bluuebunny/crossref_metadata_2025 huggingface dataset:
Coverage gaps in seat belt use laws.
Authors: Wells J K , Williams A F , Fields M
Published: November 2008

Some seat belt use laws exempt occupants in certain seating positions and in certain types of vehicles, or both. A state-by-state analysis was conducted of the extent to which passenger vehicle occupants killed before the laws went into effect would have been covered by the laws subsequently passed. Only five states had laws that covered all passenger vehicle occupants; the majority excluded 4 to 8 per cent and six states excluded 14 per cent or more. More inclusive laws can reduce injuries and save lives.
Reducing knee morbidity among carpetlayers.
Authors: Tanaka S , Lee S T , Halperin W E , Thun M , Smith A B
Published: November 2008

Carpetlayers have a high prevalence of occupational knee morbidity, partly attributable to their use of the knee kicker to stretch carpet for wall-to-wall installation. While a mechanical alternative "power stretcher" is available, knee kickers are still widely used. A questionnaire survey indicated that unavailability of the mechanical stretcher at installation sites was a major factor for continued use of the knee kicker. Strategies to reduce use of the knee kicker are discussed.
Coronary arteriography and coronary bypass survey among whites and other racial groups relative to hospital-based incidence rates for coronary artery disease: findings from NHDS.
Authors: Ford E , Cooper R , Castaner A , Simmons B , Mar M
Published: November 2008

To assess racial differences in health care utilization for coronary artery disease (CAD) the data of the National Hospital Discharge Survey (NHDS) from 1979-84 were examined. Discharge rates for acute myocardial infarction (AMI) were utilized as a measure of hospital-based incidence and relative need for the designated cardiac procedures. Although 35-74 year old Black men had discharge rates of AMI that were 77 per cent of those observed for White men, they underwent coronary arteriography half as often and were only a third as likely to have coronary artery bypass graft (CABG) surgery. Black women in this age range were hospitalized at a slightly higher rate than White women for AMI, yet experienced a 19 per cent lower rate of coronary arteriography and a 52 per cent lower rate of CABG surgery. These data suggest a racial bias in the pattern of care delivered for CAD in US hospitals at the present time.
Physician ratings of appropriate indications for three procedures: theoretical indications vs indications used in practice.
Authors: Park R E , Fink A , Brook R H , Chassin M R , Kahn K L , Merrick N J , Kosecoff J , Solomon D H
Published: November 2008

We previously reported substantial disagreement among expert physician panelists about the appropriateness of performing six medical and surgical procedures for a large number of theoretical indications. A recently completed community-based medical records study of about 4,500 patients who had one of three procedures--coronary angiography, upper gastrointestinal endoscopy, and carotid endarterectomy--shows that many of the theoretical indications are seldom or never used in practice. However, we find that there is also substantial disagreement (5, 25, or 32 per cent for angiography, endoscopy, or endarterectomy, respectively) about the appropriateness of indications used in actual cases if disagreement is defined by first discarding the two extreme of nine ratings, then looking for at least one rating near the bottom (1 to 3) and one near the top (7 to 9) of the 9-point scale. Patients should know that a substantial percentage of procedures are performed for indications about which expert physicians disagree.
Beliefs about AIDS as determinants of preventive practices and of support for coercive measures.
Authors: Allard R
Published: November 2008

We performed a telephone survey to explore relations between knowledge, beliefs (as defined in the Health Belief Model) and reported AIDS-preventive practices in a sample of 1,072 persons ages 18-65, living in the Montreal health region. AIDS-preventive practices were more frequent among the young or single, and among those with one of four health beliefs: perceiving oneself as particularly susceptible to AIDS, perceiving the disease as particularly severe, perceiving it as particularly amenable to prevention, and having a strong general health motivation. Support for coercive measures to control the AIDS epidemic was widespread but was stronger among the less educated, married people, and those with a high level of one of the following beliefs about AIDS: perceived severity, susceptibility, curability, or barriers to treatment. AIDS-preventive practices and support for coercion under epidemic conditions share their most important modifiable determinants: perceived severity of AIDS and perceived susceptibility to it. This finding suggests that emphasizing them, as is done so often in public educational campaigns about AIDS, may indeed promote preventive practices, but may also unwittingly increase support for coercive measures toward people with the disease or at high risk of it.
Illness associated with child day care: a study of incidence and cost.
Authors: Bell D M , Gleiber D W , Mercer A A , Phifer R , Guinter R H , Cohen A J , Epstein E U , Narayanan M
Published: November 2008

We studied 843 children under 36 months of age enrolled in a prepaid health plan from September 1985 through March 1986, to identify characteristics of day care which might be risk factors for infection and to describe the resulting economic costs. Children cared for in their own home had a mean of 2.03 infections diagnosed during the study period. Adjusted rates of excess infection (95 per cent CI) for children cared for in other settings were: -.09 (-.73, .54) in relatives' homes; .10 (-.51, .71) in day care homes; .79 (.13, 1.45) in day care centers; .60 (-.24, 1.46) in mother's day out programs; and .66 (-.01, 1.34) in multiple settings. Children in day care centers were 4.5 times more likely to be hospitalized than those in other settings (95 per cent CI = 1.55, 13.00), primarily due to an increased rate of tympanostomy tube placement (relative risk 3.79, 95 per cent CI = 1.04, 13.36). The strongest predictor of illness risk was the number of other children in the room. The mean monthly cost of medical care was $32.94 for children in the highest risk settings compared with $19.78 for those in other settings. Illness in a child in our study accounted for 40 per cent of parental absenteeism from work; the mean number of days lost per month was 0.52 for parents of children in day care centers compared with 0.37 for those of children in other forms of full time care outside the home.
The relationship between women's attitudes about condoms and their use: implications for condom promotion programs.
Authors: Valdiserri R O , Arena V C , Proctor D , Bonati F A
Published: November 2008

A survey of 759 women attending contraceptive care clinics revealed that a majority of women endorsed condom use as an important way to reduce the spread of AIDS (acquired immunodeficiency syndrome); 82 per cent reported past use of condoms, but only 14 per cent reported using condoms in addition to another form of contraception to prevent infection with sexually transmitted pathogens, including HIV (human immunodeficiency virus). Acceptance of condom advertisement, perceived male and peer acceptance of condoms, and the effect of condom use on the enjoyment of sexual intercourse predicted condom use.
A comparison of acquired immunodeficiency syndrome and Kaposi's sarcoma incidence rates, Atlanta, 1983-86.
Authors: Chow W H , Liff J M , Greenberg R S , Williams B O
Published: November 2008

Recent temporal trends in incidence rates for acquired immunodeficiency syndrome (AIDS) and Kaposi's sarcoma were compared in metropolitan Atlanta, Georgia. From 1983 through 1986 the age-adjusted incidence rate of Kaposi's sarcoma among White males ages 25-49 increased 11-fold (2.2-24.4/100,000 person years). The annual incidence rate of AIDS increased ten-fold (11.3-113.3/100,000). These findings do not support earlier reports that the proportion of AIDS patients with Kaposi's sarcoma has decreased over time.
Immunization coverage and social differentiation in urban Senegal.
Authors: Fassin D , Jeannee E
Published: November 2008

We studied sociocultural factors associated with immunization coverage among a random sample of 500 mothers in the underprivileged suburbs of Dakar, Senegal. Factors associated with immunization of children under age 5 were maternal educational level and socioeconomic conditions (especially husband's regular salary); maternal age on arrival in town was more influential than total number of resident years in town; no effect of ethnicity was evident.
Prevalence of diabetes in a Navajo Indian community.
Authors: Sugarman J , Percy C
Published: November 2008

The age- and sex-adjusted prevalence of non-insulin-dependent diabetes mellitus (NIDDM) of 494 (76 per cent) Navajo adults living in a reservation community was 10.2 per cent, approximately 60 per cent greater than the estimated prevalence (6.4 per cent) in the general US population. The screening protocol utilized likely underestimates the prevalence of NIDDM in this population. A high proportion of Navajo people were overweight when compared to the general US population.
Trends in dental fluorosis and dental caries prevalences in Newburgh and Kingston, NY.
Authors: Kumar J V , Green E L , Wallace W , Carnahan T
Published: November 2008

A study was undertaken in New York State to determine the changes in dental fluorosis prevalence from 1955 to 1986 in fluoridated Newburgh and non-fluoridated Kingston children. The frequency and severity of dental fluorosis among 884 7-14-year-old children were measured by two dentists utilizing Dean's Index. Data regarding residential and fluoride history were obtained from the parents of participants. Among the Newburgh residents, the prevalence of dental fluorosis (very mild to moderate) varied from a low of 5 per cent for the 9-10-year-old group to a high of 9.4 per cent for 11-12-year-olds. Except for the 13-14-year-old group, children in non-fluoridated Kingston had the lowest dental fluorosis prevalence rates. A comparison of Dean's Community Fluorosis Indices to the 1955 baseline data obtained from studies conducted after 10 years of fluoridation in Newburgh revealed no changes of consequence among Newburgh residents. However, the changes are apparent for Kingston residents, indicating the availability of fluorides in non-fluoridated areas. The increased risk for dental fluorosis for Kingston residents appears to be from the use of fluoride tablets. An analysis of dental caries data revealed that caries prevalence declined substantially in both fluoridated and non-fluoridated areas.
Two variants of coronary atherosclerosis in six populations.
Authors: Tracy R E , Kissling G E , Oalmann M C
Published: November 2008

Coronary arteries and aortas obtained at autopsy in six populations were examined microscopically. Two variants of atherosclerosis could be separately quantified by objective morphometry. These two variants, fibroplasia and atheronecrosis, were both found to increase with age and to correlate with each other from one autopsy to the next after age adjustment. Despite the correlation of these two variables among individuals, the measures of fibroplasia and atheronecrosis did not correlate with each other across population groupings. A positive correlation of this kind between some populations was canceled by an inverse correlation between other populations. For example, Manila was the population with the greatest intimal fibroplasia in the coronary arteries at each age, and Sao Paulo was among those with the least intimal fibroplasia. Nevertheless, Sao Paulo showed the greatest tendency toward atheronecrosis, while Manila was among the populations with the least tendency toward atheronecrosis. The possibility arises, therefore, that the subjects from Sao Paulo were exposed to a different assortment of etiologic agents than were the subjects from Manila, and that their arteries, therefore, manifested a different kind of atherosclerosis.
Hypertension in Israeli adolescents: prevalence according to weight, sex and parental origin.
Authors: Shohat M , Shohat T , Mimouni M , Nitzan M , Danon Y L
Published: November 2008

We studied the prevalence of hypertension in 57,499 male and 35,803 female Israeli military recruits and its relation with sex, weight, and parents' ethnic origin. The overall prevalence of systolic hypertension (greater than 140 mmHg) was 1.75 per cent for males and 0.32 per cent for females. The prevalence of diastolic hypertension (greater than 90 mmHg) was 0.41 per cent for males and 0.06 per cent for females. For males, the prevalence of systolic and diastolic hypertension increased with weight, exponentially. Males of Ashkenazi origin had a significantly higher prevalence of hypertension (systolic 2.52 per cent, diastolic 0.55 per cent) compared with those of Sephardi origin (systolic 1.12 per cent, diastolic 0.3 per cent). The prevalence of adolescents with systolic or diastolic blood pressure greater than the mean +2SD of each weight group ranged between 1.5-2.3 per cent.
Results of routine restaurant inspections can predict outbreaks of foodborne illness: the Seattle-King County experience.
Authors: Irwin K , Ballard J , Grendon J , Kobayashi J
Published: November 2008

To analyze the association between the results of routine inspections and foodborne outbreaks in restaurants, we conducted a matched case-control study using available data from Seattle-King County, Washington. Case restaurants were facilities with a reported foodborne outbreak between January 1, 1986 and March 31, 1987 (N = 28). Two control restaurants with no reported outbreaks during this period were matched to each case restaurant on county health district and date of routine inspection (N = 56). Data from the routine inspection that preceded the outbreak (for case restaurants) or the date-matched routine inspection (for control restaurants) were abstracted from computerized inspection records. Case restaurants had a significantly lower mean inspection score (83.8 on a 0 to 100 point scale) than control restaurants (90.9). Restaurants with poor inspection scores and violations of proper temperature controls of potentially hazardous foods were, respectively, five and ten times more likely to have outbreaks than restaurants with better results. Although this study demonstrates that Seattle-King County's routine inspection form can successfully identify restaurants at increased risk of foodborne outbreaks, it also illustrates that more emphasis on regulation and education is needed to prevent outbreaks in restaurants with poor inspection results.
Multiple program participation: comparison of nutrition and food assistance program benefits with food costs in Boston, Massachusetts.
Authors: Wiecha J L , Palombo R
Published: November 2008

The values of government cash and food assistance benefits are compared to estimated food costs in Boston for households whose sole source of income is Aid to Families with Dependent Children (AFDC) and who have housing in the private sector. Methods developed by the General Accounting Office (GAO) in 1978 are replicated. GAO found that the value of combined benefits can exceed the cost of the United States Department of Agriculture's Thrifty Food Plan. Key assumptions underlying GAO's methodology are challenged, and an alternate method is applied. The new results contradict GAO's conclusions and suggest that Boston food costs exceed the combined value of benefits that AFDC households may receive, although participation in multiple food assistance programs is more beneficial than receipt of benefits from single programs. The authors conclude that food stamps and AFDC benefits indexed to actual costs of living are needed to meet the food needs of low-income families in Boston.
Olfactory function in chemical workers exposed to acrylate and methacrylate vapors.
Authors: Schwartz B S , Doty R L , Monroe C , Frye R , Barker S
Published: November 2008

An investigation of the olfactory function of 731 workers at a chemical facility which manufacturers acrylates and methacrylates was undertaken using a standardized quantitative test. In a cross-sectional analysis of the data, no associations of chemical exposure with olfactory test scores were observed. A nested case-control study designed to evaluate the cumulative effects of exposure on olfactory function, however, revealed elevated crude exposure odds ratios (95% confidence interval) of 2.0 (1.1, 3.8) for all workers and 6.0 (1.7, 21.5) for workers who never smoked cigarettes. Logistic regression analysis, adjusting for multiple confounders, revealed exposure odds ratios of 2.8 (1.1, 7.0) and 13.5 (2.1, 87.6) in these same groups, respectively, and a dose-response relationship between olfactory dysfunction and cumulative exposure scores--semi-quantitative indices of lifetime exposure to the acrylates. The data also revealed decreasing exposure odds ratios with increasing duration since last exposure to these chemicals, suggesting that the effects may be reversible.
Hearing loss among high school farm students.
Authors: Broste S K , Hansen D A , Strand R L , Stueland D T
Published: November 2008

To study the prevalence of hearing loss among teen-aged farm children in central Wisconsin, audiometric threshold testing of 872 vocational agriculture students was carried out over a three-year period. The results indicate an increased prevalence of hearing loss among students actively involved in farm work, as compared to their peers not involved in farm work. Findings also suggest that use of hearing protection may reduce the risk of hearing loss among students who work on the farm, although few students report the use of such devices. These data also suggest that the hearing loss often observed in adult farmers may begin in childhood.
Respiratory disease associated with community air pollution and a steel mill, Utah Valley.
Authors: Pope C A
Published: November 2008

This study assessed the association between hospital admissions and fine particulate pollution (PM10) in Utah Valley during the period April 1985-February 1988. This time period included the closure and reopening of the local steel mill, the primary source of PM10. An association between elevated PM10 levels and hospital admissions for pneumonia, pleurisy, bronchitis, and asthma was observed. During months when 24-hour PM10 levels exceeded 150 micrograms/m3, average admissions for children nearly tripled; in adults, the increase in admissions was 44 per cent. During months with mean PM10 levels greater than or equal to 50 micrograms/m3 average admissions for children and adults increased by 89 and 47 per cent, respectively. During the winter months when the steel mill was open, PM10 levels were nearly double the levels experienced during the winter months when the mill was closed. This occurred even though relatively stagnant air was experienced during the winter the mill was closed. Children's admissions were two to three times higher during the winters when the mill was open compared to when it was closed. Regression analysis also revealed that PM10 levels were strongly correlated with hospital admissions. They were more strongly correlated with children's admissions than with adult admissions and were more strongly correlated with admissions for bronchitis and asthma than with admissions for pneumonia and pleurisy.
Lead toxicity and iron deficiency in Utah migrant children.
Authors: Ratcliffe S D , Lee J , Lutz L J , Woolley F R , Baxter S , Civish F , Johnson M
Published: November 2008

We determined the frequency of presumptive iron deficiency and lead toxicity in 198 Utah migrant children, ages 9-72 months, during the summer of 1985. There were no confirmed cases of lead toxicity. Thirteen per cent of those tested and 30 per cent of the children ages 9-23 months were iron deficient. Hematocrit determinations accurately predicted iron deficiency in only 35 per cent of the children confirmed to have this disorder via erythrocyte protoporphyrin screening.
The relationship of park maintenance and accessibility to dogs to the presence of Toxocara spp. ova in the soil.
Authors: Ludlam K E , Platt T R
Published: November 2008

Three parks in St. Joseph/Benton Harbor, Michigan were examined for the presence of Toxocara spp. ova in the soil. Nineteen per cent (22/114) of the samples contained ova, and mean density (eggs/5 g soil) was 0.73. The density of two samples, collected at the base of playground equipment in one park, was greater than 2.1, which is considered sufficient for human infection. Subjective assessments of park maintenance and accessibility to dogs were not good indicators of the presence of Toxocara spp. ova.
Family physicians' views of chiropractors: hostile or hospitable?
Authors: Cherkin D , MacCornack F A , Berg A O
Published: November 2008

Family physicians in the State of Washington were surveyed about their knowledge and views about chiropractors; 79 per cent (476) responded. Sixty-six per cent indicated discomfort with what they believed chiropractors do while acknowledging their effectiveness for some patients; 25 per cent viewed chiropractors as an excellent source of care for some musculoskeletal problems and only 3 per cent dismissed chiropractors as quacks that patients should avoid; 57 per cent admitted having encouraged patients to see a chiropractor. These views are less negative than those of organized medicine.
Reflections on curative health care in Nicaragua.
Authors: Slater R G
Published: November 2008

Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a "medicina integral" residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress.
Predictors of healthy aging: prospective evidence from the Alameda County study.
Authors: Guralnik J M , Kaplan G A
Published: November 2008

Long-term predictors of high levels of physical functioning were examined in a representative sample of Alameda County, California residents followed from 1965 through 1984. The cohort investigated in this study was born between 1895 and 1919, with survivors being age 65 to 89 at the time of follow-up. A scale of physical functioning was developed from a comprehensive set of questionnaire items which assessed the full spectrum of physical functioning. Those scoring in the top 20 percent, defined as healthy aging, were compared to the remainder of the cohort, including those who died and those with lower levels of functioning at follow-up. After adjustment for age and functional status at baseline, the following variables were predictive of high functioning at follow-up 19 years later: race (those not Black), higher family income level, absence of hypertension, absence of arthritis, absence of back pain, being a non-smoker, having normal weight, and consuming moderate amounts of alcohol. Sex did not predict high function because of the counterbalancing effects of higher survival in females but greater likelihood of high functioning among surviving males.
Psychiatric disorders and 15-month mortality in a community sample of older adults.
Authors: Bruce M L , Leaf P J
Published: November 2008

The relation between psychiatric disorders, defined by the Diagnostic Interview Schedule (DIS), and mortality over 15 months is compared in 3007 adults age 55 and over in the New Haven Epidemiologic Catchment Area (ECA) project. Our results indicate that the odds of dying are more than four times greater for individuals with affective disorders than for others in the sample, controlling for age, sex, and physical health. Cause of death is also examined. There were no suicides or deaths from external causes.
Health practices of the elderly poor.
Authors: Lubben J E , Weiler P G , Chi I
Published: November 2008

The purpose of the present study was to describe the health practices of the elderly poor and to examine the association between specific health practices and subsequent hospital use. Data came from a sample of 931 Medicaid elderly living in California. Smoking, limited social networks, and lack of regular exercise significantly increased the odds of subsequent hospital utilization. Implications of these findings, which could benefit health promotion intervention and treatment programs for the elderly, were discussed.
Ethnic variation in cholecystectomy rates and outcomes, Manitoba, Canada, 1972-84.
Authors: Cohen M M , Young T K , Hammarstrand K M
Published: November 2008

We used population-based data from the Province of Manitoba's universal health insurance plan to compare the cholecystectomy experience of Native Americans and non-Natives from 1972 to 1984. The age-adjusted cholecystectomy rates for Native females were higher than for non-Native females with the peak rate occurring at age 30-39 for Native Americans and at age 60-69 for non-Natives. The rates for males were three times lower than for females and did not differ between Natives and non-Natives. Native Americans were more likely readmitted to hospital for surgical complications than non-Natives and this held true after controlling for age, sex, rural versus urban residence, teaching versus non-teaching hospital, multiple discharge diagnoses or complex versus simple cholecystectomy (relative odds 1.46, 95 per cent confidence interval 1.17, 1.18). The explanation for the relatively high rates of cholecystectomy among Native American females may be related to high rates of known risk factors for gallstone disease (such as obesity and high parity). However, the higher rates of surgical complications require further study.
Utilization of hospital services by cardiovascular patients, Alberta, Canada.
Authors: Bay K S , Maher M , Lee S J
Published: November 2008

Using hospital discharge records, and United States DRG (diagnosis related groups) data, we studied hospital utilization by cardiovascular patients, associated hospital expenditures, and the per capita cost of treating cardiovascular diseases in Alberta, Canada between 1971 and 1986. Expressed in constant 1984 Canadian dollars, the estimated total hospital cost increased from $84 million in 1971 to $131 million in 1986; during this period the Province of Alberta spent about $51 Canadian per resident each year for cardiovascular hospital services. It was noted that rural residents consumed a higher volume of resources per capita than their urban counterparts. A patient origin-destination analysis indicated an increasing dependence of rural patients on urban hospitals for secondary or tertiary care, underscoring the effects of medical technology on referral patterns.
The association of age-related macular degeneration and lens opacities in the aged.
Authors: Liu I Y , White L , LaCroix A Z
Published: November 2008

Data from 3,087 persons age 45 or older in the National Health and Nutrition Survey, 1971-74, showed that subjects with lens opacifying disease had an increased odds for age-related macular degeneration (AMD) compared to those who had no lens opacities. The crude odds ratio for aphakic patients was 4.6 (95% CI = 2.5, 8.6). The association remained after controlling for age, sex, and systolic blood pressure (a common risk factor) in a logistic regression model. These data are consistent with the hypothesis that light-induced damage may contribute to both lens and retinal disease and suggest that cataract extraction without implantation of ultra-violet/blue light absorbing intraocular lens may place subjects at increased risk of AMD.
Self-reported diabetes in Mexican Americans: HHANES 1982-84.
Authors: Perez-Stable E J , McMillen M M , Harris M I , Juarez R Z , Knowler W C , Stern M P , Haynes S G
Published: November 2008

In the Hispanic Health and Nutrition Examination Survey (HHANES) of 3,928 Mexican Americans ages 20-74 years, the age-adjusted prevalence of self-reported diabetes was 6.8 percent among men and 7.6 percent among women. Comparable age-adjusted rates for the US population in a national survey were 2.9 percent in men and 3.8 percent in women. The prevalence of diabetes in Mexican Americans is greater in older age groups, was similar in men and women, and among women only was inversely associated with education.
Black/white differences in non-treatment of bladder cancer patients and implications for survival.
Authors: Mayer W J , McWhorter W P
Published: November 2008

Analysis of 20,764 White and 882 Black bladder cancer patients diagnosed during 1978-85 indicates that Black patients were more likely than White patients to go untreated following diagnosis after adjustment for age- and stage-at-diagnosis, sex, and tumor histology (OR = 1.80, 95% CI = 1.33, 2.43). Treatment status was found to be a significant predictor of five-year survival after adjustment (treated/untreated odds ratio = 3.16, 95% CI = 2.08, 4.79). Results suggest that differences in initial therapy may contribute to the survival differential between Black and White bladder cancer patients.
Factors associated with participation in a community senior health promotion program: a pilot study.
Authors: Buchner D M , Pearson D C
Published: November 2008

Factors associated with participation in a community senior health promotion program were studied in 103 participants and a population-based control group of 531 non-participants. Compared to controls, participants had similar physical health status, but lower mental and social health status. Both men and women participants reported more depressive symptoms, lower positive affect, and lower social participation. Mental and social health may be important yet under-studied factors influencing participation in community health promotion programs.
Application of clearance concepts to the assessment of exposure to lead in drinking water.
Authors: Bois F Y , Tozer T N , Zeise L , Benet L Z
Published: November 2008

This paper explores the application of clearance concepts to environmental toxicology. Lead, for which a clearance of about 0.5 ml/min is estimated from published data, is chosen as an example. An index for the contribution of drinking water to total exposure is developed using these concepts. For lead, this index is shown to increase with the concentration of the metal in water; it is higher for children than for adults. At the maximum contaminant level (MCL) of 10 micrograms/L proposed by the US Environmental Protection Agency (EPA), the average contribution from lead in drinking water is estimated to be 7 percent. The contribution in children is about twice as great. At and above the current MCL of 50 micrograms/L, drinking water becomes a major source of lead exposure.
Birthplace and the risk of AIDS among Hispanics in the United States.
Authors: Selik R M , Castro K G , Pappaioanou M , Buehler J W
Published: November 2008

To extend previous work showing that the risk of AIDS (acquired immunodeficiency syndrome) is higher in US Hispanics than in Whites who are not Hispanic, we compared US residents born in different Latin American countries. We computed the cumulative incidence (CI) of AIDS and the distribution of cases by mode of exposure. Cases were those reported to the Centers for Disease Control between June 1, 1981 and December 12, 1988, and populations specific for birthplace were from the 1980 census. The reference group was the White population that was not Hispanic, CI 25.7/100,000. We estimated a similar rate in Mexican-born persons (25.3/100,000). In the South and West, the rate in Mexican-born Hispanics was half the reference rate. In each US region, the CI of AIDS in heterosexual intravenous drug abusers (IVDAs) in Puerto Rican-born persons was several times greater than that in other Latin American-born persons. Puerto Rican-born persons were the only Latin American-born persons in whom most cases were in heterosexual IVDAs. The data suggest that resources for preventing AIDS in Hispanics are needed most in those of Puerto Rican ethnicity for AIDS related to intravenous drug abuse.
Partner notification in the control of human immunodeficiency virus infection.
Authors: Potterat J J , Spencer N E , Woodhouse D E , Muth J B
Published: November 2008

Partner notification should be standard public health practice in the control of human immunodeficiency virus (HIV) infection. A universal partner notification program for the United States is affordable, operationally manageable, and can effectively reach high-risk persons. Such a focused approach personalizes the epidemic and probably enhances the efficacy of risk reduction messages. Confidentiality protections are attainable. Voluntary partner notification is acceptable to our constituents; while counseling is "mandatory," testing is optional. Evidence of partner notification's usefulness as a case prevention tool should be a by-product of program outcomes and not a prerequisite for its implementation.
What do we really know about AIDS control?
Authors: Judson F N
Published: November 2008

For the near term, control of the AIDS epidemic depends entirely upon altering the human behavior which results in HIV transmission. How best to achieve the required changes has been controversial with approaches ranging from education/information only, to a vast array of largely unproven voluntary behavior modification techniques, to mandatory testing and restrictive measures. Given the complexity of human behavior and the reality of a still uncontrolled epidemic, at least among poor urban drug using minorities, there is a legitimate role for most approaches and any promising behavior modification strategy deserves evaluation. However, because voluntarism will not work for some individuals, society still must choose between effective public health law--including restrictive measures--now, and a much larger reservoir of HIV infection and more deaths from AIDS for many generations to come.
Sero survey of human immunodeficiency virus infection in women at a family planning clinic: absence of infection in an indigent population in San Francisco.
Authors: Darney P D , Myhra W , Atkinson E S , Meier J
Published: November 2008

To determine the seroprevalence of human immunodeficiency virus (HIV) in contracepting women, 1,308 consecutive attendees at an inner-city family planning clinic completed a risk factor questionnaire and were then asked to have an HIV test. None of the 1,000 women tested was seropositive. Preventive efforts in family planning clinics are likely to be productive because few contraceptors, including those with risk factors, are already infected. The factors which determine differences in HIV positivity between childbearing and contracepting women, who are similar in demographic and HIV risk characteristics, warrant further investigation.
Characteristics of self-selected responders to a health risk appraisal: generalizability of corporate health assessments.
Authors: Lynch W D , Golaszewski T J , Clearie A , Vickery D M
Published: November 2008

Selected characteristics and total medical claims of health risk appraisal (HRA) responders and non-responders were compared in a sample of employees having a three-year employment and claims history. HRA responders were younger and more likely to file medical claims than non-responders. Although mean medical claims were greater for HRA responders than non-responders, when adjusted for age and sex this difference reflected the proportion of employees reporting claims, not a difference in the claims amount.
Psychoactive drug use in a general population sample, Sweden: correlates with perceived health, psychiatric diagnoses, and mortality in an automated record-linkage study.
Authors: Allgulander C
Published: November 2008

Three person-based computer files were linked to provide a data-set of a random sample of 32,679 Swedes, drawn for interviews regarding perceived health, socioeconomic conditions, and psychoactive drug use. All diagnoses from inpatient psychiatric care in the sample during a 15-year period and the causes of death after the sampling point were combined with the interview responses. Among those admitted for inpatient psychiatric care, substance abuse was an infrequent diagnosis; the majority of schizophrenics and of those with an affective disorder appeared not to medicate regularly; survey non-responders had higher rates of mental disorders than responders. Drug use correlated with both subjective and objective measures of mental ill health. The rate of prescription drug abuse was low. Automated record-linkage is a feasible method to generate hypotheses about mental health in the general population.
A case-control study of pancreatic cancer and cigarettes, alcohol, coffee and diet.
Authors: Olsen G W , Mandel J S , Gibson R W , Wattenberg L W , Schuman L M
Published: November 2008

A pancreatic cancer case-control study was conducted in the Minneapolis-St. Paul area. Family members were interviewed about the subject's usage of cigarettes, alcohol, coffee, and other dietary factors in the two years prior to death (cases, n = 212) or prior to interview (controls, n = 220). The adjusted odds ratio for two packs or more of cigarettes per day was 3.92 (95% CI = 1.18, 13.01) and four or more drinks per day OR 2.69 (95% CI = 1.00, 7.27). Coffee was not a risk factor (seven cups or more per day; OR 0.58 (95% CI = 0.27, 1.27). A positive trend was observed for beef and pork consumption, and a negative trend from cruciferous vegetables.
The reliability of self-reported cigarette consumption in the United States.
Authors: Hatziandreu E J , Pierce J P , Fiore M C , Grise V , Novotny T E , Davis R M
Published: November 2008

To investigate the possibility that self-reported smoking is not a valid measure for assessing trends in smoking prevalence, we compared total self-reported cigarette consumption with the adjusted consumption data from cigarette excise taxes as reported by the US Department of Agriculture (USDA) for the period 1974 through 1985. Self-reported consumption was calculated by using data from the National Health Interview Surveys (NHIS) for adults and from the National Household Surveys on Drug Abuse for adolescents. For this period, the average ratio of self-reported cigarette consumption to the USDA estimate of consumption was 0.72 (range = 0.69 to 0.78). There was no statistical difference in this consumption ratio from year to year, indicating no apparent increase in the underreporting of cigarette smoking in these surveys. We conclude that cross-sectional surveys of self-reported smoking status remain a reliable surveillance tool for monitoring changes in population smoking behavior.
Two episodes of acute illness in a machine shop.
Authors: Sinks T , Kerndt P R , Wallingford K M
Published: November 2008

Following an explosion in a machine shop and temporary plant closure, on the day the plant returned to full operations a degreaser malfunctioned. Workers in the assembly room were exposed to trichloroethylene levels later estimated to have exceeded 220 ppm (OSHA PEL 100 ppm). The plant was evacuated and the degreaser taken out of operation. Blood testing for carbon monoxide (CO) on five employees found carboxyhemoglobin levels in excess of normal. The plant reopened the following morning. Over the next two weeks, 15 employees were seen by the plant nurses for similar complaints; although all returned to work, their carboxyhemoglobin levels, later found to be inaccurate, were reported by a local medical clinic to range from 13.7 to 20.0 percent. At the end of the second week, another outbreak of illness occurred, but carboxyhemoglobin, trichloroethylene, fluorocarbons, and methylene chloride were not elevated in all 17 persons tested; plant-wide monitoring for CO found no elevated levels. During the first outbreak of illness, cases were 2.26 times as likely to have entered the assembly room as noncases. During the second outbreak, cases were no more likely than noncases to have entered the assembly room. We believe the explosion, earlier toxic exposures and illness, and the misleading blood test results led to plant-wide anxiety which culminated in a collective stress reaction and the second outbreak. An open meeting with all employees, informing them of our findings, provided reassurance and no further episodes of illness occurred in this workforce.
Accuracy of women's self-report of their last Pap smear.
Authors: Sawyer J A , Earp J A , Fletcher R H , Daye F F , Wynn T M
Published: November 2008

We compared interview data and physician records on when women last had a Pap smear in a sample of 98 rural Black women. We found 20 per cent of women could not accurately report on whether a Pap smear had been done within three years (sensitivity = 0.95, specificity = 0.47). Source of gynecological care and perceived barriers to obtaining a Pap smear but not education were associated with inaccurate reports. Self-report may be a misleading measure of Pap smear screening in comparable groups of women.
Left-handedness and accident-related injury risk.
Authors: Coren S
Published: November 2008

Self-reported injuries among left-handed and right-handed people were compared in a survey of 1,896 college students in British Columbia, Canada. Left-handers were more likely to report having an injury requiring medical attention during the last two years (OR = 1.89, 95% CI = 1.39, 2.58). Relative risk was highest for left-handed males when driving motor vehicles (OR = 2.35, CI = 1.25, 4.43). Regardless of handedness, males had slightly higher relative risks of injury than females.
Deaths, injuries, and evacuations from acute hazardous materials releases.
Authors: Binder S
Published: November 2008

We examined reports from three surveillance systems of 587 acute releases of hazardous materials in 1986. These releases resulted in at least 115 deaths, 2,254 injuries, and 111 evacuations. Only eight (1 percent) of the 587 events were common to all three systems. Estimates of the public health consequences of hazardous materials releases could be improved by enforcing existing laws, modifying report forms, and validating collected information.
Formaldehyde exposures from tobacco smoke: a review.
Authors: Godish T
Published: November 2008

Reports of formaldehyde levels in mainstream, sidestream, and environmental tobacco smoke from nine studies are reviewed. Considerable disparity exists between formaldehyde production rates determined from mainstream-sidestream studies and those reporting levels in environmental tobacco smoke. Tobacco smoke does not appear to increase vapor-phase formaldehyde levels significantly in indoor environments, but formaldehyde exposure in mainstream smoke may pose a risk of upper respiratory system cancer and increase the risk of cancer in smokers.
Elimination of cotinine from body fluids: disposition in smokers and nonsmokers.
Authors: Haley N J , Sepkovic D W , Hoffmann D
Published: November 2008

We have evaluated differences in the elimination of cotinine, a major nicotine metabolite, in smokers who quit smoking and never-smokers who were exposed to environmental tobacco smoke (ETS) under controlled conditions. The mean biological half-life of cotinine in urine, collected from the nine smokers was 16.5 +/- 1.2 h, in never-smokers exposed to ETS, 27.3 +/- 1.9 h. Differences in the mode of uptake and absorption of nicotine and possible differences in nicotine metabolism may play roles in the clearance rate differences between smokers and nonsmokers.
Model Standards impact on local health department performance in California.
Authors: Spain C , Eastman E , Kizer K W
Published: November 2008

An evaluation of a state-local negotiation process to implement Model Standards in 18 California local health departments was conducted during 1985-87. Model Standards specific to California were developed by state and local public health officials for seven programs. Nine counties participated in state-local negotiations to set performance standards in these seven programs. During the two-year effort, greater use of Model Standards and more improvement in local program performance occurred in local health departments that participated in the state-local negotiation process. The use of Model Standards appeared to contribute to establishing program priorities, emphasizing the measurement of outcomes, improving data management systems, and evaluating the current performance of programs. While this state-local negotiation process is suggested as the preferred approach to encouraging the use of Model Standards in local health departments, it must be recognized that this process requires time and commitment of resources from both the state and local levels.
A case-control study of pedestrian and bicyclist injuries in childhood.
Authors: Pless I B , Verreault R , Tenina S
Published: November 2008

We identified children ages 0 to 14 years injured in traffic as pedestrians or bicyclists in Montreal, Canada. Two hundred children with injuries who received a score of 2 or more on the Maximum Abbreviated Injury Severity scale were considered as cases and compared with 400 uninjured children seen in the same hospitals for non-traumatic reasons. Systematic, blinded interviews and tests were conducted with parents to determine the role of a series of social, familial, personal, and behavioral characteristics. After adjustment for age, gender and socioeconomic area of residence, logistic regression analyses showed higher risks of injury to be related to fewer years of parents' education, a history of accident to a family member, an environment judged as unsafe, and poor parental supervision. Absence of physical health problems, fewer family preventive behaviors and reported lack of cautiousness were also related to a higher risk, whereas neither aggressivity nor behavioral disturbance, whether internalizing or externalizing, showed any such relation. These data suggest that the child's personality and behavior are weaker risk factors for pedestrian and bicyclist injuries than are family and neighborhood characteristics.
Induced abortion and the risk of subsequent ectopic pregnancy.
Authors: Holt V L , Daling J R , Voigt L F , McKnight B , Stergachis A , Chu J , Weiss N S
Published: November 2008

This study assessed the effect of legal induced abortion on ectopic pregnancy risk by using a comparison group of reproductive-age women who were at risk of becoming pregnant during the same time period the women with ectopic pregnancy conceived. Cases were members of Group Health Cooperative of Puget Sound who were hospitalized for ectopic pregnancy from October 1981 through September 1986 (N = 211). Controls were randomly selected members matched to cases on age and county of residence (N = 457). All subjects in this analysis had had one or more prior pregnancies. Eighty-eight cases (41.7 per cent) and 177 controls (38.7 per cent) had a history of one or more induced abortions. The relative risk of ectopic pregnancy associated with one abortion was 0.9 (95 per cent confidence interval 0.6, 1.3), adjusted for age, county, reference date, religion, gravidity, age at first pregnancy, lifetime number of sexual partners, and miscarriage history. Among women with two or more prior pregnancies, the risk associated with two or more abortions was 1.2 (0.6, 2.4). Controlling for pelvic inflammatory disease and use of intrauterine devices did not alter these risks. We conclude that legal abortion as performed in the US since 1970 has little or no influence on a woman's risk of ectopic pregnancy in subsequent pregnancies.