bluuebunny/crossref_metadata_2025 huggingface dataset:
O cuidar da criança de/na rua na perspectiva dos graduandos de enfermagem
Authors: Oliveira Alfredo Almeida Pina de , Ribeiro Moneda Oliveira
Published: April 2008

As crianças de/na rua vivenciam situações que prejudicam seu desenvolvimento. O enfermeiro precisa buscar alternativas para atuar na inclusão social dessas crianças. Este estudo teve esse propósito: relacionar alternativas de intervenções de saúde propostas por graduandos de enfermagem para crianças nesse contexto social. Empregou-se o método qualitativo de investigação, de cunho exploratório e descritivo, para obtenção de dados. Estes foram organizados em categorias e analisados segundo o processo de análise de conteúdo. Os resultados indicam que o aluno identifica um papel importante do enfermeiro na integração da equipe de saúde e o estabelecimento de parcerias com instituições sociais. Este estudo também mostra que os estudantes foram capazes de definir cuidados de enfermagem específicos para as crianças de/na rua que valorizam as necessidades do ser humano em âmbito social e político.
Background and managerial practice of nurses: paths for transforming praxis
Authors: Resck Zélia Marilda Rodrigues , Gomes Elizabeth Laus Ribas
Published: April 2008

Qualitative research using a dialectics view; the objective is to analyze the demands and the expectations from the setting of managerial practices in view of the Pedagogical Project and the strategies which may or may not favor the transforming praxis. It involves 11 students, 12 professors, and 12 service nurses who are the participants in the teaching-learning process of managerial knowledge, in the interceding space, in the fields of practice and in the curricular training programs, both in the hospital environment and in the basic health services and of the Nursing graduation course from a Federal University, from the city of Alfenas-MG. It uses the collecting technique by focal group and the analysis of the contents is subsided by two great discussions: background and work. The results point that the nurse's background and praxis must go through the work processes in the caring, managerial and educative dimensions as well as in the scientific investigation, building paths for the development of competences, in the teaching and service interaction, following the current National Curriculum Guidelines.
Superficial peripheral vein type classification of adolescents, adults and elderly according to the Delphi technique
Authors: Arreguy-Sena Cristina , Carvalho Emilia Campos de
Published: April 2008

This descriptive research attempts to cooperate with the standardization of communication about vein types in Nursing. Authors utilized the "Delphi" technique and aimed at elaborating and validating a peripheral vein type classification of adolescents/adults/elderly according to their vein characteristics. Initially, authors identified different vein types in literature. This was a preliminary classification that contained the titles and definitions, which were complemented during the expert (nurses, angiologists, anesthetists and biochemists) validation process. Twelve criteria and 27 vein types were validated (agreement level > 90%). In addition, authors organized a set of pictures representing the different vein types. From these, 144 were used; 35 experts chose one picture to exemplify each classification title. The pictures representing 21 vein types were identified. This classification contributes to the clinical assessment of blood vessels and can be used in teaching, research and patient care management.
Collective prenatal consultation: a new proposal for comprehensive health care
Authors: Penna Lucia Helena Garcia , Carinhanha Joana Iabrudi , Rodrigues Raquel Fonseca
Published: April 2008

This article describes the Collective Prenatal Consultation as a new healthcare methodology, which is performed according to government standards, but collectively. Relaxation and sensitization techniques are used, as well as group dynamics, including a collective exam of the pregnant women. The Collective Consultation is carried out in a welcoming environment, which provides clarification and socialization of experiences and information, centered on those women. The healthcare professional records every obstetric parameter and behavior in the patient's prenatal card and history file. Priority is given to the principle of integrality and citizenship, with the aim to break the biomedical care paradigm, thus favoring humanized and comprehensive care to the women.
Políticas sociais: desigualdade, universalidade e focalização na saúde no Brasil
Authors: Marsiglia Regina M. G. , Silveira Cássio , Carneiro Junior Nivaldo
Published: April 2008

O presente artigo tem por finalidade contribuir para o debate sobre as políticas sociais em saúde e para a elaboração de estratégias que viabilizem a organização de serviços de saúde, a extensão da cobertura às regiões desprovidas de serviços e a conseqüente transformação das condições de saúde da população. Para isso, propõe uma reflexão sobre os sentidos das políticas, seus desdobramentos nas concepções da universalização e da focalização, e a pertinência das concepções e práticas em saúde estabelecidas nos últimos anos quanto ao encaminhamento da diminuição dos problemas da desigualdade e da pobreza. Esta análise toma como base a reflexão sobre a experiência de implantação do Programa de Saúde da Família na área central da cidade de São Paulo, seus desdobramentos e ajustes, além do questionamento sobre as características e a qualidade que devem configurar tal programa, de acordo com as especificidades de cada região do país. Conclui-se o estudo com a afirmação de que o princípio da universalidade tem contribuído para o incremento do acesso aos serviços de saúde, porém não tem criado condições para o estabelecimento da eqüidade, necessitando para isso reformulação e adaptação de programas e ações em saúde.
Transdisciplinaridade e antropoformação: sua importância nas pesquisas em saúde
Authors: Paul Patrick
Published: April 2008

Além das normas de referência provenientes das estatísticas - quando comportamentos da pessoa a ser cuidada ou educada devem ser levados em conta de maneira singular - o posicionamento dos cuidadores é dificultado entre imperativos oriundos de modelos normativos que se referem à doença e não levam em conta os doentes de um lado e, do outro lado, a evidência de dever considerar as particularidades próprias a cada sujeito que se acompanha e que interferem, necessariamente, sobre a saúde pelos comportamentos mas que são fonte de complexidade, portanto difícil de tratar. A transdisciplinaridade convida ao imperativo de mudança paradigmática e de um caminho de dupla face, com essa bipartição não podendo jamais distinguir- se totalmente. Ela se aproxima por um lado - o que corresponde a sua definição clássica - de uma epistemologia que apontaria para a importância nova das fronteiras disciplinares, das zonas imprecisas, não acessíveis aos fechamentos clássicos que definem os objetos disciplinares. Mas ela impõe, por outro lado, a construção de nova epistemologia do sujeito e que participa sempre, de uma maneira ou de outra, da observação pela sua interação mais ou menos forte com o objeto, o que definimos pelo neologismo "antropoformação". Pela mudança que opera, ela permite oferecer, ao mesmo tempo, uma atitude para religar os saberes disciplinares entre eles e uma capacidade de integração do sujeito, sua indisciplina e suas interações. Ela conduz para uma fenomenologia da saúde associando os modos de ser aos modos de compreender. O texto visa a precisar, no campo da saúde, os diferentes pontos levantados por essa mudança paradigmática.
Alunos com deficiência nas escolas regulares: limites de um discurso
Authors: Barros Alessandra
Published: April 2008

Este artigo é resultado de uma pesquisa que analisou aspectos do discurso em favor da inclusão de alunos deficientes em escolas regulares. Para tanto, se escolheu como corpus de análise a propaganda do Governo Federal - representado pelo Ministério da Educação - tendo, como recorte específico, a peça publicitária que encabeçou a segunda campanha governamental pela inclusão escolar de deficientes, então lançada no início do ano 2000. A análise de discurso empreendida foi situada em seus condicionantes sócio-históricos a partir de duas contextualizações que se entrecruzaram: as circunstâncias operacionais de criação e discussão da peça publicitária entre a agência de propaganda contratada e o MEC, e a postura de Governo presente em discursos que ora justificavam a inclusão como uma política pública, ora denunciavam intenções concorrentes como aquelas expostas por campanhas de saúde pública. Na medida em que um dos fundamentos da análise de discurso é o assinalamento das suas condições históricas de produção, então, pode-se dizer que uma de suas finalidades é evidenciar o caráter socialmente construído deste discurso. Tomada desse modo, a análise de discurso empreendida, ao descrever os passos de elaboração do slogan de uma campanha de política social destinada aos deficientes buscou desnaturalizar palavras de ordem que, repetidas como chavões, fazem adormecer a percepção de que um dia elas não estiveram lá.
A qualidade da prescrição de antimicrobianos em ambulatórios públicos da Secretaria Municipal de Saúde de Belo Horizonte, MG
Authors: Abrantes Patrícia de Magalhães , Magalhães Sérgia Maria Starling , Acúrcio Francisco de Assis , Sakurai Emília
Published: April 2008

Este estudo investiga o uso de antimicrobianos e os padrões de prescrição e identifica os antimicrobianos mais freqüentemente prescritos nas unidades do serviço público de saúde de Belo Horizonte, MG. O estudo foi observacional, transversal de investigação da utilização da prescrição de antibacterianos em unidades públicas de saúde de Belo Horizonte, a partir da avaliação de amostra de prontuários e prescrições dispensadas no mês de março de 2002. A pediatria apresentou o maior índice de prescrição de antimicrobianos. A amoxicilina foi o antibacteriano mais prescrito. As hipóteses diagnósticas registradas com maior freqüência foram infecções das vias aéreas superiores, tonsilite e otite média. O percentual de inadequação entre hipótese diagnóstica registrada e antimicrobiano prescrito foi superior a 25%. Observou-se variabilidade nos tempos de tratamento instituídos e, em cerca de 10% das prescrições, o dado estava ausente. Verificou-se uma ausência sistemática de registro de informações gerais no prontuário. O estudo demonstrou a necessidade de intervenções que assegurarem o cumprimento dos protocolos como forma de garantir o uso adequado dos antimicrobianos.
Perfil de utilização de medicamentos em usuários da rede básica de saúde de Lorena, SP
Authors: Fleith Valeska Danielli , Figueiredo Marco Aurélio , Figueiredo Karina Fernanda Lais Rainho de Oliveira , Moura Erly Catarina
Published: April 2008

Estudo transversal desenvolvido com a clientela da clínica médica das Unidades Básicas de Saúde de Lorena (SP) com o objetivo de descrever o perfil de utilização de medicamentos em adultos e idosos. Foram coletados dados sobre características sociodemográficas, razões de procura do serviço, prescrição medicamentosa, identificação do(s) medicamento(s) utilizado(s) no último mês, local de aquisição do(s) mesmo(s), automedicação e uso de medicamento(s) homeopático(s). Foram entrevistados 766 indivíduos, sendo 66% do sexo feminino. Mais de 46% dos entrevistados referiram existência de doença crônica e a maioria se considerava em bom estado de saúde. A prescrição de medicamentos alcançou cerca de 70% da população, com média de 1,5 medicamento por pessoa, a maioria anti-hipertensivos. Este número aumentou com o aumento da idade, foi maior nas situações de manutenção do estado de saúde e casos de doença, na existência de doença crônica, nos casos auto-referidos como estado de saúde ruim para os homens e regular para as mulheres. Para as mulheres, também foi maior para as não inscritas em alguma UBS e para aquelas em consulta de retorno. A automedicação e o uso de medicamentos homeopáticos foram baixos.
Desigualdades sociais e homicídios na cidade de São Paulo, 1998
Authors: Barata Rita Barradas , Ribeiro Manoel Carlos Sampaio de Almeida , Sordi Meri De
Published: April 2008

Este estudo teve como objetivo identificar os padrões de ocorrência dos homicídios quanto a características dos agressores, das vítimas e das circunstâncias que motivaram a agressão, segundo estratos de condições de vida. As condições de vida foram avaliadas pela escolaridade, renda e condições de habitação. Os distritos administrativos da cidade foram agrupados através de análise de cluster formando cinco estratos. Amostras casuais simples de 100 óbitos por homicídios foram obtidas para cada estrato. Atestado de óbito, boletim de ocorrência e inquérito policial foram utilizados como fontes de dados. No estrato A foram mais comuns os homicídios associados a assaltos, enquanto nos estratos B, C e D predominaram os homicídios relacionados ao tráfico de drogas e a outras atividades ilegais. No estrato E, a maioria dos casos estudados estava relacionada com brigas e desavenças entre indivíduos. Vítimas e os agressores foram predominantemente indivíduos do sexo masculino, jovens, brancos ou pardos, com baixa escolaridade, nascidos em São Paulo ou em Estados do Nordeste, com ocupação no setor terciário ou desempregados. Há maior freqüência relativa de homicídios de mulheres no estrato A. Neste estrato, a maioria das vítimas não conhece os agressores, enquanto nos outros estratos, predomina o conhecimento entre vítima e agressor envolvendo parentes, amigos ou conhecidos.
Doenças diarréicas em menores de cinco anos no Estado de Pernambuco: prevalência e utilização de serviços de saúde
Authors: Vasconcelos Maria Josemere de Oliveira Borba , Batista Filho Malaquias
Published: April 2008

Objetivou-se, com um estudo transversal de base populacional de 2.074 crianças menores de cinco anos no Estado de Pernambuco (Região Metropolitana do Recife - RMR; Interior Urbano - IU; Interior Rural - IR), avaliar comparativamente a prevalência das diarréias, bem como suas implicações na produção de consultas ambulatoriais e internações hospitalares. Ademais, a pesquisa propõe-se a estabelecer uma linha de base para avaliar tendências temporais do problema. A amostra, de caráter probabilístico, foi distribuída em 18 municípios do Estado, sendo cinco na RMR e os demais nas zonas rurais e urbanas de 13 municípios do interior (Zona da Mata, Agreste e Sertão). A ocorrência mais elevada (22,7% nas últimas duas semanas) e a maior demanda de atendimentos ambulatoriais (8,6% nos últimos 03 meses) foram encontradas no IU, enquanto as internações hospitalares, (4,1% das crianças pesquisadas num retrospecto de 12 meses) predominavam no IR. No conjunto do Estado de Pernambuco, estimou-se que para cada cem casos de diarréia ocorreu uma taxa de 0,44 hospitalizações, com freqüências mais elevadas na RMR. Concluiu-se, tomando como referência os compromissos internacionais assumidos pelo Brasil junto às Nações Unidas (UNICEF 1990) para a década passada, que as diarréias ainda representavam um relevante problema de saúde coletiva em todo Estado de Pernambuco, bem como uma pesada carga de demandas sobre os serviços ambulatoriais e, secundariamente, como demandas hospitalares.
Biokinetics of cadmium and zinc in a marine bacterium: Influences of metal interaction and pre-exposure
Authors: Chen Dongshi , Qian Pei-Yuan , Wang Wen-Xiong
Published: April 2008

The uptake kinetics of Cd and Zn, as influenced by metal interaction and metal pre-exposure, was examined in the gram-positive marine bacterium Bacillus firmus over a wide range of ambient free-Cd and -Zn concentrations. Bacteria were exposed to experimental media with different concentrations of Cd and Zn over a short, 15-min period. Zinc was found to be an effective competitive inhibitor of Cd uptake when the Zn2+ concentration ([Zn2+]) was increased to 10−8 M, whereas the Cd concentration (ranging from 10−9 to 10−6 M) did not affect Zn uptake. Inhibition of Cd uptake was dependent on [Zn2+] instead of the [Zn2+] to Cd2+ concentration ratio. Cadmium uptake at different [Zn2+] was significantly inhibited by a sulfur ligand (SH) blocker (N-ethylmaleimide) and a Ca-channel blocker (lanthanum), suggesting that competition between Cd and Zn most likely occurred via binding to the same transport sites. Cadmium efflux also was determined in the presence of different [Zn2+]. A biphasic depuration of Cd was found when [Zn2+] was greater than 10−8 M, whereas the calculated Cd efflux rate was independent of [Zn2+]. We further exposed B. firmus at different Cd or Zn concentrations for 24 h, then determined the metal uptake and efflux kinetics as well as the metallothionein (MT) induction. Both the Cd and Zn cellular concentrations increased with greater exposed metal concentration, but the MT levels and efflux were little affected by the elevated metal concentration. To some extent, however, the Cd uptake was reduced with an elevated intracellular Zn concentration, suggesting that at high Cd concentrations, intracellular Zn can suppress the Cd uptake in B. firmus. These results help to understand the interactions of metals in the marine environments.
Distribution and variance/covariance structure of pesticide environmental fate data
Authors: Spurlock Frank
Published: April 2008

Hydrophobicity, persistence, and volatility data for individual pesticides are widely used in risk assessment and transport modeling, so it is important to understand their distribution, variation, and covariation. Correlations (normalized covariance) among properties across a range of multiple pesticides are also important for understanding fundamental relationships among the properties. For the present study, multiple determinations of 11 physicochemical properties of 262 individual pesticides were compiled, primarily from registrant submissions. A Z-score normality analysis indicates that, barring specific data to the contrary, log normality is a reasonable assumption for three properties commonly treated as random variables in modeling: Organic carbon-normalized soil sorption coefficient, aerobic soil metabolism half-life, and field dissipation half-life. Various percentiles for coefficients of variation of the variables are provided, allowing probabilistic modelers to choose realistic population parameters for sampling distributions. A second data set consisting of median values of individual properties for each pesticide was used to investigate the covariance structure of eight of the most important fate properties across 172 pesticides using correlation analysis and exploratory common factor analysis. That analysis demonstrated the use of common factor analysis for reducing the dimensionality of multicollinear environmental fate data, yielding three new orthogonal variables containing most of the information in the original data, and provided insight into the fundamental data structure.
Impacts of some environmentally relevant parameters on the sorption of polycyclic aromatic hydrocarbons to aqueous suspensions of fullerene
Authors: Hu Xialin , Liu Jingfu , Mayer Philipp , Jiang Guibin
Published: April 2008

The wide application of engineered carbon nanomaterials (CNMs), such as fullerene (C60), inevitably will result in their introduction into the aqueous environment. It is likely CNMs will associate with abundant natural organic matter (NOM) and engineered surfactants to form stable aqueous suspensions through various environmental processes. The present study reveals that sorption of polycyclic aromatic hydrocarbons (PAHs) to fullerene resulted in a remarkable decline of freely dissolved PAH concentrations. For the three PAHs studied (phenanthrene, fluoranthene, and chrysene) with log KOW in the range of 4.56 to 5.81, the measured sorption coefficients to aqueous suspensions of fullerene (log KC60 = 4.71–5.48) were close to that of dissolved organic carbon (DOC) from Aldrich humic acid (log KDOC = 4.48–5.91). Aqueous suspensions of fullerene were stable for a wide range of pH (3.0–11.0) and salinity conditions (0–25 mM NaCl), and the pH and salinity had minor effects on the sorption of PAHs to aqueous suspensions of fullerene. The addition of humic acids (5 mg/L DOC) to the fullerene (5 mg/L) suspensions resulted in an additional reduction of freely dissolved PAH concentrations. The high PAH sorption coefficients to suspended fullerene suggest that the release of fullerene to the aquatic environment might affect PAH fate and exposures.
Ethics in Public Health Research
Authors: Myers Julie , Frieden Thomas R. , Bherwani Kamal M. , Henning Kelly J.
Published: April 2008

Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people.

Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information.

Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies.
Reduction of State Victim Compensation Disparities in Disadvantaged Crime Victims Through Active Outreach and Assistance: A Randomized Trial
Authors: Alvidrez Jennifer , Shumway Martha , Boccellari Alicia , Green Jon Dean , Kelly Vanessa , Merrill Gregory
Published: April 2008

Objectives. We examined whether providing active outreach and assistance to crime victims as part of comprehensive psychosocial services reduced disparities in access to state compensation funds.

Methods. We analyzed data from a randomized trial of injured crime victims (N = 541) and compared outcomes from comprehensive psychosocial services with usual community care. We examined the impact of outreach and assistance on disparities in applying for victim compensation by testing for interactions between victim characteristics and treatment condition in logistic regression analyses.

Results. Victims receiving comprehensive services were much more likely to apply for victim compensation than were victims receiving usual care. Comprehensive services decreased disparities associated with younger age, lower levels of education, and homelessness.

Conclusions. State-level victim compensation funds are available to help individuals recover physically, psychologically, and financially from crime victimization. However, few crime victims apply for victim compensation, and there are particularly low application rates among young, male, ethnic minority, and physical assault victims. Active outreach and assistance can address disparities in access to victim compensation funds for disadvantaged populations and should be offered more widely to victims of violent crime.
Being Poor and Coping With Stress: Health Behaviors and the Risk of Death
Authors: Krueger Patrick M. , Chang Virginia W.
Published: April 2008

Objectives. Individuals may cope with perceived stress through unhealthy but often pleasurable behaviors. We examined whether smoking, alcohol use, and physical inactivity moderate the relationship between perceived stress and the risk of death in the US population as a whole and across socioeconomic strata.

Methods. Data were derived from the 1990 National Health Interview Survey’s Health Promotion and Disease Prevention Supplement, which involved a representative sample of the adult US population (n=40335) and was linked to prospective National Death Index mortality data through 1997. Gompertz hazard models were used to estimate the risk of death.

Results. High baseline levels of former smoking and physical inactivity increased the impact of stress on mortality in the general population as well as among those of low socioeconomic status (SES), but not middle or high SES.

Conclusions. The combination of high stress levels and high levels of former smoking or physical inactivity is especially harmful among low-SES individuals. Stress, unhealthy behaviors, and low SES independently increase risk of death, and they combine to create a truly disadvantaged segment of the population.
Long-Term Trends in Adolescent and Young Adult Smoking in the United States: Metapatterns and Implications
Authors: Nelson David E. , Mowery Paul , Asman Kat , Pederson Linda L. , O’Malley Patrick M. , Malarcher Ann , Maibach Edward W. , Pechacek Terry F.
Published: April 2008

Objectives. We sought to describe long-term adolescent and young adult smoking trends and patterns.

Methods. We analyzed adolescent data from Monitoring the Future, 1976 to 2005, and young adult (aged 18–24 years) data from the National Health Interview Survey, 1974 to 2005, overall and in subpopulations to identify trends in current cigarette smoking prevalence.

Results. Five metapatterns emerged: we found (1) a large increase and subsequent decrease in overall smoking over the past 15 years, (2) a steep decline in smoking among Blacks through the early 1990s, (3) a gender gap reversal among older adolescents and young adults who smoked over the past 15 years, (4) similar trends in smoking for most subgroups since the early 1990s, and (5) a large decline in smoking among young adults with less than a high school education.

Conclusions. Long-term patterns for adolescent and young adult cigarette smoking were decidedly nonlinear, and we found evidence of a cohort effect among young adults. Continued strong efforts and a long-term societal commitment to tobacco use prevention are needed, given the unprecedented declines in smoking among most subpopulations since the mid- to late 1990s.
The Effect of Vaccinated Children on Increased Hepatitis B Immunization Among High-Risk Adults
Authors: Koya Deepika L. , Hill Elizabeth G. , Darden Paul M.
Published: April 2008

Objectives. We sought to examine trends in hepatitis B virus (HBV) vaccination among high-risk adults and assess the potential effect vaccinated adolescents have on these trends as they age.

Methods. We used data from the National Health Interview Survey 2000, 2002, and 2004 to examine trends in HBV vaccination among high-risk adults aged 18 to 49 years and in age subgroups (18–29, 30–39, and 40–49 years). We investigated temporal differences in vaccination rates for the 18- to 29-year-old cohort with model-based linear contrasts constructed from a logistic regression model with age and survey year as predictors.

Results. There was a significant increasing trend in vaccination prevalence across the 3 survey years (32.6%, 35.3%, and 41.4%; trend test, P=.001). We found that respondents aged 18 to 29 years were more likely to be vaccinated in 2004 than in 2000, after adjusting for relevant confounders (odds ratio=1.73; 95% confidence interval=1.14, 2.6); there was no significant increase in vaccination for the other cohorts.

Conclusions. A cohort effect, in which successfully vaccinated adolescents have reached young adulthood, contributes significantly to recent trends showing improved HBV vaccination among high-risk adults.
Health Effects of Exposure to Water-Damaged New Orleans Homes Six Months After Hurricanes Katrina and Rita
Authors: Cummings Kristin J. , Cox-Ganser Jean , Riggs Margaret A. , Edwards Nicole , Hobbs Gerald R. , Kreiss Kathleen
Published: April 2008

Objectives. We investigated the relation between respiratory symptoms and exposure to water-damaged homes and the effect of respirator use in posthurricane New Orleans, Louisiana.

Methods. We randomly selected 600 residential sites and then interviewed 1 adult per site. We created an exposure variable, calculated upper respiratory symptom (URS) and lower respiratory symptom (LRS) scores, and defined exacerbation categories by the effect on symptoms of being inside water-damaged homes. We used multiple linear regression to model symptom scores (for all participants) and polytomous logistic regression to model exacerbation of symptoms when inside (for those participating in clean-up).

Results. Of 553 participants (response rate=92%), 372 (68%) had participated in clean-up; 233 (63%) of these used a respirator. Respiratory symptom scores increased linearly with exposure (P<.05 for trend). Disposable-respirator use was associated with lower odds of exacerbation of moderate or severe symptoms inside water-damaged homes for URS (odds ratio (OR)=.51; 95% confidence interval (CI)=0.24, 1.09) and LRS (OR=0.33; 95% CI=0.13, 0.83).

Conclusions. Respiratory symptoms were positively associated with exposure to water-damaged homes, including exposure limited to being inside without participating in clean-up. Respirator use had a protective effect and should be considered when inside water-damaged homes regardless of activities undertaken.
Status of Influenza and Pneumococcal Vaccination Among Older American Indians and Alaska Natives
Authors: Lindley Megan C. , Groom Amy V. , Wortley Pascale M. , Euler Gary L.
Published: April 2008

Objectives. We sought to estimate the influenza and pneumococcal vaccination coverage among older American Indian and Alaska Native (AIAN) adults nationally and the impact of sociodemographic factors, variations by geographic region, and access to services on vaccination coverage.

Methods. We obtained our sample of 1981 AIAN and 179845 White respondents 65 years and older from Behavioral Risk Factor Surveillance System data from 2003 to 2005. Logistic regression provided predictive marginal vaccination coverage for each covariate and adjusted for demographic characteristics and access to care.

Results. Unadjusted influenza coverage estimates were similar between AIAN and White respondents (68.1% vs 69.5%), but pneumococcal vaccination was lower among AIAN respondents (58.1% vs 67.2%; P<.01). After multivariable adjustment for sociodemographic characteristics, self-reported coverage for both vaccines was statistically similar between AIAN and White adults.

Conclusions. Although there was no disparity in influenza coverage, pneumococcal coverage was lower among AIAN than among White respondents, probably because of sociodemographic risk factors. Regional variation indicates a need to monitor coverage and target interventions to reduce disparities within geographically and culturally diverse subpopulations of AIAN persons.
Discharge Planning and Continuity of Health Care: Findings From the San Francisco County Jail
Authors: Wang Emily A. , White Mary C. , Jamison Ross , Goldenson Joe , Estes Milton , Tulsky Jacqueline P.
Published: April 2008

Continuity of health care among the formerly incarcerated is an emerging public health challenge. We used data from the San Francisco County Jail to determine whether discharge planning improves access to care on release. Inmates who were HIV positive and received discharge planning were 6 times more likely to have a regular source of care in the community compared with inmates with other chronic medical conditions, and they were as likely to have a regular source of care compared with the general San Francisco population.
Trends in Recorded Influenza Mortality: United States, 1900–2004
Authors: Doshi Peter
Published: April 2008

Objectives. I sought to describe trends in historical influenza mortality data in the United States since 1900 and compare pandemic with nonpandemic influenza seasons.

Methods. I compiled a database of monthly influenza-classed death rates from official US mortality tables for the years 1900 to 2004 (1905–1909 excluded), from which I calculated adjusted influenza season (July 1–June 30) mortality rates.

Results. An overall and substantial decline in influenza-classed mortality was observed during the 20th century, from an average seasonal rate of 10.2 deaths per 100 000 population in the 1940s to 0.56 per 100 000 by the 1990s. The 1918–1919 pandemic stands out as an exceptional outlier. The 1957–1958 and 1968–1969 influenza pandemic seasons, by contrast, displayed substantial overlap in both degree of mortality and timing compared with nonpandemic seasons.

Conclusions. The considerable similarity in mortality seen in pandemic and non-pandemic influenza seasons challenges common beliefs about the severity of pandemic influenza. The historical decline in influenza-classed mortality rates suggests that public health and ecological factors may play a role in influenza mortality risk. Nevertheless, the actual number of influenza-attributable deaths remains in doubt.
New York City’s Initiatives on Diabetes and HIV/AIDS: Implications for Patient Care, Public Health, and Medical Professionalism
Authors: Goldman Janlori , Kinnear Sydney , Chung Jeannie , Rothman David J.
Published: April 2008

Two recent New York City Department of Health and Mental Hygiene initiatives expanded the mission and scope of public health, with implications for both New York and the nation.

The programs target diabetes and HIV/AIDS for greater systemic and expanded reporting, surveillance, and intervention. These initiatives do not balance heightened surveillance and intervention with the provision of meaningful safeguards or resources for prevention and treatment. The programs intrude on the doctor–patient relationship and may alienate the very patients and health professionals they aim to serve.

Better models are available to achieve their intended goals. These initiatives should be reconsidered so that such an expansion of public health authority in New York City does not become part of a national trend.
Correlates of the Stages of Change for Physical Activity in a Population Survey
Authors: Garber Carol Ewing , Allsworth Jenifer E. , Marcus Bess H. , Hesser Jana , Lapane Kate L.
Published: April 2008

Objectives. We sought to identify variables associated with being in a particular stage of change for physical activity—a measure of behavioral intention to engage in regular physical activity. Understanding behavioral intentions can be useful in explaining why individuals are physically inactive or active.

Methods. Data from the Rhode Island 2000 Behavioral Risk Factor Surveillance System were used to evaluate predictors of stage of change for physical activity. There were 3454 observations in the data set, representing a weighted population of 742636 people. Estimates were obtained from polytomous multiple logistic models.

Results. Being a woman, Hispanic, non-Hispanic Black, and older than 55 years of age were associated with being in precontemplation and contemplation stages of change rather than maintenance. Self-perceived health status and rarely feeling healthy or full of energy were strongly predictive of stage of change. Having a health limitation was a dichotomous predictor, predicting being in action and precontemplation stages.

Conclusions. Several sociodemographic and health variables were associated with varying patterns of stages of change for physical activity. The complexity of individual intentions for physical activity provides evidence for the potential existence of mediating, effect-modifying, and confounding variables that differ depending on individual characteristics.
Random Drug Testing in US Public School Districts
Authors: Ringwalt Chris , Vincus Amy A. , Ennett Susan T. , Hanley Sean , Bowling J. Michael , Yacoubian George S. , Rohrbach Louise A.
Published: April 2008

We estimated the proportion of the nation’s public school districts that have high school grades in which random drug testing is conducted. We collected data in spring 2005 from 1343 drug prevention coordinators in a nationally representative sample of school districts with schools that have high school grades; of these districts, 14% conducted random drug testing. Almost all districts randomly tested athletes, and 65% randomly tested other students engaged in extracurricular activities; 28% randomly tested all students, exceeding the current sanction of the US Supreme Court.
Temperature and electric field dependences of the mobility of electrons in vertical transport in GaAs/Ga1−y
AlyAs barrier structures containing quantum wells
Authors: Altunöz Safi , Çelik Hüseyin , Cankurtaran Mehmet
Published: April 2008

The mobility of electrons in vertical transport in GaAs/Ga1−y
AlyAs barrier structures was investigated using geometric magnetoresistance measurements in the dark. The samples studied had Ga1−y
AlyAs (0 ≤ y ≤ 0:26) linearly graded barriers between the n+-GaAs contacts and the Ga0:74Al0:26As central barrier, which contain N
w (=0, 2, 4, 7 and 10) n-doped GaAs quantum wells. The mobility was determined as functions of (i) temperature (80–290 K) at low applied voltage (0.01–0.1 V) and (ii) applied voltage (0.005–1.6 V) at selected temperatures in the range 3.5–290 K. The experimental results for the temperature dependence of low-field mobility suggest that space-charge scattering is dominant in the samples with N
w=0 and 2, whereas ionized impurity scattering is dominant in the samples with N
w=4, 7 and 10. The effect of polar optical phonon scattering on the mobility becomes significant in all barrier structures at temperatures above about 200 K. The difference between the measured mobility and the calculated total mobility in the samples with N
w=4, 7 and 10, observed above 200 K, is attributed to the reflection of electrons from well-barrier interfaces in the quantum wells and interface roughness scattering. The rapid decrease of mobility with applied voltage at high voltages is explained by intervalley scattering of hot electrons.
Regeneration cycles of the keystone species Carnegiea gigantea are linked to worldwide volcanism
Authors: Drezner Taly Dawn , Balling Jr. Robert C.
Published: April 2008

Question:

We know of no study that has linked volcanic eruptions occurring anywhere worldwide and the local population cycles of any species. The keystone saguaro cactus (Carnegiea gigantea) establishes in cohorts. We test whether there is a statistical relationship between Carnegiea gigantea establishment and volcanic eruptions.

Location:

Northern Sonoran Desert, Arizona, USA.

Methods:

We use both a region‐wide dataset made up of 30 populations, and a dataset from a marginal site. We incorporate data for over 750 individuals over an area of more than 50 000 km2. We created a 111‐year time series of population peaks and troughs and correlated this over the 111‐year record with the annual Weighted Historical Dust Veil Index (WHDVI). A t‐test compared establishment patterns with the WHDVI.

Results:

We found a significant relationship between volcanism and C. gigantea regeneration at both the marginal site, and in the region‐wide dataset.

Conclusions:

We suggest that while different populations are influenced by temporary global temperature ameliorations to different extents, our results show that populations do derive significant benefits from volcanic eruptions that promote their regeneration over large portions of their range, as is also exhibited locally at our marginal site, where populations are most susceptible to the inhospitable conditions that are witnessed at the edge of their range. This paper draws a link between the population fluctuations and regeneration of a species locally with geologic events from distant parts of the earth.
The influence of tree age and microhabitat quality on the occurrence of crustose lichens associated with old oaks
Authors: Ranius Thomas , Johansson Per , Berg Niclas , Niklasson Mats
Published: April 2008

Questions:

How do tree age, microhabitat characteristics and epiphytic competitors affect the occurrence of crustose lichens associated with old oaks? How do microhabitat characteristics and microclimate affect the cover of competitors (bryophytes and macrolichens)? How do microhabitat characteristics correlate with microclimatic variables?

Location:

Southeast Sweden.

Methods:

Eight crustose lichen species were surveyed on 165 Quercus robur trees, 17–478 years old, at three study sites. The occurrence patterns of these species were examined at two spatial scales: among trees and within trees. Occurrence patterns within trees were examined in 10 cm × 10 cm plots at all four cardinal aspects at different heights from 0.5 to 4.5 m above the ground.

Results:

At the tree level, age‐related factors were the most important predictors of species occurrence. All species were more frequent on trees > 100 years than on younger trees. At the plot level, the frequency of occurrence increased with increasing bark crevice depth. The frequencies of all study species decreased with increasing cover of bryophytes. Bryophytes were in turn more frequent in plots that were exposed to rainwater and showed a low evaporation rate. Patches most exposed to rainwater were directed upwards, and the lowest evaporation rates occurred on the northern side of the trunks.

Conclusions:

For many crustose lichens the association with old oak trees seems at least partly to depend on their preference for the deep bark crevices that only occur on old trees. Trees represent epiphyte habitat patches that differ in size due to within‐tree variability in habitat quality, such as bark crevice depth and microclimate. This study shows that variability at a finer scale, within habitat patches, contribute to explain species occurrence patterns at habitat patch level.
Tumor Necrosis Factor-α (TNF-α) Stimulates Chemotactic Response in Mouse Myogenic Cells
Authors: Torrente Y. , Fahime E. El , Caron N. J. , Del Bo R. , Belicchi M. , Pisati F. , Tremblay J. P. , Bresolin N.
Published: April 2008

Migration of transplanted myogenic cells occurs during both embryogenesis and regeneration of skeletal muscles and is important for successful myoblast transplantation, but little is known about factors that promote chemotaxis of these cells. Tumor necrosis factor-α (TNF-α) is known to induce chemotactic effect on several cell types. In this study, we investigated its influence on the in vitro and in vivo motility of C2C12 and primary myoblasts. In the in vitro test performed in the blind-well Boyden chambers, we showed that TNF-α (50–400 U/ml) significantly enhanced the ability of myogenic cells to migrate. The dose–response curve for this factor was bell shaped, with maximum activity in the 200 U/ml range. In the in vivo test, intramuscular administration of TNF-α was performed by an Alzet pump connected to a perforated polyethylene microtube inserted in the tibialis anterior (TA) of CD1 mice. In these experiments, myoblasts were injected under the muscle epimysium. The recipient mice were immunosuppressed with FK506. Our results showed that, 5 days after myoblast transplantation, cells migrated further in the muscles infused with TNF-α than in the muscles not exposed to TNF-α. TNF-α not only has a chemotactic activity but may also modify cell migration via its action on matrix metalloproteinase (MMP) expression. The proteolytic activities of the MMPs secreted in the muscles were thus also assessed by gelatin zymography. The results showed an increased of MMP-2 and MMP-9 transcripts in the TNF-α-infused muscles injected with myogenic cells. Myoblast migration during transplantation may be enhanced by overlapping gradients of several effector molecules such as TNF-α, interferon-γ (INF-γ), and interleukins, released at the site of muscle injury. We propose that TNF-α may promote myoblast migration directly through chemotactic activity and indirectly by enhancing MMP activity at the site of muscle injury.
Donor Age and Gender Are the Strongest Predictors of Marrow Recovery from Cadaveric Vertebral Bodies
Authors: Newman Helen , Reems Jo Anna , Rigley Theodore H. , Bravo Daniel , Strong D. Michael
Published: April 2008

The purpose of this retrospective analysis was to determine whether there were donor factors that were useful for predicting the yield of nucleated cells from marrow derived from cadaveric vertebral bodies. An analysis of 132 donors over a 6-year period was performed. The average number of vertebral bodies procured from each donor was 10.2 ± 1.6 (range 5–14). The total number of nucleated cells recovered per donor ranged from 24 × 109 to 160 × 109 with an average recovery of 69 ± 28 × 109 cells. The cell viability of the recovered cells was >95%. The average age of the donors was 33 ± 14 years (mean ± SD; range 12–65) with an average weight of 169 ± 41 lb (range 82–308 lb). Males comprised 68% of the donor population. The average number of days from admission to death was 1.9 ± 1.7 with a range of 1–11.4 days and the interval between asystole and procurement averaged 3.1 ± 2.3 h (range (0.1–14.7 h). The majority of donors died from head trauma due to an intracranial bleed, gunshot wound, or closed head injury. Regression analysis of the data indicated that the total nucleated cell yield tended to decrease with increasing time between hospital admission and death. The data also indicated that in general female donors yielded lower cell numbers independent of age and male donors under 30 years of age yielded the highest number of cells.
Tolerance and Immunity following in Utero Transplantation of Allogeneic Fetal Liver Cells: The Cytokine Shift
Authors: Donahue H. Sefrioui, J. , Gilpin E. A. , Srivastava A. S. , Carrier E.
Published: April 2008

Although in utero transplantation (IUT) has resulted in donor-specific tolerance to postnatal solid organ transplantation, the mechanisms of this tolerance remain poorly understood. Our recent findings demonstrate that under specific conditions prenatal injection of allogeneic cells may lead to allosensitization instead of tolerance. These laboratory observations were supported by clinical findings as well, and therefore suggested that, depending on the conditions of prenatal transplantation, tolerance or immunity may develop. The present study explored the role of CD4 cells, cytokines, and I-E superantigen in developing tolerance vs. immunity after in utero transplantation. Sixteen animals survived IUT (40–60% survival rate) and were free from any signs of graft-versus-host disease (GVHD). Mice were considered tolerant when their antidonor and antihost CTL responses were similar, sensitized when antidonor responses were significantly higher than antihost and anti-third-party responses, and nontolerant when antidonor responses in transplanted and control mice were similar. The TH1 → TH2 shift was associated with tolerance and TH2 → TH1 shift with allosensitization. Our results showed that tolerant BALB/c (H-2d, I-E+) → C57BL/6 (H-2b, I-E–) (2/7) mice showed higher IL-4 (p < 0.05) in antidonor MLR, and partial deletion of recipient I-E-reactive T cells (CD3Vβ11) (p < 0.045). On the other hand, nontolerant animals (5/7) demonstrated high production of IFN-γ (p < 0.05) without deletion of CD3Vβ11 T cells. In C57CBL/6 (H-2b, I-E–) → C3H (H-2k, I-E+) mice CD3Vβ11 T cells do not play any role in tolerance induction because they are deleted in the C3H background. Tolerant mice (4/9) showed an overproduction of IL-4 (p < 0.05) in antidonor MLR whereas allosensitized animals (5/9) demonstrated high level of IFN-γ (p < 0.05). Suppressor cells seem to play no role in tolerant C57BL/6 → C3H as demonstrated by suppressor assay. Hence, a shift from TH1 → TH2 or TH2 → TH1 cytokines may determine whether tolerance or immunity develops.