bluuebunny/crossref_metadata_2025 huggingface dataset:
Children can't fly: a program to prevent childhood morbidity and mortality from window falls.
Authors: Spiegel C N , Lindaman F C
Published: November 2008

"Children Can't Fly" is a health education program developed by the New York City Department of Health to combat the high incidence of child mortality and morbidity due to falls from windows. The success of the program, begun in 1972, in drastically reducing death and injury persuaded the New York City Board of Health to amend the Health Code in 1976 to require that landlords provide window guards in apartments where children ten years old and younger reside. The law is the first and only one of its kind in the nation. The program has four major components: 1) reporting of falls by hospital emergency rooms and police precincts, followed up by counseling, referral, and data collecting by public health nurses; 2) a media campaign to inform the public and elevate their awareness of the hazards; 3) community education for prevention through door-to-door hazard identification, counseling by outreach workers, community organization efforts with schools, tenant groups, clinics, churches, health care providers, etc; 4) provision of free, easily installed window guards to families with young children living in high-risk areas. Significant reduction in falls resulted, particularly in the Bronx, where reported falls declined 50 percent from 1973 to 1975. The program is one solution to an urgent urban problem which other cities might consider to avert the loss of life and limb, and the corollary financial burden for hospitalization, rehabilitation, and maintenance of the injured and permanently disabled.
Moderate alcohol use during pregnancy and decreased infant birth weight.
Authors: Little R E
Published: November 2008

Maternal alcoholism during pregnancy may result in severe prenatal growth deficiency. In this prospective study, the relationship of moderate maternal alcohol consumption to infant birth weight is explored. Subjects were 263 paying members of a health maintenance organization who delivered single live children. Their alcohol consumption before pregnancy, and in early and late pregnancy, was estimated. In order to control for smoking, which is strongly related to both infant birth weight and maternal alcohol use, the sample was selected so that similar proportions of smokers were represented in both light and heavier drinkers. Multiple linear regression was employed. A regression equation was computed for each of the three periods in which drinking was estimated. Independent variables entered into the equation were maternal age, height, parity, daily cigarettes, alcohol use in the period, and gestational age and sex of child. The regression of birth weight on these variables revealed a significant relationship (p less than or equal to .01) with alcohol consumption in two of the periods. Ingestion of an average of one ounce of absolute alcohol daily before pregnancy was associated with an average decrease in birth weight of 91 grams; the same amount ingested in late pregnancy was associated with a decrease of 160 grams. The associations were independent of the other variables entered into the equation, and in particular, of tobacco use.
Toxocara infection in animal hospital employees.
Authors: Glickman L T , Cypess R H
Published: November 2008

The recent development of a sensitive and specific test (Enzyme-linked immunosorbent assay) for Toxocara canis infection has made it possible to study the epidemiology of this parasite in man. Antibody to Toxocara was measured in veterinarians, kennel workers, nurses, laboratory technicians, and clerical personnel in an animal hospital (Animal Medical Center, New York, NY) in order to determine the risk of infection in persons with varying degrees of occupational and home exposure to pet dogs. Antibodies were found in 8 (11 per cent) of 73 employees, and the prevalence and intensity of antibody was not statistically associated with either job exposure or dog ownership. However, antibody was not detected in any of the 14 employees who denied both past and present dog ownership. Additional studies using larger numbers of sera are required to determine the significance of these findings.
Nutrition surveillance in Arizona: selected anthropometric and laboratory observations among Mexican-American children.
Authors: Yanochik-Owen A , White M
Published: November 2008

A nutrition surveillance system in public health clinics is providing data for patient care and program planning. Through this system, Arizona's Mexican-American population has been shown to differ from other ethnic groups seen in clinic. Anemia and low height-for-age are significant problems in the Mexican-American population. Over-nutrition, in the form of overweight and high cholesterol, is also a problem among the Mexican-American clinic population.
Detergent toxicity survey.
Authors: Seabaugh V M , Bayard S P , Osterberg R E , Porter W K , McCaulley D F , Hoheisel C A , Hehir R M , Bierbower G W
Published: November 2008

A survey of over 249 detergent products involving biological testing, chemical analyses, and product label reviews has been conducted from 1971-1976 for determining compliance with the Federal Hazardous Substances Act. Test results for 145 detergent products having both chemical and biological data were examined. All of the tested detergents were rabbit eye irritants. Forty-seven per cent were also either rabbit primary skin irritants or corrosives. Eighty-one per cent were either rabbit esophageal test irritants or corrosives, and 80 per cent had rat oral toxicities 5g/kg or less.
Metals in municipal landfill leachate and their health effects.
Authors: James S C
Published: November 2008

The leachate from five municipal landfills (containing no industrial waste or sewage sludge) was studied in 1975 by the U. S. Environmental Protection Agency (EPA). Copper was not present in concentrations above EPA standards. Zinc concentrations decreased with age of the site and were below standards. The amounts of cadmium and chromium appear to vary greatly from site to site. Lead, selenium, iron, and mercury were present at each site in concentrations above standards, regardless of site age. Although raw leachate contains concentrations of heavy metals in excess of the drinking water standards, it is not clear how likely it would be for these recorded levels to be found in drinking water supplies or for contamination to reach the human body. Before leachate reaches an aquifer, it is subject to the attenuating effect of the unsaturated zone. If municipal solid waste is placed directly into ground water, or if leachate is allowed to drain directly into surface water, severe damage to water quality can result. Further study of the environmental effects of leachate are being undertaken by the Environmental Protection Agency.
Five year follow-up of a smoking withdrawal clinic population.
Authors: West D W , Graham S , Swanson M , Wilkinson G
Published: November 2008

Eight hundred volunteers who attended smoking clinics at Roswell Park Memorial Institute from 1964-1965 were followed up five years later to ascertain their current smoking status. From three waves of a mailed questionnaire, plus a telephone campaign, we obtained 559 usable responses. The relationship between smoking status at the five-year follow-up and clinic protocols and selected social and psychological characteristics as determined during the clinics were examined. Of those individuals contacted five years after the clinic, 17.8 per cent were not smoking. Variations in clinic protocol in terms of drugs and education methods had no relation to long-term smoking withdrawal. Several social and psychological variables, however, were related to smoking behavior five years after the clinics. Non-smokers were more likely than smokers to be males, to be older, to have smoked less before the clinic, to have started smoking at a later age, to have a milieu that was supportive of their stopping, and to have fewer indices of neurosis and fewer psychosomatic symptoms.
Maternal Mortality in Michigan: An Epidemiologic Analysis, 1950-1971
Authors: Schaffner William , Federspiel Charles F. , Fulton Mary L. , Gilbert Donna G. , Stevenson Lee B.
Published: November 2008

An analysis was performed of direct maternal mortality over 22 years (1950 through 1971) in the state of Michigan. The overall direct maternal mortality rate fell from 5.0/10,000 live births in 1950 to 1.5 in 1971. The rate among nonwhites was more than four times greater than among whites and the difference in relative risk did not narrow over the 22 years. Mortality rates increased with increasing maternal age but not with increasing parity. Nulliparous women had a significantly higher mortality rate than did parous women, particularly those over 25 years of age. when the white gravida of urban Wayne County were compared with the white gravida of 33 rural counties, no difference in direct maternal mortality rates could be attributed to rurality per se. Hemorrhage, infection, and toxemia were the leading causes of direct maternal death. The data suggest that hospitals with less active obstetrical services were associated with a higher risk of direct maternal mortality than were hospitals whose obstetrical services were more active. An increasing proportion of the direct maternal deaths was designated as preventable over the study period. It is believed that analyses of maternal mortality have led to improved perinatal and obstetrical care and that further advances require their continued support. (Am. J. Public Health 67:821-829, 1977)
The impact of state maternal mortality study committees on maternal deaths in the United States.
Authors: Grimes D A , Cates W
Published: November 2008

State maternal mortality study committees have been widely credited with playing a prominent role in reducing maternal death rates in the United States. To evaluate this hypothesis, we compared the rates of decline in maternal mortality ratios by decades from 1938-40 to 1968-70 for states with such committees to those without. Ratios were calculated from published vital statistics of the United States, and committee initiation dates were obtained from a previous survey. States with committees and those without had nearly equal declines during the first decade; however, states with committees had smaller declines during the latter two decades. Although these committees may have been an important factor in the decline in maternal mortality in the United States, vital statistics data do not document larger declines for states with committees.
Hemoglobin levels in children from a biracial southern community.
Authors: Frerichs R R , Webber L S , Srinivasan S R , Berenson G S
Published: November 2008

Hemoglobin levels were determined for 4,081 children, ages 2 1/2-14 years, from a biracial southern community. Back children had lower levels of hemoglobin than white children at every age interval with a mean difference of 0.64 gm/dl. This diffence persisted even when comparing children from similar socioeconomic level households. If black children maintain lower hemoglobin levels consistent with optimum health than do white children, then different hemoglobin standards may be warranted for each race.
Pediatric nurse associates in a large official health agency: their education, training, productivity, and cost.
Authors: Heagarty M C , Grossi M T , O'Brien M
Published: November 2008

During 1974, 29 pediatric nurse associates and 15 pediatric nurse associate trainees worked in the child health care system of the New York City Department of Health. All of these nurse associates, formerly public health nurses from the Department of Health, were trained in a one-year, intensive, closely supervised didactic and clinical course. Within the child health units the nurse associates assumed clinical roles in the care of well and sick preschool children according to the written guidelines and protocols of the Department. In addition, they continued to function in the traditional role of the public health nurse for their own patients, rendering counseling, referral, and follow-up services as indicated. Physicians acted as consultants to the pediatric nurse associates. Comparisons are made between pediatric nurse associate-physician staff versus public health nurse-physician staff in terms of productivity and cost.
Quality assessment of a telephone care system utilizing non-physician personnel.
Authors: Katz H P , Pozen J , Mushlin A I
Published: November 2008

An approach to providing medical care by telephone is described and its content and quality assessed by means of an outcome study. Pediatric health assistants have been trained to evaluate, triage and offer home management advice in lieu of an office visit for medical problems presented by parents via telephone. During a four-week study period, data were collected on all calls (N = 2520) using a telephone encounter form. Fifty-nine per cent of all calls involved requests for care of illness, 30 per cent of which were independently handled by the health assistant. Quality of care was evaluated for those cases who received advice in home management by means of a seven day follow-up interview with parents (N = 247). Access, parent satisfaction, residual symptoms, and the need for further care were ascertained. Greater than 90 per cent of parents expressed satisfaction and 92 per cent of problems had resolved. Results indicate that this telephone care system can effectively sort out and advise parents in home management for the many minor problems which occur in a pediatric practice, thereby increasing time for direct contact with patients.
Validity of 24-hour dietary recalls by adolescent females.
Authors: Greger J L , Etnyre G M
Published: November 2008

The validity of 24-hour dietary recalls was tested by comparing the recalled intake of adolescent girls to their actual intake during a metabolic study. Diet recalls were a valid bases of estimating the dietary intake of energy, protein, calcium, and zinc by this group of adolescents. However, the majority of the subjects were unable to recall their food intake with enough accuracy so that their intake of vitamins A and C, thiamin, riboflavin, niacin, and iron could be calculated within the range of two-thirds to four-thirds of their actual intake.
Driver education and fatal crash involvement of teenaged drivers.
Authors: Robertson L S , Zador P L
Published: November 2008

Fatal crash involvement of teenagers per licensed driver and per population in 27 states was related to the proportions of teenagers who received high school driver education. Among 16--17 year olds, driver education was associated with a great increase in the number of licensed drivers, without a decrease in the fatal crash involvement per 10,000 licensed drivers- About 80 per cent of the 16--17 year olds who took high school driver education obtained licenses that they would not otherwise have obtained until age 18 or thereafter. The net effect is much higher death involvement rates per 10,000 population, on average, in states with greater proportions of 16-17 year olds receiving high school driver education. The data suggest that most teenagers would obtain licenses when they are 18--19 years old, irrespective of high school driver education, and indicate that differences among the states in fatal crash involvement rates per 10,000 licensed 18--19 year old drivers were not significantly related to either high school driver education or delayed licensure.
The rural nurse practitioner: a challenge and a response.
Authors: Sullivan J A , Dachelet C Z , Sultz H A , Henry M
Published: November 2008

From a cohort of 525 employed nurse practitioners (NPs) who graduated between May 1975 and June 1976, 85 (16 per cent) reported practicing in rural areas. While 91 per cent of the rural NPs chose the short-term certificate programs rather than the master's degree for their NP preparation, 47 per cent had already earned a baccalaureate or master's degree prior to NP training. Family NPs comprised the most frequent specialty area chosen, followed by pediatric and adult specialties. Of the 85, 99 per cent were actually providing a broad array of primary care services to clients over a wide age range. Physicians were periodically available on site in about 80 per cent of the practices, by telephone in 97 per cent of the practices, and in 60 per cent of the practices provided additional consulation by record review. Major motivations of the NPs for entering rural practice were to participate in a creative approach to health care delivery (50 per cent of the practice setting were less than five years old), and for the opportunity for role autonomy. Over 95 per cent of these NPs and employers were satisfied with the NP role.
Prevalence of sickle cell trait and HbC-trait in Blacks from low socioeconomic conditions.
Authors: Hicks E J , Miller G D , Horton R
Published: November 2008

In the present investigation we did not observe age or sex differentials in the prevalence of sickle cell or HbC-traits in Black males or females of low socioeconomic status. When our data were compared to those of others, we found no evidence for a socioeconomic differential in the prevalence of these traits.
Voting behavior of HSA interest groups: a case study.
Authors: Grossman R M
Published: November 2008

A study of the voting behavior of both consumers and providers involved on a Health Systems Agency (HSA) review committee was undertaken to determine the amount of voting cohesion (solidarity) demonstrated by these two basic interest groups as well as the directions in review decisions desired by both of these groups. The case study involved the application of the Rice Index of voting cohesion behavior to 23 decisions in one of the largest HSAs in the country. The conclusions reached are that: 1) consumers and providers do have differences in their intra-group voting cohesion, but that more importantly 2) they do not appear to be different with respect to the decisions (approve or deny) both groups desire for project reviews.
Smoking education programs 1960-1976.
Authors: Thompson E L
Published: November 2008

This paper is a review of published reports, in English, of educational programs designed to change smoking behavior. Attempts to change the smoking behavior of young people have included anti-smoking campaigns, youth-to-youth programs, and a variety of message themes and teaching methods. Instruction has been presented both by teachers who were committed or persuasive and by teachers who were neutral or presented both sides of the issue. Didactic teaching, group discussion, individual study, peer instruction, and mass media have been employed. Health effects of smoking, both short- and long-term effects, have been emphasized. Most methods used with youth have shown little success. Studies of other methods have produced contradictory results. Educational programs for adults have included large scale anti-smoking campaigns, smoking cessation clinics, and a variety of more specific withdrawal methods. These methods have included individual counseling, emotional role playing, aversive conditioning, desensitization, and specific techniques to reduce the likelihood that smoking will occur in situations previously associated with smoking. Some of these techniques have produced poor results while studies of other methods have shown inconsistent results. The two methods showing the most promise are individual counseling and smoking withdrawal clinics.
Problems in suicide statistics for whites and blacks.
Authors: Warshauer M E , Monk M
Published: November 2008

The accuracy of suicide statistics was assessed by comparing published Health Department suicide rates for an area of New York City with Medical Examiner records. For the period 1968--1979, records from the Medical Examiner's Office were searched to determine all deaths classified as definite suicides. Another group of deaths was considered suicide by the Medical Examiner but never classified as such. These deaths we labeled "assigned suicides." When definite suicides were compared with all deaths considered suicide by the Medical Examiner (definite and assigned suicides), black suicide was underestimated by 80 per cent and white suicide by 42 per cent. Underestimation was the same for males and females but varied by age group. In 1968, when the seventh revision of the International Classification of Deaths (ICD) was used, Health Department suicide rates for blacks were almost identical to Medical Examiner rates, while white rates were underestimated by 25 per cent. In 1969--1970, when the eighth revision was used, Health Department statistics underestimated black suicides by 82 per cent and white suicides by 66 per cent. Reasons for the underestimations were related to the methods used in committing suicide by the two ethnic groups and to the ways that suicide classification has changed from the seventh to eighth revision. Implications for research using official death certificate reports are discussed.
Psychiatry and general health care.
Authors: Coleman J V , Patrick D L
Published: November 2008

The paper presents a study of psychiatric morbidity in the general health care program of a Health Maintenance Organization. Mental health services are built into the program as an integral component of primary care teams in internal medicine and pediatrics. The following were some of the findings: 15.7% of patients visiting the Health Center over a two-year period presented emotional problems; 72% were treated by primary care clinicians alone and 28% by mental health clinicians. Treatment by primary and mental health clinicians is broken down by diagnostic categories. A study of patients with chronic emotional problems revealed that they tended to be high utilizers of all Health Center services for both physical and emotional difficulties. Chronic patients represented 2% of all patients who visited in 1974; of these, 54% were seen by mental health clinicians and 46% by primary care clinicians. In the case of patients with non-chronic emotional problems, over a two-year period, there was an increase in the per cent seen by primary clinicians. The use of psychoactive drugs by primary physicians and the advantages and difficulties of developing a program of integrated health-mental services are described.
Follow-up study of patients treated by X-ray epilation for tinea capitis: psychiatric and psychometric evaluation.
Authors: Omran A R , Shore R E , Markoff R A , Friedhoff A , Albert R E , Barr H , Dahlstrom W G , Pasternack B S
Published: November 2008

To investigate the late effects of radiation to the head upon subclinical mental disorders, a psychiatric and psychometric evaluation was performed on 177 cases treated 10-29 years earlier for ringworm of the scalp by X-ray therapy (N :109) or, by chemotherapy (N :68). Analyses which controlled for educational level and family psychiatric disorders showed that, among whites, the irradiated group manifested more psychiatric symptoms and more deviant MMPI (Minnesota Multiphasic Personality Inventory) scores. They were also judged more maladjusted from their MMPI profiles, and more frequently had a history of treated psychiatric disorders; however, the psychiatrist's overall rating of current psychiatric status showed only a borderline differnece between the two groups. There were no significant differences between irradiated and chemotherapy treated blacks.
Evaluation of the effectiveness of a high school course in cardiovascular nutrition.
Authors: Podell R N , Keller K , Mulvihill M N , Berger G , Kent D F
Published: November 2008

High school biology students participated in a cardiovascular nutrition education program. The program was evaluated for its effect on the student's knowledge, attitudes, reported eating behavior, and serum lipid levels by matching individual's pre-and post-program results. There was a significant improvement in cardiovascular nutrition knowledge and attitudes toward a low cholesterol pattern of eating. There was also a signigicant improvement in reported eating patterns. However, the rise in serum cholesterol levels one year later did not differ from the rise in serum cholesterol levels in a control school. Improvement in attitudes and reported eating behavior was significantly greater for students whose initial cholesterol level was in the upper quartile of U.S. 16-year olds.
Monitoring consumer satisfaction with the clinical services provided to 'exceptional' children.
Authors: Sommers P A , Nycz G R
Published: November 2008

Given recent federal and state legislation mandating all necessary services for children with handicapping conditions, it is incumbent upon the providers of health care services to demonstrate accountability for their services to children with special needs. A procedure to assess the satisfaction of parents and community-based case coordinators with clinical services provided to such children has been demonstrated. By focusing on specific service elements, it is possible to align optimum versus actual consumer satisfaction. Through an analysis of observed variance, the modification of documented weaknesses can decrease the difference between optimum and actual consumer satisfaction levels. This procedure will be continued on a bi-annual, longitudinal follow-up basis to monitor progress. The concept of consumer input into the provision of clinical services is relevant to other developments in the field of health care which place importance on administration accountability. Those health care providers who recognize the value of consumer input and allow for its incorporation into their service programs will be better able to adapt their systems to the emerging trend towards medical accountability. Self-ordered accountability is more meaningful, is easier to understand than government imposed regulations, and can be smoothly blended into an organization's goals and objectives.
Blizzard morbidity and mortality: Rhode Island, 1978.
Authors: Faich G , Rose R
Published: November 2008

The total number of outpatient visits to 10 hospital emergency rooms declined 64 per cent and emergency admissions 35 per cent immediately after the February 1978 blizzard in Rhode Island; both quickly returned to normal levels. Three days after the storm, admissions for myocardial infarction increased markedly. Total mortality and ischemic heart disease deaths showed a considerable increase for the five-day period following the blizzard. The physical and psychological stress of the blizzard probably precipitated cardiac deaths in susceptible individuals.
Ascaris and growth rates: a randomized trial of treatment.
Authors: Willett W C , Kilama W L , Kihamia C M
Published: November 2008

Three hundred forty-one Tanzanian preschool children were randomly assigned to levamisole or placebo treatment given at three-month intervals. Weights and heights were measured at the tri-monthly treatment visits for a period of one year. Among the 273 children who were seen and weighed at the one-year follow-up visit, the rate of weight gain was 8 per cent greater for those receiving levamisole than for placebo-treated controls (p = .06). In 78 children known to be infected with Ascaris at baseline, the rate of weight gain was 21 per cent greater in children treated with levamisole than in those receiving placebo (p = .03). The rate of height gain was no different for treatment and placebo groups.
A student community dental experience with migrant farmworker families and the rural poor.
Authors: Barnett S E , Call R L
Published: November 2008

For the past six years, 78 dental students have worked with 25 rural dentists to provide over 31,000 dental health services to migrant patients for all of Colorado's agricultural communities. In 1977, each of 19 dental students averaged over $538 per week in value of comprehensive dental services, including preventive and peridontal services (36 per cent, N=3,006); restorative services (46 per cent, N = 3,904); surgical services (8 per cent, N = 705); services in pulp therapy (5 per cent, N = 413); and an additional 5 per cent (N = 412) in miscellaneous services. A unique combination of federal resources from the Departments of Labor, and of Health, Education and Welfare, were combined through the Colorado State Health Department and the University of Colorado Medical Censtrated by: 1) a relatively low extraction to restoration ratio (1 to 5) when compared to reported studies (1 to 2); 2) a relatively low extract to root canal therapy (10 to 1) when compared to reported studies (400 to 1); 3) no statistical difference between students and rural practitioners in the quality of services as determined by peer review study. This dental program is an integrated component of a comprehensive program combining student and professional services in medicine, nursing, nutrition, and health education.
The use of a technical questionnaire in laboratory proficiency testing.
Authors: Neimeister R P , Wilf C Z , Cocklin J H , Bartola J , Pidcoe V
Published: November 2008

As an adjunct to laboratory improvement, a technical questionnaire concerning specific steps of the more commonly employed laboratory procedures was incorporated into three proficiency testing evaluations: syphilis serology, mycobacteriology, and parasitology. This addition to proficiency testing revealed some basic and detrimental procedural deviations which could affect the validity of reported clinical values. These procedural deviations were communicated to the laboratories in an attempt to improve performance.
Farm tractor fatalities: the failure of voluntary safety standards.
Authors: Karlson T , Noren J
Published: November 2008

There are no governmental standards for operator protection which require compliance by farm tractor manufacturers. To see how the Wisconsin farming population fares under voluntary safety standards, death certificate data were used to determine rates of tractor-associated fatal injuries. The injury deathrate associated with tractors on farms increased from 10.9 per 100,000 male farm residents during 1961-1965 to 13.6/100,000 during 1971-1975 (p less than .05). Deaths associated with overturning tractors were most common; with death rates of 6/100,000 male farm residents for 1961-1975. The rise in tractor-associated death rates shows that voluntary safety standards are not protecting the farm population. Rollover protective structures (ROPS) are designed to protect operators when tractors overturn but under voluntary safety standards these ROPS are sold only as optional accessory devices. Current Occupational Safety and Health Administration regulations which require ROPS for employees operating tractors do not protect self-employed farmers and their families. It is recommended that the government require all tractors sold to be equipped with ROPS as is currently the case in England and Sweden.
Body contact swimming rescues--what are the risks?
Authors: Dahl A M , Miller D I
Published: November 2008

A survey of 482 lifeguards and Water Safety Instructors revealed that at least one-half had performed body contact swimming rescues (BCRs). Over two-thirds of these BCRs occurred when the lifesaver was relatively inexperienced in actual water rescues of any kind although virtually all rescuers had received formal lifesaving training. The victim tried to grasp the rescuer in 26 per cent of the BCRs which took place in swimming pools and 39 per cent of those occurring in lakes. Most of these attempts were made during the approach and were predominantly from the front, around the rescuer's head and neck or wrists and arms. Since the majority of victims were younger and smaller than their rescuers and got into difficulty less than 3 m from safety, only a small proportion of the grasps were perceived as endangering the lifesaver. Consequently, the victim was often permitted to retain the hold while being rescued. Grasps which were reported to be threatening tended to be applied by individuals of equal or larger physical size than the rescuer and usually occurred at distances exceeding 3 m from safety.
A comparison of mail, telephone, and home interview strategies for household health surveys.
Authors: Siemiatycki J
Published: November 2008

The method of data collection in household health surveys can be a major determinant of cost and data quality. A survey strategy can comprise mail, telephone, or home interview methods, individually or in combination to follow up non-respondents. The purpose of this study in Montreal was to compare cost and data quality of various strategies. Strategies which began with mail or telephone contact, followed by the two other methods, provided response rates as high as a home interview strategy (all between 80 and 90 per cent), for one-half the cost of home interviews when used as the sole method. The telephone response rate was higher than the mail response rate. Comparing different follow-up approaches to strategies beginning with mail or telephone, it proved less costly, and equally effective, to use home interviewing as a last resort for persistent non-respondents. Validity of response (comparing individual responses with records of a government health insurance data bank) and willingness to answer sensitive questions were greatest in mail strategy.
Evaluation of an automated blood pressure measuring device intended for general public use.
Authors: Berkson D M , Whipple I T , Shireman L , Brown M C , Raynor W , Shekelle R B
Published: November 2008

Responding to Chicago newspaper reports, measurements of blood pressure by a publicly available, automated coin-operated device were compared with those of human observers using the standard cuff and auscultatory technique. One machine was examined in the laboratory, and eight others at randomly selected sites. Analysis of readings made on 100 persons in the laboratory and 227 in the field led to the following conclusions: 1) On the average, the machines measured fifth phase diastolic blood pressure at nearly the same level as did human observers; 2) The machines were more variable measuring systolic blood pressure with four differing from the average human reading by 1mm Hg or less, but two differing by 8mm Hg or more; 3) The agreement between machine-human pairs of readings was not as good as between human-human pairs, but the differences in level of agreement--both in determining the actual value and in categorizing the values as normal, borderline, or high--were small and have little practical importance; 4) Linear regression analyses of the relationship between simultaneously determined machine and human readings indicated that the average human-machine difference was the same over the range of pressures tested. Publicly available blood pressure measuring devices should be labeled concerning their purposes, capabilities, and limitations. Rules and regulations governing their use in the City of Chicago are being prepared by this city's Legal Department.
Prenatal monitoring in upstate New York.
Authors: Zdeb M S , Logrillo V M
Published: November 2008

In upstate New York, birth certificates of all babies born in hospitals include response to a question on procedures used in fetal monitoring. During the first six months of 1978, some form of monitoring was reported on 47 per cent of all live births in hospitals, 33.6 per cent being monitored externally. The primary cesarean section rate in monitored women was over twice that among those not monitored.
A hospital-based screening, referral, and follow-up program for high blood pressure.
Authors: Theisen V , Caldwell J R , Erfurt J C , Foote A
Published: November 2008

A hypertension program staffed largely by volunteer nurses in a hospital outpatient department is described. A three-year evaluation shows 19% of 4,282 clients screened as having high readings, 86% of those referred saw a physician for high blood pressure, 92% of those who saw a physician began treatment for high blood pressure and 50% of those under treatment were showing successful control or progress toward successful control.
Studies on the reliability of vital and health records: I. Comparison of cause of death and hospital record diagnoses.
Authors: Gittelsohn A , Senning J
Published: November 2008

Based on computer linkage of death records and hospital discharge abstracts, underlying cause of death and discharge diagnoses are compared for 9,724 Vermont resident in-hospital deaths occurring between 1969 and 1975. The agreement between the diagnoses recorded in the two data systems provides a measure of the reproducibility of recording, abstracting, and coding practices. Using the first three digits of the International Classification of Diseases, the agreement between cause and closest medical record diagnosis was 72 per cent. Concordance declined by patient age and length of hospital stay and varied significantly by coded cause of death. A major source of variation was the hospital of death where agreement levels ranged between 45 and 84 per cent. The latter finding is regarded as a potential starting point for targeting investigation of sources of discrepancy and initiating efforts to improve diagnosis recording and coding in the two record systems. The value of both depends on continuing efforts to improve and maintain data quality.
Evaluation of a group nutrition education approach to effective weight loss and control.
Authors: Kelly K L
Published: November 2008

Fifty-three male officers of the Boston Police Department voluntarily participated in a 12-week nutrition program with weight control as a primary goal, and education in related health factors as a secondary goal. One year after graduation, 26 respondents to a survey reported losing an average additional 0.5 kg since graduation for a mean weight loss of 11.4 kg since their introduction into the classes. None had returned to their original weight status.
Self care for colds: a cost-effective alternative to upper respiratory infection management.
Authors: Zapka J , Averill B W
Published: November 2008

A Cold Self-Care (CSC) Center was established in a prepaid ambulatory care setting serving 21,500 subscribers and their dependents. After CSC establishment, a decrease in visits to practitioners for common colds was demonstrated. The operating cost ratio of an outpatient visit as compared to a CSC visit was 14.7/1. Savings over a two-year period are estimated at over $46,000, representing an average estimated ratio of $.09 cost per dollar saved per member per year.
Waterborne giardiasis in the United States: a review.
Authors: Craun G F
Published: November 2008

Twenty-three waterborne outbreaks of giardiasis have been reported in the US, 1972-77. Data indicate that disinfection as the only treatment for surface water sources is ineffective in preventing waterborne transmission of this organism. To protect against transmission, all surface water should receive chemical pretreatment, preferably with sedimentation, and filtration in addition to disinfection. Outbreak data indicate that negative coliform tests do not provide assurance that water is free of Giardia cysts.
Validation of a poison prevention program.
Authors: Braden B T
Published: November 2008

The effectiveness of an empirically designed poison warning label and an educational program for three and four year old children was assessed in four groups of 39 such children, with one group serving as a control. The educational program appeared to improve intellectual (verbal) awareness of poisons, the label to improve visual discrimination, and the combination of the two to have the greatest overall impact.
Prevalence of Prior Hysterectomy in the Seattle- Tacoma Area
Authors: Koepsell Thomas D. , Weiss Noel S. , Thompson Donovan J. , Martin Diane P.
Published: November 2008

Hysterectomy is the most common major surgical procedure performed in the United States. The frequency of hysterectomy among women in the general population is of interest because it affects the population at risk for uterine diseases and because the procedure itself carries significant personal and socioeconomic consequences. We studied factors related to the occurrence of hysterectomy by interviewing a representative sample of women ages 35-74 (n= 1087) in two urban Washington counties during 1976-1977.

One-third of the women studied had had a hysterectomy. Later birth cohorts were at higher risk. The ageadjusted prevalence of prior hysterectomy was negatively associated with education and age at first childbirth; it was positively associated with parity, history of irregular menses, and history of a variety of other health conditions. Contrary to expectation, income was negatively associated with hysterectomy rates in one county and showed no association in the other. Part of the income effect was due to confounding by age at first childbirth, which was a surprisingly strong predictive factor.

We conclude that: 1) despite economic predictions based on the discretionary nature of the procedure, hysterectomies are not necessarily more common among high-income women; 2) age at first childbirth may be a more important risk factor for uterine disease than previously thought; and 3) estimates of hysterectomy frequency based on clinic populations may be misleading. (Am J Public Health 70:40-47, 1980.)
Nitrates, chlorates and trihalomethanes in swimming pool water.
Authors: Beech J A , Diaz R , Ordaz C , Palomeque B
Published: November 2008

Water from swimming pools in the Miami area was analyzed for nitrates, chlorates and trihalomethanes. The average concentrations of nitrate and chlorate found in freshwater pools were 8.6 mg/liter and 16 mg/liter respectively, with the highest concentrations being 54.9 mg/liter and 124 mg/liter, respectively. The average concentration of total trihalomethanes found in freshwater pools was 125 micrograms/liter (mainly chloroform) and in saline pools was 657 micrograms/liter (mainly bromoform); the highest concentration was 430 micrograms/liter (freshwater) and 1287 micrograms/liter (saltwater). The possible public health significance of these results is briefly discussed.
The recent decline in mortality of the extreme aged: an analysis of statistical data.
Authors: Rosenwaike I , Yaffe N , Sagi P C
Published: November 2008

Official U.S. statistics reveal a 26 per cent decline in the mortality rate for the extreme aged population (persons 85 years and over) between 1966 and 1977. This reduction was greater than that exhibited by other adult age groups and substantially larger than earlier declines for the extreme aged. This study examines the possible effect of statistical artifacts, such as errors in population estimation, on the changed mortality trend. Data from the Social Security files on Medicare enrollment are utilized to test the accuracy of population estimates for the extreme aged. Mortality rates are decomposed by selected cause of death, sex, and race to determine the influence of demographic, social, and health factors on the shift in the pattern. The results of the analysis indicate that substantial real reduction in mortality has occurred among the elderly population. Reductions among females continue to exceed those among males, but less markedly than in the past. Rates for nonwhites are subject to particularly large margins of error due to incorrect population estimates. A sharp downturn in the age-adjusted rates for the cardiovascular diseases, which are more common among the aged, appears to account for the relatively greater reduction in mortality in this age group.
A follow-up study of parent education in pediatric office practices: impact at age two and a half.
Authors: Chamberlin R W , Szumowski E K
Published: November 2008

The relationship between physician efforts to educate mothers of first born children about child behavior and development, and various outcome measures of mother and child functioning has been extended from 18 months to a time period of two and a half years. As was found earlier, there was a modest relationship between physician effort and mother gain in knowledge about child development, her feeling of being supported by the practice in her child-rearing role, and the frequency of her participation in affectional and cognitively stimulating activities with her child. These relationships, however, did not significantly increase in strength over time. At the end of 30 months there were still no significant positive relationships between teaching input and the child's developmental status, and mothers receiving care form physicians who taught more continued to report more behavior problems with their child than mothers receiving care from physicians who taught less. A content analysis of a small sample of the visits of high and low scoring physicians indicated that neither focused their teaching efforts on ways that mothers could interact with their children in more affectionate and cognitively stimulating ways. It is suggested that more focused teaching in this area might lead to better child development outcomes.
Risk factors for toxocaral ocular larva migrans: a case-control study.
Authors: Schantz P M , Weis P E , Pollard Z F , White M C
Published: November 2008

Twenty-four patients with serologically confirmed toxocaral ocular larva migrans (OLM) and 24 age- and sex-matched controls were the subjects of an epidemiologic study. Information on the exposure to dogs and other factors possibly associated with transmission of toxocariasis was obtained by contacting the parents of the subjects. The odds of having had a dog present in the household within the year previous to onset of illness were 3 to 1 for cases vs controls. An association of pups (< 3 months) in the households of OLM patients within one year of onset was statistically significant (P < .05). Twenty-three of 24 OLM patients had had dogs in their homes some time before their illness, and the twenty-fourth patient had a history of geophagia, a behavioral pattern previously identified as a risk factor for toxocariasis. Exposure to cats and other animals in or outside the home did not differ for patients and controls. Infected dogs, especially pups, in the patients' homes were the most probably sources of infection for this group of OLM patients.
Women, work and coronary heart disease: prospective findings from the Framingham heart study.
Authors: Haynes S G , Feinleib M
Published: November 2008

This study examined the relationship of employment status and employment-related behaviors to the incidence of coronary heart disease (CHD) in women. Between 1965 and 1967, a psychosocial questionnaire was administered to 350 housewives, 387 working women (women who had been employed outside the home over one-half their adult years), and 580 men participating in the Framingham Heart Study. The respondents were 45 to 64 years of age and were followed for the development of CHD over the ensuing eight years. Regardless of employment status, women reported significantly more symptoms of emotional distress than men. Working women and men were more likely to report Type A behavior, ambitiousness, and marital disagreements than were housewives; working women experienced more job mobility than men, and more daily stress and marital dissatisfaction than housewives or men. Working women did not have significantly higher incidence rates of CHD than housewives (7.8 vs 5.4 per cent, respectively). However, CHD rates were almost twice as great among women holding clerical jobs (10.6 per cent) as compared to housewives. The most significant predictors of CHD among clerical workers were: suppressed hostility, having a nonsupportive boss, and decreased job mobility. CHD rates were higher among working women who had ever married, especially among those who had raised three or more children. Among working women, clerical workers who had children and were married to blue collar workers were a highest risk of developing CHD (21.3 per cent).
Cigarette smoking among medical students.
Authors: Coe R M , Cohen J D
Published: November 2008

A survey of first and second year medical students at Saint Louis University revealed that only 6 per cent were current cigarette smokers. This represents a continuation of a downward trend in the percentage of smokers among American medical students as reported in earlier, independent surveys. Implications for improved health status and for better preventive care for patients by these future physicians are discussed.