bluuebunny/crossref_metadata_2025 huggingface dataset:
Current sickle cell screening program for newborns in New York City, 1979-1980.
Authors: Grover R , Shahidi S , Fisher B , Goldberg D , Wethers D
Published: November 2008

The newborn screening program mandated by the New York State Public Health Law requires that every baby born in the state be tested for eight conditions including sickle cell anemia. Although sickle cell screening of newborns has been in operation since 1975, the follow-up program for case retrieval to obtain repeat blood samples for definitive diagnosis and referral of diagnosed patients for ongoing medical care was established only in 1979. Of the 106,565 blood samples tested in New York City Newborn Screening Laboratory, March 1, 1979 to February 29, 1980, 141 infants were identified on repeat blood testing as having various forms of sickle cell disease (SS, SC and S beta-Thalassemia) and were referred for ongoing medical care. Data received on 131 patients from follow-up clinics revealed that the disease diagnosis made by the Newborn Screening Laboratory was confirmed in all patients. There were no deaths reported among the study patients (131 infants) followed for the period of 8-20 months despite the life-threatening complications among eight patients. Binomial distribution of the data on Black infants according to the Hardy-Weinberg equation showed reasonable agreement between the observed and computed incidence of various forms of sickle cell disease.
Weight and sodium reduction for the prevention of hypertension: a comparison of group treatment and individual counseling.
Authors: Jeffery R W , Gillum R , Gerber W M , Jacobs D , Elmer P J , Prineas R J
Published: November 2008

Ninety-three overweight adult males with labile blood pressure elevation participated in a 20-week dietary intervention program to achieve a 10 per cent reduction in body weight and a reduction in dietary sodium intake to 70 milliequivalents per day. By random assignment, half were treated with intensive group treatment procedures and half with individual counseling. Written handouts and assignments were identical, as was the schedule of treatment visits. Both techniques produced significant decreases in weight, sodium intake, calorie intake, and blood pressure. Calorie and sodium knowledge also increased significantly with both intervention approaches. The two treatment modalities did not differ in effectiveness.
The effect of retirement on physical health.
Authors: Ekerdt D J , Baden L , Bossé R , Dibbs E
Published: November 2008

This prospective study compared pre- to post-retirement changes in physical health among male retirees with changes among age peers who continued to work. The 229 retirees and 409 workers aged 55-73 at follow-up were all participants in the Veterans Administration Normative Aging Study. Physical health at baseline and follow-up (three to four years apart) was rated on a four-point scale according to the findings of medical examinations. Although physical health declined generally over time, regression analyses showed no significant difference between eventual retirees and continuing workers on health change, after controlling for age and excluding men who retired due to illness or disability. Among retirees alone, pre- to post-retirement health change was also not significantly associated with several circumstances which purportedly make the retirement transition more stressful, such as mandatory retirement or retirement to a reduced standard of living. The results of this study of physical health, which corroborate those of other studies based on self-reported health measures and mortality data, support the conclusion that the event of retirement does not influence the risk of health deterioration.
Dietary lead intake of preschool children.
Authors: Bander L K , Morgan K J , Zabik M E
Published: November 2008

A nationwide, seven-day food consumption survey of 371 preschool children between the ages of birth and five years indicated that a direct linear relationship existed between age and increased dietary lead intake from foods consumed. Daily dietary lead intake averaged 62 micrograms and ranged from 15 micrograms to 234 micrograms. The various levels of lead intake were attributed to frequency of consumption of food items, quantity of food consumed, and the lead content of particular food items. To account for variation in the quantity of food consumed by the various children, average lead intake per 500 kilocalories consumed and per 500 g of food consumed was calculated. When these standardization procedures were followed, an equalization in the average daily dietary lead intake values was observed among the various aged children.
Employment, sense of well-being, and use of professional services among women.
Authors: Wheeler A P , Lee E S , Loe H D
Published: November 2008

Utilizing data from the National Health and Nutrition Examination Survey of 1971-1975 (NHANES I), comparisons were made of general well-being scores and utilization of professional services between employed and non-employed women. Employed women tend to have a higher sense of well-being and utilize fewer professional services to cope with personal and mental health problems than their non-employed counterparts. This tendency is more pronounced among non-married and less-educated women, with an indication of a counter-tendency among college-educated non-White women.
A reappraisal of time trends in ulcer disease: factors related to changes in ulcer hospitalization and mortality rates.
Authors: Kurata J H , Elashoff J D , Haile B M , Honda G D
Published: November 2008

There has been a dramatic decline in reported hospitalization and mortality rates for peptic ulcer disease in the past two decades. Data from the National Center for Health Statistics and from the Commission on Professional and Hospital Activities were examined to determine the cause(s) for this decline. Gastric and duodenal ulcer mortality rates decreased by 58 per cent and 68 per cent, respectively, from 1962 to 1978; changes in criteria for selecting the underlying cause of death might account for some of this apparent decrease. Hospitalization rates for duodenal ulcers decreased nearly 50 per cent from 1970 to 1978, but hospitalizations for gastric ulcers did not decrease. During this same time period, hospitalizations for peptic ulcers as one of the "all listed" causes remained stable, and hospitalizations for a closely related diagnosis, gastritis/duodenitis, increased. Changes in coding practices, hospitalization criteria, and diagnostic procedures appear to have contributed to the decline in reported hospitalization and mortality rates for peptic ulcer disease.
Health services reforms in revolutionary Nicaragua.
Authors: Garfield R M , Taboada E
Published: November 2008

Before the Nicaraguan revolution of 1979, access to health services was largely limited to the affluent sectors of the urban population and the minority of workers with social security coverage. Repeated attempts at reform by organized medicine were ineffective. Since the revolution, a tremendous expansion in health services has occurred. The national health system receives approximately one-third of its funds from the social security system. Steadily increasing equity in access is a result of the promotion of primary care, health campaigns involving up to 10 per cent of the general population as volunteers, the use of paramedical aides, and foreign assistance. Private practice nevertheless remains strong. In the coming years, several complex issues must be examined, including: a balance in the number of nurses and doctors trained, the role of private practice, and the relationship of the Ministry of Health to the social security system. Further progress in health reforms may be delayed by the defensive war which Nicaragua is fighting on its northern and southern borders. Despite emergent health problems in the war zones, most of the innovative aspects of the health system remain intact as of this writing.
Therapeutic abortions following rubella infection in pregnancy: the potential impact on the incidence of congenital rubella syndrome.
Authors: Serdula M K , Marks J S , Herrmann K L , Orenstein W A , Hall A D , Bomgaars M R
Published: November 2008

In 1977, a large rubella outbreak occurred in Hawaii. Because attack rates were high among women of childbearing age, we conducted extensive surveillance efforts to detect both pregnancies complicated by rubella and cases of congenital rubella syndrome (CRS). Initial surveillance included a survey of physicians and hospitals, review of fetal death and birth certificates, and cord blood screening for rubella-specific IgM of infants born following the epidemic. Two years after the outbreak, the medical community was again surveyed to identify affected children who were missed initially. No case of CRS was identified either shortly after the outbreak or in the ensuing two years. In addition, none of the 5,605 cord serum samples obtained was found to contain rubella-specific IgM antibody. Through active surveillance, we received 12 reports of rubella in pregnant women, of whom 11 elected to terminate their pregnancies. The extensive use of therapeutic abortion by exposed women may have prevented the birth of infants with CRS. Surveillance for rubella-related abortions is an important component in assessing the health impact of rubella in a community.
The effects of physicians' training and personality on test ordering for ambulatory patients.
Authors: Epstein A M , Begg C B , McNeil B J
Published: November 2008

We studied records of 351 hypertensive patients cared for by 30 internists in private office practice. We correlated the use of outpatient diagnostic tests with personal characteristics of the prescribing physicians. Doctors trained in medical schools with academic orientations used more tests than other physicians. Patterns of use were not strongly related to the number of years since medical school graduation, or physicians "intolerance of ambiguity" as measured by a standard psychological instrument. These findings suggest that certain types of training may predispose physicians to be high testers.
Weight loss competitions at the work site: impact on weight, morale and cost-effectiveness.
Authors: Brownell K D , Cohen R Y , Stunkard A J , Felix M R , Cooley N B
Published: November 2008

Three weight loss competitions were held in business/industrial settings. One competition was between three banks; the other two were within industries, either between employee teams selected at random or between divisions of the industry. Attrition in the competitions was less than 1 per cent and weight loss averaged 5.5 kg. Both employees and management reported positive changes in morale and employee/management relations, and both considered the competition important to the success of the program. The cost-effectiveness ratio ($ 2.93 per 1 per cent reduction in percentage overweight) is the best yet reported.
Mental health needs associated with Tourette syndrome.
Authors: Stefl M E
Published: November 2008

Tourette Syndrome (TS) is an uncommon developmental disability characterized by repetitive and involuntary verbal and motor tics. A survey of all known affiliates of the Tourette Syndrome Association of Ohio was conducted. A total of 431 questionnaires was returned, and behavioral problems were found to be pervasive in Tourette people. Some 53.1 per cent of the sample had sought some form of counseling for these problems, but this counseling was generally not perceived as being very helpful. Medication was not reported to ameliorate behavioral problems. When compared to a normal population sample, self-ratings of mental health status were low among Tourette persons. Problems experienced by TS persons were aggregated into a Behavioral Problem Scale, which successfully discriminated between levels of need in TS persons.
Tubal sterilization in women 15-24 years of age: demographic trends in the United States, 1970-1980.
Authors: Lee N C , Dicker R C , Hughes J M , Duarte-Franco E F , Layde P M
Published: November 2008

Between 1970-1980, approximately 942,000 women 15-24 years of age underwent tubal sterilization in the United States. These women represented about 17 per cent of all women ages 15-44 years who underwent tubal sterilization in the United States during this 11-year period. During 1970-1980, sterilization rates rose steadily from three per 1,000 to 11 per 1,000 for women in the 20- to 24-year age group, but remained stable at less than one per 1,000 for women in the 15- to 19-year age group. For each year, rates for Black women were greater than those for White women. Sterilization rates increased over the time period for both currently and previously married women, but remained low for never-married women. Most tubal sterilizations were performed after delivery of an infant.
Utilization of child health clinics following introduction of a copayment.
Authors: Fischer P J , Strobino D M , Pinckney C A
Published: November 2008

The effect of introduction of a copayment on utilization of well child services was investigated in St. Mary's County, Maryland between 1975 and 1979. Utilization declined between the pre-copayment and post-copayment periods for White and non-White infants under six months of age. The deterrent impact of the copayment suggested by the results may be related to crossover to private care but may also represent a drop in use of preventive services.
Changes in perceived heart disease risk and health during a community-based heart disease prevention program: the North Karelia project.
Authors: Kottke T E , Puska P , Salonen J T , Tuomilehto J , Nissinen A
Published: November 2008

To test whether the cardiovascular disease declines in North Karelia were accompanied by subjective improvements in health, we analyzed responses to two questions about perceived risk of heart disease and health status on independent random population samples surveyed 10 years apart. Age stratified perceived risk of heart disease declined significantly more (p less than .01) and age stratified perceived health status improved significantly more in North Karelia than in the reference area (p less than .005).
Giardiasis in an infant and toddler swim class.
Authors: Harter L , Frost F , Grunenfelder G , Perkins-Jones K , Libby J
Published: November 2008

A Giardia infected Washington State child was found to participate in an infant and toddler swim class. A stool survey of 70 child participants revealed a 61 per cent prevalence of Giardia infection. Also, 39 per cent of 53 mothers and 28 per cent of 21 fathers were Giardia positive. None of the non-swimming playmates were positive. Thirty-five per cent of 23 children exposed only at a better maintained pool to which the classes had been moved four weeks prior to the survey were positive. No evidence of transmission to non-swim class pool users was found.
A community waterborne gastroenteritis outbreak: evidence for rotavirus as the agent.
Authors: Hopkins R S , Gaspard G B , Williams F P , Karlin R J , Cukor G , Blacklow N R
Published: November 2008

A community waterborne nonbacterial gastroenteritis outbreak occurred in Eagle-Vail, Colorado in March 1981. Illness (defined as vomiting and/or diarrhea) was statistically associated with water consumption (chi 2 for linear trend = 7.07, p less than .005). Five of seven persons associated with the outbreak were infected with rotavirus as shown by virus detection or serological methods. Bacterial pathogens, Giardia lamblia, and Norwalk virus were excluded as responsible agents. Rotavirus should be looked for as a cause of waterborne outbreaks.
An analysis of the effects of suicide prevention facilities on suicide rates in the United States.
Authors: Miller H L , Coombs D W , Leeper J D , Barton S N
Published: November 2008

Since the 1960s, there has been a massive effort to reduce suicide mortality in the United States through prevention centers which invite suicidal persons to phone for supportive services. In spite of virtually total lack of evidence concerning the efficacy of these services, they proliferated until, by 1973, nearly every metropolitan area in the United States had at least one. Suicide rates increased slightly throughout this time. We studied 1968 through 1973, the years of greatest growth of suicide prevention facilities, comparing suicide rates in counties that added these centers with counties that did not do so. An association of centers with the reduction of suicides in young white females emerged. This finding was replicated on a different set of counties for a different time span. The results are discussed in light of the fact that this group constitutes the major clients of these centers.
The effect of mothers' social support and life changes on the stimulation of their children in the home.
Authors: Pascoe J M , Earp J A
Published: November 2008

The relationship between mothers' life changes, social support, and the preschool home environment of their children was analyzed three years after all study children were discharged from a neonatal intensive care unit. The number of reported life changes occurring to mothers since the births of the children in the group was not related to the amount of home stimulation mothers provided their children; however, mothers reporting more social support provided a more stimulating home environment unrelated to the number of life changes.
Prevalence of Staphylococcus aureus, phage type 29/52/80, in Michigan.
Authors: Martin R , Adcock M P , Wentworth B B
Published: November 2008

Staphylococcus aureus, phage type 29/52/80, caused an outbreak of infections in Michigan over a period of two years and continues to be the most prevalent type seen. Of 3,752 isolates typed in 1980-81, 25 per cent were this phage type, which was strongly associated with methicillin resistance. Using this phage type as an indicator, we could demonstrate the spread of methicillin resistant staphylococci from Detroit metropolitan hospitals to suburban and, to a lesser extent, to hospitals outside the Detroit area.
Placement changes in long-term care: three years' experience.
Authors: Stark A J , Kliewer E , Gutman G M , McCashin B
Published: November 2008

This paper describes the place and level of care of an urban and a semi-rural health unit for which 1,653 clients began their experience in British Columbia's Long-Term Care (LTC) program and where they were one and three years later. Three years after admission, 54 per cent of 759 clients initially admitted at home to the lowest level of care were still active clients: 25.8 per cent unchanged, 11.3 per cent at home but at a higher level of care, 16.9 per cent had moved to facilities, 25.4 per cent had died; the remainder of this group had been discharged from LTC. A similar proportion of the 184 clients admitted to the lowest level of care in facilities were still in the program at the end of three years. In contrast, 25 per cent of those admitted to the highest level of care at home (N = 60) and 14.1 per cent of those admitted to the highest level in facilities (N = 64) remained in the program after three years. The potential of the study data for planning purposes is suggested.
Elevated levels of carbon monoxide in the patient compartment of ambulances.
Authors: Iglewicz R , Rosenman K D , Iglewicz B , O'Leary K , Hockemeier R
Published: November 2008

Six hundred and ninety New Jersey ambulances were monitored for carbon monoxide (CO); 27 per cent had CO levels of 10 ppm or more greater than ambient air in the breathing zone of the patient. Twenty-nine of these ambulances had levels of at least 35 ppm greater than ambient air. Results indicate that a CO exposure problem exists in ambulances.
Age-specific hysterectomy and oophorectomy prevalence rates and the risks for cancer of the reproductive system.
Authors: Howe H L
Published: November 2008

A sample survey was conducted in 1982 to determine the prevalence of hysterectomy and oophorectomy among upstate New York women, ages 25-74. The effects of this surgery on age-specific estimates of the risk for cancer of the uterus, cervix, and ovary were calculated. Overall, 16.9 per cent of the women reported having had a hysterectomy and 9.9 per cent reported a bilateral oophorectomy. The adjustment for age-specific hysterectomy increased the 1977-1979 average annual incidence rate of cervical and uterine cancer by 21 per cent. In several five-year age categories, the increase reached 54 per cent. The 1977-1979 average annual incidence rate of ovarian cancer increased by 12 per cent after adjusting for age-specific bilateral oophorectomy. The increase reached 29 per cent in one five-year age group. The sample results show a lower prevalence of hysterectomy among women 25 to 40 years old and among women 70 to 74 than estimates based on the application of mathematical models to data on surgical incidence.
Epidemiology of musculoskeletal impairments and associated disability.
Authors: Cunningham L S , Kelsey J L
Published: November 2008

Data from the US Health and Nutrition Examination Survey (HANES I) of 1971-1975 confirm the high prevalence of musculoskeletal impairments among United States adults. Musculoskeletal impairments tend to be more prevalent among older persons, and persons with less education and with lower annual family incomes. Prevalence rates are slightly higher in females than in males, while Whites and non-Whites are affected with almost equal frequency. Among persons reporting a history of musculoskeletal symptoms, those who have some disability tend to be older, non-White, of lower education and income, and widowed, separated, or divorced. Persons with multiple parts of the body involved, or reporting that their symptoms are due to accident or injury are also especially likely to report disability. Taken as a whole, the data suggest that medical, social, and economic factors all play a role in determining whether a person with musculoskeletal impairment goes on to develop disability related to his or her impairment.
An assessment of the incidence of maternal mortality in the United States.
Authors: Smith J C , Hughes J M , Pekow P S , Rochat R W
Published: November 2008

Recent studies in several states have found that the incidence of maternal mortality is higher than traditional vital statistics reports indicate. Since no comprehensive national study has been done to evaluate the completeness of maternal mortality ascertainment through the national vital statistics reporting system, the Centers for Disease Control (CDC) undertook such a study with the assistance of the National Center for Health Statistics and state health departments. The state health departments provided CDC with death certificates for all pregnancy-related deaths occurring during 1974-78. We reviewed and classified these certificates using both International Classification of Diseases, Adapted, Eighth Revision (ICDA-8) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) maternal death codes. We found that the actual incidence of maternal mortality for 1974-78 was approximately 20 per cent and 30 per cent greater than that published in national vital statistics reports using ICDA-8 and ICD-9-CM, respectively.
An epidemiologic study of gypsy moth rash.
Authors: Tuthill R W , Canada A T , Wilcock K , Etkind P H , O'Dell T M , Shama S K
Published: November 2008

In 1981, outbreaks of itchy skin rashes were reported accompanying the heavy infestation of gypsy moths (GM) in the Northeastern United States. The rash problem was widespread and a considerable public annoyance. In the spring of 1982, during the period of greatest contact with the caterpillars, a telephone survey was carried out in a highly infested community (HI) and a minimally infested community (LO). Information was collected from 1,000 persons, representing more than 90 per cent of those selected for study. The one-week risk of rash was 10.4 per cent in the HI area and 1.6 per cent in the LO area, for a risk ratio (RR) of 6.5. The occurrence of rash was strongly related to a history of having had a rash in the previous year or having had a caterpillar crawl on the affected area. The combination of both factors additively increased the risk of rash. Hay fever and hanging the wash outside were other related variables. History of allergies other than hay fever since childhood and the use of insecticides were unrelated to rash occurrence.
Hepatitis B exposure incidents in community hospitals.
Authors: Dandoy S E , Kirkman-Liff B L , Krakowski F M
Published: November 2008

To determine the frequency and distribution of potential hepatitis B exposure incidents among employees of community hospitals, a two-year retrospective study and a one-year prospective study were undertaken in Arizona hospitals. The annual rate of exposure incidents was, respectively, 7.9 and 7.7 per 100 employees; 78 per cent of the incidents were needle punctures. The rate of incidents increased significantly with the size of the hospital and decreased in older employees. While the highest risks of incidents were in phlebotomists, surgical technicians, and laboratory technicians, 14 per cent of all exposures occurred in housekeepers and central supply workers. Only 45 per cent of incidents were reported from employees who would normally expect to be targeted to receive hepatitis B vaccine. The post-exposure use of immune globulins (IG and HBIG) increased from 9 per cent of exposures in the retrospective study to 16 per cent during the prospective study. Exposure incidents occurred at the same rates and in the same occupational groups in community hospitals as previously reported from teaching hospitals and medical centers.
Water supply and health in developing countries: selective primary health care revisited.
Authors: Briscoe J
Published: November 2008

The inclusion of water supply and sanitation programs as a component of primary health care (PHC) has been questioned on the basis of calculations of the costs of these programs per infant death averted. In this paper the procedures used in these cost-effectiveness calculations are examined and found to be wanting. The calculations are misleading since gross rather than net costs have been used, and the health impact of these programs underestimated. It is also shown that the methodology used is biased against water supply and sanitation and other programs with multiple outputs. The time constraints facing mothers in implementing PHC programs, as well as the contribution of improved water supplies in alleviating these constraints are outlined. Data are presented to show that, if poor women in developing countries were to choose the mix of activities to be included in PHC programs, improved water supplies would frequently constitute part of that mix.
Nonoccupational exposures to indoor air pollutants: a survey of state programs and practices.
Authors: Bernstein R S , Falk H , Turner D R , Melius J M
Published: November 2008

A national survey of health department activities in 1982 revealed that 32 states (63 per cent) had a program or person(s) responsible for evaluating exposures to one or more nonoccupational indoor air pollutants (NIAPs). Only four states (8 per cent) had existing or proposed NIAP exposure standards. Twenty-nine (57 per cent) of the states had a program to evaluate nonoccupational exposures to formaldehyde, but these varied widely. There is a need for coordinated, consistent approaches to defining and controlling emerging environmental public health problems such as indoor air pollution.
Hepatitis B in Wisconsin male prisoners: considerations for serologic screening and vaccination.
Authors: Anda R F , Perlman S B , D'Alessio D J , Davis J P , Dodson V N
Published: November 2008

To develop a protocol for prevention of hepatitis B virus (HBV) transmission in Wisconsin prisons, we interviewed 619 male prisoners at incarceration to obtain information on hepatitis B risk factors. We defined previous infections by the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), or antibody to hepatitis B core antigen (anti-HBc). Logistic regression was used to develop a model of relative risk (RR) of HBV infection. Use of illicit intravenous (IV) drugs was the most important risk factor because of a high prevalence of IV drug use and an RR which ranged from 2.93-7.47. Other important risk factors were: prior hepatitis or jaundice (RR = 6.28), race (RR = 2.54 for Blacks, RR = 3.28 for Latinos), transfusion (RR = 3.00), and age. Previous imprisonment was not an independent risk factor for HBV, hence selective serologic screening and vaccination of prisoners are justified rather than mass screening and vaccination. Based upon prevalence of hepatitis B markers in subgroups, it is necessary to screen prisoners with prior hepatitis or jaundice, prior transfusion, and users of IV drugs. The identification of HBsAg carriers by such screening could prevent infection of "household" contacts. Users of IV drugs who are susceptible to HBV infection should be vaccinated. The remaining prisoners constitute a low-risk group for HBV infection and do not require serologic screening or vaccination.
Multidisciplinary treatment of obesity with a protein-sparing modified fast: results in 668 outpatients.
Authors: Palgi A , Read J L , Greenberg I , Hoefer M A , Bistrian B R , Blackburn G L
Published: November 2008

Six hundred sixty-eight obese outpatients, 71 per cent (+/- 34) in excess of ideal weight, were enrolled in a multidisciplinary weight control program. The major components of the program included nutrition, education, behavior modification, and exercise. Rapid weight loss was accomplished using a very low calorie (less than 800 kcal) ketogenic diet. Patients adhered to the protein sparing modified fast (PSMF) for 17 +/- 12 weeks and averaged 9 +/- 17 weeks in a refeeding/maintenance program. Mean weight loss was 47 +/- 29 lb (21 +/- 13 kg) at the point of minimum weight and 41 +/- 29 lb (19 +/- 13 kg) at the end of the maintenance period. Systolic and diastolic blood pressure and serum triglycerides fell significantly in men and women. Success in weight loss was greatest in the heaviest patients, those who adhered the longest to the PSMF, and those who stayed the longest in the maintenance program.
Correlates of depressive symptoms among a select population of black men.
Authors: Gary L E
Published: November 2008

This study was undertaken to provide information on the impact of demographic factors, stressful life events, and sociocultural patterns on depressive symptomatology among 142 noninstitutionalized Black men. The findings indicate that age, family income, household size, employment status, and conflict between the sexes were related to the presence of depressive symptoms. When controls were introduced, only family income and conflict between the sexes were correlates of depressive symptoms among Black men in this study.
Dog and cat ownership among suicides and matched controls.
Authors: Helsing K J , Monk M
Published: November 2008

In Washington County, Maryland, ownership of cats and/or dogs was compared among 48 residents who committed suicide in the years 1975-83 and 96 living controls matched to the suicides by race, sex, and date of birth. Another comparison used as controls persons of same race, sex, and age who died of causes other than suicide in the same year as the suicide. No material association between pet ownership and suicide was observed.
Mortality among workers exposed to coal tar pitch volatiles and welding emissions: an exercise in epidemiologic triage.
Authors: Silverstein M , Maizlish N , Park R , Mirer F
Published: November 2008

The United Automobile Workers International Union has established a system of epidemiologic triage to evaluate patterns of mortality among groups of union members. In response to worker concerns, the Union examined mortality at a metal stamping plant, using a method which linked pension records with the State of Michigan computerized death registry. The observed proportion of malignant neoplasms was nearly twice that expected (95% Confidence Limits 1.36, 2.62). Two- to five-fold excess proportional mortality from cancer of the digestive organs, lung cancer, and leukemia accounted for most of the overall excess. Strong associations were found between lung and digestive organ cancer and employment as maintenance welders or millwrights in the plant (odds ratios greater than 10). High levels of six polycyclic aromatic hydrocarbons with mutagenic and carcinogenic properties were found during hot coal tar application to wood block floors, work conducted by the high-risk groups. These levels were substantially reduced following the purchase of new tar pots. The example demonstrates that epidemiologic tools can play a valuable role in occupational health decision making, but care must be taken to avoid mechanical reliance on quantitative testing and to acknowledge the important role of social and political value judgments in the establishment of responsible public policy.
Self-reported physical health practices and health care utilization: findings from the National Health Interview Survey.
Authors: Wetzler H P , Cruess D F
Published: November 2008

Cross-sectional physical health practice and health care utilization data from the 1977 National Health Interview Survey were analyzed. After adjusting for the effects of age, sex, race, income, education, and marital status, there were significant relationships between hours of sleep and both doctor visits and hospital days; increased physical activity was associated with fewer doctor visits. Prospective intervention studies are needed to determine whether changes in health practices will lead to decreased utilization.
A cross-cultural comparison of health status values.
Authors: Patrick D L , Sittampalam Y , Somerville S M , Carter W B , Bergner M
Published: November 2008

The extent to which the values attached to health states are similar in different cultures or social groups is important for understanding health and illness behaviors and for developing standardized health status measures. A cross-cultural study was conducted to compare the health status values obtained in a United States population (Seattle, Washington) with those from another English-speaking culture (London, England) on the Sickness Impact Profile, a standardized measure composed of 136 items. London judges rated the severity of dysfunction described in each item on an equal interval scale using the same methods of scaling and analysis employed in the Seattle study. A regression of English mean item values on US mean values yielded a slope of 1.00 and an intercept of -0.07, indicating that judges gave strikingly similar ratings to most items. Agreement was higher at the more severe end of the dysfunction continuum than at the least severe end, a finding consistent with the notion that what constitutes health is more difficult to define than what constitutes illness. While a universal conception of dysfunction may exist in English-speaking societies, the social and cultural determinants of health status values deserve more systematic study.
A randomized controlled study of a home health care team.
Authors: Zimmer J G , Groth-Juncker A , McCusker J
Published: November 2008

This report describes the findings of a randomized study of a new team approach to home care for homebound chronically or terminally ill elderly. The team includes a physician, nurse practitioner, and social worker delivering primary health care in the patient's home, including physician house calls. Weekly team conferences assure coordination of patient care. The team is available for emergency consultation through a 24-hour telephone service. The team physician attends to the patient during necessary hospitalizations. This approach was evaluated in a randomized experimental design study measuring its impact on health care utilization, functional changes in patients, and patient and caretaker satisfaction. The team patients had fewer hospitalizations, nursing home admissions, and outpatient visits than the controls. They were more often able to die at home, if this was their wish. As expected, they used more in-home services, measured in weighted cost figures; their overall cost was lower than their controls, but the difference was not statistically significant. Their functional abilities did not change differently from the controls, but they, and especially their informal caretakers in the home, expressed significantly higher satisfaction with the care received.
An assessment of the California Child Passenger Restraint Requirement.
Authors: Guerin D , MacKinnon D P
Published: November 2008

To evaluate the California Child Passenger Restraint Law requiring children under four years of age to be transported in car seats, we examined monthly injury and fatality levels from January 1978 to December 1983 for children 0-3 and 4-7 years of age using Box-Jenkins time series models. A significant 8.36 per cent reduction in injuries was found for the 0-3 year old age group, but no significant reduction in injuries was found for 4-7 year olds. No significant reduction in fatalities was found for either age group. A similar analysis of injuries and fatalities in Texas, a state without a car seat law, showed no significant reductions in either injuries or fatalities. There was no change in the number of California 0-3 year olds in the years after the law was enacted.
Mortality patterns in the modernized Pacific Island nation of Nauru.
Authors: Taylor R , Thoma K
Published: November 2008

Nauru is a small phosphate-rich independent island country situated in the Central Pacific. The population is Micronesian and was estimated to be 4,680 in mid-1981. An analysis of mortality data for the years 1976-81 indicates a high adult male mortality due to accidents, injuries, cardiovascular disease, and diabetes. The life expectancy estimate at birth for men was 49 years, and for women 62 years. The male life expectancy is among the lowest in the region. The considerable adult male mortality appears to be related to the rapidly acquired affluence and the ready availability of motorcycles, cars, imported foods, tobacco, and alcohol. The data suggest that modernization of the economy in Pacific Island nations can lead to new and serious public health problems.
Benefit-cost analysis of active surveillance of primary care physicians for hepatitis A.
Authors: Hinds M W , Skaggs J W , Bergeisen G H
Published: November 2008

We identified two random samples of 216 primary care physicians each. In one sample, we made weekly telephone contact for active hepatitis A (HA) surveillance; in the other, we made no such contact (passive surveillance). Appropriate county health departments were notified whenever we identified a HA case by active surveillance. Active surveillance was associated with a 2.8-fold increase in reported HA cases compared to passive surveillance. The estimated benefit: cost ratio active/passive surveillance was 2.5:1.
Florence Nightingale on public health nursing.
Authors: Monteiro L A
Published: November 2008

Florence Nightingale, in addition to her role in initiating nursing education programs, was also involved in developing nursing for the sick poor at home and in workhouses through her work for poor law and workhouse reform of the 1860s. Her writings on public health nursing--11 items that were written during a space of more than 30 years--emphasize the need for special training for public health nurses, the importance of sanitation and disease prevention through the nurse's teaching of the sick poor, and the demoralizing nature of poverty and pauperization.
Two successive outbreaks of Clostridium perfringens at a state correctional institution.
Authors: Tavris D R , Murphy R P , Jolley J W , Harmon S M , Williams C , Brumback C L
Published: November 2008

An outbreak of acute gastrointestinal illness of short duration involving 100 inmates at a correctional institution followed a similar outbreak among the same population by eight days. Clostridium perfringens was the specific etiology in both outbreaks; the vehicle was roast beef in the first outbreak, ham in the second. Direct observation of food handling practices revealed that the meats were not cooled quickly enough following cooking; not reheated adequately prior to serving, and; held at improper temperatures prior to serving.
Imported measles outbreak in a university.
Authors: Narain J P , Farrell J B , Lofgren J P , Gunn R A
Published: November 2008

In 1981, a measles outbreak in an Arkansas university involved 16 students and four persons who were contacts of these students. The first two cases were in students who recently returned from Honduras. Of the 16 students with measles, 12 had significant gastrointestinal symptoms; five had elevated liver transaminase, and eight were hospitalized. Only two of the students were considered adequately immunized. A voluntary immunization clinic held on the university campus resulted in 67 per cent of 3,076 students being vaccinated.
Fiber intake and childhood appendicitis.
Authors: Brender J D , Weiss N S , Koepsell T D , Marcuse E K
Published: November 2008

Parents of 135 children with appendicitis and of 212 comparison children were interviewed about their children's diet. Children in the upper two quartiles of fiber intake were estimated to have a 30 per cent lower risk of appendicitis than children in the lowest quartile. Estimated risk of appendicitis decreased as monthly intake of whole-grain foods increased. Children 7 to 18 years of age who had an intake of whole-grain foods in the upper fiftieth percentile were estimated to have a 50 per cent lower risk of appendicitis. This reduction in risk was not observed in the group of children less than 7 years of age.
Working life of New York State physicians, 1980.
Authors: Tu E J
Published: November 2008

Physicians' working life tables are constructed to summarize the New York State physicians' activity patterns. Male physicians could be expected to spend 47.0 years in full-time activity, 65 per cent of their total lifetime. Female physicians could be expected to spend 41.3 years, 53 per cent of their total lifetime, in full-time activity. Full-time activity refers to working 30 hours or more per week in clinical practice, research, teaching, or other professional activity.
Identification and immunization of medical students susceptible to measles and rubella: a nationwide survey.
Authors: Murray D L , Weatherly M R , Sperling J L , Farquhar L J
Published: November 2008

Responses to a questionnaire regarding student immunization from 101 of 129 allopathic medical schools (78.3 per cent) indicated that 16 schools (15.8 per cent) do not request historical information or perform serologic tests on their students. Only 47 of 85 schools (55.3 per cent), who do screen students, utilize antibody titers.
Disabled adults in sheltered employment: an assessment of dental needs and costs.
Authors: Strauss R P , Hairfield W M , George M C
Published: November 2008

In this dental survey of a multi-disability sheltered industry, 233 adults were examined. When compared to adjusted North Carolina values, the workers exhibited poorer oral hygiene with higher rates and severity of periodontal disease. DMF-T totals were equal to those statewide; however, workers had more decayed and fewer missing teeth. Significant unmet restorative and prosthodontic needs were found. Treatment cost estimates at 1983 fees were $421 per capita, with a median fee of $240.
Public opinion about doctors' pay.
Authors: Ross C E , Lauritsen J
Published: November 2008

Public opinion about doctors' incomes was examined in a national random sample of 843 respondents; 70.1 per cent of those questioned felt physicians are overpaid. There was a high degree of agreement among various groups that physicians are overpaid, but older people and Whites were more likely to think so than younger people and other ethnic groups. People who believe that the United States is characterized by unequal educational opportunity, unfair income distribution, and limited resources were also more likely to think physicians are overpaid.
Industrial wastes and public health: some historical notes, Part I, 1876-1932.
Authors: Tarr J A
Published: November 2008

This article has focused on the relatively low priority accorded industrial wastes compared to human wastes by the public health community in the period from 1876 through 1932. The critical reason for this prioritization was the potential for acute health effects from human wastes as compared with the belief that industrial wastes had only indirect effects. State departments of health normally only responded to industrial wastes when they endangered the potable nature of water supplies or interfered with water and sewage treatment processes. Within the public health community, however, a relatively small group of interdisciplinary professionals argued for attention to the indirect health effects of industrial wastes and their impacts on the total stream environment. In conjunction with other groups interested in clean streams--such as sportsmen and manufacturers who required high quality process water--they pushed for a broader state legislative mandate in regard to pollution control. Some states created new bureaus or boards with responsibility for industrial wastes and the larger stream environment but the attack on industrial pollution remained limited in this period. The final significant development regarding industrial pollution and public health concerned the formulation by Streeter-Phelps of the Public Health Service of a theory of stream purification with a set of general quantitative indicators. This application was of particular importance in regard to the high-oxygen consuming nature of organic industrial wastes and the wide variety of effluents that existed. Industrial wastes constituted what Harvey Brooks, in his essay "Science Indicators and Science Priorities" calls a very "messy" research problem--one that does "not lend itself to elegant and widely applicable generalizations."(ABSTRACT TRUNCATED AT 250 WORDS)
Childhood tuberculosis in North Carolina: a study of the opportunities for intervention in the transmission of tuberculosis to children.
Authors: Nolan R J
Published: November 2008

New cases of tuberculosis in children continue to appear. A retrospective review of the medical records of a representative sample of such cases occurring from 1977 through 1981 was conducted to gain an understanding of why this preventable disease continues to occur in North Carolina children. Three per cent of cases were detected by routine screening; 17 per cent were diagnosed after the child's symptomatic presentation; and 80 per cent after contact screening. However, 14 per cent of cases detected by contact screening developed disease while receiving isoniazid prophylaxis for a positive tuberculin test; and 19 per cent of cases detected by contact screening developed disease while under surveillance, but not receiving isoniazid prophylaxis, as tuberculin negative contacts of known infectious cases. Adherence to accepted recommendations for prophylaxis should reduce the childhood tuberculosis case rate.
Level of response in epidemiologic studies using the card-back system to contact subjects.
Authors: Mueller B A , McTiernan A , Daling J R
Published: November 2008

Response levels obtained from two methods of patient contact to obtain subject consent for participation in epidemiologic studies were compared. When a signed, return card was required prior to further contact, 70 to 83 per cent of patients consented to participate, compared with consistently higher levels (89 to 93 per cent) obtained with telephone contact. These data suggest that the likelihood of obtaining the high response level required in epidemiologic studies is increased by methods that do not rely on a return card.
Acceptance of hepatitis B vaccine among hospital workers: a follow-up.
Authors: Fulton J P , Bodenheimer H C , Kramer P D
Published: November 2008

We reported earlier on 1,500 hospital employees whose desire for hepatitis B vaccine was assessed. We followed 229 of these subjects to measure the effect of a voluntary educational intervention on desire for vaccine. Acceptance of vaccine declined in 37 per cent of subjects and increased in 13 per cent. One of the extraneous influences on demand for vaccine may have been high-profile media coverage of the AIDS (acquired immune deficiency syndrome) epidemic.