bluuebunny/crossref_metadata_2025 huggingface dataset:
Young Children's Imitation and Comprehension of Sentential Singularity and Plurality
Authors: Keeney Terrence J. , Smith Nancy D.
Published: July 2017

The number of the subject is marked in most third-person sentences both in the subject-noun (e.g., " dog/dogs ") and in the verb (e.g., " barks/bark "). The verb inflection for number is redundant with the noun inflection except in those rare instances in which the subject-noun is not marked for number (e.g., " sheep/sheep "). Since the verb inflection for number is rarely crucial for determining the meaning of a sentence, and since number is marked in exactly the opposite manner in regularly formed verbs from the manner in which it is marked in regularly formed nouns, children might be expected to acquire the verb inflection for number relatively late in the course of language development. Sentences in which number was marked in (a) the verb only, and (b) the subject-noun and the verb were presented to a sample of 24 children 4 years of age in both imitation and comprehension tests. The results indicated that the children did not comprehend the verb inflection for number even when the noun was unmarked and the verb inflection was the only cue for number. Despite explicit training on the meaning of unmarked nouns, the children understood the unmarked subject-noun as singular and responded to the entire sentence as if it were singular. At four years of age, the apparent number of the subject-noun is the only effective cue for sentential singularity or plurality.
A Behavioural Analysis of Figurative Language in Psychotherapy: One Session in a Single Case-Study
Authors: Pollio Howard R. , Barlow Jack M.
Published: July 2017

In an attempt to examine the frequency of occurrence and significance of figurative language in spoken discourse, a line-by-line analysis of such language in a single session of psychotherapy was performed. Results of such an analysis showed that for this particular case, figurative language occurred at a rate of between 3 and 6 figures per 100 words of text, and that novel, as opposed to frozen, figures tended to occur in extended bursts. These bursts were shown to relate to other aspects of the therapeutic process, particularly those involving patient problem-setting and problem-solving. In general, novel figurative language was seen to be a method whereby intimate personal qualities and problems could be talked about in a non-intrusive and therapeutically helpful manner.
Some Notes on the Physiology of Speech Production
Authors: Sawashima Masayuki
Published: July 2017

Three different topics in speech research are discussed from the point of view of the physiology of the speech production mechanism. Concerning the problem of the laryngeal adjustments for the voicing distinction, fairly clear physiological evidence has been obtained about the abduction-adduction dimension of the glottis, while the tenseness feature of the vocal folds is still to be examined. Detailed analysis of the articulatory movements in syllable repetition is considered to be a promising approach for the study of articulatory dynamics in both normal and pathological cases. Neurophysiological studies of the cerebro-cerebellar communication system as a control mechanism of skilled voluntary movements should be referred to in the study of motor control of speech production.
Speech Perception
Authors: Studdert-Kennedy Michael
Published: July 2017

The paper reviews selected studies in speech perception, most of them published in the past five years. Topics include the contributions of prosody to segmental perception, the problems of segmentation and invariance, categorical perception of speech and non-speech, the role of feature detectors, the scaling of speech sounds to an auditory-articulatory space, acoustic phonetic dependencies within the syllable, the contributions of higher order (nonphonetic) factors to the comprehension of fluent speech, and cerebral specialization. The bias of the paper is toward viewing phonetic segments as abstract processes that link sound and articulation, and that become available to the listener through specialized sensorimotor mechanisms.
Phonology
Authors: Basbøll Hans
Published: July 2017

This report deliberately does not cover a number of central topics in the current debate on phonological theory (such as psychological reality, phonological universals and language acquisition) which were treated in some depth in symposia at the congress. In section 1.1, it is claimed that there still exists a broad "school" of generative phonology in some sort of sociological sense (built upon shared references, etc.), although scholars belonging to this "school" certainly differ in fundamental ways with respect to basic assumptions. Within this broad "school," a "formal" and a "substance-based" trend is distinguished (section 1.2). Within both of these trends, phonologists tend to work towards less abstract analyses (section 1.3), and generative phonologists seem to agree that rules belong to several functionally different types (section 1.4). In section 2, some metatheoretical issues are discussed, departing from Lass' Popperian statements on linguistics as metaphysics. In section 3.1, the so-called autosegmental and non-segmental phonology is considered. In the remainder of section 3, a number of issues involving distinctive features, markedness and archi-segments are briefly touched upon.
Notes on the Development of Phonological Theory
Authors: Anderson Stephen R.
Published: July 2017

An analogy is drawn between the recent history of (generative) phonology and the history of the philosophy of mathematics. It is suggested that the formal project of Chomsky and Halle's Sound Pattern of English is closely parallel to the axiomatization of mathematics proposed by Whitehead and Russell. In these terms, the development of such restrictive theories as that of Natural Generative Phonology — and in general, the work characterized in Basbøll's Status Report as "substance—based" — represents a reaction similar to that of the Intuitionist school of mathematics. As such, it has a certain intrinsic interest, but its difficulties in reconstructing the full range of material usually considered part of phonology suggest that a modification of the interpretation of the "formalist" program represented by the standard theory is ultimately more satisfactory.
Formal and Substantive Approaches to Phonology
Authors: Hooper Joan Bybee
Published: July 2017

The distinction made by Basbøll between "formal" and "substantive" interests in current phonological research can be cross-classified with a distinction between two approaches to surface data. One, usually labelled "abstract," works toward squeezing all possible generalizations out of the data despite counter-indications on the surface. The other, called "concrete," works with generalizations whose validity and productivity can be verified with surface forms. A number of recent works are mentioned briefly with these distinctions in mind.
Head Movement Correlates of Juncture and Stress at Sentence Level
Authors: Hadar U. , Steiner T.J. , Grant E.C. , Clifford Rose F.
Published: July 2017

Body movement during speech has been recognized as closely relating to suprasegmental features, but little evidence has been offered to support this thesis, probably for lack of adequate techniques. The present study investigated this issue by continuously recording, with a polarized-light goniometer, movement of the head in four subjects engaged in conversation. Rapid movements were found to indicate stress, while juncture involved contrasting ordinary movements with stillness. This was believed to indicate that the dissipative structure coordinating speech resorts to body movement in regulating high energies, and that prosodic features may accentuate inner continuity by varying smoothly towards terminal juncture.
Perception of Silent Pauses in Continuous Speech
Authors: Duez Danielle
Published: July 2017

The perception of silent pauses in continuous speech was investigated experimentally in three genres: political speeches, political interviews and casual interviews. Normal and inverted speech yielded similar perception. The result is interpreted as being an indicator of the salient role of the prosodic structures. The distributional patterning of pauses proves to be responsible for the variability of perception. Pause duration is the essential parameter; pause identification rate is positively correlated with it, and it interacts with the parameter values of the vowel preceding the pause.
A Comparison of Language Functions Used by Normal Male and Female Pre-School Children in a Structured Setting
Authors: Klecan-Aker Joan S.
Published: July 2017

The purpose of the present study was to examine the use of language functions in a structured setting by normal pre-school males and females. Two hundred and forty subjects were selected between the ages of 2 and 5 years. Results indicated statistically significant differences between the groups of children. These results are discussed relative to the need for a complete and thorough data base on how pre-school children use language.
Interaction Involvement and the use of Referential and Formal Anaphora in Conversation
Authors: Villaume William A.
Published: July 2017

This study examined whether there are different cognitive burdens associated with the use of referential and formal anaphora in conversation, and whether these differences are systematically exploited by speakers seeking to converse coherently. It was assumed that speakers encountering difficulty in managing the pragmatics of conversation should rely more on the formal anaphoric devices of ellipsis and substitution and less on reference devices to create cohesive ties in their talk. The transcripts of 60 conversations among high-involved and low-involved speakers were coded and analyzed for the use of anaphora. Results indicated that the conversational partners of high-involved speakers used a significantly different pattern of reference and formal cohesive devices than did the conversational partners of low-involved speakers. in addition, this effect was especially pronounced for a low-involved conversational partner. Thus, a pattern of increased use of referential devices and decreased use of formal anaphora was shown to be sensitive to social situational factors that facilitate the pragmatic processing of conversation.
Beginnings of Prosodic Organization: Intonation and Duration Patterns of Disyllables Produced by Japanese and French Infants
Authors: Hallé Pierre A. , De Boysson-Bardies Bénédict , Vihman Marilyn M.
Published: July 2017

In this study, some prosodic aspects of the disyllabic vocalizations (both babbling and words) produced by four French and four Japanese children of about 18 months of age, are examined. F0 contour and vowel durations in disyllables are found to be clearly language-specific. For French infants, rising F0 contours and final syllable lengthening are the rule, whereas falling F0 contours and absence of final lengthening are the rule for Japanese children. These results are congruent with adult prosody in the two languages. They hold for both babbling and utterances identified as words. The disyllables produced by the Japanese infants reflect adult forms not only in terms of global intonation patterns, but also in terms of tone and duration characteristics at the lexical level.
Errors of Inflection in the Writing of Normal and Poor Readers
Authors: Smith-Lock Karen M.
Published: July 2017

This study investigated the speech and writing of 18 normal and 11 poor readers in second grade in order to determine whether children make morphological errors in writing that they do not make in speech. Ten sentences with complex syntactic structures were elicited, both orally and in writing (e.g., “Who do you think eats fries?” “Point to the dog that licks babies”). Each sentence provided opportunities for the children to erroneously omit, add, or substitute an inflection. In the spoken task, virtually no inflectional errors were observed in either group. In contrast, in the written task, good readers omitted an average of 0.4 inflections out of a possible 20 whereas the poor readers omitted an average of 7.6 inflections each, a highly significant difference. This suggests that poor readers have adequate grammatical knowledge, but poor explicit awareness of morphological structure.
Comprehension of Synthetic Speech Produced by Rule: A Review and Theoretical Interpretation
Authors: Duffy Susan A. , Pisoni David B.
Published: July 2017

In this paper, we review research on the perception and comprehension of synthetic speech produced by rule. We discuss the difficulties that synthetic speech causes for the listener and the evidence that the immediate result of those difficulties is a delay in the point at which words are recognized. We then argue that this delay in processing affects not only lexical access but also comprehension processes. We consider the mechanisms by which the comprehension system adjusts to this delay, the resulting costs to higher level comprehension processes, and the changes that occur in the language processing system as its familiarity with synthetic speech increases. Based on the framework we have developed, we suggest several directions for future research on the comprehension of synthetic speech.
Focus Conditions and the Prominence of Pitch-Accented Syllables
Authors: Rump H. H. , Collier R.
Published: July 2017

The purpose of the present study is to find out how the pitch peak heights on two pitch-accented syllables in one utterance relate to different focus conditions. The focus conditions are neutral focus, double contrastive focus, and single contrastive focus on either the first or the second pitch-accented syllable. In Experiment 1, subjects adjusted the height of one of two pitch peaks, so as to make the pitch contour express different focus structures. No systematic relationship was found between different fixed heights of one peak and the adjusted heights of the other, which suggests the existence of target values for focus-related pitch peaks. In Experiment 2, listeners judged which of the four focus structures was most likely represented by a given relation between peak heights. The results show that some pitch contours are ambiguous with respect to focus, but the majority of them is classified unanimously as signalling only one possible focus structure. The present results also shed new light on some unexplained findings of earlier prominence experiments.
The UCLA Tobacco Control Program
Authors: Berman Barbara A. , Kominski Gerald F.
Published: July 2017

Tobacco use, the most preventable cause of death in our society and a growing international epidemic, should be well understood by all students preparing to enter the field of public health. Despite its importance, however, tobacco does not always enjoy the prominence it deserves in public health education. We report here on efforts to expand the focus on tobacco in the University of California Los Angeles School of Public Health through a program supported by the Association of Schools of Public Health/American Legacy Foundation's Scholarship, Training, and Education Program for Tobacco Use Prevention funding mechanism. We describe steps to increase tobacco content in required and elective courses; offer elective courses on tobacco; implement a pre-doctoral scholarship program featuring coursework, fieldwork, and exposure to tobacco issues at national meetings; and establish a tobacco-focused workshop series. We outline program successes, structural barriers to achieving some programmatic goals, and the program's early termination.
Building an Academic Tobacco Control Program While Forging Links with Practice: The University of Washington Tobacco Studies Program
Authors: Savage Sara E. , Halperin Abigail C.
Published: July 2017

Despite the tremendous impact that tobacco use and tobacco smoke exposure have on morbidity, mortality, and health disparities, few schools of public health in the U.S. offer courses of study on tobacco control or make it a priority in their curricula. An academic concentration in tobacco studies and a master's-level scholarship program were developed at the University of Washington School of Public Health and Community Medicine to support and encourage students to pursue tobacco-related coursework, seminars, internships, and thesis work. This article discusses the goals, strategies, and accomplishments of the programs, emphasizing a collaborative approach between the university and state and local health departments, nongovernmental agencies, and research organizations as instrumental to the program's success and ultimate continuation.
The Relationship of Cigars, Marijuana, and Blunts to Adolescent Bidi Use
Authors: Delnevo Cristine D. , Hrywna Mary
Published: July 2017

Objective.

Previous research suggests that bidi, cigar, and marijuana use may be interrelated, but to date, this hypothesis has not been empirically tested.

Methods.

We explored the relationships among use of these products using data from 17,429 youths who completed the 2001 National Household Survey on Drug Abuse. Variables of interest included demographics, tobacco use (i.e., cigarettes, cigars), marijuana use, and blunting (i.e., cigars filled with marijuana). Adjusted odds ratios (AOR) for past-month bidi use were generated for each variable; regression models were also generated separately by race/ethnicity.

Results.

Overall, 1.1% of the youths surveyed reported past month bidi use; higher prevalence was noted for those who were past-month users of cigarettes (4.6%), cigars (7.0%), marijuana (5.8%), and blunts (7.3%). Logistic regression yielded significant odds ratios for all tobacco products, marijuana, and blunts, with the greatest odds associated with past-month cigarette use. Interestingly, the pattern varied notably by race. Among white youth, the greatest odds for past-month bidi use were associated with cigarette use (AOR=3.9), while among black youth the greatest odds were associated with blunting (AOR=9.5).

Conclusion.

The findings demonstrate that the use of cigars and blunts is highly associated with bidi use among youths and these patterns differ by race/ethnicity. Tobacco control efforts that target youths must address other tobacco products and marijuana and should be tailored appropriately and effectively, with consideration of racial, ethnic, and cultural variations.
The Saskatchewan Farm Injury Cohort: Rationale and Methodology
Authors: Pickett William , Day Lesley , Hagel Louise , Brison Robert J. , Marlenga Barbara , Pahwa Punam , Koehncke Niels , Crowe Trever , Snodgrass Phyllis , Dosman James
Published: July 2017

The Saskatchewan Farm Injury Cohort (SFIC) is a major new Canadian study that was developed to evaluate potential causes of injury among farmers and their family members. The cohort involves 2,390 farms and 5,492 farm people being followed over a two-year period. The article describes the rationale and methodology for the baseline and longitudinal components of this study. The SFIC is one of the first studies to apply population health theory to the modeling of risks for injury in a defined Canadian population. In doing so, the relative influence of several potential causes of farm injury, including physical, socioeconomic, and cultural factors, will be estimated. Study findings will inform the content and targeting of injury prevention initiatives specific to the farm occupational environment.
Assessing and Forecasting Population Health: Integrating Knowledge and Beliefs in a Comprehensive Framework
Authors: van Meijgaard Jeroen , Fielding Jonathan E. , Kominski Gerald F.
Published: July 2017

A comprehensive population health-forecasting model has the potential to interject new and valuable information about the future health status of the population based on current conditions, socioeconomic and demographic trends, and potential changes in policies and programs. Our Health Forecasting Model uses a continuous-time microsimulation framework to simulate individuals' lifetime histories by using birth, risk exposures, disease incidence, and death rates to mark changes in the state of the individual. The model generates a reference forecast of future health in California, including details on physical activity, obesity, coronary heart disease, all-cause mortality, and medical expenditures. We use the model to answer specific research questions, inform debate on important policy issues in public health, support community advocacy, and provide analysis on the long-term impact of proposed changes in policies and programs, thus informing stakeholders at all levels and supporting decisions that can improve the health of populations.
Lessons from the Fields: A Migrant HIV Prevention Project
Authors: McCoy H. Virginia , Hlaing WayWay M. , Ergon-Rowe Emma , Samuels Deanne , Malow Robert
Published: July 2017

Migrant and seasonal workers are vulnerable to human immunodeficiency virus (HIV) due to poverty, inadequate knowledge of preventive strategies, and lack of access to health care. This study addresses the disparate impact of HIV among Hispanic and African American migrant workers in Immokalee, Florida, who use alcohol and other drugs. Through pilot testing to adapt the experimental and comparison interventions to these two distinct populations, research staff have learned the importance of (1) establishing and maintaining trust between outreach staff and the migrant community; (2) being aware of cultural nuances and practices that might create challenges to the research process, and the interaction of these factors with poverty; and (3) having flexibility in recruitment and intervention. As one of the first intervention studies in this population to use an experimental design and to focus on the social and contextual factors that contribute to risky behaviors, these lessons may provide guidance for future researchers.
Comparing the National Death Index and the Social Security Administration's Death Master File to Ascertain Death in HIV Surveillance
Authors: Hanna David B. , Pfeiffer Melissa R. , Sackoff Judith E. , Selik Richard M. , Begier Elizabeth M. , Torian Lucia V.
Published: July 2017

Objectives.

New York City (NYC) maintains a population-based registry of people with human immunodeficiency virus (HIV) infection to monitor the epidemic and inform resource allocation. We evaluated record linkages with the National Death Index (NDI) and the Social Security Administration's Death Master File (SSDMF) to find deaths occurring from 2000 through 2004.

Methods.

We linked records from 32,837 people reported with HIV and not previously known to be dead with deaths reported in the NDI and the SSDMF. We calculated the kappa statistic to assess agreement between data sources. We performed subgroup analyses to assess differences within demographic and transmission risk subpopulations. We quantified the benefit of linkages with each data source beyond prior death ascertainment from local vital statistics data.

Results.

We discovered 1,926 (5.87%) deaths, which reduced the HIV prevalence estimate in NYC by 2.03%, from 1.19% to 1.16%. Of these, 458 (23.78%) were identified only from NDI, and 305 (15.84%) only from SSDMF. Agreement in ascertainment between sources was substantial (kappa = [K] 0.74, 95% confidence interval [CI] 0.72, 0.76); agreement was lower among Hispanic people (K=0.65, 95% CI 0.62, 0.69) and people born outside the U.S. (K=0.60, 95% CI 0.52, 0.68). We identified an additional 13.62% of deaths to people reported with HIV in NYC; white people and men who have sex with men were disproportionately likely to be underascertained without these linkages ( p<0.0001).

Conclusion.

Record linkages with national databases are essential for accurate prevalence estimates from disease registries, and the SSDMF is an inexpensive means to supplement linkages with the NDI to maximize death ascertainment.
Comparison of Risk Factors for Recovery of Acinetobacter baumannii during Outbreaks at Two Kentucky Hospitals, 2006
Authors: Beavers Suzanne F. , Blossom David B. , Wiemken Timothy L. , Kawaoka Kelly Y. , Wong Andrew , Goss Linda , McCormick Malkanthie I. , Thoroughman Douglas , Srinivasan Arjun
Published: July 2017

Objectives.

Acinetobacter baumannii ( A. baumannii) is a well-described cause of nosocomial outbreaks and can be highly resistant to antimicrobials. We investigated A. baumannii outbreaks at two Kentucky hospitals to find risk factors for Acinetobacter acquisition in hospitalized patients.

Methods.

We performed case-control studies at both hospitals. We defined a case as a clinical culture growing A. baumannii from a patient from August 1 to October 31, 2006 (Hospital A), or April 1 to October 31, 2006 (Hospital B).

Results.

Twenty-nine cases were identified at Hospital A and 72 cases were identified at Hospital B. The median case patient age was 42 years in Hospital A and 46 years in Hospital B. The majority of positive cultures were from sputum (Hospital A, 51.7%; Hospital B, 62.5%). The majority of case patients had multidrug-resistant A. baumannii (Hospital A, 75.9%; Hospital B, 70.8%). Using logistic regression, controlling for age and admitting location, mechanical ventilation (Hospital A odds ratio [OR] = 21.6; 95% confidence interval [CI] 3.5, 265.9; Hospital B OR=4.5, 95% CI 1.9, 11.1) was associated with A. baumannii recovery. Presence of a nonsurgical wound (OR=6.6, 95% CI 1.2, 50.8) was associated with recovery of A. baumannii at Hospital A.

Conclusions.

We identified similar patient characteristics and risk factors for A. baumannii acquisition at both hospitals. Our findings necessitate the importance of review of infection control procedures related to respiratory therapy and wound care.
Trends in Prevalence of Obesity and Overweight among Children Enrolled in the New York State WIC Program, 2002–2007
Authors: Sekhobo Jackson P. , Edmunds Lynn S. , Reynolds Daniel K. , Dalenius Karen , Sharma Andrea
Published: July 2017

Objectives.

We examined recent overweight and obesity trends in a multiethnic population of low-income preschool children.

Methods.

We defined overweight as sex-specific body mass index (BMI)-for-age ≥85th and <95th percentile and obesity as sex-specific BMI-for-age ≥95th percentile, and calculated them using demographic data and randomly selected height and weight measurements that were recorded while 2- to <5-year-old children were enrolled in the New York State (NYS) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during 2002–2007.

Results.

Obesity prevalence peaked at 16.7% in 2003, declined from 2003 through 2005, and stabilized at 14.7% through 2007. Among both boys and girls, the downward trend in annual prevalence of obesity was evident only among Hispanic children (22.8% boys and 20.9% girls in 2002 vs. 19.3% boys and 17.5% girls in 2007) and non-Hispanic black children (15.6% boys and 14.2% girls in 2002 vs. 13.6% boys and 12.4% girls in 2007). In contrast, the annual prevalence estimate for overweight showed an increasing trend from 2002 through 2007.

Conclusions.

These results showed a slight decline in prevalence of childhood obesity and a continuing rise in prevalence of childhood overweight among children enrolled in the NYS WIC program during 2002–2007. Future research should investigate the extent to which the slight decline in childhood obesity prevalence may be attributable to population-based and high-risk obesity prevention efforts in NYS.
Comparing Lead Poisoning Risk Assessment Methods: Census Block Group Characteristics vs. Zip Codes as Predictors
Authors: Kaplowitz Stan A. , Perlstadt Harry , Post Lori A.
Published: July 2017

Objective.

We determined which children should be tested for elevated blood lead levels (BLLs) in the face of financial and practical barriers to universal screening efforts and within 2009 Centers for Disease Control and Prevention recommendations allowing health departments to develop BLL screening strategies.

Methods.

We used the Michigan database of BLL tests from 1998 through 2005, which contains address, Medicaid eligibility, and race data. Linking addresses to U.S. Census 2000 data by block group provided neighborhood sociodemographic and housing characteristics. To derive an equation predicting BLL, we treated BLL as a continuous variable and used Hierarchical Linear Modeling to estimate the prediction equation.

Results.

Census block groups explained more variance in BLL than tracts and much more than dichotomized zip code risk (which is current pediatric practice). Housing built before 1940, socioeconomic status and racial/ethnic characteristics of the block group, child characteristics, and empirical Bayesian residuals explained more than 41% of the variance in BLL during 1998–2001. By contrast, zip code risk and Medicaid status only explained 15% of the BLL variance. An equation using 1998–2001 BLL data predicted well for BLL tests performed in 2002–2005. While those who received BLL tests had above-average risk, this method produced minimal bias in using the prediction equation for all children.

Conclusions.

Our equation offers better specificity and sensitivity than using dichotomized zip codes and Medicaid status, thereby identifying more high-risk children while also offering substantial cost savings. Our prediction equation can be used with a simple Internet-based program that allows health-care providers to enter minimal information and determine whether a BLL test is recommended.
Access to Antiretroviral Therapy for Adults and Children with HIV Infection in Developing Countries: Horizons Studies, 2002–2008
Authors: Sarna Avina , Kellerman Scott
Published: July 2017

The Access-to-Treatment research initiative of the Population Council's Horizons program undertook 11 projects across Asia and sub-Saharan Africa from 2002 to 2008. The projects included a variety of cross-sectional exploratory studies, situation analyses, and longitudinal randomized, controlled intervention studies that examined service delivery, community awareness, health-seeking behaviors, adherence, cost, and other factors affecting treatment for adults and children infected with human immunodeficiency virus (HIV). This article summarizes the key findings and lessons learned from these projects, and examines cross-cutting issues such as stigma, quality of life, and sexual-risk behaviors among people living with HIV and acquired immunodeficiency syndrome on antiretroviral therapy. The article concludes with recommendations for evidence-based programming and future research around treatment for both children and adults.
Promoting Health and Safety in San Francisco's Chinatown Restaurants: Findings and Lessons Learned from a Pilot Observational Checklist
Authors: Gaydos Megan , Bhatia Rajiv , Morales Alvaro , Lee Pam Tau , Liu Shaw San , Chang Charlotte , Salvatore Alicia L. , Krause Niklas , Minkler Meredith
Published: July 2017

Noncompliance with labor and occupational health and safety laws contributes to economic and health inequities. Environmental health agencies are well positioned to monitor workplace conditions in many industries and support enhanced enforcement by responsible regulatory agencies. In collaboration with university and community partners, the San Francisco Department of Public Health used an observational checklist to assess preventable occupational injury hazards and compliance with employee notification requirements in 106 restaurants in San Francisco's Chinatown. Sixty-five percent of restaurants had not posted required minimum wage, paid sick leave, or workers' compensation notifications; 82% of restaurants lacked fully stocked first-aid kits; 52% lacked antislip mats; 37% lacked adequate ventilation; and 28% lacked adequate lighting. Supported by a larger community-based participatory research process, this pilot project helped to spur additional innovative health department collaborations to promote healthier workplaces.
Institutional Racism and Pregnancy Health: Using Home Mortgage Disclosure Act Data to Develop an Index for Mortgage Discrimination at the Community Level
Authors: Mendez Dara D. , Hogan Vijaya K. , Culhane Jennifer
Published: July 2017

Objectives.

We used Home Mortgage Disclosure Act (HMDA) data to demonstrate a method for constructing a residential redlining index to measure institutional racism at the community level. We examined the application of the index to understand the social context of health inequities by applying the residential redlining index among a cohort of pregnant women in Philadelphia.

Methods.

We used HMDA data from 1999–2004 to create residential redlining indices for each census tract in Philadelphia County, Pennsylvania. We linked the redlining indices to data from a pregnancy cohort study and the 2000 Census. We spatially mapped the levels of redlining for each census tract for this pregnancy cohort and tested the association between residential redlining and other community-level measures of segregation and individual health.

Results.

From 1999–2004, loan applicants in Philadelphia County, Pennsylvania, of black race/ethnicity were almost two times as likely to be denied a mortgage loan compared with applicants who were white (e.g., 1999 odds ratio [OR] = 2.00, 95% confidence interval [CI] 1.63, 2.28; and 2004 OR=2.26, 95% CI 1.98, 2.58). The majority (77.5%) of the pregnancy cohort resided in redlined neighborhoods, and there were significant differences in residence in redlined areas by race/ethnicity ( p<0.001). Among the pregnancy cohort, redlining was associated with residential segregation as measured by the percentage of black population (r=0.155), dissimilarity (r=0.250), exposure (r=–0.115), and isolation (r=0.174) indices.

Conclusions.

The evidence of institutional racism may contribute to our understanding of health disparities. Residential redlining and mortgage discrimination against communities may be a major factor influencing neighborhood structure, composition, development, and wealth attainment. This residential redlining index as a measure for institutional racism can be applied in health research to understand the unique social and neighborhood contexts that contribute to health inequities.
Spatial Visualization of Multivariate Datasets: An Analysis of STD and HIV/AIDS Diagnosis Rates and Socioeconomic Context Using Ring Maps
Authors: Fede Ana Lòpez-De , Stewart John E. , Hardin James W. , Mayfield-Smith Kathy , Sudduth Dawn
Published: July 2017

Objectives.

We used existing data systems to examine sexually transmitted disease (STD) and HIV/AIDS diagnosis rates and explore potential county-level associations between HIV/AIDS diagnosis rates and socioeconomic disadvantage.

Methods.

Using South Carolina county data, we constructed multivariate ring maps to spatially visualize syphilis, gonorrhea, chlamydia, and HIV/AIDS diagnosis rates; gender- and race-specific HIV/AIDS diagnosis rates; and three measures of socioeconomic disadvantage—an unemployment index, a poverty index, and the Townsend index of social deprivation. Statistical analyses were performed to quantitatively assess potential county-level associations between HIV/AIDS diagnosis rates and each of the three indexes of socioeconomic disadvantage.

Results.

Ring maps revealed substantial spatial association in STD and HIV/AIDS diagnosis rates and highlighted large gender and racial disparities in HIV/AIDS across the state. The mean county-level HIV/AIDS diagnosis rate (per 100,000 population) was 24.2 for males vs. 11.2 for females, and 34.8 for African Americans vs. 5.2 for white people. In addition, ring map visualization suggested a county-level association between HIV/AIDS diagnosis rates and socioeconomic disadvantage. Significant positive bivariate relationships were found between HIV/AIDS rate categories and each increase in poverty index category (odds ratio [OR] = 2.03; p=0.006), as well as each increase in Townsend index of social deprivation category (OR=4.98; p<0.001). A multivariate ordered logistic regression model in which all three socioeconomic disadvantage indexes were included showed a significant positive association between HIV/AIDS and Townsend index categories (adjusted OR=6.10; p<0.001).

Conclusions.

Ring maps graphically depicted the spatial coincidence of STD and HIV/AIDS and revealed large gender and racial disparities in HIV/AIDS across South Carolina counties. This spatial visualization method used existing data systems to highlight the importance of social determinants of health in program planning and decision-making processes.
Return of Epidemic Dengue in the United States: Implications for the Public Health Practitioner
Authors: Bouri Nidhi , Sell Tara Kirk , Franco Crystal , Adalja Amesh A. , Henderson D.A. , Hynes Noreen A.
Published: July 2017

Conditions that facilitate sustained dengue transmission exist in the United States, and outbreaks have occurred during the past decade in Texas, Hawaii, and Florida. More outbreaks can also be expected in years to come. To combat dengue, medical and public health practitioners in areas with mosquito vectors that are competent to transmit the virus must be aware of the threat of reemergent dengue, and the need for early reporting and control to reduce the impact of dengue outbreaks. Comprehensive dengue control includes human and vector surveillance, vector management programs, and community engagement efforts. Public health, medical, and vector-control communities must collaborate to prevent and control disease spread. Policy makers should understand the role of mosquito abatement and community engagement in the prevention and control of the disease.
An Explanation for the Recent Increase in the Fall Death Rate among Older Americans: A Subgroup Analysis
Authors: Hu Guoqing , Baker Susan P.
Published: July 2017

Objective.

We sought to explain the recent increase in the death rate from falls among Americans aged 65 years and older.

Methods.

Using the CDC WONDER online database, a longitudinal analysis of subgroups of fall mortality based on the International Classification of Diseases, 10th Revision (ICD-10) was conducted in older adults and in younger people. We used linear regression to examine the statistical significance of trends in mortality rates during 1999–2007.

Results.

The overall mortality rate from falls increased by 55% among older Americans (≥65 years of age) during 1999–2007, from 29 per 100,000 population to 45 per 100,000 population. For those aged ≥65 years, the largest increase by far (698%) occurred in the subgroup “other falls on the same level,” followed by a moderate increase in falls involving wheelchairs or furniture (48%). The steepest increases at all ages occurred from 1999 to 2000, after ICD-10 took effect. State-level analysis confirmed the findings for the entire United States. From 1999 to 2007, total mortality from falls decreased by 5% in people younger than 45 years of age and increased by 44% for those aged 45–64 years; mortality from “other falls on the same level” increased by 202% and 431%, respectively, in these age groups.

Conclusions.

Because the reported minor increases in emergency department and hospitalization rates for falls were insignificant, the almost sevenfold increase in death rates from “other falls on the same level” strongly suggests an effect of improved reporting quality.
Health, Chronic Conditions, and Behavioral Risk Disparities among U.S. Immigrant Children and Adolescents
Authors: Singh Gopal K. , Yu Stella M. , Kogan Michael D.
Published: July 2017

Objective.

We examined differentials in the prevalence of 23 parent-reported health, chronic condition, and behavioral indicators among 91,532 children of immigrant and U.S.-born parents.

Methods.

We used the 2007 National Survey of Children's Health to estimate health differentials among 10 ethnic-nativity groups. Logistic regression yielded adjusted differentials.

Results.

Immigrant children in each racial/ethnic group had a lower prevalence of depression and behavioral problems than native-born children The prevalence of autism varied from 0.3% among immigrant Asian children to 1.3%–1.4% among native-born non-Hispanic white and Hispanic children Immigrant children had a lower prevalence of asthma, attention deficit disorder/attention deficit hyperactivity disorder; developmental delay; learning disability; speech, hearing, and sleep problems; school absence; and ≥1 chronic condition than native-born children, with health risks increasing markedly in relation to mother's duration of residence in the U.S. Immigrant children had a substantially lower exposure to environmental tobacco smoke, with the odds of exposure being 60%–95% lower among immigrant non-Hispanic black, Asian, and Hispanic children compared with native non-Hispanic white children. Obesity prevalence ranged from 7.7% for native-born Asian children to 24.9%–25.1% for immigrant Hispanic and native-born non-Hispanic black children. Immigrant children had higher physical inactivity levels than native-born children; however, inactivity rates declined with each successive generation of immigrants. Immigrant Hispanic children were at increased risk of obesity and sedentary behaviors. Ethnic-nativity differentials in health and behavioral indicators remained marked after covariate adjustment.

Conclusions.

Immigrant patterns in child health and health-risk behaviors vary substantially by ethnicity, generational status, and length of time since immigration Public health programs must target at-risk children of both immigrant and U.S.-born parents.
Enhanced Chronic Hepatitis C Surveillance in New York City, April 2009–January 2011
Authors: Drezner Kate , Bornschlegel Katherine , McGibbon Emily , Balter Sharon
Published: July 2017

Objective.

We analyzed and evaluated enhanced chronic hepatitis C virus (HCV) surveillance in New York City (NYC), which involved detailed investigations on a sample of newly reported HCV patients.

Methods.

Beginning in July 2009, we generated a simple random sample bimonthly from all patients newly reported with a positive HCV test. We administered questionnaires to clinicians and patients to collect clinical and epidemiological information on patients diagnosed from April 2009 to January 2011 and evaluated the staff resources required to conduct enhanced surveillance.

Results.

Of 205 patients meeting inclusion criteria, 40 (19.5%) tested HCV ribonucleic acid (RNA) negative. For the remaining 165 patients, questionnaires were completed by 164 clinicians (99.4%) and 77 patients (46.7%). Many patients (54.0%) were born between 1945 and 1964, and most patients were Hispanic (32.7%) or non-Hispanic black (32.7%). Common risk factors were injection (43.0%) and intranasal (33.9%) drug use. One-third of patients were diagnosed in nontraditional medical settings including substance abuse/detoxification centers (25.0%), jail/prison (6.7%), and psychiatric facilities (1.8%). Of 98 patients with positive HCV RNA tests, 38.8% were immune to hepatitis A and 39.8% were immune to hepatitis B. Investigators required approximately 3.5 hours to complete each investigation and averaged 50 days from assignment to completion.

Conclusions.

Although conducting enhanced HCV surveillance requires significant resources, investigating a representative sample provides detailed information about NYC's HCV population. Surveillance data have been used to plan educational initiatives for clinicians and patients, which may have led to increased awareness of HCV status, improved patient support, and better overall care.
Electronic Health Information Quality Challenges and Interventions to Improve Public Health Surveillance Data and Practice
Authors: Dixon Brian E. , Siegel Jason A. , Oemig Tanya V. , Grannis Shaun J.
Published: July 2017

Objective.

We examined completeness, an attribute of data quality, in the context of electronic laboratory reporting (ELR) of notifiable disease information to public health agencies.

Methods.

We extracted more than seven million ELR messages from multiple clinical information systems in two states We calculated and compared the completeness of various data fields within the messages that were identified to be important to public health reporting processes We compared unaltered, original messages from source systems with similar messages from another state as well as messages enriched by a health information exchange (HIE). Our analysis focused on calculating completeness (i e, the number of nonmissing values) for fields deemed important for inclusion in notifiable disease case reports.

Results.

The completeness of data fields for laboratory transactions varied across clinical information systems and jurisdictions. Fields identifying the patient and test results were usually complete (97%–100%). Fields containing patient demographics, patient contact information, and provider contact information were suboptimal (6%–89%). Transactions enhanced by the HIE were found to be more complete (increases ranged from 2% to 25%) than the original messages.

Conclusion.

ELR data from clinical information systems can be of suboptimal quality. Public health monitoring of data sources and augmentation of ELR message content using HIE services can improve data quality.
Rates of Substance Use of American Indian Students in 8th, 10th, and 12th Grades Living on or near Reservations: Update, 2009–2012
Authors: Stanley Linda R. , Harness Susan D. , Swaim Randall C. , Beauvais Fred
Published: July 2017

Objectives.

Understanding the similarities and differences between substance use rates for American Indian (AI) young people and young people nationally can better inform prevention and treatment efforts. We compared substance use rates for a large sample of AI students living on or near reservations for the years 2009–2012 with national prevalence rates from Monitoring the Future (MTF).

Methods.

We identified and sampled schools on or near AI reservations by region; 1,399 students in sampled schools were administered the American Drug and Alcohol Survey. We computed lifetime, annual, and last-month prevalence measures by grade and compared them with MTF results for the same time period.

Results.

Prevalence rates for AI students were significantly higher than national rates for nearly all substances, especially for 8th graders. Rates of marijuana use were very high, with lifetime use higher than 50% for all grade groups. Other findings of interest included higher binge drinking rates and OxyContin® use for AI students.

Conclusions.

The results from this study demonstrate that adolescent substance use is still a major problem among reservation-based AI adolescent students, especially 8th graders, where prevalence rates were sometimes dramatically higher than MTF rates. Given the high rates of substance use-related problems on reservations, such as academic failure, delinquency, violent criminal behavior, suicidality, and alcohol-related mortality, the costs to members of this population and to society will continue to be much too high until a comprehensive understanding of the root causes of substance use are established.
A response criterion for aircraft with fly-by-wire control systems
Authors: Campbell George S.
Published: July 2017

The use of completely electrical control systems for aircraft (so-called "fly-by-wire" systems) has re quired a complete change in the way of describing boundaries for acceptable response characteristics. Acceptability, for either conventional or fly-by-wire systems, is of course based upon the opinions expres sed by pilots in man-in-the-loop simulation studies and in flight tests. This paper presents boundaries for acceptable response which are based upon man-in- the-loop simulations carried out by McDonnell Doug las3,4 and earlier studies by the Boeing Company.6 The present investigation involves digital simulation of fly-by-wire control systems. The primary result of the study is a two-parameter boundary for accept able response; it could have advantages over the three-parameter boundaries proposed by Kisslinger and Wendl.3