bluuebunny/crossref_metadata_2025 huggingface dataset:
Geographic variations in elderly hospital and surgical discharge rates, New York State.
Authors: Pasley B , Vernon P , Gibson G , McCauley M , Andoh J
Published: November 2008

Hospital and surgical discharges for 1981, as recorded by the uniform hospital discharge data of New York State, were aggregated by county of residence and converted into age-sex adjusted rates. Elderly hospital discharge and surgery rates in New York State, 1981, varied 2.4- and 2-fold, respectively. Discharge rates of elderly with specific surgical procedures showed even greater variation. However, proportions of highly complex and non-elective procedures performed on the elderly were similar in counties with high and low surgical rates. A multiple regression model consisting of independent dimensions of county demographic and medical resources characteristics plus a proxy variable for surgical practice styles was applied to hospital and surgery rates. Variations in elderly surgical discharge rates were found to be related to the supply of medical resources and to surgical practice styles.
The San Francisco Men's Health Study: III. Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982-86.
Authors: Winkelstein W , Samuel M , Padian N S , Wiley J A , Lang W , Anderson R E , Levy J A
Published: November 2008

The prevalence and incidence of infection by the human immunodeficiency virus (HIV) has been under study in a cohort of 1,034 single men recruited by area probability sampling from a six kilometer square area of San Francisco where the epidemic of acquired immunodeficiency syndrome (AIDS) has been most severe. Prevalence of infection among homosexual/bisexual study subjects increased from an estimated 22.8 per cent during the last half of 1982 to 48.6 per cent during the period July through December 1984. During three subsequent six-month periods, prevalence remained stable at approximately 50 per cent. Annual infection rates, measured by seroconversion among seronegative study subjects, decreased from an estimated 18.4 per cent per year from 1982 to 1984, to 5.4 and 3.1 per cent during the first and second halves of 1985, and to 4.2 per cent during the first six months of 1986. These declines were associated with reductions of 60 per cent or more in the prevalence of high-risk sexual practices associated with both acquiring and disseminating infection by the human immunodeficiency virus.
The impact of neuroleptic medication on tardive dyskinesia: a meta-analysis of published studies.
Authors: Morgenstern H , Glazer W M , Niedzwiecki D , Nourjah P
Published: November 2008

To quantify the impact of chronic exposure to neuroleptic medication on the occurrence of tardive dyskinesia (TD), we conducted a meta-analysis of data collected from 21 studies published between 1966 and 1985. The observed prevalence of dyskinesia was greater among exposed subjects in all 21 studies; we estimate that, on the average, the occurrence rate was 2.9 times greater in exposed persons than would be expected if they had been unexposed. We estimate that 65 per cent of exposed cases and 51 per cent of all cases in these investigations were caused by long-term neuroleptic exposure. Among adult United States residents in 1980, we estimate that there were approximately 193,000 neuroleptic-induced TD cases of which about 60 per cent occurred in outpatients. We also observed substantial heterogeneity of effect (rate ratio) across studies, however, partially explained, by changes and differences in the rate of dyskinesia, by differences in the frequency of certain effect modifiers, and by differences in diagnostic methods. Methodologic limitations of the studies and their possible effects on our results are discussed.
CPR training for patients' families: do physicians recommend it?
Authors: Mandel L P , Cobb L A , Weaver W D
Published: November 2008

All Seattle-area cardiologists and 25 per cent of selected other physicians were queried by mail to determine whether they recommended CPR (cardiopulmonary resuscitation) training for families of their patients. Two-thirds reported that they advocated training for some patients' families, but only 52 per cent of cardiologists and 37 per cent of the others did so for families of at least half of the patients considered at risk. Physicians who had performed out-of-hospital CPR or had received advanced or recent training were more likely to recommend instruction.
Hospitalizations for AIDS, United States, 1984-85.
Authors: Graves E J , Moien M
Published: November 2008

Data from the National Hospital Discharge Survey on hospitalizations for acquired immunodeficiency syndrome (AIDS) were analyzed for 1984-85. During 1984, an estimated 10,000 discharges from short-stay hospitals had a diagnosis of AIDS. In 1985, this figure more than doubled to 23,000. Ninety-seven percent of all AIDS discharges were male and 85 per cent were between the ages of 25 and 44. Hospitalizations for AIDS accounted for 510,000 days of hospital care and lasted an average of 15.6 days each.
Stigmatization of AIDS patients by physicians.
Authors: Kelly J A , St Lawrence J S , Smith S , Hood H V , Cook D J
Published: November 2008

A randomly selected sample of physicians in three large cities was asked to read one of four vignettes describing a patient. They then completed a set of objective attitude measures eliciting their reactions to the patient described in the vignette. The vignettes were identical except that the patient's illness was identified as either acquired immunodeficiency syndrome (AIDS) or leukemia and the patient's sexual preference as either heterosexual or homosexual. Harsh attitude judgements were associated with the AIDS portrayals, as well as much less willingness to interact even in routine conversation when the patient's illness was identified as AIDS. Increasing numbers of AIDS patients will be seeking medical attention from physicians in all areas of the country and it will be important for health care professions to develop programs which counter unreasonable stigma and prejudicial attitudes that may be associated with this illness.
AIDS-related competence of California's primary care physicians.
Authors: Lewis C E , Freeman H E , Corey C R
Published: November 2008

We conducted a telephone survey of a random sample of primary care physicians practicing throughout the State of California to determine their AIDS-related experiences and competencies. Interviews were completed early in 1986 with 1,000 family and general practitioners and internists, 60 per cent of those eligible. Data on practice experiences reflect the increased incidence of AIDS (acquired immunodeficiency syndrome) in Los Angeles and San Francisco. The proportion of practitioners in rural areas who evaluated possible cases (17 per cent), and counseled patients at risk (50 per cent) indicated the generalized nature of the problem. Compared to similar data obtained in 1984, levels of competency in diagnosing and counseling persons with AIDS-related disorders increased in Los Angeles. However, on a statewide basis, a majority of those interviewed lack the AIDS-related knowledge and skills required to carry out their roles in dealing with AIDS. Competency was associated with physicians' personal and professional characteristics and their level of discomfort in dealing with homosexuals.
Preventive care: do we practice what we preach?
Authors: Lurie N , Manning W G , Peterson C , Goldberg G A , Phelps C A , Lillard L
Published: November 2008

We used insurance claims from enrollees in the Rand Health Insurance Experiment to determine the amount of selected components of preventive care received by a representative sample of the non-aged population in the United States and to determine whether insurance coverage was an important determinant of that amount. Only 45 percent of infants received timely immunization for DPT and polio; 93 per cent received some well child care by 18 months of age. In the three-year experimental period, only 4 per cent of adults had a tetanus shot, 66 per cent of women aged 17-44 and 57 per cent aged 45-65 received a Pap smear, and 2 per cent of women aged 45-65 had a mammogram. Cost sharing was associated with even less preventive care: 60 per cent of children on the free plan and 49 per cent on cost sharing plans received preventive care of any type. For adults, women on the free plan received more preventive care of several kinds, and those aged 45-65 received more Pap smears than those on cost-sharing plans. Even with free care, most enrollees did not receive adequate preventive care. Thus, free care alone, while significant, is not a sufficient incentive to providing recommended levels of preventive care. The average per person insurance charge for increasing the amount of preventive care to a level consistent with that recommended would be $22 for a complete set of immunizations by age 18 months, $9 for a Pap smear every three years, and $97 for a Pap test and mammogram every three years.
Evaluation of a minimal-contact smoking cessation intervention in an outpatient setting.
Authors: Janz N K , Becker M H , Kirscht J P , Eraker S A , Billi J E , Woolliscroft J O
Published: November 2008

We examined the ability of a provider-initiated, minimal-contact intervention to modify the smoking behavior of ambulatory clinic patients. Smokers at two outpatient sites were assigned to one of three groups: provider intervention only (PI); provider intervention plus self-help manual (PI/M); and usual care (control) group (C). The physician message emphasized the patient's personal susceptibility, the physician's concern, and the patient's ability to quit (self-efficacy). The nurse consultation concentrated on benefits and barriers associated with stopping, and on strategies for cessation. Telephone interviews were conducted with the 250 participants within a few days of their clinic visit and again at one and six months. Both PI and PI/M proved to be superior to usual care in motivating attempts to quit at both one-month and six-month follow-ups, and logistic regression analyses indicated that participants receiving the self-help manual in addition to the health provider message were between two and three times more likely to quit smoking during the study period than were participants in either of the other study groups.
Head injury with and without hospital admission: comparisons of incidence and short-term disability.
Authors: Fife D
Published: November 2008

All persons with head injuries (skull fracture or injury to the cranial contents resulting in a physician visit or at least one day of disability), regardless of treatment or hospital admission status, were identified from National Health Interview Survey data for the years 1977-81. Among those who reported such head injuries within the two weeks prior to interview, only 16 per cent were admitted to hospitals. Children, members of low-income families, and those injured at home, school, or in a recreational setting were less likely to be admitted to hospital than others. Among those who sustained a head injury in the previous three months and had some disability from that injury during the two weeks prior to interview, those not admitted to hospital included one-half of those with three to seven days of bed disability and one-third of those with more than seven days of bed disability; and they accounted for one-half of all disability days. These findings indicate that hospital-based head injury incidence data are incomplete and may contain substantial biases.
WIC prenatal participation and its relation to pregnancy outcomes in Missouri: a second look.
Authors: Stockbauer J W
Published: November 2008

We studied the association of WIC prenatal supplementation with pregnancy outcome using Missouri WIC participants who delivered in 1982 linked with their offspring's birth/fetal death certificates. A 93 per cent match rate resulted in a final study population of 9,411 pregnancies. A control population of like number was acquired by matching on key demographic characteristics. The majority of the results generally confirm the results of a 1980 Missouri study; WIC participation was associated with decreases in low birthweight (7.8 vs 9.2 per cent), prematurity (9.7 vs 12.0 per cent) and inadequate prenatal care (30.5 vs 31.7 per cent), and an increase in mean gestational age (39.9 vs 39.6 weeks). Low birthweight rates were lower for infants of WIC participants in each of the risk categories reviewed. As noted in the 1980 study, duration of WIC of at least seven months was needed before improvements in birthweight outcomes measures were noted.
Smoking during pregnancy, 1967-80.
Authors: Kleinman J C , Kopstein A
Published: November 2008

Data from two national samples of live births to married mothers (the 1967 and 1980 National Natality Surveys) were used to document changes in smoking during pregnancy. Smoking among married teenagers remained essentially constant between 1967 and 1980. For married mothers age 20 and over, the prevalence of smoking during pregnancy decreased from 40 to 25 per cent among Whites and 33 to 23 per cent among Blacks. There were striking differences in the magnitude of the decrease by educational attainment. Among the White married mothers age 20 and over, the prevalence of smoking during pregnancy decreased from 48 to 43 per cent for those with less than 12 years education and from 34 to 11 per cent for those with 16 or more years education.
Predicting charges for inpatient medical rehabilitation using severity, DRG, age, and function.
Authors: McGinnis G E , Osberg J S , DeJong G , Seward M L , Branch L G
Published: November 2008

We examined the effectiveness of using diagnosis related groups (DRGs), Severity of Illness Index (SII), age and function at admission to predict inpatient charges for medical rehabilitation. Data from our sample of 199 indicate that DRGs alone explained approximately 12 per cent of the variation in charges for inpatient rehabilitation while SII explained 26 per cent of the variation. SII, DRG, and age together yielded the highest regression coefficient, accounting for nearly 39 per cent of the variation in total charges; SII and age accounted for 36 per cent of the variation. Within DRG categories, SII was the only important predictor of inpatient charges accounting for 23 per cent of the variation in charges among stroke patients (DRG 014) and 28 per cent of the variation in charges among hip fracture patients (DRG 210). Function at admission was not a useful predictor of inpatient rehabilitation charges within DRGs. These results suggest that SII and age may be useful in developing a DRG-based prospective payment system for inpatient medical rehabilitation.
Drowning in childhood and adolescence: a population-based study.
Authors: Wintemute G J , Kraus J F , Teret S P , Wright M
Published: November 2008

We present the results of a residence-based study of drownings among Sacramento County, California children and adolescents ages 0-19 years for the years 1974-84. Children ages 1-3 had the highest drowning rates. The majority of drownings in this group, and one-third of all drownings in the study, occurred in residential swimming pools. Males ages 15-19 had a high drowning rate as well; at least 38 per cent of drownings in that age group were alcohol-associated. The implications for preventive efforts are discussed.
Reproductive mortality in the United States: recent trends and methodologic considerations.
Authors: Rosenberg M J , Rosenthal S M
Published: November 2008

Between 1975 and 1982, the annual number of deaths attributable to pregnancy and childbirth, induced abortion, and contraception in the United States declined from 1,083 to 751. The mortality rates for each of these components decreased by 35,89, and 35 per cent, respectively, and the overall reproductive mortality rate dropped by 35 per cent. The death rate due to pregnancy and childbirth is 25 times greater than that due to induced abortion and eight times more than that to contraceptive-associated mortality. In 1982 nearly 30 million women used contraceptives, while slightly fewer than four million women were pregnant to term. The decrease in contraceptive-associated mortality between 1975 and 1982 probably reflects a combination of safer contraceptives, fewer women using contraceptive methods that may not be safest for them, and an increasing number of sterilizations, which remove women from the group at highest risk of contraceptive-related mortality. Maternal mortality appears to be slowing its rate of decline, while induced abortion mortality has been very low since the legalization of abortion.
A methodology for identifying workers exposed to asbestos since 1940.
Authors: Stanbury M , Rosenman K D
Published: November 2008

This paper describes a method to identify individual workplaces and to determine the number of employees at those workplaces who have had substantial exposure to asbestos. A total of 486,400 individuals are estimated to have had substantial exposure to asbestos in New Jersey since the start of World War II, including 102,700 individuals from 16 manufacturing plants, 376,200 from eight shipyards, and 7,500 insulators.
Relationship of participation in food assistance programs to the nutritional quality of diets.
Authors: Emmons L
Published: November 2008

This study describes the participation of 76 low-income families in six food assistance programs, and analyzes their diets using 24-hour recalls collected weekly during one month. Larger families participated in more food assistance programs than smaller families but did not have diets with higher nutrient content. Although 71 per cent of the families participated in more than the Food Stamp Program (FSP), many did not consume nutrients supposedly available with the FSP alone.
Disease surveillance and emergency services at the 1982 World's Fair.
Authors: Gustafson T L , Booth A L , Fricker R S , Cureton E , Fowinkle E W , Hutcheson R H , Schaffner W
Published: November 2008

We designed a special surveillance system to detect health complaints of visitors to the 1982 World's Fair. Heat-related illness occurred during the first month of the Fair but was substantially reduced by public education, environmental modification, and provision of additional water fountains. There was no disruption of emergency health services in the communities surrounding the Fair. Advance planning and the provision of on-site medical services can minimize the public health impact of large gatherings.
Measles hospitalizations, United States, 1977-84: comparison with national surveillance data.
Authors: Markowitz L E , Tomasi A , Sirotkin B I , Carr R W , Davis R M , Preblud S R , Orenstein W A
Published: November 2008

Trends in measles discharges from hospitals participating in the Commission on Professional and Hospital Activities, Professional Activities Study (CPHA-PAS) from 1977 to 1984 reflected the rapid decline in measles morbidity indicated by national surveillance data with an 88 per cent decrease in hospitalizations and a 95 per cent decrease in reported cases from 1977 to 1984. Overall trends in number, age, and seasonal distribution were also generally similar. Thirty-four per cent of the hospitalizations listed respiratory complications, 8.5 per cent otitis media, and 3.4 per cent neurologic complications.
Neonatal mortality in Missouri home births, 1978-84.
Authors: Schramm W F , Barnes D E , Bakewell J M
Published: November 2008

A study was conducted of 4,054 Missouri home births occurring from 1978 through 1984. Of the 3,645 births whose planning status was identified, 3,067 (84 per cent) were planned to be at home. Neonatal mortality was elevated for both planned (17 observed deaths vs 8.59 expected deaths) and unplanned home births (45 observed vs 33.19 expected) compared with physician-attended hospital births. Nearly all of the mortality excess for planned home births occurred in association with lesser trained attendants (12 observed vs 4.42 expected), while for unplanned home births the excess was entirely among infants weighing 1500 grams or more (19 observed vs 3.50 expected). For planned home births attended by physicians, certified nurse-midwives, or Missouri Midwife Association recognized midwives, there was little difference between observed and expected deaths (5 observed vs 3.92 expected). There also was little difference in deaths for unplanned home births weighing less than 1500 grams (26 observed vs 29.69 expected) compared with hospital births. The study provides evidence of the importance of having skilled attendants present at planned home births.
Diphtheria-tetanus-pertussis immunization and sudden infant death syndrome.
Authors: Walker A M , Jick H , Perera D R , Thompson R S , Knauss T A
Published: November 2008

We compared the recency of diphtheria-tetanus-pertussis (DTP) immunization in healthy children with birthweights greater than 2500 gms who died of sudden infant death syndrome (SIDS) to that of age-matched reference children, using a modified case-control analysis. Focusing on very narrow time intervals following immunization, we found the SIDS mortality rate in the period zero to three days following DTP to be 7.3 times that in the period beginning 30 days after immunization (95 per cent confidence interval, 1.7 to 31). The mortality rate of non-immunized infants was 6.5 times that of immunized infants of the same age (95 per cent CI, 2.2 to 19). The latter result and to some extent the former appear to be ascribable to known risk factors for SIDS. Although the mortality ratios for SIDS following DTP, as estimated from this study, are high the period of apparently elevated risk was very short, so that only a small proportion of SIDS cases in infants with birthweights greater than 2500 gms could be associated with DTP.
Prevalence of dental caries and periodontal disease in Mexican American children aged 5 to 17 years: results from southwestern HHANES, 1982-83. National Health and Nutrition Examination Survey.
Authors: Ismail A L , Burt B A , Brunelle J A
Published: November 2008

This paper describes the estimated prevalence of dental caries and periodontal disease in 2,550 children, 5 through 17 years of age, who resided in five southwestern states of the United States and were examined in the Hispanic Health and Nutrition Examination Survey (HHANES) of 1982-84 of the National Center for Health Statistics. Dental caries in the Mexican American children was predominantly a disease of occlusal surfaces of molars; few smooth surfaces of posterior and anterior teeth were affected by caries. This intra-oral distribution of dental caries strongly supports the use of fissure sealants as a preventive procedure. Filled tooth surfaces contributed about 66 per cent of the total DMFS (decayed, missing, filled surfaces) scores. The analysis also shows that about 50 per cent of the 17 year old Mexican Americans had five or more filled or decayed teeth. Mild gingivitis was prevalent (76.9 per cent) in the Mexican American children.
The accuracy of health risk appraisal in predicting mortality.
Authors: Foxman B , Edington D W
Published: November 2008

In order to determine the accuracy of the Centers for Disease Control/Health Risk Appraisal (CDC/HRA) program, the authors compared observed to predicted mortality for the 3,135 persons followed from 1959-79 as part of the Tecumseh Community Health Study. The analysis was limited to smokers and never-smokers aged 25-60 whose 1959 questionnaires included at least the minimal variables for prediction using the CDC/HRA (age, sex, race, height, weight, and smoking habits). For men and women overall and in each age group, the observed proportion dying over 20 years of follow-up increased as the difference between 1959 age and risk age increased. CDC/HRA predicted 10-year risks of mortality appeared to improve upon age-sex-race predicted risks of mortality when compared to the observed proportion dying over 10 years and when predictors were used in a logistic regression model with vital status after 10 years as the dependent variable. Thus, CDC/HRA may be an appropriate method for identifying high-risk populations for health interventions.
Contraceptive and fertility behavior of family planning clinic dropouts: a Maryland study.
Authors: Chow L P , Rider R V , Su S I , Hou W I
Published: November 2008

A study to examine the acceptance of and drop-out from family planning clinic services in Maryland was undertaken during 1984-85 by interviewing a random sample of 1,020 women who came to the clinics as "new clients" during 1980 through 1982 when they were 20 through 39 years of age. This article examines the contraceptive and fertility behavior after their last clinic visits. The results showed that most of these women were "protected" from pregnancy risk considerably beyond their last clinic visit. However, the analysis also revealed that in spite of the reported high contraceptive use rate, unplanned pregnancies occurred after the client's last clinic visit, suggesting that contraceptive use was either inconsistent or ineffective. These findings suggest that instead of allocating a large proportion of resources to follow-up acceptors to bring the "drop-outs" back to the clinics, a more effective program strategy would be to systematically and effectively educate and counsel the clients during their clinic attendance, especially during their first clinic visit.
Elective foot surgery: relative roles of doctors of podiatric medicine and orthopedic surgeons.
Authors: Weiner J P , Steinwachs D M , Frank R G , Schwartz K J
Published: November 2008

We examined the roles of Doctors of Podiatric Medicine (DPMs) and orthopedic surgeons in the provision of foot surgery by analyzing the 1982 computerized claims of over 1.1 million federal employees, retirees, and family members. We found that DPMs provided over 60 per cent of all elective insured foot surgery. Without being able to adjust for the severity of the patient's underlying condition or the appropriateness and outcome of the surgery, the average per procedure charge submitted by an orthopedist was 17 per cent higher than that of a DPM; orthopedists were five times as likely to perform a procedure on an inpatient basis, and admitted patients to a hospital had longer stays; DPMs perform a greater number of procedures per episode, but their overall charges during the average foot surgery episode were 30 per cent lower, primarily because of their lower hospitalization rates. The possible impact of recent changes in health care delivery on the DPM/orthopedist practice comparison are discussed as are several questions regarding the quality and need of the care provided by these two groups.
The relation of body weight to length of stay and charges for hospital services for patients undergoing elective surgery: a study of two procedures.
Authors: Epstein A M , Read J L , Hoefer M
Published: November 2008

We studied the relation of body weight to lengths of stay and total charges for all patients hospitalized at the Brigham and Women's Hospital for total knee replacement and total hip replacement during a 12-month period. Patients with moderate obesity (actual body weight 141-170 per cent of ideal) had lengths of stay and total charges similar to normal weight patients (body weight 100-110 per cent ideal). However, patients who were extremely overweight (body weight greater than or equal to 188 per cent ideal) had mean lengths of stay 35 per cent longer (28.9 days vs 21.5) and total charges 30 per cent higher ($25,692 vs $19,576) than patients with normal weight. Those who were extremely underweight (body weight less than or equal to 75 per cent ideal) had mean lengths of stay 40 per cent longer (30.1 days vs 21.5) and total charges 35 per cent higher ($26,447 vs $19,576).
Prevalence of hepatitis B serologic markers in community hospital personnel.
Authors: McLean A A , Monahan G R , Finkelstein D M
Published: November 2008

The seroprevalence of hepatitis B markers among predominantly high-risk staff members and personnel of 31 community hospitals located throughout the United States was 8.4 per cent (greater than or equal to 5 per cent in 25 hospitals and greater than or equal to 10 per cent in 13 hospitals). Only two hospitals had seroprevalence rates less than or equal to 3 per cent. The institutional seroprevalence ranged from 0 per cent to 16.7 per cent, with a median of 8.2 per cent. Although there are limitations to this survey, the results suggest that the well established increased risk of contracting HBV infection among certain groups of health-care workers in urban teaching medical centers may also hold true for personnel in similar occupational and professional categories in community hospitals.
The economic costs of Alzheimer's disease.
Authors: Hay J W , Ernst R L
Published: November 2008

This paper estimates the economic costs of Alzheimer's Disease to individuals and to society, based on review of published Alzheimer's Disease-related research. The analysis is derived from epidemiological projections and cost information for the United States population in 1983. Estimated costs include both direct medical care and social support costs, as well as indirect costs, such as support services provided by family or volunteers, and the value of lost economic productivity in Alzheimer's Disease patients. Mid-range estimates of net annual expected costs for an Alzheimer's Disease patient, excluding the value of lost productivity, are $18,517 in the first year and $17,643 in subsequent years, with direct medical and social services comprising about half of these costs. Under base case assumptions, the total cost of disease per patient in 1983, was $48,544 to $493,277, depending upon patient's age at disease onset. The estimated present value of total net costs to society for all persons first diagnosed with Alzheimer's Disease in 1983 was $27.9-31.2 billion. Development of a public or private insurance market for the economic burdens of Alzheimer's Disease would fill some of the gaps in the current US system of financing long-term chronic disease care.
Continuance of elderly on home-delivered meals programs.
Authors: Frongillo E A , Williamson D F , Roe D A , Scholes J E
Published: November 2008

Data from 2,002 elderly receiving home-delivered meals in 23 counties of New York State in 1984-85 were analyzed using a baseline survey and a six-month follow-up survey. Survival analysis estimated that 37.4 per cent of the clients left the program by the follow-up. The initial drop-out rate was estimated to be 14.2 per cent per month; by six months the rate fell to 3.3 per cent. Whites left the program at a rate 2.6 times (95% CI = 1.9, 3.8) that of minorities. Recent discharge from hospital was associated with the highest relative probability of program discontinuance (2.7, 95% CI = 2.2, 3.4), followed by having cancer (2.1, 95% CI = 1.6, 2.8), and having a non-hip fracture (2.0, 95% CI = 1.3, 2.9). Many of those with cancer died, while those recently discharged and those with non-hip fractures were more likely to leave the program because they were again able to cook for themselves.
Brain cancer and nonoccupational risk factors: a case-control study among workers at two nuclear facilities.
Authors: Carpenter A V , Flanders W D , Frome E L , Cole P , Fry S A
Published: November 2008

In a nested case-control study of nuclear workers, 82 brain cancer cases were compared with 328 matched controls to investigate the possible association with nonoccupational risk factors such as histories of epilepsy or head injury. We observed a moderately strong association between brain cancer occurrence and history of epilepsy (OR = 5.7, 95 per cent CI: 1.0, 32.1), but did not find a positive association with previous head injury (OR = 0.9, 95 per cent CI: 0.2, 4.2).
Hepatitis B infection in a day school for mentally retarded students: transmission from students to staff.
Authors: Remis R S , Rossignol M A , Kane M A
Published: November 2008

We carried out a seroepidemiologic study to evaluate the transmission of hepatitis B virus (HBV) from students to staff in a day school for mentally retarded students. Of 505 students tested, 37 (7.3 per cent) had HBsAg; 74 per cent of HBsAg-positive sera tested were HBeAg-positive. Of 162 staff members tested, 21 (13.0 per cent) were HBV marker positive and two (1.2 per cent) had HBsAg; specialized educators and teachers showed the highest HBV marker prevalence (22.2 per cent and 21.3 per cent, respectively). The prevalence of HBV markers among staff was independently associated with classroom contact with a HBsAg-positive student, duration of employment at the school, and previous work with mentally retarded individuals. The incidence of HBV infection among teaching staff with regular classroom contact, estimated by logistic regression analysis, was 2.6 per cent per year. This observation indicates that teaching staff in schools for mentally retarded students with direct classroom contact may carry an occupational risk of HBV infection.
Spontaneous cigarette brand switching: consequences for nicotine and carbon monoxide exposure.
Authors: Lynch C J , Benowitz N L
Published: November 2008

A group of smokers who had participated in smoking-related studies three to six years earlier were re-studied to assess changes in their smoking practices. Individuals who smoked the same brands of cigarettes showed no change in plasma cotinine (reflecting exposure to nicotine) or expired carbon monoxide (CO) concentration. Those who switched to cigarettes of lower nicotine yield (average decrease 38 per cent) showed reduced plasma cotinine concentrations, due primarily to smoking fewer cigarettes per day. The intake of nicotine per cigarette was not different. Subjects who smoked cigarettes of higher yield (102 per cent increase) had higher cotinine and CO levels, due to greater intake per cigarette.
Prevention of tap water scald burns: evaluation of a multi-media injury control program.
Authors: Katcher M L
Published: November 2008

A prospective study was designed to evaluate a mass media injury prevention program reaching two million people to determine its impact on risk awareness of hot tap water burns and injury-prevention behavior. Liquid-crystal thermometers for testing hot water temperature were offered at no cost; 140,000 were requested. Pre- and post-program general population random surveys (N = 337 and 318, respectively) found increased awareness of the danger of hot tap water, from 72 per cent to 89 per cent, but no increase in testing or lowering of water heater temperatures. A third random sample survey (N = 325) among thermometer requesters found a higher rate of testing (difference 58.1 per cent, 95 per cent CL 55.3 per cent, 60.9 per cent) than in the general population. Of those who tested, 43 per cent reported temperatures in the dangerous range of 54.4 degrees C (130 degrees F) or greater; 52 per cent of this group lowered their water heater thermostat. These findings indicate that: more than 25 per cent of the public is unaware of the potential danger of hot tap water; a safety education program which increases awareness will not necessarily result in injury-control behavior; and most people motivated to request a free thermometer will test their hot water temperature and lower it if necessary. As a result of this effort, thermostats of an estimated 20,000 water heaters were lowered from dangerously high levels.
Randomized trial of brief individual treatment for smoking using nicotine chewing gum in a workplace setting.
Authors: Sutton S , Hallett R
Published: November 2008

In a controlled trial of brief treatment for smoking using nicotine chewing gum in a workplace setting, 270 of 334 cigarette smokers who expressed interest were invited to take part in the program, which consisted of two individual consultations; 172 attended. The remaining 64 smokers constituted a no-intervention control group. Using a criterion of sustained one-year abstinence with biochemical validation, success rates were 12 per cent among participants, 1 per cent among those who were invited but did not attend, and 2 per cent in the control group.
Recurrent tuberculosis: why do patients develop disease again? A United States Public Health Service cooperative survey.
Authors: Kopanoff D E , Snider D E , Johnson M
Published: November 2008

In October 1983, a retrospective survey was initiated to determine if patients reported to the Centers for Disease Control as having recurrent tuberculosis truly had recurrent disease and, if so, why they had developed tuberculosis again. Twenty-three health jurisdictions provided information on 800 patients diagnosed as having recurrent tuberculosis during 1981 and 1982. We found that 199 (25 per cent) of the cases did not meet the criteria for recurrent disease. Of the remaining 601 recurrent cases, 20 per cent had no chemotherapy prescribed for their previous episodes of tuberculosis, 20 per cent were prescribed inadequate or inappropriate therapy, and 33 per cent were not compliant with their prescribed therapy regimens. Patients who, during their original episode of tuberculosis, received the major portion of their medical care from physicians in private practice were more compliant than those treated by other health care providers. However, those same patients were more likely to have received inappropriate therapy than patients treated by other providers. Better patient and physician education, closer monitoring, and greater use of preventive therapy and directly observed therapy are necessary to resolve these problems.
Correcting spontaneous abortion rates for the presence of induced abortion.
Authors: Figa'-Talamanca I , Repetto F
Published: November 2008

This paper introduces a method for correcting spontaneous abortion rates by taking into consideration the fact that a number of spontaneous abortions are "prevented" by induced abortions. This correction may be important in settings of high induced abortion incidence. The method is then applied to the data of the Italian region of Lombardy. The results obtained are compared to those obtained with previous correction methods, and it is concluded that the present method is useful and appropriate when data on induced and spontaneous abortions are available by gestational age.
An epidemiologic investigation of the relationship between DBCP contamination in drinking water and birth rates in Fresno County, California.
Authors: Wong O , Whorton M D , Gordon N , Morgan R W
Published: November 2008

This report describes an epidemiologic investigation of the relationship between DBCP (dibromochloropropane) contamination in drinking water and birth rates between 1978 and 1982 in Fresno County, California. Census tracts in the county were categorized according to DBCP level in their drinking water. Standardized birth ratios and relative birth ratios (adjusted for age, race, per cent Hispanic, and parity) were calculated for these census tracts. No relation between birth ratios and DBCP contamination in drinking water was found.
The impact of Medicare on early cancer detection in the elderly.
Authors: Grover S A , Cook E F , Goldman L
Published: November 2008

In an analysis of 23 sex-specific tumors in the Connecticut Tumor Registry, only seven tumors showed more than a 20 per cent increase in the ratio of localized tumors detected post-Medicare (1967-75) versus ante-Medicare (1960-65) in the 65-75 year age group compared to the 60-64 year age group. Of these seven, the information was more convincing for lung cancer in males. Overall, however, Medicare had little if any impact on early tumor diagnosis in the elderly.
Behavioral risk factors for HIV infection among homosexual men at a Boston community health center.
Authors: McCusker J , Stoddard A M , Mayer K H , Cowan D N , Groopman J E
Published: November 2008

Social and behavioral factors associated with human immunodeficiency virus (HIV) infection were analyzed using cross-sectional data from homosexual and bisexual male clients of a Boston community health center. Partners from California, and a previous period of greater sexual activity (a "high period"), were independently associated with positive HIV antibody status, as were the frequency of receptive anogenital contact, both during the "high period" and during the last six months.
The effect of sunglasses on ocular exposure to ultraviolet radiation.
Authors: Rosenthal F S , Bakalian A E , Lou C Q , Taylor H R
Published: November 2008

Thirty-two pairs of inexpensive sunglasses were examined for their effectiveness in preventing ultraviolet radiation (UVR) from reaching the eyes. The transmission of UVB (290-310 nm) by all of the sunglass lenses was less than 2 per cent. However, in measurements performed with mannikins wearing the sunglasses, up to 14.1 per cent of the incident UVR passed through to the eyes. When the sunglasses were moved 6 mm from the forehead, the per cent reaching the eyes ranged from 3.7 to 44.8 per cent. Although sunglasses are somewhat more effective than untinted prescription eyewear in attenuating ocular exposure, the amount of attenuation is highly variable and depends mainly on their size, shape, and wearing position.
Secular trends of obesity in early life: the Bogalusa Heart Study.
Authors: Shear C L , Freedman D S , Burke G L , Harsha D W , Webber L S , Berenson G S
Published: November 2008

Secular changes in height and weight measurements were examined in five- to 14-year-olds from 1973 to 1984. The age-sex specific 85th percentile was used to classify persons as overweight (based on ponderal index; kg/m3). Secular increases in weight (2.5 kg), and ponderosity (0.5-0.7 kg/m3) were found. Gains in ponderosity over the 11-year period were greater at the 75th percentile than at the 25th percentile, and the prevalence of overweight increased from 15 per cent to 24 per cent.
Marital status and the risk of suicide.
Authors: Smith J C , Mercy J A , Conn J M
Published: November 2008

No recent United States study has previously calculated national suicide rates by marital status for specific age, race, and sex categories in order to better identify high-risk groups for suicide. We used national vital statistics and census data to calculate marital-status-specific rates. Results show that for each marital status group, by age and sex, married persons have the lowest suicide rates and young widowed males have exceptionally high rates.
Health family trees: a tool for finding and helping young family members of coronary and cancer prone pedigrees in Texas and Utah.
Authors: Williams R R , Hunt S C , Barlow G K , Chamberlain R M , Weinberg A D , Cooper H P , Carbonari J P , Gotto A M
Published: November 2008

We report on the feasibility and utility of a new approach for identifying the small percentage of families in the general population with strong familial predisposition to early coronary heart disease, strokes, and common familial cancers (breast, colon, lung), using the "Health Family Tree," a medical family history. A total of 24,332 "trees" were completed by parents and students in 37 high schools in 14 urban and rural communities in Texas and Utah during the years 1980-86. Completed "trees" were obtained from 68 per cent of all enrolled students. High-risk families, included 1,796 families with early coronary disease (7.5 per cent of all student families or 3.7 per cent of their parents' families), 870 stroke families (3.6 per cent), and 415 cancer prone families (1.7 per cent). Among these 3,081 high-risk families there were 8,245 family members already reported to have been diagnosed by a physician to have the familial disease of interest and 43,269 high risk unaffected siblings and offspring of these persons. The average cost per identified high-risk unaffected person was under $10. We conclude that the "Health Family Tree" is a feasible and cost-effective way to find high-risk families.
The prevalence of bulimia nervosa in the US college student population.
Authors: Drewnowski A , Hopkins S A , Kessler R C
Published: November 2008

A phone survey to determine the prevalence of bulimia nervosa was conducted with a national probability sample of 1,007 male and female students from a stratified sample of 53 universities and colleges in the continental United States. Using the revised (DSM IIIR) diagnostic criteria, 1 per cent of the women and 0.2 per cent of the men were classified as bulimic. Bulimia was most prevalent (2.2 per cent prevalence rate) among undergraduate women living in group housing on campus.
Divergence of the recent trends in coronary mortality for the four major race-sex groups in the United States.
Authors: Sempos C , Cooper R , Kovar M G , McMillen M
Published: November 2008

Since 1976 there has been a leveling off or slowdown in the rate of decline in coronary heart disease (CHD) mortality. The age-adjusted absolute annual rate of decline in CHD mortality rates during 1968-75 (delta rate/100,000 population/year) was virtually identical for White males (-7.54), Black males (-7.85), and Black females (-7.20), and somewhat lower for White females (-4.25). During 1976-85, however, the secular trends diverged considerably. Age-adjusted rates continued to decline at the same annual rate for White males, while the decline was approximately half as steep for the other three race-sex groups. During 1976-85 there was also a leveling off in the average annual per cent change in age-adjusted CHD mortality for Black males and females and White females when compared to 1968-75, while there was no change for White males. As a result, more than 40,000 White and Black females and Black males died of CHD in 1985 than would have died if CHD rates would have continued to decline at the 1968-75 trends. All comparisons were based on a reclassification of cause-of-death codes to maximize comparability between the 8th and 9th Revisions of the International Classification of Disease. These results suggest that the factors which have led to the continued decline in coronary heart disease may not have influenced all the demographic groups in this country equally over the last decade.
Seating position in cars and fatality risk.
Authors: Evans L , Frick M C
Published: November 2008

Fatality risk in passenger cars according to seating position (front versus rear; left versus center or right) was examined using Fatal Accident Reporting System (FARS) data for 1975 through 1985. Comparing the fatality risk of unrestrained occupants matched in sex and age (within three years) revealed effects attributable to seating position, and not to occupant characteristics correlated with use of different seats. Fatality risk to drivers was the same as fatality risk to right front passengers to within 1 per cent; this was so for crashes in all directions and for frontal crashes. Fatality risk in rear seats was (26 +/- 2) per cent lower than in front seats, and lower in center compared to outboard seats by (22 +/- 4) per cent for front seats and (15 +/- 4) per cent for rear seats. The center rear seat was associated with the lowest fatality risk.
The San Francisco Men's Health Study: continued decline in HIV seroconversion rates among homosexual/bisexual men.
Authors: Winkelstein W , Wiley J A , Padian N S , Samuel M , Shiboski S , Ascher M S , Levy J A
Published: November 2008

The incidence of infection by the human immunodeficiency virus (HIV) has been monitored since 1984 in an area probability sample of homosexual/bisexual men drawn from a six-kilometer square area of San Francisco where the epidemic of acquired immunodeficiency syndrome (AIDS) has been most severe. Annualized HIV seroconversion rates in previously uninfected cohort members have declined by 88 per cent from 5.9 per cent during the first six months of 1985 to 0.7 per cent during the last six months of 1987. Concurrent declines of approximately 80 per cent in the prevalence of sexual behaviors associated with HIV transmission were also observed in the sample.