bluuebunny/crossref_metadata_2025 huggingface dataset:
Male urethritis in King County, Washington, 1974-75: II. Diagnosis and treatment.
Authors: Hinds M W , Gale J L
Published: November 2008

Methods of diagnosing and treating male urethritis in King County. Washington in 1974-1975 were examined by a retrospective postal survey, records review, and prospective surveillance. A Gram-stained smear of urethral discharge was used by 86 per cent of private physicians and urethral culture by 56 per cent. Only 5 per cent made a diagnosis without laboratory aid. U.S. Public thealth Service gonorrhea treatment regimens were used by 54-81 per cent of private physicians. Over 90 per cent of physicians not in private practice (emergency room and housestaff) used smear, cultures, and recommended treatment regimens. The Gram-stained smear appeared to be under-utilized and the urethral culture overutilized. There is a significant need for physician education regarding recommended treatment for male gonorrhea.
A factor analytic approach to an effective lung function screening protocol.
Authors: Azen S P , Linn W S , Hackney J D , Jones M P
Published: November 2008

Interrelationships among simple indices of pulmonary function derived from flow-volume curves and single-breath nitrogen tests were investigated by performing a factor analysis on data obtained from a generally healthy office working population (n = 388). Smoking was regarded as the major contribution to pulmonary dysfunction. Delta nitrogen was largely independent of all other measures, while flow-volume measures, including flow rates at high and low lung volumes, were highly intercorrelated but largely independent of closing volume and closing capacity. Delta nitrogen was most affected by smoking in both sexes. Scores derived from flow-volume measurements and from closing-volume measurements were significantly different, on the average, between male smokers and male nonsmokers. The methods and results presented prove to be useful in the design of protocols for effective pulmonary testing of large populations.
Children's views of health: a developmental study.
Authors: Natapoff J N
Published: November 2008

Two hundred and sixty-four first, fourth, and seventh grade children were asked to define health, state what it felt like to be healthy and not healthy, and to give criteria they would use to judge another person's health status. A chi square analysis was done to compare differences for age, sex, intelligence, and socioeconomic status. Results indicated that children saw health as a positive attribute which enabled them to participate in desired activities, that a person was healthy if he could do what he wanted to do, and that health and illness were two different cncepts rather than on a continuum as is often cited in the literature. Mental health was not considered as part of being healthy except by a few of the oldest children. There were both qualitative and quantitative changes with age which were consistent with theories of concept development. It is recommended that future studies be conducted with both adults and health workers. (There is some evidence that consumers and health professionals do not have the same ideas about health.)
Skin color, ethnicity, and blood pressure I: Detroit blacks.
Authors: Harburg E , Gleibermann L , Roeper P , Schork M A , Schull W J
Published: November 2008

Census areas in Detroit were ranked for their stress scores based on instability (e.g., crime, marital break up) and socioeconomic status. Four areas were selected for detailed study: 1) high stress, population predominantly black, 2) white, 3) low stress, population predominantly black, 4) white. A sample was drawn from each area of persons of the predominant race, 25-60 years old, married and living with spouse, and having relatives in the Detroit Area. Nurses interviewed such persons; three blood pressure readings were taken during the first half-hour of medical history, and skin color was rated. Results show that darker skin color, for black males especially, is related to higher pressure, independently of nine control variables (e.g., age, weight, socioeconomic status, etc.). However, younger black males (25-39 years of age) in high stress areas had higher pressure than counterparts in low stress areas, regardless of skin color and relative weight; for older black males (40-59 years of age) darker skin color was correlated with higher pressure, regardless of relative weight or stress area. For 35 blacks whose fathers were from the West Indies, pressures were higher than those with American-born fathers. These findings suggest that varied gene mixtures may be related to blood pressure levels and that skin color, an indicator of possible metabolic significance, combines with socially induced stress to induce higher blood pressures in lower class American blacks.
Aquatic vegetation and water pollution control: public health implications.
Authors: Dinges R
Published: November 2008

Results obtained from pilot studies and the operation of a plant scale treatment facility located at the Williamson Creek Wastewater Treatment Plant at Austin, Texas, demonstrate that culture of the water hyacinth Eichhornia crassipes in shallow earthen basins is effective in the removal of algae, fecal coliform bacteria dn deleterious impurities from wastewater stabilization pond effluent. Stabilization ponds followed by hyacinth culture constitute an economical, low energy treatment system which reduces significantly those potential health hazards associated with wastewaters. Harvested hyacinths represent a useful product which could be converted into compost, or used directly as a soil amendment.
Planning and developing a prehospital mobile intensive care system in an urban setting.
Authors: Pascarelli E F , Katz I B
Published: November 2008

A suggested model for the development of an urban based prehospital emergency care system is described. Factors considered in the planning and development include: 1) demand for services, projected and actual; 2) analysis of costs; 3) design and maintenance of the delivery system; and 4) establishment of the evaluation mechanisms. Over one year's experience and 1,144 mobile intensive care unit (MICU) calls in a densely populated urban setting with over 500,000 persons are reported. During the peak 8-hour period, predetermined dispatch categories were employed to activate one MICU operating in conjunction with three conventional ambulances. This partial conversion imparted MICU capability to the entire system at an 11 per cent increase in the ambulance budget. MICU calls averaged 4.5 per 8-hour peak shift and took 45 minutes each.
A method for selecting criteria to evaluate medical care.
Authors: Wagner E H , Williams C A , Greenberg R , Kleinbaum D , Wolf S , Ibrahim M A
Published: November 2008

This study tests a questionnaire method for eliciting process criteria for medical care appraisal. The questionnaire was sent to national samples of family physicians, pediatricians, and pediatricians specializing in infectious diseases asking their opinions about various clinical actions in 125 clinical situations concerning respiratory infection in infants. Five hundred twenty-four (54%) physicians returned completed questionnaires. Questionnaire responses favored the performance of a majority of actions and opposed very few. Opinions concerning individual actions, particularly diagnostic tests and treatments, varied widely depending upon the clinical situation presented. A second questionnaire sent one year later indicated that the opinions expressed in the first questionnaire remained stable over time, especially if the initial opinion favored performance of the action. Comparison of the questionnaire responses and medical records of a group of practitioners demonstrated that only 55% of actions favored in a practitioner's questionnaire appeared in his records. Although the questionnaire method appears to be a feasible, specific, and reliable means of identifying clinical opinion, there remains considerable discordance between opinion as expressed in the questionnaire and recorded clinical practice.
Assessing the timeliness of ambulatory medical care.
Authors: Steinwachs D M , Yaffe R
Published: November 2008

The extent to which individuals receive necessary and timely care (timeliness) is one dimension of the process of care that has received little attention. Timeliness can be viewed as the interaction between patient care-seeking behavior and system accessibility,both of which are expected to influence the effectiveness of medical care. This study examines the provider's assessment of the timeliness of care received in the department of medicine of a prepaid program. Provider judgments are found to be significantly related to the provider's perception of problem severity and to the patient's prognosis. Anaylsis of patient-reported problem status one week later are also found to be related to the timeliness of care. Implications of timeliness assessments for monitoring and improving access and care-seeking behavior are discussed.
The animal bite epidemic in Baltimore, Maryland: review and update.
Authors: Berzon D R
Published: November 2008

In 1972 in Baltimore, a peak of 7,436 reported animal bites (8/1,000 population) was reached. The bite rate for the most susceptible age group (5-14) was 19 per 1,000 population. By 1976, only 5,092 bites were reported, 5.8 per 1,000 total population, and 12.3 per 1,000 population 5-14 years of age. The decline in the number and rates of animal bites is believed due in large measure to the actions taken by the Bureau of Animal Control: education and publicity, increased fees and penalties, and enforcement of the new laws and regulations.
School achievement: risk factor in teenage pregnancies?
Authors: Hansen H , Stroh G , Whitaker K
Published: November 2008

A review of live births, spontaneous fetal deaths, and induced abortions in residents of Upstate New York ages 12--17 shows that pregnancy rates increased during the period 1971 through 1974. This increase was attributable to pregnancies ending in induced abortion while live births remained relatively stable. White teenagers had a higher frequency of induced abortions than non-white teenagers, but induced abortions increased more rapidly among non-whites over the four-year period. School achievement as reflected by highest grade completed at the end of pregnancy was related to risk of pregnancy as well as to election of induced abortions. The distribution of pregnancies by age and school grade suggests that an increased risk of pregnancy is associated with below average but also, and unexpectedly, with above average grade attainment. Incongruity of age and school achievement may identify groups of teenage schoolgirls with special needs for preventive programs.
Health consequences of the snow disaster in Massachusetts, February 6, 1978.
Authors: Glass R I , O'Hare P , Conrad J L
Published: November 2008

On February 6, 1978, the largest New England blizzard of the century struck eastern Massachusetts. On request, four days later, the Center for Disease Control provided epidemiologic assistance. On-site disaster assistance provided decision-makers with immediate health surveillance information useful in helping the area return to normal. No outbreaks of infectious diseases and no significant increase in the number of deaths were observed in the week following the blizzard. Some of the deaths which occurred immediately after the blizzard might have been prevented if traffic had been banned earlier.
Failure of indicator bacteria to reflect the occurrence of enteroviruses in marine waters.
Authors: Gerba C P , Goyal S M , LaBelle R L , Cech I , Bodgan G F
Published: November 2008

The results of several studies conducted along the upper Texas Gulf coast, where a substantial amount of quantitative virological data were collected, are compared to bacteriological indicators and other environmental factors on a statistical basis. Variables common to all these studies were anlayzed by multivariate regression. Although multivariate analysis indicated that the number of viruses detected in water was related to rainfall, salinity, and total coliforms in the water, the amount of variation in the number of viruses accounted for by these factors was not large enough to make them good predictors. Enteroviruses were detected 43 per cent of the time in recreational waters considered acceptable as judged by coliform standards, and 44 per cent of the time when judged by fecal coliform standards. Enteroviruses were detected 35 per cent of the time in waters which met acceptable standards for shellfish-harvesting. Our failure to correlate the occurrence of enteroviruses in marine waters with indicator bacteria, and the frequent occurrence of enteroviruses in water which met current bacteriological standards, indicates that these standards do not reflect the occurrence of enteroviruses, and perhaps other human pathogenic viruses, in marine waters.
Attitudes of women and men physicians.
Authors: Heins M , Hendricks J , Martindale L , Smock S , Stein M , Jacobs J
Published: November 2008

Attitudinal data obtained from interviewing random samples of women and men physicians in metropolitan Detroit indicated that women were generally more liberal and egalitarian than men. Older women were more liberal/egalitarian than older men while younger men were closer in attitudes to younger women. Within specialities, women and men physicians frequently held similar attitudinal scores; however, controlling for age, sex accounted for more variation than did specialty. A weighted combination of variables which together most significantly discriminated between age and sex subgroups pointed to a sensitivity dimension. This was stronger in the women; yet men demonstrating a similar sensitivity were found in almost every age and specialty grouping. Although younger men physicians are less conservative than older men physicians, both younger and older women physicians demonstrated strong liberalism/egalitarianism.
The stability of health and illness behavior: results from a 16-year follow-up.
Authors: Mechanic D
Published: November 2008

In 1977, 302 young adults who were among 350 children first studied in 1961 responded to a questionnaire related to their health and illness behavior. Ten types of adult health and illness behaviors and orientations are examined including seat belt use, smoking, exercise, drinking, and risk taking. These patterns are associated only to a modest degree, and patterns of health and illness behavior appear to have low levels of continuity over a 16-year period (correlations varying from .02 to .20).
A comparison of age-specific burn injury rates in five Massachusetts communities.
Authors: MacKay A , Halpern J , McLoughlin E , Locke J , Crawford J D
Published: November 2008

We measured burn incidence rates for residents of five Massachusetts cities. The data set included all non-occupational burn injuries and cases of smoke inhalation requiring treatment on an inpatient or an outpatient basis in a hospital, occurring between October 1, 1973 and September 30, 1976. Rates of burn injuries by age, and by burn type were calculated for each city. Examination of the data revealed large differences in the magnitude of the age-specific incidence rates among cities but remarkably similar patterns of rates for each city. Differences in the economic status among the cities and among census tracts within the cities appeared to explain a large proportion of the variation in the crude burn rates. A similar specificity of certain types of burn injury by age and sex was common to each city. These findings can be used by health education specialists to design and implement burn prevention programs in these communities appropriate for those individuals at highest risk.
Validation of students' self-reported cigarette smoking status with plasma cotinine levels.
Authors: Williams C L , Eng A , Botvin G J , Hill P , Wynder E L
Published: November 2008

Plasma cotinine levels were measured in 137 students (ages 14 to 17 years), as an independent validation of self-reported cigarette smoking status. Ninety-five per cent of the students who reported daily cigarette smoking had detectable cotinine levels. In contract, only 2 per cent of students who reported that they never smoke cigarettes had detectable levels of plasma cotinine. Results suggest that adolescents can report accurately on their smoking status if sufficient assurance of confidentiality is stressed.
Diabetes among the three affiliated tribes: correlation with degree of Indian inheritance.
Authors: Brosseau J D , Eelkema R C , Crawford A C , Abe T A
Published: November 2008

The health records of all members of the Three Affiliated Indian Tribes of Fort Berthold, North Dakota were reviewed in order to define the extent of diabetes in this population. Full-inheritance Indians age 35 years and older have a known prevalence rate of diabetes of 22.3 per cent; persons between half- and full-inheritance Indian have a rate of 14.9 per cent; persons less than one-half Indian inheritance have a rate of 4.1 per cent, the same as whites living on this reservation. Below age 35, diabetes is rare among all racial subgroups.
Side Effects of Diphtheria-Tetanus Toxoid in Adults
Authors: Middaugh John P.
Published: November 2008

During a mass diphtheria-tetanus immunization campaign in November 1975, more than 220,000 doses of diphtheria-tetanus toxoid, adult type were administered to adults throughout Alaska. In Anchorage, where more than 87,000 doses were given, a survey was conducted to determine the frequency of side effects. Postcard questionnaires were mailed to 2,000 randomly selected Anchorage residents; 467 questionnaires were returned by the post office as undeliverable, and 697 questionnaires were completed and returned. A follow-up survey was done of a random sample of the 836 non-responders.

Of those responding, 57.8 per cent reported at least one reaction to the toxoids. The most frequent side effects were sore arm (42.7 per cent), swelling at the site of injection (34.8 per cent), and itching (24.2 per cent). Serious side effects occurred less frequently—swelling of the arm below the elbow (1.1 per cent) and abscess or infection (0.7 per cent). Of those vaccinated, 0.5 per cent saw a physician. There were no statistically significant differences in reaction rates by age group, except for sore arms. The jet injector produced more arm swelling at the site of injection, hives, and itching. More women than men reported adverse reactions, especially sore arm, swelling at the site of injection, and itching. Fear of adverse side effects should not preclude mass vaccination of adults. (Am. J. Public Health (69:246-249,1979.)
Impacts of the medical malpractice slowdown in Los Angeles County: January 1976.
Authors: James J J
Published: November 2008

The Los Angeles County (California) physician strike of January 1976 resulted in a partial withdrawal of physician services. Among recorded impacts were a $17.5 million loss in hospital revenues and an $8.5 million pay loss for hospital employees. Several surveys revealed no evidence of a significant impact on the general public in finding medical care. Analysis of emergency room visits and paramedical ambulance calls showed no significant increases during the strike. County mortality statistics for the strike were not affected. Eighty-eight fatalities among 2,171 patients transferred during the strike were analyzed; a Case Attributable Mortality Probability generated on 21 cases selected for final review by a five-physician multispecialist panel indicated that 29 per cent of the Attributable Mortality could be ascribed to the strike itself and 71 per cent to ongoing "patient dumping" from private sector to County hospitals. Even if sample attributable mortality rates were generalized to overall county deaths, the resultant figures are below the estimated range of 55 to 153 deaths that did not occur because of the number of elective operations not performed secondary to the strike.
Interviewer effects in psychiatric epidemiology: a study of medical and lay interviewers and their impact on reported symptoms.
Authors: Riessman C K
Published: November 2008

Utilizing data from a field study of psychiatric disorder, the study examined sex differences in patterns of response to interviewers in contrasting status positions. The dependent variables in the analysis were mean scores on nosological scales measuring three dimensions of symptomotology identified in a factor analysis. Independent variables were interviewer status and respondent sex. Three categories of interviewers were randomly assigned to administer a structured interview schedule. Strong interaction effects between interviewer status and respondent sex were noted. Women disclosed significantly fewer symptoms to the high status interviewers (identified physicians), whereas males reported most symptoms to this group. Theoretical explanations derived from the literature on sex roles were offered regarding the origins of women's response to high status figures.
Treatment of women in childbirth: implications for family beginnings.
Authors: Danziger S K
Published: November 2008

This paper presents an ethnographic analysis of a woman's interaction with staff members during the early stage of labor, focusing on the factors that shape the childbirth experience. The observational data were gathered in several hospitals as part of a study of the medical context of childbearing. The paper presents a model of naturalistic inquiry into the transition to parenthood. Nurses and physicians are found to offer arbitrary, uniform, and often inappropriate responses to birthing women that may inhibit well-being.
Evaluation of the relationship of sodium in drinking water and toxemia of pregnancy.
Authors: Jones R F , Cech I I , Holguin A H , Hardy R J
Published: November 2008

This study is a retrospective case comparison analysis of the relationship of water-borne Na+ and toxemia of pregnancy as a part of a continuous investigation at our facility on the role of various water constituents in human chronic disease. Five hundred thirty-seven toxemic pregnant women delivered at Jefferson Davis Hospital, Houston, Texas, during 1976 were matched by age, race, obstetrical history, and month of delivery to 537 non-toxemic controls. Sodium concentration in each patient's drinking water was derived, based on her address, from earlier prepared maps of sodium distribution in Houston's water supplies. Paired t-tests were performed to compare the Na+ levels, which varied from 19 to 250 mg/l in water supplies of cases and controls. Odds ratio analysis was used to test for the presence of a gradient in occurrence of toxemia in parallel with the gradient of Na+. No significant impact of water-borne Na+ in the indicated range was observed. Further studies incorporating still higher ranges are contemplated.
Policies toward medical technology: the case of electronic fetal monitoring.
Authors: Banta H D , Thacker S B
Published: November 2008

Electronic fetal monitoring (EFM) is an example of a medical technology that has been widely accepted since its introduction in the mid-1960s. However, review of the literature does not provide convincing evidence of EFM efficacy, and four recent, controlled, clinical trails show little if any benefit in terms of preventing death or long-term disability of the baby. Public and private policies have largely acted to encourage use of EFM, and none have acted to slow or prevent its spread. This need for mechanisms to assure the timely evaluation of new medical technologies before they are accepted as a medical practice has led to a new medical devices program in the Food and Drug Administration, consensus development groups at the National Institutes of Health, and congressional legislation to establish a new National Center for Health Care Technology.
Practice settings and prescribing profiles: the simulation of tension headaches to general practitioners working in different practice settings in the Montreal area.
Authors: Renaud M , Beauchemin J , Lalonde C , Poirier H , Berthiaume S
Published: November 2008

The purpose of this study was to determine whether physicians practicing in one type of setting manage a medical problem differently than those practicing in another type of setting. The investigation took the form of presenting physicians with a simulated case of tension headache with a history going back three years, for which diazepam had been taken daily for the past year. Four simulated patients (aged 20-23) visited a stratified random sample of 111 general practitioners practicing in health centers funded by government (CLSCs) and in private group practice clinics in the Montreal area. Fifty-one per cent of group practice physicians recommended therapy rated as "inadequate" compared to 25 per cent in CLSCs; in addition, the data show significant differences between CLSC and group practice physicians in performing various aspects of the clinical examination. Alternative explanations for the observed differences are discussed.
Patient compliance with antihypertensive medication.
Authors: Hershey J C , Morton B G , Davis J B , Reichgott M J
Published: November 2008

Self-reported medication taking compliance behavior of 132 high blood pressure patients was analyzed using an expanded version of the health belief model. Subjects were selected through random sampling procedures from regular hypertension program sessions at a large urban hospital. A questionnaire was constructed to measure the model components, and interviews were conducted with each patient. Bivariate analysis showed that control over health matters, dependence on providers, perceived barriers, duration of treatment, and others' nonconfirming experience were significantly related to compliance (p < .05). Log-linear multivariate analysis revealed that three of these five variables--control over health matters, perceived barriers, and duration of treatment--contributed independently to patient compliance. Self-reported medication taking was significantly related to blood pressure control (p < .02). These data provide the basis for developing interventions for providers to facilitate the medication taking behavior of clinic patients.
The impact of a pediatric practice on hospital admissions in a rural area.
Authors: Osgood K , Bunch G P , Shonick W
Published: November 2008

The establishment of a two-man pediatric practice in a rural area of New Mexico was followed by a decrease in hospital admissions of children and an increase in average length of stay. While other factors may have been involved, The reliance of the study region's children on pediatricians rather than family physicians for primary care may have contributed to the decline in hospitalization. Further research on the relationship between source of care and hospital utilization is needed.
A comparison of the level of care predictions of six long-term care patient assessment systems.
Authors: Foley W J , Schneider D P
Published: November 2008

Six patient assessment systems that have explicit decision rules for replicating team judgments on level of care patient placement were selected for analysis. The six were selected because of their origin, logic or decision diversity, and their ability to be programmed on a computer (i.e., explicit decision rules). Six hundred seventy-nine patient descriptor profiles were collected on patients currently in New York State nursing homes. These patients were then "placed" by level of care for each assessment system. The probability of agreement of placement between pairs of assessment systems ranges from 38 per cent to 91 per cent. Among SNF (skilled nursing facility) patients only, the level of agreement drops as low as 39 per cent. Uniformity of placement criteria is, in fact, the exception rather than the rule. A patient's placement is quite dependent on both his/her state of residence and his/her health status. The effect of differences in placement decisions has major implications for the patients being placed and for the cost of LTC (long-term care). This analysis was confined to systems that had a well developed set of guidelines--the situation is likely to be even more variable where guidelines are vaguely stated.
Data for long-term care planning by Health Systems Agencies.
Authors: Brody S J , Masciocchi C
Published: November 2008

Planning for the long-term care and support of the elderly is uncoordinated. Although several agenices are charged with the planning role, the Health Systems Agency (HSA) has emerged as the major planning unit. Long-term care planning is currently based on skilled nursing facility (SNF) utilization rates. This limited focus is inappropriate and the data are inconclusive. Population-based data, including levels of functioning, age, and living arrangements of those in need of extended support would provide a more useful approach. Sources for such information are suggested. The HSA should commit itself to population-based planning with special consideration of the mental health needs of the SNF residents, and the function of nursing home auspice. All types of health and social services should be taken into account in planning a system for long-term care and support.
How many die? A set of demographic estimates of the annual number of infant and child deaths in the world.
Authors: Gwatkin D R
Published: November 2008

Estimates concerning the annual number of infant and child deaths in the world range from around 15 million to well over 30 million. Although infant and child mortality is difficult to measure with any precision, the range of uncertainty can be narrowed considerably through the application of standard demographic techniques to readily available population data. A set of estimates based on the most recent and authoritative data compilations points to a range of from 12-13 million to about 17-18 million infant and child deaths annually during the late 1970s, with an average of around 15 million. On the basis of what is known about mortality conditions of the world today, a figure much larger than the 17-18 million at the high end of this range would be extremely difficult to substantiate.
Los Angeles airport noise and mortality--faulty analysis and public policy.
Authors: Frerichs R R , Beeman B L , Coulson A H
Published: November 2008

A well-publicized investigation in Los Angeles showed a higher mortality rate in 1970-1971 among residents in a high-noise area near Los Angeles International Airport than in a low-noise control area. The authors of this report attributed the difference to the effects of jet aircraft noise. A reanalysis of the data did not confirm the original results. Once the confounding effects of age, race, and sex were taken into account by direct and indirect methods of standardization, there was little difference in the mortality experience of the airport and control areas. Adjusted mortality rates due to all causes, cardiovascular diseases, or cerebrovascular disease did not differ appreciably between the two areas and were nearly identical to those of Los Angeles County during 1970.
Methodological issues in health care surveys of the Spanish heritage population.
Authors: Aday L A , Chiu G Y , Andersen R
Published: November 2008

This paper examines national survey data on access to medical care to explore methodological issues associated with conducting health care surveys of Spanish-heritage persons. These include problems of identifying and sampling such groups, achieving respondent cooperation, designing valid interview protocols, and controlling biases that may result from the cultural specificity of the concepts being studied. The findings suggest that more attention should be given to the following in designing health care surveys of Spanish-heritage individuals: cultural and economic heterogeneity of "Spanish-heritage" grouping, validity studies of health care utilization, and yea-saying tendencies related to health care attitude items. Given that there is a paucity of information available on methodological problems associated with health care surveys of Spanish-heritage persons, these analyses should serve to inform researchers of issues to be taken into account in designing such studies and to suggest useful hypotheses to explore in evaluating the validity of social survey data on minority (especially non-English speaking) populations' health care practices.
Psychiatric diagnoses as reported to Medicaid and as recorded in patient charts.
Authors: Schwartz A H , Perlman B B , Paris M , Schmidt K , Thornton J C
Published: November 2008

This study was undertaken to address the issue of data reporting in the psychiatric sector of New York City Medicaid, the largest publicly financed psychiatric health care delivery system in the nation. Six outpatient psychiatric clinics in general hospitals, four with residency programs, and all 29 free standing psychiatric clinics in New York City were audited as were charts from 120 psychiatrists billing for 10 or more Medicaid patients. Overall agreement of chart and Medicaid diagnoses was 91% for psychiatrists, 79% for free-standing clinics, and 77% for hospital clinics. Agreement varied by diagnosis. Bias in the Medicaid diagnosis of Neurosis was found at the four hospitals having residency programs. Patients most likely to be misreported as having minimizing diagnoses were male, or between the ages of 18 and 29 years, or to have a prior history of psychiatric treatment. The errors in reporting in each provider sector would pose a methodological obstacle if Medicaid data were used in epidemiological research.
Effectiveness of a mailed reminder on the immunization levels of infants at high risk of failure to complete immunizations.
Authors: Young S A , Halpin T J , Johnson D A , Irvin J J , Marks J S
Published: November 2008

The Ohio Department of Health initiated a program of mailing an immunization reminder to the mothers of six-month-old children predicted to be at high risk of failure to receive vaccinations based on birth certificate information. The evaluation results indicated a 50% gain in immunizations amongst children whose parents received the letter when compared with those not receiving the letter.
Asthma and air pollution in the Los Angeles area.
Authors: Whittemore A S , Korn E L
Published: November 2008

Daily asthma attack diaries of 16 panels of asthmatics residing in the Los Angeles area were collected by the Environmental Protection Agency for 34-week periods during the years 1972-1975. There data are examined here for the relationship between daily attack occurrence and daily levels of photochemical oxidant, total suspended particulates, minimum temperature, relative humidity, and average wind speed. A separate multiple logistic regression is used for each panelist's attack data. Variables representing the presence or absence of attack on the preceding day, as well as day of week and time since the start of the study, are included in the regressions. The most significant predictor of attacks was the presence of an attack on the preceding day. On the average, the panelists tended to have increased attacks on days with high oxidant and particulate pollution, on cool days, and during the first two months of the study. Panelists' attack propensity also differed by day of week; in particular they had more attacks on Saturdays (the last day of the weekly reporting period) than on Sundays. Each panelist's regression coefficients are classified according to age, sex, hay fever status, and self-assessed attack precursors; this classification is used to examine subgroups among the panelists with high coefficients corresponding to the above factors.
Health status of cable splicers with low-level exposure to lead: results of a clinical survey.
Authors: Fischbein A , Thornton J , Blumberg W E , Bernstein J , Valciukas J A , Moses M , Davidow B , Kaul B , Sirota M , Selikoff I J
Published: November 2008

The results of a cross-sectional clinical field survey of 90 telephone cable splicers are presented. Despite the rare occurrence of clinically overt lead poisoning among cable splicers, the observed prevalence of symptoms was 29% for lead-associated central nervous system symptoms and 21% for gastrointestinal symptoms. These two groups of symptoms were directly related to zinc protoporphyrin (ZPP) levels but no relationship was found between them and blood lead concentrations. Only 5% of the workers had significantly elevated blood lead levels (greater than 40 microgram/100ml). Because of the intermittent lead exposure encountered in this trade, individuals were identified with "normal" blood lead levels associated with "elevated" zinc protoporphyrin concentrations, indicating the difference in biological significance between exposure-(blood lead) and biological-response tests (ZPP). Suggestion is made that both types of diagnostic tests be utilized in the medical surveillance of lead-exposured workers.
Illness prevention and health promotion services provided by nurse practitioners: predicting potential consumers.
Authors: Pender N J , Pender A R
Published: November 2008

A cross-sectional survey of 388 residents of a northern Illinois county explored the relationships between psychosocial and behavioral characteristics of the population and intentions to use illness prevention and health promotion services provided by nurse practitioners. Results of the study indicated that 61 per cent of the respondents intended to use one or more of the nurse-provided services when they became available within the community. The best predictors of intention to use the services were: expressed interest in use of prevention and health promotion services for direct pay, education beyond high school, and a low level of life stress. Intentions to use the services did not differ significantly between individuals with a regular personal physician and those without a regular physician. These data were interpreted as indicating a need within the community for nurse practitioners to provide prevention and health promotion care. The findings also supported the complementary roles of nurses and physicians in providing health care to ambulatory populations.
Effect of coverage on use of an HMO alcoholism treatment program, outcome, and medical care utilization.
Authors: Hayami D E , Freeborn D K
Published: November 2008

Two-hundred-fifty alcoholics were randomly assigned to a full benefit of 50 per cent copayment group before entering an HMO (health maintenance organization) alcoholism treatment program. Data on use of treatment services, use of medical care services, and drinking behavior were collected for one year after intake. The medical care utilization and drinking behavior data were compared to data for the year before intake. The two coverage groups were comparable on sociodemographic characteristics and baseline drinking behavior, but the full benefit group tended to have higher utilization rates for the year prior to intake and significantly more treatment contracts than those having the 50 per cent copayment requirement. Changes in use of medical care services were similar in both groups. Both payment groups improved, but the full benefit group tended to be somewhat more improved. Regression analysis supported the relative unimportance of extent of alcoholism coverage in affecting outcome and subsequent medical care utilization.
Cancer in the Third World: Bangladesh 1980.
Authors: Lynch H T , Rahim M A
Published: November 2008

Bangladesh exemplifies all of the problems of Third World countries: poverty, hunger, reduced longevity, and an illiteracy rate hovering at more than 80 per cent. The current status of oncology in Bangladesh was surveyed. Staff physicians, deans, medical students, nurses, and patients at six of the eight medical college hospitals, seven village hospitals, and a large private hospital provided background and clinical material. There are no medical or surgical oncologists in Bangladesh. The eight qualified radiation therapists are able to provide only meager diagnostic potential or radiation therapy with their antiquated equipment. Pathology service was severely handicapped by understaffing and outmoded equipment. With a relatively modest investment, epidemiological studies could be undertaken and an effective cancer control program established since oral and cervical cancers are common.
The child-adolescent blood pressure study: I. Distribution of blood pressure levels in Seventh-Day-Adventist (SDA) and non-SDA children.
Authors: Harris R D , Phillips R L , Williams P M , Kuzma J W , Fraser G E
Published: November 2008

Distribution of systolic and diastolic blood pressures (measured with an automated blood pressure recorder) of two large groups of children-3,159 from Seventh-Day Adventist (SDA) schools and 4,681 from non-SDA schools-are reported. They boys and girls were from four different ethnic groups and attended grades one through 10 in 29 Southern California schools. The analysis of the data failed to show significant differences in mean blood pressure levels between the two groups of children at all ages, despite marked differences in life-style between the two groups, and despite the fact that adults from the two population groups have marked differences in mortality from diseases associated with elevated blood pressure. A comparison between boys and girls showed significantly higher trends in mean systolic blood pressure for boys after age 12. Inter-ethnic comparisons of blood pressure revealed that Black children of both sexes had slightly higher mean blood pressure levels at all ages.
Repeal of mandated premarital tests for syphilis: a survey of state health officers.
Authors: Felman Y M
Published: November 2008

Statistics on the mandated premarital tests for syphilis (PMSTs) in the United States for the year 1978 were analyzed to determine whether this program is epidemiologically and economically effective. Overall close to four million PMSTs contributed 1.27 per cent of the tests found positive for infectious syphilis in the 44 states where PMSTs are mandated. Of all mandated PMSTs, only one in 8,461 was positive for infectious syphilis. In a companion study, venereal disease control officers were canvassed for their opinions regarding the retention or abolition of the mandatory tests. Out of 44 states which mandated tests, only 13 respondents favored retention while 31 found the program unsatisfactory, preferred abolition or changes, or were undecided.
Social factors associated with breast self-examination among high risk women.
Authors: Howe H L
Published: November 2008

A sample of 708 women, who by sociodemographic characteristics are high risk to breast cancer, were interviewed by telephone about their knowledge, attitude, and practice of breast self-examination (BSE). Reported frequency of BSE, knowledge of BSE and breast cancer, and BSE attitude in this sample are comparable to data reported by others. This report analyzes the associations between the frequency of a breast self-examination practice and the variables, age, education, detection confidence, social influence, modesty, preventive health behaviors, and memory. These relationships are discussed and several new hypotheses are proposed. Since the data were collected retrospectively, they are not able to describe causal relationships.
Comparison of body proportions of one-year-old Mexican-American and Anglo children.
Authors: Kautz L , Harrison G G
Published: November 2008

The body proportions of 95 Anglo and Mexican-American children aged 48-56 weeks in the Women, Infants, and Children (WIC) Special Supplemental Food Program were determined by use of multiple anthropometric measurements. Ethnic differences were several and collectively define the Mexican-American child as being greater in weight-for-length than the Anglo child with greater chest and thigh circumferences, subscapular skinfolds, and estimated body fat.
Children's health in families with cigarette smokers.
Authors: Bonham G S , Wilson R W
Published: November 2008

Recent studies have indicated higher rates of certain respiratory conditions among children who live in households with adults who smoke cigarettes. This paper analyzes data from the 1970 National Health Interview Survey. Children in families with no smokers had an average of 1.1 fewer restricted-activity days and 0.8 fewer bed-disability days per year than did children in families with two smokers. Children in families with one smoker were in between. Acute respiratory illness accounted for the difference in disability days among children in families with different smoking characteristics. Family smoking was also measured by the combined number of cigarettes smoked by adults; children in families which smoked 45 or more cigarettes a day had 1.9 more restricted activity days and 0.9 more bed-disability days due to acute respiratory conditions than did children in families who did not smoke cigarettes. The age of the child, the number of adults in the family, the education of the family head, and the family income were all controlled and did not eliminate the relationship between children's health and family smoking.
Parasitic disease control in a residential facility for the mentally retarded: failure of selected isolation procedures.
Authors: Thacker S B , Kimball A M , Wolfe M , Choi K , Gilmore L
Published: November 2008

Asymptomatic infection with either Entamoeba histolytica or Giardia lamblia was found in 60 per cent of the residents in an institution for the mentally retarded one year after eradication of these parasites. The residents were then segregated into infected and noninfected groups and drug therapy was again successfully undertaken. The two groups remained separated except during periods of play. A one-year follow-up showed that both study and control groups were equally infected. The failure of segregation was confounded by patient age and infection with nonpathogenic parasites.
Criteria, norms and standards of quality: what do they mean?
Authors: Donabedian A
Published: November 2008

Quality assessment requires specification of: 1) a set of phenomena that are usually attributes of either process or outcome; 2) a general rule of what constitutes goodness; and 3) a precise numerical statement of what constitutes acceptable or optimal goodness with respect to each of these phenomena. The terms "criteria," "norms," and "standards," as currently employed, do not correspond well with these three components, but they could be used effectively if the basic distinctions were understood. Alternatively, one could use, as corresponding terms, "elements," "parameters," and "standards." The terms "criteria," and "norms" would then be redefined and be available to be used more uniformly, while "standards" could be further differentiated according to method of measurement, configuration, level, and flexibility.
Occupational information on death certificates: a survey of state practices.
Authors: Kaminski R , Brockert J , Sestito J , Frazier T
Published: November 2008

A national survey was conducted in 1979 to determine the extent to which state and local vital registration offices coded and stored occupational information reported on death certificates. This survey found that 11 states routinely code occupation, seven routinely code industry, and six have coded occupation and/or industry on a limited basis. State and federal cooperation is needed to facilitate increased use of mortality data for environmental and occupational health research.