bluuebunny/crossref_metadata_2025 huggingface dataset:
Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in human milk: effects on growth, morbidity, and duration of lactation.
Authors: Rogan W J , Gladen B C , McKinney J D , Carreras N , Hardy P , Thullen J , Tingelstad J , Tully M
Published: November 2008

We followed 858 children from birth to one year of age to determine whether the presence of polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in breast milk affected their growth or health. Neither chemical showed an adverse effect on weight or frequency of physician visits for various illnesses, although differences were seen between breast-fed and bottle-fed children, with bottle-fed children being heavier and having more frequent gastroenteritis and otitis media. Children of mothers with higher levels of DDE were breast-fed for markedly shorter times, but adjustments for possible confounders and biases did not change the findings. In absence of any apparent effect on the health of the children, we speculate that DDE may be interfering with the mother's ability to lactate, possibly because of its estrogenic properties.
Occupational risk of HIV, HBV and HSV-2 infections in health care personnel caring for AIDS patients.
Authors: Kuhls T L , Viker S , Parris N B , Garakian A , Sullivan-Bolyai J , Cherry J D
Published: November 2008

We have prospectively followed for 9-12 months, 246 female health care workers (HCWs): 102 with high exposure (HE), 43 with low exposure (LE), and 101 with no exposure (NE) to AIDS (acquired immunodeficiency syndrome) patients. No HCWs have clinical, serologic, or immunologic evidence of HIV (human immunodeficiency virus) infection. No HCWs in the HE group seroconverted to cytomegalovirus (CMV). One HCW in the HE group seroconverted to Hepatitis B virus (HBV), another HCW in the HE group seroconverted to herpes simplex virus type 2 (HSV-2) although all three groups were similar with respect to HBV and HSV-2 seropositivity. If hospital infection control practices are employed when HCWs care for AIDS patients or work with their biological specimens, the risk of occupationally acquiring a HIV, CMV, HBV or HSV-2 infection appears to be low.
Racial contrasts in hemoglobin levels and dietary patterns related to hematopoiesis in children: the Bogalusa Heart Study.
Authors: Nicklas T A , Frank G C , Webber L S , Zinkgraf S A , Cresanta J L , Gatewood L C , Berenson G S
Published: November 2008

Racial differences in hemoglobin (Hgb) levels were explored in two groups of children at different maturational stages, the pre-adolescent (10-year-olds: Whites n = 160, Blacks n = 56,) and the adolescent (15-year-olds; Whites n = 60, Blacks n = 44). Mean Hgb levels were higher for Whites than Blacks in both age groups. When all the dietary components (i.e., iron, zinc, copper, folacin, ascorbic acid and vitamins B12, E and B6) were considered as a group, they accounted for 8.4 per cent of the Hgb variance in 10-year-olds and 10.1 per cent of variance in 15-year-olds. However, even after controlling for the variations in dietary patterns of the adolescents and pre-adolescents, race still accounted for a notable proportion of Hgb variance in both age groups (9.1 per cent in 10-year-olds and 7.0 per cent in 15-year-olds). Within each race, gender accounted for a greater percentage of the Hgb variance in the adolescents than in the pre-adolescents. Our results indicate that in all likelihood racial differences in Hgb levels during childhood exist independent of racial differences in intake of specific "blood building" nutrients and maturational changes.
Alcohol and body weight in United States adults.
Authors: Williamson D F , Forman M R , Binkin N J , Gentry E M , Remington P L , Trowbridge F L
Published: November 2008

Alcohol contributes more than 10 per cent of the total caloric intake of adult drinkers in the United States. However, the effect of alcohol on body weight has not been adequately studied in the general population. The association between weight and frequency of alcohol consumption was examined in two national cross-sectional surveys: the Second National Health and Nutrition Examination Survey (HANESII; n = 10,929) and the Behavioral Risk Factor Surveys (BRFS; n = 18,388). Linear multiple regression was used to estimate the independent effect of alcohol on weight, adjusting for smoking, age, diet practices, physical activity, race, education, and height. Among men, alcohol had only a slight effect on weight in either survey. However, among women, alcohol was associated with a substantial reduction in weight, which was as large as the effect of smoking. Compared with nondrinkers, women who consumed alcohol 7-13 times per week had the greatest reduction in weight: -3.6 kg (95% confidence limits [CL] = -5.6, -1.5 kg) in HANESII and -3.2 kg (95% CL = -4.9, -1.5 kg) in BRFS. Alcohol confounded the association between smoking and weight, and among women it accounted for nearly 45 per cent of the weight-lowering effect of smoking. Alcohol also diminished the weight-lowering effect of smoking in men, while in women the smoking effect was slightly enhanced. Further studies are needed to understand the causal mechanisms by which alcohol is associated with body weight.
Hospital nurse counseling of patients who smoke.
Authors: Goldstein A O , Hellier A , Fitzgerald S , Stegall T S , Fischer P M
Published: November 2008

Smoking-related diseases comprise a large portion of hospital admissions. This paper reports the attitudes and behaviors of a group of hospital-based nurses toward counseling patients on smoking cessation. The majority of nurses do not counsel patients who smoke. Counseling practices vary with the smoking status of the nurse. Barriers to increased nursing participation in counseling efforts include the lack of counseling training and physician failure to utilize nurses in this role.
Battered and pregnant: a prevalence study.
Authors: Helton A S , McFarlane J , Anderson E T
Published: November 2008

We interviewed 290 pregnant women randomly selected from public and private prenatal clinics, 80 per cent of whom were at least five months pregnant (ages 18-43, 42 per cent Latino, 22 per cent Black). Twenty-four women reported physical battering during this pregnancy (44 reported physical battering before the current pregnancy). Eight of the 24 pregnant women had sought medical treatment for injuries sustained; none reported having been assessed by prenatal care providers for abuse.
Smokers' challenge: immediate and long-term findings of a community smoking cessation contest.
Authors: King A C , Flora J A , Fortmann S P , Taylor C B
Published: November 2008

The present study examined the effectiveness of a community-based smoking contest in helping 500 smokers maintain three months postcontest and one year postcontest abstinence. The majority were chronic smokers with a limited number of previous quit attempts. The three- and 12-month postcontest quit rates were 19 per cent and 15 per cent, respectively, rates exceeding naturally occurring community cessation rates. The contest was found to be more cost-effective than quit smoking classes.
Does switching from cigarettes to pipes or cigars reduce tobacco smoke exposure?
Authors: Ockene J K , Pechacek T F , Vogt T , Svendsen K
Published: November 2008

Cigarette smoking histories, reported depth of inhalation, number of pipe and cigars (PC) smoked, serum thiocyanate (SCN) and expired air carbon monoxide (CO) levels were examined in PC male smokers enrolled in the Multiple Risk Factor Intervention Trial (MRFIT). Serum SCN levels for all PC smokers were higher than for non-smokers and lower than for current cigarette smokers. Levels were related to the amount of product smoke. Prior cigarette smokers had higher SCN levels when compared to PC users who had never smoked cigarettes, smoked a larger number of tobacco products per day, and reported inhaling into the chest more often. Prospective data on baseline cigarette smokers demonstrated that smokers who stopped all tobacco products had a greater drop in SCN and CO than those who switched to PC. The findings strongly suggest that cessation of all tobacco products is the best strategy for decreasing exposure to tobacco smoke.
Contraceptive needs and practices among women attending an inner-city STD clinic.
Authors: Upchurch D M , Farmer M Y , Glasser D , Hook E W
Published: November 2008

To assess the potential need, interest, and benefits of provision of contraceptive services in sexually transmitted disease (STD) clinics, we surveyed 516 women attending an inner-city STD clinic regarding contraceptive and sexual practices, STD prevalence, knowledge of contraceptive-related STD prophylaxis, and interest in contraceptive services within the STD clinic setting. The study population was at high risk for unintended pregnancy and STDs; at time of interview 46 per cent of women were not contracepting and 59 per cent were treated for STD or STD exposure. Two-thirds of women had at least one prior pregnancy and 50 per cent had at least one living child. Only 26 per cent of women knew that some contraceptive methods may reduce the risk of STD acquisition; however, 62 per cent expressed interest in contraceptive methods which would reduce their risk of STD acquisition. This study suggests that provision of contraceptive services in STD clinic settings may address dual needs in a group at high risk for both unintended pregnancy and STD.
Comparison of tests used to distinguish smokers from nonsmokers.
Authors: Jarvis M J , Tunstall-Pedoe H , Feyerabend C , Vesey C , Saloojee Y
Published: November 2008

Questionnaire and biochemical measures of smoking were studied in 211 hospital outpatients. Eleven different tests of smoke intake were compared for their ability to categorize smokers and nonsmokers correctly. The concentration of cotinine, whether measured in plasma, saliva, or urine, was the best indicator of smoking, with sensitivity of 96-97 per cent and specificity of 99-100 per cent. Thiocyanate provided the poorest discrimination. Carbon monoxide measured as blood carboxyhaemoglobin or in expired air gave sensitivity and specificity of about 90 per cent. Sensitivities of the tests were little affected by the presence among the claimed nonsmokers of a group of 21 "deceivers" who concealed their smoking. It is concluded that cotinine is the measure of choice, but for most clinical applications carbon monoxide provides an acceptable degree of discrimination and is considerably cheaper and simpler to apply.
Seat belt use law enforcement and publicity in Elmira, New York: a reminder campaign.
Authors: Williams A F , Preusser D F , Blomberg R D , Lund A K
Published: November 2008

A three-week belt use law publicity and enforcement campaign in Elmira, New York, in November 1985, increased use from 49 per cent to 77 per cent; four months later belt use was 66 per cent. A reminder program, in April 1986, increased belt use to 80 per cent; use declined to 69 per cent four months later and to 60 per cent eight months later. Throughout these periods, belt use in Glens Falls, a comparison community, remained stable at just over 40 per cent.
Impact of a newspaper mediated quit smoking program.
Authors: Cummings K M , Sciandra R , Markello S
Published: November 2008

We present the results of a survey conducted to evaluate the impact of a newspaper mediated smoking cessation program conducted in Buffalo, New York in January 1987. Over half of all smokers surveyed reported exposure to the newspaper series; 13 per cent reported that the series prompted them to try to quit smoking, and 4 per cent stopped smoking for at least one week. We estimate that over 9,600 smokers in Erie County, New York stopped smoking for at least one week as a result of the newspaper's smoking cessation program.
Fatal occupational injuries of women, Texas 1975-84.
Authors: Davis H , Honchar P A , Suarez L
Published: November 2008

A review of Texas death certificates for 1975-84 identified 348 cases of fatal occupational injuries of civilian females. Homicides accounted for 53 per cent and motor vehicle-related injuries accounted for 26 per cent of the deaths. Injuries from firearms caused 70 per cent of the homicides. One hundred thirty-three deaths occurred to women employed in the retail trade industry; of these, 77 per cent resulted from homicide. Women workers in gasoline service stations, food-bakery-and-dairy stores, and eating-and-drinking places had especially high risks of homicide. Texas female heavy-truck drivers had the highest fatal-injury rate, with motor-vehicle-related injuries causing 89 per cent of their deaths. These results indicate that effective strategies to prevent fatal occupational injuries of Texas women will need to address the problems of workplace violence and the hazards posed by motor vehicles.
Hospice in transition: Kentucky 1982-85.
Authors: Bonham G S , Gochman D S , Burgess L
Published: November 2008

The ratio of hospice patients to 100 Kentuckians dying of cancer was 8 in 1982 and 12 in 1985. The primary increase occurred in the number of patients served by three hospices which became Medicare-certified during that time period. During this period, the average age of hospice patients increased, and patients became more likely to die at home. Hospices in some counties may have served about 40 per cent of terminally ill cancer patients.
Women's leadership status in the American Public Health Association.
Authors: Levy J A
Published: November 2008

Content analyses of the official printed programs for the 1973 and 1983 annual meetings of the American Public Health Association were used to compare the proportion of men and women serving as officers of the Association, members of the Executive Board, section representatives to the APHA Governing Council, and officers of section councils. The findings suggest substantial progress for women in gaining access to APHA leadership, despite continued underrepresentation in several of the Association's highest offices.
Depressive symptoms and substance use among adolescent binge eaters and purgers: a defined population study.
Authors: Killen J D , Taylor C B , Telch M J , Robinson T N , Maron D J , Saylor K E
Published: November 2008

We surveyed 646 tenth grade females in Northern California to assess the prevalence of binge eating and purging behaviors. Of these, 10.3 per cent met study criteria for bulimia and an additional 10.4 per cent reported purging behaviors for weight control. Bulimics and purgers were heavier, had greater triceps and subscapular skinfold thicknesses, and reported higher rates of drunkenness, marijuana use, cigarette use, and greater levels of depressive symptomatology.
The cost-effectiveness of three smoking cessation programs.
Authors: Altman D G , Flora J A , Fortmann S P , Farquhar J W
Published: November 2008

This study analyzed the cost-effectiveness and distribution of costs by program stage of three smoking cessation programs: a smoking cessation class; an incentive-based quit smoking contest; and a self-help quit smoking kit. The self-help program had the lowest total cost, lowest per cent quit rate, lowest time requirement for participants, and was the most cost-effective. The most effective program, the smoking cessation class, required the most time from participants, had the highest total cost, and was the least cost-effective. The smoking contest was in-between the other two programs in total costs, per cent quit rate, and cost-effectiveness; it required the same time commitment from participants as the self-help program. These findings are interpreted within the context of community-based intervention in which the argument is made that cost-effectiveness is only one of several factors that should determine the selection of smoking cessation programs.
Human immunodeficiency virus infection in heterosexual intravenous drug users in San Francisco.
Authors: Chaisson R E , Moss A R , Onishi R , Osmond D , Carlson J R
Published: November 2008

To investigate the risk of infection with the human immunodeficiency virus (HIV) in San Francisco, the prevalence of antibodies to HIV was determined in 281 heterosexual intravenous drug users recruited from community-based settings. Ten per cent of subjects had ELISA and Western blot confirmed seropositivity for antibodies (95 per cent CI 6.8-14.2 per cent). Analysis of behavioral factors revealed an increased risk of seropositivity in addicts who reported regularly sharing needles when injecting, particularly those sharing with two or more persons (odds ratio = 5.43; 95 per cent CI 1.08-52.5). Blacks and Latinos also had a greater prevalence of seropositivity than Whites, and this finding persisted after adjustment for needle sharing (adjusted odds ratio = 2.8; 95 per cent CI .84-8.59). Seropositivity was not associated with age, sex, duration of drug use, or history of prostitution. These data indicate that a new epidemic of AIDS (acquired immunodeficiency syndrome) in intravenous drug users, similar to that which has occurred among homosexuals in San Francisco, is possible. The relatively low seroprevalence in 1985 provides health officials an important opportunity to intervene and attempt to prevent widespread infection of drug users with HIV.
Norwalk-like gastroenteritis epidemic in a Toronto hospital.
Authors: Leers W D , Kasupski G , Fralick R , Wartman S , Garcia J , Gary W
Published: November 2008

An epidemic of gastroenteritis in a teaching hospital affected 57 patients and 69 staff over a 26-day period. The index case was a patient admitted with acute abdominal pain and diarrhea two days prior to the outbreak. The epidemic curve indicated person-to-person transmission. The incubation period, duration and types of symptoms were typical of Norwalk gastroenteritis, and Norwalk-like virus particles, serologically different from the prototype Norwalk virus strain, were observed in 17 of 20 fecal specimens examined by immune-electron microscopy.
Progress toward meeting the 1990 nutrition objectives for the nation: nutrition services and data collection in state/territorial health agencies.
Authors: Kaufman M , Heimendinger J , Foerster S , Carroll M A
Published: November 2008

Promoting Health, Preventing Disease, Objectives for the Nation, specifies nutrition as a priority area for improving the health of Americans by 1990. Eleven of the 15 nutrition objectives target adults or the public while four address pregnant and lactating women, infants, and children. To determine progress by states toward achieving the nutrition objectives, the Association of State and Territorial Public Health Nutrition Directors conducted a survey in 1985 to which 54 state and territorial nutrition directors responded. Three-fourths of the nutrition personnel focused efforts on maternal and child populations, and were supported largely by federal funds from the Special Supplemental Food Program for Women, Infants, and Children (WIC) and the Maternal and Child Health Block Grant. Only 15 per cent were funded by state and local sources. While most agencies reported using nutrition consultation in adult health programs, only 25 per cent paid for these personnel. Data to monitor progress were commonly available for only five of the 15 objectives. Achievement of the nutrition objectives by states will require a more comprehensive approach to nutrition programming with increased allocation of appropriate resources and expansion of health data systems.
Counseling medical and dental patients about cigarette smoking: the impact of nicotine gum and chart reminders.
Authors: Cohen S J , Christen A G , Katz B P , Drook C A , Davis B J , Smith D M , Stookey G K
Published: November 2008

To investigate methods for improving and expanding the counseling of smokers by physicians and dentists, we assigned 112 physicians and 50 dentists (in separate studies) to one of the following conditions: the control or advice-only group received a one-hour lecture on the consequences and management of smoking and a booklet detailing a four-step protocol for counseling patients about smoking; three other groups received, in addition, either, protocol reminder stickers placed on their patients' charts; nicotine gum made freely available to their patients; or both chart reminders and nicotine gum. Exit interviews of 1,091 medical and 647 dental patients indicated that the presence of chart reminders and/or the availability of nicotine gum increased the time spent counseling and altered the nature of the smoking cessation counseling provided by both physicians and dentists.
Factors influencing return to work following hospitalization for traumatic injury.
Authors: MacKenzie E J , Shapiro S , Smith R T , Siegel J H , Moody M , Pitt A
Published: November 2008

This paper describes the employment experience of 266 individuals one year after traumatic injury severe enough to require hospitalization. Of those working full-time prior to their injury, 56 per cent were employed full-time at one year; an additional 5 per cent were working part-time. Those sustaining a severe head or spinal cord injury were at highest risk of not returning to work (only 43 per cent and 21 per cent, respectively, had returned within the year). Low one-year employment rates (58 per cent) were also noted for individuals whose most severe injury was to one or more extremities. The extent and rate of return to work was examined in relation to selected socioeconomic and personal characteristics. Findings indicate that after controlling for type and severity of injury, personal income, and educational level of the injured person, as well as the identification of a strong social network as defined by the presence of one or more confidants, were important correlates of post-injury employment status.
Mortality rates among opioid addicts in a longitudinal study.
Authors: Joe G W , Simpson D D
Published: November 2008

Mortality rates and survival curves were estimated for a sample of opioid addicts who had survived to an initial six-year follow-up interview. A total of 52 of the 555 addicts died between the six-year and 12-year follow-up interviews, which corresponds to an average of 13.8 deaths/1,000 person years. This rate is 6.9 times greater than the general population, adjusting for age. Approximately 29 per cent of the deaths were due to violence and 48 per cent to drugs.
Epidemiology of premenstrual symptoms.
Authors: Boyle C A , Berkowitz G S , Kelsey J L
Published: November 2008

We examined the prevalence of selected premenstrual symptoms among 520 Connecticut women in relation to demographic, reproductive, contraceptive, and medical characteristics. The prevalence ranged from 39 per cent for breast swelling to 81 per cent for premenstrual weight gain. Socioeconomic status, race, history of benign breast disease, bra cup size, and history of abortions were some of the factors associated with premenstrual symptoms.
What are the odds that smoking will kill you?
Authors: Mattson M E , Pollack E S , Cullen J W
Published: November 2008

We calculated the long-term risks of death from smoking for individuals of various ages and smoking status in terms of the excess mortality contributed by smoking, over and above the baseline mortality from the same diseases caused by factors other than smoking using standard life table procedures. Since mortality data for specific smoking categories were available only from prospective studies in the late 1950s, we scaled these to the 1982 mortality levels. We assumed, for lung cancer, that the death rates for nonsmokers have not changed and, for other smoking-related diseases, that the risks of death for smokers relative to those for nonsmokers have not changed since the 1950s. Probabilities that result from alternative assumptions were also investigated and are presented. As many as one-third of heavy smokers age 35 will die before age 85 of diseases caused by their smoking. The probabilities of death from smoking when compared with other causes may be persuasive as public education tools. Their effective use for this purpose is affected not only by the deficiencies in the public's factual knowledge of the magnitude of the risks from smoking, but also by numerous apparent misconceptions relating to the interpretation of risk information. Risk data should be presented to the public in a manner that clarifies these misconceptions and facilitates their understanding of the overwhelming risk imposed by smoking.
Associations between smoking and body weight in the US population: analysis of NHANES II.
Authors: Albanes D , Jones D Y , Micozzi M S , Mattson M E
Published: November 2008

Recent recommendations for increases in desirable body weights are based upon studies which did not consider the potential confounding effect of cigarette consumption on body weight. We investigated the relation between tobacco use and several anthropometric measurements in 12,103 men and women 19-74 years of age in the United States examined between 1976 and 1980 during the Second National Health and Nutrition Examination Survey (NHANES II). Cigarette smokers weighed less (mean +/- standard error = 69.8 +/- 0.2 kg) and were leaner (body mass index (weight (kg)/height (m)2) = 24.6 +/- 0.1) than nonsmokers (72.5 +/- 0.2 kg and 25.7 +/- 0.1, respectively), controlling for age and sex. Body leanness increased with the duration (but not intensity) of smoking. Ex-smokers were not heavier or fatter than nonsmokers, and these groups experienced similar weight gain after age 25 (approximately 6 kg in men, 9 kg in women), while current smokers gained substantially less weight (3.5 kg in men, 5.4 kg in women). Compared to nonsmokers, former and current smokers were also slightly taller. Most of these associations were evident in both sexes and all ages evaluated, and were not explained by differences in caloric intake, physical activity, illness, or socioeconomic status. Our findings suggest that the increased mortality observed among lean individuals in previous studies may have been due to smoking rather than leanness per se, and that as a result, currently accepted desirable body weights may be overestimated.
Risk factors for human immunodeficiency virus (HIV) infections in homosexual men.
Authors: Darrow W W , Echenberg D F , Jaffe H W , O'Malley P M , Byers R H , Getchell J P , Curran J W
Published: November 2008

To clarify risk factors for infection with the human immunodeficiency virus (HIV) we selected at random 785 homosexual men who had participated in studies of hepatitis B in San Francisco in 1978-80 for a follow-up study of the acquired immunodeficiency syndrome. Although most had not been contacted in over five years, 492 (63 per cent) were located and enrolled. The 240 (67 per cent) who had developed antibodies to HIV, as measured by an enzyme-linked immunosorbent assay (ELISA), were compared with 119 who had remained seronegative. In multivariate analyses, receptive anal intercourse with ejaculation by nonsteady sexual partners, many sexual partners per month, and other indicators of high levels of sexual activity were highly associated with seroconversions. None of the sexual practices that we studied appeared to offer protection against HIV infection.
Factors associated with low birthweight in an inner-city population: the role of financial problems.
Authors: Binsacca D B , Ellis J , Martin D G , Petitti D B
Published: November 2008

A case-control study of low birthweight among residents of high risk areas of Alameda County was conducted in 1983. The relation of 13 variables to low birthweight was assessed using a multiple logistic regression analysis. A six-fold increase in the risk of low birthweight was found in association with financial problems during the current pregnancy, controlling for differences in race, certain poor health habits, complications of pregnancy, and several other factors between cases and controls.
Persistence of juvenile-onset obesity over eight years: the Bogalusa Heart Study.
Authors: Freedman D S , Shear C L , Burke G L , Srinivasan S R , Webber L S , Harsha D W , Berenson G S
Published: November 2008

The persistence of obesity and overweight over eight years was assessed in a biracial (Black-White) cohort of 1,490 two-to 14-year-olds. Initial levels of triceps skinfold thickness (TRSF) and Rohrer index (weight/height3) were moderately predictive of subsequent levels: r = 0.54 and 0.67, respectively. However, TRSF and Rohrer index tended to track most strongly in Black females (r = 0.64 and 0.72) and less well in both White females (r = 0.45 and 0.57) and preschool children (r = 0.45 and 0.54). Based on elevated levels of TRSF or Rohrer index, children were classified as obese or overweight, respectively. Of the 222 children who were initially above the 85th percentile for TRSF, 43 per cent remained obese after eight years. Persistence of overweight was slightly greater at follow-up, with 50 per cent of initially overweight children staying above the 85th percentile for Rohrer index. Severe, initial obesity/overweight (greater than 95th percentile) and consecutively elevated levels increased the probability of remaining obese/overweight. Results indicate that moderate, juvenile-onset obesity is malleable, but that the child who is extremely obese over consecutive examinations is likely to become an obese adult.
Mortality differentials among persons born in Cuba, Mexico, and Puerto Rico residing in the United States, 1979-81.
Authors: Rosenwaike I
Published: November 2008

This paper examines the mortality experience in 1979-81 of three first generation Hispanic subpopulations in the United States, as defined by area of birth (Cuba, Mexico, Puerto Rico). Numerators were derived from National Center for Health Statistics (NCHS) mortality tapes, which included codes for selected places of birth appearing on the death certificate. Denominators were based on decennial census data for these migrant populations from the 1980 census. Generally, mortality is relatively high among Cuban-born, Mexican-born and Puerto Rican-born adolescents and young adults, particularly males, largely due to violent deaths. Aged migrants, despite their disadvantaged socioeconomic status, exhibit relatively low death rates from heart disease and cancer.
The impact of a parental notification law on adolescent abortion decision-making.
Authors: Blum R W , Resnick M D , Stark T A
Published: November 2008

In 1984, we investigated the impact of a parental notification statue with judicial bypass procedures in Minnesota. Subjects were interviewed on the day of their abortion at four Minnesota and two Wisconsin clinics. Relatively few were aware of the statute in Minnesota. Parental notification rates were similar in Minnesota and Wisconsin, which has no parental notification statute.
Increasing influenza vaccination among high-risk elderly: a randomized controlled trial of a mail cue in an HMO setting.
Authors: Mullooly J P
Published: November 2008

A randomized controlled trial demonstrated that a single mailed influenza vaccination cue increased the vaccination rate among elderly HMO members with high-risk chronic conditions (n = 2217) from 30 per cent to 39 per cent during the fall and winter of 1984/85.
Primary liver cancer mortality and incidence in Texas Mexican Americans, 1969-80.
Authors: Suarez L , Martin J
Published: November 2008

During the years 1969-80, primary liver cancer mortality rates for Mexican American males were 2.2 times higher than for other Whites; Mexican American females had rates 2.8 times higher than other White females. Age-specific mortality rates showed even higher risks for older Mexican Americans exceeding both other White and Black rates three to four-fold. Incidence data for El Paso County (Texas) confirmed the increased risk for Mexican American males (risk ratio = 2.3) and females (risk ratio = 13.7). Cirrhosis mortality was also higher in Texas Mexican Americans but risk ratios were not as large as seen for primary liver cancer.
On changing Indian eligibility for health care.
Authors: Bashshur R , Steeler W , Murphy T
Published: November 2008

We analyzed the ramifications and potential effects of a pending regulation that restricts Indian eligibility for health care. The most serious implication is a dwindling of support for Indian health care while the health of Indians continues to lag behind that of all other groups in the United States. Empirical analysis in one service area of the Indian Health Service (IHS) in Oklahoma reveals Indians of lower blood quantum to be younger, lower utilizers of expensive medical services, especially hospitals. The sudden loss of health care benefits from IHS will be detrimental not only to this population and to an ever increasing number of Indians in the future but also to the local service units in the Indian Health Service.
Impact of growing numbers of the very old on Medicaid expenditures for nursing homes: a multi-state, population-based analysis.
Authors: Ray W A , Federspiel C F , Baugh D K , Dodds S
Published: November 2008

We utilized Medicaid data from five states which account for 39 per cent of Medicaid expenditures to study the impact of the near-trebling of persons age 85 and older (the very old) projected to occur by the year 2012 upon Medicaid nursing home expenditures. We found a one-year prevalence of Medicaid-covered nursing home residence of 20 per 100 among the very old. If this rate continues, with no changes in current levels of Medicaid nursing home payments, and if population forecasts are accurate, increasing numbers of the very old will generate an additional +6.3 billion (1982 dollars) annually of Medicaid nursing home payments by 2012: an increase of 280 per cent from 1982 levels. The stress this trend will place upon societal ability to check growth in public expenditures for medical care while maintaining basic services for other low income populations will be an important force shaping public health policy in the next 25 years.
Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985.
Authors: Lui K J , Kendal A P
Published: November 2008

Baseline levels of mortality in the United States in the absence of influenza epidemics were estimated using cyclical regression models applied to national vital statistics from October 1972 to May 1985. Models were developed by age and by region. Results from 1983 to 1985 are preliminary. More mortality than predicted by the theoretical baseline occurred during nine influenza seasons. Epidemics with high morbidity in children and young adults occurred in 1976/77 and 1978/79. Regional differences in the impact of influenza occurred occasionally. Total influenza-associated excess mortality in six epidemics from the winters of 1972/73 to 1980/81 was about 200,000. About 80-90 per cent of excess mortality occurred in persons over 64 years old.
The initial effects of the prospective payment system on nursing home patients.
Authors: Lewis M A , Leake B , Leal-Sotelo M , Clark V
Published: November 2008

We examined the discharge outcomes and admission characteristics of patients admitted to Southern California skilled nursing facilities (SNFs) for the first time following an episode of hospitalization in 1980, 1982-83 (all pre-prospective payment system), and all admissions during July through September 1984 (post-prospective payment). The proportion of patients covered by Medicare on admission was 18 per cent in 1980, 36 per cent in 1982-83, and 57 per cent in 1984. For patients discharged within 30-60 days to SNFs, in all three time periods more Medicare than non-Medicare patients were bed-bound, had indwelling catheters, and were comatose. There were only modest case-mix differences between the groups and no changes over time in discharge outcomes, including the proportion dying in the SNF, or being returned to a hospital. The time-related changes that were found preceded the implementation of the diagnosis related group (DRG) based prospective payment system.
Prisoners as medical patients.
Authors: Krupp L B , Gelberg E A , Wormser G P
Published: November 2008

Nonpsychiatric and nonobstetrical principal diagnoses of 527 prison inmates discharged in 1981 from one referral hospital were reviewed. Male prisoners had the following discharge diagnoses more frequently than an age-matched and sex-matched sample of the general population: lymphadenopathy, viral hepatitis, foreign body insertion into the gastrointestinal tract, dental caries, and pulmonary tuberculosis. Some differences may be due to lifestyles preceding incarceration, others may result from conditions of the prison environment.
Dentists' consulting behavior and associated knowledge levels.
Authors: Sadowsky D , Kunzel C
Published: November 2008

Telephone interviews with stratified random samples of urban and rural dental general practitioners (GPU, n = 120; GPR, n = 97) and oral surgeons (OS, n = 105) in New York State indicated that requests for expertise, additional data, confirmation of patient's medical status, or medico-legal issues were frequent motives for requesting a consult. Those who consulted more frequently had lower mean knowledge scores than those who consulted less frequently, suggesting that the quality of patient care is potentially improved via the consulting process.
Dental caries in permanent teeth in children of migrant farm workers.
Authors: Call R L , Entwistle B , Swanson T
Published: November 2008

A 1984 study of dental disease in 534 children (aged 6-15) of migrant farm workers in Colorado found that the prevalence of disease for this population continues to exceed the national and regional average. The mean DMFS was 3.56 with only 23 per cent caries free compared to a regional non-migrant DMFS mean of 2.50 with 44.7 per cent caries free. Results indicate that the children of migrant farm workers should remain a priority in preventive and restorative dental care programs.
Occupational disease surveillance data sources, 1985.
Authors: Muldoon J T , Wintermeyer L A , Eure J A , Fuortes L , Merchant J A , Van Lier S F , Richards T B
Published: November 2008

Health department epidemiologists in 50 states, New York City, and the District of Columbia were surveyed in 1985 about seven potential data sources for occupational disease surveillance. Reported sources of occupational disease data were: automated workers' compensation claims (63 per cent of the 52 respondents); provider reports (62 per cent); death certificates with occupation or industry (60 per cent); cancer registries with occupational histories (35 per cent); birth certificates with parent's occupation (27 per cent); non-cancer disease registries (13 per cent); and hospital or insurance records (8 per cent).
Trends in the United States cesarean section rate and reasons for the 1980-85 rise.
Authors: Taffel S M , Placek P J , Liss T
Published: November 2008

The rate of cesarean section delivery in the United States rose from 4.5 per 100 deliveries in 1965 to 22.7 in 1985, and in 1985 an estimated 851,000 live births were cesarean deliveries, according to data from the National Hospital Discharge Survey. This increase has been observed for all ages, and within all regions of the country. The rate for teenagers and mothers aged 20 to 29 was five to six times as high in 1985 as in 1965, and four times as high for mothers aged 30 years and older. Repeat cesareans account for an increasing share of all cesarean deliveries; in 1985 one in three cesareans were repeats. The increase in the cesarean rate of 6.2 percentage points between 1980 and 1985 (from 16.5 to 22.7) was partitioned according to five complications of delivery recorded on hospital discharge records: previous cesarean delivery, breech presentation, dystocia, fetal distress, and all other complications. Nearly half (48 per cent) of the increase was associated with previous cesarean delivery, 29 per cent with dystocia, 16 per cent with fetal distress, 5 per cent with breech presentation, and 2 per cent with all other complications.
The recent revival of breast-feeding in the city of São Paulo, Brazil.
Authors: Monteiro C A , Zũniga H P , Benicio M H , Rea M F , Tudisco E S , Sigulem D M
Published: November 2008

A random sampling of children under age five in Sao Paulo, Brazil, 1984/85, disclosed the median duration of breast-feeding to be 3.5 months and the duration of exclusive breast-feeding, 2.0 months. A comparison of these figures with those of a similar survey carried out in the same city in 1973/74 revealed a substantial increase in both the frequency and duration of breast-feeding. The trend was evident in all socioeconomic strata but most marked among women from higher income and educational levels.
Adjusted hospital death rates: a potential screen for quality of medical care.
Authors: Dubois R W , Brook R H , Rogers W H
Published: November 2008

Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist.
Sudden death in sleep of Laotian-Hmong refugees in Thailand: a case-control study.
Authors: Munger R G
Published: November 2008

A syndrome of sudden and unexpected death during sleep occurs among adult Southeast Asian refugees in the United States. Surveillance for sudden deaths was conducted among Laotian-Hmong refugees in the Ban Vinai refugee camp in northeastern Thailand to determine if a similar cause of death occurs there. Sixteen sudden and unexpected deaths associated with sleep were found that were similar to the sudden deaths noted among Southeast Asian refugees in the United States. A case-control study in Ban Vinai revealed associations between sudden death in sleep and membership in the Green-Hmong subgroup, a family history of sudden death, and previous non-fatal sleep disturbances. Sudden and unexpected death during sleep of young adults is a regional phenomenon within Asia and occurs in populations that are culturally and genetically distinct. Migrants from affected populations in Asia carry with them the susceptibility to sudden death in sleep.
Depressive symptomatology in northern Mexico adults.
Authors: Vega W A , Kolody B , Hough R L , Figueroa G
Published: November 2008

A cross-sectional field survey of 991 people in Tijuana, Mexico, a border city experiencing unbridled population growth, was designed to measure levels of depressive symptoms and identify correlates using the Center for Epidemiological Studies Depression measure (CES-D). Bivariate and multivariate analyses of the data indicate that similar variables are highly associated with depressive symptoms in the US and Mexico: low socioeconomic status, female gender, disrupted marital status, unemployment, and poor health. Risk-for-caseness is 19.1 per cent for males and 33.0 per cent for females.
A measles outbreak at university medical settings involving health care providers.
Authors: Sienko D G , Friedman C , McGee H B , Allen M J , Simonsen W F , Wentworth B B , Shope T C , Orenstein W A
Published: November 2008

In 1985, a measles outbreak involved 14 students and non-student contacts in Michigan. Eight transmissions occurred at university medical facilities; five of these were likely airborne transmissions. Medical students and a medical resident were involved in the outbreak's propagation. Health care providers need to be immune to measles. Measles should be suspected in young adults with compatible illnesses; persons suspected to have measles should be placed in stringent respiratory isolation to preclude airborne transmission.
Lead exposure in a firing range.
Authors: Novotny T , Cook M , Hughes J , Lee S A
Published: November 2008

We report lead exposure in four employees of a privately owned shooting range, one of whom had neurological toxicity due to lead. Increasing time worked at the range was associated with elevation of blood lead. This incident emphasizes the risk of airborne lead exposure to employees of firing ranges.
Lower respiratory tract illness in the first two years of life: epidemiologic patterns and costs in a suburban pediatric practice.
Authors: McConnochie K M , Hall C B , Barker W H
Published: November 2008

The epidemiologic patterns and the economic impact of acute lower respiratory tract illness (LRTI) in children under age two were studied using data collected from November 1, 1971-August 30, 1975 in a suburban pediatric practice in Monroe County, New York. LRTI was responsible for 23 illness episodes per 100 child-years among children in their first two years of life. This indicates that a cohort of 100 children might be anticipated to have 46 LRTI episodes from birth until their second birthday. The majority of episodes correlated with the presence of four viruses in the community, most commonly respiratory syncytial virus. The minimal, estimated direct cost of LRTI in the first two years of life based on 1984 cost data was equivalent to $35.14 for every child and was comprised of hospitalization cost ($19.68) and ambulatory care cost ($15.46). Hospitalization costs attributable to LRTI comprised at least 2.5 per cent of all hospitalization costs in this age group. Immunization against the four most common respiratory viruses, at a reasonable cost per child immunized, would appear to be cost beneficial.
Problems associated with collecting drinking water quality data for community studies: a case example, Fresno County, California.
Authors: Whorton M D , Morgan R W , Wong O , Larson S , Gordon N
Published: November 2008

This paper discusses methodology in developing exposure data for the water supply contaminant dibromochloropropane (DBCP) in Fresno County, California. There are 532 drinking water systems (49 large and 483 small) within Fresno County plus 14,000 private wells. We determined the number of wells per system, the output per well, and the population served by each system. The task of deriving water quality estimates for each census tract was complicated by the fact that a single census tract can be served by more than one system; each system usually has more than one well; and a single well can have several episodes of testing for various contaminants. We calculated a series of weighted averages for concentrations of DBCP, arsenic, and nitrates for each census tract, using water production figures for each well as the weighting factor. Water quality data were derived from a total of 14,861 laboratory reports, although the majority did not report on all contaminants. Mean DBCP levels ranged from 0.0041 ppb to 5.7543 ppb among the census tracts. We found no correlation between DBCP levels per census tract compared to either arsenic or nitrates. We believe that we made as complete an exposure assessment as practically feasible.
Minorities and AIDS: knowledge, attitudes, and misconceptions among black and Latino adolescents.
Authors: DiClemente R J , Boyer C B , Morales E S
Published: November 2008

White adolescents in San Francisco high schools were more knowledgeable than Black adolescents about the cause, transmission, and prevention of AIDS (acquired immunodeficiency syndrome), and Black adolescents were more knowledgeable than their Latino peers. Black and Latino adolescents were approximately twice as likely as White adolescents to have misconceptions about the casual transmission of AIDS. Less knowledge about AIDS and prevalent misconceptions were associated with greater levels of perceived risk of contracting AIDS.