bluuebunny/crossref_metadata_2025 huggingface dataset:
Cotinine in the serum, saliva, and urine of nonsmokers, passive smokers, and active smokers.
Authors: Wall M A , Johnson J , Jacob P , Benowitz N L
Published: November 2008

Cotinine was measured in the serum, saliva, and urine of nonsmokers, passive smokers, and active smokers. Serum and saliva could not discriminate between nonsmokers and passive smokers. Mean urine cotinine was higher in passive smokers than nonsmokers but there was a great deal of intersubject overlap. Cotinine in all body fluids could separate active smokers from the other two groups. Among smokers, light smokers had lower levels than heavier smokers.
Urban hospital cesarean section delivery rates in Paraíba State, Brazil, 1977-81.
Authors: Rodrigues J
Published: November 2008

Paraíba State, Brazil is one of the poorest areas in that country; many of the hospitals are not high quality and medical training is not comparable to that of developed countries. Nevertheless, the rate of cesarean section delivery in urban hospitals has risen from 19.0 per cent in 1977 to 28.5 in 1981. Despite the larger volume of obstetric services in government hospitals, these hospitals had lower cesarean section rates than private hospitals, both profit and non-profit.
Community health effects of a municipal water supply hyperfluoridation accident.
Authors: Petersen L R , Denis D , Brown D , Hadler J L , Helgerson S D
Published: November 2008

For 12 hours, excess hydrofluorosilicic acid was diverted to a 127-home community water supply. Fluoride levels peaked at 51 parts per million (ppm). Water acidification caused copper to leach from the domestic plumbing; raising copper levels to 25-41 ppm. Fifty-two (33 per cent) of those who drank hyperfluoridated water developed mild gastroenteritis. Vomiting was uncommon and symptom onsets usually occurred greater than 30 minutes after drinking water; suggesting that fluoride, rather than copper, caused illness. Skin contact with hyperfluoridated water caused itching and skin rashes.
Blood pressure and social class in a Jamaican community.
Authors: Dressler W W , Grell G A , Gallagher P N , Viteri F E
Published: November 2008

A study of social factors and blood pressure was conducted in a Jamaican community among a sample of 199 persons ages 30 to 50. After controlling for obesity, age, and respondent tension (and other covariates), interaction effects of social class x sex for systolic and diastolic blood pressure were found. Blood pressure increased with increasing social class for males and decreased with increasing social class for females.
The New England Maternal PKU Project: identification of at-risk women.
Authors: Waisbren S E , Doherty L B , Bailey I V , Rohr F J , Levy H L
Published: November 2008

Young women with phenylketonuria (PKU) are at risk for bearing children with mental retardation, microcephaly, heart defects, and low birthweight. These effects may be prevented if a low phenylalanine diet is maintained prior to and throughout pregnancy. This report describes the procedures of the New England Regional Maternal PKU Project for identifying and locating this population of at-risk women. Newborn screening records, routine umbilical cord blood screening, and PKU Clinic records provided most of the identifying information. We identified 235 women with hyperphenylalaninemia, ages 12 to 44 years. Of these, 183 had PKU or atypical PKU while 52 had non-PKU mild hyperphenylalaninemia. The 235 women represent 88 per cent of the expected number of women with hyperphenylalaninemia in New England. We identified more than the expected number of those with PKU but only 57 per cent of the expected number with mild hyperphenylalaninemia. Developing a national registry, as well as screening women who utilize birth control clinics or prenatal clinics, may be helpful. Implementing routine umbilical cord blood screening programs may be beneficial in efforts to identify women with hyperphenylalaninemia who have had a child and may want more children in the future.
Optimistic biases in public perceptions of the risk from radon.
Authors: Weinstein N D , Klotz M L , Sandman P M
Published: November 2008

Survey data were obtained from a random sample of 657 homeowners in New Jersey and also from 141 homeowners who had already monitored their homes for radon. People who had not tested tended to believe that they were less at risk than their neighbors, and they interpreted ambiguous predictors of home radon levels in ways that supported their beliefs of below-average risk. Residents who had already tested their homes were relatively accurate about the probability of health effects. In both groups less than half of those who knew that radon can cause lung cancer were willing to admit that it would be serious if they suffered health effects from this source. The optimistic biases of the public may hamper attempts to encourage home radon monitoring and to promote appropriate mitigation measures in homes with elevated radon concentrations.
Variables influencing condom use in a cohort of gay and bisexual men.
Authors: Valdiserri R O , Lyter D , Leviton L C , Callahan C M , Kingsley L A , Rinaldo C R
Published: November 2008

Nine hundred fifty-five of 1,384 (69 per cent) gay and bisexual men enrolled in a prospective study of the natural history of human immunodeficiency virus (HIV) infection who reported engaging in anal intercourse in the past six months were surveyed about condom use practices for both insertive (IAI) and receptive anal intercourse (RAI). The following results were obtained: 23 per cent of the men reported that they always used condoms for IAI and 21 per cent for RAI; 32 per cent sometimes used condoms for IAI; 28 per cent sometimes used condoms for RAI; 45 per cent never used condoms for IAI; and 50 per cent never used condoms for RAI. Multiple logistic regression analysis revealed that the following variables were associated with both insertive and receptive condom use: condom acceptability; a history of multiple and/or anonymous partners in the past six months, and the number of partners with whom one is "high" (drugs/alcohol) during sex. Knowledge of positive HIV serostatus was more strongly associated with receptive than with insertive use. Condom use is a relatively complex health-related behavior, and condom promotion programs should not limit themselves to stressing the dangers of unprotected intercourse.
The estimated predictive value of screening for illicit drugs in the workplace.
Authors: Wells V E , Halperin W , Thun M
Published: November 2008

This paper estimates the predictive values of screening tests for six illicit drugs of common concern in the workplace (amphetamines, barbiturates, cocaine, hallucinogens, marijuana, and opiates) using published information on test sensitivity and specificity and survey data on prevalence. Estimated predictive values (negative) were generally high, whereas the estimated predictive value of a positive test ranged from 1 per cent for amphetamines to 100 per cent for hallucinogens and was only 38 per cent for marijuana, the most prevalent drug.
A risk profile comparison of runaway and non-runaway youth.
Authors: Yates G L , MacKenzie R , Pennbridge J , Cohen E
Published: November 2008

All initial visits (N = 765) to an outpatient medical clinic during calendar year 1985 were analyzed. Six hundred and fifty-five of these visits made by non-runaway youth were compared to 110 visits made by runaways. Based on data from the Childrens Hospital Adolescent Risk Profile Interview, runaway street youth are at greater risk for a wide variety of medical problems and of health-compromising behaviors including suicide and depression, prostitution, and drug use. The implications for public health and social policy are discussed.
Characteristics of childhood homicide in Ohio, 1974-84.
Authors: Muscat J E
Published: November 2008

Childhood homicide deaths in Ohio from 1974 to 1984 were examined using Ohio Vital Statistics records and US Census Data. Homicide rates varied from 25/100,000 for Black infant males to 0.8/100,000 for White females ages 5-9. Child battering was the leading cause of death for children less than 5 years. Firearms accounted for 56 per cent of homicide deaths for children 10-14 years of age. The childhood homicide rates in the four largest Ohio cities were substantially higher in areas with low socioeconomic indicators.
Suicides and pesticides in Sri Lanka.
Authors: Berger L R
Published: November 2008

Sri Lanka has one of the highest rates of suicide in the world (29 per 100,000 population in 1980). Suicides are especially frequent among young adults, both male and female. Compared to the US, the suicide rate for males ages 15 to 24 years in Sri Lanka is nearly four times greater; the female rate nearly 13 times greater. The most common mode of suicide is ingestion of liquid pesticides.
The preventability of 'premature mortality': an investigation of early diabetes deaths.
Authors: Will J C , Connell F A
Published: November 2008

Certifying physicians were surveyed regarding the 40 diabetic deaths under 45 years of age occurring in Washington State between July 1 and December 31, 1984. At most, it is estimated that three deaths may have been prevented by more accessible, timely or careful medical management immediately prior to death. Over 50 per cent of decedents were reported to be financially disadvantaged and 81 per cent had significant psychological problems. The role of these psychosocial factors needs further delineation.
Compliance with fecal occult blood testing: the role of restrictive diets.
Authors: Joseph A
Published: November 2008

In this clinical trial, 786 patients screened for colorectal cancer with fecal occult blood testing were assigned to either a "diet" or "no diet" group to examine the effect of advice to restrict intake of red meat and peroxidase-containing vegetables on patient compliance and positivity rates. Restrictive diets did not significantly decrease compliance. Interviews of patients in the "diet" group demonstrated that the majority followed instructions. Positivity rates were similar in the two groups, and clinically significant lesions were found with comparable frequency.
Properties of saliva cotinine in young adult light smokers.
Authors: Carey K B , Abrams D B
Published: November 2008

The half-life of saliva cotinine and its accuracy at detecting light or intermittent smoking were examined. Five subjects provided daily saliva samples for 23 days and quit smoking on day 4. An average of 2.8 days was required for saliva continue to drop below the cutoff for classification as a smoker. All smokers smoked intermittently at various times after day 9. In most cases the smoking of one or two cigarettes was detected in the saliva sample on subsequent days. Saliva cotinine was sensitive to low rates of smoking and to intermittent smoking.
Sociodemographic and behavioral characteristics of HIV antibody-positive blood donors.
Authors: Cleary P D , Singer E , Rogers T F , Avorn J , Van Devanter N , Soumerai S , Perry S , Pindyck J
Published: November 2008

This paper describes the sociodemographic and behavioral characteristics of 173 blood donors who were confirmed by Western blot tests to have antibodies to human immunodeficiency virus (HIV), the etiologic agent for acquired immunodeficiency syndrome (AIDS). Seropositive donors were predominantly young, unmarried, and male, and major risk factors could be identified for almost all donors. However, more than 20 per cent of the study participants were women, and many participants were not aware that they were at risk of infection. The heterogeneity of the study population, the lack of awareness among many subjects of risk factors and self-exclusion procedures, and the high level of distress among many subjects after notification, emphasize the need for intensive, well-designed education and support programs.
Physician acceptance of the hepatitis B vaccine at a university medical center.
Authors: Hashimoto F , Hunt W C , Brusuelas P
Published: November 2008

To examine how physicians at different training levels accepted the hepatitis B vaccine (Heptavax), we mailed questionnaires to all medical students, residents, and faculty at our university medical center. Eighty-one per cent responded; 57 per cent of those had been vaccinated. Attitudes of vaccine safety and efficacy and the perception of increased risk of getting hepatitis B were associated with having been vaccinated. The associations were strongest for the faculty and weak or negative for the medical students.
Eradication of head lice with a single treatment.
Authors: DiNapoli J B , Austin R D , Englender S J , Gomez M P , Barrett J F
Published: November 2008

Single application of Nix (permethrin 1% creme rinse) and Rid were compared as treatments for Pediculosis capitis in 435 patients, the majority of whom were children. Seven days after the treatment, 98 per cent of the permethrin-treated and 85 per cent of the Rid-treated patients were free of lice. At 14 days, prior to nit removal, 96 per cent of the permethrin-treated and 62 per cent of the Rid-treated patients were still lice free. Seventeen (7 per cent) permethrin-treated and 32 (16 per cent) Rid-treated patients were reported to have adverse experiences.
State laws and the practice of lay midwifery.
Authors: Butter I H , Kay B J
Published: November 2008

A national survey was conducted to assess the current status and characteristics of state legislation regulating the practice of lay midwives. As of July 1987, 10 states have prohibitory laws, five states have grandmother clauses authorizing practicing midwives under repealed statutes, five states have enabling laws which are not used, and 10 states explicitly permit lay midwives to practice. In the 21 remaining states, the legal status of midwives is unclear. Much of the enabling legislation restricts midwifery practice often resulting in situations similar to those in states with prohibitory laws. Given the growth of an extensive grassroots movement of lay midwives committed to quality of care, this outcome suggests that 21 states with no legislation may provide better opportunities for midwifery practice than states with enabling laws.
Smoking by blacks and whites: socioeconomic and demographic differences.
Authors: Novotny T E , Warner K E , Kendrick J S , Remington P L
Published: November 2008

Using data from the 1985 National Health Interview Survey for persons aged 25-64 years, we controlled simultaneously for socioeconomic status (SES), demographic factors, and race in multivariate logistic regression analyses. We found that the odds of ever smoking are not higher for Blacks compared with Whites, when the other variables are controlled. By contrast, the odds of heavy smoking for Blacks are far less than for Whites, while Blacks are significantly less likely than Whites to quit smoking regardless of SES or demographic factors. Smoking cessation and prevention programs must be planned with these behavioral, SES, and demographic differences in mind.
Mandatory driver training and road safety: the Quebec experience.
Authors: Potvin L , Champagne F , Laberge-Nadeau C
Published: November 2008

In January 1983, the Quebec Government made driver training courses mandatory for any person seeking a first driver's license. Using accident and licensure data over a five-year period, we conducted an evaluation of the impact of the enactment of mandatory driver training on: the risk of accident for newly licensed drivers; the mortality and morbidity of these accidents; the number of new drivers; and the mean age of licensure. Results of our time series analyses show that this legislation had no appreciable effect on the risk of accident or on the mortality/morbidity rate per accident for newly licensed drivers aged 18 and over. However, since 1983, the number of women under 18 years of age getting their first driver's license has increased by 20 per cent, and their mean age has decreased from over 18 to under 18. Mandatory driver training may have increased the numbers and risks of accidents for young, primarily female, drivers.
Fatal occupational injuries in US industries, 1984: comparison of two national surveillance systems.
Authors: Stout-Wiegand N
Published: November 2008

This paper compares the results of analyses of 1984 fatalities as identified in the National Institute for Occupational Safety and Health (NIOSH) National Traumatic Occupational Fatality (NTOF) data base with those of the Bureau of Labor Statistics' Annual Survey of Occupational Injuries and Illnesses (AS) for 1984. The fatality rates for industries were similar in both analyses; however, differences in number of injuries suggest underrepresentation in the AS of fatal injuries in several, high-risk industries. Differences and similarities in methods and results between the two national surveillance systems are described and their application to research and injury prevention are discussed.
Compliance with OSHA record-keeping requirements.
Authors: Seligman P J , Sieber W K , Pedersen D H , Sundin D S , Frazier T M
Published: November 2008

The Occupational Safety and Health Act of 1970 requires employers to maintain records of workplace injuries and illnesses. To assess compliance with the law, data from the National Occupational Exposure Survey (NOES) were examined. Of the 4,185 companies with 11 or more employees, 75 per cent maintained OSHA Form 200 designed for recording illnesses and injuries. The number of employees and the presence of a union were positive determinants in the record maintenance. Of companies with 500 or more employees, 95 per cent kept records compared with 60 per cent of companies with between 11 and 99 employees.
Bicyclists, helmets and head injuries: a rider-based study of helmet use and effectiveness.
Authors: Wasserman R C , Waller J A , Monty M J , Emery A B , Robinson D R
Published: November 2008

We interviewed 516 bicyclists over age 10 regarding helmet use and head injuries. Although 19 per cent owned helmets, only 8 per cent were wearing them when interviewed. Riders wearing helmets were more highly educated and reported higher car seat belt use. Nearly 4 per cent of the bicyclists reported striking their heads in a cycling mishap during the previous 18 months; those wearing helmets at the time of the mishap were less likely to have sustained head injuries.
The epidemiology of S. sonnei and S. flexneri in Pima County, Arizona: an exploratory study.
Authors: McCombie S C , Funk D B , Browning J A , Nolan P A
Published: November 2008

Investigation of 189 cases of shigellosis reported to the Pima County, Arizona Health Department in 1986 revealed that 23 per cent of cases could be attributed to travel to Mexico, and 10 per cent to day care attendees and their household contacts. No source of infection or high-risk activity could be demonstrated for 43 per cent of the cases. Households in which S. flexneri occurred were more likely to be characterized by crowded living situations and to have no known source of infection.
Potential for exposure to tick bites in recreational parks in a Lyme disease endemic area.
Authors: Falco R C , Fish D
Published: November 2008

Eight recreational parks located in a Lyme disease endemic area of southern New York State were surveyed for the presence of ticks during the summer of 1985 by drag sampling. Ixodes dammini, the primary vector of Lyme disease in the northeast, was found in all but one park and accounted for 580 (91.8 per cent) of the 632 ticks collected. Of these, 18 per cent were larvae, 80 per cent were nymphs, and 2 per cent were adults. An I. dammini encounter distance, defined as the mean number of meters traveled before encountering a nymphal or adult I. dammini on a drag cloth, ranged from 36 m in high-risk parks, to infinity (no tick encounters). Generally, areas of high use presented higher encounter distances (lower risk) than those of the entire park. Two of the three parks with the highest annual attendance also had the highest I. dammini population indices as projected from our sampling regimen. These results indicate that recreational parks in Lyme disease endemic areas represent a substantial human risk for tick bites and Lyme disease.
Changes in alcohol-related inpatient care in Stockholm County in relation to socioeconomic status during a period of decline in alcohol consumption.
Authors: Romelsjö A , Diderichsen F
Published: November 2008

Alcohol sales in Stockholm County decreased by 18 per cent from 1976 to 1981. The socioeconomic status of inpatients treated for alcohol psychosis, alcoholism, alcohol intoxication, liver cirrhosis, and pancreatitis was studied by linking data from the National Housing and Population Censuses in 1975 and 1980 with the inpatient care registers for 1976 and 1981. In both years, all rates were highest for people outside the labor market and lowest among white collar employees. The employment rate for those aged 25-44 years and treated in 1981 for alcohol psychosis, alcoholism, and alcohol intoxication--already low in 1975--had drifted further downward by 1980. Total rates of inpatient treatment for alcohol-related diagnoses generally declined but the gap between blue collar workers and white collar workers widened. We conclude that the goal for national alcohol policy, suggested by the WHO--a reduction of per capita consumption--should be combined with additional measures that will reach all social groups.
Barriers to implementation of a prenatal care program for low income women.
Authors: Miller C L , Margolis L H , Schwethelm B , Smith S
Published: November 2008

By the middle of the second year of the Michigan Prenatal/Postpartum Care (PPC) program to provide pregnancy-related services to low income women who were ineligible for Medicaid or other insurance, only 25 per cent of the participating health departments were enrolling greater than 90 per cent of contracted potential clients. Using a survey of program directors and relevant state documents, we identified several barriers to successful implementation: institutional (program complexity, high levels of administrative concerns along with low levels of communication between local health departments and providers); economic (inadequate resources for provider reimbursement, outreach, transportation, high-risk pregnancies, or administrative overhead); psychological (servicing populations with multiple and hard to care for problems, potential discomfort of low income women with traditional providers); and informational (insufficient information about the program infiltrating the target community).
Bowel function and breast cancer in US women.
Authors: Micozzi M S , Carter C L , Albanes D , Taylor P R , Licitra L M
Published: November 2008

We studied bowel function in relation to 123 breast cancer cases among 7,702 women from the US NHANES I Epidemiologic Follow-up Study. Results suggest a slight increased risk of breast cancer for both decreased frequency of bowel movements (relative risk = 1.5, 95% confidence interval = 0.8, 2.7) and firm stool consistency (RR = 1.8, 95% CI = 1.0, 3.2.) These observations are consistent with an hypothesized association between constipation and increased risk of breast cancer.
Risk reduction among intravenous drug users in Amsterdam under the influence of AIDS.
Authors: van den Hoek J A , van Haastrecht H J , Coutinho R A
Published: November 2008

We evaluated the impact of a needle/syringe exchange program among 263 drug users in the period December 1985 to April 1988. Participants in this study were asked about their risk-behavior at three different visits. We found no increase in the proportion injecting drugs or in the frequency of intravenous drug use. A strong decrease in borrowing and lending of used needle/syringes was found and this behavioral change was not dependent on learning human immunodeficiency virus (HIV) serostatus. Although use of the exchange program increased over time, reduction in needle sharing was mainly an effect of the study with only a limited impact of the exchange program. We conclude that ample provision of needles and syringes is an important starting point but in itself not enough to produce the necessary drastic change in risk behavior. Intensive counseling of the drug user is also needed.
Impact of the AIDS epidemic on morbidity and mortality among intravenous drug users in a New York City methadone maintenance program.
Authors: Selwyn P A , Hartel D , Wasserman W , Drucker E
Published: November 2008

To examine the impact of the AIDS epidemic on morbidity and mortality in a defined population of intravenous drug users, we analyzed overall and cause-specific death rates, AIDS incidence, and acute medical hospitalizations among patients in a long-term methadone maintenance program in New York City for the years 1984 through 1987 (midyear population for each year 828 to 891; demographic characteristics did not differ). The number of deaths while in treatment increased from 11 (13.3/1000) in 1984 to 39 (44.2/1000) in 1987. Deaths from AIDS increased from 3.6/1000 to 14.7/1000, deaths due to bacterial pneumonia/sepsis from 3.6/1000 to 13.6/1000; deaths from cirrhosis, drug overdose, trauma, and other causes remained relatively stable. AIDS incidence rose from six cases/1000 in 1984 to 20.4.1000 in 1987. Hospitalizations for AIDS, pneumonia, tuberculosis, and endocarditis/sepsis increased from 84.9/1000 in 1986 to 144.8/1000 in 1987. These data suggest that the AIDS epidemic has had a profound effect on patterns of morbidity and mortality among intravenous drug users in this methadone program population. Drug treatment programs may be important sites for targeting clinical services for drug users with AIDS, although the increasing burden of AIDS-related disease will require expansion of existing funding and treatment resources.
Suicide risk among women with alcohol problems.
Authors: Gomberg E S
Published: November 2008

The current study compares 301 alcoholic women, ages 20 to 50, interviewed in 21 treatment facilities, and a control group of nonalcoholic women matched for age and socioeconomic status of family of origin. A significantly higher percentage of alcoholic women (40.0% vs 8.8%) reported having made suicide attempts, a difference of 31.2 percentage points (95% CI = 23.9, 38.5). Age comparisons within the alcoholic sample show the percentage of younger alcoholic women attempting suicide to be twice as great as the percentage of the alcoholic women suicide attempters in their forties. Such age differences were not found among the nonalcoholic control group. The findings suggest that youthfulness and alcohol/drug abuse are the critical combination for high risk. Awareness of the suicide attempt risk potential is necessary both for emergency room personnel and for substance abuse facility workers.
One year follow-up of the Chicago televised smoking cessation program.
Authors: Flay B R , Gruder C L , Warnecke R B , Jason L A , Peterson P
Published: November 2008

We compared the relative effectiveness of four different conditions of self-help and social support provided to people attempting to quit smoking in conjunction with a televised cessation program: Smokers ready to quit were able to request written manuals from hardware stores to accompany a televised program. At worksites we provided the written manual to all workers. At a random half of the worksites, we also provided training to discussion leaders who subsequently led discussions among smokers attempting to quit with the program. At health maintenance organization sites we invited smokers who had requested program materials to participate in similar group discussions at health centers. In this paper we report one year follow-up results for the above four groups and compare them with previously reported results of a self-help manual alone. Results for the television plus manual condition were better than those of past studies (25 percent nonsmoking prevalence and 10 percent continuous cessation one year after the program) and considerably better than the manual alone. None of the other conditions designed to supplement the manual plus television produced better long-term outcomes; we explore the reasons for this. The program did encourage and help over 50,000 Chicago smokers to attempt quitting with the American Lung Association manual, 100 times as many as would have done so without the televised program. At least 15 other similar programs implemented since 1984 multiply this effect.
Delayed blood regeneration in lead exposure: an effect on reserve capacity.
Authors: Grandjean P , Jensen B M , Sandø S H , Jøgensen P J , Antonsen S
Published: November 2008

Twenty-five lead-exposed Danish battery production workers and 25-age-matched controls were examined to evaluate subclinical effects on blood formation. Blood lead levels averaged 2.14 mumol/L and 0.35 mumol/L in the two groups; the lead workers also showed high levels of erythrocyte protoporphyrin, as compared to the controls. Otherwise, the hematological parameters indicated an appropriate iron status and no other deviations. From all subjects, 0.45 L of blood was bled as part of a normal blood donation. Five and 11 days later, reticulocyte counts were significantly higher in the control group than in the lead-exposed workers. On day 15, the lead workers showed a significant delay in blood regeneration, as evidenced by lower hemoglobin concentration, and erythrocyte and reticulocyte counts. The lead exposure in the present study was within legal limits, and lead-induced anemia would be expected only at much higher exposure levels. Thus, despite the normal hematological findings in the initial examination, the lead exposure caused a decreased reserve capacity for blood formation, and this effect became evident only after the blood loss.
The mortality consequences of raising the speed limit to 65 mph on rural interstates.
Authors: Baum H M , Lund A K , Wells J K
Published: November 2008

As of April 1987, states were permitted to raise the speed limit on rural interstates to 65 mph without incurring federal sanctions; 38 states elected to do so in 1987. Fatality data for the months when the new limit was in effect in 1987 were compared with fatalities in the same months of 1982-86 on rural interstates and other rural roads. Fatalities on rural interstates in the states with increased speed limits in 1987 were conservatively estimated to be 15 percent higher than they would have been if the states had retained the 55 mph limit (95% CI = 6, 24). Among states that retained the 55 mph limit, fatalities on rural interstates were 6 percent lower than expected (95% CI = -23, 13).
Homicide, suicide, motor vehicle crash, and fall mortality: United States' experience in comparative perspective.
Authors: Rockett I R , Smith G S
Published: November 2008

US mortality data on motor vehicle crashes, falls, suicide, and homicide for 1980 are compared with corresponding data for France, Japan, West Germany, and the United Kingdom. Unadjusted and age-specific death rates are presented, together with age-adjusted rates of years of life lost (YLL). A large male excess in rates is typical outside the fall category. Motor vehicle crashes are the predominant cause of YLL, and the United States manifests the highest YLL rates for each sex. US fall death rates at the older ages are exceeded by those of France and West Germany. The elderly generally manifest the greatest risk of suicide; American females exhibit a unique rate decline after ages 45-54 years, however. Beyond early adulthood, US suicide rates are lower than those of France, Japan, and West Germany. US homicide rates dwarf those of the comparison countries with 16- to 29-fold differentials separating prime-risk American males aged 25-34 years from their foreign counterparts.
Cocaine and heroin dependence compared: evidence from an epidemiologic field survey.
Authors: Anthony J C , Petronis K R
Published: November 2008

Analyzing self-report interview data from a multi-site collaborative study of mental disorders in the community, we examined suspected differences between 611 cocaine users and 126 heroin users in relation to indicators of drug dependence. Cocaine users were less likely to report dependence-related problems as compared to heroin users. These epidemiologic sample data underscore concerns about the generalizability of published clinical sample data on self-reported cocaine dependence.
Improving patient comprehension of literature on smoking.
Authors: Meade C D , Byrd J C , Lee M
Published: November 2008

This study was designed to determine if simplification of smoking literature improved patient comprehension. Subjects (N = 129) were randomized in three groups: to receive no smoking booklet, receive one written at the 5th grade, or the 10th grade reading level. Subjects receiving the 5th grade booklet showed 13 percent better comprehension than those receiving the 10th grade booklet, and 18 percent better than the controls. Comprehension of written smoking materials can be improved by adjustment of the reading grade level.
Mentholated cigarette use among multiphasic examinees, 1979-86.
Authors: Sidney S , Tekawa I , Friedman G D
Published: November 2008

Mentholated cigarette use was studied in relation to age and race in 29,037 current smokers who were Kaiser Permanente Medical Care Program members. The percentages of mentholated cigarette users were much higher in Blacks and Asians than in Whites, especially in the younger age groups. A marked inverse relationship between mentholated cigarette use and age was present in Blacks and Asians; mentholated cigarette use showed little difference with age in Whites.
State-specific progress toward the 1990 objective for the nation for cigarette smoking prevalence.
Authors: Remington P L , Novotny T E , Williamson D F , Anda R F
Published: November 2008

We predicted the smoking prevalences for 1990 for each state in the US, assuming that the decline in each state from 1985-1990 would be the same as the decline in the US from 1965-1985. In 1985, only three states had smoking prevalences less than 25 percent. Based upon the observed decline in smoking in the US from 1965-1985 of 0.5 percent per year, we predict that only seven states will have smoking prevalences less than 25 percent by 1990. States need to consider current smoking prevalence and achievable rates of decline when setting objectives for 1990 and beyond.
Person-years of life lost due to cancer in the United States, 1970 and 1984.
Authors: Horm J W , Sondik E J
Published: November 2008

The number of deaths due to cancer in the United States reached an all-time high of 453,450 deaths in 1984 and, due to the dynamics of population growth, will continue to increase if the risk of dying from cancer does not change. Between 1970 and 1984, the total Person-Years of Life Lost (PYLL), the sum of the difference between the actual age at death and the expected remaining lifetime for each person who died of cancer, increased for most cancer sites as well as for all sites combined. In 1984, 6,881,281 person-years of life were lost due to cancer deaths, up from 5,303,668 in 1970. The exceptions are those cancers for which there has been major progress in either prevention or treatment; e.g., stomach and cervix uteri (prevention) and testicular, Hodgkin's disease, leukemia, and childhood cancers (treatment). The Average Years of Life Lost (AYLL) per person dying from cancer in 1984 was generally less than in 1970. Overall, each person who died from cancer in 1984 died 15.2 years earlier than his/her life expectancy. The greatest loss was for those who died of childhood cancers (66.9 years earlier), followed by testicular cancer (35.8 years earlier). The least loss relative to the expectation of life was for those who died of prostate cancer. The 25,400 men who died from prostate cancer in 1984 died an average of nine years earlier than otherwise expected.
Breast cancer risk and participation in mammographic screening.
Authors: Taplin S , Anderman C , Grothaus L
Published: November 2008

Within the context of an organized breast cancer screening program we conducted a prospective evaluation of the relation between breast cancer risk and participation in mammographic screening. The influence on participation of known breast cancer risk factors, as well as a summary risk label, (i.e. "high", or "moderate") were examined. The overall participation rate was 71 percent among 2,422 women, 50 to 79 years of age, invited to a centralized clinic. Multivariate analyses showed participation to be somewhat decreased among women with late menopause and definitely increased among women with any of the following factors: 1) increased age; 2) a family history of breast cancer; and 3) a previous breast biopsy. Women in the high-risk group were most likely to participate but the effect of the label was stronger among women ages 50 to 59 compared to women ages 60 to 79. The study results are generally consistent with previous findings that participants in screening programs have higher rates of breast cancer. The results also suggest the possibility that providing breast cancer risk information may encourage participation in screening.
Breast cancer screening by mammography: utilization and associated factors.
Authors: Zapka J G , Stoddard A M , Costanza M E , Greene H L
Published: November 2008

The status of mammography screening experience and factors related to utilization were examined in six towns serviced by physician staffs at five hospitals. Data were collected via random digit dial telephone interview of a probability sample of 1184 women, aged 45-75 years. The results showed that 55% of the women reported ever having had a mammogram. Of those who had ever had a mammogram, 21% reported that the mammogram in the past year was their first one. Of those women who are over 50 and had ever had a mammogram, 57% reported one in the past year. Analyses demonstrated that a combination of demographic factors, certain beliefs and knowledge, having a regular physician, social interaction and media exposure are independently related to ever having a mammogram, and to having one in the past year. Despite anecdotal and empirical evidence that the proportion of women ever having had a mammogram has substantially increased in the past several years, increasing utilization among older and lower-income women provides a challenge for public health.
Nulliparity, decade of first birth, and breast cancer in Connecticut cohorts, 1855 to 1945: an ecological study.
Authors: Hahn R A , Moolgavkar S H
Published: November 2008

Risk of breast cancer increases with age at first birth, and is lower in women who bear their first children while young than in nulliparous women. While previous studies have investigated risk of breast cancer in birth cohorts by examining partial aspects of cohort childbearing, the present ecological study assesses total cohort childbearing risk in Connecticut women born between 1855 and 1945. In each cohort, the proportion of women nulliparous and first bearing children in their twenties, thirties, and forties are weighted by relative risks associated with these events as ascertained in previous studies. Summed cohort childbearing risks are compared to the incidence of breast cancer in women 40 years of age and older in the same cohorts. Changes in decade of first birth and nulliparity do not explain the changes in breast cancer incidence observed: while cohort childbearing risk has declined over the period examined, breast cancer incidence has increased in the same cohorts. Alternative explanations for cohort increases in breast cancer incidence are reviewed.
Late-stage diagnosis of breast cancer in women of lower socioeconomic status: public health implications.
Authors: Farley T A , Flannery J T
Published: November 2008

To assess the success of breast cancer control activities in Connecticut, we examined data from the Connecticut Tumor Registry, determining differences in breast cancer stage at time of diagnosis over time and in selected subgroups. From 1982 to 1985, the percentage of women with cancer confined to the breast increased from 54.0 percent to 61.3 percent. During 1984 and 1985, lower socioeconomic status (SES) women with breast cancer were less likely than higher SES women to be diagnosed with early-stage disease (56.9 percent vs 62.7 percent). SES was estimated by census tract of residence. In the same years, the overall incidence of breast cancer was greater in higher SES women. Projections based on these incidence data found that lower SES women, as compared to higher SES women, had a higher rate of expected breast cancer deaths (24.6 vs 19.7 per 100,000), and a greater percentage of those deaths considered preventable by early detection (22 percent vs 11 percent). The rate of preventable deaths in lower SES women was 2.5 times as great as that for higher SES women (5.3 vs 2.1 per 100,000). Tumor registries can serve as useful surveillance systems to aid cancer control programs. Breast cancer early-detection programs should give special attention to lower SES women.
Sentinel health event surveillance: skin cancer of the scrotum in New York State.
Authors: Weinstein A L , Howe H L , Burnett W S
Published: November 2008

Skin cancer of the scrotum is a disease that has been identified as a sentinel health event (occupational) (SHE(O] that is necessarily occupationally related. The present paper examines the feasibility of using this disease in active cancer surveillance in New York State. After consulting cancer case reports, hospital records, death certificates, and city directories, we obtained occupational data for 17 of 22 cases of nonmelanoma skin cancer of the scrotum diagnosed between 1979 and 1984. Only three cases had occupations previously linked to scrotal cancer, while 11 of 19 cases had one or more possibly contributory medical conditions. The probable under-reporting of scrotal cancer cases and incompleteness of occupational data may limit the usefulness of scrotal cancer as a sentinel health event (occupational) unless additional steps are taken.
Carcinogenicity of dark liquor.
Authors: Rothman K J , Cann C I , Fried M P
Published: November 2008

To investigate whether the non-alcohol content of distilled alcoholic beverages affects the carcinogenicity of the beverage, we conducted an epidemiologic study of laryngeal and hypopharyngeal cancer. We interviewed 384 cases (or spouses, for deceased cases), and compared their responses with those of 876 controls. We classed distilled liquors as dark or light, a rough division according to content of potentially carcinogenic compounds in the beverages. The relative effect on hypopharyngeal cancer risk was much stronger for those who reported high consumption of dark liquor (relative risk = 4.4, 90% confidence interval = 2.9, 6.8) than for those reporting comparable consumption of light liquor (relative risk = 1.3, 90% CI = 0.8, 2.1). For laryngeal cancer, consumption of dark liquor had a smaller effect, and there was little distinction between the effects of dark and light liquor. The data appear consistent with the theory that the non-alcoholic content of distilled alcoholic beverages is a determinant of cancer risk, and that alcoholic beverages act topically rather than systemically in their carcinogenic action.
Polymedicine use among community resident older women: how much a problem?
Authors: Cadigan D A , Magaziner J , Fedder D O
Published: November 2008

In a community-based study of older women describing the prevalence of specific medication combinations, the risk of deleterious consequence from polymedicine was concentrated in a minority of older women. There were few prevalent medication combinations, and many of the more common combinations were unavoidable. These results suggest that broad, community-based drug education programs may be less effective than those targeting medical providers and multi-drug users.
To tell or not to tell: the ethical dilemmas of HIV test notification in epidemiologic research.
Authors: Avins A L , Lo B
Published: November 2008

Epidemiologic studies involving HIV (human immunodeficiency virus) antibody testing create ethical dilemmas, particularly about notifying asymptomatic seropositive subjects. Four study designs address this problem: mandatory notification, optional notification, anonymous testing, and blind testing. No single design consistently optimizes the trade-off between valid and ethical research. Each strategy differs substantially from the others in its effect on response rates, bias, ability to perform longitudinal studies, numbers of subjects who learn their test results, and the number of subjects counseled about HIV risk reduction. Both local institutional review boards and potential subjects of study (and their sexual partners) should participate in decisions regarding the conduct of sensitive AIDS (acquired immunodeficiency syndrome) research.
Is testicular cancer incidence in blacks increasing?
Authors: Van Den Eeden S K , Weiss N S
Published: November 2008

Using data collected by the Surveillance, Epidemiology and End Results Program (SEER) from 1973-84, we found no evidence of an increase in the incidence of testicular cancer in Blacks, in contrast to an increase of nearly 33 percent in Whites.
Lead exposure and radiator repair work.
Authors: Lussenhop D H , Parker D L , Barklind A , McJilton C
Published: November 2008

In 1986, the ambient air for lead in radiator repair shops in the Minneapolis-St. Paul metropolitan area exceeded the Occupational Safety and Health Administration (OSHA) action level in nine of 12 shops sampled by Minnesota OSHA. We therefore sought to determine the prevalence of lead exposure/toxicity in this industry. Thirty-five radiator shops were identified, 30 were visited, and 53 workers were studied. The mean blood lead level was 1.53 (range 0.24-2.80). Seventeen individuals had blood lead levels greater than or equal to 1.93 mumol/L (40 micrograms/dl). The mean zinc protoporphyrin level (ZPP) was 0.55 mumol/L (range 0.16-1.43). No single worksite or personal characteristic was a strong determinant of either blood lead or ZPP level.
A survival analysis of hospitalization among patients with acquired immunodeficiency syndrome.
Authors: Quesenberry C P , Fireman B , Hiatt R A , Selby J V
Published: November 2008

Survival analysis techniques were used in estimating lifetime inpatient utilization among patients diagnosed with acquired immunodeficiency syndrome (AIDS) using data on 863 members of the Kaiser Permanente Medical Care Program in the Northern California Region diagnosed with AIDS between January 1, 1981 and June 30, 1987. Using information on both deceased and living patients, we estimated means of 40.3 lifetime inpatient days and 3.3 hospitalizations among all AIDS patients. Those presenting with Kaposi's sarcoma experienced a mean of 7.6 fewer lifetime inpatient days than those presenting with Pneumocystis carinii pneumonia (95% confidence interval = .61, 14.6) and a mean of 11.0 (3.9, 18.6) fewer inpatient days than all other AIDS patients. Older patients had fewer hospital admissions than younger ones. Year of diagnosis does not appear to be related to lifetime utilization, and there is an indication that increased survival has been accompanied by decreased inpatient utilization intensity as measured on a per person-year basis. We recommend the use of survival analysis methods in the study of utilization among groups of patients with incomplete follow-up.