bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Underdeterminacy and Reference in the Sentence Recall of Young Children
Authors: Feldman Carol F.
Published: July 2017

Children of five and eight years of age were asked to repeat sentences. The sentences were (1) underdetermined sentences containing modal verbs, (2) referential sentences in which the subject referred to an object presented simultaneously with the sentence, and (3) control sentences containing neither. Sentences were presented in a conversation condition approximating an ordinary conversation and on a tape recording. In eight-year-olds, but not five-year-olds, the adult meaning system was observed. Modal sentences were recalled better than control sentences in the conversation condition, but not in the tape condition. At both ages referentiality of the sentence subject improved its recall without regard to condition.
An Allophonic Problem in Australian English
Authors: Burgess Neil
Published: July 2017

The phoneme /ou/ normally manifests itself with a consistent difference as between Non-Broad and Broad Australian English but yields before /I/ an allophone that is common to both speech varieties. The spectrographic investigation described below indicates that the starting-point of this allophonic glide has been retracted and lowered to about the / / position. A perception test has revealed a marked disinclination on the part of speakers of Australian English to accept the glides in such words as so and soul as the same "sound" i.e. to respond in the normal fashion to allophonic variation. Nonetheless economy in procedure seems to preclude a resultant phonemic re-writing of Australian English.
Speech Intelligibility for Interaural Alternated Speech With and Without Intervening Noise for Words and Nonsense
Authors: Kreul E. James
Published: July 2017

Speech discrimination for nine sophisticated listeners was examined for the effect of interaural alternation of both word and nonsense syllable test materials in the presence and absence of intervening noise. No degradation of speech discrimination was noted for words without intervening noise; however, there was some effect for speech discrimination of nonsense syllable test materials. When intervening noise was employed, difficulty in speech discrimination was noted for both the word and nonsense syllable test materials.
Social Class Differences in the Expression of Uncertainty in Five-Year-Old Children
Authors: Turner G.J. , Pickvance R.E.
Published: July 2017

Speech samples were obtained from five-year-old children differing in social class, verbal intelligence test scores and sex. The linguistic devices used by the children to express uncertainty were analysed. It was found that middle-class children, relative to working-class children, were more likely to use the egocentric sequence, certain types of question, refusals, suppositions based on perception and, in a certain context, hypothetical statements. Medium ability children, relative to high ability children, were more likely to use one type of sociocentric sequence, the reversed polarity tag, and certain types of question. These results support the hypothesis that the orientation towards the use of expressions of uncertainty is more strongly related to social class than to verbal ability. The results are related to Bernstein's work on types of familial socialisation.
A Test of the Independence of Linguistic Dimensions
Authors: Holloway C.M.
Published: July 2017

Several investigations of the perception of consonants spoken in noise have purported to show the independence of the linguistic dimensions which define a consonant. A new procedure for data analysis is applied to the results of an experiment reported by the author. This analysis suggests that there is a small but reliable dependency effect. Application of the present technique to the data of Miller and Nicely (1955) also shows a significant dependency effect.
The Effects of Translation On Readability
Authors: Dye Omar A.
Published: July 2017

This investigation studied the effects of translating French into English and how readability changed following the translation. French works were paired with English translations of the same works. Flesch Reading Ease scores were significantly lower for the French indicating that the English translations were more easily read than the French originals. Different English translations of the same French work were paired and very little difference resulted. The position that readability measures difficulty of style was confirmed.
Strategies in the Comprehension of Relative Clauses
Authors: Cook V.J.
Published: July 2017

An experiment is described to test the hypothesis that errors in the comprehension of relative clauses in English are caused by perceptual strategies resorted to when the normal capacity of the processing channel is exceeded. Native children, foreign adults, and native adults were asked to show Subject and Object relations in sentences that were read to them. The same type of error pattern was found in native children and foreign adults with single embedded clauses, in native adults with double embedded clauses, and, to a lesser extent, in native adults with single embedded clauses. The dominating strategies appeared to be that the first Noun Phrase was the Subject and the Noun Phrase following the verb the Object. These results suggest that the difficulty of relative clauses is indeed due to the load they put on the processing system and that an overload is reached with a single embedding for children and foreign adults, and with a double embedding for most native adults.
Speech Behaviour- a Foundation of Language
Authors: Locke Simeon
Published: July 2017

A hierarchical view of the central nervous system suggests the principle that " lower level " activities are often recruited for utilization by subsequently evolved functions. In this view, speech, as distinguished from language, is a more automatic process in part responsive to perceptual input. It both shapes and is shaped by those aspects of language it serves.
Simultaneous Interpretation: Qualitative and Linguistic Data
Authors: Barik Henri C.
Published: July 2017

This paper presents qualitative data in relation to a previously reported study on simultaneous interpretation (Barik, 1973).

The interpreter's version of a passage may reveal omissions, additions and substitutions or errors of translation. Several categories of each type of event are noted and related to temporal and grammatical attributes of the input material. Other linguistic observations are also made. One critical factor in interpretation is the interpreter's ability to segment the incoming message at linguistically appropriate locations. Failure to do so can lead to a number of difficulties and to inadequate performance. Examples are given.
Articulatory Parameters
Authors: Ladefoged Peter
Published: July 2017

The production of speech is constrained by the articulatory parameters that people can vary. It is suggested that there are seven parameters affecting tongue shapes, three determining the positions of the lips, one controlling the position of the velum, four varying laryngeal actions, and one controlling respiratory activity. Descriptions of all linguistic utterances can be made in terms of about 16 parameters.
The Acquisition of Communicative Intentions in Infants Eight to Fifteen Months of Age
Authors: Carpenter Robert L. , Mastergeorge Ann M. , Coggins Truman E.
Published: July 2017

The acquisition of a set of nonverbal intentionally communicative behaviors is described for six preverbal infants followed longitudinally between eight and 15 months of age. The infants were observed at monthly intervals as they interacted with their mothers in a free play situation. There was a statistically significant trend for the set of communicative intentions to emerge in the following sequence: Protesting, Request for Action, Request for Object, Comment on Action, Comment on Object, and Answering. Gesture alone and gesture + vocalization were the primary modes of expressing communicative intentions at eight months. By 15 months, the majority of communicative intentions were still conveyed by the gesture + vocalization mode; however, the gesture-alone mode had become relatively infrequent and seemed to be replaced by the. use of single-word utterances as a means of conveying communicative intentions at that time. The data corroborate the findings of other studies regarding the early onset of intentional communication prior to speech and additionally suggest a pattern of emergence of communicative intentions for the six infants studied.
Redundancy, Pause Distributions and Thought Disorder in Schizophrenia
Authors: Maher Brendan A. , Manschreck Theo C. , Molino Michael A.C.
Published: July 2017

Recent studies have indicated that schizophrenics with current evidence of formal thought disorder (FTD) can be distinguished from schizophrenics without such disorder on measures of ability to use available redundancies in the recall of words, redundancy and lexicon variability of spoken language, and deficient motor synchrony in the production of rhythmic movements. This investigation examined pause patterns, redundancy, word frequency, and disordered thinking in a group of conservatively diagnosed schizophrenic patients, utilizing Butterworth's model of language production. It was hypothesized that schizophrenics with FTD would be more vulnerable than those without FTD to breakdown in control processes of the interactive type than the autonomous type because of impaired capacities for involuntary attention. The results indicate that schizophrenics with FTD show a disruption of the normal systematic relationship between word redundancy and pauses in speech. This disruption is not found in schizophrenics without FTD, whose responses resemble those of normal speakers. The results are discussed in the light of attempts to integrate findings from language and motor research in schizophrenia.
On the Similarities Between Spoken and Written Language
Authors: Akinnaso F. Niyi
Published: July 2017

This paper challenges both the theoretical assumptions and the quantitative method underlying comparative studies of spoken and written language and proposes a sociolinguistic model that relates linguistic forms to macro-sociological contexts, communicative goal, and function. Drawing upon data derived from oral ritual communication in nonliterate societies and adopting a comparative, meta-analytical approach, the paper provides evidence for basic similarities in form and function between formal spoken and formal written language. It is argued that more is known about the relationships between discourse types by viewing linguistic structures in relation to historical, social, cultural, political, and ideological contexts rather than by viewing them as "autonomous" objects reducible to mere tokens. The implications of the findings for sociolinguistic theory are highlighted, while future research directions are indicated.
The Effects of Linguistic Complexity On Children's and Adults' Motor Programming of Speech
Authors: Abbeduto Leonard
Published: July 2017

The role of syntactic/semantic structure in the motor programming of speech by 5-year-olds, 8-year olds, and adults was investigated. Subjects repeated sentences, each at maximum rate, on numerous, consecutive trials. Linguistically simple and complex sentence types, matched on rhythm, were selected for each age. On a current model, linguistic structure determines programming unit size with increased size resulting in shorter and less variable repetition durations. Repetition durations were found to be shorter for simple than for complex sentences at all ages. However, linguistic complexity affected durational variability only for adults. A new model is proposed to account for these results.
Phonetic Implementation of Implosives
Authors: Nihalani Paroo
Published: July 2017

This article demonstrates that implosives in Sindhi involve ingressive airflow, unlike the implosives in Hausa. The immediate consequence of this fact is that the proposal that there are no true implosives, i.e., those that involve suction, must be rejected. It also raises the question whether implosives should be characterized in phonological theory as sounds involving suction, or as sounds involving the lowering of the larynx. Comparison of the implosives in Sindhi with those of Hausa also demonstrates the need for including certain kinds of “phonetic implementational phenomena” in the domain of phonology.
Tone 4 and Tone 3 Discrimination in Modern Standard Chinese
Authors: Gårding Eva , Kratochvil Paul , Svantesson Jan-Olof , Zhang Jialu
Published: July 2017

Productions of Tone 4 and Tone 3 ( mài/măi, ‘sell’/‘buy’) in comparable sentences suggest that although the two tones are realized in different ways by different speakers in different speech acts, some features are constant. Tone 3 is connected with a low pitch level throughout the second half of the vowel and Tone 4 with a gradual fall over the main part of the vocalic segment. These observations were tested in a series of manipulations of pitch movements over mài from Tone 4 to Tone 3 in the sentence Sòng Yán mài niúròu. The manipulated sentences were presented in a test, in which listeners were asked if they heard mài or năi. The result confirmed the observed constant features and indicated in addition that it was important for both tones to have a clear reference. The identification of Tone 4 was favoured by an introductory rising or level part, and for Tone 3 an introductory fall seemed to be important. Creaky voice is a concomitant but not a necessary feature of Tone 3.
Filling Gaps On-Line: Use of Lexical and Semantic Information in Sentence Processing
Authors: Stowe Laurie A. , Tanenhaus Michael K. , Carlson Greg N.
Published: July 2017

Two experiments investigated how people assign an interpretation to question phrases. In order to determine the meaning of the WH-phrase (e.g., who, what), a “gap” must be located and the role associated with the gap assigned to the WH-phrase. Two experiments tested the Lexical Expectation model of Fodor (1978), according to which lexical properties of the verb determine when a gap is posited, and the All Resorts model of Stowe (1984), according to which all possibilities are considered and evaluated on their pragmatic appropriateness. In Experiment 1, subjects judged the meaningfulness of full sentences. The frequency with which verbs are used transitively determined whether there was an effect of the plausibility of the WH-phrase to act as an object of the verb. Effects of plausibility of the WH-phrase as an object showed up in just those cases where the object role should be assigned to the WH-phrase according to the Lexical Expectation model, rather than as predicted by the All Resorts model. In Experiment 2, these results were replicated using the word-by-word self-paced reading paradigm. The plausibility effect showed up at the verb itself when it is normally used transitively. This evidence suggests that a gap is preferred even over a lexically filled object for transitive expectation verbs.
A Case-Based Clinician Training Program for Treating Tobacco Use in College Students
Authors: Halperin Abigail C. , Thompson L. Anne , Hymer Jennifer C. , Peterson Amber K. , Thompson Beti
Published: July 2017

Tobacco use rates are high among college students, and while many of them try to quit every year, only a small percentage are successful at maintaining abstinence. Most colleges have campus health centers that offer treatment for tobacco cessation, but few students access these resources. Little is known about how to motivate young adult college students to seek treatment or assist them in their attempts to quit smoking.

In the context of a comprehensive, group-randomized intervention study to decrease smoking among college students, a case-based tobacco cessation training program for campus health center providers and staff was developed and conducted at 14 intervention colleges during the 2003–2004 academic year. Six case studies were created for this training, using responses from 39 student elicitation interviews conducted at 12 colleges in Spring 2002. Common themes relating to smoking, quitting, and relapse experiences reported by students in the elicitation interviews were woven into the cases and integrated into the training program.
Are State Patterns of Smoking Different for Different Racial/Ethnic Groups? An Application of Multilevel Analysis
Authors: Osypuk Theresa L. , Kawachi Ichiro , Subramanian S.V. , Acevedo-Garcia Dolores
Published: July 2017

Objectives.

Tobacco use research has often assumed “average” effects across place, race, and socioeconomic position. We explored and mapped the variation in smoking prevalence for racial/ethnic groups by gender and state after adjusting for demographic factors.

Methods.

We executed a cross-sectional, weighted, two-level multilevel multiple regression analysis (individuals in states), with current smoking as the outcome, using the 1995–1996 Current Population Survey Tobacco Use Supplement, for non-Hispanic (NH) whites, NH blacks, and Hispanics. We also calculated adjusted smoking prevalence, 95% confidence intervals, Spearman correlations, and state residual-based maps to examine state patterns.

Results.

We found different smoking patterns for each racial group. Black women's smoking rates were markedly lower than the national subgroup rate in six clustered states in the deep South. Smoking rates for whites were higher than the subgroup national rate in several Great Lakes states, Texas, Nevada, and North Carolina. For white women, several rural Midwest states displayed lower-than-expected smoking rates (Idaho, Utah, South Dakota, and Nebraska). We documented positive correlations for smoking prevalence between men and women within each racial group, but not between racial groups, indicating a race-specific pattern of smoking. We found that state tobacco variables (taxation and agriculture) did not account for remaining state smoking variance after inclusion of demographic variables.

Conclusion.

Multilevel modeling may enhance surveillance of tobacco use patterns. Focusing on race-specific state smoking patterns may illuminate why racial/ethnic minority groups exhibit lower smoking prevalence compared to their white counterparts, by examining context of smoking that may be race-specific.
Preferred Smoking Policies at 30 Pacific Northwest Colleges
Authors: Thompson Beti , Coronado Gloria D. , Chen Lu , Thompson L. Anne , Hymer Jennifer C. , Peterson Amber K.
Published: July 2017

Objective.

Research shows that restrictive smoking policies on college campuses could discourage smoking onset or help facilitate cessation efforts among students. However, many colleges and universities are reluctant to establish restrictive smoking policies for fear of student objections. Our study examined preferred smoking policies among college students in the Pacific Northwest.

Methods.

We conducted a baseline cross-sectional descriptive study of a grouped randomized controlled trial at 30 four-year colleges and universities in Idaho, Oregon, and Washington.

Results.

Of the 14,237 students who responded to the survey, 17.3% were smokers. All respondents were knowledgeable about indoor smoking policies; however, there was incongruence regarding outside policies. Some 88% of never smokers wanted a completely smoke-free indoor policy, while a substantial percentage (58%) of smokers concurred (odds ratio [OR]=0.19, p<0.001). Fewer respondents were supportive of outdoor policies (43.3% for never smokers and 6.9% for smokers). Respondents agreed that the desire to breathe clean air should have priority over the desire to smoke; however, smokers agreed to a lesser extent (97.5% for never smokers and 81.5% for smokers [OR=0.012, p<0.001]).

Conclusion.

Both non-smokers and smokers have high approval rates for restrictive smoking policies on campus. Administrators can use this information to help enact restrictive campus smoking policies.
Disaster Mythology and Fact: Hurricane Katrina and Social Attachment
Authors: Jacob Binu , Mawson Anthony R. , Marinelle Payton , Guignard John C.
Published: July 2017

Misconceptions about disasters and their social and health consequences remain prevalent despite considerable research evidence to the contrary. Eight such myths and their factual counterparts were reviewed in a classic report on the public health impact of disasters by Claude de Ville de Goyet entitled, The Role of WHO in Disaster Management: Relief, Rehabilitation, and Reconstruction (Geneva, World Health Organization, 1991), and two additional myths and facts were added by Pan American Health Organization.

In this article, we reconsider these myths and facts in relation to Hurricane Katrina, with particular emphasis on psychosocial needs and behaviors, based on data gleaned from scientific sources as well as printed and electronic media reports. The review suggests that preparedness plans for disasters involving forced mass evacuation and resettlement should place a high priority on keeping families together—and even entire neighborhoods, where possible—so as to preserve the familiar and thereby minimize the adverse effects of separation and major dislocation on mental and physical health.
Place Matters: Variation in the Black/White Very Preterm Birth Rate across U.S. Metropolitan Areas, 2002–2004
Authors: Kramer Michael R. , Hogue Carol R.
Published: July 2017

Objective.

We reported on the distribution of very preterm (VPT) birth rates by race across metropolitan statistical areas (MSAs).

Methods.

Rates of singleton VPT birth for non-Hispanic white, non-Hispanic black, and Hispanic women were calculated with National Center for Health Statistics 2002–2004 natality files for infants in 168 MSAs. Subanalysis included stratification by parity, age, smoking, maternal education, metropolitan size, region, proportion of MSA that was black, proportion of black population living below the poverty line, and indices of residential segregation.

Results.

The mean metropolitan-level VPT birth rate was 12.3, 34.8, and 15.7 per 1,000 live births for white, black, and Hispanic women, respectively. There was virtually no overlap in the white and black distributions. The variation in mean risk across cities was three times greater for black women compared with white women. The threefold disparity in mean rate, and two- to threefold increased variation as indicated by standard deviation, was maintained in all subanalyses.

Conclusion.

Compared with white women, black women have three times the mean VPT birth risk, as well as three times the variance in city-level rates. The racial disparity in VPT birth rates was composed of characteristics that were constant across MSAs, as well as factors that varied by MSA. The increased sensitivity to place for black women was unexplained by measured maternal and metropolitan factors. Understanding determinants of differences in both the mean risk and the variation of risk among black and white women may contribute to reducing the disparity in risk between races.
Risk Factor Redistribution of the National HIV/AIDS Surveillance Data: An Alternative Approach
Authors: Harrison Kathleen Mc David , Kajese Tebitha , Hall H. Irene , Song Ruiguang
Published: July 2017

Objective.

The purpose of this study was to assess an alternative statistical approach—multiple imputation—to risk factor redistribution in the national human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) surveillance system as a way to adjust for missing risk factor information.

Methods.

We used an approximate model incorporating random variation to impute values for missing risk factors for HIV and AIDS cases diagnosed from 2000 to 2004. The process was repeated M times to generate M datasets. We combined results from the datasets to compute an overall multiple imputation estimate and standard error (SE), and then compared results from multiple imputation and from risk factor redistribution. Variables in the imputation models were age at diagnosis, race/ethnicity, type of facility where diagnosis was made, region of residence, national origin, CD-4 T-lymphocyte cell count within six months of diagnosis, and reporting year.

Results.

In HIV data, male-to-male sexual contact accounted for 67.3% of cases by risk factor redistribution and 70.4% (SE=0.45) by multiple imputation. Also among males, injection drug use (IDU) accounted for 11.6% and 10.8% (SE=0.34), and high-risk heterosexual contact for 15.1% and 13.0% (SE=0.34) by risk factor redistribution and multiple imputation, respectively. Among females, IDU accounted for 18.2% and 17.9% (SE=0.61), and high-risk heterosexual contact for 80.8% and 80.9% (SE= 0.63) by risk factor redistribution and multiple imputation, respectively.

Conclusions.

Because multiple imputation produces less biased subgroup estimates and offers objectivity and a semiautomated approach, we suggest consideration of its use in adjusting for missing risk factor information.
Public Dental Expenditures and Dental Visits among Children in the U.S., 1996–2004
Authors: Wall Thomas P. , Brown L. Jackson
Published: July 2017

Objectives.

Congress created the State Children's Health Insurance Program (SCHIP) in 1997 as an expansion of the Medicaid program to provide health insurance to children whose family income is above the Medicaid eligibility standards—generally up to 200% of the federal poverty level (FPL). This article examines changes in the utilization of dental services during a period of increasing public funding of dental services.

Methods.

Public dental expenditure estimates came from the Centers for Medicare & Medicaid Services (CMS), and a breakdown of these expenditures by patient age and income level was based on the Medical Expenditure Panel Survey (MEPS).

Results.

According to CMS, funding for dental SCHIP and dental SCHIP expansion grew from $0 prior to 1998 to $517 million in 2004. According to the MEPS, between 1996 and 2004 there was an increase in the number and percent of children 2 to 20 years of age who reported a dental visit during the past year. These increases were most notable among children in the 100% to 200% FPL category. Approximately 900,000 more children in this income group visited a dentist in 2003–2004 than in 1996–1997. Children in this income group reported an increase in the amount of mean dental charges paid for by Medicaid and a real increase in mean dental charges per patient from $217 to $310.

Conclusions.

Recent increases in the public funding of dental services targeted to children in the 100% to 200% FPL category were related to increased utilization of dental services among these children from 1996 to 2004.
Characteristics of Successful Asthma Programs
Authors: Clark Noreen , Lachance Laurie , Milanovich Amy Friedman , Stoll Shelley , Awad Daniel F.
Published: July 2017

Objective.

We identified characteristics of interventions associated with positive asthma outcomes to understand how programs can be improved.

Methods.

We identified asthma interventions from the peer-reviewed literature or through a nomination process for unpublished programs. Initially, we identified 532 interventions. Of those, 223 met our eligibility criteria (e.g., focus on asthma, completed an evaluation, and demonstrated at least one asthma-related health outcome) and provided information on program components and processes, administration, evaluation, and findings through telephone interviews, program documents, and published reports. We analyzed bivariate relationships between programmatic factors and outcomes using Chi-square statistics, Fisher's exact tests, and unconditional logistic regression. We confirmed findings for all programs by analyzing the subset with published results in peer-reviewed journals.

Results.

Our findings indicated that programs were more likely to report a positive impact on health outcomes if they (7) were community based, (2) engaged the participation of community-based organizations, (3) provided program components in a clinical setting, (4) provided asthma training to health-care providers, (5) collaborated with other organizations and institutions and with government agencies, (6) designed a program for a specific racial/ethnic group, (7) tailored content or delivery based on individual health or educational needs, and (8) conducted environmental assessments and tailored interventions based on these assessments.

Conclusions.

Positive asthma outcomes were associated with specific program characteristics: being community centered, clinically connected, and continuously collaborative. Program developers and implementers who build these characteristics into their interventions will be more likely to realize desired asthma outcomes.
Domestic Understanding of the Revised International Health Regulations
Authors: Katz Rebecca , Allen Heather
Published: July 2017

Objective.

The International Health Regulations (IHR) (2005) require countries to report potential public health emergencies of international concern to the World Health Organization. Given that in the U.S. federal system, disease surveillance and reporting is a state, territory, or local-level responsibility, we wanted to discern the level of familiarity at the state and local level with the international obligations for disease reporting under IHR (2005).

Methods.

We conducted a multisectoral survey of states, commonwealths/territories, and localities to assess basic knowledge of IHR (2005) and potential impediments to implementation. Respondents included both legal and policy experts from departments of health, agriculture, transportation, and homeland security.

Results.

Our survey demonstrated that domestic knowledge of IHR (2005) and of the United States' obligations under the regulations is not widespread, particularly in nonhealth sectors. Of the respondents who were familiar with IHR (2005), some noted legal issues as a concern for implementation, but the lack of federal guidance was perceived as a more fundamental impediment.

Conclusion.

Considerably more work needs to be done at the federal level to educate and guide state sectors for the U.S. to ensure its fulfillment of international legal obligations.
Decline in Smoking during Pregnancy in New York City, 1995–2005
Authors: Stein Cheryl R. , Ellis Jennifer A. , Savitz David A. , Vichinsky Laura , Perl Sarah B.
Published: July 2017

Objectives.

The 1998 Master Settlement Agreement (MSA) between 46 states and four major tobacco companies increased tobacco control funding and restricted tobacco marketing. In 2002, New York City (NYC) began a comprehensive tobacco control program that raised the price of cigarettes, banned indoor workplace smoking, and increased access to cessation treatment. We examined the temporal pattern of smoking during pregnancy, including ethnic variation in smoking prevalence, relative to the implementation of the MSA and NYC's comprehensive tobacco control program using birth certificate data.

Methods.

Using multiple logistic regression, we analyzed NYC birth certificate data to examine prenatal smoking during three time periods: 1995–1998 (pre-MSA), 1999–2002 (post-MSA, pre-NYC tobacco control), and 2003–2005 (post-MSA, post-tobacco control).

Results.

Overall, 3.0% of 1,136,437 births included were to smoking mothers. The proportion of smoking mothers declined from 4.5% in 1995–1998 to 1.7% in 2003–2005. Compared with non-Hispanic white women, African American women had 2.46 increased odds (95% confidence interval [CI] 2.36, 2.55) of smoking during 1995–1998, and 3.63 increased odds (95% CI 3.39, 3.88) of smoking during 2003–2005, despite an absolute reduction in smoking from 10.4% to 5.0%. Puerto Rican women also smoked considerably more than non-Hispanic white women.

Conclusions.

These findings document a striking temporal decline in prenatal smoking in NYC concurrent with changing tobacco control policies. Targeted efforts may be required to address the increasing disparity in prenatal smoking between non-Hispanic white and African American and Puerto Rican women.
Newborn Hearing Screening and Follow-up: Are Children Receiving Recommended Services?
Authors: Gaffney Marcus , Green Denise R. , Gaffney Claudia
Published: July 2017

Objectives.

Newborn hearing screening programs have been implemented by all 50 states and most U.S. territories to detect hearing loss in infants and prevent delays in speech, language, and social and emotional development. To monitor progress toward national goals, the Centers for Disease Control and Prevention (CDC) collects data from state and territorial programs. This article summarizes findings from the CDC Early Hearing Detection and Intervention (EHDI) Hearing Screening and Follow-up Survey (HSFS) and provides a summary of recent efforts to identify infants with hearing loss in the U.S.

Methods.

The HSFS was sent to representatives of U.S. EHDI programs to gather aggregate screening, diagnostic, intervention, and demographic data for 2005 and 2006. We analyzed these data to evaluate progress toward national goals.

Results.

In 2005 and 2006, more than 90% of infants were screened for hearing loss. Of these infants, 2% in both years did not pass their final screening. Out of those not passing the final screening, approximately two-thirds were not documented as having a diagnostic finding. In both years, the reason reported for the majority of infants was loss to follow-up/loss to documentation (LFU/LTD). Although the majority of infants with permanent hearing loss were receiving intervention, more than 30% were classified as LFU/LTD and could not be documented as receiving intervention services.

Conclusions.

The HSFS enables the collection of more complete data that highlight the progress in screening infants for hearing loss. However, data indicate improvements are needed to reduce LFU/LTD and meet the national benchmarks.
Characteristics of Asian and Pacific Islanders Admitted to U.S. Drug Treatment Programs in 2005
Authors: Wong Wynnie , Barnett Paul G.
Published: July 2017

Objective.

We determined how Asian and Pacific Islanders (APIs) differ from clients from other ethnic groups in regard to drug use and admissions to drug treatment programs.

Methods.

We used national survey and treatment admissions data to characterize drug problems and first-time adult admissions to publicly funded drug treatment programs in the U.S. in 2005.

Results.

APIs accounted for 1.9% of illicit drug use in U.S. adults and for 1.3% of adult clients entering drug treatment for the first time. Compared with other ethnic groups, APIs were significantly more likely to be entering treatment for the first time. Stimulants were the primary drug problem for 57.3% of API first-time treatment clients, a significantly greater proportion than other ethnic groups. This figure had increased from 45.3% in 2001, significantly greater than the increase among Caucasian or African American clients. API first-time admissions had used drugs less frequently (13.6 days in the prior 30 days), began drug use at a slightly older age (mean = 20.7 years), and had a shorter period between start of use and first admission (mean = 9.4 years) than other racial/ethnic groups.

Conclusion.

Stimulant use was the predominant problem of API clients entering treatment for the first time. APIs were underrepresented in the treatment system relative to their share of the population with drug problems. Diverse groups were aggregated to form the API category. Information on APIs needs to be disaggregated to develop more culturally appropriate and effective treatment.
HIV Vulnerability of Men Who Have Sex with Men in Developing Countries: Horizons Studies, 2001–2008
Authors: Geibel Scott , Tun Waimar , Tapsoba Placide , Kellerman Scott
Published: July 2017

While male-to-male sexual behavior has been recognized as a primary risk factor for human immunodeficiency virus (HIV), research targeting men who have sex with men (MSM) in less-developed countries has been limited due to high levels of stigma and discrimination. In response, the Population Council's Horizons Program began implementing research activities in Africa and South America beginning in 2001, with the objectives of gathering information on MSM sexual risk behaviors, evaluating HIV-prevention programs, and informing HIV policy makers. The results of this nearly decade-long program are presented in this article as a summary of the Horizons MSM studies in Africa (Senegal and Kenya) and Latin America (Brazil and Paraguay), and include research methodologies, study findings, and interventions evaluated. We also discuss future directions and approaches for HIV research among MSM in developing countries.
Improving the Lives of Vulnerable Children: Implications of Horizons Research among Orphans and other Children Affected by AIDS
Authors: Schenk Katie D. , Michaelis Annie , Sapiano Tobey Nelson , Brown Lisanne , Weiss Ellen
Published: July 2017

From 1997 through 2007, the Horizons program conducted research to inform the care and support of children who had been orphaned and rendered vulnerable by acquired immunodeficiency syndrome in sub-Saharan Africa. Horizons conducted studies in Kenya, Malawi, Rwanda, South Africa, Uganda, Zambia, and Zimbabwe. Research included both diagnostic studies exploring the circumstances of families and communities affected by human immunodeficiency virus (HIV) and evaluations of pioneering intervention strategies. Interventions found to be supportive of families included succession planning for families with an HIV-positive parent, training and supporting youth as caregivers, and youth mentorship for child-headed households. Horizons researchers developed tools to assess the psychosocial well-being of children affected by HIV and outlined key ethical guidelines for conducting research among children. The design, implementation, and evaluation of community-based interventions for orphans and vulnerable children continue to be a key gap in the evidence base.
Process for Determining the Cancer Burden of the Hopi Tribe
Authors: Brown Sylvia R. , Joshweseoma Lori , Flood Timothy , Coe Kathryn
Published: July 2017

The Hopi Tribe is located in the northeastern part of Arizona on more than one million acres of federally reserved land. Tribally based community research, conducted in collaboration with University of Arizona researchers, has been successfully implemented on Hopi beginning with a cross-sectional community survey in 1993 and continuing with a second survey in 2006. Both surveys identified a strong community interest in cancer.

This article reports on the process involved in a third study, in which official Hopi enrollment data were matched with Arizona Cancer Registry data. The process involved bringing in a new partner and obtaining tribal, state, and university approvals, as well as a signed data exchange agreement between the state and the Hopi Tribe. Technical implementation of the data match required computer programming and epidemiologic expertise, as well as an understanding of the community and the culture. Close collaboration among Hopi residents and university epidemiologists was critical.
Most Pregnant Women in California Do Not Receive Dental Care: Findings from a Population-Based Study
Authors: Marchi Kristen S. , Fisher-Owens Susan A. , Weintraub Jane A. , Yu Zhiwei , Braveman Paula A.
Published: July 2017

Objectives.

We examined the prevalence of dental care during pregnancy and reasons for lack of care.

Methods.

Using a population-based survey of 21,732 postpartum women in California during 2002–2007, we calculated prevalence of dental problems, receipt of care, and reasons for non-receipt of care. We used logistic regression to estimate odds of non-receipt of care by maternal characteristics.

Results.

Overall, 65% of women had no dental visit during pregnancy; 52% reported a dental problem prenatally, with 62% of those women not receiving care. After adjustment, factors associated with non-receipt of care included non-European American race/ethnicity, lack of a college degree, lack of private prenatal insurance, no first-trimester prenatal insurance coverage, lower income, language other than English spoken at home, and no usual source of pre-pregnancy medical care. The primary reason stated for non-receipt of dental care was lack of perceived need, followed by financial barriers.

Conclusions.

Most pregnant women in this study received insufficient dental care. Odds were elevated not only among the poorest, least educated mothers, but also among those with moderate incomes or some college education. The need for dental care during pregnancy must be promoted widely among both the public and providers, and financial barriers to dental care should be addressed.
Real-Time Surveillance for Tuberculosis Using Electronic Health Record Data from an Ambulatory Practice in Eastern Massachusetts
Authors: Calderwood Michael S. , Platt Richard , Hou Xuanlin , Malenfant Jessica , Haney Gillian , Kruskal Benjamin , Lazarus Ross , Klompas Michael
Published: July 2017

Objective.

Electronic health records (EHRs) have the potential to improve completeness and timeliness of tuberculosis (TB) surveillance relative to traditional reporting, particularly for culture-negative disease. We report on the development and validation of a TB detection algorithm for EHR data followed by implementation in a live surveillance and reporting system.

Methods.

We used structured electronic data from an ambulatory practice in eastern Massachusetts to develop a screening algorithm aimed at achieving 100% sensitivity for confirmed active TB with the highest possible positive predictive value (PPV) for physician-suspected disease. We validated the algorithm in 16 years of retrospective electronic data and then implemented it in a realtime EHR-based surveillance system. We assessed PPV and the completeness of case capture relative to conventional reporting in 18 months of prospective surveillance.

Results.

The final algorithm required a prescription for pyrazinamide, an International Classification of Diseases, Ninth Revision (ICD-9) code for TB and prescriptions for two antituberculous medications, or an ICD-9 code for TB and an order for a TB diagnostic test. During validation, this algorithm had a PPV of 84% (95% confidence interval 78, 88) for physician-suspected disease. One-third of confirmed cases were culture-negative. All false-positives were instances of latent TB. In 18 months of prospective EHR-based surveillance with this algorithm, seven additional cases of physician-suspected active TB were detected, including two patients with culture-negative disease. A review of state health department records revealed no cases missed by the algorithm.

Conclusions.

Live, prospective TB surveillance using EHR data is feasible and promising.
Effect of School Closure on the Incidence of Influenza among School-Age Children in Arizona
Authors: Wheeler Colleen C. , Erhart Laura M. , Jehn Megan L.
Published: July 2017

Objective.

We assessed the impact of school closures as a viable intervention in the event of an influenza pandemic.

Methods.

We evaluated the effect of scheduled, two-week winter break school closures during the 2004–2008 school years on the occurrence of influenza among children aged 5–17 years in Arizona.

Results.

We found a consistent pattern of benefit to school-age children during winter school closures when non-school-age children and adults experienced significant increases in influenza incidence, an increase not seen among school-age children. Quantitative analysis showed that school closures may prevent or delay as much as 42% of potential influenza cases among school-age children. In addition, the ratio of illness in school-age children as compared with adults and non-school-age children decreased significantly from before to during the same school closure periods.

Conclusion.

This analysis provides evidence to suggest that school-age children may experience a slowing of influenza transmission during winter school closures compared with those not of school age. Federal, state, and local policy makers may consider these findings in their pandemic influenza and public health emergency preparedness planning efforts.
Varicella Seroprevalence in the U.S.: Data from the National Health and Nutrition Examination Survey, 1999–2004
Authors: Reynolds Meredith A. , Kruszon-Moran Deanna , Jumaan Aisha , Schmid D. Scott , McQuillan Geraldine M.
Published: July 2017

Objective.

We estimated the varicella seroprevalence among the U.S. population aged 6–49 years based on retested National Health and Nutrition Examination Survey (NHANES) specimens collected between 1999 and 2004—originally tested using a method unsuitable for detecting vaccine-induced immunity—and compared it with historical estimates.

Methods.

We performed a confirmatory test suitable for detecting vaccine-induced immunity on all available specimens from 6- to 19-year-olds who originally tested negative ( n=633), and on 297 randomly selected specimens that had tested positive. Retest results superseded original results for determining seroprevalence. We assessed seroprevalence for the entire sample aged 6–49 years ( n=16,050) by participant demographic characteristics and compared it with historical estimates (NHANES 1988–1994).

Results.

The percentage of false-negative results for the original test was higher for specimens from younger children (6–11 years of age: 27.5%; 12–19 years of age: 13.3%) and for specimens collected most recently (2001–2004: 26.0%; 1999–2000: 12.6%). The age-adjusted rate of varicella seroprevalence for 1999–2004 was 93.6% for 6- to 19-year-olds and 98.0% for adults aged 20–49 years compared with 90.0% and 98.1%, respectively, for 1988–1994. We found an increase in seropositivity between the survey periods, from 93.2% to 97.2% ( p<0.001) among 12- to 19-year-olds. For children, non-Hispanic black ethnicity and younger age were associated with lower seroprevalence in both survey periods.

Conclusions.

Varicella seroprevalence increased with age among children and was uniformly high in the U.S. adult population between 1999 and 2004. The original testing produced false-negative seroprevalence results among children's specimens collected between 1999 and 2004 from 6- to 19-year-olds.
Evaluation of a Communications Campaign to Increase Physician Reporting to a Surveillance System
Authors: Gelberg Kitty H. , Brissette Ian F. , Cummings Karen
Published: July 2017

While all states have regulations requiring reporting of diseases from healthcare professionals and facilities, underreporting is substantial. To improve reporting to the New York State (NYS) Occupational Lung Disease Registry (OLDR), the NYS Department of Health's Bureau of Occupational Health initiated a multimedia campaign to increase case ascertainment and establish communication channels and partnerships for conducting prevention. The outreach campaign was successful in raising physician awareness about the OLDR, familiarizing physicians with reporting forms and procedures, and increasing physician reporting. It also raised awareness of the contribution of occupational factors to respiratory illness and other conditions. However, while our evaluation indicated it is possible to affect short-term outcomes, such as knowledge, attitudes, and behavior among health-care providers, the campaign was not as successful in promoting sustained reporting.