bluuebunny/crossref_metadata_2025 huggingface dataset:
Language and Play: a Study of the Relationship Between Functions and Structures in the Language of Five Year Old Children
Authors: Teece Cathleen
Published: July 2017

The purpose of the study was to consider the value of 'play' activities in the infant school in relation to language development. Linguistic analyses were made of samples of the language of five year old children to determine functional and structural characteristics. Piaget's functional classification was applied together with a transformational analysis.

Results confirmed the value of play activities for language development and illustrated the nature of linguistic interaction amoung groups of children. The transformational analysis gave a detailed description of the language sampled.
Cloze Procedure and Written Language in Schizophrenia
Authors: Manschreck Theo C. , Maher Brendan A. , Rucklos Mary E.
Published: July 2017

Little information exists regarding the sensitivity of the Cloze technique in various modes of language response in schizophrenia. In an experiment calling for spoken and written responses, Cloze scores of spoken responses were different for schizophrenics and controls, while scores of written responses did not distinguish the two groups. Controlling for thought disorder did not enhance the sensitivity of the procedure. These results are discussed in the light of current criticism of Cloze investigations of language produced by schizophrenics.
Accent Scaling and Language Attitudes: Reactions to Mexican American English Speech
Authors: Brennan Eileen M. , Brennan John Stephen
Published: July 2017

The relationship between degree of accent in the English of Mexican American speakers as assessed by naive raters, and the evaluative judgments of the raters toward accented speakers was explored. Tape recordings were prepared in a prior study of nine Mexican American readers having varying degrees of accent as judged by three linguists. An Accentedness Index score was obtained for each recorded speaker from the linguists' ratings of occurrences of 18 pronunciation variables. Estimations of degree of accentedness and evaluative reactions of status and solidarity were given for the nine readers by 43 Mexican American and 37 Anglo high school students. The accent estimation scores, Accentedness Index, and status ratings were all highly correlated within speakers. Solidarity ratings given by Mexican Americans were significantly related to the Accentedness Index. As the level of accentedness increased from speaker to speaker, the naive judges gave significantly lower status ratings. There were no group differences in the evaluative reactions given by Anglos and Mexican Americans. Results of the study are discussed in relation to Giles and Powesland's (1975) incremental theory of class-related standard.
The Effect of Context on the Intelligibility of Hearing and Deaf Children's Speech
Authors: Mcgarr Nancy S.
Published: July 2017

This study examines the effect of redundancy of information on the intelligibility of hearing and deaf children's speech. Listeners, including those experienced and inexperienced with respect to the speech of the deaf, heard two kinds of stimuli: (1) test words in sentences that varied in the amount of redundant information available, and (2) test words excised from these sentences and presented to the listeners as isolated words. For both groups of children, test words heard in sentences were perceived correctly more often than the same words heard in isolation. However, the effect of redundant information on intelligibility was opposite to that reported for adults (Lieberman, 1963). That is, in the speech of both hearing and deaf children, the scores for test words segmented from sentences with high redundancy were greater than scores for test words segmented from sentences with low redundancy. This suggests that children are not using the same production strategies as adults to assist listeners. The data also do not support the hypothesis that experienced listeners to deaf speech achieve higher intelligibility scores than inexperienced listeners by simply making better use of context.
The Relationship Between Ratings of Persons' Facial Appearance and Ratings of Their Conversations
Authors: Bull Ray , Stevens Julia
Published: July 2017

It has been suggested that because of society's reaction to them, the facially attractive develop greater social skill. Support for this notion has come from the work of Goldman and Lewis (1977) who found facially attractive students to be judged to have greater conversational expertise. The present experiment, in which the faces and conversations of students were independently evaluated, found no evidence to support this view.
The Contribution of Speech Rhythm and Pitch to Speaker Recognition
Authors: Van Dommelen Wim A.
Published: July 2017

Using a Fourcin laryngograph, Lx recordings of three male speakers were made. After manipulation, the Lx signals were presented to a group of eight listeners, who performed both an AX discrimination and a speaker identification test. The results show that the listeners made use of the three parameters varied in the listening tests, viz. speech rhythm, F0 contour and F0 height. Furthermore, the data suggest that the relevance of these different parameters for speaker recognition is speaker-dependent rather than absolute.
Stress and Intonation in the Speech of Hearing-Impaired Hebrew-Speaking Children
Authors: Frank Yael , Bergman Moe , Tobin Yishai
Published: July 2017

This study was designed to compare the acoustic characteristics of lexical stress and intonation in the speech of hearing-impaired Hebrew-speaking children with those of their hearing peers and to relate these characteristics to their intelligibility. Recordings of the speech of 23 hearing-impaired children and 11 matched normally hearing children were subjected to spectrographic analysis and fundamental-frequency measurements and played to a panel of 20 judges. The listeners' judgments of the speech of the hearing-impaired children were supported by the physical analyses. The average fundamental frequency of the hearing-impaired children's speech was significantly higher and the average duration of the vowels significantly longer than for their hearing peers. The relative durations of their stressed to unstressed vowels, however, were similar in the two groups. The findings of the study have implications for training strategies with hearing-impaired children.
A Behavioural Correlate of Phonological Structure
Authors: Nettle Daniel
Published: July 2017

Data from a cross-cultural study of conversational behaviour were compared with the phonological inventories of the languages being spoken. There was a highly significant inverse relationship between the number of contrastive vowels and the average volume of native speakers' voices. It seems that different languages are not equally salient perceptually.
Faster Orientation Latencies Toward Native Language in Two-Month-Old Infants
Authors: Dehaene-Lambertz G. , Houston D.
Published: July 2017

There is increasing evidence that infants can discriminate native and non-native speech from an early age. Prosody may be essential to this ability. In this paper, we assess the amount of linguistic information needed by 2-month-old infants to recognize whether or not a sentence belongs to their native language. We conducted a cross-linguistic study of French and American 2-month-old infants, measuring the latency of the first ocular saccade toward a loudspeaker playing short French and English utterances. The results indicated a significant interaction between the infants' nationality and the language of the stimuli. Infants oriented faster to their native language, even when the utterances were short (1.2 s mean). However, eliminating the prosodic organization (scrambled words condition) of the sentences, neutralized the effect. The results confirm that prosody plays a predominant role when young infants process continuous speech, and that short utterances are sufficient to recognize a language as long as prosodic information is present and coherent across the utterance.
The Influence of Rhythmic Context on Schwa Epenthesis and Schwa Deletion in Dutch
Authors: Kuijpers Cecile , van Donselaar Wilma
Published: July 2017

Schwa epenthesis and schwa deletion are two types of phonological variation which frequently occur in Dutch. These phonological variations are optional since speakers are free to insert or delete a schwa. A series of picture naming experiments investigated whether schwa epenthesis and schwa deletion are arbitrary processes or whether they are contextually driven and take place in the speech planning process. It is assumed that schwa epenthesis and schwa deletion change the rhythmic structure of the word, and may therefore be favored by the rhythmic structure of the context. The results show that a rhythmic context which contains a sequence of sw feet favors: (i) schwa epenthesis in monosyllabic words (e.g., tulp ‘tulip’ realized as the phonological variant [tyl[UNKNOWN]p] and not as the standard form [tylp]), and (ii) schwa deletion in trisyllabic sww words (e.g., kinderen ‘children’ realized as the phonological variant [kindr[UNKNOWN]n] and not as the standard form [kind[UNKNOWN]r[UNKNOWN]n]). A sww context does not favor schwa epenthesis in bisyllabic words (e.g., tulpen ‘tulips’ not realized as [tyl[UNKNOWN]p[UNKNOWN]n]), and a ss context does not favor schwa deletion in trisyllabic sws words (e.g., batterij ‘battery’ not realized as [batr∊i]). It is argued that speakers are sensitive to the rhythmic structure of the context in encoding the phonological variant or the standard form. The findings are discussed in relation to the speech planning mechanism, and are incorporated in a speech production model.
Reflections on Studying Prosody in Talk-in-Interaction
Authors: Schegloff Emanuel A.
Published: July 2017

Rather than focusing on conversation as one context among many in which to study prosody, this paper approaches prosody as one set of resources and practices among many by which participants interactively produce conversation and other talk-in-interaction. Three episodes of conversation are examined, each exemplifying a different order of organization in which prosodic practices may be implicated. The first develops various lines of evidence to show that pitch peaks may be deployed and understood as projecting that a next syntactic possible completion is the designed end of the turn. In the second, the initial turns in the opening of a telephone conversation are examined as the site in which the participants work out the pitch level at which the conversation—or at least its first part—will be conducted, and thereby “negotiate” the tenor of the conversation's launching. The third episode focuses on the central part which prosody can play in the constitution of the action which an utterance is implementing. The paper closes with some reflections on what is needed for students of conversation in dealing with prosody—focusing especially on the need for a relevant way of describing the mediating operations which take the prosody as (partial) input and yield the action (or other conversational feature) being accomplished as outcome.
Who's Next? The Melodic Marking of Question vs. Continuation in Dutch
Authors: Caspers Johanneke
Published: July 2017

The present study is concerned with functional differences between the accent-lending rise followed by sustained level pitch (GDI-notation “1Ø,” cf., 't Hart, Collier, and Cohen, 1990) and the combination of the accent-lending rise and final rise (“12”) in Dutch. Theoretical analyses of the meaning of Dutch intonation claim that “1Ø” can be interpreted as a question. In contrast, recent investigations of the relevance of intonation for turn-taking indicate that “1Ø” signals that the speaker wants to keep the turn. The main goal of the present experimental investigation is to find evidence for the idea that speakers may use contour “1Ø” to keep the floor. Thirty subjects were presented with short utterances bearing either a “12” or a “1Ø” contour in three perception experiments. Results support the hypothesis that “1Ø” is not readily interpreted as a question, as opposed to contour “12,” which indicates that contour “1Ø” may play a role in signaling turn-keeping in Dutch.
Intonation and Dialog Context as Constraints for Speech Recognition
Authors: Taylor Paul , King Simon , Isard Stephen , Wright Helen
Published: July 2017

This paper describes a way of using intonation and dialog context to improve the performance of an automatic speech recognition (ASR) system. Our experiments were run on the DCIEM Maptask corpus, a corpus of spontaneous task-oriented dialog speech. This corpus has been tagged according to a dialog analysis scheme that assigns each utterance to one of 12 “move types,” such as “acknowledge,” “query-yes/no” or “instruct.” Most ASR systems use a bigram language model to constrain the possible sequences of words that might be recognized. Here we use a separate bigram language model for each move type. We show that when the “correct” move-specific language model is used for each utterance in the test set, the word error rate of the recognizer drops.

Of course when the recognizer is run on previously unseen data, it cannot know in advance what move type the speaker has just produced. To determine the move type we use an intonation model combined with a dialog model that puts constraints on possible sequences of move types, as well as the speech recognizer likelihoods for the different move-specific models. In the full recognition system, the combination of automatic move type recognition with the move specific language models reduces the overall word error rate by a small but significant amount when compared with a baseline system that does not take intonation or dialog acts into account. Interestingly, the word error improvement is restricted to “initiating” move types, where word recognition is important. In “response” move types, where the important information is conveyed by the move type itself—for example, positive versus negative response—there is no word error improvement, but recognition of the response types themselves is good. The paper discusses the intonation model, the language models, and the dialog model in detail and describes the architecture in which they are combined.
Rethinking Race/Ethnicity, Income, and Childhood Asthma: Racial/Ethnic Disparities Concentrated among the Very Poor
Authors: Smith Lauren A. , Hatcher-Ross Juliet L. , Wertheimer Richard , Kahn Robert S.
Published: July 2017

Objective.

Past studies of the prevalence of childhood asthma have yielded conflicting findings as to whether racial/ethnic disparities remain after other factors, such as income, are taken into account. The objective of this study was to examine the association of race/ethnicity and family income with the prevalence of childhood asthma and to assess whether racial/ethnic disparities vary by income strata.

Methods.

Cross-sectional data on 14,244 children aged <18 years old in the 1997 National Health Interview Survey were examined. The authors used logistic regression to analyze the independent and joint effects of race/ethnicity and income-to-federal poverty level (FPL) ratio, adjusting for demographic covariates. The main outcome measure was parental report of the child having ever been diagnosed with asthma.

Results.

Bivariate analyses, based on weighted percentages, revealed that asthma was more prevalent among non-Hispanic black children (13.6%) than among non-Hispanic white children (11.2%; p<0.01), but the prevalence of asthma did not differ significantly between Hispanic children (10.1 %) and non-Hispanic white children (11.2%; p=0.13). Overall, non-Hispanic black children were at higher risk for asthma than non-Hispanic white children (adjusted odds ratio [OR] = 1.20; 95% confidence interval [CI] 1.03, 1.40), after adjustment for sociodemographic variables, including the ratio of annual family income to the FPL. Asthma prevalence did not differ between Hispanic children and non-Hispanic white children in adjusted analyses (adjusted OR=0.85; 95% CI 0.71, 1.02). Analyses stratified by income revealed that only among children from families with incomes less than half the FPL did non-Hispanic black children have a higher risk of asthma than non-Hispanic white children (adjusted OR=1.99; 95% CI 1.09, 3.64). No black vs. white differences existed at other income levels. Subsequent analyses of these very poor children that took into account additional potentially explanatory variables did not attenuate the higher asthma risk for very poor non-Hispanic black children relative to very poor non-Hispanic white children. Conclusions. Non-Hispanic black children were at substantially higher risk of asthma than non-Hispanic white children only among the very poor. The concentration of racial/ethnic differences only among the very poor suggests that patterns of social and environmental exposures must overshadow any hypothetical genetic risk.
Orofacial Pain: Patient Satisfaction and Delay of Urgent Care
Authors: Riley Joseph L. , Gilbert Gregg H. , Heft Marc W.
Published: July 2017

Objective.

Accomplishing the Healthy People 2010 goal of eliminating disparities in oral disease will require a better understanding of the patterns of health care associated with orofacial pain. This study examined factors associated with pain-related acute oral health care.

Methods.

The authors used data on 698 participants in the Florida Dental Care Study, a study of oral health among dentate adults aged 45 years and older at baseline.

Results.

Fifteen percent of the respondents reported having had at least one dental visit as the result of orofacial pain. The majority of the respondents reportedly delayed contacting a dentist for at least one day; however, there was no difference between respondents reporting pain as the initiating symptom and those with other problems. Once respondents decided that dental services were needed, those with a painful symptom were nearly twice as likely as those without pain to want to be seen immediately. Rural adults were more likely than urban adults to report having received urgent dental care for a painful symptom. When orofacial pain occurred, those who identified as non-Hispanic African American were more likely than those who identified as non-Hispanic white to delay care rather than to seek treatment immediately, and women were more likely then men. Having a pain-related oral problem was associated with significantly less satisfaction with the services provided; non-Hispanic African American respondents were less likely than non-Hispanic white respondents to report being very satisfied, and rural residents were less likely than urban residents. Furthermore, men were more likely than women to suffer with orofacial pain without receiving either scheduled dental care or an urgent visit.

Conclusions.

Barriers to care are complex and likely to be interactive, but must be understood before the goals of Healthy People 2010 can be accomplished.
Recent Incarceration Independently Associated with Syringe Sharing by Injection Drug Users
Authors: Wood Evan , Li Kathy , Small Will , Montaner Julio S. , Schechter Martin T. , Kerr Thomas
Published: July 2017

Objectives.

Few prospective studies are available on the relationship between incarceration and HIV risk among injection drug users (IDUs). The authors evaluated self-reported rates of syringe sharing and incarceration among a cohort of IDUs.

Methods.

This study analyzed syringe lending by HIV-infected IDUs and syringe borrowing by HIV-negative IDUs among participants enrolled in the Vancouver Injection Drug Users Study (VIDUS). Since serial measures for each individual were available, variables potentially associated with each outcome (syringe lending and borrowing) were evaluated using generalized estimating equations for binary outcomes.

Results.

The study sample consisted of 1,475 IDUs who were enrolled into the VIDUS cohort from May 1996 through May 2002. At baseline, 1,123 (76%) reported a history of incarceration since they first began injecting drugs. Of these individuals, 351 (31%) reported at baseline that they had injected drugs while incarcerated. Among 318 baseline HIV-infected IDUs, having been incarcerated in the six months prior to each interview remained independently associated with syringe lending during the same period (adjusted odds ratio [OR] = 1.33; 95% confidence interval [CI] 1.06, 1.69; p=0.015). Similarly, among the 1,157 baseline HIV-negative IDUs, having been incarcerated in the six months prior to each interview remained independently associated with reporting syringe borrowing during the same period (adjusted OR=1.26; 95% CI 1.12, 1.44; p<0.001).

Conclusions.

Incarceration was independently associated with risky needle sharing for HIV-infected and HIV-negative IDUs. This evidence of HIV risk behavior should reinforce public health concerns about the high rates of incarceration among IDUs.
Risk Factors for Lead Poisoning among Cuban Refugee Children
Authors: Trepka Mary Jo , Pekovic Vukosava , Santana Juan Carlos , Zhang Guoyan
Published: July 2017

Objectives.

This study was designed to explore whether parental activities such as repairing cars, welding, and rebuilding car batteries are risk factors for lead poisoning among Cuban refugee children in Miami-Dade County.

Methods.

The authors performed a cross-sectional study of 479 children aged 12–83 months who had lived in Cuba during the six months prior to immigrating to the U.S. Lead levels were obtained, and parents provided information on demographics, home/neighborhood environment in Cuba prior to immigration, family/occupational factors prior to immigration, and child behavior factors.

Results.

Of 479 children, 30 (6.3%) had elevated blood lead levels (EBLLs), defined as ⩾10 μg/dL, based on the Centers for Disease Control and Prevention action level. In multivariate analysis, racial/ethnic identification other than white, living in a home built after 1979, car repair in the home or yard, eating paint chips, and male sex were independently associated with EBLL.

Conclusions.

Risk factors for lead poisoning among immigrant children may differ from those among U.S.-born children. Screening of immigrant children who may have been exposed in their country of origin and education of immigrant parents about lead exposure hazards associated with activities such as car repair should be considered in the design of lead poisoning prevention and control programs.
Expanding Tuberculosis Case Detection by Screening Household Contacts
Authors: Becerra Mercedes C. , Pachao-Torreblanca Iliana F. , Bayona Jaime , Celi Rosa , Shin Sonya S. , Kim Jim Yong , Farmer Paul E. , Murray Megan
Published: July 2017

Objectives.

Tuberculosis (TB) case detection remains low in many countries, compromising the efficacy of TB control efforts. Current global TB control policy emphasizes case finding through sputum smear microscopy for patients who self-report to primary health centers. Our objective was to assess the feasibility and yield of a simple active case finding strategy in a high incidence population in northern Lima, Peru.

Methods.

We implemented this pilot strategy in one health center's catchment area. Health workers visited household contacts of new TB case subjects to identify symptomatic individuals and collect sputum for screening. Neighboring households were screened in the same manner. Secondary analyses measured risk of TB by ( 1) sputum smear status of the index case subject, ( 2) compliance with testing, and ( 3) risk factors for disease detected through active contact tracing in contrast to self-report.

Results.

The TB prevalence detected through combined active and passive case finding among 1,094 household contacts was 0.91% (914 per 100,000), much higher than with passive case finding alone (0.18%; 183 per 100,000; p=0.02). Among 2,258 neighbors, the combined strategy detected a TB prevalence of 0.22% (221 per 100,000) in contrast to 0.08% (80 per 100,000) detected through passive case finding alone ( p=0.25). Risk factors for being diagnosed through active case finding in contrast with self-report included age >55 years (odds ratio [OR]=5.5; 95% confidence interval [CI] 1.2, 22.8) and female gender (OR=3.9; 95% CI 0.99, 22.3).

Conclusions.

Risk of active TB among symptomatic household contacts of active case subjects in this community is very high. Results suggest that contact tracing in such settings may be a powerful means of improving case detection rates for active TB disease.
Invasive Cervical Cancer among American Indian Women in the Northern Plains, 1994–1998: Incidence, Mortality, and Missed Opportunities
Authors: Leman Richard F. , Espey David , Cobb Nathaniel
Published: July 2017

Objectives.

Cervical cancer mortality rates among the American Indian and Alaska Native (AI/AN) population in North and South Dakota were five times the national average (15.6 per 100,000 vs. 3.1 per 100,000, age adjusted) when last evaluated (from 1989 through 1993). Our goals were to update the AI/AN population cervical cancer mortality rates and to present incidence rates for AI/AN women in the region.

Methods.

We reviewed charts for women diagnosed with invasive cervical cancer at Indian Health Service (IHS) facilities in North and South Dakota from 1994 through 1998 and collected information about cervical cancer screening and treatment history. Incidence and mortality rates were standardized to the 1970 U.S. population.

Results.

Twenty-one cases of invasive cervical cancer and eight deaths were identified. Annualized incidence and mortality rates were 11.5 per 100,000 and 4.5 per 100 000. These compare with national all-race/ethnicity rates of 8.5 per 100,000 and 2.7 per 100,000 for incidence and mortality. Fifteen (71%) of 21 cases were diagnosed due to symptoms.

Conclusions.

While cervical cancer mortality rates have declined, incidence and mortality rates among AI/AN women remain higher than in the general U.S. population. Increased use of pap tests and careful follow-up of abnormal results should be aggressively promoted among AI/AN women in North and South Dakota.
Improved Program Activities are Associated with Decreasing Tuberculosis Incidence in the United States
Authors: Lobato Mark N. , Wang Yong-Cheng , Becerra Jose E. , Simone Patricia M. , Castro Kenneth G.
Published: July 2017

Objective.

This study was conducted to determine whether improvements in tuberculosis (TB) program activities correlate with incident TB cases.

Methods.

National TB surveillance data and program data from patients with pulmonary and laryngeal TB and their contacts were collected. These data were analyzed using regression models to assess the association between changes in incident TB cases and indicators of program performance (a time series of percent changes in program indices).

Results.

A total of 1,361,113 contacts exposed to 150,668 TB patients were identified through contact investigations. From 1987 to 1992 (the period of TB resurgence and antedating increased funding), there was a decline in several measures used by TB programs for outcomes of contact investigations. From 1993 to 1998 (the period after increases in TB funds), there was an observable improvement in the program indices. Four program indices for contacts and two for TB cases (directly observed therapy and completion of therapy) were statistically associated ( p≤0.01) with the decline in TB incident cases.

Conclusions.

These analyses suggest that expanded TB program activities resulted in the reduction in national TB cases and underscore the importance of treatment completion for TB disease and latent TB infection. Based on these results, we propose that further improvements in these activities will accelerate the decline of TB in the United States.
Riskier than We Thought: Revised Estimates of Noncontracepting Women Risking Unintended Pregnancy
Authors: Gaydos Laura M.D. , Hogue Carol J. Rowland , Kramer Michael R.
Published: July 2017

Objectives.

Risk-taking is defined as non-use of contraception among sexually active women who do not desire pregnancy. The published National Survey of Family Growth (NSFG) definition of risk of unintended pregnancy includes sterilized women and women relying on partner sterilization in the statistic. However, this inclusion skews percentages of risk-taking women to appear smaller than is realistic since sterilized women face minimal risk of pregnancy. The objective of this study was to obtain realistic estimates of risk-taking behavior to identify groups at special need for improved services.

Methods.

In calculating risk-taking statistics, sterilized women and women relying on partner sterilization are removed from both the numerator and denominator. The numerator includes all non-contracepting women who believe that they are fecund. The authors calculated the proportion of risk-taking women for various age, ethnic, and marital status groups.

Results.

Overall, 14.0% of sexually active, fecund women are risk-taking. Except for teenagers, who do not use sterilization, the proportions of risk takers are higher than the NSFG estimates of proportion of women at risk of unintended pregnancy in all groups. Differences in risk estimates ranged from 0.4% to 10.7%, with the greatest differences seen among formerly married and Hispanic black women.

Conclusions.

These results indicate that published NSFG percentages of adult women at risk of unintended pregnancy underestimate risk-taking behavior for groups previously thought to be at lower risk of unintended pregnancy.
Use of Public School Immunization Data to Determine Community-Level Immunization Coverage
Authors: Ramirez Enrique , Bulim Igor D. , Kraus John M. , Morita Julie
Published: July 2017

Objectives.

To evaluate whether immunization data collected on a child's entry into kindergarten, i.e., Chicago Public School Immunization Data (PSID), was comparable to coverage levels determined by the National Immunization Survey (NIS) and to use these data to identify community areas with consistently low immunization coverage.

Methods.

The Chicago Department of Public Health obtained four years of PSID (2000–2003); these data included demographic information, home address, and immunization records. Coverage levels were determined in two ways: ( 1) one dose of measles-containing vaccine (MCV) and ( 2) four doses of diphtheria and tetanus toxoids and pertussis vaccine, three doses of poliovirus vaccine, and one dose of measles-containing vaccine (the 4:3:1 series), stratified by racial/ethnic group; these levels were compared to NIS estimates for the respective time periods. We used geographic information system software to illustrate variations in coverage levels between distinct community areas within Chicago.

Results.

Year 2000 MCV coverage levels determined from PSID closely approximated NIS estimates (84.6% vs. 87.2% ± 4.6%, respectively). MCV coverage levels determined by race/ethnicity from PSID were within the 95% confidence intervals (CI) for all racial categories (white, 89.5% vs. 92.2% ± 6.4%; black, 79.0% vs. 83.5% ± 9.4%; Hispanic, 89.5% vs. 87.5% ± 5.8%). Comparison of PSID and NIS 4:3:1 coverage levels revealed similar findings. For each study year, PSID identified 12 community areas with consistently low MCV coverage levels, i.e., <80%.

Conclusions.

PSID closely approximated NIS coverage estimates for MCV and 4:3:1 immunization. These methods can be used by state and city health departments to identify and direct resources to communities at greatest need.
Assessing Intimate Partner Violence in Health Care Settings Leads to Women's Receipt of Interventions and Improved Health
Authors: McCloskey Laura A. , Lichter Erika , Williams Corrine , Gerber Megan , Wittenberg Eve , Ganz Michael
Published: July 2017

Objective.

This study investigated whether disclosure of violence to health care providers and the receipt of interventions relate to women's exit from an abusive relationship and to their improved health.

Methods.

A volunteer sample of 132 women outpatients who described intimate partner violence during the preceding year were recruited from multiple hospital departments and community agencies in suburban and urban metropolitan Boston. Through in-person interviews, women provided information on demographics, past year exposure to violence, past year receipt of interventions, and whether they disclosed partner violence to their health care provider. They also described their past month health status with the 12-Item Short-Form Health Survey and further questions.

Results.

Of the 132 women, 44% had exited the abusive relationship. Among those who were no longer with their partner, 55% received a domestic violence intervention (e.g. advocacy, shelter, restraining order), compared with 37% of those who remained with their partner. Talking to their health care provider about the abuse increased women's likelihood of using an intervention (odds ratio [OR]=3.9). Those who received interventions were more likely to subsequently exit (OR=2.6) and women no longer with the abuser reported better physical health based on SF-12 summary scores ( p=0.05) than women who stayed.

Conclusions.

Health care providers may make positive contributions to women's access to intimate partner violence services. Intimate partner violence interventions relate to women's reduced exposure to violence and better health.
Judgments about Intimate Partner Violence: A Statewide Survey about Immigrants
Authors: Sorenson Susan B.
Published: July 2017

Objectives.

The purpose of this research was to: ( 1) examine judgments about immigrants who are victims of and assailants in intimate partner violence, and ( 2) assess whether immigrants to the U.S., a diverse and growing population, know that intimate partner violence is illegal in the United States and their judgments about what sanctions, if any, should follow.

Methods.

A random-digit-dial telephone survey was conducted in four languages with 3,679 California adults. There were roughly comparable numbers of white, black, Latino, Korean American, Vietnamese American, and other Asian American participants; 60.1% were born outside the U.S. An experimental vignette design was used to vary victim, assailant, and contextual factors about incidents of intimate partner violence and to assess respondents' judgments about the behavior and what should be done about it. Multivariate analyses were conducted to examine the independent effect of these predictor variables and characteristics of the respondents.

Results.

Respondent judgments about whether an incident of intimate partner violence was wrong, illegal, or about what sanctions should follow were not related to nativity of either the victim or the assailant. Immigrant respondents differed from native-born respondents on two outcomes: immigrants were more likely to think that the behavior was illegal and that guns should be removed from the assailant.

Conclusions.

Concerns that immigrants do not know that intimate partner violence is illegal in the U.S. are largely misplaced—immigrants know it soon after their arrival in the U.S. In addition, it appears that a cultural defense regarding domestic violence is not likely to sway others.
The New Mexico Clinical Prevention Initiative: A Statewide Prevention Partnership
Authors: Espey David K. , Baum Susan L. , Jung Ann Moore , Kozoll Richard L.
Published: July 2017

The New Mexico Department of Health and the New Mexico Medical Society invited organizations to participate in an initiative to promote clinical preventive services. The Clinical Preventive Initiative (CPI) focuses on the following interventions based on burden of illness, preventability of the condition, cost, current level of services, availability of leadership, and programmatic support: adult pneumococcal vaccination, tobacco use prevention and cessation, mammography screening, colorectal cancer screening, healthier weight, screening and treatment for chlamydia and gonorrhea, screening and intervention for problem drinking, childhood immunization, and prevention of unintended pregnancy. Specific workgroups plan and implement interventions directed at New Mexico medical practices, practitioners, and health-care systems. Several state measures suggest effectiveness of CPI efforts.

CPI is a successful public-private collaboration providing an active forum for statewide clinical prevention policy development, an effective mechanism to achieve greater awareness of prevention and improved delivery of preventive services.
Racially Disproportionate Admission Rates for Ambulatory Care Sensitive Conditions in North Carolina
Authors: Howard Daniel L. , Hakeem Farrukh B. , Njue Christopher , Carey Timothy , Jallah Yhenneko
Published: July 2017

Objective.

This study examines race variations in quality of care through the proxy of ambulatory care sensitive (ACS) conditions. Hospital admission rates for eight ACS conditions were examined for African American and white Medicare beneficiaries in North Carolina. Temporal variations for ACS were also examined.

Method.

Enrollment and inpatient claims files from the Centers for Medicare and Medicaid Services (CMS) for a 1999–2002 cohort who were aged 65 years or older in 1999 were examined. Descriptive statistics were computed for each year. Cochran-Mantel Haenszel tests were performed to assess differences in the admission rates for both individual and aggregate ACS conditions controlling for time. The Cochran-Armitage test for trend was used to evaluate changes in admission rates over time.

Results.

African Americans had higher admission rates for five of the eight ACS conditions. The highest rates were for diabetes among African Americans (odds ratio [OR]=2.86; 95% confidence interval [CI] [2.73, 2.99]) and adult asthma (OR=1.51; 95% CI [1.43, 1.61]). African Americans tended to have lower ACS admission rates than white patients for chronic obstructive pulmonary disease (OR=0.67; 95% CI [0.65, 0.69]); bacterial pneumonia (OR=0.86; 95% CI [0.84, 0.89]), and angina (OR=0.90; 95% CI [0.84, 0.97]).

Conclusions.

Using the ACS proxy for quality of health care as applied to examining race and ethnicity is a promising approach, though challenges remain. Admissions for ACS conditions between African American and white patients differ, but it is unclear why. This exploratory study must lead to an examination of social, economic, historical, and cultural factors for preventive, remedial, and beneficial policy initiatives.
Operational Evaluation of High-Throughput Community-Based Mass Prophylaxis Using Just-in-Time Training
Authors: Spitzer James D. , Hupert Nathaniel , Duckart Jonathan , Xiong Wei
Published: July 2017

Community-based mass prophylaxis is a core public health operational competency, but staffing needs may overwhelm the local trained health workforce. Just-in-time (JIT) training of emergency staff and computer modeling of workforce requirements represent two complementary approaches to address this logistical problem.

Multnomah County, Oregon, conducted a high-throughput point of dispensing (POD) exercise to test JIT training and computer modeling to validate POD staffing estimates. The POD had 84% non-health-care worker staff and processed 500 patients per hour. Post-exercise modeling replicated observed staff utilization levels and queue formation, including development and amelioration of a large medical evaluation queue caused by lengthy processing times and understaffing in the first half-hour of the exercise.

The exercise confirmed the feasibility of using JIT training for high-throughput antibiotic dispensing clinics staffed largely by nonmedical professionals. Patient processing times varied over the course of the exercise, with important implications for both staff reallocation and future POD modeling efforts. Overall underutilization of staff revealed the opportunity for greater efficiencies and even higher future throughputs.
Volume of Tobacco Advertising in African American Markets: Systematic Review and Meta-Analysis
Authors: Primack Brian A. , Bost James E. , Land Stephanie R. , Fine Michael J.
Published: July 2017

Objective.

African Americans currently bear the greatest burden of morbidity and mortality due to smoking, and exposure to pro-tobacco media messages predicts smoking. This study compared the concentration (proportion of media messages that are for tobacco) and density (pro-tobacco media messages per person) of pro-tobacco media messages between African American and Caucasian markets.

Methods.

We searched Medline (1966 to June 2006), PsychINFO (1974 to June 2006), and CINAHL (1982 to June 2006) for studies from peer-reviewed journals directly comparing the volume of pro-tobacco media messages in African American and Caucasian markets. From each study, we extracted the number of total media messages, the number of tobacco-related messages, and the number of residents living in each market area. We calculated the concentration and density of tobacco advertising in each market.

Results.

Out of 131 studies identified, 11 met eligibility criteria, including seven comparing billboard/signage in African American and Caucasian markets and four comparing magazine advertising in African American and Caucasian markets. Meta-analysis estimated a pooled odds ratio of 1.7 (95% confidence interval [CI] 1.1, 2.6) for a given billboard being smoking-related in African American vs. Caucasian market areas (i.e., concentration). The pooled rate ratio of the density of smoking-related billboards was 2.6 (95% CI 1.5, 4.7) in African American vs. Caucasian market areas. Magazine data were insufficient for meta-analysis.

Conclusion.

Available data indicated that African Americans are exposed to a higher volume of pro-tobacco advertising in terms of both concentration and density. These findings have important implications for research, policy measures, and educational interventions involving racial disparities due to tobacco.
Ischemic Heart Disease and Ambient Air Pollution of Particulate Matter 2.5 in 51 Counties in the U.S.
Authors: Balluz Lina , Wen Xiao-Jun , Town Machell , Shire Jeffrey D. , Qualter Judy , Mokdad Ali
Published: July 2017

Objective.

Ischemic heart disease (IHD) is one of the most common health threats to the adult population of the U.S. and other countries. The objective of this study was to examine the association between exposure to elevated annual average levels of Particulate matter 2.5 (PM2.5) air quality index (AQI) and IHD in the general population.

Methods.

We combined data from the Behavioral Risk Factor Surveillance System and the U.S Environmental Protection Agency air quality database. We analyzed the data using SUDAAN software to adjust the effects of sampling bias, weights, and design effects.

Results.

The prevalence of IHD was 9.6% among respondents who were exposed to an annual average level of PM2.5 AQI >60 compared with 5.9% among respondents exposed to an annual average PM2.5 AQI ≤60. The respondents with higher levels of PM2.5 AQI exposure were more likely to have IHD (adjusted odds ratio 5 1.72, 95% confidence interval 1.11, 2.66) than respondents with lower levels of exposure after adjusting for age, gender, race/ethnicity, education, smoking, body mass index, diabetes, hypertension, and hypercholesterolemia.

Conclusions.

Our study suggested that exposure to relatively higher levels of average annual PM2.5 AQI may increase the likelihood of IHD. In addition to encouraging health-related behavioral changes to reduce IHD, efforts should also focus on implementing appropriate measures to reduce exposure to unhealthy AQI levels.
Differences among U.S. States in Estimating the Number of People Living with HIV/AIDS: Impact on Allocation of Federal Ryan White Funding
Authors: Nash Denis , Andreopoulos Evie , Horowitz Deborah , Sohler Nancy , Vlahov David
Published: July 2017

Objective.

We assessed the impact of differing laboratory reporting scenarios on the completeness of estimates of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) in the U.S., which are used to guide allocation of federal Ryan White funds.

Methods.

We conducted a four-year simulation study using clinical and laboratory data on 1,337 HIV-positive women, including 477 (36%) who did not have AIDS at baseline. We estimated the completeness of HIV (non-AIDS) case ascertainment for three laboratory reporting scenarios: CD4<200 cells/μL and detectable viral load (Scenario A); CD4<500 cells/μL and no viral load reporting (Scenario B); and CD4<500 cells/μL and detectable viral load (Scenario C).

Results.

Each scenario resulted in an increasing proportion of HIV (non-AIDS) cases being ascertained over time, with Scenario C yielding the highest by Year 4 (Year 1: 69.0%, Year 4: 88.1%), followed by Scenario A (Year 1: 63.3%, Year 4: 84.5%), and Scenario B (Year 1: 43.0%, Year 4: 67.7%). Overall completeness of PLWHA ascertainment after four years was highest for Scenario C (95.8%), followed by Scenario A (94.5%), and Scenario B (88.5%).

Conclusions.

Differences in laboratory reporting regulations lead to substantial variations in the completeness of PLWHA estimates, and may penalize jurisdictions that are most successful at treating HIV/AIDS patients or those with weak or incomplete HIV/AIDS surveillance systems.
Respiratory Protection Programs for Firefighters: A Survey of Practices for the State of Kentucky
Authors: Easterling Gregory H. , Prince Scott
Published: July 2017

Objective.

Firefighters play a crucial role as first responders in a variety of situations that can expose them to respiratory hazards. To ensure their safety and health, fire departments should have a respiratory protection program in place for all firefighters. A survey of Kentucky fire departments was conducted to assess their respiratory protection practices, barriers to program implementation, and medical evaluation programs.

Method.

A 21-question survey assessing respiratory practices during the previous 12 months was mailed to all Kentucky fire departments.

Results.

A 62% survey response rate was achieved, with 116 of Kentucky's 120 counties returning at least one survey. All respondents indicated they were utilizing some type of respiratory protection, but only 37% indicated they had a written respiratory protection program. Compensation status and department sizes were found to be significant variables ( p<0.01) in determining if a fire department had a written respiratory protection program. Lack of funding (48%) and lack of understanding (39%) were cited as the greatest barriers to program implementation. Only 51% indicated they require their firefighters to receive a fit testing of their respirator, and 23% indicated they had a health-care provider who reviewed medical questionnaires or provided medical evaluations.

Conclusion.

This survey indicates that many Kentucky fire departments are not meeting the legal and voluntary respiratory protection standards and guidelines, and demonstrates the need for improved education and funding to ensure that firefighters are adequately protected from respiratory hazards. This is particularly applicable to small rural volunteer departments, which had the greatest gap in compliance.