bluuebunny/crossref_metadata_2025 huggingface dataset:
The rural dental health program: the effect of a school-based, dental health education program on children's utilization of dental services.
Authors: Bentley J M , Cormier P , Oler J
Published: November 2008

Eighteen-hundred rural children ages five through thirteen were randomly assigned for dental treatment to a school-based practice, and to private practitioners in the community. Simultaneously, five of the nine public schools attended by the children offered an enriched program of dental education while the remaining schools taught the regular health education courses. All children participated in a school based fluoride program and their dental treatment was provided without charge. Data indicating how the children utilized dental services were collected over the three-year treatment phase of the study. Evidence from the third treatment year indicates that children assigned to the school based practice who also attended a school offering enriched dental health education used dental services on a more regular basis than children in the other three groups. Evidence obtained from log-linear modeling supports the hypothesis that dental health education had a positive effect on children's utilization of dental service.
Cancer surveillance in a remote Indian population in northwestern Ontario.
Authors: Young T K , Frank J W
Published: November 2008

The incidence and mortality rates of malignant neoplasms in an isolated Indian population in northwestern Ontario, Canada during the period 1972-81 were determined and age-adjusted comparisons with the Canadian national population computed. Indian men were at half the risk of developing and dying from cancer compared to Canadian men, while among women the risks were similar. The most outstanding feature was the high mortality and incidence rates of kidney cancer in both sexes (relative risks for mortality and incidence 7 to 13 times that for Canadians). Gallbladder cancer was of importance in females, similar to observations in other Amerindian groups. Low-risk sites among Indians included: lung in men, breast in women, and skin in both sexes. Other sites such as colon and prostate were common in both populations. Establishing baseline incidence and mortality data and continuing surveillance over a period of time in a well-defined, geographically isolated Native population undergoing rapid social change is of interest both epidemiologically and from the health service perspective. Further studies may elucidate risk factors, of which diet appears most responsible for the peculiar pattern observed.
Health promotion programs sponsored by California employers.
Authors: Fielding J E , Breslow L
Published: November 2008

A survey of California employers with more than 100 employees at one or more sites was undertaken to determine: 1) the nature and extent of health promotion activities; 2) plans for continuation and/or expansion of these activities; 3) plans for initiation of new activities; and 4) the relationship between reported health promotion activities and other characteristics of employers. Of 511 employers with whom interviews were attempted, 49 possible respondents could not be reached and 38 respondents refused to be interviewed, leaving 424 or 83 per cent. Almost one-half of the sites where interviews were conducted had fewer than 200 employees. A total of 332 (78.3 per cent) of employers offered one or more health promotion activities. The most frequent activities provided were accident prevention (64.9 per cent) and CPR (52.8 per cent) with other frequent programs including alcohol/drug abuse (18.6 per cent), mental health counseling (18.4 per cent), stress management (13.0 per cent), fitness (11.6 per cent), hypertension screening (10.1 per cent), and smoking cessation (8.3 per cent). Employers with at least one activity averaged 2.8 activities. The likelihood of having health promotion activities increased with company size. Establishment of new programs appeared to accelerate rapidly in recent years.
Problem drinking and the dimension of involvement with drugs: a Guttman scalogram analysis of adolescent drug use.
Authors: Donovan J E , Jessor R
Published: November 2008

Analyses of data from two nationwide surveys of high school students, one carried out in 1974 and the other in 1978, suggest that problem drinking may be seen as yet another step along an underlying dimension of involvement with both licit and illicit drugs. The dimension of involvement with drugs consists of the following levels: nonuse of alcohol or illicit drugs; nonproblem use of alcohol; marijuana use; problem drinking; use of pills (amphetamines, barbiturates, hallucinogenic drugs); and the use of "hard drugs" such as cocaine or heroin. The dimension possesses excellent Guttman-scale properties in both national samples as well as in subsamples differing in gender and ethnic background. The ordering of the levels of involvement was confirmed by the ordering of the alcohol-drug involvement groups based on their mean scores on measures of psychosocial proneness for involvement in problem behavior. The excessive use of a licit drug, i.e., problem drinking, appears to indicate greater involvement in drug use than does the use of an illicit drug, marijuana. This finding points to the importance of distinguishing between use and problem use of drugs in efforts to understand adolescent drug involvement.
Delay, stage of disease, and survival among White and Black women with breast cancer.
Authors: Gregorio D I , Cummings K M , Michalek A
Published: November 2008

Delay in obtaining treatment, stage of disease at diagnosis, and five-year survival were compared for 29 Black and 156 White females treated for breast cancer at Roswell Park Memorial Institute between 1957 and 1965. No statistically significant differences were found between Black and White patients in treatment delay although a tendency for longer delay among Blacks was noted. Race had little effect on survival when delay, stage of disease, and age were controlled.
Measurement of the primary care roles of office-based physicians.
Authors: Weiner J P , Starfield B H
Published: November 2008

The Baltimore City Primary Care Study examined the role of the urban office-based physician in the delivery of primary care. During the course of the study, questionnaires were completed by over 90 per cent of licensed physicians in the city, and data were collected from a sample of 16,000 patients. The study developed and assessed three approaches for the measurement of primary care. An empirical method was based upon information regarding the following characteristics of each visit: first contact visit, referral visit, specialized care visit, or principal care visit. A normative method was based on an assessment of the degree to which the practice provided care that was comprehensive, longitudinal, accessible, and family-centered. The third method used physicians' judgments as to the proportion of patients for whom they maintained ongoing responsibility for general medical care. All three methods produced the same categorization of different specialties as providing either primary, intermediate, or specialty care. As a group, primary care physicians included general and family physicians, pediatricians, and general internists. General surgeons and obstetrician/gynecologists have characteristics of both primary care and specialist care. All other physician groups have characteristics of specialists. Any of these methods or a combination of methods can be used to assess the extent to which the practice of a particular physician or group of physicians provides primary care.
Northeastern Ohio trauma study: I. Magnitude of the problem.
Authors: Barancik J I , Chatterjee B F , Greene Y C , Michenzi E M , Fife D
Published: November 2008

This study measured the incidence of cause-specific trauma in the Cleveland and Lorain-Elyria Standard Metropolitan Statistical Areas (SMSAs), population 2.2 million, as reported to hospital emergency departments (ED). Cases were selected according to a stratified probability sampling plan (N = 9268). The participating hospitals accounted for 97.6 per cent of 903,346 ED visits in 1977; 52 per cent of these visits were for trauma (ICDA-8 E800-E999). The trauma incidence rate was 197 per 1,000 population. The six leading causes of injury were: falls, 24.4 per cent; cut/piercing injury, 14.2 per cent; striking or struck by object, 13.8 per cent; motor vehicle collisions (MVC), 11.6 per cent; overexertion/strain, 8.2 per cent; and assault, 4.3 per cent. Only falls, MVCs, and assaults were leading causes of both injury and death. The injury incidence rates for vehicular crashes and assault were 1.4 and 3.8 times higher, respectively, than the official incidence rates for these SMSAs. These differences point to a significant underreporting of data needed for public health decision making. Because data were not collected on cases treated outside the participating hospitals, the incidence rates reported here represent a conservative estimate of the magnitude of the problem.
Tetanus and diphtheria immunity in an elderly population in Los Angeles County.
Authors: Weiss B P , Strassburg M A , Feeley J C
Published: November 2008

Fifty-four per cent of 246 subjects attending senior citizen centers (mean age 69), and 29 per cent of 111 convalescent hospital subjects (mean age 82) had protective levels of tetanus antitoxin (greater than or equal to 0.01 units/ml). Age-specific immunity levels were lower for females than males, and generally decreased with age. Forty-eight and one-half per cent of the senior citizen center subjects and 55.9 per cent of the convalescent hospital subjects had protective levels of diphtheria antitoxin (greater than or equal to 0.01 units/ml).
Differential mortality among alcoholics by sample site.
Authors: Combs-Orme T , Taylor J R , Robins L N , Holmes S J
Published: November 2008

In a sample of 1,289 alcoholics from four clinical sites, the overall mortality rate after five to eight years of observation was 22.0 per cent, 3.1 times the expected rate. Patients from the medical and surgical services of a general hospital suffered 4.0 times the rate of expected mortality and died most often of medical causes associated with alcoholism. Patients of the public alcoholism ward had a mortality rate 3.3 times the expected rate and died of causes often associated with low social class. Private psychiatric patients had a mortality rate 2.3 times the expected rate, and psychiatric outpatients had an excess mortality ratio of 2.1. Sample site must be considered as a variable in the study of mortality among alcoholics.
Adult cancer prevention in primary care: patterns of practice in Québec.
Authors: Battista R N
Published: November 2008

We conducted a survey of a representative sample of all primary care physicians in the province of Québec to ascertain their patterns of preventive practice with respect to cancer in four anatomical sites: breast, colon-rectum, cervix, and lung. A stratified random sample of 430 physicians in general practice was interviewed individually and weighted population estimates derived. Physicians report teaching breast self-examination to their patients (96 per cent), performing breast examination (99 per cent), taking pap tests routinely (91 per cent), and pursuing anti-smoking counseling (98 per cent). Very few of them report submitting their patients over 50 years of age to annual mammography (8 per cent) or checking for occult blood in stools in patients over 45 years of age (15 per cent). Many still use routine chest X-rays as an early detection measure of cancer of the lung (77 per cent); an estimated 41 per cent use sputum cytology for the same purpose. Preventive practices, when in-use, are carried out mainly in the context of major encounters with patients such as general check-ups. Less than 28 per cent of the population is estimated to be reached by this strategy for prevention. The unrealized potential for prevention through capitalizing on all encounters with primary care physicians is important, and should stimulate creative efforts to enhance preventive activities in medical practice.
Reported cigarette smoke values: a closer look.
Authors: Hoffmann D , Adams J D , Haley N J
Published: November 2008

Effects of mechanical compression of the filter tips and of blocking the air channels of a special filter design on the smoke yields of seven brands of commercial filter cigarettes were investigated. In addition, the influence of these variables on actual uptake of smoke constituents by smokers was studied with four subjects. Compression of filter tips produced major increases in smoke yields for the cigarette which features a filter tip with four longitudinal air channels at its periphery. Blocking of these air channels increased tar yields by 51 per cent, nicotine by 69 per cent, and carbon monoxide by 147 per cent. Subjects who smoked the cigarette with this special filter design tended to smoke fewer cigarettes per day than when they smoked cigarettes with perforated filter tips, yet their plasma cotinine levels were significantly higher. Blood pressure and pulse rate were markedly elevated after first exposure to smoke from the special filter cigarette, as were plasma nicotine levels. These results point out that individuals inhale different quantities of smoke constituents from cigarettes with reportedly similar smoke yields according to Federal Trade Commission methods. A redefinition of "average" smoking parameters readjustment of standard laboratory methodology are suggested.
The influence of observing carbon monoxide level on cigarette smoking by public prenatal patients.
Authors: Bauman K E , Bryan E S , Dent C W , Koch G G
Published: November 2008

From theories that suggest behavior is influenced by direct observation of personal and immediate consequences of the behavior, we hypothesized that public prenatal patients would reduce their smoking if they observed the level of carbon monoxide in their own alveolar air. An experimental design was used that involved 170 subjects, multiple measures of smoking, and data collection before the intervention and six weeks later. It was concluded that the intervention had either a small or no influence on cigarette smoking.
Is the period of rapidly declining adult mortality in the United States coming to an end?
Authors: Cooper R , Cohen R , Amiry A
Published: November 2008

Age-standardized death rates from all causes for persons age 35-74 fell 23 per cent, 1968-1979. The monotonic decline was interrupted by only one period of excess influenza mortality. In the late 1970s, however, the decline in mortality decelerated and no further decrease was observed, 1979-1981. The recurrence of epidemic influenza contributed significantly to this trend although it would appear that the underlying mortality pattern has begun to change.
WIC participation and pregnancy outcomes: Massachusetts Statewide Evaluation Project.
Authors: Kotelchuck M , Schwartz J B , Anderka M T , Finison K S
Published: November 2008

The effects of WIC prenatal participation were examined using data from the Massachusetts Birth and Death Registry. The birth outcomes of 4,126 pregnant women who participated in the WIC program and gave birth in 1978 were compared to those of 4,126 women individually matched on maternal age, race, parity, education, and marital status who did not participate in WIC. WIC prenatal participants are at greater demographic risk for poor pregnancy outcomes compare to all women in the same community. WIC participation is associated with improved pregnancy outcomes, including, a decrease in low birthweight (LBW) incidence (6.9 per cent vs 8.7 per cent) and neonatal mortality (12 vs 35 deaths), an increase in gestational age (40.0 vs 39.7 weeks), and a reduction in inadequate prenatal care (3.8 per cent vs 7.0 per cent). Stratification by demographic subpopulations indicates that subpopulations at higher risk (teenage, unmarried, and Hispanic origin women) have more enhanced pregnancy outcomes associated with WIC participation. Stratification by duration of participation indicates that increased participation is associated with enhanced pregnancy outcomes. While these findings suggest that birth outcome differences are a function of WIC participation, other factors which might distinguish between the two groups could also serve as the basis for alternative explanations.
Occurrence and impact of zoonoses in pet dogs and cats at US Air Force bases.
Authors: Warner R D
Published: November 2008

A descriptive epidemiologic study was conducted to quantitate the occurrence of zoonoses in pet animals (almost exclusively dogs and cats) at 30 Air Force bases in nine regions of the United States during 1980 and 1981. Reviews of reported cases of pet-associated zoonoses in humans at these bases were included. Occurrence of a zoonotic disease in dogs and cats was expressed as a ratio of reported cases per 100 rabies vaccinations (cs/Crv). Overall, the four zoonoses reported most frequently from these pets were hookworms, roundworms, tapeworms, and fleas. Annual ratios revealed geographic variations: for example, hookworms in dogs and cats in the southeast ranged from 12.3 to 9.4 cs/Crv; in the northern Great Plains, hookworms ranged from 0.9 to 0.4 cs/Crv. Dermatomycoses in the southeast ranged from 1.3 to 1.1 cs/Crv, and in Alaska from 0.3 to 0.2 cs/Crv. Quarterly zoonoses occurrence revealed seasonal variations in several regions. Reports of zoonoses in people from these bases indicated that five less frequent zoonoses in dogs and cats (Microsporum canis dermatomycosis, fleas, Sarcoptes scabiei var canis, Gram-positive bacterial infections, and rabies) presented greater acute threats to humans than did the four most frequent zoonoses reported from their pets.
Post-cesarean section insertion of intrauterine devices.
Authors: Chi I C , Zhou S W , Balogh S , NG K
Published: November 2008

Among 52 women who delivered by cesarean section in a medical center in Beijing, China and had either a Delta Loop or Delta T intrauterine device (IUD) inserted manually through the incision wound, the expulsion rates were significantly lower than among a comparable group of 147 women who both delivered and had the IUD inserted vaginally (4.1 versus 20.5 per 100 women at six months post-insertion). Since the cesarean delivery rate is increasing worldwide, we deem this preliminary finding important for postpartum contraception programs and urge further studies.
The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System.
Authors: Gallagher S S , Finison K , Guyer B , Goodenough S
Published: November 2008

This study describes the incidence of fatal and nonfatal injuries occurring in 87,022 Massachusetts children and adolescents during a one-year period. A surveillance system for injuries at 23 hospitals captured 93 per cent of all discharges for ages 0-19 in the 14 communities under study. Sample data were collected on emergency room visits, hospital admissions, and deaths for all but a few causes of unintentional injuries. The overall incidence was 2,239 per 10,000. The true incidence rates are probably higher than those reported. The ratio of emergency room visits to admissions to deaths was 1,300 to 45 to 1. Injury rates varied considerably by age, sex, cause, and level of severity. Age-specific injury rates were lowest for infants and elementary school age children and highest for toddlers and adolescents. The overall ratio of male to female injury rates was 1.66 to 1. Injuries from falls, sports, and cutting and piercing instruments had a high incidence and low severity. Injuries from motor vehicles, burns, and drownings had lower incidence, but greater severity. Results provide evidence that both morbidity and mortality must be considered when determining priorities for injury prevention. Current prevention efforts must be expanded to target injuries of higher incidence and within the adolescent population.
Senile dementia: public policy and adequate institutional care.
Authors: Brody E M , Lawton M P , Liebowitz B
Published: November 2008

Increasing costs of institutional care for the aged have occasioned a variety of government cost containment measures. People with senile dementia of the Alzheimer's type (SDAT) will be the principal group to suffer from cutbacks. SDAT patients are usually eligible for Intermediate Care Facilities (ICFs), rather than Skilled Nursing Facilities (SNFs) and therefore for lower reimbursement. Because such patients require heavy care and are the ones most likely to be Medicaid-dependent, nursing homes are being provided with incentives to prevent admissions. At the same time, community services to aid overburdened caregivers are grossly inadequate. Costs to other parts of the health systems are increased by backups in acute hospitals when nursing home beds cannot be found. SDAT and Medicaid eligibility are the principal causes of such "administratively necessary" backup days, but in the main Diagnostic Related Groups (DRGs) may close even that temporary resource. Thus, virtually all avenues of care are shrinking for those who need them most.
Automobile safety regulation: rebuttal and new data.
Authors: Robertson L S
Published: November 2008

A respecification of the regression model applied to additional data results in an estimate of about 45,000 lives preserved by regulations during 1975-78, similar to my previous estimates, and 105,000 lives during 1975-1982. The model allows for introduction of new regulations after 1968 and increased compliance. This result is similar to estimates obtained by several investigators using a variety of methods.
Treated incidence of mental disorders in a prepaid group practice setting.
Authors: Kessler L G
Published: November 2008

We followed a cohort of 7,666 individuals enrolled continuously for five years in a prepaid group practice in Columbia, Maryland. Incidence rates of all diagnosed mental disorders were estimated at approximately 3.7 per cent, lower for adolescents and children (about 3 per cent), higher for adult males aged 20-49 (4.3 per cent), and highest for adult females (5.8 per cent). Diagnoses are primarily for acute mental disorders and show a tendency to recur at fairly high rates.
Prevalence of overweight and weight loss behavior in a metropolitan adult population: the Minnesota Heart Survey experience.
Authors: Jeffery R W , Folsom A R , Luepker R V , Jacobs D R , Gillum R F , Taylor H L , Blackburn H
Published: November 2008

Data from two major surveys, conducted in the Minneapolis-St. Paul metropolitan area in 1973-74 and 1980-81, were used to estimate the prevalence of overweight. In 1980-81, weight history and the prevalence of dieting behaviors were also obtained. The prevalence of overweight was greater in the 1980-81 survey than in 1973-74. Increases were observed in all ages in women, but only in the 40-59 year age ranges in men. In 1980-81, dieting to control weight was widely reported by both sexes, even among those who had never been overweight. Of those who reported having been overweight, approximately one-third reported they had successfully reduced. More men than women reported having been overweight, but more women reported having dieted to lose weight. Formal weight reduction programs were used much more by women than men. Although most dieting attempts consisted of balanced, reduced calorie regimens, a significant percentage were "fad" types, whose nutritional safety may be questioned. Overall, contrary to findings based on clinical populations, weight reducing efforts often appear to be successful. Nevertheless, overweight remains a significant public health problem in this community.
United States cancer reporting laws: structure and utility.
Authors: Enterline J P , Kammer A , Gold E B , Lenhard R , Powell G C
Published: November 2008

Authorities in 52 United States jurisdictions were contacted to determine the existence and structure of cancer reporting laws and registration systems. Of the 52 US reporting areas examined; 30 (58 per cent) had a law requiring cancer reporting; 36 (69 per cent) of the reporting areas had at least one centralized cancer registry covering a geographically defined population. Among the 30 areas with cancer reporting laws, 26 had population-based registries; of the 22 areas with no cancer reporting law, 10 had a population-based registry. Among the 30 areas with cancer reporting laws, 12 required one reporting source (hospital, physician, laboratory), 11 required two reporting sources, four required three reporting sources, two areas gave the health department the authority to designate reporting sources, and one did not specify any reporting source. While 11 of the laws provided legal protection for both the data provider and the cancer patient, eight did not specify any such legal protection. While 13 laws made provisions for research uses of cancer reporting data, 17 did not do so. None of the laws had ever been legally tested at or beyond the State Appellate Court level.
Changing patterns in mental health service coverage within health maintenance organizations.
Authors: Levin B L , Glasser J H , Roberts R E
Published: November 2008

This 1982 national survey of all operational health maintenance organizations (HMOs) provides information on the current status of mental health services, benefits, costs, and utilization within HMOs, updating and augmenting a 1978 study. Approximately 94 per cent of the responding HMOs offered mental health service coverage; over one-half (54 per cent) offered alcohol and drug abuse service coverage. The present coverage benefits and utilization of mental health services within HMOs continue to reflect greater variability vis-a-vis other health services within HMOs. Over one-half (57 per cent) of the HMOs provided for 30 days of inpatient mental health coverage (per member per year). Three out of four (77 per cent) of the health plans provided for 20 ambulatory visits (per member per year). The mean mental health hospital utilization rate was 32 days (per 1,000 members per year). The mean mental health ambulatory utilization rate was 0.33 encounters (per member per year). Further studies should investigate the combined influence of organization characteristics, mental health service organization characteristics, and service benefits on the costs and utilization of HMO mental health services.
The role of skin absorption as a route of exposure for volatile organic compounds (VOCs) in drinking water.
Authors: Brown H S , Bishop D R , Rowan C A
Published: November 2008

Assessments of drinking water safety rely on the assumption that ingestion represents the principal route of exposure. A review of the experimental literature revealed that skin penetration rates for solvents are remarkably high, and that the stratum corneum is a less effective barrier to penetration than traditionally assumed. Based on published skin absorption rates, we used Fick's law (Jos = Kop delta Cos) to determine permeability constants for selected compounds. We then calculated dose per kilogram for nine different exposure situations and compared this to the oral dose per kilogram. We found that skin absorption contributed from 29-91 per cent of the total dose, averaging 64 per cent. Dose per kilogram body weight ranged from .0002 mg/kg-.18 mg/kg, with an average of .03 mg/kg. In weak aqueous solutions, flux of the solute is directly proportional to concentration. Laboratory approaches differ markedly from environmental exposures and can underestimate absorption. We conclude that skin absorption of contaminants in drinking water has been underestimated and that ingestion may not constitute the sole or even primary route of exposure.
Podiatry: critical issues in the 1980s.
Authors: Skipper J K , Hughes J E
Published: November 2008

As part of a larger study on the place of podiatry within the American health care system, this report suggests four critical issues facing podiatry as an independent health profession in the 1980s. The four concerns are: low visibility and credibility, lack of a strong professional self-image, struggle for more liberal hospital privileges, and the threat of loss of federal financial support.
The relationship between weight-height indices and the triceps skinfold measure among children age 5 to 12.
Authors: Michielutte R , Diseker R A , Corbett W T , Schey H M , Ureda J R
Published: November 2008

This study examines several weight for height indices--Quetelet's index W/H2, W/H, and Rohrer's index W/H3--for their appropriateness in estimating adiposity among young children. Data were obtained for a sample of 1,668 children age 5-12 residing in Forsyth County, North Carolina. Although W/H2 was found to be the most useful of these indices, the results suggest that no index, including the tricep skinfold measure, can be considered completely satisfactory in estimating adiposity among children.
The benefits of comprehensive care of hemophilia: a five-year study of outcomes.
Authors: Smith P S , Levine P H
Published: November 2008

Eleven of 22 federally funded Comprehensive Hemophilia Centers have collected data on outcomes, before and after five years of this program's existence. Improved health, decreased hospitalization, decreased absenteeism, and a decrease in the unemployment rate from 36 per cent to 13 per cent were accompanied by decreased costs of care. In this model of a chronic handicapping illness, the early application of comprehensive care is preferable to the previous emphasis on end-stage rehabilitative efforts.
What does hospice cost?
Authors: Birnbaum H G , Kidder D
Published: November 2008

This paper presents the preliminary results of the economic analyses of the National Hospice Study (NHS), mandated by the United States Congress to investigate the implications of including hospice services in Medicare. Data were collected over an 18-month period from approximately 4,000 patients receiving hospice and conventional terminal care in 25 hospices and 12 conventional care sites. Subsequent analysis may lead to changes in the specific results, and some of the differences may be due to confounding variables that cannot be adjusted for. According to these data, hospital based (HB) hospice costs per day are 44 per cent higher than home care (HC) hospice costs per day ($95 versus $66, respectively). In addition, per patient hospice costs are 24 per cent more for patients enrolled in HB than in HC hospices ($5,890 versus $4,758, respectively). The proportional difference between HB and HC in cost per patient is smaller than the cost per day difference due to the shorter average HB length of stay, 62.3 days compared to 72.5 days for HC. Regarding the cost savings of hospice compared to conventional care, HC hospice costs are lower than conventional care costs regardless of length of stay. However, HB costs seem lower than conventional care costs only for patients with lengths of stay less than two months. Hospice and conventional care patients appear to differ with respect to predisposition toward intensive health care utilization. When this difference is explored more thoroughly in subsequent analyses, the estimated cost differential between hospice and conventional care may change.
Willingness to pay for reduction in fatality risk: an exploratory survey.
Authors: Muller A , Reutzel T J
Published: November 2008

Willingness to pay surveys represent one method for measuring the benefit of health and life saving programs. However, the reliability and validity of survey responses to questions concerning the reduction of fatality or injury risks have been questioned. The results of a survey of 77 senior year undergraduate students show that reasonable appearing and consistent responses to willingness to pay questions on car crash protection can be obtained. However, the implied value of life was over 100 times greater for an unidentified life than for the respondent's own life. Also, no relationship was found between willingness to pay responses and variables reflecting respondent's rational considerations. These paradoxical results seem to be due to the mistaken assumptions that people employ rational considerations when responding to willingness to pay questions and that they are capable of matching their responses with the functional relationship (proportionality) underlying implied value of life calculations.
Race, socioeconomic status, and domestic homicide, Atlanta, 1971-72.
Authors: Centerwall B S
Published: November 2008

It has been assumed that, under comparable socioeconomic conditions, Blacks are more likely than Whites to commit violent acts. To test this assumption, 222 intra-racial domestic homicides (186 Black and 36 White victims) committed in Atlanta, 1971-1972, were subjected to analysis. A domestic homicide was defined as a criminal homicide committed in a residence by a relative or acquaintance of the victim. When Black and White populations were unmatched, the relative risk of intra-racial domestic homicide in Black populations was 5.8 (95 per cent C.I.: 4.3-8.0). When Black and White populations were matched for rates of household crowding, the relative risk of intra-racial domestic homicide in Black populations was no longer significantly elevated (relative risk = 1.2; 95 per cent C.I.: 0.7-2.0). Using rates of household crowding as an index of socioeconomic status, Atlanta Blacks were no more likely to commit domestic homicide than were Whites in comparable socioeconomic circumstances. Further research is needed to determine whether household crowding per se is a risk factor for domestic homicide, independent of socioeconomic status.
Dental health and public policy: the social impact of dental disease.
Authors: Reisine S T
Published: November 2008

This paper analyzes the potential of using measures of social function as health indicators in dental research. It discusses existing methodologies and presents findings from a cross-section of studies that adopt a social function perspective in the investigation of oral health status. While the literature in this area is small, much of the research concerns disability days associated with dental problems. The United States National Health Interview Survey reported in 1981 that 4.87 million dental conditions caused 17.7 million days of restricted activity, 6.73 million days of bed disability, and 7.05 million days of work loss. Other reports suggest that these data may be underestimates due to the National Health Survey's definition of disability days. Several other studies have found work loss to affect from 15 per cent to 33 per cent of samples studied resulting in many more work loss days than reported by the National Health Survey. Our study concludes that traditional measures of oral health status--such as decayed, missing, and filled teeth and the periodontal index--should be linked to measures of social outcome in order to place dental conditions within the broader context of health status in terms that are relevant to policy makers.
Sex education and sexual experience among adolescents.
Authors: Furstenberg F F , Moore K A , Peterson J L
Published: November 2008

This paper examines the association between sex education and adolescent sexual behavior. Data from the 1981 National Survey of Children show that 15- and 16-year-olds who have been exposed to sex education are less likely to be sexually experienced, and are neither more nor less likely to discuss sex with parents at home. Retrospective or longitudinal data are needed to more directly test the casual link between sex education and experience.
Caffeine-containing beverages and premenstrual syndrome in young women.
Authors: Rossignol A M
Published: November 2008

I evaluated the hypothesis that consumption of caffeine-containing beverages causes premenstrual syndrome by studying 295 college sophomores. Data about premenstrual syndrome and beverage consumption were collected by a self-administered questionnaire. Analysis of the data revealed that consumption of caffeine-containing beverages is strongly related to the presence and severity of premenstrual syndrome and that the effects exist for most of the premenstrual symptoms studied.
Age- and sex-specific prevalence of scoliosis and the value of school screening programs.
Authors: Morais T , Bernier M , Turcotte F
Published: November 2008

A prevalence study of idiopathic scoliosis was conducted among 29,195 children of a community health district in the province of Quebec. The study was designed to determine whether a permanent screening program for idiopathic scoliosis was justified. The prevalence of the condition among school children aged 8 to 15 years was 42.0 per 1,000 in the screened population, 51.9 per 1,000 among girls, and 32.0 per 1,000 among boys. The positive predictive value of the bending test is estimated as 42.8 per cent for scolioses of 5 degrees or more; it is only 6.4 per cent when curves of 15 degrees or more are considered. The average cost of finding one child with a scoliosis of 5 degrees or more is $194. Mass screening for idiopathic scoliosis does not seem to be justified in the present state of knowledge of the disease.
Utilization of case definitions and laboratory reporting in the surveillance of notifiable communicable diseases in the United States.
Authors: Sacks J J
Published: November 2008

In 1984, questionnaires were sent to the chief epidemiologist in all 50 states, Puerto Rico, and Washington, DC, with a 100 per cent response rate. There were substantial variations in case definitions of reportable diseases, criteria for counting as a case, and sources of surveillance. Laboratory reporting of any notifiable condition is mandated by 54 per cent of jurisdictions. These differences in ascertainment and case-counting practices constitute potential sources of error in national surveillance data on communicable diseases.
VMA mass screening program of neuroblastoma for infants in Nagoya City, Japan.
Authors: Kodama K , Nakata T , Ishii J , Mitani K , Tsunooka H , Masaoka A , Aoyama M
Published: November 2008

In Nagoya City, Japan, VMA mass screening for detection of neuroblastoma has been performed since 1977. Filter paper strips wetted with urine are mailed to a central laboratory. Positive tests are followed up by more definitive testing. Of the 20,053 urine samples of 6-month-old infants tested, January 1977 to March 1983, five asymptomatic infants with neuroblastoma have been discovered. All have been treated and are alive as of January 1984.
Driver licensing age and lifestyles of 16 year olds.
Authors: Preusser D F , Williams A F , Lund A K
Published: November 2008

The relationship of driver licensure rate differences to 16 year old lifestyles was assessed by surveying 15 and 16 year olds in New York, Michigan, and New Jersey. Michigan 16 year olds reported the highest rates of licensure (56 per cent), whereas New York (14 per cent licensed) and New Jersey (2 per cent licensed) had much lower rates. Teenagers in Michigan reported greater decreases in use of bicycles and reliance on parents and relatives for transportation but, for the most part, the differences in 16 year old licensure and mobility were not reflected in lifestyle differences.
Human and sylvatic Trypanosoma cruzi infection in California.
Authors: Navin T R , Roberto R R , Juranek D D , Limpakarnjanarat K , Mortenson E W , Clover J R , Yescott R E , Taclindo C , Steurer F , Allain D
Published: November 2008

In August 1982, a 56-year-old woman from Lake Don Pedro, California, developed acute Chagas' disease (American trypanosomiasis). She had not traveled to areas outside the United States with endemic Chagas' disease, she had never received blood transfusions, and she did not use intravenous drugs. Trypanosoma cruzi cultured from the patient's blood had isoenzyme patterns and growth characteristics similar to T. cruzi belonging to zymodeme Z1. Triatoma protracta (a vector of Trypanosoma cruzi) infected with T. cruzi were found near the patient's home, a trypanosome resembling T. cruzi was cultured from the blood of two of 19 ground squirrels (Spermophilus beecheyi), and six of 10 dogs had antibody to T. cruzi. A serosurvey of three groups of California residents revealed antibody to T. cruzi by complement fixation in six of 237 (2.5 per cent) individuals living near the patient and in 12 of 1,706 (0.7 per cent) individuals living in a community 20 miles northeast of the patient's home, but in only one of 637 (0.2 per cent) blood donors from the San Francisco Bay area. This is the first case of indigenously acquired Chagas' disease reported from California and the first case recognized in the United States since 1955. This investigation suggests that transmission of sylvatic Trypanosoma cruzi infection to humans occurs in California but that Chagas' disease in humans is rare.
Effects of unemployment on mental and physical health.
Authors: Linn M W , Sandifer R , Stein S
Published: November 2008

From a prospective study of the impact of stress on health in 300 men assessed every six months, men who became unemployed after entering the study were compared with an equal number, matched for age and race, who continued to work. Psychological and health data after unemployment were compared between the two groups by multivariate analysis of variance and covariance. After unemployment, symptoms of somatization, depression, and anxiety were significantly greater in the unemployed than employed. Large standard deviations on self-esteem scores in the unemployed group suggested that some men coped better than others with job-loss stress. Further analysis showed those with higher esteem had more support from family and friends than did those with low self-esteem. Furthermore, unemployed men made significantly more visits to their physicians, took more medications, and spent more days in bed sick than did employed individuals even though the number of diagnoses in the two groups were similar.
Economic development and occupational health in Latin America: new directions for public health in less developed countries.
Authors: Michaels D , Barrera C , Gacharná M G
Published: November 2008

Occupational Health is increasingly recognized as an area of importance in Latin American public health. In the agricultural sector of the region, the concentration of arable land into large holdings devoted to the production of export crops has resulted in the formation of a large migrant work force and greatly increased use of pesticides. The manufacturing sector of Latin America has grown rapidly in size and importance. Throughout the continent, increasing numbers of workers are employed in high-hazard industrial jobs. Limited studies of occupational disease in agriculture, mining, and manufacturing suggest that there is a high prevalence of work-related illness in the populations at risk. Trade unions are generally weak, and the high rate of unemployment and underemployment render occupational health a low priority for many workers. Engineering controls and personal protective equipment are unknown or inadequate in many industries, and there is a shortage of trained occupational health professionals in the region. Steps are being taken by many Latin American governments to begin to address this problem. Needed are: increased worker and professional training; a uniform set of exposure standards; control of multinational marketing and usage of hazardous substances; the development of technical equipment appropriate for local use and increased research on occupational exposure in populations in less developed countries.
Hospital falls: a persistent problem.
Authors: Morgan V R , Mathison J H , Rice J C , Clemmer D I
Published: November 2008

During a 22-month period in 1981-82, 250 falls were recorded at a 152-bed acute care specialty hospital in a United States metropolitan area. Rates were highest for patients age 65 years and older and for patients admitted with mental disorders. Patients who had fallen once had a subsequent fall rate of 91.7 per 1,000 patients compared to an overall rate of 18.7 for first falls. Half the falls occurred in or enroute to the private bathroom attached to each room. Only three falls resulted in injury sufficient to prolong hospital stay.
Nutritional status of men attending a soup kitchen: a pilot study.
Authors: Laven G T , Brown K C
Published: November 2008

Nutritional status and socioeconomic characteristics of 49 men attending a soup kitchen in a residential neighborhood of Birmingham, Alabama were determined by interview, anthropometry and laboratory assays. Laboratory or anthropometric evidence of nutrient deficiency was present in 94 per cent of the subjects. Deficiency of ascorbate (63 per cent), folate (35 per cent), and thiamin (29 per cent) was higher in these men than in either patients or presumably healthy adults. Since soup kitchen meals provided insufficient vitamin C and folate, additional sources of these nutrients should be provided.
A prospective study of swimming-related illness. II. Morbidity and the microbiological quality of water.
Authors: Seyfried P L , Tobin R S , Brown N E , Ness P F
Published: November 2008

A prospective cohort epidemiological-microbiological study was carried out at 10 beaches in Ontario, Canada. Lake water and sediment samples collected at the beaches were analyzed for fecal coliforms, fecal streptococci, heterotrophic bacteria, Pseudomonas aeruginosa, and total staphylococci. Mean fecal coliform levels in the surface water of the lakes were within accepted guidelines. Bacterial densities were found to be approximately 10 times higher in the sediment than in the corresponding surface water samples. Morbidity among swimmers was shown to be related to staphylococcal counts, to fecal coliform levels, and, somewhat less strongly, to fecal streptococcal counts. Total staphylococci appeared to be more consistent indicators for predicting total morbidity rates among swimmers.
A seroprevalence survey of hepatitis B markers among Haitians in a southwest Florida farming community.
Authors: Malison M D , Kane M A , Johnson J M , Schable C A , Gridley M J , Polkowski J
Published: November 2008

We determined the seroprevalence of hepatitis B virus markers among 123 Haitian mothers and children in a southwest Florida farming community. Fifty-five per cent of mothers had one or more markers including two who were HBsAg positive. Only seven (10 per cent) children had markers; none were HBsAg positive. Pregnant Haitian women should be screened for HBsAg and infants born to those who are positive should receive immunoprophylaxis. Medical, dental, and laboratory workers caring for Haitian patients should also receive hepatitis B vaccine.
Some properties of saliva cotinine measurements in indicating exposure to tobacco smoking.
Authors: Di Giusto E , Eckhard I
Published: November 2008

The studies reported herein were designed to investigate some properties of saliva cotinine measurements in indicating exposure to tobacco smoke. Such measurements were found to be minimally affected by saliva flow rate or time since smoking as well as being sensitive to a low level of exposure to tobacco smoke. Results supported the view that the saliva cotinine assay is the most useful currently available method for objectively measuring exposure to tobacco smoke.
Evaluation of pharmacists' compliance with the Poison Prevention Packaging Act.
Authors: Dole E J , Czajka P A , Rivara F P
Published: November 2008

Sixty pharmacies in Memphis, Tennessee were given two prescriptions at seven-day intervals to determine whether the medicine would be dispensed in child-resistant containers (CRCs) as required by federal law. One prescription included the statement "dispense in child-resistant container." Without such a statement, 77 per cent of the pharmacies dispensed the drug in a CRC; the prescription with the reminder elicited a compliance rate of 75 per cent. Factors such as cost of the prescription and time required to fill the prescription had no discernible effect on local pharmacy practice to dispense the prescription in a CRC.