bluuebunny/crossref_metadata_2025 huggingface dataset:
New York City's 1993 child immunization day: planning, costs, and results.
Authors: Fairbrother G , DuMont K A
Published: November 2008

OBJECTIVES. This study evaluates New York City's Child Immunization Day (1993), with emphasis on the cost and effects of a mass campaign and the use of strategies from developing nations in an inner-city context. METHODS. The methodology was designed to (1) document the planning and implementation process, (2) analyze the number and characteristics of children in the target group, and (3) estimate costs. RESULTS. Neither the social mobilization nor the political will that characterize successful campaigns in developing nations occurred in New York City's campaign. Despite substantial time and effort from both private and public agencies, turnout for the event was low. In total, 2647 families and 5237 children were assessed for health care and insurance needs, 2949 children were immunized at a cost of about $279 per immunized child, and 7236 vaccines were administered. CONCLUSIONS. The differences between inner cities and developing nations have a bearing on strategies used in planning and implementing mass campaigns. New strategies need to be forged from a blending of these contexts to create effective campaigns in industrialized inner cities.
A model for estimating the impact of changes in children's vaccines.
Authors: Simpson K N , Biddle A K , Rabinovich N R
Published: November 2008

OBJECTIVES. To assist in strategic planning for the improvement of vaccines and vaccine programs, an economic model was developed and tested that estimates the potential impact of vaccine innovations on health outcomes and costs associated with vaccination and illness. METHODS. A multistep, iterative process of data extraction/integration was used to develop the model and the scenarios. Parameter replication, sensitivity analysis, and expert review were used to validate the model. RESULTS. The greatest impact on the improvement of health is expected to result from the production of less reactogenic vaccines that require fewer inoculations for immunity. The greatest economic impact is predicted from improvements that decrease the number of inoculations required. CONCLUSIONS. Scenario analysis may be useful for integrating health outcomes and economic data into decision making. For childhood infections, this analysis indicates that large cost savings can be achieved in the future if we can improve vaccine efficacy so that the number of required inoculations is reduced. Such an improvement represents a large potential "payback" for the United States and might benefit other countries.
The tracking of nutrient intake in young children: the Framingham Children's Study.
Authors: Singer M R , Moore L L , Garrahie E J , Ellison R C
Published: November 2008

OBJECTIVES. This study compared the nutrient intake of children at 3 through 4 years of age with that in subsequent years to determine whether nutrient intake tracked over time. METHODS. Intakes of 10 nutrients were estimated by means of multiple days of food diaries collected over a span of up to 6 years of follow-up for 95 children in the Framingham Children's Study. All diaries collected during each of three age periods (age 3 through 4, age 5 through 6, and age 7 through 8) were averaged. Nutrient density intakes at each age period were compared. RESULTS. Nutrient-specific correlations ranged from .37 to .63 between nutrient density intakes at age 3-4 and age 5-6. Correlations between intakes at age 3-4 and age 7-8 ranged from .35 to .62. Consistency of classification was strong; 35.7% to 57.1% of children in the highest quintile of intake at age 3-4 remained in that quintile at age 5-6, and 57.1% to 85.7% remained in the top two quintiles. At age 7-8, 40.0% to 66.7% of those with the highest intake at baseline were still in the top quintile, and 60.0% to 93.3% remained in the top two quintiles. Results were similar in the lowest quintile of intake. Extreme misclassification was rare. CONCLUSIONS. This study suggests that tracking of nutrient intake begins as young as 3-4 years of age.
Fluoride exposure and childhood osteosarcoma: a case-control study.
Authors: Gelberg K H , Fitzgerald E F , Hwang S A , Dubrow R
Published: November 2008

OBJECTIVES. This study tests the hypothesis that fluoride exposure in a nonoccupational setting is a risk factor for childhood osteosarcoma. METHODS. A population-based case-control study was conducted among residents of New York State, excluding New York City. Case subjects (n = 130) were diagnosed with osteosarcoma between 1978 and 1988, at age 24 years or younger. Control subjects were matched to case subjects on year of birth and sex. Exposure information was obtained by a telephone interview with the subject, parent, or both. RESULTS. Based on the parents' responses, total lifetime fluoride exposure was not significantly associated with osteosarcoma among all subjects combined or among females. However, a significant protective trend was observed among males. Protective trends were observed for fluoridated toothpaste, fluoride tablets, and dental fluoride treatments among all subjects and among males. Based on the subjects' responses, no significant associations between fluoride exposure and osteosarcoma were observed. CONCLUSIONS. Fluoride exposure does not increase the risk of osteosarcoma and may be protective in males. The protective effect may not be directly due to fluoride exposure but to other factors associated with good dental hygiene. There is also biologic plausibility for a protective effect.
The availability of low-fat milk in an inner-city Latino community: implications for nutrition education.
Authors: Wechsler H , Basch C E , Zybert P , Lantigua R , Shea S
Published: November 2008

Substitution of low-fat for whole milk is an important strategy for reducing saturated fat consumption, but intake of whole milk remains high among Latinos. To assess whether this is related to the unavailability of low-fat milk, we surveyed 251 grocery stores (bodegas) and 25 supermarkets in a predominantly low-income, urban Latino community. Low-fat milk was available in 73% of bodegas and 96% of supermarkets, but it constituted only 15% of total milk volume in bodegas and 37% of that volume in supermarkets. Since lack of availability was not a major obstacle to increasing low-fat milk consumption, public health nutrition campaigns should focus on increasing consumer demand.
Inhaled and oral corticosteroids: their effects on bone mineral density in older adults.
Authors: Marystone J F , Barrett-Connor E L , Morton D J
Published: November 2008

Use of oral and inhaled corticosteroids and bone mineral density were examined cross-sectionally in 1673 community-dwelling white subjects aged 56 to 91 years. Bone mineral densities at the ultradistal and midshaft radii, hip, and lumbar spine were compared in users of inhaled (n = 34) and oral (n = 44) corticosteroids and nonusers. Women who used oral corticosteroids had significantly lower bone mineral densities at the midshaft radius, hip, and spine than never users. Women who used inhaled corticosteroids had bone mineral densities at the ultradistal radius, hip, and spine that were intermediate between those of oral corticosteroid users and those of never users. Bone mineral density did not vary significantly according to corticosteroid use in men.
Changes in perinatal cocaine use in an inner-city hospital, 1988 to 1992.
Authors: McCalla S , Feldman J , Webbeh H , Ahmadi R , Minkoff H L
Published: November 2008

Temporal trends in perinatal drug use among parturients at an inner-city hospital were assessed in a cohort study of 1300 parturients in 1991 through 1992 and 1111 parturients in 1988 through 1989. Toxicology results were coupled to data sheets containing demographic and obstetrical information. A decrease was noted between 1988 and 1992 in the prevalence of cocaine metabolites, independent of the utilization of prenatal services. An increase in marijuana use and no change in opiate use were seen. When adjusted for ethnicity and receipt of care, a 50% decline in the odds ratio (OR) of cocaine use was noted between 1988 and 1992 (OR = 0.55; 95% confidence interval = 0.39, 0.79).
Correlates of high-density lipoprotein cholesterol in Black girls and White girls: the NHLBI Growth and Health Study.
Authors: Simon J A , Morrison J A , Similo S L , McMahon R P , Schreiber G B
Published: November 2008

To determine the correlates of serum high-density lipoprotein cholesterol (HDL-C) in 9- and 10-year-old girls, data were examined from 624 Black girls and 773 White girls. Black girls had, on average, 3.6 mg/dL higher levels than White girls. Each 10-mm increase in sum of skinfolds was associated with a decrease of 1.4 mg/dL; each unit increase in the tricep/suprailiac skinfold ratio was associated with an increase of 2 mg/dL; and each 10% increase in polyunsaturated fat intake was associated with an increase of 3.4 mg/dL. The associations of sedentary activity and sexual maturation with HDL were mediated by differences in adiposity. Interventions to decrease adiposity may be important for the primary prevention of heart disease in women.
The reporting sensitivities of two passive surveillance systems for vaccine adverse events.
Authors: Rosenthal S , Chen R
Published: November 2008

To evaluate reporting sensitivities for vaccine adverse events, reporting rates were estimated by dividing the number of events reported to the Monitoring System for Adverse Events Following Immunization and the Vaccine Adverse Event Reporting System in a given period by the number of doses administered or distributed during the same period. Reporting sensitivity was calculated as the ratio of the rates at which events were reported to each passive surveillance system (numerator) and occurred in controlled studies (denominator). Reporting sensitivities were generally better in the public sector than in the private sector. The significant underreporting of known outcomes, together with the nonspecific nature of most adverse event reports, highlights the limitations of passive surveillance systems in assessing the incidence of vaccine adverse events.
Changes in adult cigarette smoking in the Minnesota Heart Health Program.
Authors: Lando H A , Pechacek T F , Pirie P L , Murray D M , Mittelmark M B , Lichtenstein E , Nothwehr F , Gray C
Published: November 2008

OBJECTIVES. The Minnesota Heart Health Program was a research and demonstration project designed to reduce risk factors for heart disease in whole communities. This paper describes smoking-specific interventions and outcomes. METHODS. Three pairs of matched communities were included in the study. After baseline surveys, one community in each pair received a 5-year education program, while both cross-sectional and cohort surveys continued in all sites. Adult education programs for smoking cessation included Quit and Win contests, classes, self-help materials, telephone support, and home correspondence programs. RESULTS. Encouraging short-term results were obtained for several adult education programs. Overall long-term outcomes were mixed, with evidence of an intervention effect only for women in cross-sectional survey data. Unexpectedly strong secular declines in smoking prevalence were observed in comparison communities. CONCLUSIONS. The findings suggest that community education may be unlikely to exceed dramatic secular reductions in smoking prevalence. The success of several key interventions and the incorporation of Minnesota Heart Health Program interventions by education communities are encouraging, however.
The association between leisure-time physical activity and dietary fat in American adults.
Authors: Simoes E J , Byers T , Coates R J , Serdula M K , Mokdad A H , Heath G W
Published: November 2008

Relations between leisure-time physical activity and dietary fat were examined in a population-based probability sample of 29,672 adults in the 1990 Behavioral Risk Factor Surveillance System. Consumption of 13 high-fat food items and participation in physical activities were measured, and fat and activity scores were calculated. Dietary fat and physical activity were strongly and inversely associated. This association was independent of nine other demographic and behavioral risk factors. Etiologic researchers should consider that diet and physical activity can potentially confound each other, and creators of public health messages that target one behavior should consider including the other.
Politics and practice: introducing Norplant into a school-based health center in Baltimore.
Authors: Beilenson P L , Miola E S , Farmer M
Published: November 2008

As one element of Baltimore's effort to combat its high rate of teenage pregnancy, the Baltimore City Health Department added the implantable contraceptive Norplant to the array of services offered at one of its school-based health centers in early 1993. The initial findings with the adolescents who received this contraceptive at the school were favorable, particularly regarding condom use, parental involvement, and patient acceptance of the contraceptive. This new policy garnered a significant amount of attention, both nationally and locally. It attempts to address problems that have complicated etiologies as well as diverse clinical, social, and ethical ramifications, all complicated by political realities. The Norplant experience offers useful lessons regarding controversial health initiatives that address problems facing public health practitioners today.
The administrative prevalence of mental retardation in 10-year-old children in metropolitan Atlanta, 1985 through 1987.
Authors: Murphy C C , Yeargin-Allsopp M , Decouflé P , Drews C D
Published: November 2008

OBJECTIVES. In this study, data from the Metropolitan Atlanta Developmental Disabilities Study were used to determine the administrative prevalence (i.e., the number of children previously identified for service provision) of mental retardation among 10-year-old children during the years 1985 through 1987. METHODS. Children with mental retardation (intelligence quotient [IQ] of 70 or lower) were identified by review of records from multiple sources, with the public schools as the primary source. RESULTS. The overall administrative prevalence of mental retardation was 12.0 per 1000 children. The rate for mild mental retardation (IQ of 50 to 70) was 8.4 per 1000 and the rate for severe mental retardation (IQ lower than 50) was 3.6 per 1000. The prevalence was higher in Black children than in White children (prevalence odds ratio [POR] = 2.7) and in boys than in girls (POR = 1.4). Children with severe mental retardation had more coexisting disabilities than did children with mild mental retardation. CONCLUSIONS. The mental retardation prevalence rates reported here, especially the race-specific rates, may reflect social and demographic features unique to the metropolitan Atlanta area and therefore should be used with caution in making comparisons with other populations.
Mild mental retardation in black and white children in metropolitan Atlanta: a case-control study.
Authors: Yeargin-Allsopp M , Drews C D , Decouflé P , Murphy C C
Published: November 2008

OBJECTIVES. This study assessed differences in the prevalence of mild mental retardation, defined as an intelligence quotient (IQ) from 50 to 70, between Black and White children. METHODS. A case-control study design was used. Ten-year-old children with mental retardation were identified from multiple sources. Information on race, sex, maternal age, birth order, economic status, and maternal education was abstracted from birth certificates of 330 case children and 563 control children (public school students). RESULTS. The crude Black-White odds ratio (OR) was 2.6, but it was reduced to 1.8 after the other five covariates were controlled. The disparity was largest among children whose mental retardation was first diagnosed when they were 8 to 10 years old (adjusted OR = 2.5). We found no significant difference in the occurrence of mild mental retardation between Black and White children diagnosed before the age of 6 years (adjusted OR = 1.2). Black children had a higher prevalence of mild mental retardation within all strata of the other five covariates. CONCLUSIONS. Five sociodemographic factors accounted for approximately half of the excess prevalence of mild mental retardation among Black children. Possible reasons for the residual difference are discussed.
Access to hospitals with high-technology cardiac services: how is race important?
Authors: Blustein J , Weitzman B C
Published: November 2008

OBJECTIVES. Relatively few hospitals in the United States offer high-technology cardiac services (cardiac catheterization, bypass surgery, or angioplasty). This study examined the association between race and admission to a hospital offering those services. METHODS. Records of 11,410 patients admitted with acute myocardial infarction to hospitals in New York State in 1986 were analyzed. RESULTS. Approximately one third of both White and Black patients presented to hospitals offering high-technology cardiac services. However, in a multivariate model adjusting for home-to-hospital distance, the White-to-Black odds ratio for likelihood of presentation to such a hospital was 1.68 (95% confidence interval = 1.42, 1.98). This discrepancy between the observed and "distance-adjusted" probabilities reflected three phenomena: (1) patients presented to nearby hospitals; (2) Blacks were more likely to live near high-technology hospitals; and (3) there were racial differences in travel patterns. For example, when the nearest hospitals did not include a high-technology hospital, Whites were more likely than Blacks to travel beyond those nearest hospitals to a high-technology hospital. CONCLUSIONS. Whites and Blacks present equally to hospitals offering high-technology cardiac services at the time of acute myocardial infarction. However, there are important underlying racial differences in geographic proximity and tendencies to travel to those hospitals.
Access to neonatal intensive care for low-birthweight infants: the role of maternal characteristics.
Authors: Bronstein J M , Capilouto E , Carlo W A , Haywood J L , Goldenberg R L
Published: November 2008

OBJECTIVES. This study assessed the impact of mother's race, insurance status, and use of prenatal care on very low birthweight infant delivery in or transfer to hospitals with neonatal intensive care units (ICUs). METHODS. Multivariate analysis of Alabama vital statistics records between 1988 and 1990 for infants weighing 500 to 1499 g was conducted, comparing hospital of birth and maternal and infant transfer status, and controlling for infant birthweight and for maternal pregnancy history and demographic characteristics. RESULTS. With other factors adjusted for, non-White mothers with early prenatal care were more likely than White mothers to deliver their very low birthweight infants in hospitals with neonatal ICUs without transfer. Among the mothers who presented first at hospitals without such facilities, those who had late prenatal care were less likely than those with early care to be transferred to hospitals with neonatal ICUs before delivery. Medicaid coverage increased the likelihood of antenatal transfer for White women. Likelihood of infant transfer was not associated with these maternal characteristics. CONCLUSIONS. Maternal race, prenatal care use, and insurance status may influence the likelihood that very low birthweight infants will have access to neonatal intensive care. Interventions to improve perinatal regionalization should address individual and system barriers to the timely referral of high-risk mothers.
Passive and active maternal smoking as measured by serum cotinine: the effect on birthweight.
Authors: Eskenazi B , Prehn A W , Christianson R E
Published: November 2008

To determine how maternal exposure to environmental tobacco smoke affects birthweight, maternal sera obtained from 3529 pregnant women around 27 weeks gestation were analyzed for cotinine, a metabolite of nicotine. Based on cotinine levels, nonsmokers were divided into those exposed to environmental tobacco smoke (2-10 ng/mL) and those unexposed (< 2 ng/mL), and smokers were divided into tertiles. Compared with unexposed nonsmokers' infants, infants of exposed nonsmokers averaged 45 g less (P = .28) after adjustment for confounders, and smokers' infants averaged 78, 191, and 233 g less for the first, second, and third cotinine tertiles, respectively. Birthweight decreased 1 g for every nanogram per milliliter of cotinine increase (P < .001).
The need to restore the public health base for environmental control.
Authors: Goldstein B D
Published: November 2008

Restoration of the public health base for local, national, and international efforts aimed at protection against adverse health consequences of environmental degradation should be of prime concern for today and the future. Wherever possible, whether it be a mission statement for a cabinet-level EPA or the training and composition of the environmental health work force, we must reinvigorate the public health mission of our environmental protection activities. This cannot be accomplished without recognition by the public health community that environmental health is a central public health concern. As we move toward facing the initially more subtle, but eventually more consequential, global environmental health challenges, it will become even more important for the public health profession to respond.
DDE and shortened duration of lactation in a northern Mexican town.
Authors: Gladen B C , Rogan W J
Published: November 2008

OBJECTIVES. Worldwide declines in the duration of lactation are cause for public health concern. Higher levels of dichlorodiphenyl dichloroethene (DDE) have been associated with shorter durations of lactation in the United States. This study examined whether this relationship would hold in an agricultural town in northern Mexico. METHODS. Two hundred twenty-nine women were followed every 2 months from childbirth until weaning or until the child reached 18 months of age. DDE was measured in breast milk samples taken at birth, and women were followed to see how long they lactated. RESULTS. Median duration was 7.5 months in the lowest DDE group and 3 months in the highest. The effect was confined to those who had lactated previously, and it persisted after statistical adjustment for other factors. These results are not due to overtly sick children being weaned earlier. Previous lactation lowers DDE levels, which produces an artifactual association, but simulations using best estimates show that an effect as large as that found here would arise through this mechanism only 6% of the time. CONCLUSIONS. DDE may affect women's ability to lactate. This exposure may be contributing to lactation failure throughout the world.
The role of psychological distress and personality in the incidence of sciatic pain among working men.
Authors: Pietri-Taleb F , Riihimäki H , Viikari-Juntura E , Lindström K , Moneta G B
Published: November 2008

OBJECTIVES. The role of personality characteristics and psychological distress in the incidence of sciatic pain was investigated in a 3-year prospective study. METHODS. The study population consisted of 1149 Finnish men aged 25 through 49 years (387 machine operators, 336 carpenters, and 426 office workers) with no history of sciatic pain at the beginning of follow-up. The psychological distress and personality characteristics were assessed by the Middlesex Hospital Questionnaire and the Maudsley Personality Inventory. RESULTS. The 3-year cumulative incidence rate for sciatic pain was 22% among the machine operators, 24% among the carpenters, and 14% among the office workers. The multivariate analysis of psychological factors, taking into account individual and occupational factors, showed that only hysteria was significantly associated with the incidence of sciatic pain among the blue-collar workers. Among the white-collar workers, none of the psychological dimensions were associated with sciatic pain. CONCLUSIONS. These results are in accordance with previous relationships found between hysteria and low-back disorders. Further follow-up investigations are needed to elucidate the role of psychological factors in the occurrence of back problems.
Ocular and dermatologic health effects of ultraviolet radiation exposure from the ozone hole in southern Chile.
Authors: Schein O D , Vicencio C , Muñoz B , Gelatt K N , Duncan D D , Nethercott J , Honeyman J , Koren H S , West S
Published: November 2008

OBJECTIVES. This study sought to investigate numerous reports emanating from Punta Arenas, Chile (population 110,000, latitude 53 degrees S), that associated acute ocular and dermatologic disease in humans and animals with excess ultraviolet-B (UV-B) exposure in the setting of the thinning of the ozone column. METHODS. Ophthalmologic and dermatologic records in Punta Arenas were systematically reviewed to enumerate sentinel diagnoses potentially associated with UV-B exposure, ocular examinations on representative animal populations were performed, and the ambient UV-B exposure in the region during the time of maximal thinning was estimated. RESULTS. No increase in patient visits or conditions attributable to UV-B exposure was seen for periods of known ozone depletion compared with control periods. Although ambient UV-B exposure was 1.6 to 2.3 times the habitual exposure on individual days, this excess exposure conferred only a 1% increase in annual exposure on the region. CONCLUSION. This study does not support existing lay reports of ocular and dermatologic disease in humans and animals that had been associated with the ozone hole over southern Chile.
Go tell it on the mountain: Hilla Sheriff and public health in the South Carolina Piedmont, 1929 to 1940.
Authors: Hill P E
Published: November 2008

As director of the South Carolina units of the American Women's Hospitals and as the state's first female county health official, Hilla Sheriff combined elements of the Progressive Era's social gospel; the New Deal notion that concerned, public-spirited officials could make a difference; and a nascent feminism that led her into the controversial fields of family planning and nutrition. Sheriff's responses to endemic pellagra, innovative maternal and child health campaigns, and contraceptive research for the Milbank Memorial Fund attracted national attention and spawned programs based on her models throughout the South. Her ability to tailor programs to diverse communities--mothers who bore double burdens as textile workers, isolated farm families, mountaineers, and African Americans denied access to most health care facilities in the Jim Crow South--serves as a timeless example for those committed to community medicine.
An outbreak of hypervitaminosis D associated with the overfortification of milk from a home-delivery dairy.
Authors: Blank S , Scanlon K S , Sinks T H , Lett S , Falk H
Published: November 2008

OBJECTIVES. The purpose of the study was to identify cases of hypervitaminosis D caused by the inadvertent overfortification of milk from a home-delivery dairy and to identify risk factors for this illness. METHODS. Hospital discharge, laboratory, and state health department data were used to define, identify, and describe cases of hypervitaminosis D diagnosed in the exposed communities between January 1, 1985, and June 30, 1991. To identify disease risk factors, community-based sex- and age-matched controls were used in a case-control study. RESULTS. Of the 56 case patients identified, at least 41 were hospitalized; 2 died. The study included 33 case patients and 93 control subjects. Nineteen of the 33 case patients had been customers of the implicated dairy. Risk of illness rose with increasing consumption of the dairy's milk and was also associated with vitamin D supplement use, sunburn susceptibility, and cancer history. Accounting for these factors did not alter the association between drinking the dairy's milk and developing hypervitaminosis D. CONCLUSIONS. Overfortification of milk with vitamin D can lead to hypervitaminosis D, manifested by severe illness and death. The episode highlights the need for monitoring the fortification process and enforcing the upper limit for vitamin D addition to milk.
Folic acid fortification of grain: an economic analysis.
Authors: Romano P S , Waitzman N J , Scheffler R M , Pi R D
Published: November 2008

OBJECTIVES. The purpose of this study was to compare the economic costs and benefits of fortifying grain with folic acid to prevent neural tube defects. METHODS. A cost-benefit analysis based on the US population, using the human capital approach to estimate the costs associated with preventable neural tube defects, was conducted. RESULTS. Under a range of assumptions about discount rates, baseline folate intake, the effectiveness of folate in preventing neural tube defects, the threshold dose that minimizes risk, and the cost of surveillance, fortification would likely yield a net economic benefit. The best estimate of this benefit is $94 million with low-level (140 micrograms [mcg] per 100 g grain) fortification and $252 million with high-level (350 mcg/100 g) fortification. The benefit-to-cost ratio is estimated at 4.3:1 for low-level and 6.1:1 for high-level fortification. CONCLUSIONS. By averting costly birth defects, folic acid fortification of grain in the United States may yield a substantial economic benefit. We may have underestimated net benefits because of unmeasured costs of neural tube defects and unmeasured benefits of higher folate intake. We may have overestimated net benefits if the cost of neurologic sequelae related to delayed diagnosis of vitamin B12 deficiency exceeds our projection.
Macronutrient intakes among adult Hispanics: a comparison of Mexican Americans, Cuban Americans, and mainland Puerto Ricans.
Authors: Loria C M , Bush T L , Carroll M D , Looker A C , McDowell M A , Johnson C L , Sempos C T
Published: November 2008

OBJECTIVES. The purpose of this study was to compare energy and macronutrient intakes between adult Mexican Americans, Cuban Americans, mainland Puerto Ricans, and non-Hispanics. METHODS. Age-specific mean intakes were estimated based on 24-hour recalls from the Hispanic Health and Nutrition Examination Survey (HHANES) (1982 to 1984) and the Second National Health and Nutrition Examination Survey (NHANES II) (1976 to 1980) and were compared with the use of t tests. RESULTS. Mexican Americans had higher total fat, saturated fat, and monounsaturated fat intakes than did Puerto Ricans and older Cuban Americans. Cuban Americans and Puerto Ricans had similar intakes, except for younger Cuban Americans, who had higher total and saturated fat and lower carbohydrate intakes. Cholesterol intakes among Mexican American men and 60- to 74-year-old women were higher than those among other Hispanic groups. Carbohydrate and protein intakes were higher among Hispanic groups compared with those among non-Hispanics while total fat intakes were generally lower. CONCLUSIONS. Since macronutrient intakes differ between Hispanic groups, dietary research, recommendations, and interventions should be targeted to each group individually. Older Puerto Rican and Cuban American adults met population guidelines for reducing chronic disease risk for more macronutrients than any other group.
Weight concerns and change in smoking behavior over two years in a working population.
Authors: French S A , Jeffery R W , Klesges L M , Forster J L
Published: November 2008

The hypothesis that weight concerns are related to less successful smoking cessation and greater relapse among ex-smokers was prospectively evaluated. A population-based sample of 4981 working women and men 17 to 71 years of age was surveyed at 32 work sites. Current and previous weight loss efforts and smoking behavior were self-reported at baseline and 2 years later. Dieting and weight concerns were unrelated to smoking cessation or relapse. However, female smokers who had previously participated in a formal weight control program were three times more likely to quit smoking than those without a history of participation (25% vs 11%; odds ratio = 3.25, 95% confidence interval = 1.86, 5.67). Weight concerns and dieting efforts do not appear to inhibit smoking cessation or increase relapse in adults.
Does WIC participation improve breast-feeding practices?
Authors: Schwartz J B , Popkin B M , Tognetti J , Zohoori N
Published: November 2008

The effects of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on breast-feeding behavior have been sometimes found inadequate. The determinants of breast-feeding initiation and duration among WIC participants and nonparticipants were modeled by using retrospective cross-sectional data from the 1988 National Maternal and Infant Health Survey. This study corrects for self-selection bias as far as the data allow, in addition to controlling for parents' ages, education, race, and family income. Findings suggest that prenatal WIC participation, combined with breast-feeding advice, significantly increases the initiation of breast-feeding but does not affect duration. The exact nature of effective breast-feeding advice given prenatally at WIC clinics is unclear and warrants further research.
The feasibility and desirability of public health credentialing: a survey of public health leaders.
Authors: Livingood W C , Woodhouse L D , Godin S W
Published: November 2008

OBJECTIVES. The goal of this study was to provide insight concerning the potential of credentialing public health workers through an exploratory examination of public health leaders' perceptions. METHODS. Qualitative and quantitative procedures were used. Credentialing issues were identified through the literature and through open-ended interviews with leaders and experts. A 74-item Likert-type survey was used to quantify perceptions. Key informants and survey participants were identified through pertinent organizations. RESULTS. The public health leaders leaned toward consensus on some benefits of and concerns about credentialing. There was no consensus related to a specific form of desired credentialing, although national certification was supported by a plurality. State licensing and an emphasis on the master's in public health (MPH) degree were opposed by large margins. Public health leadership survey results were similar to results of a survey of credentialing experts. CONCLUSIONS. The lack of consensus and the vehemence of some opposing positions indicate that movements toward credentialing should proceed cautiously. However, many of the response patterns indicate that the issue merits further exploration.
The practice of prophylactic mastectomy: a survey of Maryland surgeons.
Authors: Houn F , Helzlsouer K J , Friedman N B , Stefanek M E
Published: November 2008

OBJECTIVES. Bilateral prophylactic mastectomy is a drastic breast cancer preventive option for which indications are not standardized and efficacy has not been proven. To estimate the magnitude of this controversial practice, surgeons were surveyed on their recommendations about and performance of prophylactic mastectomy. METHODS. A cross-sectional survey was sent to general surgeons (n = 522), plastic surgeons (n = 80), and gynecologists (n = 801) licensed to practice in Maryland in 1992. Proportions responding were 41.9%, 66.3%, and 54.9%, respectively. In addition, there were 30 respondents who identified "other" as their specialty. The respondents were asked about the role of bilateral prophylactic mastectomy and the number of times they had recommended and performed it in a year. RESULTS. Seven hundred forty-two surgeons responded (51.8%). More plastic surgeons (84.6%) than general surgeons (47.0%) and gynecologists (38.3%) agreed that bilateral prophylactic mastectomy has a role in the care of high-risk women. Eighty-one percent of plastic surgeons had recommended the procedure, compared with 38.8% of general surgeons and 17.7% of gynecologists. CONCLUSIONS. Indications and practice patterns reveal heterogeneity of medical opinion and practice of prophylactic mastectomy. This study raises the need for better evaluation of the efficacy and appropriateness of prophylactic mastectomy.
The surveillance of work-related pesticide illness: an application of the Sentinel Event Notification System for Occupational Risks (SENSOR)
Authors: Maizlish N , Rudolph L , Dervin K
Published: November 2008

OBJECTIVES. In response to limitations in state-based occupational disease surveillance, the California Department of Health Services developed a model for surveillance of acute, work-related pesticide illness. The objectives were to enhance case reporting and link case reports to preventive interventions. METHODS. Elements from surveillance of communicable diseases and sentinel health events were used to integrate a model into the preexisting system in one agricultural country. RESULTS. Between 1988 and 1991, 45 Fresno County health care providers reported 230 suspected cases, of which 217 from 80 work sites met reporting guidelines. Risk factors were profiled from interviews of 81 prioritized case patients and 36 employers. Fifteen work sites were visited and 117 recommendations were made, of which 6% were identified in enforcement inspections. Pest management experts consulted with growers on reducing future pesticide use. CONCLUSIONS. Risk factors for pesticide illness were prevalent. Agricultural inspectors did not detect routine and serious hazards. Integrated pest management should be expanded and linked to occupational health. Agricultural enforcement personnel should be oriented and trained in occupational safety and health.
Video-based sexually transmitted disease patient education: its impact on condom acquisition.
Authors: O'Donnell L N , Doval A S , Duran R , O'Donnell C
Published: November 2008

OBJECTIVES. This study assessed the impact of video-based educational interventions on condom acquisition among men and women seeking services at a large sexually transmitted disease clinic in the South Bronx, New York. METHODS. During 1992, 3348 African American and Hispanic patients were enrolled in a clinical trial of video-based interventions designed to promote safer sex behaviors, including increased condom use. Patients were assigned to one of three groups: control, video, or video plus interactive group discussion. Subjects were given a coupon to redeem for free condoms at a pharmacy several blocks from the clinic. Rates of condom acquisition were assessed by level of intervention. RESULTS. In comparison with a control group, subjects who viewed videos were significantly more likely to redeem coupons for condoms (21.2% redemption rate vs 27.6%). However, participation in interactive sessions after video viewing augmented the positive effects of video viewing alone (27.6% redemption rate vs 36.9%). Gender and ethnicity were significantly associated with outcomes. CONCLUSIONS. The condom acquisition are almost doubled with the use of culturally appropriate, video-based interventions. Designed to present minimal disruption to clinical services, these interventions can be implemented in clinics servicing at-risk men and women.
Empirically based guidelines for moderate drinking: 1-year results from three studies with problem drinkers.
Authors: Sanchez-Craig M , Wilkinson D A , Davila R
Published: November 2008

OBJECTIVES. The study was conducted to refine guidelines on moderate drinking for problem drinkers, persons whose alcohol use is hazardous or harmful. Information on levels of alcohol intake unlikely to cause problems is useful for health professionals, educators, and policymakers. METHODS. Based on their reports of alcohol-related problems, participants in three studies assessing interventions to reduce heavy drinking (114 men, 91 women) were categorized as "problem-free" or "problem" drinkers at follow-up. Drinking measures were examined to identify patterns separating these outcome categories. RESULTS. Analyses using 95% confidence intervals for means on drinking measures showed that guidelines should be sex-specific. Based on analyses of positive and negative predictive value, sensitivity, and specificity, it is recommended that men consume no more than 4 standard drinks in any day and 16 drinks in any week, and that women consume no more than 3 drinks in any day and 12 drinks in any week. CONCLUSIONS. These guidelines are consistent with those from several official bodies and should be useful for advising problem drinkers when moderation is a valid treatment goal. Their applicability to the general population is unevaluated.
Breast and cervical cancer screening in a low-income managed care sample: the efficacy of physician letters and phone calls.
Authors: Lantz P M , Stencil D , Lippert M T , Beversdorf S , Jaros L , Remington P L
Published: November 2008

A randomized trial was conducted to evaluate the combined impact of a physician reminder letter and a telephone contact on the use of Pap tests and mammograms in a low-income managed care program. Women 40 to 79 years of age who were past due for cancer screening were randomly assigned to an intervention or control group. Medical claims were reviewed after 6 months to determine intervention effectiveness. The odds of receiving all needed cancer screening tests during follow-up were four times higher in the intervention group. Women who reported having to take time off from work to see a doctor had lower odds of getting screened.
Has the use of cervical, breast, and colorectal cancer screening increased in the United States?
Authors: Anderson L M , May D S
Published: November 2008

This report describes trends in reported breast, cervical, and colorectal cancer screening within the US population from 1987 to 1992. Data from the 1987 and 1992 Cancer Control Supplements of the National Health Interview Survey were analyzed to determine use of Pap smears by women aged 18+; of mammography and clinical breast examination by women aged 50+; and of proctoscopy, digital rectal examination, and fecal occult blood testing among men and women aged 50+. Use of mammography doubled between 1987 and 1992 while Pap smear use changed very little. Use of the three colorectal cancer screening modalities increased but levels remained low. Usage trends were also assessed in relation to several sociodemographic factors. Disparities in screening reported in 1987 according to income and education persisted in 1992.
Routine hepatitis B vaccination in a clinic for sexually transmitted diseases.
Authors: Weinstock H S , Bolan G , Moran J S , Peterman T A , Polish L , Reingold A L
Published: November 2008

Patients were assigned to one of two vaccine schedules to assess the feasibility of vaccinating a sexually transmitted disease clinic population against hepatitis B virus. Of 1386 patients entering an inner-city clinic between June and July 1990, 611 (44%) accepted a first dose of vaccine. Twenty-one percent of all susceptible patients received at least two doses of vaccine. Annualizing these findings shows that an ongoing program could prevent 636 hepatitis B virus infections per year. Although a significant proportion of sexually transmitted disease clinic patients can be successfully vaccinated, strategies for preventing hepatitis B virus infections in this high-risk population must consider patient behavior as well as vaccine efficacy.
Could you starve to death in England in 1839? The Chadwick-Farr controversy and the loss of the "social" in public health.
Authors: Hamlin C
Published: November 2008

The public health field has long been pulled in two directions, either toward a narrower biomedical mission to control infectious disease or toward a broader mission to address the social and economic factors that adversely affect health and wellbeing. This paper explores as an instance of this tension an 1839 controversy between the statistician William Farr and the pioneering sanitary reformer Edwin Chadwick on the role of starvation as a cause of death. Farr thought hunger contribution significantly to many deaths; Chadwick wanted Farr to concentrate on the diseases from which people actually died. The paper then considers what the "constitutional" disease theories, which underlay Farr's concerns, implied for public health using medical testimony on child labor in industrial revolution factories as an illustration. An exploration of this constitutional medicine may help provide a "useable past" for modern public health workers interested in broadening the scope of public health.
Trauma among Hispanic children: a population-based study in a regionalized system of trauma care.
Authors: Matteucci R M , Holbrook T L , Hoyt D B , Molgaard C
Published: November 2008

We studied 1164 injured Hispanic and 2560 injured non-Hispanic White children newborn through 14 years triaged to the San Diego County Regionalized Trauma System from 1985 through 1990. Incidence rates did not differ by ethnic group. Hispanic children were more likely to be struck as pedestrians (odds ratio [OR] = 1.5) and less likely to be injured in falls (OR = 0.7) than non-Hispanic White children. For motor vehicle and pedal cycle injuries, Hispanic children were more likely not to have been restrained by seatbelts (OR = 4.0) or car seats (OR = 3.7).
Workplace assaults on minority health and mental health care workers in Los Angeles.
Authors: Sullivan C , Yuan C
Published: November 2008

Workplace violence is becoming increasingly recognized as a serious problem in health care settings. All 628 workers' compensation assaults claimed by minority Los Angeles County health care workers from 1986 through 1990 were abstracted. Population-at-risk data from county personnel computer tapes provided denominators by age, sex, race, job classification, and type of facility. Rates varied by type of facility (rate ratio = 38 for psychiatric hospitals vs public health facilities) and varied by job, with inpatient nursing attendants having the highest rate for caregivers. Most assaults were committed by patients (86%), followed by coworkers (8%). The average cost of an assault ($4879) was relatively low but related to the costlier problem of work-related emotional illness.
Sociocultural factors in the use of prenatal care by Hmong women, Minneapolis.
Authors: Spring M A , Ross P J , Etkin N L , Deinard A S
Published: November 2008

Understanding the sociocultural context of prenatal care underuse by an immigrant population can suggest programmatic changes that result in more effective health care delivery. Ethnographic survey interviews of female Hmong clinic patients conducted in 1987/88 revealed that they objected to biomedical procedures and to being attended by several doctors; the women also reported poor communication with staff as a problem. Clinic reforms implemented in 1989/90 included hiring a nurse-midwife, reducing the number of pelvic examinations, expanding hours of operation, creating a direct telephone line to Hmong interpreters, and producing a Hmong-language prenatal health care education videotape. Women interviewed in 1993 reported a more positive clinic experience.