bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of hepatitis B markers among pregnant Hispanic women in migrant/seasonal work in Oregon.
Authors: Fehrs L J , Eisele L , Conrad R , Foster L R , Fleming D
Published: November 2008

We screened 303 Hispanic pregnant women who were migrant or seasonal agricultural workers in Oregon for the presence of Hepatitis B serological markers. One carrier was identified (0.3 per cent, 95% confidence interval [CI] .02%, 2.1%). Evidence of previous HB infection was present in 5.3 per cent (16/303) of the women (95% CI 3.2%, 8.6%), rates similar to those for the general US population.
Calories, fat and cholesterol: intake patterns in the US population by race, sex and age.
Authors: Block G , Rosenberger W F , Patterson B H
Published: November 2008

Nutrient intakes were investigated for Blacks and Whites using data from the NHANES II survey (1976-80). Intake of energy, total fat, saturated fat, dietary cholesterol, P/S ratio, and per cent of calories derived from total and saturated fat are examined by sex and age, both in absolute terms and per unit of body weight. For most age and sex categories, Blacks are found to have a lower intake of energy and fats than Whites; however, Blacks have a consistently higher intake of dietary cholesterol. The ratio of polyunsaturated fats to saturated fats is higher in females than in males, but all age-sex groups are substantially below recommended levels. Per cent of calories from total and saturated fat are similar in most age-sex groups. Possible explanations of the observed patterns include activity level and metabolic differences.
Child care and children's illness.
Authors: Johansen A S , Leibowitz A , Waite L J
Published: November 2008

This paper uses nationally representative data from the Child Health Supplement of the 1981 National Health Interview Survey to test the hypothesis that the larger the groups in which children receive care, the more days per year they spend in bed due to illness. We estimate a model of annual bed days for children ages six months to two and one-half years old, and separately for children two and one-half to five years old. Our results show significantly higher numbers of bed days for children in day care centers than for children at home for both age groups, controlling for confounding factors. Children in family day care have significantly more bed days than those at home, but only among the younger sample. The negative effect of family day care is less than that of child care centers. Although the relative effect of group care is to increase annual bed days by 30 to 19 per cent, the absolute effect is modest with children in group care having 1.3 to .6 more bed days per year.
Awareness, use, and impact of the 1984 Joint National Committee consensus report on high blood pressure.
Authors: Hill M N , Levine D M , Whelton P K
Published: November 2008

A random sample of Maryland physicians stratified by practice specialty (family, general, internal medicine, cardiology, and nephrology) was surveyed before and one year after dissemination of the 1984 Report of the Third Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (The JNC III Report). Fourty-four per cent of the total eligible sample responded to both questionnaires. One year after publication, 62 per cent of physicians participating in both parts of the study were aware of the report. Although availability of a copy (58 per cent), familiarity with the recommendations (81 per cent), and the extent to which care was based on the guidelines (65 per cent) were high, use of the report in practice (17 per cent) and the amount of change in practice behavior required to adhere to the guidelines (18 per cent) were low. Prior to publication of the report, more than two-thirds of responding physicians were found to be practicing in a manner congruent with nine of ten treatment recommendations studied. One year after JNC III's release, they reported practice behavior which was not significantly different. It seems that this consensus report codified, rather than changed, practice behavior in this sample.
Diabetes in Utah among adults: interaction between diabetes and other risk factors for microvascular and macrovascular complications.
Authors: Schumacher M C , Smith K R
Published: November 2008

From a telephone survey of the health status of a random sample of the general population of Utah, we identified 255 people with adult onset diabetes. We compared them to 622 non-diabetic controls, matched for age, sex, and urban/rural country of residence. We examined diabetes as a risk factor for heart diseases, stroke, and blindness and its interaction with other known risk factors. Diabetes interacted with smoking history so as to increase the risk of stroke, heart disease, and blindness. Diabetes also interacted with hypertension in their effect on the prevalence of blindness and, to a small extent, heart disease. Among the diabetics, duration of diabetes was associated with macrovascular and microvascular complications developing after the diagnosis of diabetes. Those with longer duration of disease showed an increase in risk for microvascular (kidney disease, blindness) and macrovascular (heart disease, stroke, amputations) complications. Although the estimates were imprecise, the effect of duration on macrovascular complications was greater among diabetics with a history of hypertension; the effect on microvascular complications was greater among smokers. The findings are compared to previous studies and the utility of diabetes prevalence data is discussed.
Years of potential life lost (YPLL) before age 65 in Italy.
Authors: Arcà M , di Orio F , Forastiere F , Tasco C , Perucci C A
Published: November 2008

The Italian death rates and years of potential life lost (YPLL) for all causes and for 12 selected aggregations of causes are reported for 1979 and 1983, with the latter compared to United States data. Cancer is the leading cause of YPLL in Italy (23.8 per cent of total YPLL), followed by unintentional injuries (16.3 per cent) and heart disease (11.2 per cent). Rates of YPLL for all causes decreased 12.0 per cent from 1979 to 1983, the strongest declines in absolute terms being observed for prematurity and unintentional injuries, and in percentage decline for pneumonia and influenza, and infectious diseases; during the same period, YPLL for diabetes increased. The rates of YPLL are higher for males than for females (rate ratio = 1.9) especially for causes related to lifestyle factors. Premature mortality is lower in Italy than in the USA, because of the striking difference in mortality from injuries and heart diseases.
An evaluation of the American Lung Association's home video smoking cessation program.
Authors: Marston A R , Bettencourt B A
Published: November 2008

One hundred and one participants received In Control: A Home Video Freedom from Smoking Program. Of 53 completing self-treatment, 31 were verified by CO testing as abstinent one month after completion. Twenty-one per cent of the sample (40 per cent of those completing treatment) had not smoked in the past three months prior to 12 month follow-up and 16 per cent of the total sample (30 per cent of those completing treatment) had not smoked at all in the past 11 months.
Erythema infectiosum (fifth disease) occurrence in Iowa.
Authors: Naides S J
Published: November 2008

Review of Iowa school nurse surveillance for erythema infectiosum, or fifth disease (FD), since 1973 demonstrated occurrence yearly except 1985 without a clear pattern of disease spread. We conclude that FD is more common than previously recognized. Failure to identify cases representing the background incidence of disease may account for underreporting.
Health problems of homeless children in New York City.
Authors: Alperstein G , Rappaport C , Flanigan J M
Published: November 2008

We reviewed the outpatient medical records of 265 homeless children less than 5 years of age in New York City and compared them with children of similar low socioeconomic status (SES) attending the same pediatric clinic. The frequency of health problems among the homeless children, including delayed immunizations, elevated blood lead levels, the rate of admission to hospital, and the rate of child abuse and neglect reports, exceeded those for the comparison groups.
Frequency of worksite health promotion activities.
Authors: Fielding J E , Piserchia P V
Published: November 2008

The first National Survey of Worksite Health Promotion Activities surveyed a random sample of all private sector worksites with 50 or more employees, stratified by number of employers, geographic location, and type of industry. The 1,358 completed interviews constituted a response rate of 83.1 per cent. Of responding worksites 65.5 per cent had one or more areas of health promotion activity with slightly more than 50 per cent of activities initiated within the previous five years. Overall prevalence by type of activity included health risk assessment (29.5 per cent), smoking cessation (35.6 per cent), blood pressure control and treatment (16.5 per cent), exercise/fitness (22.1 per cent), weight control (14.7 per cent), nutrition education (16.8 per cent), stress management (26.6 per cent), back problem prevention and care (28.5 per cent), and off-the-job accident prevention (19.8 per cent). Mean number of activities across all worksites was 2.1 and for worksites with activities, 3.2. Activity frequency increased with worksite size, was highest in the western region (2.34) and lowest in the northeast (1.96), and varied considerably by industry type. The majority of worksites paid the entire cost of these activities.
National trends in the use of preventive health care by women.
Authors: Makuc D M , Freid V M , Kleinman J C
Published: November 2008

This study investigates national changes between 1973-74 and 1985 in women's use of three preventive health services based on data from the National Health Interview Survey. Smoothed proportions of women with recent preventive care were estimated using weighted least squares for subgroups categorized by age (20-39, 40-59, 60-79), race (White, Black), income (poor, nonpoor), and year of interview. Older women and Black women experienced the largest increases in recent use of clinical breast examinations and Pap tests. Between 1973 and 1985 changes in recent breast examination ranged from zero for White women ages 20-39 years to a 23 percentage point increase (95% CI = 17,30) for Black women ages 60-79 years. A similar pattern was found for Pap testing. Changes between 1974 and 1985 in recent blood pressure testing ranged from zero for women ages 20-39 years to an 8 percentage point increase (95% CI = 6, 10) for women ages 60-79 years. Despite the increases among older women, in 1985 recent use of breast exams and Pap tests remained lower among older women. Further, the poor remained less likely than the nonpoor to have recent preventive care (except blood pressure testing among older women). Most women without recent cancer screening tests had a recent physician contact, highlighting the need for greater emphasis on cancer prevention by health care providers.
A recent increase of breastfeeding duration in Jakarta, Indonesia.
Authors: Joesoef M R , Annest J L , Utomo B
Published: November 2008

Comparison of breastfeeding practices from two similar surveys conducted in Jakarta, Indonesia shows an increase in breastfeeding duration from 14.4 months in 1976 to 19.8 months in 1983. This increase was predominantly among noneducated women (20.3 months among noneducated women versus 0.9 months among women with greater than elementary education). Among working women breastfeeding duration declined slightly (1.1 months). Unlike industrialized countries where increases in breastfeeding have occurred initially among the higher socioeconomic groups, recent increases in Jakarta have occurred initially among the lower socioeconomic groups. If breastfeeding practices among working or better educated women who delivered mostly in hospitals or clinics are to be improved, the breastfeeding promotion programs should be targeted to these groups.
Current medical, legal and demographic perspectives on artificial reproduction in Czechoslovakia.
Authors: Heitlinger A
Published: November 2008

This paper examines artificial reproduction (AR) within a broad comparative perspective and with specific reference to Czechoslovak law, medicine, and demography. It proceeds form an analysis of the social context that gives rise to technologies of AR to a review of the two principal technologies, artificial insemination (AI) and in vitro fertilization (IVF). A final section briefly discusses some of the implications of AR for new judicial conceptions of motherhood and fatherhood.
Tea and premenstrual syndrome in the People's Republic of China.
Authors: Rossignol A M , Zhang J Y , Chen Y Z , Xiang Z
Published: November 2008

We evaluated the hypothesis that tea consumption causes premenstrual syndrome by studying 188 nursing students and tea factory workers in the People's Republic of China via questionnaires distributed in classes (nursing students) or during routine physical examinations (tea factory workers). Analysis of the data revealed that tea consumption is strongly related to the prevalence of premenstrual syndrome and that the effects are dose-dependent.
X-ray examinations during pregnancy: National Natality Surveys, 1963 and 1980.
Authors: Kaczmarek R G , Moore R M , Keppel K G , Placek P J
Published: November 2008

Based on 1963 and 1980 National Natality Surveys, the rate of medical x-ray examinations during pregnancy per 100 mothers fell 34.2 percent. A decrease in chest x-ray examinations accounted for almost all of the decline in total x-ray examinations. The reductions were greater for older mothers and those who were not White. While the number of births fell from 4,071,000 in 1963 to 3,612,000 in 1980, the number of pelvimetry examinations actually increased by 45,000.
Quality of death certificates in Valencia, Spain.
Authors: Benavides F G , Bolumar F , Peris R
Published: November 2008

Certificates of 1,454 deaths occurring over 11 months were retrieved from the Civil Register in Valencia, Spain. Relevant medical information was systematically gathered from hospital records, questionnaires, and Coroner reports. We compared the underlying cause of death (UCD) from the original death certificate, and a reference cause of death (RCD) determined by a panel of experts based on all available information. Overall, 80.2 percent of the certificates were concordant for disease category, but there was a great disparity among some specific disease categories.
Business recession, alcohol consumption, drinking and driving laws: impact on Oklahoma motor vehicle fatalities and fatal crashes.
Authors: Muller A
Published: November 2008

In 1982, Oklahoma enacted a series of drinking and driving laws. In the ensuing years, motor vehicle fatalities and fatal crashes were reduced by one-third. Factors contributing to this reduction were examined using interrupted time series analysis of monthly rates of motor vehicle deaths and fatal crashes for the period January 1980 to December 1986. Decreasing per capita alcohol consumption and increased unemployment apparently account for most of the fatality and fatal crash reduction in Oklahoma. The enactment of two traffic safety laws--one specifying the illegal blood alcohol concentration level (BAC law) and the other facilitating license withdrawal from suspected drunk drivers (administrative per se law)--together reduced Oklahoma traffic deaths and fatal crashes by about 9 percent. The effectiveness of the laws appeared to be greatest in the first two years following their enactment.
Six-year follow-up of the first Waterloo school smoking prevention trial.
Authors: Flay B R , Koepke D , Thomson S J , Santi S , Best J A , Brown K S
Published: November 2008

This paper reports six-year follow-up data from the first large-scale randomized trial of the social influences approach to smoking prevention. In 1979, 22 schools were randomly assigned to program or control conditions. Students in program schools received a social influences curriculum in six core and two maintenance sessions in grade 6, two booster sessions in grade 7, and one booster session in grade 8. All students were assessed at pretest (T1), immediate posttest (T2), end of grade 6 (T3), beginning and end of grade 7 (T4 and T5), end of grade 8 (T6), and grades 11 and 12 (T7 and T8). Ninety percent of study students were relocated and data obtained from over 80 percent of them at T8. Program effects on experimental smoking observed in grades 7 and 8 had completely decayed by T8, six years after the beginning of the program. Grade 6 smoking experience and social risk were each strong predictors of T8 smoking behavior. Subjects who had left school were smoking at more than twice the rate of subjects still in high school (grade 12) at T8. We discuss implications of the results.
Elevated blood levels of carcinogens in passive smokers.
Authors: Maclure M , Katz R B , Bryant M S , Skipper P L , Tannenbaum S R
Published: November 2008

The hypothesis that involuntary exposure to tobacco smoke--passive smoking--results in greater risk of cancer was assessed by measuring the levels of two known carcinogens in the blood of 57 nonsmokers with varying degrees of involuntary exposure, including six heavily exposed bartenders. The concentrations of hemoglobin adducts of 4-aminobiphenyl, a bladder carcinogen, were significantly higher in subjects with confirmed involuntary exposure (plasma cotinine concentrations between 2 and 23 ng/ml) compared with subjects with undetectable levels of cotinine. Similarly, adducts of 3-aminobiphenyl were significantly elevated in subjects with confirmed exposure. The odds of 3-aminobiphenyl adduct levels exceeding 2 pg/g of hemoglobin were 6:7 among the confirmed exposed, compared with the odds of 2:42 among subjects with undetectable cotinine (odds ratio = 18; 95 percent confidence interval = 3.3, 94). The validity of the assay was demonstrated by showing striking declines in adduct levels among quitting smokers.
The expense of testing in a teaching hospital: the predominant role of high-cost tests.
Authors: Hartley R M , Markowitz M A , Komaroff A L
Published: November 2008

We analyzed all 32,206 tests ordered in a random sample of 1,000 patients admitted to a teaching hospital. The analysis examined costs instead of charges, included professional costs in addition to hospital costs, and considered the effect of combining tests that are ordered as a panel (e.g., cardiac enzymes) or as part of a procedure (e.g., bronchoscopy). High-cost tests (costing more than $100) accounted for only 4 percent of the total number of tests ordered, but for nearly 50 percent of total test costs. The pattern varied by clinical service: high-cost tests accounted for 31, 47, and 51 percents of total test costs on the obstetrics, medicine, and surgery services, respectively. It would seem to be efficient to concentrate on the use of high-cost tests in attempting to foster cost-effective use of diagnostic technologies.
Fluoridation referendum in La Crosse, Wisconsin: contributing factors to success.
Authors: Jones R B , Mormann D N , Durtsche T B
Published: November 2008

Residents of La Crosse, Wisconsin approved a public referendum in favor of water fluoridation on April 5, 1988. The vote, 57 percent supportive, culminated a two-year community effort. Three public referenda had been defeated in the past. Contributing to the success of this recent campaign were: broad-based community support led by a 34-member Citizens for Better Dental Health in La Crosse Committee; American Dental Association/Wisconsin Division of Health/US Public Health Service consultation and support; knowledgeable and supportive press coverage; the timing of the ballot to coincide with the Wisconsin Presidential Primary; and local chiropractic support to offset chiropractic anti-fluoridation leadership. La Crosse, population 50,000, was the largest fluoride-deficient community in a nine-state upper Midwest area.
Influenza immunization in the elderly: knowledge and attitudes do not explain physician behavior.
Authors: McKinney W P , Barnas G P
Published: November 2008

The records of 847 elderly clinic patients were reviewed and the 95 primary care physicians who managed their care were surveyed to determine factors related to their ordering of influenza immunization. Overall, 41 percent of the eligible patients were offered vaccine (range 0-90 percent). Physician offering of vaccine was unrelated to patient age, sex, or race but was higher in patients seen on multiple visits (47 vs 39 percent) and in those vaccinated during the prior year (61 vs 35 percent). Physician offering of vaccine was not associated with perceived incidence of severe side effects or estimates of vaccine efficacy.
Occupational exposure to human immunodeficiency virus (HIV) and hepatitis B virus (HBV) among embalmers: a pilot seroprevalence study.
Authors: Turner S B , Kunches L M , Gordon K F , Travers P H , Mueller N E
Published: November 2008

We performed a serosurvey of 133 embalmers in an urban area where human immunodeficiency virus (HIV) infection is prevalent. Although we found histories of needlesticks to be common, and the seropositivity rate of hepatitis B virus (HBV) (13%) was approximately twice that of a blood donor comparison group, HIV antibody was uniformly absent in 129 embalmers who denied HIV risk factors, and present in one of four with self-described risk behaviors. The risk of HBV infection was higher among embalmers who have worked more than 10 years, relative risk (RR) 16.2 (95% confidence interval 2.1, 126.5), did not routinely wear gloves, RR 9.8 (CI 3.4, 28.5), or are employed in the city of Boston, RR 4.7 (CI 1.8, 12.0).
Prevalence of depressive symptoms in a Japanese occupational setting: a preliminary study.
Authors: Iwata N , Okuyama Y , Kawakami Y , Saito K
Published: November 2008

We measured the prevalence of depressive symptoms in 2,190 Japanese tax office workers using the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D). Score distribution by sex was more symmetrical and the mean score of each sex was higher than in the United States population. A high level of depressive symptoms was found in 15.2 percent of males and 10.6 percent of females by controlling for age and marital status. Males aged 50 years and over had more depressive symptoms than other male age groups. Perceived stress, related both to family life and the workplace, was associated with a high level of depressive symptoms. "Long-distance marriage" ("business bachelorhood"), peculiar to Japanese occupations, had little influence on depressive symptomatology.
Prevention of childhood injuries: evaluation of the Statewide Childhood Injury Prevention Program (SCIPP).
Authors: Guyer B , Gallagher S S , Chang B H , Azzara C V , Cupples L A , Colton T
Published: November 2008

We evaluated the effectiveness of a community-based injury prevention program designed to reduce the incidence of burns, falls in the home, motor vehicle occupant injuries, and poisonings and suffocations among children ages 0-5 years. Between September 1980 and June 1982, we implemented five injury prevention projects concurrently in nine Massachusetts cities and town; five sites, matched on selected demographic characteristics, were control communities. An estimated 42 percent of households with children ages 0-5 years were exposed to one or more of the interventions over the two-year period in the nine communities. Participation in safety programs increased three-fold in the intervention communities and two-fold in the control communities. Safety knowledge and practices increased in both intervention and control communities. Households that reported participatory exposure to the interventions had higher safety knowledge and behavior scores than those that received other community exposure or no exposure to intervention activities. We found a distinct reduction in motor vehicle occupant injuries among children ages 0-5 years in the intervention compared with control communities, associated with participatory exposure of about 55 percent of households with children ages 0-5 years. We have no evidence that the coordinated intervention programs reduced the other target injuries--although exposure to prevention messages was associated with safety behaviors for burns and poisonings.
Breast cancer screening legislation in the United States.
Authors: Thompson G B , Kessler L G , Boss L P
Published: November 2008

We discuss some of the issues emerging from a powerful legislative movement for preventive services over the past three years. During this time an increasing number of states passed, considered, or are currently developing breast cancer screening legislation. Most of these laws require some form of third party payment for mammography or establish breast cancer screening programs. The legislation varies markedly with regard to periodicity of examinations, ages covered, type and extent of third party coverage, dosage regulation, and radiographic equipment standards. This shows a need for common standards. Legislation provides an essential incentive for a public health response to a serious problem, but more than laws are needed. Health care providers and the general public need to be aware and take advantage of the coverage provided as a result of legislation. Moreover, public health officials need to be aware that such legislation may lead to a demand for services that exceeds present capacity to deliver them.
The impact of media coverage of Nancy Reagan's experience on breast cancer screening.
Authors: Lane D S , Polednak A P , Burg M A
Published: November 2008

In surveys of random samples of women 50 years of age and older residing in two communities in Long Island, New York, both within-subject (cohort) and independent-sample comparisons were made before and after the media announcements of Nancy Reagan's breast cancer. Knowledge of lifetime risk of breast cancer increased significantly only in the cohort comparison, while self-perception of risk did not increase. Small proportions of women surveyed, however, reportedly were influenced to contact a health professional (6-8 percent) and to have their first mammogram (1.5-2 percent) which they attributed directly to Mrs. Reagan's experience with breast cancer.
Geographic variation in the occurrence of hip fractures among the elderly white US population.
Authors: Bacon W E , Smith G S , Baker S P
Published: November 2008

Geographic variations in hip fracture rates across the nine US Census Divisions were examined using data for elderly Whites from the 1979-85 National Hospital Discharge Survey. Rates varied considerably and were highest in the West North Central Division where rates for females were 50 percent higher than the US rate. Reasons for the geographic variations in hip fracture rates are unknown but do not appear to be closely related to latitude or fall-related deaths.
The reliability of health risk appraisals: a field trial of four instruments.
Authors: Smith K W , McKinlay S M , McKinlay J B
Published: November 2008

A field trial was conducted to evaluate the reliability of four widely used health risk appraisals (HRAs). A total of 338 randomly selected adults aged 25 to 65 years residing in the Boston metropolitan area completed an HRA on two occasions seven to 12 weeks apart. Test-retest reliability was assessed by comparing self-reported baseline risk scores to follow-up scores for heart attack risk and selected coronary heart disease risk factors. Respondents generally gave consistent reports for family history, cigarette smoking, and relative weight (test-retest r greater than .75), but self-reported scores for physiologic status (blood pressure and cholesterol) and lifestyle (diet, physical activity, and stress) were much less stable. Coefficients for heart attack risk and appraised age ranged from .43 to .87 for the four HRAs. The reliabilities of two self-scored instruments were greatly reduced by mathematical errors made by respondents when computing their heart attack risk scores. These results were not affected by the length of the follow-up period (seven to 12 weeks).
Accuracy of perceptions of heart attack risk: what influences perceptions and can they be changed?
Authors: Avis N E , Smith K W , McKinlay J B
Published: November 2008

Using perceived risk of a heart attack, we examined the relative importance of perceived risk factors and sociodemographic variables on subjects' perception of heart attack risk, the relationship between perceived and objectively measured heart attack risk, and the effect of health risk appraisal (HRA) feedback on risk perceptions. Data derive from a random sample of 732 Greater Boston, Massachusetts area men and women ages 25-65 years, who participated in a field trial of health risk appraisal instruments. At baseline and approximately two months later, all respondents completed a questionnaire assessing their own health-related behavior, risk factors, and perception of heart attack risk. At baseline, respondents also completed one of four HRA instruments. Physiologic measures of cholesterol, blood pressure, and weight were taken at either baseline or follow-up visit. Results showed that respondents used established risk factors in estimating overall risk; that compared to objective measures of risk, a high percentage of respondents displayed an optimistic bias; and that HRA feedback had some effect on perception of heart attack risk for those at high risk. Implications of these results for health promotion are discussed.
The prevention of silicosis and prediction of its future prevalence in China.
Authors: Lou J Z , Zhou C
Published: November 2008

We studied the effects of preventive and therapeutic interventions on the 18-year cumulative incidence of silicosis of 26,603 dust-exposed workers in seven Chinese mines and industrial plants. Cumulative silicosis incidence decreased from 36.1 percent in workers employed before 1950 to 1.5 percent in workers employed after 1960. From the 1950s to 1970s, eight-year cumulative incidence of tuberculosis decreased from 54.7 percent to 16.7 percent and case fatality of silicosis patients dropped from 53.9 percent to 18.3 percent. From 1950s to 1980s, the average age at the detection of silicosis increased from 41.3 to 52.7 and the average survival time of silicosis patients prolonged from 2.0 to 12.2 years. Workers over age 40 who began exposure to dust before 1960 will be the main source of new silicosis patients in future. Most expected new cases of silicosis will occur within the next 15 years. The silicosis population will remain unchanged for the next 20 years and will decrease dramatically after 25 years. There will be few silicosis patients in 30 years and new cases of silicosis will be difficult to find in 45 years. These results show that the preventive and therapeutic actions against silicosis in China have been effective.
Risk of carotid endarterectomy in the elderly.
Authors: Fisher E S , Malenka D J , Solomon N A , Bubolz T A , Whaley F S , Wennberg J E
Published: November 2008

We used the Medicare claims files to describe operative mortality for 2,089 New England residents over the age of 65 who underwent carotid endarterectomy in 1984 and 1985. For patients ages 65 to 69, the risk of death within 30 days of surgery was 1.1 percent, (95% confidence interval = 0.5, 2.1), for those ages 70 to 74, 2.8 percent (1.7, 4.4), for those ages 75 to 79, 3.2 percent (1.8, 5.2), and for those over age 80, 4.7 percent (2.3, 8.5). Nearly 80 percent of patients underwent surgery at hospitals performing 40 or fewer carotid endarterectomies per year on the Medicare population. The adjusted odds ratio for 30 day mortality for patients undergoing surgery in these low-volume hospitals was 2.8 (95% CI = 1.1, 7.2) compared to higher volume hospitals. Although the Medicare claims data provided only limited data about post-operative strokes, analysis of post-operative stroke risk supported these findings.
Geographic variation in the onset of decline of male ischemic heart disease mortality in The Netherlands.
Authors: Mackenbach J P , Looman C W , Kunst A E
Published: November 2008

We studied variation in the year of onset of ischemic heart disease mortality decline among regions (n = 39) in the Netherlands. Using loglinear regression methods, a quadratic regression model was fitted to the observed numbers of male deaths in each region in the period 1950-84, controlling for changes in age-structure of populations. The quadratic regression model proved inadequate to describe the mortality experience of females. For the country as a whole, the estimated year of onset of male ischemic heart disease mortality decline is 1973.9. The difference between the earliest and the latest region is almost nine years (1970.0 and 1978.9, respectively). An early onset of decline (less than or equal to 1972) is only found in the urbanized, western part of the country. A later (greater than or equal to 1975) onset of decline is characteristically found in more peripheral regions in the South-West and South-East, as well as in the North. Exploratory correlation and regression analyses show that both average income and percent of population living in larger cities have independent, negative associations with the year of onset of male ischemic heart disease mortality decline. We argue that regional variation in the timing of lifestyle changes is a more plausible explanation of these observations than regional variation in the timing of medical care improvements.
Effect of a gatekeeper plan on health services use and charges: a randomized trial.
Authors: Martin D P , Diehr P , Price K F , Richardson W C
Published: November 2008

A randomized trial was conducted to determine the effectiveness of a health care plan which uses physicians as gatekeepers to control health services use and charges. New enrollees in United Healthcare (UHC), an independent practice association, were randomly assigned to the standard UHC plan requiring a gatekeeper, or to an alternate plan with equal benefits but without a gatekeeper. Individuals in both plans were similar in demographic characteristics, perceived health status, and other health insurance coverage. The gatekeeper plan had 6 percent lower total charges per enrollee than the plan without a gatekeeper. There were minor differences in hospital use and charges. Ambulatory charges were $21 lower per person per year in the plan with a gatekeeper (95% CI = -39.9, -2.1) and these were due to .3 fewer visits to specialists (95% CI = -0.50, -0.10). We conclude that a health plan which incorporates incentives and penalties for physicians to act as gatekeepers can reduce the cost of ambulatory services by limiting specialist visits.
Increased suppressor T cells in probable transmitters of human immunodeficiency virus infection.
Authors: Seage G R , Horsburgh C R , Hardy A M , Mayer K H , Barry M A , Groopman J E , Jaffe H W , Lamb G A
Published: November 2008

To evaluate behavioral and immunologic factors related to transmission of human immunodeficiency virus (HIV) by homosexual intercourse, we studied a population of 329 homosexual/bisexual men (155 partner-pairs) seen in a community health center and medical outpatient clinic. Logistic regression analysis showed that behavioral risk factors for infection in the 130 HIV-infected men included: receptive anal intercourse (OR 4.6, 95% CI-1.8, 12.1); receptive fisting (OR 2.5, CI-1.1, 7.0); nitrite use (OR 2.3, CI-1.2, 4.6); history of gonorrhea or syphilis (OR 2.3, CI-1.4, 3.9); and history of sexual contact with men from areas with many AIDS cases (OR 1.9, CI-1.0, 3.5). Comparing seven men who were probable transmitters of HIV and 11 men who had not transmitted HIV to their uninfected partners despite unprotected insertive anal intercourse, we found no differences in HIV isolation from peripheral blood mononuclear cells, circulating HIV antigen detection, or presence of neutralizing antibody to HIV. Helper T-cell numbers were not significantly different between the two groups, but transmitters had more suppressor T-cells than did nontransmitters.
A comparison of perceived and objective CVD risk in a general population.
Authors: Niknian M , McKinlay S M , Rakowski W , Carleton R A
Published: November 2008

This report examines correspondence between perceived and objective (American Heart Association's RISKO) risk of heart attack and stroke in a randomly selected sample from two surveys (n = 4,171) conducted in each of two New England cities, in 1981-82 and 1983-84, respectively. Results confirmed prior reports that people tend to underestimate their CVD (cardiovascular disease) risk and showed that estimates of those at lowest risk were most accurate.
Demographic change in a corporate health benefits population, 1983-87.
Authors: Kintner H J
Published: November 2008

This paper describes changes in the population for which General Motors provides health benefits using data from domestic personnel records. Total population size grew from 2.01 million in 1983 to 2.14 million in 1987, twice as fast as the US population. Dependents, particularly spouses, fueled the population growth. Trends suggest that nonworker eligibility for employer-provided health benefits may receive more attention in health care cost containment efforts.
Fatal unintended carbon monoxide poisoning in West Virginia from nonvehicular sources.
Authors: Baron R C , Backer R C , Sopher I M
Published: November 2008

Based on medical examiner reports and state vital records, 1978-84, nonvehicular carbon monoxide (CO) caused 62 unintended deaths, representing 42 percent of all unintended fatal CO poisonings in West Virginia. Sources were almost always heating or cooking appliances associated with incomplete combustion of fuels (methane, butane, or propane) not commonly recognized for their potential to produce CO. Hazards included failure to provide recommended venting, neglected maintenance, or use in small areas without natural ventilation.
Warnings unheeded: a history of child lead poisoning.
Authors: Rabin R
Published: November 2008

Child lead poisoning has been a major public health issue only for the last 20-25 years. However, awareness that lead-based paint is a source of lead poisoning in children dates back to the first few years of the twentieth century. Articles in medical journals and textbooks appeared in the United States and elsewhere, recounting cases of children poisoned by the lead paint in their homes on woodwork, baby cribs, and other furniture. The number of positively diagnosed cases was limited both by the imprecision of diagnostic tools and physicians' lack of familiarity with the signs and symptoms of plumbism in children. Nevertheless, a number of hospitals and at least one large city health department recorded numerous cases of child lead poisoning in the 1920s and 1930s. The mounting evidence in those years made it clear that child lead poisoning was a serious public health hazard. And the activities and statements of the lead industry's representatives left little doubt that they were aware of the dangers of lead paint. Nevertheless, the lead paint companies continued to manufacture and sell their product well past 1940.
International comparisons of trends in cigarette smoking prevalence.
Authors: Pierce J P
Published: November 2008

Data on smoking prevalence since 1974 are presented for the United States, Canada, Great Britain, Australia, Norway and Sweden. During this period, sex-specific prevalence has decreased in all the countries studied, with the exception of Norway, where women showed an increase. There was also a considerable decline in uptake of smoking by the young over this period, suggesting that the observed decline in prevalence is likely to continue. In the United States, the rate of decline in adult smoking prevalence has been linear. This linear pattern is probably similar in prevalence in most other countries studied, with the notable exception of Australia, which demonstrated no change for the majority of the period. Among the six countries studied, the United States had neither the lowest smoking prevalence nor the fastest rate of decline over the period. Differential patterns of change infer that the successful public health interventions in some countries are not being applied in others. While the lack of change in Australia prior to 1983 is surprising, this was followed by a sizable drop in smoking prevalence for both higher and lower educational groups in conjunction with the introduction of mass media-led antismoking campaigns. Most of the other countries report an ever increasing gap in prevalence between higher and lower educational groups. These findings suggest that all countries might benefit from a greater exchange of antismoking ideas and public health action.
The influence of smoking on vitamin C status in adults.
Authors: Schectman G , Byrd J C , Gruchow H W
Published: November 2008

To further define the relation between smoking and vitamin C status, the dietary and serum vitamin C levels of 11,592 respondents in the second National Health and Nutrition Examination Survey (NHANES II) were analyzed. Smokers of 20 cigarettes daily had the lowest vitamin C dietary intake (79 mg, 95% CI:73, 84) and serum levels (0.82 mg/dl, 95% CI: 0.77, 0.86; 46.6 mumol/L, 95% CI: 43.7, 48.8), while smokers of 1-19 cigarettes daily had decreased vitamin C intake (97 mg; 95% CI: 90, 104 mg) and serum levels (0.97 mg/dl, 95% CI: 0.92, 1.03; 55.1 mumol/L, 95% CI: 52.2, 58.5) compared to respondents who had never smoked (109 mg, 95% CI: 105, 113 and 1.15 mg/dl, 95% CI: 1.11, 1.18; 65.3 mumol/L, 95% CI: 63.0, 67.0, respectively). This inverse association between both intake and serum levels of vitamin C and smoking was independent of age, sex, body weight, race, and alcoholic beverage consumption. Following further adjustment for dietary vitamin C intake, the negative correlation between cigarette smoking and serum vitamin C levels persisted. The risk of severe hypovitaminosis C (serum levels less than or equal to 0.2 mg/dl; 11.4 mumol/L) was increased in smokers, particularly when not accompanied by vitamin supplementation (odds ratio 3.0, 95% CI: 2.5, 3.6). These data suggest that even though smoking adversely affects preferences for vitamin C rich foods, the inverse association between smoking and serum vitamin C levels occurs independently of dietary intake.
Validity of telephone surveys in assessing cigarette smoking in young adults.
Authors: Luepker R V , Pallonen U E , Murray D M , Pirie P L
Published: November 2008

Self-reports of cigarette smoking in a sample of young adults, aged 17 to 21 (n = 359) obtained by telephone were validated by home interview and saliva cotinine measurement. While most subjects were in agreement for their reported behaviors, the telephone methodology underestimated cigarette smoking rates by 3 to 4 per cent. Reported quitting by telephone was an unstable category with 35 per cent of quitters reporting smoking on home interview. Reliance on telephone methods alone may underestimate smoking behavior. Validation of surveys, preferably by biochemical methods, is recommended.
Traffic safety effects of sobriety checkpoints and other local DWI programs in New Jersey.
Authors: Levy D , Shea D , Asch P
Published: November 2008

We examined the efficacy of three Driving While Intoxicated (DWI) programs in New Jersey from 1980 through 1985, using covariance analysis of county data. Road blocks, the major component of the Strike Force program, were associated with a drop of 10-15 per cent in the single vehicle nighttime crash rate and showed a relatively stable effect over time. DWI Task Force, an education program, was associated with a 6-10 per cent total decline in the crash rate and declining impact over time. SOBER, another education program, was associated with a small effect in the first year and little or no effect thereafter.
Risk of fatal rollover in utility vehicles relative to static stability.
Authors: Robertson L S
Published: November 2008

The risk of fatal rollover of utility vehicles per 100,000 registered vehicles relative to cars during 1982-87 was strongly correlated to the static stability of the vehicles. Distance between the center of the tires divided by twice the height of center of gravity explained 62 per cent of the variation in fatal rollover rates where rollover was the first harmful event. Statistical controls for 20 major risk factors indicated no correlations that would deflate the correlation between stability and rollover. Low stability utility vehicles roll over more often on the road suggesting that the lateral force of turning is often the tipping force.
Evaluation of a community-wide incentive program to promote safety restraint use.
Authors: Foss R D
Published: November 2008

A program was designed and evaluated to determine the feasibility of implementing an incentive campaign to promote safety restraint use, primarily among children up to age 13. During a five-month period, community residents were eligible to win monthly prizes and a grand prize by buckling up all automobile occupants when driving. Systematic monitoring of traffic and a telephone survey indicate that the program was minimally effective, reaching the attention of only about half the families with children in the community despite extensive advertising. Effects of the program on seat belt use closely paralleled airing of radio announcements, appear to have been confined primarily to children under age four, and tailed off somewhat after the initial response.
Evaluation of the efficacy of simulation games in traffic safety education of kindergarten children.
Authors: Renaud L , Suissa S
Published: November 2008

Using a simulation game designed to teach children to obey certain traffic safety rules, an experimental study was conducted with 136 five-year-old children in four Quebec schools. Within each classroom, subjects were randomly divided into four groups: three intervention groups and one control group. Each of the experimental groups was subjected to a different intervention with outcome measured using three instruments related to attitudes, behavior, and transfer of learning of pedestrian traffic safety. Results suggest that simulation games including role-playing/group dynamics and modeling/training can change attitudes and modify behavior in the area of pedestrian traffic safety in children of this age.
Childhood injury deaths: national analysis and geographic variations.
Authors: Waller A E , Baker S P , Szocka A
Published: November 2008

Twenty-three causes of injury mortality in children ages 0-14 in the United States were analyzed by age, race, sex, and state of residence for the years 1980-85. Motor vehicles caused 37 per cent of all injury-related deaths and were the leading cause of injury mortality in every group except children younger than one year, for whom homicide was the leading cause. Male death rates were at least four times female rates for suicide, unintentional firearm injury, and injuries related to farm machinery or motorcycles. The drowning rate among Whites was almost twice that of Blacks for ages 1-4, but in the 10-14 year age group the drowning rate for Blacks was over three times that of Whites. In general, the highest injury death rates were in the mountain states and the south. Between 1980 and 1985, the suicide rate in the 10-14 year age group more than doubled.
The inaccessibility of seat belts in taxicabs.
Authors: Davis R M
Published: November 2008

The accessibility of seat belts was determined in a total sample of 200 taxicabs waiting to pick up passengers at eight city airports. A rear seat belt was "accessible" (able to be fastened within 10 seconds) in 111 (55.5 per cent) taxicabs. The proportion varied by city from 16.0 per cent (New York City) to 96.0 per cent (Minneapolis-St. Paul) and was higher for taxicabs in cities covered by mandatory state seat belt legislation.