bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Officer's Exchange: Ventilation of Privies in Birmingham
Authors: Hardenbergh W. A.
Published: November 2008

Under this head the Journal will print short articles giving accounts of actual experiences, methods and plans which have proved of practical utility in local health organizations, in the hope that health officers and sanitarians generally will find them of interest and value. Health officers and other health workers are invited to submit their experiences. Manuscripts must be limited to 1,500 words, preferably 1,000. The briefer and more concisely written they are, the better the chance of their publication.
The Medical Care Bookshelf
Authors: Axelrod S. J.
Published: November 2008

“There is no harder scientific fact in the world than the fact that belief can be produced in practically unlimited quantity and intensity, without observation or reasoning, and even in defiance of both, by the simple desire to believe founded on a strong interest in believing.”—The Doctor's Dilemma, Bernard Shaw.
THE USE OF LIFE TABLES IN PUBLIC HEALTH WORK
Authors: Dawson Miles M.
Published: November 2008

In this paper a man not professionally engaged in public health work but familiar with the difficulties of rendering vital statistics useful in that work and technically trained to cope with such difficulties, discusses some of the important features of “The Book-keeping of Public Health.”
THE SUPPRESSION OF THE DRUG VICE CONSIDERED FROM THE DEMAND SIDE
Authors: Chase J. Frank
Published: November 2008

In this paper the author attacks this vice from a new angle. Continue the restriction of the supply, but also cure the users.
LATEST FEATURES IN THE DIAGNOSIS AND PREVENTION OF SOME OF THE OCCUPATIONAL POISONINGS
Authors: Rand W.H.
Published: November 2008

Doctor Rand herein reviews some of the recent work done in other countries in connection with the problem of industrial poisonings as distinguished from infection.
Planning health care delivery systems.
Authors: Baum M A , Bergwall D F , Reeves P N
Published: November 2008

The increasing concern and interest in the health delivery system in the United States has placed the health system planners in a difficult position. They are inadequately prepared, in many cases, to deal with the management techniques that have been designed for use with system problems. This situation has been compounded by the failure, until recently, of educational programs to train new health professionals in these techniques. Computer simulation is a technique that allows the planners dynamic feedback on his proposed plans. This same technique provides the planning student with a better understanding of the systems planning process.
The law and the expanding nursing role.
Authors: Bullough B
Published: November 2008

Nursing has moved through two major phases in licensure. From 1900 to 1938 basic registration acts were passed and amended. In 1938 the goal became mandatory licensure for all those who nursed for hire. This move was linked with the stratification of the nursing role to include both practical and registered nurses. The third and current phase in licensure began in 1971 with the Idaho revision of the nurse practice act; 30 states have now revised their nurse practice acts to facilitate role expansion for registered nurses. Several approaches are being used in these laws including mandating new board regulations, expanding the definitions of nursing; increasing the power of physicians to delegate, and mandating the use of standardized protocols to guide the practice of nurses who are accepting new responsibilities.
Drinking water for the future.
Authors: Okun D A
Published: November 2008

The Safe Drinking Water Act of 1974 represents an important step in improving the quality of public water supply in the United States. However, it fails to address two important problems: (1) The 1970 Public Health Service Community Water Supply Survey revealed that small public water supply systems often deliver poor quality water. The Act does not assure that these supplies will now receive appropriate attention; furthermore, the Act does not address the needs of the 50 million people not now served by public water systems; (2) About one-third of our population draws its drinking waters from polluted sources. The decisions to use these low cost sources were made generations ago when consumers could be protected from water-borne infectious disease. A new problem has now arisen--the presence of numerous synthetic organic chemicals of uncertain health consequence, not removed by conventional water treatment. The Act does not address this problem. Regionalization and the integration of water resource and water pollution control authorities are proposed as a reasonable solution to these problems. The development of dual water supply systems in order to conserve scarce pure water sources for human consumption appears to be a feasible way to avoid using polluted waters for drinking. The development of dual supplies would be enhanced by regionalization and integration of water authorities.
What kinds of people do not use seat belts?
Authors: Helsing K J , Comstock G W
Published: November 2008

In the course of a Community Mental Health Epidemiology study conducted in Washington County, Maryland between December, 1971 and July, 1974, interviews were conducted with randomly selected adults in a weekly systematic sampling of households. In a subsequent re-interview of 1009 respondents who had family cars with seat belts, nearly 47 per cent said they did not use them. Non-use of seat belts was significantly higher among females and among persons with less than high school education or low income. Non-use of seat belts was also higher among those who felt that their station in life as measured by the Cantril ladder was unsatisfactory, who felt powerless to change at least some aspects of their lives, and who were infrequent church attenders. Significant associations were also found with infrequency of two other preventive health behaviors, dental checkups and Pap tests. Among young adults the tendency seemed to be for marriage to increase the non-use of seat belts among females but to decrease non-use among males.
The uses of multiple causes of death data to clarify changing patterns of cirrhosis mortality in Massachusetts.
Authors: Speizer F E , Trey C , Parker P
Published: November 2008

Evaluation of death rates from cirrhosis of the liver in Massachusetts since 1950 indicate a changing pattern suggestive of a substantial increase in the frequency with which cirrhosis is being recorded as the underlying cause of death. By comparing the relationship between the frequency with which cirrhosis is mentioned on the death certificate with its occurrence as the underlying cause of death, it would appear that the increase in death rate represents a real change. Additional evidence is presented to indicated that the increase is occuring in the urban center of the state. Males aged 40-49 and females aged 50-59 have shown the greatest changes. In spite of similar changes occuring on the national scene, the increase appears to be substantially greater in Massachusetts. The evaluation of multiple cause of death as mentioned on death certificates can allow for assessment of significant co-factors contributing to a fatal outcome in a disease like cirrhosis of the liver.
A pitfall in sampling medical visits.
Authors: Shepard D S , Neutra R
Published: November 2008

Samples of outpatient visits often must be used to identify users of a health facility with a given chronic condition. Such samples can lead to biases, however, because patients with more frequent visits are overrepresented. These biases can be avoided by a weighting procedure in which each sampled visit is weighted inversely to the number of clinic visits made by that patient during the sample period. This procedure proved critical in estimating the number and characteristics of hypertensive patients seen in the medical clinic of a teaching hospital. The unweighted estimate of the number of hypertensives was 7,373 patients, more than three times the weighted estimate of 2,250. Similarly,, the number of visits per year by these patients would be overestimated by almost 50 per cent without weighting. The estimated proportion of hypertensives still under treatment after 18 months was 68 per cent without weighting, compared to 51 per cent with weighting. Thus biases from failure to weight may be substantial. Analogous biases and solutions apply to other sampling problems in health services research.
Community medicine in the British National Health Service.
Authors: Jagdish V
Published: November 2008

Reorganization of the British National Health Service in April 1974 brought about the creation of Community Medicine as a service specialty. Development of thinking on the type of role British community medicine should play is briefly described. The functions of the community medicine specialist at the different tiers of the health service are described in the context of the objectives of reorganization and the problems facing the specialty today are discussed.
An epidemiological approach to the study of users and nonusers of child health services.
Authors: Selwyn B J
Published: November 2008

A case-comparison study was carried out in 1972 to determine the characteristics of users and nonusers of child health services. A sample of 529 mothers with children under five years of age (eligible children) residing in one poor barrio in Cali, Colombia was selected. The characteristics of mothers and their eligible children were described in relation to their use or nonuse of health services and a set of indicators was develop which differentiated the nonuser group from the user group. A two-stage sampling technique was used. First, blocks in the barrio were sampled, and second, an equal number of mothers with eligible children who used and who did not use services in the year prior to the study were selected for interview. Nonusers were matched with users on distance from home to local health center. The set of indicators which best discriminated the groups was: the number of eligible children, age of mother, access to free medical care, the action proneness score (attitudes), and knowledge of health, illness, and services. The study method permitted identification of the target population for services, determination of current patterns of use, and quantification of morbidity and immunization levels.
Improvement in infant and perinatal mortality in the United States, 1965--1973: I. Priorities for intervention.
Authors: Eisner V , Pratt M W , Hexter A , Chabot M J , Sayal N
Published: November 2008

Changes in United States infant and perinatal mortality in the period 1965--1973 were examined by race, age at death or length of gestation, and degree of urbanization. The decline of postneonatal mortality rates was greater than the declines of fetal and neonatal mortality rates. Other-than white infant and fetal mortality rates improved more than the white rates, except in the first day of life. Postneonatal mortality rates improved more in rural than in urban areas, while neonatal and perinatal mortality rates improved more in urban areas than in rural. These improvements in mortality rates have occurred at the same time as changes in medical techniques and the organization and availability of health services, improvements in economic conditions and standards of living, and changes in the demographic characteristics of the child-bearing population of the United States. Each of these changes was in a direction expected to have a favorable effect on infant and perinatal mortality. Nevertheless, the improvement of infant mortality rates has not changed the relative position of the United States in comparison with other countries. Programs to improve infant and perinatal mortality can use the data in this study to define high priority target groups using a method based on the size of the problem in the target group, the severity of the problem, and the amount and direction of change.
Health services needs of children in day care centers.
Authors: Chang A , Zukerman S , Wallace H M
Published: November 2008

In order to assess health services needs of children in day care centers, interviews were carried out with health coordinators or directors of 52 licensed day care centers in Berkeley, California. Over one-third of the centers lacked a designated health coordinator; one-fourth of the centers lacked written health guidelines and/or emergency guidelines; almost one-half lacked nutrition education services; and over two-thirds lacked a dental health education program. Only one out of five centers was willing to admit mildly ill children. Health coordinators and directors showed strong preference for care of mildly ill children at home by a trained worker. The presence of a designated health coordinator and of state funds was highly associated with the content and scope of health services provided.
Environmental quality as an issue in the legislative history of the National Health Planning and Resources Development Act of 1974 (PL93-641).
Authors: Pond M A
Published: November 2008

It is the purpose of this brief communication to examine the history of the most recently enacted health planning legislation (PL 93-641) to assess how environmental health issues were addressed and resolved during the legislative process.
Physician importation--a solution to developing countries' rural health care problems?
Authors: Zeighami B , Zeighami E , Mehrabanpour J , Javidian I , Ronaghy H
Published: November 2008

Developing countries almost universally suffer from severe health service shortages, particularly in rural areas. Manpower problems are the most critical aspect of the shortages. Iran has recently begun a massive program to increase physician supply in its rural areas by importation of physicians from India, Pakistan, and the Philippines. The present study investigated two questions: What are physicians' reasons for accepting a post in a rural area of another country, and what are the attitudes of residents in such rural areas toward foreign physicians? Results of a questionnaire survey of foreign physicians indicate that the most common reasons for physician acceptance of the posts were higher salaries and the desire to go eventually to a Western country. Results of an interview survey of Iranian consumers indicate that residents of rural areas were far more likely to prefer Iranian auxiliaries than non-Iranian physicians.
Presence of observers at patient-practitioner interactions: impact on coordination of care and methodologic implications.
Authors: Starfield B , Steinwachs D , Morris I , Bause G , Siebert S , Westin C
Published: November 2008

In this study in an urban practice, the presence of a neutral observer at follow-up visits enhanced the extent to which practitioners recognized problems which patients had in a previous visit. This improvement was limited to those problems which initially had been mentioned by patients as requiring follow-up. Follow-up of problems initially mentioned by practitioners as needing follow-up was not improved by the observer unless the problem was also mentioned by the patient. Investigators whose information about practitioner-patient interaction depends upon the presence of an observer should be aware of this and possibly other effects. Although routine involvement of a neutral observer in patient-practitioner interactions is probably undesirable, selected deployment of observers or similar alternatives may be useful in situations where practitioner-patient communication is inadequate.
Prevalence of hepatitis B in 27 Michigan hemodialysis centers.
Authors: Mayor G H , Hourani M R , Greenbaum D S , Patterson M J
Published: November 2008

A large epidemiological survey of inhospital chronic hemodialysis patients was conducted in 27 (93%) of the 29 dialysis centers in Michigan. Serum was collected from 699 patients on chronic maintenance hemodialysis for periods from one month to eight years. Hepatitis B surface antigen (HBsAg) was determined in all patients by radioimmunoassay and positive samples were confirmed by specific neutralization. Antibody against HBsAg (anti-HBs) was determined by radioimmunoassay in 110 HBsAg negative patients from six dialysis units with a high prevalence of hepatitis B. HBsAg was detected in 80 (11.4%) patients distributed among 21 (78%) of 27 dialysis units and anti-HBs in 34 (31%) patients from the selected dialysis units. The prevalence of HBsAg was related to duration of dialysis, number of blood transfusions, and to a history of bilateral nephrectomy, but not to age, sex, race, nor the underlying renal disease. Twenty-one (26%) of the 80 HBsAg positive patients had not been previously identified by the clinical laboratories of their institutions. Since preventive measures were not taken in the care of these inapparent carriers of HBsAg, they represent an unrecognized risk.
The risk of low birthweight.
Authors: Eisner V , Brazie J V , Pratt M W , Hexter A C
Published: November 2008

Descriptive analyses of birthweight for single live births in the United States during 1974, using birth certificate information, show that several factors are associated with a high incidence of low birthweight babies. Multivariate analyses were performed to determine correlates of low birthweight. When other factors are held constant, race not white, previous reproductive loss, short interpregnancy interval, out-of-wedlock birth, no prenatal care, and maternal age under 18 years or over 35 years each increase the risk of having an infant of low birthweight. High birth order and maternal education under 12 years of schooling were not consistent risk factors for low birthweight. Odds ratios are presented and the method for combining these, to estimate the risk for an individual mother having a low-birthweight infant, is illustrated.
METHOD OF DISTRIBUTING AND COLLECTING DIAGNOSIS OUTFITS FOR THE BUREAU OF LABORATORIES IN CLEVELAND
Authors: Perkins R. G.
Published: November 2008

Doctor Perkins tells how one feature of health department routine is carried out in one of our large cities. This is a well written paper which will prove of particular interest to laboratory workers and communicable disease men.
Fertility planning status of Chicano couples in Los Angeles.
Authors: Sabagh G
Published: November 2008

Data presented in this paper were obtained from interviews of 1,129 Chicanas in Los Angeles in 1973. The women were 15--44 years of age, and married to Chicanos. While the level of contraceptive use prior to the last pregnancy was somewhat lower for Chicanas than for all women in the United States, they were equally successful in their fertility planning. For Chicano contraceptors, the success rate ranged from 65 per cent before the first pregnancy to 42 per cent before the fourth, a little high than for all women in the United States. For non-contraceptors, there were similar differences in success between the two groups. These findings suggest that the higher fertility of Chicanas is a consequence of their desire for larger families rather than unsuccessful family planning. The findings on the determinants of fertility planning success suggest that ethnicity and type of health facility care for the last pregnancy are more important variables than age, age at marriage, socioeconomic status, and religiosity.
Missed opportunities for early diagnosis of cancer of the cervix.
Authors: Fruchter R G , Boyce J , Hunt M
Published: November 2008

In a low-income community, 52% of new invasive cancer of the cervix arose in women who had no previous Pap smear, while 62% arose in women with no smear within five years. In the previous five years, 73% of the unscreened women had received ambulatory medical care (including 41% who had regular care for chronic conditions), while 16% were hospitalized. Much of the unscreened low-income population could be reached by routine screening in regular ambulatory health services and hospitals.
Focused interviewing in gonorrhea control.
Authors: Phillips L , Potterat J J , Rothenberg R B , Pratts C , King R D
Published: November 2008

To develop an operational approach to the identification of high risk gonorrhea transmitters, three groups of women infected with Neisseria gonorrhoeae (recent repeaters, routine discoveries, and women with pelvic inflammatory disease) were offered intensive casefinding services during an 18-month period. Approximately three contacts per case were investigated, and 27.4% of the contacts were infected. Of infected contracts, 61% were asymptomatic. Asymptomatic, remote contacts to these women appear to be important in the continuing transmission of gonorrhea. The interviewing approach used reflected that employed in syphilis (thorough, detailed, and long) rather than the more casual interviews usually employed for gonorrhea patients. During this period, gonorrhea morbidity declined 22%. Further exploration of a targeted approach to gonorrhea epidemiology is indicated.
Public support for National Health Insurance.
Authors: Goodman L J , Steiber S R
Published: November 2008

In 1978 a majority of the American public felt there was a need for National Health Insurance (NHI). This study develops models of public support for NHI both with and without a tax subsidy. Support for NHI is highest among the young, lower socioeconomic groups, non-Whites, and urbanites. The older, more educated, White, and rural population are less supportive. In addition, substantial differences exist across political party orientation and health insurance status. Although support for NHI declines by considering a tax subsidy, logit estimates remain relatively stable. Only age and socioeconomic status lose statistical significance when the tax issue is considered.
GMENAC: its manpower forecasting framework.
Authors: McNutt D R
Published: November 2008

The Graduate Medical Education National Advisory Committee (GMENAC) was an advisory group to the Secretary, US Department of Health and Human Services. Its charter ended September 30, 1980. It submitted 107 recommendations to achieve a better balance between future physician requirements and future physician supply, by specialty and geography. Among its contributions were the development of a manpower forecasting framework and series of models which are described here, together with the results of these models. These models may have significant utility in future human resource planning at both national and local levels.
Trends in contraceptive method of use by California family planning clinic clients aged 10-55, 1976-1979.
Authors: Aved B M
Published: November 2008

The types of primary contraceptive method chosen by women seeking services in California family planning clinics are reviewed for the years 1976-1979. Of most significance was the decline in the use of oral contraceptives (OC) and the concurrent rise in nonprescription methods at all ages. A striking difference in OC use between the earlier and latter time periods was noted for women age 40 and older.
Choosing populations to study the health effects of low-dose ionizing radiation.
Authors: Dreyer N A , Loughlin J E , Friedlander E R , Clapp R W , Fahey F H
Published: November 2008

In January 1978, the United States Congress requested information about the utility of additional epidemiologic studies for quantifying the health effects of low-dose ionizing radiation. In our judgment, no single population can be recommended for study on purely scientific grounds, since the largest group offers only a small chance to obtain a definitive result. On the other hand, if social pressures and regulatory agencies mandate that such studies be attempted, we would recommend prospective cohort studies of occupational populations. We propose that a national worker registry be developed using ionizing radiation as the prototype for studying other occupational exposures. The problems related to studying low-level radiation are not unique, but apply equally to investigations dealing with a great variety of toxic agents. A national plan for collecting information on workers' exposure and health could provide a cost-efficient means to answer public health questions posed by the Congress, scientists and the public.
The triage experiment in coordinated care for the elderly.
Authors: Hicks B , Raisz H , Segal J , Doherty N
Published: November 2008

Triage is a model project designed to overcome the organizational and financial barriers inhibiting the provision of appropriate care to the elderly. Teams made up of a nurse clinician and a social worker performed assessment, service coordination, and monitoring functions. Services arranged by the teams were financed through a series of waivers on the use of the Medicare Trust Fund. Three hundred and seven Triage clients were followed and compared to a group of 195 elderly in a two year quasi-experimental study of functioning status outcomes, use of services, and health care costs. Triage clients had slightly better mental functioning outcomes than comparison clients; results of physical and social functioning outcomes were inconclusive. Both service utilization and costs were somewhat higher for Triage clients; the proportional difference in utilization was greater than the proportional difference in costs.
Putting the lamentations of epidemiologists in perspective.
Authors: Hershey N
Published: November 2008

Epidemiologists have expressed concern about constraints upon the conduct of epidemiological research imposed by Institutional Review Boards (IRBs), attorneys, and both institutional and individual health services providers. The epidemiologists assert that these constraints, not necessarily required by law or sound policy, will deprive society of the benefits such research can yield. It is suggested that the complex of law and regulation, resulting from increased awareness of privacy and confidentiality interests, can often be dealt with if there is clearer understanding of the roles of attorneys, and flexibility shown by both epidemiologists and health services administrators and practitioners in the structuring and review of epidemiological research protocols.
Activities of an employer independent Occupational Medicine Clinic, Cook County Hospital, 1979-1981.
Authors: Orris P , Kennedy M J , Guerriero J , Hessl S M , Hryhorczuk D O , Hoffman D
Published: November 2008

In July 1976, Cook County Hospital, a 1,363-bed general public hospital in Chicago, Illinois, established a hospital-funded Occupational Medicine Clinic. A review was made of the clinic records of the 486 new patients evaluated at the clinic from July 1979 to June 1981. Information is presented concerning age, ethnic origin, sex, union representation, referral sources, reason for the referral, number and type of toxic exposure, diagnosis, occupational relationship of the disease, and disposition.
The effect of psychological intervention on recovery from surgery and heart attacks: an analysis of the literature.
Authors: Mumford E , Schlesinger H J , Glass G V
Published: November 2008

A quantitative review of 34 controlled studies demonstrates that, on the average, surgical or coronary patients who are provided information or emotional support to help them master the medical crisis do better than patients who receive only ordinary care. A review of 13 studies that used hospital days post-surgery or post-heart attack as outcome indicators showed that on the average psychological intervention reduced hospitalization approximately two days below the control group's average of 9.92 days. Most of the interventions were modest and, in most studies, were not matched in any way to the needs of particular patients or their coping styles. Beyond the intrinsic value of offering humane and considerate care, the evidence is that psychological care can be cost-effective.
A Study of Intestinal Protozoa Including Non-Pathogenic Entamoeba histolytica from Patients in a Group of Mental Hospitals
Authors: Sargeaunt Peter G. , Williams John E.
Published: November 2008

Twenty-five per cent of 174 patients residing in three mental hospitals were found to be infected with protozoa. Seven per cent of the patients were infected with Entameba histolytica. Isoenzyme characterization of the E. histolytica grown in culture showed that there were no pathogenic zymodemes of this organism in any of the specimens tested. (Am J Public Health 1982;72:178-180.)
Seasonal trends in reported poisonings.
Authors: Greenberg R S , Osterhout S K
Published: November 2008

Review of 2,339 Duke Poison Control Center records for calendar year 1977 revealed that preschool children had an autumn peak for all poisonings; older victims a summer predominance. When the reports were stratified by poisoning agent, significant summer predominance was noted in preschool victims for plants, pesticides, paints, and cosmetics; winter predominance for external medicines. In older victims, spring predominance was found for pesticides and soaps, summer predominance for envenomations, plants, internal medicines, ethanol, soaps, and external medicines.
Completeness of infant death registration for very low birthweight infants: Washington State 1978-79.
Authors: Frost F , Jennings T , Starzyk P
Published: November 2008

Washington State hospitals were queried about the fate of 507 infants born in 1978-79 for whom no linked death certificate existed. Only ten previously unregistered deaths were discovered, raising mortality for this group by 2.5 per cent. In addition, 13 previously unmatched death records were linked to birth records, providing more accurate calculation of birthweight-specific mortality rates. Washington State infant death registration is more complete that that found in either Georgia or North Carolina.
The Impact on Breastfeeding and Pregnancy Status of Household Contraceptive Distribution in Rural Haiti
Authors: Bordes Ary , Allman James , Verly Adeline
Published: November 2008

This paper presents data from an experimental project which distributed oral contraceptives, foam, and condoms to households in three rural areas of Haiti between January 1978 and March 1980. The contraceptive distribution had little apparent impact on traditional, prolonged breastfeeding patterns, and the percentage of women pregnant after eight months of field operations declined over 35 per cent in the two areas where contraceptive acceptance and use were highest. (Am J Public Health 1982; 72:825-838.)
Bottled beverages and typhoid fever: the Mexican epidemic of 1972-73.
Authors: Gonzalez-Cortes A , Gangarosa E J , Parrilla C , Martin W T , Espinosa-Ayala A M , Ruiz L , Bessudo D , Hernandez-Arreortua H
Published: November 2008

A chloramphenicol resistant strain of S. typhi which caused a very large epidemic of typhoid fever in Mexico in 1972-73 survived in opened bottles of one carbonated drink with a pH of 4.6 for two weeks and in another such drink with a pH of 5.1 for six months. Bottled beverages are potential sources of large outbreaks of enteric disease, and deserve the same type of standards sand monitoring as comparable fluids such as milk.
A model for dental workload measurement.
Authors: Parker W A , Williams D L , Mayotte R V , James J J , Mangelsdorff A D
Published: November 2008

The primary purpose of the study was to develop a model that would provide an efficient and standardized approach to workload reporting in a non-fee (HMO-like) dental care system. The model was also designed to predict the dental personnel resource requirements in the system as the overall dental needs of the population were already known. To accomplish this, a set of 246 task/procedures representing the broad scope of dental practice was developed. For each task/procedure, a Best Time-weighted Estimate (BTE) in terms of average expected man-minutes of work required for accomplishment was developed from over 35,000 actual time measurements on patient visits to 29 US Army dental clinics located throughout the United States. Because of the nature of the specific task/procedure data, it was necessary to use four different mathematical models to produce statistically optimal BTEs. It was concluded that, cumulatively the BTEs developed for each task/procedure evaluated could be used as a basis for both the development of a Dental Care Composite Unit workload measure and the determination of overall dental personnel resource requirements in a non-free dental care system.
What good is legislation--or planning--if we can't make it work? The need for a comprehensive approach to health and welfare.
Authors: Snoke A W
Published: November 2008

Health and welfare programs continue to be developed and implemented on a piecemeal basis in this country. There is difficulty in recognizing not only that health and social affairs are intimately related, but that the system must be dealt with as a whole of its interrelated problems are to be solved. Increasing costs for health and social programs are becoming of even greater concern, and cost containment (voluntary or regulatory) preoccupies both the payers and the recipients. Complicating the current situation is uncertainty of the role of financing and regulation on the part of the federal government and the states (the New Federalism), and the fragmentation and uncertainty of the private delivery sector and its third party reimbursement agencies. Questions are raised as to whether viable solutions can be obtained until all components (governmental and private) can work together in a partnership rather than an adversarial relationship in the development of an overall strategy with understandable objectives. Of basic importance is consideration of matters of organization, administration, and leadership at all levels so that whatever program may be developed or evolved can be successfully implemented. The subject is of such magnitude and is so complicated that it deserves a major coordinated effort of the federal government, the state governments, and the diverse private sector components to ensure a coordinated and systematic approach to any realistic solution.
Non-participation in telephone follow-up interviews.
Authors: Marcus A C , Telesky C W
Published: November 2008

The present analysis examined sample attrition in a one-year longitudinal health survey that made use of telephone follow-up interviews (N = 1210). Overall, respondent attrition had little impact on the sociodemographic and health status characteristics of the sample at the final interview. However, certain subgroups were statistically less likely to participate in the follow-up interviews, including younger respondents, the non-employed, people from the lower socioeconomic groups, and those who initially rated their health as fair or poor. Reports of physical illness and disability obtained at the initial interview were unrelated to rates of sample attrition.
Diabetes mortality in persons under 45 years of age.
Authors: Connell F A , Louden J M
Published: November 2008

A detailed review of death certificates in Washington State for the years 1968-1979 was undertaken to analyze diabetes mortality for persons under 45 years of age. Diabetics in this age group had a mortality rate from medical causes eight times higher than that of the comparable general population. Almost one-third of the deaths were due to acute complications for which there is definitive medical therapy. Over the 12-year period there was no consistent decline in mortality rates or in deaths from acute complications, nor was there evidence of increased survivorship as reflected in the average age at death. Although residence in areas of sparse medical resources was not associated with high mortality rates, a significant proportion of deaths in all geographical areas occurred at home or before arrival at a hospital. Mortality rates and the proportion of deaths from acute, potentially preventable causes were higher in this study than in other recently published series, suggesting that early diabetes mortality may be a more serious problem than has been previously recognized. Diabetes mortality in this age group can be considered a "sentinel health event" and should call attention to potential problems in health care delivery.
Does smoking cessation lead to weight gain? The experience of asbestos-exposed shipyard workers.
Authors: Coates T J , Li V C
Published: November 2008

We examined the relationship between smoking cessation and weight change in a sample of 373 asbestos-exposed workers who had participated in a smoking cessation program. Those who quit smoking for one year and those who quit for shorter periods gained significantly more weight than those who continued to smoke. Those with initially poorer health and those who quit to avoid illness gained less weight.
Inadequate transfer of breast cancer self-detection technology.
Authors: Sheley J F
Published: November 2008

Results of a telephone interview of 290 New Orleans women indicate that, at best, only about 10 per cent of them efficaciously applied breast cancer self-detection technology. These findings suggest that research to date regarding breast self-examination efficacy in early tumor detection actually is problematic since few controls have been provided for the degree to which research subjects possess the knowledge to perform the examination correctly.
The practice and efficacy of breast self-examination: a critical review.
Authors: Holtzman D , Celentano D D
Published: November 2008

Evaluation of the results of breast self-examination (BSE) is inconclusive. Studies which address the question of proper method of BSE find that most women do not know how to carry out the procedure correctly. Socio-demographic characteristics most consistently related to BSE practice are age and education. New research on BSE must not only take into account such correlates but also provide some verification of the procedure to determine the importance of BSE in the detection and control of breast cancer.
Establishing efficient interview periods for gonorrhea patients.
Authors: Starcher E T , Kramer M A , Carlota-Orduna B , Lundberg D F
Published: November 2008

From February through December 1978, venereal disease casefinders in Polk County, Iowa used an expanded interview period of at least 120 days to interview 983 gonorrhea patients for sexual partner information. We grouped patients according to sex and clinical findings and evaluated the percentage of all new cases identified by time intervals within the expanded interview period. Ninety-one per cent of all untreated, infected sexual partners of symptomatic males were identified by using an interview period which spanned the interval from date of treatment to 15 days before symptom onset. In contrast, the traditional 30-day interview period missed 23 per cent of those untreated, infected partners named by women with pelvic inflammatory disease (PID), 34 per cent of those partners named by women with uncomplicated gonorrhea, and 29 per cent of those named by asymptomatic men. The Polk County data suggest the importance of basing interview periods upon a patient's sex and clinical presentation.
Coffee consumption during pregnancy and selected congenital malformations: a nationwide case-control study.
Authors: Kurppa K , Holmberg P C , Kuosma E , Saxén L
Published: November 2008

Finland leads the world in per capita coffee consumption. To evaluate the hypothesis that coffee consumption during pregnancy is teratogenic, 755 pairs of mothers of malformed children and their controls were personally interviewed soon after delivery. After excluding tea drinkers and pairs with inadequate information, the study group included 706 pairs. Study subjects consisted of mothers of children with 112 defects of the central nervous system, 241 orofacial clefts, 210 structural defects of the skeleton, and 143 cardiovascular malformations. The coffee consumption during pregnancy was similar for the mothers of malformed or non-malformed children. The comparison of the mothers drinking at least four cups of coffee a day during pregnancy with those not consuming coffee at all showed a relative risk point estimate of 1.0 with the 95 per cent confidence limits of 0.7 and 1.3.
Patterns in hospitals' use of a regional poison information center.
Authors: Chafee-Bahamon C , Caplan D L , Lovejoy F H
Published: November 2008

A statewide poison center undertook a study to identify types of hospitals which used its information services. Initial trends in calls from hospitals to the center over the center's first two years and percentages of hospitals' patient caseloads for which the center consulted were analyzed for 104 acute care hospitals by hospitals' location, size, and emergency room staffing. After the center's establishment as a regional resource, emergency room staff in urban teaching hospitals showed the greatest increase in calls within a year (88 per cent) and the highest consultation rates for poison patients seen (57 per cent). Private physician emergency room staff, and staff in distant and rural hospitals, showed lower or no increases in calls and lower consultation rates. Findings suggest that private physician emergency room staff and staff in distant and rural hospitals be considered for poison center outreach. Marketing of consultation services for non-pediatric overdoses is also indicated.
An evaluation of subsidized rural primary care programs: II. The environmental contexts.
Authors: Ricketts T C , Konrad T R , Wagner E H
Published: November 2008

The placement of subsidized primary care programs in rural communities has been an important aspect of national health policy over the last decade. Using survey and secondary data from programs in over 700 counties in the United States, it was found that while about one-fourth of all counties with some rural populations have been affected by these programs, certain environmental factors are associated with more or less likelihood of placement. High levels of need and low levels of health care resources are positively associated with the presence of a program. States with health policy climates supportive of reimbursement and broader staffing of primary care programs also contained programs in a higher proportion of their rural counties. The effects of decreased federal funding, increased state responsibility, and the precarious market conditions for primary care programs are discussed with emphasis on the mechanisms for developing favorable climates for these programs.
Household size and the cost of nutritionally equivalent diets.
Authors: Morgan K J , Johnson S R , Burt J
Published: November 2008

Economy of scale factors were developed in 1975 and have since been utilized as household size adjustment factors in estimating household costs of US Department of Agriculture (USDA) food plans. As such, these adjustment factors have a direct impact on the Food Stamp Program coupon allotments. In the present study, the stability of these factors over time was assessed, and the impact of diet quality measures in determining the adjustment factors was investigated. The reported household scale factors, estimated using regression analyses and the Nationwide Food Consumption Survey, Survey of Food Consumption in Low-Income Households, 1977-78, varied somewhat from former estimates and were found to be highly dependent on the diet quality measures incorporated in the analysis. Incorporation of several diet quality variables as well as partition specific means are recommended for determining household size adjustment factors to be used in estimating household costs of USDA food plans.
Severe local reactions to live measles virus vaccine following an immunization program.
Authors: Stetler H C , Gens R D , Seastrom G R
Published: November 2008

A cluster of nine severe local reactions occurred in a Pennsylvania school district following a mass measles immunization program in February 1981. A case-control study showed that the nine cases had a statistically significant increased history of having received killed measles vaccine previously (p less than .001, Fisher's exact test) and a statistically significant higher geometric mean measles antibody titer (p less than .01, Student's t test) than controls, suggesting that previous receipt of killed measles vaccine was the underlying cause of these reactions.
Fluoride analyses of patient water supplies requested by North Carolina health professionals.
Authors: Levy S M , Bawden J W , Bowden B S , Rozier R G
Published: November 2008

The frequencies, patterns, and results of 1,900 patient drinking water assays for fluoride content requested in a six-month period by North Carolina health professionals were determined. Twelve per cent of the samples warranted adjustment from the full dosage fluoride supplement. Less than 3 per cent of physicians and 8 per cent of dentists submitted samples. Water supplies should be tested before a systemic fluoride supplement is prescribed. Either few dentists and physicians in North Carolina test water before prescribing supplements or few prescribe them at all.
Firearms and suicide in the United States.
Authors: Markush R E , Bartolucci A A
Published: November 2008

Regional United States suicide rates in the mid 1970s were associated with the household prevalence of all guns and of pistols. The term "regional" applies to the nine Census divisions of the four US census regions. A literature review suggests that the relation may be etiologic, and that more definitive studies and pilot programs are needed. Arming may be an etiologic factor common both to individual and to national self-destructive behaviors.
Health status of survivors of out-of-hospital cardiac arrest six months later.
Authors: Bergner L , Bergner M , Hallstrom A P , Eisenberg M , Cobb L A
Published: November 2008

The health status of long-term survivors of out-of-hospital cardiac arrest was studied six months after the event. Although Sickness Impact Profile scores for arrest survivors were higher (worse) than scores of enrollees in a prepaid closed panel health plan, in most cases problems of survivors were not incapacitating. Approximately three-fifths of survivors reported same or better memory function and stair climbing ability compared to that at time of arrest. Three-fifths of those who had been working continued to do so.
Consumption of 'low-yield' cigarettes: its frequency and relationship to serum thiocyanate.
Authors: Folsom A R , Pechacek T F , de Gaudemaris R , Luepker R V , Jacobs D R , Gillum R F
Published: November 2008

To determine the use and possible health risks of low-yield cigarettes, we ascertained the cigarette brands and serum thiocyanate (SCN) levels of 2,561 adult smokers (age 25-74) in population-based samples of seven upper Midwestern communities during 1980-82. Brands were coded according to December 1981 Federal Trade Commission (FTC) ratings for "tar", nicotine, and carbon monoxide (CO). Compared to 1980 data from the National Center for Health Statistics for the United States as a whole, a greater proportion of smokers in these communities smoked low-yield brands. More people with higher education than lesser and more women than men smoked low-yield cigarettes. Greater proportions of older people (65-75 years) than younger people (less than 65 years) smoked cigarettes in the highest and lowest brand yield categories. SCN, adjusted for number of cigarettes smoked and for sex, was only weakly associated with brand ratings for "tar" (r = +.12), nicotine (R = +.11), and CO (r = +.15). Furthermore, the gradient in SCN between lowest and highest quintiles of brand strength was less than 16 per cent--much lower than the 300-500 per cent gradient in smoke components implied by FTC ratings. These data add to the evidence that smoking low-yield cigarettes may not be significantly less hazardous than smoking high-yield brands.