bluuebunny/crossref_metadata_2025 huggingface dataset:
Dioxins and dibenzofurans in adipose tissue of the general US population and selected subpopulations.
Authors: Orban J E , Stanley J S , Schwemberger J G , Remmers J C
Published: November 2008

OBJECTIVES. The Environmental Protection Agency's National Human Adipose Tissue Survey (NHATS) was conducted in fiscal year (FY) 1987 to (1) estimate average concentrations of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) in the adipose tissue of humans in the US population, (2) identify differences in average concentrations among subpopulations, and (3) compare average concentrations with those from the FY 1982 NHATS. METHODS. Population estimates of the average levels of PCDDs and PCDFs were established on the basis of 865 human adipose tissue specimens collected in FY 1987. Average levels among subpopulations were compared. RESULTS. The average concentration of 2,3,7,8-tetrachlorodibenzo-p-dioxin in the adipose tissue of the US population was 5.38 pg/g, increasing from 1.98 pg/g in children under 14 years of age to 9.40 pg/g in adults over 45. The effect of age was significant for nine compounds. Regional differences in the levels of 2,3,4,7,8-pentachlorinated dibenzofurans were statistically significant, but there were no significant differences associated with sex or race. CONCLUSIONS. The survey provides a baseline of average levels of PCDDs and PCDFs in the adipose tissue of humans in the US population.
AIDS risk reduction and reduced HIV seroconversion among injection drug users in Bangkok.
Authors: Des Jarlais D C , Choopanya K , Vanichseni S , Plangsringarm K , Sonchai W , Carballo M , Friedmann P , Friedman S R
Published: November 2008

Human immunodeficiency virus (HIV) seroconversion was studied in a group of 173 injection drug users in Bangkok, Thailand, who had been previously tested for HIV and were interviewed and retested in the fall of 1989. Ten percent of the group had seroconverted. Two factors protected against HIV seroconversion: having stopped sharing injection equipment in response to the acquired immunodeficiency syndrome (AIDS) and having a regular sexual partner. The association between self-reported deliberate risk reduction and reduced HIV seroconversion among persons continuing to inject illicit drugs indicates that injection drug users can change their behavior in response to AIDS and will accurately report on the behavior change, and that the changes can protect against HIV infection.
Screening for insecticide overexposure under field conditions: a reevaluation of the tintometric cholinesterase kit.
Authors: McConnell R , Magnotti R
Published: November 2008

A semiquantitative tintometric field kit has been used in the developing world for almost 30 years to measure whole blood cholinesterase levels in persons exposed to organophosphate pesticides. The validity of this screening kit was evaluated among 79 workers heavily exposed to organophosphates by comparison with a reference assay for erythrocyte cholinesterase. Overall correlation between the two methods was good. However, either sensitivity or specificity of the tintometric kit was less than 75% for each of the three tintometric categories commonly used to define the limit of normal. Because baseline erythrocyte cholinesterase levels were not available for this population, the true sensitivity and specificity of the tintometric assay may be even lower.
Homicide, handguns, and the crime gun hypothesis: firearms used in fatal shootings of law enforcement officers, 1980 to 1989.
Authors: Wintemute G J
Published: November 2008

OBJECTIVES. Many policies seeking to limit handgun violence rest on the largely untested "crime gun hypothesis," which holds that subclasses of handguns differ in their risk for use in violent crime. This study tests that hypothesis for handguns used in homicides of law enforcement officers and describes the population of homicide-involved handguns. METHODS. A cross-sectional study was done of civilian (criminal) handguns used in homicides of law enforcement officers from 1980 to 1989. Life tables were generated for each year's cohort of new handguns to estimate gun-years at risk, analogous to person-years, for rate and relative risk calculations. RESULTS. Four hundred thirty-five deaths involved 428 civilian handguns. Revolvers were at greater risk than pistols. For both, risk was lowest for .22-caliber handguns. Risk was greatest for .32-caliber pistols and .38-caliber revolvers. Forty-six percent of handguns had a barrel length of 3 in or less. CONCLUSIONS. Subclasses of handguns differ substantially in their risk for use in fatal shootings of law enforcement officers. Such epidemiological data may be useful in formulating efforts to prevent these and similar instances of firearm violence.
Using physician correspondence and postcard reminders to promote mammography use.
Authors: Taplin S H , Anderman C , Grothaus L , Curry S , Montano D
Published: November 2008

OBJECTIVES. In a health maintenance organization that mails letters to women recommending that they schedule mammograms, we conducted a randomized trial to evaluate simple methods of increasing the use of screening mammography. METHODS. Using a 2 x 2 factorial design, we tested the effects of (1) mailing the recommendation letter from each woman's primary care physician rather than from the program director and (2) sending a subsequent reminder postcard. RESULTS. Sending a reminder postcard nearly doubled the odds that women would get mammograms within 1 year (participate). The letter from the woman's personal physician had no effect. Attending a clinic more than 45 minutes from the screening center, being a current smoker, or being in fair or poor health were negatively associated with subsequently obtaining a mammogram. The odds of participation doubled if women had had previous mammograms. CONCLUSIONS. When preceded by written recommendations to schedule mammograms, reminder postcards effectively increased participation. Future randomized trials to promote use of screening mammography should compare interventions with a reminder condition.
The effects of recall on estimating annual nonfatal injury rates for children and adolescents.
Authors: Harel Y , Overpeck M D , Jones D H , Scheidt P C , Bijur P E , Trumble A C , Anderson J
Published: November 2008

OBJECTIVES. This study used a recent national population survey on childhood and adolescent non-fatal injuries to investigate the effects of recall bias on estimating annual injury rates. Strategies to adjust for recall bias are recommended. METHODS. The 1988 Child Health Supplement to the National Health Interview Survey collected 12-month recall information on injuries that occurred to a national sample of 17,110 children aged 0 through 17 years. Using information on timing of interviews and reported injuries, estimated annual injury rates were calculated for 12 accumulative recall periods (from 1 to 12 months). RESULTS. The data show significantly declining rates, from 24.4 per 100 for a 1-month recall period to 14.7 per 100 for a 12-month recall period. The largest declines were found for the 0- through 4-year-old age group and for minor injuries. Rates of injuries that caused a school loss day, a bed day, surgery, or hospitalization showed higher stability throughout recall periods. CONCLUSIONS. Varying recall periods have profound effects on the patterns of childhood injury epidemiology that emerge from the data. Recall periods of between 1 and 3 months are recommended for use in similar survey settings.
Factors associated with the use of violence among urban black adolescents.
Authors: DuRant R H , Cadenhead C , Pendergrast R A , Slavens G , Linder C W
Published: November 2008

OBJECTIVES. The purpose of this study was to examine social and psychological factors associated with the use and nonuse of violence among Black adolescents living in a community with a high level of violent crime. METHODS. Adolescents (n = 225, 44% male) 11 to 19 years of age living in or around nine housing projects in an urban area were administered an anonymous questionnaire. RESULTS. Self-reported use of violence was associated with exposure to violence and personal victimization, hopelessness, depression, family conflict, previous corporal punishment, purpose in life, self-assessment of the probability of being alive at age 25, and age and was higher among males. CONCLUSIONS. These data support the hypothesis that exposure to violence is associated with adolescents' self-reported use of violence. However, adolescents with a higher sense of purpose in life and less depression were better able to withstand the influence of exposure to violence in the home and in the community.
Aggression and fighting behavior among African-American adolescents: individual and family factors.
Authors: Cotten N U , Resnick J , Browne D C , Martin S L , McCarraher D R , Woods J
Published: November 2008

OBJECTIVES. This study examined the extent to which individual and family factors are associated with aggression and fighting behavior among African-American middle school adolescents. METHODS. Four hundred thirty-six African-American boys and girls from two middle schools in a predominantly low-income North Carolina school system were surveyed and their school records examined. Information was collected concerning students' aggression levels, school fighting behavior, school suspensions for fighting, attitudes toward violence, perceptions of their families' attitudes toward violence, weapon-carrying behavior, and sociodemographics. Multivariate analyses were employed to predict the students' aggression levels, fighting behavior, and school suspensions. RESULTS. Factors related to the individual adolescents, such as gender, age, weapon-carrying behavior, and attitudes toward violence, were associated with students' reports of aggression and fighting behavior. Factors related to family and school were associated with school suspension for fighting. CONCLUSIONS. This study suggests that violence prevention programs set in our elementary and middle schools may reduce aggression and fighting among our youth. School teachers and public health practitioners are encouraged to work together in understanding and preventing adolescent violence.
Traumatic child death and documented maltreatment history, Los Angeles.
Authors: Sorenson S B , Peterson J G
Published: November 2008

OBJECTIVES. Child abuse is a presumed but largely untested risk factor for child homicide. This research investigated the social and child protective service history of child homicide victims. METHODS. A pairwise matched case-control design was used to assess documented child maltreatment as a risk factor for homicide vs unintentional injury death. Homicide victims aged 0 to 14 years were identified through Los Angeles Police Department case summaries. Control subjects (children who died of an unintentional injury) were matched to case subjects (children who died from homicide) by age, sex, race/ethnicity, and date of death. Case and control subjects were linked with county service records to determine any known history of maltreatment. RESULTS. A total of 220 children were homicide victims during 1978 through 1987 in the city of Los Angeles. Only one in six children who died (of homicide or unintentional injury) or his/her family was known to county social or child protective services prior to the death. Recorded history of child protective services was associated with homicide victimization (adjusted odds ratio = 3.40, 95% confidence interval = 1.25, 9.27). CONCLUSIONS. Current service systems need assistance in identifying and protecting children at high risk of homicide.
A cost-benefit analysis of legislation for bicycle safety helmets in Israel.
Authors: Ginsberg G M , Silverberg D S
Published: November 2008

Legislation requiring bicyclists to wear helmets in Israel will, over a helmet's 5-year duration (assuming 85% compliancy, 83.2% helmet efficiency for morbidity, and 70% helmet efficiency for mortality), save approximately 57 lives and result in approximately 2544 fewer hospitalizations; 13,355 and 26,634 fewer emergency room and ambulatory visits, respectively; and 832 and 115 fewer short-term and long-term rehabilitation cases, respectively. Total benefits ($60.7 million) from reductions in health service use ($44.2 million), work absences ($7.5 million), and mortality ($8.9 million) would exceed program costs ($20.1 million), resulting in a benefit-cost ratio of 3.01:1.
Adolescent occupational injuries requiring hospital emergency department treatment: a nationally representative sample.
Authors: Layne L A , Castillo D N , Stout N , Cutlip P
Published: November 2008

Data from a nationally representative sample of emergency departments for the 6-month period July through December 1992 were used to examine nonfatal occupational injuries sustained by adolescents aged 14 through 17 years. There were 679 occupational injuries, corresponding to an estimated 37,405 injuries nationwide. Males constituted 65.8% of the injury victims. The injury rate for males was 7.0 per 100 full-time employees, compared with 4.4 for females. Lacerations to the hand or finger accounted for 25.6% of all injuries. The majority of injuries occurred in retail trades (53.7%), which also had the highest rate (6.3 per 100 full-time employees). Seventy-one percent of the injuries in retail trade occurred in eating and drinking establishments.
Risk behavior and correlates of risk for HIV infection in the Dallas County Household HIV survey.
Authors: McQuillan G M , Ezzati-Rice T M , Siller A B , Visscher W , Hurley P
Published: November 2008

OBJECTIVES. The Dallas County study of a proposed national household seroprevalence survey was designed to assess the feasibility of conducting a national survey and to estimate the prevalence of human immunodeficiency virus (HIV) and hepatitis B virus infection for Dallas County. Risk behavior data were collected and correlated with HIV infection. METHODS. Participants in this survey represented a probability sample of the county. A self-administered questionnaire on demographic characteristics and HIV risk behavior was completed and a blood sample was obtained. RESULTS. Of the 1724 adults eligible for the survey, 1446 completed the questionnaire and 1374 provided a blood sample. The prevalence estimates were 0.4% for HIV and 7.3% for hepatitis B virus. A strong relationship was observed between HIV and hepatitis B status and risk behavior. CONCLUSIONS. In this study population, receptive anal intercourse and increasing numbers of male partners had the strongest correlation with the prevalence of HIV and hepatitis B virus infection in men. The high level of risk reporting for individuals positive for HIV or hepatitis B suggests that survey participants who engage in risk behaviors were willing to report those behaviors.
A community-based heart disease intervention: predictors of change.
Authors: Winkleby M A , Flora J A , Kraemer H C
Published: November 2008

OBJECTIVES. This paper presents a prospective examination of sociodemographic, psychosocial, and physiologic characteristics associated with positive change in cardiovascular disease risk factors during a 6-year multiple risk factor intervention study. METHODS. Data are presented on 221 women and 190 men (aged 25 through 74 years) who participated in four cohort surveys (1979 through 1985). A signal detection model was used to identify baseline variables that best divide the sample into subgroups on the basis of the probability of positive change in a composite risk factor score. RESULTS. Sixty-nine percent of the respondents showed a positive change in risk factor score during the intervention. The subgroup with the highest proportion of positive changers (83%) was composed of older adults (> 55 years) with the highest perceived risk, highest health media use, and highest blood pressure and cholesterol levels. The subgroup with the lowest proportion of positive changers (42%) was the least educated, was the most likely to be Hispanic, and had the lowest health knowledge and self-efficacy scores. CONCLUSIONS. The differing composition of subgroups who respond or do not respond to community cardiovascular disease interventions illustrates the need to develop specific interventions that target different age, socioeconomic, and cultural subgroups.
Outbreak and sporadic egg-associated cases of Salmonella enteritidis: New York's experience.
Authors: Morse D L , Birkhead G S , Guardino J , Kondracki S F , Guzewich J J
Published: November 2008

Since 1985, egg-associated Salmonella enteritidis has emerged as a major cause of foodborne disease. New York State has been especially affected, with 47 documented egg-associated S enteritidis outbreaks involving 2279 cases and 10 deaths. Individual case reports of salmonella have also increased 56%, and sporadic cases of S enteritidis have been shown to be associated with egg consumption. Further educational and regulatory activities are needed to control this continuing public health problem.
Temporal trends in the socioeconomic gradient for breast cancer mortality among US women.
Authors: Wagener D K , Schatzkin A
Published: November 2008

Temporal trends in breast cancer mortality among US women were examined for 1969 through 1989 by age, race, and county-level socioeconomic status (SES). The mortality ratio for high- relative to low-SES counties declined significantly among women 25 to 44, 45 to 64, and more than 65 years of age, respectively, from 1.13 to 0.96, 1.32 to 1.19, and 1.48 to 1.26. The narrowing of mortality occurred among Whites and, to a lesser extent, Blacks. A relative increase in either breast cancer incidence among women in lower SES counties or improved survival among women in higher SES counties (reflecting greater use of screening and treatment) could account for this relative worsening of breast cancer mortality among lower SES women in lower SES counties.
Access to family planning services and health insurance among low-income women in Arizona.
Authors: Kirkman-Liff B , Kronenfeld J J
Published: November 2008

This paper uses 1984 and 1989 Arizona survey data to explore the importance of insurance coverage for access to family planning services. In Arizona, Medicaid was provided through the Arizona Health Care Cost Containment System, a managed care model. Family planning was not provided in 1984 but had been added by 1989. Low-income women were 2.3 times more likely to receive services in 1989 than in 1984. Women in the system were 60% more likely to have received services. To improve access, health reform proposals should explicitly include family planning in managed care benefits packages.
The trials of Hanna Porn: the campaign to abolish midwifery in Massachusetts.
Authors: Declercq E R
Published: November 2008

The case of Hanna Porn affords an opportunity to examine how the laws that led to the abolition of midwifery in Massachusetts evolved and were applied to the midwife whose case set the state legal precedent. Mrs Porn served primarily a Finnish-Swedish clientele of wives of laborers. The outcomes of the births she attended appear to have been positive, and she maintained a neonatal mortality rate of less than half that of local physicians. She also repeatedly defied court orders to stop practicing. Her case exemplifies the efforts that occurred nationally to abolish midwifery in the United States.
The effects of early education intervention on maternal employment, public assistance, and health insurance: the infant health and development program.
Authors: Brooks-Gunn J , McCormick M C , Shapiro S , Benasich A , Black G W
Published: November 2008

OBJECTIVES. The purpose of this study was to test whether early education intervention influences maternal employment, education, fertility, and receipt of public assistance and health insurance. METHODS. The Infant Health and Development Program is a randomized trial of the efficacy of early education on the outcomes of 985 low-birthweight, premature children. Families in eight sites received either pediatric follow-up and referral (follow-up only group) or pediatric services plus early intervention services (intervention group) for the first 3 years of the child's life. RESULTS. Mothers in the intervention group were employed more months and returned to the work force earlier than those in the follow-up only group. Fertility and education were not associated with treatment. Mothers who had some college education received more months of public assistance in the intervention group compared with the follow-up only group. Mothers who were employed received more public assistance and public health insurance in the intervention group compared with the follow-up only group, when maternal employment was controlled. CONCLUSIONS. Findings are discussed in terms of the recent emphasis on two-generational programs directed to providing health, welfare, and child care services to young children and their families.
The size of mortality differences associated with educational level in nine industrialized countries.
Authors: Kunst A E , Mackenbach J P
Published: November 2008

OBJECTIVES. This study addresses the question of whether inequalities in premature mortality related to educational level differ among countries. METHODS. Data on mortality by educational level were obtained from longitudinal studies from nine industrialized countries. The data referred to men between 35 and 64 years of age. The follow-up periods occurred between 1970 and 1982. The size of mortality differences associated with educational level was measured by means of two inequality indices, both based on Poisson regression analysis. RESULTS. Inequalities in mortality are relatively small in the Netherlands, Sweden, Denmark, and Norway and about two times as large in the United States, France, and Italy. Finland and England and Wales occupy intermediate positions. The large inequalities in mortality in the United States and France can be attributed in part to large inequalities in education in these countries. CONCLUSIONS. The international pattern found in this study was also observed in a comparison that used occupation as the socioeconomic indicator. Differences between countries in levels of inequality in mortality may be partially explained by the countries' different levels of egalitarian social and economic policies.
Why did black life expectancy decline from 1984 through 1989 in the United States?
Authors: Kochanek K D , Maurer J D , Rosenberg H M
Published: November 2008

OBJECTIVES. The objective of this study was to partition the change in US life expectancy into those major causes of death and age groups that contributed most to the decline in life expectancy for Black males and females and to the increase in life expectancy for White males and females in the period from 1984 through 1989. METHODS. By means of a life table partitioning technique, the positive and negative contributions of age and cause of death to changes in life expectancy were estimated. RESULTS. Causes contributing most to the decrease in life expectancy for Black males included human immunodeficiency virus (HIV) infection (< 5 and 20-69 years of age) and homicide (1-4 and 10-34 years of age); for Black females the causes included HIV infection (< 5 and 20-59 years of age) and cancer (65-79 and > or = 85 years of age). CONCLUSIONS. Mortality trends between the two major race groups in the United States diverged sharply, and without precedent, during the late 1980s. A description of these trends in terms of contributions to change in life expectancy may help us better analyze and interpret changes in the health of these groups and may contribute to a better allocation of resources for research, education, and public health programs.
Behavioral risk factors: a comparison of Latinos and non-Latino whites in San Francisco.
Authors: Pérez-Stable E J , Marín G , Marín B V
Published: November 2008

OBJECTIVES. The purpose of the study was to evaluate differences between Latino and non-Latino White adults in health-related behavioral risk factors. METHODS. Telephone interviews were conducted with 652 Latinos and 584 non-Latino Whites in San Francisco selected by random-digit dialing. RESULTS. Latino men and women, compared with their non-Latino White counterparts, were less likely to have consumed any alcoholic beverage in the previous month (59% and 29% vs 77% and 75%, respectively), consumed fewer drinks per week (6.6 and 3.0 vs 8.9 and 5.1, respectively), and were more likely to be sedentary (40% and 46% vs 17% and 23%). Latina women were less likely than non-Latina Whites to smoke cigarettes (8% vs 29%), to have ever had a Pap smear (76% vs 93%), and to have ever had a clinical breast examination (81% vs 96%). Multivariate analyses adjusting for sex, age, education, and employment confirmed univariate findings. CONCLUSIONS. Behavioral risk factor profiles by ethnicity help emphasize priorities of health promotion programs for a community. Latino needs include maintenance of limited consumption of alcohol and cigarettes, promotion of regular physical activity, and increasing use of low-cost cervical and breast cancer screening tests.
Mass media and school interventions for cigarette smoking prevention: effects 2 years after completion.
Authors: Flynn B S , Worden J K , Secker-Walker R H , Pirie P L , Badger G J , Carpenter J H , Geller B M
Published: November 2008

The long-term cigarette smoking prevention effects of mass media and school interventions were assessed. Adolescents in two communities received both mass media and school interventions; those in two matching communities received only school interventions. Surveys of 5458 students were conducted at baseline in grades 4 through 6 and 2 years after the 4-year interventions were completed, when students were in grades 10 through 12. Students exposed to the media-plus-school interventions were found to be at lower risk for weekly smoking (odds ratio = 0.62, 95% confidence interval = 0.49, 0.78) than those receiving school interventions only, indicating that the effects of the combined interventions persisted 2 years after the interventions' completion.
The outcomes of patients newly admitted to nursing homes after hip fracture.
Authors: Kiel D P , Eichorn A , Intrator O , Silliman R A , Mor V
Published: November 2008

OBJECTIVES. The outcomes of elderly, hospitalized patients discharged to nursing homes after hip fracture were examined. METHODS. For 2624 hip fracture patients admitted to any of 43 proprietary nursing homes between 1984 and 1988, admission assessments were examined in relation to 1-month outcomes. RESULTS. Mean patient age was 82 +/- 7 y; 85% of the sample were female. Within 1 month after discharge, 24% had returned home, 12% had been rehospitalized, 3% had died, and 61% remained in the nursing home. Characteristics significantly associated with morality included disorientation, functional dependency, neurologic diagnoses, and use of cardiac medications, antidepressants, or narcotics. Rehospitalization was significantly associated with age, gender, living with someone, being ambulatory, and functional dependency. Returning home was associated with younger age, living with someone, being ambulatory, and having no disorientation, functional dependency, or psychiatric or neurologic diagnoses, nor any pressure sores. CONCLUSIONS. Better-functioning persons and those with social support returned home; physically and cognitively impaired persons and those taking narcotics, cardiac medications, or antidepressants were likely to die; and younger men, those with social support, those with functional dependency, and those who were free of disorientation were more likely to be rehospitalized.
Projected numbers of cancers diagnosed in the US elderly population, 1990 through 2030.
Authors: Polednak A P
Published: November 2008

As based on Bureau of the Census population projections and age-specific cancer incidence rates for 1985 to 1989 from the National Cancer Institute's Surveillance, Epidemiology and End Results program, the number of incident cancers diagnosed annually in the United States among persons aged 65 and over is projected to reach 1.5 million by the year 2030, or 2.4 times the number estimated for 1990. These projections, which may be conservative because birth cohort patterns (based on Connecticut rates) suggest possible future increases in incidence rates for all cancer sites combined, have implications for planning expanded primary prevention efforts, such as smoking cessation (especially for women) and dietary modification programs, and for projecting health care needs and costs.
How effective is drug abuse resistance education? A meta-analysis of Project DARE outcome evaluations.
Authors: Ennett S T , Tobler N S , Ringwalt C L , Flewelling R L
Published: November 2008

OBJECTIVES. Project DARE (Drug Abuse Resistance Education) is the most widely used school-based drug use prevention program in the United States, but the findings of rigorous evaluations of its effectiveness have not been considered collectively. METHODS. We used meta-analytic techniques to review eight methodologically rigorous DARE evaluations. Weighted effect size means for several short-term outcomes also were compared with means reported for other drug use prevention programs. RESULTS. The DARE effect size for drug use behavior ranged from .00 to .11 across the eight studies; the weighted mean for drug use across studies was .06. For all outcomes considered, the DARE effect size means were substantially smaller than those of programs emphasizing social and general competencies and using interactive teaching strategies. CONCLUSIONS. DARE's short-term effectiveness for reducing or preventing drug use behavior is small and is less than for interactive prevention programs.
Trends in the US prevalence of drug-using parturient women and drug-affected newborns, 1979 through 1990.
Authors: Dicker M , Leighton E A
Published: November 2008

OBJECTIVES. There has been a lack of reliable national data on the number of pregnant women using drugs and the number of newborns affected by such use. The major reasons for this lack have been inadequate sampling and data collection procedures and the lack of a risk assessment perspective in analysis. This paper corrects for these inadequacies. METHODS. Data from 1979 through 1990 from the National Hospital Discharge Survey, an annual survey by the National Center for Health Statistics, were analyzed. RESULTS. Between 1979 and 1990 there was a 576% increase in the rate of discharges of drug-using parturient women in the United States and a 456% increase in the rate of discharges of drug-affected newborns. After adjustment for underreporting, a "best estimate" of the number of discharges from 1988 through 1990 was about 88,000 per year for drug-using parturient women and about 48,000 per year for drug-affected newborns. CONCLUSIONS. Although the data support the occurrence of a national epidemic of drug use among pregnant women during the 1980s, the size and severity of this epidemic have been overstated.
Is breast-feeding in infancy associated with adult longevity?
Authors: Wingard D L , Criqui M H , Edelstein S L , Tucker J , Tomlinson-Keasey C , Schwartz J E , Friedman H S
Published: November 2008

OBJECTIVES. The purpose of the study was to determine whether breast-feeding is associated with increased longevity or cause-specific survival. METHODS. Teachers throughout California identified intellectually gifted children as part of a prospective study begun in the 1920s by Lewis Terman. Information on breast-feeding was available on 1170 subjects, who have been followed for more than 65 years. RESULTS. Survival analysis (Cox proportional hazards model) indicated that breast-feeding was associated with increased longevity, even after adjustment for age at baseline, birthweight, infant health, and childhood socioeconomic status, but only among men, and the association was not significant (P = .15). Neither cardiovascular disease nor cancer survival was significantly associated with duration of breast-feeding for either sex. Survival from deaths due to injuries was positively associated with breast-feeding after adjustment (P = .03) and demonstrated a clear gradient with duration, but only among men. CONCLUSIONS. Overall, the present study does not provide strong evidence that breast-feeding is associated with adult longevity. The reduced risk of death from injury may reflect chance, in that the association was significant only for men, or it may reflect psychosocial correlates of breast-feeding practices.
Harsh social conditions and perinatal survival: an age-period-cohort analysis of the World War II occupation of Norway.
Authors: Wilcox A J , Skjaerven R , Irgens L M
Published: November 2008

OBJECTIVES. The hypothesis was tested that unfavorable social conditions are associated with poor perinatal survival through direct effects on pregnancy or, more indirectly, through effects on mothers born under such conditions. The occupation of Norway by Nazi Germany was used as a period of social hardship. METHODS. Data from Norwegian vital statistics and the Medical Birth Registry were used to describe perinatal mortality during World War II and also a generation later, among babies born to mothers who had themselves been born during the war. Logistic regression was used to identify a possible cohort effect among mothers born in 1940 through 1944 compared with mothers born before or after that period. RESULTS. Harsh conditions in Norway during the occupation increased childhood mortality. However, perinatal mortality declined during that period. Likewise, no adverse effect was seen on the survival of babies born to mothers who had themselves been born during the war (odds ratio = 1.00; 95% confidence interval = 0.96, 1.04). CONCLUSIONS. We find no evidence that wartime conditions in Norway impaired perinatal survival, either directly or through an effect on women born during the war. These data underscore how little is known about the ways that social conditions influence perinatal mortality.
The costs and financing of perinatal care in the United States.
Authors: Long S H , Marquis M S , Harrison E R
Published: November 2008

OBJECTIVES. The purpose of this study was to estimate the aggregate annual costs of maternal and infant health care and to describe the flow of funds that finance that care. METHODS. Estimates of costs and financing based on household and provider surveys, third-party claims data, and hospital discharge data were combined into a single, best estimate. RESULTS. The total cost of perinatal care in 1989 was $27.8 billion, or $6850 per mother-infant pair. Payments made directly by patients or third parties for this care totaled $25.4 billion, or about 7% of personal health care spending by the nonaged population. Payments were less than costs because they did not include a value for direct delivery care or for bad debt and charity care, which accounted for $2.4 billion. Private insurance accounted for about 63% of total payments, and Medicaid accounted for 17% of the total. CONCLUSIONS. National health reform would provide windfall receipts to hospitals, which would receive payment for the considerable bad debt and charity care they provide. Reform might also provide short-term gains to providers as private payment rates are substituted for those of Medicaid.
Intrauterine cocaine, lead, and nicotine exposure and fetal growth.
Authors: Neuspiel D R , Markowitz M , Drucker E
Published: November 2008

Intrauterine tobacco, lead, and cocaine exposure often co-occur and may affect fetal growth and development, yet studies of gestational cocaine effects have not adequately measured lead or tobacco. In this anonymous survey, blood lead and urine cotinine levels were determined and mothers were queried about tobacco use. Eighteen cocaine-exposed mother-infant dyads had higher lead and cotinine levels than 46 random nonexposed dyads, regardless of reported cigarette smoking. Crude growth decrements in cocaine-exposed newborns were attenuated after control for lead and cotinine. Future studies of gestational cocaine effects should measure other toxic exposures with more precision.
The risk of pregnancy-induced hypertension: black and white differences in a military population.
Authors: Irwin D E , Savitz D A , Hertz-Picciotto I , St André K A
Published: November 2008

The relationship between race and risk of pregnancy-induced hypertension was investigated in a cohort of active-duty military women who gave birth during the period 1987 through 1989. Cases were identified through hospital discharge diagnoses and included transient gestational hypertension, pre-eclampsia, eclampsia, and unspecified hypertension complicating pregnancy. Multivariate analysis showed nulliparous Black women to be at a slightly increased risk for all pregnancy-induced hypertension (risk ratio [RR] = 1.2) and for pre-eclampsia (RR = 1.3) compared with nulliparous White women. Black parous women were found to have a slightly reduced risk of all pregnancy-induced hypertension (RR = 0.77) and pre-eclampsia (RR = 0.38) compared with White parous women.
Trends in cigarette smoking among US adolescents, 1974 through 1991.
Authors: Nelson D E , Giovino G A , Shopland D R , Mowery P D , Mills S L , Eriksen M P
Published: November 2008

OBJECTIVES. The purpose of this study was to determine national trends in adolescent cigarette smoking prevalence. METHODS. We conducted trend analyses based on 1974 through 1991 current smoking prevalence data among persons aged 12 through 19 years from the National Household Surveys on Drug Abuse, High School Seniors Surveys, and National Health Interview Surveys. RESULTS. Overall smoking prevalence declined much more rapidly from 1974 through 1980 (1.9 percentage points annually among younger adolescents; the range among surveys of older adolescents was 0.2 to 2.0 percentage points annually) than from 1985 through 1991 (0 to 0.5 percentage points annually among all adolescents). Since 1980, smoking has generally declined at a slightly faster rate among older female adolescents than among male adolescents. Smoking among Black adolescents of all ages declined in nearly every survey population during each study period (range among surveys: 1974-1985 = 1.0 to 2.9 percentage points; 1985-1991 = 0.7 to 1.5 percentage points annually); for White adolescents, only minimal declines in smoking have occurred since 1985. CONCLUSIONS. Since 1974, major changes in adolescent smoking patterns have occurred, especially among Blacks. The overall slowing rate of decline in smoking prevalence since 1985 may indicate success of increased tobacco advertising and promotional activities targeted at adolescents or inadequate antitobacco education efforts.
Trends in the treatment of alcohol problems in the US general population, 1979 through 1990.
Authors: Weisner C , Greenfield T , Room R
Published: November 2008

OBJECTIVES. The purpose of this study was to conduct a comprehensive analysis of alcohol-treatment service utilization trends in the general population during the 1980s. METHODS. Three national surveys of the US household population (1979, 1984, and 1990) were used for trend analysis of treatment utilization. Trends in demographic characteristics of persons with lifetime treatment rates and particular types of treatment were examined by means of logistic regression analysis, controlling for alcohol problem severity and other variables. RESULTS. Substantial increases in the numbers reporting treatment were found. In all surveys, Alcoholics Anonymous was the treatment used most frequently and its use increased most, especially for women. Men were more likely than women (odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.20, 5.39) and unmarried persons were twice as likely as married persons to have been treated [corrected]. Social consequences carried more predictive power than dependence symptoms. CONCLUSIONS. From a general population perspective, while overall treatment capacity has increased, the structural changes in the public/private balance of services have not positively affected the representation of women or other characteristics of the treatment population.
What if Americans drank less? The potential effect on the prevalence of alcohol abuse and dependence.
Authors: Archer L , Grant B F , Dawson D A
Published: November 2008

OBJECTIVES. Several advisory committees have recently recommended that alcohol consumption be limited to moderate levels. Moderate drinking has been defined generally as not more than two drinks per day for healthy men and not more than one drink per day for healthy, nonpregnant women. The impact of reducing alcohol consumption to within the recommended guidelines on the prevalence of two serious alcohol-related problems was examined by modeling the relationship between average daily ethanol intake and alcohol abuse and dependence. METHODS. The recommended drinking guidelines, both in their existing form and modified by a measure of impairment, were applied to the observed distribution of consumption derived from a large representative survey of the US general population. RESULTS. The results demonstrated that restricting drinking to the maximum allowable levels under the existing and the modified guidelines would reduce the prevalence of alcohol abuse and dependence by 14.2% and 47.1%, respectively, in the adult US general population. CONCLUSIONS. Implications of these findings are discussed in terms of the validity of the assumptions underlying the models and the nature and direction of future research that would form the basis of newly developed guidelines for safe drinking limits.
Menthol vs nonmenthol cigarettes: effects on smoking behavior.
Authors: McCarthy W J , Caskey N H , Jarvik M E , Gross T M , Rosenblatt M R , Carpenter C
Published: November 2008

OBJECTIVES. The purpose of this study was to examine intraindividual differences in smoking behavior between smoking regular and mentholated cigarettes. METHODS. Healthy male smokers (n = 29) smoked either a regular or a mentholated cigarette in two separate sessions 1 week apart. Commercial brands with comparable tar, nicotine, and CO content were used. Smoking behavior was constrained by fixed 15-second interpuff intervals, but puff volume and number of puffs were unconstrained. RESULTS. When smoking the non-mentholated brand of cigarettes, participants smoked 22% more puffs and had 13% higher mean volumes per puff than they did when smoking the mentholated brand of cigarettes. The aggregate 39% excess exposure to cigarette smoke in the regular-cigarette condition was not accompanied by commensurate excesses in expired carbon monoxide or in physiological measures normally correlated with nicotine exposure. CONCLUSIONS. These findings parallel differences in physiological correlates of exposure to nicotine found in cross-sectional comparisons of African-American and White smokers and are consistent with the results of emerging laboratory investigations.
Characteristics associated with excessive weight gain after smoking cessation in men.
Authors: Swan G E , Carmelli D
Published: November 2008

OBJECTIVES. Data from two surveys of the National Academy of Sciences-National Research Council Twin Registry, conducted 16 years apart, were used to determine characteristics of individuals that were predictive of excessive weight gain after smoking cessation. METHODS. Over the follow-up, 2179 men quit smoking and averaged a weight gain of 3.5 kg. Quitters were grouped into four categories of weight change: lost weight, no change, gained weight, and excessive weight gain ("super-gainers"). RESULTS. In comparison with quitters reporting no change in weight, super-gainers were younger, were of lower socioeconomic status, and differed on a number of health habits before quitting (all Ps < .05). At follow-up, super-gainers reported changes in health habits that were significantly different from those seen in quitters reporting stable weight (all Ps < .05). Pairwise concordance for weight change in 146 monozygotic and 111 dizygotic twin pairs in which both twins quit smoking was significantly greater in monozygotic than dizygotic pairs (P < .01). CONCLUSIONS. These results indicate that super-gainers differ in important ways from those who do not gain weight after smoking cessation and that these weight changes may be influenced by underlying genetic factors.
Facial wrinkling in men and women, by smoking status.
Authors: Ernster V L , Grady D , Miike R , Black D , Selby J , Kerlikowske K
Published: November 2008

OBJECTIVES. This study examined the association of smoking status and pack-years of smoking with facial wrinkling in men and women. METHODS. We conducted a cross-sectional study of 299 never smokers, 551 former smokers and 286 current smokers, aged 30 through 69 years, drawn from a health maintenance organization. Smoking status, pack-years of smoking, and potential confounding variables were assessed by questionnaire. Facial wrinkle category, a dichotomous variable, and facial wrinkle score, a computed continuous variable, were assessed by blinded standardized visual assessment. Wrinkling was so uncommon among 30- through 39-year-old subjects that analyses were restricted to subjects aged 40 and over (227 never smokers, 456 former smokers, and 228 current smokers). RESULTS. With age, average sun exposure, and body mass index controlled, the estimated relative risk of moderate/severe wrinkling for current smokers compared to never smokers was 2.3 (95% confidence interval [CI] = 1.2, 4.2) among men and 3.1 (95% CI = 1.6, 5.9) among women. Pack-years was positively associated with facial wrinkle score in women aged 40 through 69 years and in men aged 40 through 59 years. In both groups, the increased risk of wrinkling was equivalent to about 1.4 years of aging. CONCLUSIONS. Our results support earlier findings that risk of facial wrinkling is greater in cigarette smokers than in never smokers.
Farm-related fatalities among children in California, 1980 to 1989.
Authors: Schenker M B , Lopez R , Wintemute G
Published: November 2008

To evaluate farm-related deaths among children in California and to identify specific risk factors, this study used death certificate tapes to identify 40 farm-related deaths among children under age 15 in California for 1980 to 1989. Mortality rates and odds ratios for cause-specific unintentional farm deaths were calculated. While California's farm-related mortality rate was lower than those in the midwestern states studied, the rate for Hispanic boys was 70% higher than that for non-Hispanics. The odds of death from machinery (81.3), animals (10.1), electricity (5.2), and nontraffic motor vehicles (3.4) were significantly greater than those in nonfarm locations; those from drowning were significantly lower (0.2). Specific factors associated with the lower California mortality rate need to be identified.
Daylight saving time and motor vehicle crashes: the reduction in pedestrian and vehicle occupant fatalities.
Authors: Ferguson S A , Preusser D F , Lund A K , Zador P L , Ulmer R G
Published: November 2008

Fatal crashes were tabulated for 6-hour periods around sunrise and sunset, from 13 weeks before the fall change to standard time until 9 weeks after the spring change to daylight saving time. Fatal-crash occurrence was related to changes in daylight, whether these changes occurred abruptly with the fall and spring time changes or gradually with the changing seasons of the year. During daylight saving time, which shifts an hour of daylight to the busier evening traffic hours, there were fewer fatal crashes. An estimated 901 fewer fatal crashes (727 involving pedestrians, 174 involving vehicle occupants) might have occurred if daylight saving time had been retained year-round from 1987 through 1991.