bluuebunny/crossref_metadata_2025 huggingface dataset:
Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).
Authors: Karasek R A , Theorell T , Schwartz J E , Schnall P L , Pieper C F , Michela J L
Published: November 2008

Associations between psychosocial job characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used which imputes to census occupation codes, job characteristic information from national surveys of job characteristics (US Department of Labor, Quality of Employment Surveys). Controlling for age, we find that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load (a multiplicative product term isolating 20 per cent of the population) have a higher prevalence of myocardial infarction in both data bases. In a logistic regression analysis, using job measures adjusted for demographic factors and controlling for age, race, education, systolic blood pressure, serum cholesterol, smoking (HANES only), and physical exertion, we find a low decision latitude/high psychological demand multiplicative product term associated with MI in both data bases. Additional multiple logistic regressions show that low decision latitude is associated with increased prevalence of MI in both the HES and the HANES. Psychological workload and physical exertion are significant only in the HANES.
Teenage fathers and the fathers of infants of urban, teenage mothers.
Authors: Hardy J B , Duggan A K
Published: November 2008

Data from Certificates of Live Birth, for recorded resident births in Baltimore in 1983, were used to describe fathers whose child was born to a teenage mother. Four groups were identified: 1) both father and mother were teenagers (12 per cent); 2) only the mother was a teenager (14 per cent); 3) only the father was a teenager (2 per cent); 4) both parents were aged 20 years of above (72 per cent). The fathers in the first three groups appeared at serious educational and financial disadvantage as compared with those where neither parent was a teenager. Within the teenage parent groups, White fathers had lower educational attainment than Black; one in four White fathers was married vs less than 5 per cent of Black. Although limited in scope, the data indicate that disadvantages associated with being a teenage father or the father of an infant born by a teenage mother are clear cut.
Children of migrant farm work families are at high risk for maltreatment: New York State study.
Authors: Alvarez W F , Doris J , Larson O
Published: November 2008

Utilizing a crosstabulation between data collected by the Migrant Student Records Transfer System and the New York State Central Register, it was determined that 298 of the 7,408 migrant children, age 18 years or younger, censused in 1982 were on file as having been maltreated in 1982. This rate, 40.2 per 1,000, is substantially higher than the rate found for upstate New York children (5.5). Maltreatment rates also varied by migrant status and household composition.
Medical costs of ambulatory patients with AIDS-related complex (ARC) and/or generalized lymphadenopathy syndrome (GLS) related to HIV infection, 1984-85.
Authors: Seage G R , Landers S , Mayer K H , Barry M A , Lamb G A , Epstein A M
Published: November 2008

A cost-of-illness study July 1, 1984-June 30, 1985 evaluating 28 patients with AIDS-Related Complex (ARC) and/or Generalized Lymphadenopathy Syndrome (GLS) found the average cost to be $489 per patient per year. None of the ARC or GLS patients in our study was hospitalized during the one year period, and none progressed to AIDS. No AIDS-specific treatment such as AZT was available at the time this study was completed.
Indoor air pollution of coal fumes as a risk factor of stroke, Shanghai.
Authors: Zhang Z F , Yu S Z , Zhou G D
Published: November 2008

A cohort of 957 male persons in Shanghai has been followed up for 12 years after they entered a screening program for coronary heart disease and stroke. During the period of study, 24 of the subjects who had no previous history of heart disease and stroke died from stroke. Risk factors for stroke were analyzed by the Cox proportional hazards model. Coal fumes were found to be an independent risk factor for stroke in addition to diastolic blood pressure, age, and cigarette smoking.
Parent involvement with children's health promotion: the Minnesota Home Team.
Authors: Perry C L , Luepker R V , Murray D M , Kurth C , Mullis R , Crockett S , Jacobs D R
Published: November 2008

This study compares the efficacy of a school-based program to an equivalent home-based program with 2,250 third grade students in 31 urban schools in Minnesota in order to detect changes in dietary fat and sodium consumption. The school-based program, Hearty Heart and Friends, involved 15 sessions over five weeks in the third grade classrooms. The home-based program, the Home Team, involved a five-week correspondence course with the third graders, where parental involvement was necessary in order to complete the activities. Outcome measures included anthropometric, psychosocial and behavioral assessments at school, and dietary recall, food shelf inventories, and urinary sodium data collected in the students' homes. Participation rates for all aspects of the study were notably high. Eighty-six per cent of the parents participated in the Home Team and 71 per cent (nearly 1,000 families) completed the five-week course. Students in the school-based program had gained more knowledge at posttest than students in the home-based program or controls. Students in the home-based program, however, reported more behavior change, had reduced the total fat, saturated fat, and monounsaturated fat in their diets, and had more of the encouraged foods on their food shelves. The data converge to suggest the feasibility and importance of parental involvement for health behavior changes with children of this age.
Association of electronic fetal monitoring during labor with cesarean section rate and with neonatal morbidity and mortality.
Authors: McCusker J , Harris D R , Hosmer D W
Published: November 2008

Data from the 1980 National Natality Survey by the National Center for Health Statistics were used to assess the relation of electronic fetal monitoring (EFM) during labor with cesarean section rates and neonatal morbidity and mortality. In univariate analyses, EFM was associated with higher cesarean section rates, lower five-minute Apgar scores, and a higher rate of respiratory distress. Logistic regression analysis controlling for other risk factors for poor neonatal outcome indicated that the association of EFM with higher cesarean section rates persisted (odds ratio 1.45, 95% CI 1.16, 1.81), except in certain pregnancies at very high risk for cesarean section. EFM was associated with an Apgar score less than 6 at five minutes only if delivery was by cesarean section. EFM was not found to be independently associated with respiratory distress. Neither univariate nor multivariate analyses found an association of EFM with neonatal mortality. These results suggest that EFM may identify hypoxic infants, who are frequently delivered by cesarean section. The lack of association of EFM with beneficial neonatal outcomes is consistent either with lack of effect of EFM or with uncontrolled selection bias.
Acculturation and alcohol consumption among Mexican Americans: a three-generation study.
Authors: Markides K S , Krause N , Mendes de Leon C F
Published: November 2008

Data from a three-generation study of Mexican Americans conducted in the San Antonio, Texas area are utilized to examine the influence of acculturation into the larger society on alcohol consumption. Acculturation was not related to alcohol consumption in the older generation. In the middle generation, it was related to lower alcohol consumption among men, as well as among women. In the younger generation, acculturation was related to more drinking among women, but not among men. Within-family analysis showed that the alcohol consumption of members of the younger generation was associated with the consumption of their parents, particularly in the case of younger women.
Mortality from lung cancer and chronic obstructive pulmonary disease in New Mexico, 1958-82.
Authors: Samet J M , Wiggins C L , Key C R , Becker T M
Published: November 2008

We examined mortality from lung cancer and from chronic obstructive pulmonary disease in Hispanic White, Other White, and Native American residents of New Mexico during the period 1958-82. Age-specific mortality was calculated by combining death certificate data with population estimates based on the 1960, 1970, and 1980 censuses that were adjusted for inconsistencies in the designation of race and ethnicity. In Other Whites, age-adjusted mortality rates from lung cancer and from chronic obstructive pulmonary disease increased progressively in males and females. Mortality rates for both diseases also increased in Hispanics during the study period, but the most recent rates for Hispanics were well below those for Other Whites. Age-specific mortality rates for lung cancer declined for more recently born Hispanic women at older ages. In Native Americans, rates for both diseases were low throughout the study period and did not show consistent temporal trends.
Setting AIDS priorities: the need for a closer alliance of public health and clinical approaches toward the control of AIDS.
Authors: Henry K
Published: November 2008

The approach to the acquired immune deficiency syndrome (AIDS) taken by public health departments and clinicians varies. Public health programs often neglect the human side of AIDS while clinicians often overlook public health issues. Current research on AIDS has failed to address many fundamental questions including: the biology of the human immunodeficiency virus (HIV) in semen; whether present antiretroviral therapy has any effect on sexual infectivity; and whether adequate counseling was given to persons in HIV discordant partner studies. These unanswered basic questions highlight how research efforts framed from clinical, basic science, or public health viewpoints may have too narrow a focus. Three suggestions are made: 1) additional studies about the biology of HIV in the genital tract need to be conducted; 2) clinical trials studying drug therapy of HIV infection need to assess effect on HIV in the genital tract; 3) clinicians involved in studies and care of HIV infection need to implement educational strategies minimizing transmission of HIV from their patients. More interaction between public health and clinical approaches toward AIDS is needed.
Laboratory-acquired infections and injuries in clinical laboratories: a 1986 survey.
Authors: Vesley D , Hartmann H M
Published: November 2008

A mail survey of all 54 US State and Territorial Public Health Laboratories and the 165 Hospital Clinical Laboratories in Minnesota was carried out, soliciting information on laboratory-acquired infections and injuries for calendar year 1986. The aggregate infection incidence rates were 3.5/1,000 full-time equivalent (FTE) workers for hospital laboratories and 1.43/1,000 for public health laboratories. Injury rates were 21.2/100 FTE workers for hospital laboratories and 7.21/100 for public health labs.
National trends in coverage and utilization of mental health, alcohol, and substance abuse services within managed health care systems.
Authors: Levin B L , Glasser J H , Jaffee C L
Published: November 2008

This study reports the results of a 1986 national survey of mental health, alcohol, and substance abuse services within health maintenance organizations in the United States. Ninety-seven percent of responding health maintenance organizations (HMOs) offered mental health service coverage and two-thirds of responding HMOs offered alcohol and substance abuse service coverage. Annual mean mental health hospitalization was 36.90 days per 1,000 members and annual mean ambulatory mental health utilization was 0.29 physician encounters per member.
Patient characteristics and eligibility in a Veterans Administration ambulatory care triage clinic.
Authors: Feussner J R , McFall S L , Cockrell W E
Published: November 2008

We surveyed 5,225 consecutive patients presenting to a Veterans Administration (VA) Ambulatory Care Triage Clinic to ascertain the characteristics of patients and to assess the role of eligibility in determining disposition from triage. Most patients (66 per cent) had non-service connected (low eligibility) conditions and had no health insurance (64 per cent). Lack of service connected priority (high eligibility) did not influence access to hospitalization (8.3 per cent) or longitudinal outpatient care (24.5 per cent). The study suggests that veterans with no health insurance, with low eligibility for VA service, use the VA triage clinic for episodic medical care.
Resistance to sexual assault: who resists and what happens?
Authors: Siegel J M , Sorenson S B , Golding J M , Burnam M A , Stein J A
Published: November 2008

To determine who resists sexual assault and what happens, data were examined from a probability sample of 3,132 adult community residents of Los Angeles, California. Seventy-five per cent of the respondents reporting an assault (n = 365) indicated that they had attempted to resist their most recent assault; talking was the most frequently used resistance strategy. The strongest predictor to emerge in the multivariate analyses of resistance was timing of assault: respondents assaulted only in childhood were less likely to resist than either respondents assaulted only in adulthood, or respondents assaulted in both phases. Univariate analyses indicated that resistance reduced the probability of sexual contact, however multivariate analyses suggested that assailant use of force was the most important determinant of assault outcome.
Breastfeeding trends in the Philippines, 1973 and 1983.
Authors: Popkin B M , Akin J S , Flieger W , Wong E L
Published: November 2008

This paper examines comparable national surveys of breastfeeding from the Philippines carried out in 1973 and 1983. The probability of breastfeeding at selected infant ages is estimated, using the weighted life table. The conclusions are that a 5 per cent decline in the proportion of infants ever breast-fed occurred during the referenced period, and that median length of breastfeeding remained essentially the same.
Cryptosporidiosis and surface water.
Authors: Gallaher M M , Herndon J L , Nims L J , Sterling C R , Grabowski D J , Hull H F
Published: November 2008

In the period July through October, 1986, 78 laboratory-confirmed cases of cryptosporidiosis were identified in New Mexico. To determine possible risk factors for development of this disease, we conducted a case-control study; 24 case-patients and 46 neighborhood controls were interviewed. Seventeen (71 per cent) of the 24 case-patients were females, seven (29%) were males; their ages ranged from 4 months to 44 years, median 3 years. There was a strong association between drinking surface water and illness: five of the 24 case-patients, but none of the 46 controls drank untreated surface water. Among children, illness was also associated with attending a day care center where other children were ill (odds ratio = 13.1).
A prospective follow-up study of cancer mortality in relation to serum DDT.
Authors: Austin H , Keil J E , Cole P
Published: November 2008

Serum DDT and DDE levels were measured in 919 subjects in 1974 and 1975. Two-hundred and nine of the subjects died, including 54 from cancer, during a 10-year prospective follow-up period. There was no relation between either overall mortality or cancer mortality and increasing serum DDT levels. There was weak evidence of a positive relation between respiratory cancer mortality and serum DDT. The literature on DDT and human cancer is reviewed, and it is concluded that the evidence does not support the opinion that DDT is a human carcinogen.
A birth cohort analysis of dental contact among elderly Americans.
Authors: Wolinsky F D , Arnold C L
Published: November 2008

We applied standard cohort and multiple regression techniques to data on the dental utilization rates of 129,191 elderly individuals taken from the 1972, 1973, 1976, 1977, 1980, and 1981 Health Interview Surveys. The results indicate that the marked variation in dental contact rates is a reflection of cohort succession, and not a function of aging per se. Older cohorts having lower dental contact rates are being replaced by younger cohorts having higher dental contact rates. The dental contact rates of the individual birth cohorts themselves are quite stable over time. The results also indicate that economic barriers (especially liquid assets) have become more important than ever before, especially for the oldest-old. These findings have important implications for public policy about the oral health and health care of elderly Americans.
A study of battered women presenting in an emergency department.
Authors: McLeer S V , Anwar R
Published: November 2008

Medical records of female trauma patients were retrospectively reviewed prior to introducing a protocol for enhancing identification of battered women; 5.6 per cent of 359 female trauma patients were identified as having injuries caused by battering; 30 per cent of 412 patients following use of the protocol were so identified. Standardized protocols for identifying battered women among female trauma patients should be instituted in emergency departments.
Differences in the timeliness of diagnosis, breast and cervical cancer, San Francisco 1974-85.
Authors: Saunders L D
Published: November 2008

Cancer registry data for San Francisco (1974-85) were used to identify women at greater risk of late diagnoses for breast and cervical cancers by age and ethnicity. For breast cancer, Black women were at greater risk for late diagnoses. For cervical cancer, women of all ethnic groups ages 50-69 years and Japanese and Filipino women were at greater risk for late diagnoses.
Records, recall loss, and recall bias in pregnancy: a comparison of interview and medical records data of pregnant and postnatal women.
Authors: Bryant H E , Visser N , Love E J
Published: November 2008

To determine the agreement between interview-based and medical records data concerning illnesses and medications early in pregnancy, we compared the interviews of 202 women with the ongoing records collected during their pregnancies. Substantial underrecording of most transient illnesses was found. Fewer short-term illnesses were reported by postpartum women than sill-pregnant women, suggesting the potential for recall bias or loss.
HIV seroprevalence in intravenous drug users: Los Angeles, California, 1986.
Authors: Mascola L , Lieb L , Iwakoshi K A , McAllister D , Siminowski T , Giles M , Run G , Fannin S L , Strantz I H
Published: November 2008

To estimate the seroprevalence and investigate risk behaviors for HIV (human immunodeficiency virus) infection in intravenous drug users in Los Angeles County, a stratified, random sample of 790 clients, enrolled in either methadone maintenance or detoxification programs, were studied. Thirteen study participants (1.8 per cent) were seropositive; of these, five were homosexual/bisexual males and three were female prostitutes. Ninety-five per cent of all participants reported sharing needles. Risk reduction education efforts must be expanded before the HIV antibody prevalence rate increases.
An outbreak of syphilis on an Indian reservation: descriptive epidemiology and disease-control measures.
Authors: Gerber A R , King L C , Dunleavy G J , Novick L F
Published: November 2008

From January 1983 through January 1985, 88 cases of early adult syphilis and five cases of congenital syphilis were identified among residents of a southwestern Indian reservation. The male-to-female ratio of primary and secondary syphilis cases was 1.7: 1; over 90 per cent of women were of childbearing age. Using community health workers to determine the social circles of infected persons was effective in identifying persons at risk; treatment of partners of infected persons prior to development of seroreactivity contributed to the successful control of this outbreak.
Innovations in health care: antisepsis as a case study.
Authors: Larson E
Published: November 2008

An innovation often occurs in several arenas almost simultaneously, after being preceded by a long preparatory period when information and experience are accrued to the point at which opinion is influenced to change. Nevertheless, the introduction of an innovation is usually accompanied by resistance and hostility. This article traces the development of the concept and practice of antisepsis in health care, with emphasis on the contributions of three individuals who were contemporaries practicing in different health care fields, but who apparently were uninfluenced by each others' work. Semmelweis, a Hungarian obstetrician, recognized the importance of person-to-person transmission of infectious agents and effected dramatic reductions in puerperal mortality by requiring antiseptic handwashing. Lister, a Scottish surgeon, was the first physician to apply the germ theory to clinical practice and developed the techniques of antiseptic surgery and wound care, resulting in dramatic reductions in surgical mortality. Nightingale, a British nurse, initiated sanitary reforms in hospitals, schools, and military camps in England and abroad, incorporating high levels of environmental and personal hygiene. These reforms were also succeeded by dramatic reductions in mortality. In light of historical and current evidence of efficacy and the evidence of continued inadequacies in practice, it seems reasonable to speculate that further reductions in nosocomial infection rates are possible by a more careful application among individual practitioners of the basic principles of antisepsis.
Determinants of polychlorinated biphenyls (PCBs), polybrominated biphenyls (PBBs), and dichlorodiphenyl trichloroethane (DDT) levels in the sera of young children.
Authors: Jacobson J L , Humphrey H E , Jacobson S W , Schantz S L , Mullin M D , Welch R
Published: November 2008

Serum samples from 285 4-year-old Michigan children were evaluated for levels of 11 environmental contaminants. Polychlorinated biphenyls (PCBs) were found in half the samples tested; polybrominated biphenyls (PBBs) in 13-21 percent; dichlorodiphenyl trichloroethane (DDT), in more than 70 percent. Nursing (Mothers' milk) was the principal source of these exposures. Congener-specific analysis documented the presence of at least one highly toxic PCB congener, 2,3',4,4',5-pentachlorobiphenyl. The data demonstrate the multigenerational impact of female exposure to persistent organic environmental contaminants.
Cigarette and smokeless tobacco use among Connecticut adolescents.
Authors: Kegeles S S , Burleson J A , Miozza J
Published: November 2008

Despite data that the rate of boys' cigarette use has declined nationwide, boys' total tobacco use may actually have remained high because of their substantial use of smokeless tobacco. We surveyed anonymously a random sample of entire classes of grade 7-12 boys and girls from 59 Connecticut towns concerning tobacco use. Despite girls' higher daily cigarette use, boys' total daily tobacco use was higher than that of girls in grades 7-9, and only slightly lower in grades 10-12.
The news on smoking: newspaper coverage of smoking and health in Australia, 1987-88.
Authors: Chapman S
Published: November 2008

All newspaper articles (n = 1601) mentioning tobacco or smoking drawn from a 12-month census of 30 Australian capital city newspapers in 1987-88 were coded for content, "slant," and apparent origin. Overall, 62 percent of articles were positive in their orientation toward smoking control objectives, 17 percent were negative, and 21 percent were neutral. Newspapers owned by Rupert Murdoch published 55.7 percent positive and 23.7 percent negative articles compared to 68.0 percent positive and 13.7 percent negative articles in the other large chain of Australian newspapers.
Human cryptosporidiosis associated with an epizootic in calves.
Authors: Reif J S , Wimmer L , Smith J A , Dargatz D A , Cheney J M
Published: November 2008

An outbreak of human cryptosporidiosis occurred among previously healthy persons in a veterinary medical teaching hospital. Human illness began after admission of calves from a farm which had been experiencing an epizootic of neonatal diarrhea due to Cryptosporidium. The clinical syndrome in humans was characterized by watery diarrhea, abdominal cramping, flatulence, and headache. Cryptosporidiosis was confirmed by zinc sulfate flotation of fecal specimens in four persons, three of whom had been responsible for the care and treatment of infected calves. A fourth patient had washed her husband's soiled clothing and appeared to have been infected indirectly through fomite contamination. Among 112 persons surveyed, 26 (23.2 percent) had a diarrheal illness during the outbreak and nine met the case definition of a diarrheal illness lasting at least three days. These persons were more likely to have had contact with a calf with diarrhea than were 52 referents who did not become ill during the outbreak.
A microcomputer-based vital records data base with interactive graphic assessment for states and localities.
Authors: Wartenberg D , Agamennone V J , Ozonoff D , Berry R J
Published: November 2008

Vital records data bases describe large populations over long periods of time, yet their organization and size often preclude or discourage their use. We constructed a microcomputer-based data base of all singleton births in Massachusetts, 1975-84. The original data were stored in 700,000 records, each 174 bytes long, occupying a total of over 120 megabytes (MB). By removing redundant information and unique identifiers, and packing the data, we store 21 fields of this information in a 16-byte record resulting in a data base of 11.1 MB, a saving of over 90 percent of disk space. By using programs written expressly for this data base, we can display a birth weight frequency plot of the entire data set in under 65 seconds on an IBM-compatible PC-AT. Comparable assessments in SAS-PC took over 105 minutes and in main frame SAS on an AS-9000 took over 37 CPU seconds. Implementing similar systems for state registries on births, deaths, cancers, and birth defects potentially offers investigators easy access to vast stores of information and would enable public health officials to produce timely reports, initiate a variety of surveillance activities, and respond rapidly to residents' inquiries about clusters and anomalous disease patterns.
Factors affecting place of death of hospice and non-hospice cancer patients.
Authors: Moinpour C M , Polissar L
Published: November 2008

We identified factors associated with death at home for 28,828 hospice and non-hospice cancer patients in 13 counties of western Washington State. Hospice participation was found to be the variable most strongly associated with death at home. Admission to hospice appears to override the tendency for certain subgroups of patients, such as the extreme elderly and those diagnosed close to death, to die in an institutional setting. These findings are discussed with respect to the problem of selection bias.
Self-report and medical record report agreement of selected medical conditions in the elderly.
Authors: Bush T L , Miller S R , Golden A L , Hale W E
Published: November 2008

This study assessed agreement between self- and medical record report of medical conditions in an elderly population. Medical charts of 120 participants in a screening program were abstracted, and the questionnaire report of eight major conditions was compared with the medical record. There was substantial or moderate agreement between self-report and medical record report for each condition, although strength of agreement varied by condition. Self-report by elderly individuals compares favorably with medical record report of medical conditions.
Acute illnesses among Los Angeles County lifeguards according to worksite exposures.
Authors: Sullivan C S , Barron M E
Published: November 2008

Due to public concern regarding the potential adverse health effects of exposure to Santa Monica Bay waters, a case-control study of acute illnesses among Los Angeles County lifeguards was conducted. Workers' compensation claimants (N = 112) were matched to healthy lifeguards working in the same year and having the same job classification. Conditional logistic regression showed that the southernmost worksites of the bay were associated with all acute illnesses (OR = 14.4, 95% CI = 4.7, 44.8) and with ear infections (OR = 12.5, 95% CI = 2.9, 53.4).
Declining rates of amebiasis in Los Angeles County: a sentinel for decreasing acquired immunodeficiency syndrome (AIDS) incidence?
Authors: Sorvillo F J , Lieb L , Mascola L , Waterman S H
Published: November 2008

In Los Angeles County from 1983-1988, rates of amebiasis declined 65 percent among White males 15-44 years. No such decline occurred among White females 15-44 years or White males less than 15. Reported acquired immunodeficiency syndrome (AIDS) cases in the district of highest AIDS incidence has followed the initial decline in amebiasis by four years. Amebiasis trends may be a useful predictor of human immunodeficiency virus (HIV) transmission and future rates of AIDS among gay men.
Effects of the antismoking campaign: an update.
Authors: Warner K E
Published: November 2008

In the absence of the antismoking campaign, adult per capita cigarette consumption in 1987 would have been an estimated 79-89 per cent higher than the level actually experienced. The smoking prevalence of all birth cohorts of men and women born during this century is well below that which would have been expected in the absence of the campaign. As a consequence, in 1985 an estimated 56 million Americans were smokers; without the campaign, an estimated 91 million would have been smokers. As a result of campaign-induced decisions not to smoke, between 1964 and 1985 an estimated 789,200 Americans avoided or postponed smoking-related deaths and gained an average of 21 additional years of life expectancy each; collectively this represents more than 16 million person-years of additional life. The greatest health benefit lies in the future, however, as younger individuals reach the ages at which smoking claims its greatest toll, and as middle-aged former smokers realize relative reductions in smoking mortality risks as a result of long-term abstinence from smoking. For example, campaign-induced decisions not to smoke made prior to 1986 will result in the postponement or avoidance of an estimated 2.1 million smoking-related deaths between 1986 and the year 2000.
Parental smoking and post-infancy wheezing in children: a prospective cohort study.
Authors: Neuspiel D R , Rush D , Butler N R , Golding J , Bijur P E , Kurzon M
Published: November 2008

The contribution of parental smoking to wheezing in children was studied in a subset of all British births between April 5 and 11, 1970 (N = 9,670). Children of smoking mothers had an 18.0 per cent cumulative incidence of post-infancy wheezing through 10 years of age, compared with 16.2 per cent among children of nonsmoking mothers (risk ratio 1.11, 95% CI: 1.02, 1.21). This difference was confined to wheezing attributed to wheezy bronchitis, of which children of smokers had 7.4 per cent, and those of nonsmokers had 5.2 per cent (risk ratio 1.44, 95% CI: 1.24, 1.68). The incidence of wheezy bronchitis increased as mothers smoked more cigarettes. After multiple logistic regression analysis was used to control for paternal smoking, social status, sex, family allergy, crowding, breast-feeding, gas cooking and heating, and bedroom dampness, the association of maternal smoking with childhood wheezy bronchitis persisted. Some of this effect was explained by maternal respiratory symptoms and maternal depression, but not by neonatal problems, the child's allergic symptoms, or paternal respiratory symptoms. There was a 14 per cent increase in childhood wheezy bronchitis when mothers smoked over four cigarettes per day, and a 49 per cent increase when mothers smoked over 14 cigarettes daily.
A survey of smoking and quitting patterns among black Americans.
Authors: Orleans C T , Schoenbach V J , Salmon M A , Strecher V J , Kalsbeek W , Quade D , Brooks E F , Konrad T R , Blackmon C , Watts C D
Published: November 2008

A sample of adult Black policyholders of the nation's largest Black-owned life insurance company was surveyed in 1986 to add to limited data on smoking and quitting patterns among Black Americans, and to provide direction for cessation initiatives targeted to Black smokers. Forty per cent of 2,958 age-eligible policyholders for whom current addresses were available returned a completed questionnaire. Population estimates for smoking status agree closely with national estimates for Blacks age 21-60 years: 50 per cent never-smokers; 36 per cent current smokers; 14 per cent ex-smokers. Current and ex-smokers reported a modal low-rate/high nicotine menthol smoking pattern. Current smokers reported a mean of 3.8 serious quit attempts, a strong desire and intention to quit smoking, and limited past use of effective quit smoking treatments and self-help resources. Correlates of motivation to quit smoking were similar to those found among smokers in the general population, including smoking-related illnesses and medical advice to quit smoking, previous quit attempts, beliefs in smoking-related health harms/quitting benefits, and expected social support for quitting. Methodological limitations and implications for the design of needed Black-focused quit smoking initiatives are discussed.
Compensation as a risk factor for lung cancer in smokers who switch from nonfilter to filter cigarettes.
Authors: Augustine A , Harris R E , Wynder E L
Published: November 2008

The likelihood of increasing the number of cigarettes per day (cpd), a common method of compensation, in smokers switching from nonfilter to filter cigarettes, was examined in newly diagnosed and histologically confirmed lung cancer cases including all cell types; 1,242 lung cancer cases and 2,300 sex and age matched hospital controls were interviewed in 20 hospitals from nine United States cities between 1969 and 1984. The mean increase in cpd for lung cancer cases was about twice that of controls. Using switchers who did not increase cpd as the referent group, there was a linear dose-response relationship between the odds of lung cancer and increasing level of compensation. The odds ratio increased from 1.19 to 2.37 in males and from 1.66 to 3.83 in females corresponding to increases of 1-10 to 21+ cpd after switching. Findings from this study suggest that increasing cpd after switching to filter cigarettes is an important risk factor for lung cancer that needs to be emphasized in epidemiologic studies. Proponents of the idea that switching cigarettes is of some benefit, should also advocate that individuals who continue smoking should avoid compensation after switching.
A comparative evaluation of a restrictive smoking policy in a general hospital.
Authors: Biener L , Abrams D B , Follick M J , Dean L
Published: November 2008

The impact of a restrictive smoking policy on the behavior and attitudes of smokers and non-smokers was assessed by surveying random cross-sectional samples of hospital employees before, six months after and 12 months after the policy was implemented, and comparing responses with those of employees of a hospital with no restrictive policy. Effectiveness of policy implementation was also evaluated. Results indicated that the policy was well-publicized and was approved by virtually all the non-smokers and the majority of the smokers. Following implementation, employees in the smoking policy hospital were less likely to report being bothered by smoke at their work stations than were employees of the comparison hospital. Six months and one year after the policy change, smokers reported lower smoking rates while at work, although quit smoking rates and home smoking rates were similar in both hospitals.
Evidence for limits on the acceptability of lowest-tar cigarettes.
Authors: Kozlowski L T
Published: November 2008

The sales of the lowest yield cigarettes (1-3 mg tar) seem to have been particularly resistant to the effects of promotion and advertising, while the sales of other low-yield cigarettes (4-9 mg tar) seem to have been increased by promotional efforts. This finding is consistent with the existence of a boundary of tar and nicotine acceptability below which consumers in general are not prepared to go. Use of lower tar cigarettes may be helpful for those who cannot stop smoking, but, since 1979, the percentage of cigarettes under 16 mg tar has changed little.
Determinants of recovery 12 months after hip fracture: the importance of psychosocial factors.
Authors: Mossey J M , Mutran E , Knott K , Craik R
Published: November 2008

The independent contributions to recovery from hip fracture of psychosocial factors including depression, personality, social connectedness, and self-rated health were studied in 219 women age 59 and older (mean age 78.5) who were community dwelling prior to fracture. Initial assessments were conducted shortly after surgery and follow up assessments 2, 6, and 12 months later. By 12 months, 15 patients had died and 15 had entered a nursing home. Substantial declines in physical functioning though not psychosocial status were observed. Only 21 per cent (compared to 81 per cent prefracture) reported walking independently; fewer than 30 per cent had regained reported prefracture levels of physical function. The proportion with elevated depression scores at 12 months was 20 per cent, down from 51 per cent following surgery; 64 per cent rated their health excellent or good at 12 months, up from 43 per cent after surgery. Poor cognitive status and post-surgical self-rated health were predictive of mortality. Among survivors, age, prefracture physical functioning, and cognitive status were associated with recovery in physical function but not psychosocial status. High post-surgery depression scores, but not the other psychosocial factors, were associated with poorer recovery in both functional and psychosocial status. These findings demonstrate the importance of depressive symptoms as one determinant of recovery from hip fracture and support the need to attend to the affective status of hip fracture patients following surgery.
Blood alcohol tests, prevalence of involvement, and outcomes following brain injury.
Authors: Kraus J F , Morgenstern H , Fife D , Conroy C , Nourjah P
Published: November 2008

We collected data on all residents of San Diego County, California who were hospitalized for or died from a brain injury in 1981. The objectives were to assess the frequency of blood alcohol concentration (BAC) testing and the associations of BAC prevalence with the external cause of the brain injury and case outcome. We found that high BAC levels were most frequent among brain-injured subjects between the ages of 25 and 44 and among those subjects involved in motor vehicle crashes and assaults. Contrary to expectations, injury severity and hospital mortality were inversely related to BAC level, controlling for other predictors. We believe that these inverse associations might be due to differential rates of BAC testing by severity. Among brain-injured survivors with more severe injuries, however, we found that BAC level was positively associated with the prevalence of physician-diagnosed neurological impairment at discharge and with the length of hospitalization.
Sport fish consumption advisories and projected cancer risks in the Great Lakes basin.
Authors: Foran J A , Cox M , Croxton D
Published: November 2008

Because Great Lakes sport fish are contaminated with several toxicants, the Great Lakes states individually issue advisories, principally based on Food and Drug Administration (FDA) action levels, that suggest limiting or eliminating consumption of contaminated fish. We describe the procedures the states use to determine when to issue consumption advisories and we evaluate the associated cancer risks using EPA-IARC-OSTP risk assessment procedures. Projected cancer risks are high for consumers of small quantities of sport fish contaminated with DDT or dieldrin at their respective action levels. Projected risks at concentrations that are common but below the action levels are also substantial. We propose that sport fish with tissue concentrations of DDT or dieldrin one-fifth and one-third of the action levels should be covered by consumption advisories to warn consumers of the potential adverse health impacts.
Modeling and variable selection in epidemiologic analysis.
Authors: Greenland S
Published: November 2008

This paper provides an overview of problems in multivariate modeling of epidemiologic data, and examines some proposed solutions. Special attention is given to the task of model selection, which involves selection of the model form, selection of the variables to enter the model, and selection of the form of these variables in the model. Several conclusions are drawn, among them: a) model and variable forms should be selected based on regression diagnostic procedures, in addition to goodness-of-fit tests; b) variable-selection algorithms in current packaged programs, such as conventional stepwise regression, can easily lead to invalid estimates and tests of effect; and c) variable selection is better approached by direct estimation of the degree of confounding produced by each variable than by significance-testing algorithms. As a general rule, before using a model to estimate effects, one should evaluate the assumptions implied by the model against both the data and prior information.
Improving the homogeneity of diagnosis-related groups (DRGs) by using clinical laboratory, demographic, and discharge data.
Authors: Goldman E S , Easterling M J , Sheiner L B
Published: November 2008

For 48 of the most common diagnosis-related groups (DRGs) at our hospital, we examined the ability of clinical laboratory tests, demographic data, and ICD-9-CM codes, which provide a measure of severity of illness, to predict patients' length of stay (LOS) more accurately than DRGs alone. For 10 of 20 medical DRGs and 13 of 23 surgical DRGs examined, we were able to increase the ability to predict LOS by at least 10 per cent. The laboratory tests that proved most predictive of LOS over all DRGs were the mean serum sodium, potassium, bicarbonate, and albumin. The system is data driven, objective, and flexible, thus ensuring its utility for the purpose of equitable reimbursement.
Determinants of needle sharing among intravenous drug users.
Authors: Magura S , Grossman J I , Lipton D S , Siddiqi Q , Shapiro J , Marion I , Amann K R
Published: November 2008

Data from 110 IV-drug abusing persons in methadone maintenance were analyzed to determine the correlates of needle sharing. Sharing was directly related to peer group behavior, attitudes conducive to sharing, economic motivation to share, not owning injection equipment, and fatalism about developing AIDS. Sharers were aware of their AIDS risk. Indicated measures to reduce needle sharing would be positive peer support groups to help resist pressures to share, legal and free access to fresh injection equipment, education on the utility of risk reduction, and increased treatment options for IV cocaine users.
Race and the prevalence of syphilis seroreactivity in the United States population: a national sero-epidemiologic study.
Authors: Hahn R A , Magder L S , Aral S O , Johnson R E , Larsen S A
Published: November 2008

We used the 1978 National Health and Nutrition Examination Survey to examine the prevalence of positive syphilis serologies in the US population. Analysis of risk markers--gender, age, marital status, education, income, and residence--indicates that all except gender are associated with syphilis seroreactivity, independent of race. Controlling for associated risk markers, the Black-White odds ratio of syphilis seroreactivity is 4.7 (95% CI = 2.7, 8.2). Current knowledge of racial differences in sexual and health care behavior does not explain the Black-White difference in the prevalence of syphilis seroreactivity.
The role of secondary vaccine failures in measles outbreaks.
Authors: Mathias R G , Meekison W G , Arcand T A , Schechter M T
Published: November 2008

An outbreak of measles in 1985-86 in a community where measles vaccine trials had been carried out from 1974-76 allowed the assessment of the role of secondary vaccine failures in previously immunized children. A total of 188 children from the vaccine trial were followed. Of these, 175 seroconverted initially while 13 (6 per cent) required re-immunization (primary failure). A total of 13 cases of measles, eight of which were laboratory and/or physician-confirmed, were reported in this cohort. Of these, nine cases occurred in the 175 subjects who had hemagglutination inhibition test (HI) and neutralizing antibody responses following the initial immunization. These nine cases represent secondary vaccine failures. An additional four cases occurred in the 13 subjects with primary vaccine failure. We conclude that secondary vaccine failures occur and that while primary failures account for most cases, secondary vaccine failures contribute to the occurrence of measles cases in an epidemic. A booster dose of measles vaccine may be necessary to reduce susceptibility to a sufficiently low level to allow the goal of measles elimination to be achieved.
The provision of services to persons with mental retardation and subsequent infection with human immunodeficiency virus (HIV).
Authors: Kastner T A , Hickman M L , Bellehumeur D
Published: November 2008

We present the first reported cases of individuals with mental retardation who have subsequently become infected with human immunodeficiency virus (HIV). The implications of this finding for agencies which provide services to persons with mental retardation are described. Where conflicts arise, the authors propose that ethical review committees provide consultation to service agencies who must ultimately determine how they will provide for the needs of their clients.
A comparison of gestational age reporting methods based on physician estimate and date of last normal menses from fetal death reports.
Authors: Alexander G R , Petersen D J , Powell-Griner E , Tompkins M E
Published: November 2008

Utilizing 10,587 cases from the 1980 National Center for Health Statistics Fetal Death Statistics File, we examined the comparability of two methods of determining the gestational age of a fetal death, the calculated interval from date of last normal menses (DLNM) and the physician's estimate. The physician estimated gestational age distribution exhibits even number digit preference and a distinct clustering at the 40-week value. The DLNM distribution appears more smoothly distributed but with a more pronounced post-term tail. An exact agreement between the two methods is observed in only 27.9 per cent of the cases. A 1.7 week mean difference between the methods indicates a systematic underestimation by physician reported gestational age when compared to that calculated from the DLNM, potentially biasing gestational age distributions when the physician estimate is substituted for cases with a missing DLNM. Over 8 per cent of cases 20+ weeks by DLNM are estimated as less than 20 weeks by the physician. This underestimation has important implications for the completeness of reporting of fetal deaths on vital records and the comparability of fetal death rates. Further, it may limit investigations of the completeness of reporting of less than 500 gram live births.