bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in the cigarette consumption of smokers in relation to changes in tar/nicotine content of cigarettes smoked.
Authors: Garfinkel L
Published: November 2008

Over a 13-year period, 59 per cent of 28,561 smokers decreased the tar and nicotine (T/N) level in the cigarettes they smoked without changing the number of cigarettes smoked to any important extent. On the other hand, more than 54 per cent of the "less than one pack a day" smokers as compared to only 25 per cent of the "one pack or more a day" smokers increased the number of cigarettes smoked. Nicotine dependency plays a minor role in determining the smoking habits of those who continue to smoke on a long-term basis.
Risk factors of lip cancer: a critical evaluation based on epidemiological comparisons.
Authors: Lindqvist C
Published: November 2008

A description is given of the occurrence of lip, skin, and intraoral cancers in Finland in the period 1953-1973 with the aim of testing certain etiologic hypotheses. In addition, data on lip cancer were correlated with those of some other types of cancer. Substantial differences with respect to various epidemiologic parameters were found between lip and skin cancers. However, there were similarities between lip cancer and cancers of the upper gastrointestinal canal and respiratory organs (especially lung cancer). Negative geographic correlation was found between the age-adjusted incidence rate of lip cancer and that of cancers of the colon and prostate. In addition, the correlation was highly negative for the median income per capita (p less than 0.001). It was concluded that, in terms of cancer etiology, lip cancer is more closely related to cancer of the oral cavity than to that of the skin. Moreover, some specific socioeconomic factors associated with a low standard of living must be considered as noteworthy risk factors of lip cancer.
Characteristics of individuals who identify a regular source of medical care.
Authors: Lave J R , Lave L B , Leinhardt S , Nagin D
Published: November 2008

Having a source where medical services are regularly received is an antecedent to securing high quality medical care; it facilitates access and indicates that the individual is not alienated from the health care delivery system. In this paper we develop models to characterize individuals, both children and adults, who claim a regular source of care. The models are estimated using a logit analysis (since the dependent variable is 0-1) applied to survey data on residents of East Palo Alto, California. These data indicate that in this low-income, predominately black population the most important factor influencing whether a child will have a regular source of medical care is whether the parents have a regular source. For adults, the anticipated need for care (as measured by health status), time in community, and sex were all found to be important. The type of individual least likely to have a regular source of care is a low-income, unmarried male who is in good health and is a recent arrival to the community. The individuals most likely to need easy access to medical care and continuity of care are most likely to have a regular source of care, and vice versa.
Ambient carbon monoxide levels and acute cardiorespiratory complaints: an exploratory study.
Authors: Kurt T L , Mogielnicki R P , Chandler J E , Hirst K
Published: November 2008

Over a 92-day seasonally excessive period of ambient carbon monoxide (CO), chief cardiorespiratory complaints (CRC) of a nontraumatic origin were identified from each of 8,556 patient encounters at the Emergency Room of Colorado General Hospital. Excessive numbers of CRC were seen above a CO level of 5 ppm for the 24-hour mean and 11 ppm for the one hour mean maximum ambient CO (p less than 0.05 for both). Increasing relative risk was shown by comparing daily numbers of CRC with its mean in two-day trend analyses with both ambient CO measures above and below these thresholds. Other ambient pollutants were generally low during the winter period studies. These findings suggest an association between health effects and lower levels of CO than has been previously reported.
Drowning and near-drowning involving children: a five-year total population study from the City and County of Honolulu.
Authors: Pearn J H , Wong R Y , Brown J , Ching Y C , Bart R , Hammar S
Published: November 2008

A study of all serious childhood immersion accidents (both drowned and near-drowned cases) is reported from Hawaii. This is a total population-based survey of 140 consecutive cases (0--15 years) occurring during the five-year period (1973--1977. Age-specific, sex-specific, and osmolality-specific (salt versus fresh water) data are presented both for survivors and fatalities. The overall annual drowning rate of 3.1 per 100,000 children at risk is low, for a water-oriented society. The survival rate following loss of consciousness in the water is 73 per cent. There is no evidence from this study that osmolality affected the probability of survival. The rank order of importance of drowning sites is swimming pools, surf, sheltered salt water bathing, domestic bath tubs, fresh water streams, salt water canals, and garden fish ponds. Specific accident rates, by sex, outcome, and site of immersion are also presented. No secular trend in the rate of drowning was observed in this study. Comparison with the only other available total population survey (Australia) of childhood immersions reveals common epidemiological and demographic patterns in modern urban societies and suggests that safety regulations play a role in reducing swimming accidents and fatalities in children.
Evaluation of the Tennessee Child Restraint Law.
Authors: Williams A F
Published: November 2008

In Tennessee a law came into force January 1, 1978 requiring parents to use child restraints properly when transporting their children who are less than four years old. Alternatively, the law permits children to be held in arms, a practice known to be hazardous rather than protective. Before and after the law went into force, observations were made of children in cars exiting from shopping centers in Knoxville and Nashville, Tennessee, and in Lexington and Louisville, Kentucky, an adjacent state not having a child restraint law. More than 80 per cent of Tennessee children observed in the fourth month the law was in force were not using child restraints anchored by seat belts, although use rates increased in Tennessee (8 to 16 per cent) to a greater extent than in Kentucky (11 to 15 per cent). Moreover, due to a large increase in children traveling in arms in Nashville, there was an increase in such travel in the two Tennessee cities studied (23 to 28 per cent) relative to a decrease in those studied in Kentucky (19 to 14 per cent).
The U.S. hospice movement: issues in development.
Authors: Osterweis M , Champagne D S
Published: November 2008

A grass-roots hospice care movement is underway in the United States modeled after recently popularized British hospice programs. Hospice care is intended to help the terminally ill maintain a personally acceptable quality of life until death. Attention should be given to ensuring the future viability of this service option by allowing for experimentation with and adaptation of existing models, and by integrating it with the overall health care system. Issues to be considered in integrating hospice care include utilization of existing resources, regional planning, standards and licensure, and reimbursement opportunities. Although hospice care may not have an immediate cost savings impact on the health care system, it could develop this capacity in the future. Such impact would not only assure a stable financial base for hospice care but would also affect bed use generally. Continuing dialogue among providers, consumers, and policy makers of various backgrounds is necessary to the effective and appropriate development of hospice care in the U.S.
Exercise prescription: a clinical trial.
Authors: Reid E L , Morgan R W
Published: November 2008

To assess the effectiveness of physician prescribed exercise, health education, and patient self-monitoring, 124 firefighters were medically screened and randomly allocated to a control and two treatment groups. Physiologic and reporting methods were employed to assess adherence to regular exercise at three months and six months after the initial exercise prescription. Addition of a health education program significantly improved compliance over that achieved by a physician consultation. Self-monitoring did not produce a further increase in compliance. Improvement in the treatment groups was limited to three months after prescription; at six months, the treatment and control populations had similar exercise patterns.
A comparison of growth: Spanish-surnamed with non-Spanish-surnamed children.
Authors: Duncan B , Smith A N , Briese F W
Published: November 2008

Weight, height, and head circumference measurements of 4,167 Spanish-surnamed school-aged children were compared with similar data from 2,322 non-Spanish surnamed children who resided in the same Denver, Colorado neighborhoods. These data were also compared with data from six other studies. Both male and female Spanish-surnamed children were found to weigh less, be shorter, and have smaller head circumferences than non-Spanish-surnamed children living in the same Denver neighborhoods. The sizes of the children in these two populations residing in lower and lower-middle class neighborhoods were closer to each other than to the sizes of children from middle and upper-middle socioeconomic classes as measured in previous studies or to the sizes of children in the recently published cross-sectional National Center for Health Statistics study. Such comparisons suggest that growth retardation is more a reflection of socioeconomic factors than of ethnic-genetic factors.
Attitudes of mothers toward sex education.
Authors: Block D
Published: November 2008

Data are presented on the attitudes of mothers from the entire social class spectrum toward content and timing of sex education for children (CT-Attitudes), and also toward sex education in school (S-Attitudes) in two California communities in 1969. Findings underscore the necessity to consider these two attitudinal variables separately. As a result of their separation for study purposes, it was possible to arrive at a four-fold typology or grouping of mothers: 1) CT liberals in favor, and 2) CT liberals opposed to sex education in schools, 3) CT conservatives in favor, and 4) CT conservatives opposed to school programs of sex education. It is inferred that educational planners need to pay due regard to the sentiments of all four maternal groups and all social classes in developing sex education programs for families and for school children.
Job-related activities, academic preparation, and continuing education needs of graduates of schools of public health.
Authors: Monroe L B , Tuttle D M , Lorimor R J
Published: November 2008

This survey determined the job-related activities being carried out by graduates of the University of Texas School of Public Health (UTSPH), whether the graduates received preparation for each activity in their academic program, and what continuing education was needed in each job-related activity. It was found that there was a difference between job activities of UTSPH graduates and their perceptions of their preparation at UTSPH for these activities. Further study is planned.
Pancreatic cancer mortality in Louisiana.
Authors: Pickle L W , Gottlieb M S
Published: November 2008

As a preliminary step in the investigation of high pancreas-cancer mortality among White males in a cluster of Louisiana parishes, we examined 876 pairs of certificates of death which occurred in this area during 1960--75. The pancreas-cancer death records were matched to controls by age, race, sex, year of death, and parish of residence. The odds ratios were increased about two-fold for workers in the oil refining and paper manufacturing industries, and slight elevations were seen among residents near refineries and food processing plants. Despite the limited residential and occupational information available on death certificates, this study suggests leads to environmental factors that can be further investigated by a case-control interview study in Louisiana.
The epidemic of endometrial cancer: a commentary.
Authors: Jick H , Walker A M , Rothman K J
Published: November 2008

Vital statistics show that a rise in incidence of endometrial cancer began in the mid-1960s on the West Coast of the United States. This rise was continuous and reached a peak in 1975. Elsewhere, incidence rates for endometrial cancer rose during the 1970s. It now seems evident that much of the rise in all areas of the country was due to replacement estrogen treatment. We estimated from data obtained from the Commission on Professional and Hospital Activities-Professional Activity Study of Ann Arbor, Michigan, that over 15,000 cases of endometrial cancer were caused by replacement estrogens during the five-year period 1971--1975 alone. This represents one of the largest epidemics of serious iatrogenic disease that has ever occurred in this country. With the substantial fall in estrogen sales starting in January 1976, there has been an associated decline in the incidence rates of endometrial cancer nationwide.
Selection of health insurance by an employee group in Northern California.
Authors: Piontkowski D , Butler L H
Published: November 2008

Enrollment trends for a large employee group were analyzed to determine the extent to which consumers chose Blue Cross or Health Maintenance Organization (HMO) health insurance under various premium differentials. Data were collected from employment records of six University of California campuses for the period 1967 to 1978. Enrollment in the Kaiser Foundation Health Plan (an HMO) more than doubled during this period while enrollment in Blue Cross remained relatively stable. This increased preference for Kaiser coverage was associated with a concurrent relative rise in costs to employees of Blue Cross coverage. These data suggest that consumers are sensitive to insurance costs, and that given the opportunity HMOs can compete effectively with traditional health insurance.
Natural history of obesity in 6,946 women between 50 and 59 years of age.
Authors: Hartz A J , Rimm A A
Published: November 2008

A health survey of 6946 50-to-59 year-old women of TOPS, an organization for weight reduction, was used to study the natural history of obesity. Weight history was compared for four groups of women divided on the basis of their per cent above ideal body weight (IBW) in their 50s (less than 20%, 20-49%, 50-99% and 100+%). In each of the four groups, the majority of women were not obese by age 20. Sixteen per cent of the women who were 100+% overweight in their 50s were not obese at anytime during their first 30 years of life. Thirty-six per cent of the women who were 50-99% about IBW were not overweight at anytime prior to their 30th birthday. The history of obesity prior to age 30 was not associated with weight gain between the ages of 30 and 50. These data suggest: 1) than there is no critical time for the development of obesity, and 2) that previous weight history is not a dominant factor in determining subsequent weight gain.
Evaluation of a decentralized system for chronic disease care: seven years of observation.
Authors: Miller S T , Zwagg R V , Joyner M B , Runyan J W
Published: November 2008

Observations of a publicly-financed system for the medical care of a large number of persons with chronic diseases have been made over seven years. The system combines decentralized, nurse-staffed neighborhood clinics, operated by a public health department, with a central referral clinic for consultations and the management of complicated problems. After seven years in the chronic disease program 55% of 1,004 patients with diagnoses of diabetes mellitus, hypertension, and cardiac diseases were still receiving care, 19% had died, and 26% had been lost to the program. In the seventh year, the mean diastolic blood pressure in hypertensives was 84 mm Hg and the mean serum glucose in diabetics was 203 mg/dl. For the group under care, hospital days/1000/year were 74% of the rate during the year before referral to the program and out-patient visits/1000/year were approximately the same as before referral. However, two-thirds of the visits, formerly made to a public hospital, were now being made to neighborhood clinics. The system appears to be an effective method of providing medical services for persons who formerly used the public hospital as their source of outpatient care.
The repeal of helmet use laws and increased motorcyclist mortality in the United States, 1975-1978.
Authors: Watson G S , Zador P L , Wilks A
Published: November 2008

Monthly mortality figures for motorcyclists for each state in the United States were obtained for the period January 1975 through December 1978. Twenty-four states revealed or weakened their helmet use laws at various dates within this period. Two of these states subsequently reintroduced a strengthened law. This paper measures the effects of these law changes on motorcyclist mortality. The states that repealed or weakened their helmet laws were matched with one or more states from the same geographic region that either did not have helmet use laws or did not change such existing laws in this four-year period. The effect of weakening the law in each state was then estimated in three steps: 1) the mortality data from each state for the period prior to repeal were regressed on smoothed data from the matched states; 2) these equations were used to predict the numbers of motorcyclist deaths that would have been expected in each state in the period following the repeal or weakening of the law if the laws had not been changed; 3) these numbers of expected deaths were then compared with the actual numbers of deaths that occurred. Of the 26 law changes, it was found that 23 resulted in a greater number of actual deaths in the period following the repeal or weakening of the law than were predicted to occur if the law had not been changed. It is estimated that the repeals or weakening of motorcyclist helmet use laws were typically followed by almost 40 per cent increases in the numbers of fatally injured motorcyclists.
Psychosocial Correlates of Marijuana Use and Problem Drinking in a National Sample of Adolescents
Authors: Jessor Richard , Chase James A. , Donovan John E.
Published: November 2008

Personality, environmental, and behavioral variables representing psychosocial risk factors for adolescent problem behavior were assessed in a 1974 national sample study of over 10,000 junior and senior high school students. Significant correlations were found with marijuana use, and the relationships held across differences in age, sex, and ethnic group membership. Greater involvement in marijuana use was associated with greater value on independence than on academic achievement, lower expectations for academic achievement, lesser religiosity, greater tolerance of deviance, less compatibility between friends and parents, greater influence of friends relative to parents, greater models and support for problem behavior, greater actual involvement in other problem behaviors such as drunkenness, and less involvement in conventional behavior such as attending church. Multiple regression analyses show that this pattern of psychosocial correlates accounts for over 50 per cent of the variation in marijuana use. The pattern is nearly identical to the pattern that accounts for problem drinking in these same adolescents. The similarity of the patterns of psychosocial risk, and the substantial correlations of marijuana use with problem drinking and with other problem behaviors, suggest that marijuana use is best seen as part of a syndrome of adolescent problem behavior. (Am J Public Health 70:604- 613,1980.)
Consumer product hazards: setting priorities for research and regulatory action.
Authors: Rivara F P , Berger L R
Published: November 2008

Consumer products account for 6.8 million injuries per year. The current method of prioritizing regulation of consumer products and prevention of related injuries is the Hazard Index, developed by the U.S. Consumer Product Safety Commission. This Index, however, is based on an arbitrary weighting scale and fails to include any estimate of a denominator for injuries. A new Index, the Product Injury Index, based on an objective cost-based weighting procedure, and incorporating an injury ratio is proposed and applied to existing data. The relative rankings on the two scales are compared, and the advantages of the new scale are discussed.
Mentally retarded hepatitis-B surface antigen carriers in NYC public school classes: a public health dilemma.
Authors: Bakal C W , Novick L F , Marr J S , Millner E S , Goldman W D , Pitkin O
Published: November 2008

The placement of retarded children who have been institutionalized and are asymptomatic hepatitis-B surface antigen carriers into public school classes for the retarded has caused controversy and presented the New York City Health Department with an unusual medical-ethical dilemma. In this situation, the cost of interfering with deinstitutionalization, an important social advance, must be balanced against the benefit of controlling the unquantified but real risk of transmitting a potentially serious disease. The Health Department guidelines for managing this problem recommended serological surveillance, promotion of classroom hygiene where possible, and teaching of carriers in classes separate from their susceptible peers. A federal court disallowed the cohorting provisions of these guidelines. Changing policies and practices towards the mentally retarded, such as deinstitutionalization, raise important public health issues which will have to be faced by the involved communities.
The distribution and supply of Cuban medical personnel in Third World countries.
Authors: Grundy P H , Budetti P P
Published: November 2008

More than 2,000 Cuban health care personnel are presently providing care in Third World nations; less than five years ago this number was fewer than 100. Some 1,500 of these are physicians, representing nearly 13% of Cuba's 12,000 health service physicians. Cuba dominates the health care delivery system of four small African nations and South Yemen, and Cubans are a major presence in a number of larger countries, such as Iraq.
Assessment of a pilot child playground injury prevention project in New York State.
Authors: Fisher L , Harris V G , VanBuren J , Quinn J , DeMaio A
Published: November 2008

Following a child playground equipment injury prevention project conducted in New York State in 1977, there was a 42 per cent reduction in playground equipment hazards, and a 22.4 per cent reduction in playground related injuries treated in the two largest hospitals of one of the program sites. Knowledge about unsafe playground practices and equipment hazards improved after the workshops for playground personnel. This approach to injury prevention deserves further study.
The program implications of administrative relationships between local health departments and state and local government.
Authors: DeFriese G H , Hetherington J S , Brooks E F , Miller C A , Jain S C , Kavaler F , Stein J S
Published: November 2008

A typology of organizational arrangements between state and local public health agencies was used as a framework within which the organizational environment of the local health department was studied for its effects on program development and implementation by local public health departments. Data collected in a national sample of local health officers were used in measuring the effect of four different patterns of administrative relationships on the selected characteristics of local health department programs. Important differences were observed among the four organizational types with regard to constraints on programs and program priorities, and health officers' perceptions of the primary functions of local health departments and sources of local health department funding. These findings were then used as a baseline from which to consider the possible impact of recent federal health budgetary proposals (specifically, block grants) both on existing patterns of intergovernmental relations and on the funding and operation of local health department programs. It was determined that the most likely general development arising from these proposed changes in federal budgetary policy is that the administrative control of state health agencies over those at the local level is likely to be enhanced. Other likely developments include changes in the programs and priorities of local health departments related to reductions in overall funding levels for human services and forced competition for fewer dollars by an enlarged constituency.
The Framingham Disability Study: I. Social disability among the aging.
Authors: Branch L G , Jette A M
Published: November 2008

The Framingham Disability Study (FDS), a recent component of the Heart Disease Epidemiological Study in Framingham, Massachusetts, was designed to investigate the nature and magnitude of disability among mon-institutionalized aging adults. From September 1976, through November 1978, 2,654 individuals aged 55 to 84 years from the original cohort were interviewed in person or by telephone (94 per cent of the potential participant pool). This paper reports results on the prevalence social disability in five areas: housekeeping, transportation, social interaction, food preparation, and grocery shopping. Only 6 per cent of the sample have existing unmet needs in one or more of these five areas. The magnitude of social disability increases with advancing age. Women, in general, report a higher degree of unmet social needs than men. These findings are compared with other epidemiological investigations of social disability among the elderly.
Change in smoking status among school-aged youth: impact of a smoking-awareness curriculum, attitudes, knowledge and environmental factors.
Authors: Pederson L L , Baskerville J C , Lefcoe N M
Published: November 2008

The present study examined the relationships between exposure to a smoking awareness curriculum, attitudes toward and knowledge about smoking, sociodemographic and smoking exposure characteristics, and change in smoking status over three years. During this period, 4.5 per cent of the students decreased their involvement with cigarettes, 56.6 per cent reported no change, and 38.9 per cent reported an increase. Exposure to the curriculum did not bear a significant relationship to change in smoking; however, changes in peer smoking, knowledge, and parental smoking were significant predictors.
Family Life Theatre and youth health services.
Authors: Boria M C , Welch E J , Vargas A M
Published: November 2008

The Family Life Theatre, integrated into the Youth Health Services of a medical institution in a large urban community, has achieved rather unusual success. After seven years of experience marked by a constant quest for improvements, what was started in 1973 as a very modest health education program, through the medium of improvisational theatre, has now become a pilot project, duplicated by many groups and institutions throughout the country. The experiences of the Family Life Theatre, and its multiple ramifications leading to a comprehensive approach to the adolescent health problems, are presented and analyzed in a public health perspective.
St. Louis encephalitis: a comparison of two epidemics in Harris county, Texas.
Authors: Bell R L , Christensen B , Holguin A , Smith O
Published: November 2008

The frequency and distribution of cases in two epidemics of St. Louis encephalitis in Houston, Texas are compared by age, sex, race, season, duration, geographic area and resources available. The second epidemic was far less severe than the first. The influence of community intervention on the observed differences between the two epidemics is discussed.
The risk of childbearing re-evaluated.
Authors: Rubin G , McCarthy B , Shelton J , Rochat R W , Terry J
Published: November 2008

To determine the completeness of reporting of maternal deaths after live born deliveries in Georgia for 1975 and 1976, we matched death certificates with corresponding birth certificates for women of reproductive age. For these two years, more intensive searching led to our finding a minimum of a 27 per cent higher number of maternal deaths than that found by routine death certificate surveillance. When the delivery-death interval was not restricted to 42 days, use of the record linkage method led to a 50 per cent increase in reporting of maternal deaths. We recommend that special efforts be made to obtain more complete reporting of all pregnancy-related deaths and that completeness of reporting be periodically evaluated for all states.
Help-Seeking Behavior among Select Populations of Black Unmarried Adolescent Fathers: Implications for Human Service Agencies
Authors: Hendricks Leo E. , Howard Cleopatra S. , Caesar Patricia P.
Published: November 2008

This study was undertaken to provide additional information on what are appropriate roles for agencies in relation to unmarried adolescent fathers. The findings indicate that such appropriate roles for agencies would include the provision of psychosocial counseling, vocational guidance, and parenting education. It was concluded that agency personnel would have to reach out assertively to unmarried adolescent fathers in order to serve them more effectively. (Am J Public Health 1981;71:733-735.)
Evaluation of Rural Primary Health Care Services in Iran: Report on Vital Statistics in West Azarbaijan
Authors: Barzegar Mohammad Ali , Djazayery Abolghassem
Published: November 2008

Iranian indigenous front-line health workers (FLHW) were locally trained to deliver environmental and primary health care services to mothers and children. After two years, there was a significant decline in crude birth and death rates and in infant and 1-5 year mortality rates in the test area as compared to a control area. One out of four encounters was referred to a health center physician, the remainder being handled by the FLHWs themselves. (Am J Public Health 1981;71:739-742.)
Factors associated with mortality after widowhood.
Authors: Helsing K J , Szklo M , Comstock G W
Published: November 2008

A non-concurrent prospective study in Washington County, Maryland identified 4,032 (1,204 male, 2,828 female) White persons aged 18 and over who were enumerated in a 1963 non-official census and who became widowed between 1963 and 1974, and an equal number of married persons, each matched to a widowed as to race, sex, year of birth and geography of residence. All were followed to 1975, the date of a second census. Mortality rates based on person-years at risk were about the same for widowed as for married females, but significantly higher for male widowed than male married, even after adjustment for a number of demographic, socioeconomic, and behavioral variables. Mortality rates among widowed males who remarried were very much lower than among those who did not remarry, but no significant difference was observable among widowed females who did nor did not remarry. Multiple regression analysis also showed that, for both sexes and independently of other factors, moving into a nursing home or other chronic care facility was associated with higher mortality than any other residential change or no change, and living alone was associated with higher mortality than living with someone else in the household.
The decreasing incidence of endometrial cancer: public health implications.
Authors: Austin D F , Roe K M
Published: November 2008

The incidence of endometrial cancer in the San Francisco area between 1969 and 1979 is compared to trends in estrogen sales and prescriptions. Both estrogen use and endometrial cancer incidence increased steadily until 1975 and then decreased significantly. The data support the previously documented association between endometrial cancer and estrogen use, but suggest that short-term usage may carry only slightly increased risk which can be eliminating entirely upon termination of therapy.
Development trends of first cigarette smoking experience of children: the Bogalusa heart study.
Authors: Baugh J G , Hunter S M , Webber L S , Berenson G S
Published: November 2008

During one school year a health habits survey investigated cigarette smoking behavior in a total biracial population of children, ages 8 to 17 years old. Information was collected concerning each child's first smoking experience. Over 60 per cent of the children reported they were given their first cigarettes. Half of those starting before age 12 smoked their first cigarettes with a family member or an older fried. The smoking habit appears to have become established by age 14, with a two-year gap between initiation and maintenance.
Social and contextual factors in the analysis of mortality in end-stage renal disease patients: implications for health policy.
Authors: Plough A L , Salem S
Published: November 2008

A sample of medical records of decreased End-Stage Renal Disease (ESRD) patients was reviewed by a panel of experienced clinicians. The panel's determination of cause of death was compared to that reported for these patients in the Health Care Financing Administration Management Information System. There was concurrence in only 25 per cent of the cases. The difference is attributable to increased awareness of psychosocial and behavioral antecedent factors surrounding the occurrence of death.
Ectopic pregnancies: rising incidence rates in Northern California.
Authors: Shiono P H , Harlap S , Pellegrin F
Published: November 2008

In a population of about 300,000 Northern California women aged 15--44, the age-adjusted incidence of ectopic pregnancy rose from 55.5 to 84.2/100,000 women, 1972--1978. The ratio of ectopics to 1,000 deliveries-plus-spontaneous abortions rose from 9.4 to 14.8. The change occurred mainly in women under age 30, and was observed in seven of the eight hospitals in the area. There was no alteration in the frequency of hospitalized pelvic inflammatory disease (PID); salpingitis decreased over the years studied; and tubal sterilization events remained constant at around 0.9 per cent per year of women aged 15--44.
Minor women obtaining abortions: a study of parental notification in a metropolitan area.
Authors: Clary F
Published: November 2008

Data were collected from 141 women under age 18 attending an abortion clinic that did not require parental notification. Most of them informed their girl friend but not their parents of the plans for abortion. Younger minors and those who perceive their parents to hold positive attitudes toward abortion were more apt to inform parents. Reasons for not informing parents included fears of physical retaliation. Implications for parental notification legislation are discussed.
Socioeconomic effects on child mortality in the United States.
Authors: Mare R D
Published: November 2008

Despite considerable reason for scholarly and policy interest in socioeconomic mortality differentials, socioeconomic effects on child and teenage mortality in the United States have been a neglected research topic because of several data limitations. Exploiting data obtained for other purposes, this paper reports socioeconomic effects on the mortality of children and teenagers. Socioeconomic mortality differentials among children are large--at least as large as those among adults. The major source of socioeconomic mortality differences among children is apparently differential risk to accidental death. Within the child population, the strength of socioeconomic effects varies directly with the relative importance of accidents as a component of overall mortality.
Parental smoking and the risk of childhood asthma.
Authors: Gortmaker S L , Walker D K , Jacobs F H , Ruch-Ross H
Published: November 2008

Data from two random population surveys are used to assess the relationship between parental smoking and the prevalence of asthma in children aged 0-17. Data from a 1977 Midwestern urbanized county indicate that, if mothers smoked, the prevalence of parent reported asthma increased from 5.0 per cent to 7.7 per cent (estimated relative risk of 1.5), and the prevalence of functionally impairing asthma increased from 1.1 per cent to 2.2 per cent (relative risk of 2.0). In a more rural Eastern county in 1980, a lower overall prevalence of asthma was noted. However, similar estimated relative risks of asthma (1.8) and functionally impairing asthma (2.4) were found to be associated with maternal smoking. Inconsistent relationships were found between the estimated prevalence of asthma and paternal smoking. When multivariate controls were introduced, the relationships between maternal smoking and asthma persisted. Estimated attributable risks indicate that between 18 per cent and 34 per cent of the asthma reported in these samples can be attributed to maternal smoking. Implications of these findings for primary care physicians are discussed.
A Color-Matching Technique for Monitoring Tar/Nicotine Yields to Smokers
Authors: Kozlowski Lynn T. , Rickert William S. , Pope Marilyn A. , Robinson Jack C.
Published: November 2008

We describe a technique that enables individuals to detect the number of puffs taken on a filter cigarette by comparing the “color” of the spent filter to a color scale that simulates the appearance of filters exposed to low-, standard-, or high-yield smoking-machine regimens. Average ratings of filters by 11 subjects correlated almost perfectly with the number of standard puffs to which the filters had been exposed. (Am J Public Health 1982; 72:597-599.)
Chiropractic Use: A Test of Several Hypotheses
Authors: Cleary Paul D.
Published: November 2008

Several hypotheses concerning the use of chiropractic services were examined using data on health attitudes and health care utilization collected in central Wisconsin. The analyses indicate that the major differences between users and non-users of chiropractic services are that users are older, report more chronic health problems, have used physicians relatively frequently, but report difficulty in getting doctors' appointments. (Am J Public Health 1982; 72:727-730.)
Characteristics of patients referred for treatment of end-stage renal disease in a defined population.
Authors: Hiatt R A , Friedman G D
Published: November 2008

We studied the incidence of referral for treatment of end-stage renal disease (ESRD) in the Kaiser Foundation Health Plan (KFHP) in northern California from 1972 through 1977. In this population of over 1 million persons, we found an age-adjusted annual incidence of 44.9 per million after 1973, when the Federal ESRD Program went into effect. Age-specific incidence was highest in in men greater than 70 years of age and in women in the 50- to 59-year age group; the male/female ratio was 1.4:1. The most common diagnoses of patients referred with ESRD were glomerulonephritis (11.4 per million per year), diabetic nephropathy (5.0 per million per year), primary hypertensive disease (3.1 per million per year), and polycystic kidney disease (2.4 per million per year). Estimated rates of referral for ESRD were highest for Blacks, lowest for Whites, and intermediate for Asians. Incidence varied by geographic area within the health plan service area and was highest where the percentage of the Black population was highest.
Evaluation of a continuing education program in sex therapy.
Authors: Sarrel P M , Sarrel L J , Faraclas W G
Published: November 2008

This paper describes a multi-dimensional, ongoing approach to evaluation in a sex therapy training program. The Yale Sex Therapy Training program agencies throughout Connecticut who would meet or surpass pre-determined standards for sex therapists. Because sex therapy is a new discipline, it was deemed essential that program evaluation be developed and carried out from the very beginnings of the program and throughout its course. Evaluative findings proved essential to monitoring the quality of teaching and supervisory efforts, in assessing change in knowledge and professional activity of trainees, and in measuring impact upon the communities served. Continuous feedback led to changes in program content and format through identification of needs and problems. The experience in the Yale program confirms the recommendations of others regarding the conduct of a continuing education program. These findings strongly imply that multi-dimensional, ongoing evaluation should be an integral component in any continuing education program.
Characteristics of individuals with multiple behavioral risk factors for coronary heart disease: the Netherlands.
Authors: Kok F J , Matroos A W , van den Ban A W , Hautvast J G
Published: November 2008

To test the hypothesis that risk factors are interrelated, the simultaneous occurrence of smoking, inadequate nutrition, obesity, and physical inactivity was studied in a random sample (n = 1,951) of the Dutch adult population. Although the results did not suggest systematic clustering, the assumption of independence of these risk factors could not be maintained. Sociodemographic and health-related characteristics of the group with three or four risk factors were assessed (n = 246). Comparison with a prudent life-style group (zero risk factors, n = 387) by means by discriminant analysis indicated that the target group included proportionally more men (odds ratio: OR = 3.3), of all ages, with low education and occupation (OR = 3.5 and 1.7). The two groups did not differ in awareness of cardiovascular risk factors, preventive orientation regarding cardiovascular risk, or disease in general, and the effectiveness of health education in modifying life-style. The target group exhibited a distorted perception of the healthfulness of its own life-style and unfavorable attitudes toward modifying existing smoking, eating habits, and physical activity.
Epidemiologic characteristics of mortality from diabetes with acidosis or coma, United States, 1970-78.
Authors: Holman R C , Herron C A , Sinnock P
Published: November 2008

Deaths due to diabetes with acidosis or coma (DAC) in the United States from 1970 through 1978 were analyzed to determine epidemiologic characteristics associated with mortality likely to be due to diabetic ketoacidosis (DKA), a complication of diabetes mellitus considered largely preventable. Annual age-adjusted rates for DAC deaths decreased during the study period, and the secular trend was significant in all regional, race, and sex groups examined. General population-based mortality rates increased linearly with age, were higher in non-Whites than in Whites among persons aged greater than 14, were higher in females, and increased significantly with age in both races and both sexes. By region, rates were lowest in the West. DAC mortality rates specific to estimated diabetic populations decreased annually from 1970 to 1978 in all race and sex groups, and were highest at age greater than or equal to 65, but did not show significant linear increases with age, except in non-Whites. These results indicate declining secular trends, as well as age, race, sex, and regional differences in the risk of such deaths. Further studies are warranted to determine factors contributing to these differences.
Projection of Down's syndrome births in the United States 1979-2000, and the potential effects of prenatal diagnosis.
Authors: Huether C A
Published: November 2008

This study projects the annual number of Down's syndrome (DS) births during 1979-2000 by maternal age categories, and estimates the effects of prenatal chromosomal diagnosis utilization on reducing these baseline projections. Assuming no reduction in DS births through prenatal diagnosis, projected DS births increase from about 4,300 in 1979 to 5,300 in 1990, where the level would remain approximately stable throughout the 1990s. Applying Ohio's 1980-1981 prenatal chromosomal diagnosis utilization ratio of 17 per cent to women greater than or equal to 35 results in a maximum of 6 per cent reduction in the annual baseline projections of DS births over the next two decades. However, if amniocentesis utilization by women age 30-34 increases to 37.5 per cent and to 75 per cent by women greater than or equal to 35, a one-fourth to one-third annual reduction is achieved throughout the period studied. A substantial increase in prenatal diagnosis appears necessary to offset the projected increase in DS births resulting from a larger number of births to women greater than or equal to 35.
Impact of legislation raising the legal drinking age in Massachusetts from 18 to 20.
Authors: Hingson R W , Scotch N , Mangione T , Meyers A , Glantz L , Heeren T , Lin N , Mucatel M , Pierce G
Published: November 2008

On April 16, 1979, Massachusetts raised its legal drinking age from 18 to 20 years. Massachusetts was compared with New York State, exclusive of New York City and Nassau County. New York State retained an 18-year-old drinking age. Random telephone surveys with approximately 1,000 16-19 year olds in each state were undertaken prior to the law's enactment and twice at yearly intervals after the law to assess the law's impact on teenage drinking, driving after drinking, and non-fatal accident involvement. Fatal crash data reported to the US Department of Transportation by each state from April 16, 1976-April 15, 1981 were also analyzed. After the law, although the modes of procuring alcohol changed. No significant changes were observed in Massachusetts relative to New York in the proportion of surveyed teenagers who reported that they drank or in the volume of their consumption. The proportion of teenagers who drove after drinking heavily (six or more drinks at one time) did not decline in Massachusetts relative to New York. However, the frequency that teenagers reported driving after any drinking declined significantly in Massachusetts. Frequency of teenage driving after marijuana use and non-fatal teenage accidents declined at comparable rates in both states. The numbers of teenage nighttime single vehicle fatal accidents declined more in Massachusetts than New York, in the 18-19 year age group. Overall fatal accident trends among 16-19 year olds in the two states were similar.
Effects of being overweight.
Authors: Stewart A L , Brook R H
Published: November 2008

Based on cross sectional data from a general population of 5,817 people aged 14 to 61, objective overweight is compared with perceived overweight, and information is provided on morbidity due to being overweight, and on what people are doing to try to lose weight. We found that 10 percent of this population are moderately overweight and 12 per cent are severely overweight (although 41 per cent perceive they are overweight). Being overweight is associated with poorer functional status (e.g., overweight is given as the main reason for functional limitations by 13 per cent of people with such limitations) and with considerable pain, worry, and restricted activity because of this condition (e.g., 88 per cent of people who believe they are overweight worry at least a little about it). Only about 7 per cent of those who perceive they are overweight are under a doctor's care to lose weight. If physicians wish to assume a larger role in caring for overweight people, the nature of their role must be carefully evaluated.