoking cessation to coronary heart disease and lung cancer in the Multiple Risk Factor Intervention Trial (MRFIT).
Authors: Ockene J K , Kuller L H , Svendsen K H , Meilahn E
Published: November 2008

The impact of smoking cessation on coronary heart disease (CHD) and lung cancer was assessed after 10.5 years of follow-up in the 12,866 men in the Multiple Risk Factor Intervention Trial (MRFIT). Those men who died of lung cancer (n = 119) were either cigarette smokers at entry or ex-smokers; no lung cancer deaths occurred among the 1,859 men who reported never smoking cigarettes. The risk of lung cancer for smokers, adjusted for selected baseline variables using a Cox proportional hazards model, increased as the number of cigarettes smoked increased (B = 0.0203, SE = 0.0076). There was not the same graded response for CHD among smokers at entry. The risk of CHD death was greater among smokers than nonsmokers (RR = 1.57) (B = -0.0034, S.E. = 0.0048). After one year of cessation, the relative risk of dying of CHD for the quitters as compared to non-quitters (RR = 0.63) was significantly lower even after adjusting for baseline differences and changes in other risk factors. The relative risk for smokers who quit for at least the first three years of the trial was even lower compared to non-quitters (RR = 0.38). However, the relative risk for lung cancer for quitters versus non-quitters was close to 1 both for quitters at 12 months and at three years. These data support the benefits of cessation in relation to CHD and are consistent with other epidemiologic studies which suggest that the lag time for a beneficial effect of smoking cessation on lung cancer may be as long as 20 years.