bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors related to patient smoking status.
Authors: Ockene J K , Hosmer D W , Williams J W , Goldberg R J , Ockene I S , Raia T J
Published: November 2008

To investigate those factors associated with patients' cigarette smoking status, 455 consecutive patients seen in two specialty clinics and one general medicine clinic at a university medical center were studied. Patient's age, sex, health status, and number of previous cessation attempts discriminated current from ex-smokers. A strong interaction was observed between sex and disease status with females showing a greater impact of smoking-related disease on smoking behavior than males.
HMO membership, copayment, and initiation of care for cancer: a study of working adults.
Authors: Greenwald H P
Published: November 2008

This study compares diagnosis and commencement of treatment for cancer among persons with fully financed fee-for-service coverage, persons with copaid fee-for-service coverage, and persons in an HMO (health maintenance organization). A total of 242 subjects actively employed at the time of their diagnosis were interviewed, typically within six months of beginning cancer treatment. After sex, age, income, education, residence (urban vs rural), and disease site and stage had been controlled, those who made copayments were found to have waited an average of 1.25 months longer (95 per cent confidence limit (cl) +/- .88) between initial suspicion of illness and obtaining a definitive diagnosis than those with full insurance coverage. Time from diagnosis until the beginning of treatment averaged .83 months longer (95 per cent cl +/- .41) for HMO members than those in fee-for-service. These relations were strongest in income categories equal to or exceeding $20,000 per year.
Factors affecting breastfeeding among women of Mexican origin or descent in Los Angeles.
Authors: Scrimshaw S C , Engle P L , Arnold L , Haynes K
Published: November 2008

Data on breastfeeding intentions and behavior were collected in prenatal and postpartum interviews as part of a study on first birth among 518 women of Mexican origin or descent in two Los Angeles hospitals. The prenatal intentions of 82 per cent of the women to breastfeed were maintained postpartum in one hospital but dropped sharply in the other. A greater number of hours a day with the baby in the hospital and earlier initiation of breastfeeding were associated with the hospital where prenatal breastfeeding intentions were more likely to be carried out. The intention to work postpartum was associated both with the decision not to breastfeed at all and with shorter intended duration of breastfeeding.
Incidence and costs of incidental appendectomy as a preventive measure.
Authors: Sugimoto T , Edwards D
Published: November 2008

Statewide hospital discharge data in South Carolina for the period 1979-81 were used to evaluate the effectiveness of the incidental appendectomy performed as a preventive measure. The occurrence of incidental appendectomy exceeded that of appendicitis treated by appendectomy, with population-based rates of 1.13/1,000 and 0.97/1,000 person-years, respectively. Over 64 per cent of appendicitis cases occurred in persons under 25 years of age while 74 per cent of incidental appendectomies occurred in persons age 25 and over. Extrapolating to the nation, the data suggest that 254,250 incidental appendectomies might prevent 3,382 future cases of hospitalized appendicitis. The cost of the prevented cases is estimated as $6,764,000. The cost of the incidental appendectomies would be $20,340,000 if as many as 10 per cent of surgeons' fees were separately charged and twice as much if twice as many were so charged. Information on charges for incidental appendectomies is not readily available.
Expenditure effects of changes in Medicaid benefit coverage: an alcohol and substance abuse example.
Authors: Reutzel T J , Becker F W , Sanders B K
Published: November 2008

An evaluation of the effect on total health care costs of a Medicaid demonstration project to provide coverage for alcoholism and substance abuse was conducted in Illinois in 1985. A pre/post-treatment analysis of expenditures for a subgroup of demonstration clients suggests that the addition of the alcohol and drug benefit did not result in higher total expenditures. [An important policy implication is that, when medical services substitute for one another, costs savings (increases) will not necessarily be realized when benefit packages are cut (expanded).]
Toxocara canis infection of children: epidemiologic and neuropsychologic findings.
Authors: Marmor M , Glickman L , Shofer F , Faich L A , Rosenberg C , Cornblatt B , Friedman S
Published: November 2008

Sera from 4,652 children whose blood was submitted to the New York City Department of Health for lead analysis were tested for antibodies to Toxocara canis using an enzyme-linked immunosorbent assay (ELISA). Standardized to the age distribution of the study population, T. canis seropositivity (inverse titers greater than or equal to 16) was 5.7 per cent in males and 5.1 per cent in females. T. canis antibody titers and lead exposures as measured by Centers for Disease Control lead classes were positively correlated. Children who were seropositive to T. canis (cases) were compared to seronegatives (controls) matched on age (+/- 6 months), sex, time-of-screening (+/- 3 months) and CDC lead class. Logistic regression analysis of 155 case-control pairs demonstrated elevated relative risks (RRs) for geophagia (RR = 3.14; 95% CI = 1.75, 5.64) and having had a litter of puppies in the home (RR = 5.22; 95% CI = 1.63, 16.71). Compared to controls, cases had increased eosinophil counts, serum immunoglobulin E concentrations, and anti-hemagglutinin-A titers. Small deficits in cases compared to controls were found in performance on several neuropsychological tests after adjustment for potential confounders including case-control differences in race, socioeconomic status, and current blood lead concentrations. The study thus confirmed that T. canis infection is common in urban children and suggested that infection may be associated with adverse neuropsychological effects.
A follow-up study of gastro-intestinal diseases related to bacteriologically substandard drinking water.
Authors: Zmirou D , Ferley J P , Collin J F , Charrel M , Berlin J
Published: November 2008

In a prospective follow-up study conducted in 52 French alpine villages, one weekly water sample was taken in each village provided with untreated ground water and analyzed as to the presence of four indicator bacteria: total plate count, total coliforms, thermotolerant (fecal) coliforms, and fecal streptococci. Cases of acute gastro-intestinal disease (AGID) occurring among 29,272 inhabitants were reported through physicians, pharmacists, and primary school teachers. A loglinear model identified fecal streptococcus (FS) as the best predictor; the presence of fecal coliforms enhanced the effect of FS. The total bacteria count and the total coliforms had no independent contributions. A threshold analysis suggested that any level of indicator bacteria above zero was associated with an excess of AGID.
Risk factors for endemic giardiasis.
Authors: Chute C G , Smith R P , Baron J A
Published: November 2008

In a mail survey, 171 Hitchcock Clinic patients with giardiasis were compared with an age- and sex-matched control group of 684 clinic patients with respect to potential risk factors. Households with shallow well or surface water sources had an odds ratio (OR) for giardiasis of 2.1 (95% confidence interval (95%CI) 1.3-3.2) compared with households with drilled well or municipal water supply. Other observed risks include family member in day care program (OR 2.2 95%CI 1.3-3.7) and family member with diagnosed giardiasis (OR 17, 95%CI 7.4-37). Previously reported risks such as travel out of country (OR 3.2, 95%CI 1.5-7.2) and camping (OR 1.7, 95%CI 0.9-3.2) were also observed. Virtually no giardiasis risk was observed associated with report of dog or barnyard animal proximity. Control for confounding and adjustment for recall and non-response bias does not materially alter the risk estimates. We suggest that shallow well or surface household water source is an important and previously unrecognized giardiasis risk factor.
Effects of Maine's 1981 and Massachusetts' 1982 driving-under-the-influence legislation.
Authors: Hingson R , Heeren T , Kovenock D , Mangione T , Meyers A , Morelock S , Lederman R , Scotch N A
Published: November 2008

In 1981, Maine passed a drunk driving law with mandatory penalties and a new civil charge to increase the conviction rate. One year later, Massachusetts increased drunk driving penalties, particularly for repeat offenders and intoxicated drivers involved in fatal crashes. In Maine, single-vehicle nighttime fatal crashes declined 22 per cent the year before passage of the law, and 33 per cent the year after. Maine's rates returned to pre-law levels by the third post-law year. Prior to Massachusetts' new law, single-vehicle nighttime and overall fatal crashes there also declined 20% and 22%, whereas after this law fatal crash rates did not decline further compared with the pre-law year or other New England states. Pre- and post-law surveys indicate that both laws were followed by some increases in public perceptions that drunk drivers stopped by police would be arrested, convicted, and receive automatic penalties. But, few believed it was very likely that drunk drivers would be stopped. For only two of three years studied after Maine's law did more people there report decisions not to drive because they had drunk too much. In Massachusetts, reported driving after heavy drinking declined as much the year before as the three years after its law.
Smoking behavior among participants in the nurses' health study.
Authors: Myers A H , Rosner B , Abbey H , Willet W , Stampfer M J , Bain C , Lipnick R , Hennekens C , Speizer F
Published: November 2008

We analyzed smoking behavior of 91,651 married female nurses, aged 30-55 years in 1976. The prevalence of smoking was similar among all birth cohorts. The largest percentage increase in starting to smoke occurred between ages 15 and 25 years; by age 25, 50 per cent had started smoking. The cessation rate was lowest in earlier birth cohorts and among nurses starting to smoke at earlier ages. The cessation rate increased substantially between 1963-73 compared with the period 1948-58.
The impact of diabetes education and peer support upon weight and glycemic control of elderly persons with noninsulin dependent diabetes mellitus (NIDDM).
Authors: Wilson W , Pratt C
Published: November 2008

We assessed diabetes education and peer support interventions as facilitators of weight loss and glycemic control in a community sample of 79 elderly persons with noninsulin-dependent diabetes mellitus (NIDDM). Different groups received: education only, education and peer support, and no treatment. Peer support was higher in groups where it was actively facilitated. Weight loss and reduction in level of glycemic control occurred within groups receiving both diabetes education and peer support.
Daily air pollution effects on children's respiratory symptoms and peak expiratory flow.
Authors: Vedal S , Schenker M B , Munoz A , Samet J M , Batterman S , Speizer F E
Published: November 2008

To identify acute respiratory health effects associated with air pollution due to coal combustion, a subgroup of elementary school-aged children was selected from a large cross-sectional study and followed daily for eight months. Children were selected to obtain three equal-sized groups: one without respiratory symptoms, one with symptoms of persistent wheeze, and one with cough or phlegm production but without persistent wheeze. Parents completed a daily diary of symptoms from which illness constellations of upper respiratory illness (URI) and lower respiratory illness (LRI) and the symptom of wheeze were derived. Peak expiratory flow rate (PEFR) was measured daily for nine consecutive weeks during the eight-month study period. Maximum hourly concentrations of sulfur dioxide, nitrogen dioxide, ozone, and coefficient of haze for each 24-hour period, as well as minimum hourly temperature, were correlated with daily URI, LRI, wheeze, and PEFR using multiple regression models adjusting for illness occurrence or level of PEFR on the immediately preceding day. Respiratory illness on the preceding day was the most important predictor of current illness. A drop in temperature was associated with increased URI and LRI but not with increased wheeze or with a decrease in level of PEFR. No air pollutant was strongly associated with respiratory illness or with level of PEFR, either in the group of children as a whole, or in either of the symptomatic subgroups; the pollutant concentrations observed, however, were uniformly lower than current ambient air quality standards. Moreover, since exposure estimation based on monitoring of ambient air likely results in misclassification of the true exposure, the negative findings of this study must be interpreted cautiously.
Alcohol use and depression symptoms among employed men and women.
Authors: Parker D A , Parker E S , Harford T C , Farmer G C
Published: November 2008

A representative sample of 1,367 employed men and women in Detroit responded to questions about drinking practices and symptoms of depression. After controlling for age, education, family income, marital status, medication use, fathers' drinking, and other variables, increased quantity of alcohol consumed per drinking occasion was associated with increased depression symptoms in the sober state among men and women. Depression symptoms may be one of a group of not fully identified drug after-effect disorders involving psychological functioning.
Smoking among Mexican Americans: a three-generation study.
Authors: Markides K S , Coreil J , Ray L A
Published: November 2008

Smoking behavior was investigated with data from a three-generation study of Mexican Americans in San Antonio, Texas. Rates of smoking among the men were found to be higher than rates for other White men obtained in previous studies, while rates for women were slightly lower than those reported for other White women. However, the percentage of light smokers was considerably higher among Mexican Americans than among other groups. There was no evidence that acculturation was a consistent predictor of greater likelihood of smoking. However, there was evidence that the smoking behavior of younger Mexican Americans, particularly the women, was associated with the smoking behavior of their parents.
Rubella in the workplace: the need for employee immunization.
Authors: Goodman A K , Friedman S M , Beatrice S T , Bart S W
Published: November 2008

From 1983 to 1985, the New York City Department of Health investigated five workplace outbreaks of rubella. Approximately 40 per cent of the 265 cases were detected among women of child-bearing age (15-44 years). Data are reviewed from the 1983 Financial District outbreak to illustrate the continued susceptibility of young adults, the missed opportunities for rubella immunization, and the danger of congenital infection. A comprehensive rubella immunization program is required to protect pregnant women and eliminate congenital rubella. As one important component of this effort, employee health physicians are urged to assess the immune status of women of child-bearing age and to vaccinate all susceptibles who are not pregnant.
Dental health of recent immigrant children in the Newcomer schools, San Francisco.
Authors: Pollick H F , Rice A J , Echenberg D
Published: November 2008

Dental screenings of 1,012 recent immigrant elementary school children in San Francisco showed 77 per cent of children needed dental treatment on first screening, compared to 25 per cent in the 1979-80 National Institute of Dental Research (NIDR) survey for the western United States. The prevalence of dental caries in primary teeth of the immigrant six and seven year-olds was twice that of their US counterparts. Non-refugee immigrants had more serious dental needs but used dental services less often than children with refugee status.
Home health care: who's where?
Authors: Phillips E K , Fisher M E , MacMillan-Scattergood D , Baglioni A J , Torner J C
Published: November 2008

Referrals to two home health agencies, one public and one private, were examined over a one-year period (n = 290). Clients in the public agency required greater frequency of visits, more nursing services, and care for a longer period of time than did those in the private agency. The public agency served a larger proportion of indigent and Medicaid clients. Increased service delivery with a decreased financial base may forebode an unhealthy future for traditional public home health agencies.
Somatization in the community: relationship to disability and use of services.
Authors: Escobar J I , Golding J M , Hough R L , Karno M , Burnam M A , Wells K B
Published: November 2008

We tested the hypotheses that an abridged somatization construct that we had developed would be associated with use of health services, preferential use of medical over mental health services, and an index of disability. These hypotheses were tested using structured interview data from 3,132 randomly selected community respondents. We found that: respondents meeting criteria for somatization reported a heavier use of health services than non-somatizers; of those respondents meeting criteria for a psychiatric diagnosis, somatizers preferentially used medical over mental health services whereas non-somatizers reported the opposite trend; and somatizers were more likely than non-somatizers to report recent sick leave or restricted activity.
Coronary risk factors and clinical gallbladder disease: an approach to the prevention of gallstones?
Authors: Diehl A K , Haffner S M , Hazuda H P , Stern M P
Published: November 2008

We examined the relationship of "coronary" risk factors to clinical gallbladder disease prevalence in a cross-sectional survey. Persons with hypercholesterolemia, hypertriglyceridemia, or low high-density-lipoprotein cholesterol levels had elevated risks for clinical gallbladder disease. Smokers of 20 pack-years or more and infrequent users of alcohol had increased risks, as did persons with hypertension or diabetes mellitus. After adjusting for age, body mass index, ethnicity, and the coronary variables, relationships persisted for diabetes in women (OR = 1.8) and frequent alcohol use in men (OR = 0.3). The proportion of gallbladder disease related to all coronary risk factors was estimated to be 52 per cent.
Saliva cotinine as a measure of smoking status in field settings.
Authors: Abrams D B , Follick M J , Biener L , Carey K B , Hitti J
Published: November 2008

The accuracy and reliability of saliva cotinine as an objective measure of smoking status was examined in two field studies. In Study I, saliva was collected from smokers and nonsmokers with repeated samples taken from a randomly selected subset of the smokers. Results indicated perfect classification of smokers versus nonsmokers and acceptable reliability of repeated samples. Study II investigated the accuracy of saliva cotinine in detecting recent quitters in a worksite smoking cessation program. Saliva cotinine showed greater accuracy than expired carbon monoxide at detecting quitters, provided they were abstinent for at least seven days. From pre- to post-treatment, subject's saliva cotinine levels dropped 19 per cent while self-reported rate of smoking dropped 54 per cent. Saliva collection in the field is feasible and cotinine appears to be one of the more sensitive assays currently available for epidemiologic and clinical applications.
Stop smoking advice by physicians: a feasible approach?
Authors: Folsom A R , Grimm R H
Published: November 2008

To understand the effect of brief stop smoking advice by physicians, we conducted a randomized clinical trial in 258 smokers. After three months, 8.8 per cent of the intervention group and 6.8 per cent of the control group had become nonsmokers. The intervention group also reported significantly more attempts to quit and/or cut down. At follow-up, only 60 per cent recalled receiving a smoking message and only 85 per cent of these perceived it as a message to quit.
Cancer mortality among Mexican Americans and other whites in Texas, 1969-80.
Authors: Martin J , Suarez L
Published: November 2008

Cancer mortality in Texas 1969-80 was 25 per cent lower among Mexican American males compared to other Whites; among females, rates were only 4 per cent lower. Reduced mortality was primarily a result of lower rates for cancers of the most common sites: lung, colon, breast and prostate. However, for cancers of the stomach, liver, and gallbladder, Mexican Americans had higher rates than other Whites. Female Mexican Americans were also at a higher mortality risk for cervical cancer. Implications are discussed.
The epidemiology of end-state renal disease: the six-year South-Central Los Angeles experience, 1980-85.
Authors: Ferguson R , Grim C E , Opgenorth T J
Published: November 2008

Using the End-Stage Renal Disease Medical Information System and 1980 census information, the crude cumulative incidence among Blacks, Hispanics, and Whites in south central Los Angeles was determined to be 160.1, 49.28, and 55.3 per 100,000 respectively. Sex-specific rates were slightly greater in males. Among Blacks, nephrosclerosis and diabetes represented 41.5 and 30.2 per cent of the cases respectively and increased during the period 1980-85.
Trends in routine screening examinations.
Authors: Dawson D A , Hendershot G E , Bloom B
Published: November 2008

Data from the 1973 and 1982 National Health Interview Surveys reveal increased use of routine medical examinations between the two survey dates. The proportion of adults age 40 or older who ever had a glaucoma test increased by 50 per cent. Other large increases were in the proportion of adults age 40 or older who ever had an electrocardiogram and in the proportions of women age 17 or older who ever had breast examinations or Pap smears.
Exposure to aerial malathion application and the occurrence of congenital anomalies and low birthweight.
Authors: Grether J K , Harris J A , Neutra R , Kizer K W
Published: November 2008

The association between exposure to low dose malathion, after its aerial application to 13,000 square miles in the San Francisco Bay area, and the occurrence of birth defects and low birthweight was examined using newborn hospital discharge data and vital records. No biologically plausible pattern of association was found. Limitations in the data and analysis are discussed.
Do authors check their references? A survey of accuracy of references in three public health journals.
Authors: Eichorn P , Yankauer A
Published: November 2008

We verified a random sample of 50 references in the May 1986 issue of each of three public health journals. Thirty-one per cent of the 150 references had citation errors, one out of 10 being a major error (reference not locatable). Thirty per cent of the references differed from authors' use of them with half being a major error (cited paper not related to author's contention).
Training bar personnel to prevent drunken driving: a field evaluation.
Authors: Russ N W , Geller E S
Published: November 2008

The potential of a server intervention program to decrease the likelihood that a bar patron will leave a bar intoxicated was evaluated. Research assistants posing as regular patrons ("pseudopatrons") visited two bars where about half of the servers had received server intervention training. Pseudopatrons set the occasion for server intervention to occur by drinking six alcoholic beverages in two hours. The blood-alcohol concentration (BAC) of the pseudopatrons was measured after they left the bar. Results revealed that trained servers initiated more server interventions than did untrained personnel. Moreover, pseudopatrons served by trained personnel reached substantially lower BACs than those served by untrained servers. These results suggest that, if implemented on a large scale, server intervention programs have the potential of reducing drunken driving by helping to decrease the exit BACs of bar patrons.
Seroepidemiologic study of giardiasis patients and high-risk groups in a midwestern city in the United States.
Authors: Sullivan R , Linneman C C , Clark C S , Walzer P D
Published: November 2008

Serum antibodies to Giardia lamblia were measured in giardiasis patients, in groups at high risk for intestinal parasite infection, and in controls by an indirect fluorescent antibody (IFA) technique. Symptomatic patients had the highest antibody titers, and antibodies remained present for up to 18 months in persons with chronic infection. Indochinese refugees and male homosexuals with the acquired immunodeficiency syndrome (AIDS) and pre-AIDS had higher mean antibody levels than did healthy controls, whereas sewer and highway maintenance workers had levels similar to those of controls. Serum antibodies to Entamoeba histolytica measured by an indirect hemagglutination antibody technique were detected in only a few Indochinese refugees. We conclude that serology is a promising tool in G. lamblia epidemiology and that further population studies would be of interest.
Control of a non-foodborne outbreak of salmonellosis: day care in isolation.
Authors: Chorba T L , Meriwether R A , Jenkins B R , Gunn R A , MacCormack J N
Published: November 2008

We report an outbreak of Salmonella typhimurium in the infant room of a day care center. Time between onset dates, clustering of cases in the room, lack of a common food exposure, lack of illness among other children and staff, and lack of community-wide infection suggested person-to-person or continuing-common-source transmission. Successful preventive measures included instruction of personnel in proper handwashing and diaper-changing procedures and cohorting of infected and non-infected children. This is the second description of a non-foodborne outbreak of salmonellosis in a day care center, and the first involving S. typhimurium.
The social and economic costs of alcohol abuse in Minnesota, 1983.
Authors: Parker D L , Shultz J M , Gertz L , Berkelman R , Remington P L
Published: November 2008

Alcohol abuse in the State of Minnesota has an impact on health, health care resources, and the economy. Alcohol abuse was related to 3.3 per cent (1,150) of deaths in Minnesota in 1983; of these, almost one-third were the result of fatal injuries. Alcohol abuse contributed to 12 per cent (33,909) of all years of potential life lost, two-thirds of which were secondary to injury. The estimated cost of alcohol abuse ranged from $1.4 billion to $2.1 billion, representing from 2.8 per cent to 4.3 per cent of all personal income of Minnesotans, from 32 per cent to 50 per cent of State expenditures, and from 26 to 39 times the alcohol excise tax revenues generated in 1983. Alcohol-related direct medical care costs were estimated to be at least $216 million, 3.8 per cent of Minnesota medical costs for 1983. Costs of reduced on-the-job productivity and short-term absenteeism related to alcohol abuse were estimated to be between $630 million and $1.2 billion. The documentation of the costs of alcohol abuse is an important step in the campaign to reduce alcohol-related deaths, morbidity, and health care costs.
Shelters for battered women and their children: an under-recognized source of communicable disease transmission.
Authors: Gross T P , Rosenberg M L
Published: November 2008

A survey of 73 full-time government-funded shelters for battered women and their children from five geographic regions in 15 states provided information on communicable disease problems and control measures (focusing on diarrheal illness). Outbreaks of diarrheal illness involving more than 10 persons were reported by 12 per cent (9/73) of shelter directors. Less than half reported screening potential residents for communicable diseases before admitting them, and the majority reported that most of their staff are trained in basics of first aid, principles of hygiene, and experienced in day care work. More than half of the staff in the majority of shelters are counselors, but only 5 per cent (4/73) of shelters have health care workers. Less than one-fourth of the shelters have areas designated for diapering infants and less than half of the shelter directors knew of specified health regulations applying to their shelter. For most shelters, limitations on staff size, training, and funding may restrict the types of disease control measures they can apply. However, basic hygienic practices, such as strict handwashing and identification and cohorting of sick clients, may be effective in disease prevention.
Accuracy of fetal death reports: comparison with data from an independent stillbirth assessment program.
Authors: Greb A E , Pauli R M , Kirby R S
Published: November 2008

We evaluated the completeness and accuracy of reporting on Wisconsin fetal death report forms (FDF) through case by case comparison with data from the Wisconsin Stillbirth Service Project (WiSSP), which uses extensive protocols for etiologic investigation of stillborns. Fetal deaths are underreported: no FDF was submitted for 17.8 per cent of fetal deaths evaluated through the WiSSP. For those for whom FDF were submitted, fetal anomalies were often unrecognized or unreported: only 60 per cent of stillborns identified by the WiSSP as having fetal anomalies had any indication of the presence of such anomalies on FDF. When causes of death were classified into fetal, placental/cord, maternal/environmental, and unknown, comparison of reported underlying cause of death revealed marked inaccuracies on FDF. Placental/cord causes reported on FDF often could not be documented subsequently while, in contrast, fetal causes of death were underreported. Few accurate fetal diagnoses were present on FDF. Even among common lethal malformations misdiagnosis occurred frequently.
Elective cancer education: how effective from the public health viewpoint?
Authors: Gray C H , Colome J S , Curry-Daly J R
Published: November 2008

An elective cancer education course at a public university attracted twice as many women as men. Course information was disseminated to an average of eight people by each student. The course seemed reasonably effective in stimulating positive behavioral changes. According to self-report, dietary fat was reduced by 47 per cent of women and 49 per cent of men. Fiber intake was increased by 48 per cent of women and 36 per cent of men. Breast self-examination was initiated by 36 per cent of previous nonperformers: and testicular self-examination, by 23 per cent.
An evaluation of the use of medical examiner data for epidemiologic surveillance.
Authors: Graitcer P L , Williams W W , Finton R J , Goodman R A , Thacker S B , Hanzlick R
Published: November 2008

To assess the value of medical examiner (ME) data bases for use in epidemiologic surveillance, we compared data from non-injury deaths that became ME cases to all non-injury deaths occurring in 1984 among Fulton County, Georgia residents. The decedents in the ME series were younger and included a large proportion of Black males. Although not representative of all deaths in a community, ME data bases include demographic and medical information that is often difficult to collect in community studies and in other surveillance systems.
Campylobacter infections: the emerging national pattern.
Authors: Tauxe R V , Pegues D A , Hargrett-Bean N
Published: November 2008

In the United States, 8,837 Campylobacter isolates and eight outbreaks of Campylobacter infections were reported in 1984, a national isolation rate of 4.9/100,000. C. jejuni represented 99 per cent of reported isolates. Age-specific incidence was highest among infants (11/100,000), and young adults (8/100,000); infants in the second month of life were at highest risk. An unexplained nationwide November peak, not observed in previous years, occurred in all age groups and suggests there is an homogeneous nationwide source for this infection.
Impact and costs of varicella prevention in a university hospital.
Authors: Weber D J , Rutala W A , Parham C
Published: November 2008

Information regarding all patient and staff exposures to varicella-zoster virus (VZV) was prospectively accumulated from 1/1/86 to 12/31/86 at North Carolina Memorial Hospital. During this period of time 37 sources of exposure to VZV were reported: 10 outside and 27 within the hospital. Index cases for nosocomial exposure included: 12 patients with zoster, 9 patients with varicella, two staff with varicella, three visitors with varicella, and one staff with zoster. One hundred and twenty patients received nosocomial exposures; 28 had no history of VZV infection (23 per cent), of whom 11 were serosusceptible (39 per cent). Sources of nosocomial patient exposure included: other patients (85 per cent), staff (14 per cent), and a single visitor (1 per cent). More than 300 employees received nosocomial exposure; 158 had no history of VZV infection, of whom 49 were serosusceptible (31 per cent). Only a single employee and no patients developed clinical varicella as a result of nosocomial exposure. Costs associated with VZV control during 1986 totaled $55,934: $39,658 for work furloughs, $9,800 for serologies, $4,293 for patient isolation, $155 for varicella-zoster immune globulin, and $2,028 for infection control personnel time. These costs should be considered as part of any benefit-cost analysis of varicella immunization of health care personnel.
Transmission of hepatitis B virus from adopted Asian children to their American families.
Authors: Friede A , Harris J R , Kobayashi J M , Shaw F E , Shoemaker-Nawas P C , Kane M A
Published: November 2008

In 1985, 6,991 Asian children were adopted by Americans. To estimate the risk that such children may transmit hepatitis B virus to their adoptive families, we conducted a cumulative-incidence follow-up study in the State of Washington. We examined the association between having adopted a hepatitis B surface antigen (HBsAg)-seropositive Asian child and serologic evidence of past or present hepatitis B virus infection in adoptive family members. Seven (9 per cent) of 77 family members exposed to an HBsAg-seropositive child had evidence of past or present infection compared with four (2 per cent) of 232 nonexposed (relative risk = 5.3; 90% confidence limits [CL] = 2.0-13.9). The risk was higher for those with prolonged exposure and was entirely restricted to parents.
Correlates of smokeless tobacco use in a male adolescent population.
Authors: Jones R B , Moberg D P
Published: November 2008

This paper identifies the correlates of smokeless tobacco use in a sample of 1,030 males representative of 7th through 12th grade students of Dane County (Madison), Wisconsin. Variables independently associated with frequent use of smokeless tobacco were: being White; living in other than a two-parent home; performing poorly in school; smoking cigarettes; consuming beer, wine, or hard liquor; and deviant/delinquent behavior. Participation in team sports was associated with some "experimentation" with smokeless products.
Hemolytic-uremic syndrome: a population-based study in Washington, DC and Baltimore, Maryland.
Authors: Kinney J S , Gross T P , Porter C C , Rogers M F , Schonberger L B , Hurwitz E S
Published: November 2008

A population-based study of hemolytic-uremic syndrome (HUS) revealed that 20 child residents of Washington, DC and Baltimore, Maryland were hospitalized with HUS from January 1979 through September 1983. The number of cases peaked during the summer and fall; none occurred during the winter. Incidence of hospitalized cases was higher in Whites and girls than in Blacks or boys, and the average annual incidence was 1.08 cases/100,000 children less than 5 year old. This study demonstrates that HUS is not unique to the West Coast, as previously suggested.
Racial trends in syphilis among men with same-sex partners in Atlanta, Georgia.
Authors: Landrum S , Beck-Sague' C , Kraus S
Published: November 2008

Early syphilis cases attributable to homosexual transmission declined in DeKalb County, Georgia, from 191 in 1981 to 97 in 1985. This decline occurred only among White men with same sex partners (SSP); early syphilis among Black men with same sex partners has risen. This pattern is consistent with the hypothesis that changes in sexual behavior instituted by White men at risk of acquiring HTLV-III/LAV infection may have resulted in decreased incidence of early syphilis among those men.
Clinical and financial effects of psychoeducational care provided by staff nurses to adult surgical patients in the post-DRG environment.
Authors: Devine E C , O'Connor F W , Cook T D , Wenk V A , Curtin T R
Published: November 2008

A three-hour, two-stage workshop for staff nurses on providing patient education and psychosocial support was evaluated in terms of its effects on patient welfare and recovery. Subjects were 148 persons who had either a cholecystectomy, other abdominal surgery, or transurethral resection of the prostate (TURP). Two hundred and six additional control subjects were obtained from a nearby hospital. Both hospitals were owned by the same corporation and had many of the same surgeons. After the workshop, experimental subjects used fewer sedatives or antiemetics, fewer hypnotics, and were discharged from the hospital on the average half a day sooner.
Within month variability in use of soup kitchens in New York State. p4.
Authors: Thompson F E , Taren D L , Andersen E , Casella G , Lambert J K , Campbell C C , Frongillo E A , Spicer D
Published: November 2008

This paper describes the variation in use of soup kitchens throughout the month using data from the New York State Nutritional Surveillance Program. Excluding November, December, and May, when holiday meals created a different pattern of use, number of meals served in soup kitchens generally increased toward the end of the month, averaging 43 per cent higher for Upstate and 14 per cent higher for New York City in the last week as compared to the first week of the month. The overall increase throughout the month and difference in the magnitude of increase between Upstate and New York City corresponds to the timing of income maintenance benefits distribution. Distribution of most public assistance benefits occurs at the beginning of each month in Upstate, whereas it is staggered in New York City throughout the month.
Evaluating the risks of cesarean section: low Apgar score in repeat C-section and vaginal deliveries.
Authors: Burt R D , Vaughan T L , Daling J R
Published: November 2008

Data from Washington State birth certificates from 1980-83 were used to estimate excess risk to the infant delivered via repeat cesarean section independently of any risk associated with the indication for the procedure. Using a case-control design, we compared the method of delivery of all infants with low (0-6) five-minute Apgar scores born to multiparous mothers after uncomplicated pregnancies and births to that of similar infants with a high score (7-10), frequency matched by birthweight. Of the 1,030 infants with low Apgar score, 127 (12.3 per cent) were delivered via repeat cesarean section, in contrast to 98 (9.8 per cent) of 998 controls with high Apgar score. In a regression model controlling for birthweight, gestational length, maternal age, and income the relative risk was 1.29 (95% confidence interval 0.97, 1.72). Excess risk was highest among babies of normal (2500-4000 grams) birthweight. While a number of limitations inherent in the source of data require cautious interpretation of these results, we conclude that some excess risk of low Apgar score may be associated with repeat cesarean section procedures.
Period, age, and cohort effects on substance use among young Americans: a decade of change, 1976-86.
Authors: O'Malley P M , Bachman J G , Johnston L D
Published: November 2008

In an earlier article in this Journal, we reported analyses that differentiated among period, age, and cohort effects on substance use among American youth 18 to 24 years old, from the high school classes of 1976 to 1982 during the period of 1976 to 1982. The present analyses extend the classes and years to 1986, and the age range to 18-28. A cohort-sequential design is employed, based on annual surveys of nationally representative samples of high school seniors, plus annual follow-up surveys of each senior class. Twelve different classes of drugs, both licit and illicit, are examined. Several different types of period, age, and cohort effects over the last decade are identified. Alcohol use (monthly and occasions of heavy use), and the use of marijuana, cocaine, amphetamines, methaqualone, barbiturates, LSD, psychedelics other than LSD, and tranquilizers all showed period effects. Occasions of heavy drinking, cigarette smoking, monthly and daily use of alcohol, and annual prevalence of cocaine, amphetamines, barbiturates, LSD, and narcotics other than heroin showed age effects. Class effects were seen for cigarette smoking and daily marijuana use.
Feline plague in New Mexico: risk factors and transmission to humans.
Authors: Eidson M , Tierney L A , Rollag O J , Becker T , Brown T , Hull H F
Published: November 2008

The epidemiologic features of 60 cases of feline plague from 1977-1985 in New Mexico are reviewed. The most frequent clinical presentation was lethargy, anorexia, fever, and enlarged lymph nodes or abscesses. A history of hunting rodents was reported in 75 per cent of all cases. Five human plague cases were associated with five feline cases. Recommendations are presented for prevention of plague infection and transmission to humans, including restraining cats from roaming and hunting by neutering and keeping them indoors, treating them for fleas, and seeking medical care for febrile illnesses, especially when accompanied by enlarged lymph nodes.
Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population.
Authors: Johnson J V , Hall E M
Published: November 2008

This cross-sectional study investigates the relationship between the psychosocial work environment and cardiovascular disease (CVD) prevalence in a randomly selected, representative sample of 13,779 Swedish male and female workers. It was found that self-reported psychological job demands, work control, and co-worker social support combined greater then multiplicatively in relation to CVD prevalence. An age-adjusted prevalence ratio (PR) of 2.17 (95% CI-1.32, 3.56) was observed among workers with high demands, low control, and low social support compared to a low demand, high control, and high social support reference group. PRs of approximately 2.00 were observed in this group after consecutively controlling for the effects of age together with 11 other potential confounding factors. The magnitude of the age-adjusted PRs was greatest for blue collar males. Due to the cross-sectional nature of the study design, causal inferences cannot be made. The limitations of design and measurement are discussed in the context of the methodological weaknesses of the work stress field.
Involuntary and voluntary psychiatric patients: a pilot study of resource consumption.
Authors: Perlman B P , Kentera A , Thornton J C , Griffith B
Published: November 2008

This pilot study compares the resources utilized caring for "voluntary" and "involuntary" patients in a community hospital inpatient psychiatric unit. "Voluntary" patients committed less episodes of violence. "Emergency involuntaries" experienced more episodes of restraint and were involved in more violent episodes than "other involuntaries". A critical predictor of behavior was whether patients were brought to the hospital by police. Implications for public policy and psychiatric DRGs (diagnosis related groups) are discussed.
Parental son preference in seeking medical care for children less than five years of age in a rural community in Bangladesh.
Authors: Hossain M M , Glass R I
Published: November 2008

We examined drug purchases for children less than five years of age from privately owned pharmacies in Matlab, a rural area in Bangladesh. The male to female incidence rate ratio was 1.71 (95 per cent confidence intervals = 1.27, 2.28) for overall drug purchase, and 2.94 (95% CI = 1.14, 7.73) for purchase of drugs prescribed by physicians. Our findings support and extend previous observations in this community of parental son preference in caring for children.
A cost-effectiveness analysis of exercise as a health promotion activity.
Authors: Hatziandreu E I , Koplan J P , Weinstein M C , Caspersen C J , Warner K E
Published: November 2008

We used cost-effectiveness analysis to estimate the health and economic implications of exercise in preventing coronary heart disease (CHD). We assumed that nonexercisers have a relative risk of 2.0 for a CHD event. Two hypothetical cohorts (one with exercise and the other without exercise) of 1,000 35-year-old men were followed for 30 years to observe differences in the number of CHD events, life expectancy, and quality-adjusted life expectancy. We used jogging as an example to calculate cost, injury rates, adherence, and the value of time spent. Both direct and indirect costs associated with exercise, injury, and treating CHD were considered. We estimate that exercising regularly results in 78.1 fewer CHD events and 1,138.3 Quality Adjusted Life Years (QALYs) gained over the 30-year study period. Under our base case assumptions, which include indirect costs such as time spent in exercise, exercise does not produce economic savings. However, the cost per QALY gained of $11,313 is favorable when compared with other preventive or therapeutic interventions for CHD. The value of time spent is a crucial factor, influencing whether exercise is a cost-saving activity. In an alternative model, where all members of the cohort exercise for one year, and then only those who like it or are neutral continue, exercise produces net economic savings as well as reducing morbidity.
Physical activity and coronary heart disease among asymptomatic hypercholesterolemic men (the Lipid Research Clinics Coronary Primary Prevention Trial).
Authors: Siscovick D S , Ekelund L G , Hyde J S , Johnson J L , Gordon D J , LaRosa J C
Published: November 2008

We examined the relation between reported regular strenuous exercise or hard physical labor and the incidence of coronary heart disease (CHD) death and nonfatal myocardial infarction among 1,533 hypercholesterolemic men aged 35-59 years who were in the placebo group of the Lipid Research Clinics Coronary Primary Prevention Trial. The mean follow-up of the cohort was 7.4 years. The men were free of clinical heart disease at entry; men with an abnormal resting electrocardiogram or graded exercise test also were excluded. Regular physical activity was not associated with the incidence of CHD (RR = .94, 95% CI = .68, 1.38) in this study population. Adjustment by the proportional hazards model for age, low-density lipoprotein cholesterol, smoking, family history of CHD, and occupation did not alter this finding. This observation suggests that reported regular physical activity may not be related to the risk of coronary heart disease among asymptomatic, hypercholesterolemic, middle-aged men.
The persistence of Shigella flexneri in the United States: increasing role of adult males.
Authors: Tauxe R V , McDonald R C , Hargrett-Bean N , Blake P A
Published: November 2008

The annual reported isolation rate of Shigella flexneri decreased from 1964 to 1973, but has remained constant since then at 1 per 100,000. Between 1975 and 1985, the median age of males from whom S. flexneri was isolated rose from 5 to 26 years. During this time, the isolation rate of S. flexneri rose more than five-fold among men, did not change in adult women, and decreased in children. By 1985, 23 per cent of reported S. flexneri isolates came from men aged 20-49. Increased male homosexual transmission of S. flexneri is a possible explanation for these findings.