bluuebunny/crossref_metadata_2025 huggingface dataset:
A 4M tápanyagmodell a növényi tápanyagellátás tudományos megalapozására
Authors: Fodor Nándor , Máthéné Gáspár Gabriella , Kovács Géza J.
Published: December 2008

A szimulációs növénytermesztési modellek közvetlen célja,
hogy a nagyon bonyolult légkör–talaj–növény rendszer folyamatait, beleértve az
emberi tevékenységet is, matematikai eszközökkel leírják, és számítógép
segítségével szimulálják. A végső cél azonban az, hogy ezen modellek
felhasználásával olyan kérdésekre kapjunk válas__
Measuring Attributes of Success of College Students in Nursing Programs: A Psychometric Analysis
Authors: Seago Jean Ann , Wong Sabrina T. , Keane Dennis , Grumbach Kevin N
Published: December 2008

Because of the most recent nurse shortage it has become important to determine retention factors of nursing students in the context of various aspects of college nursing programs and institutional systems. The purpose of this article is to describe the psychometric properties of a new measure that could be useful in examining nursing student retention related to the educational institution characteristics, educational processes, and individual student characteristics. The measurement instrument was conceptually designed around 4 constructs and was administered to a test group and a validation group. The dispositional construct loaded differently for each group (test group: math and science ability, confidence in the future, and confidence in ability; validation group: math and science ability, confidence in the future, self-expectation, and confidence in ability). The situational construct factored on 4 subscales (financial issues, social support, missed classes, and work issues); the institutional construct on 4 factors (peer, overall experience, diversity, and faculty); the career values construct on 5 factors (job characteristics, autonomy, caring, flexibility, and work style). Based on the results of the factor analyses and alpha reliability, evidence supported using the dispositional subscales of math and science ability, the career values subscales of job characteristics and work style, the situational subscales of work issues and financial issues, and the institutional subscales of diversity and faculty. The other potential subscales need further refinement and testing.
A “Health Commons” Approach to Oral Health for Low-Income Populations in a Rural State
Authors: Beetstra Stephen , Derksen Daniel , Ro Marguerite , Powell Wayne , Fry Donald E. , Kaufman Arthur
Published: December 2008

Oral health needs are urgent in rural states. Creative, broad-based, and collaborative solutions can alleviate these needs.

“Health commons” sites are enhanced, community-based, primary care safety net practices that include medical, behavioral, social, public, and oral health services. Successful intervention requires a comprehensive approach, including attention to enhancing dental service capacity, broadening the scope of the dental skills of locally available providers, expanding the pool of dental providers, creating new interdisciplinary teams in enhanced community-based sites, and developing more comprehensive oral health policy.

By incorporating oral health services into the health commons primary care model, access for uninsured and underserved populations is increased. A coalition of motivated stakeholders includes community leaders, safety net providers, legislators, insurers, and medical, dental, and public health providers.
Defining Early Adolescent Childbearing
Authors: Phipps Maureen G. , Sowers MaryFran
Published: December 2008

Objectives. This study determined the age group for the case definition of early adolescent childbearing based on rates of adverse clinical outcomes.

Methods. We examined rates of infant mortality, very low birthweight (<1500 g), and very preterm delivery (<32 weeks) per 1000 live births for all US singleton first births (n = 768 029) to women aged 12 to 23 years in the 1995 US birth cohort.

Results. Rates of infant mortality, very low birthweight, and very preterm delivery were graphed by maternal age. In all 3 cases, the inflection point below which the rate of poor birth outcome is lower and begins to stabilize is at 16 years; therefore, mothers 15 years and younger were grouped together to determine the case definition of early adolescent childbearing. The inflection points were similar when outcomes were stratified by the 3 largest US racial/ethnic groups (non-Hispanic White, non-Hispanic Black, and Mexican American).

Conclusions. From this population-based analysis of birth outcomes, we conclude that early adolescent childbearing is best defined as giving birth at 15 years or younger.
Attacks on Science: The Risks to Evidence-Based Policy
Authors: Rosenstock Linda , Lee Lore Jackson
Published: December 2008

As government agencies, academic centers, and researchers affiliated with them provide an increasing share of the science base for policy decisions, they are also subject to efforts to politicize or silence objective scientific research. Such actions increasingly use sophisticated and complex strategies that put evidence-based policy making at risk.

To assure the appropriate use of scientific evidence and the protection of the scientists who provide it, institutions and individuals must grow more vigilant against these tactics. Maintaining the capacity for evidence-based policy requires differentiating between honest scientific challenge and evident vested interest and responding accordingly, building and diversifying partnerships, assuring the transparency of funding sources, agreeing on rules for publication, and distinguishing the point where science ends and policy begins.
Lack of Oral Health Care for Adults in Harlem: A Hidden Crisis
Authors: Zabos Georgina P. , Northridge Mary E. , Ro Marguerite J. , Trinh Chau , Vaughan Roger , Moon Howard Joyce , Lamster Ira , Bassett Mary T. , Cohall Alwyn T.
Published: December 2008

Objectives. Profound and growing disparities exist in oral health among certain US populations. We sought here to determine the prevalence of oral health complaints among Harlem adults by measures of social class, as well as their access to oral health care.

Methods. A population-based survey of adults in Central Harlem was conducted from 1992 to 1994. Two questions on oral health were included: whether participants had experienced problems with their teeth or gums during the past 12 months and, if so, whether they had seen a dentist.

Results. Of 50 health conditions queried about, problems with teeth or gums were the chief complaint among participants (30%). Those more likely to report oral health problems than other participants had annual household incomes of less than $9000 (36%), were unemployed (34%), and lacked health insurance (34%). The privately insured were almost twice as likely to have seen a dentist for oral health problems (87%) than were the uninsured (48%).

Conclusions. There is an urgent need to provide oral health services for adults in Harlem. Integrating oral health into comprehensive primary care is one promising mechanism.
Problems With Access to Dental Care for Medicaid-Insured Children: What Caregivers Think
Authors: Mofidi Mahyar , Rozier R. Gary , King Rebecca S.
Published: December 2008

Objectives. This study aimed to gain insight into the experiences, attitudes, and perceptions of a racially and ethnically diverse group of caregivers regarding barriers to dental care for their Medicaid-insured children.

Methods. Criterion-purposive sampling was used to select participants for 11 focus groups, which were conducted in North Carolina. Seventy-seven caregivers of diverse ethnic and racial backgrounds participated. Full recordings of sessions were obtained and transcribed. A comprehensive content review of all data, including line-by-line analysis, was conducted.

Results. Negative experiences with the dental care system discouraged many caregivers in the focus groups from obtaining dental services for their Medicaid-insured children. Searching for providers, arranging an appointment where choices were severely limited, and finding transportation left caregivers describing themselves as discouraged and exhausted. Caregivers who successfully negotiated these barriers felt that they encountered additional barriers in the dental care setting, including long waiting times and judgmental, disrespectful, and discriminatory behavior from staff and providers because of their race and public assistance status.

Conclusions. Current proposals to solve the dental access problem probably will be insufficient until barriers identified by caregivers are addressed.
Population Attributable Fractions of Psychiatric Disorders and Behavioral Outcomes Associated With Combat Exposure Among US Men
Authors: Prigerson Holly G. , Maciejewski Paul K. , Rosenheck Robert A.
Published: December 2008

Objectives. This study determined the percentage of adverse outcomes in US men attributable to combat exposure.

Methods. Standardized psychiatric interviews (modified Diagnostic Interview Schedule and Composite International Diagnostic Interview assessments) were administered to a representative national sample of 2583 men aged 18 to 54 in the National Comorbidity Survey part II subsample.

Results. Adjusted attributable fraction estimates indicated that the following were significantly attributable to combat exposure: 27.8% of 12-month posttraumatic stress disorder, 7.4% of 12-month major depressive disorder, 8% of 12-month substance abuse disorder, 11.7% of 12-month job loss, 8.9% of current unemployment, 7.8% of current divorce or separation, and 21% of current spouse or partner abuse.

Conclusions. Combat exposure results in substantial morbidity lasting decades and accounts for significant and multifarious forms of dysfunction at the national level.
Bar and Club Tobacco Promotions in the Alternative Press: Targeting Young Adults
Authors: Sepe Edward , Glantz Stanton A.
Published: December 2008

Objectives. This study examined changes in tobacco promotions in the alternative press in San Francisco and Philadelphia from 1994 to 1999.

Methods. A random sample of alternative newspapers was analyzed, and a content analysis was conducted.

Results. Between 1994 and 1999, numbers of tobacco advertisements increased from 8 to 337 in San Francisco and from 8 to 351 in Philadelphia. Product advertisements represented only 45% to 50% of the total; the remaining advertisements were entertainment-focused promotions, mostly bar–club and event promotions.

Conclusions. The tobacco industry has increased its use of bars and clubs as promotional venues and has used the alternative press to reach the young adults who frequent these establishments. This increased targeting of young adults may be associated with an increase in smoking among this group.
Use of Highly Active Antiretroviral Therapy in a Cohort of HIV-Seropositive Women
Authors: Cook Judith A. , Cohen Mardge H. , Grey Dennis , Kirstein Lynn , Burke Jane , Anastos Kathryn , Palacio Herminia , Richardson Jean , Wilson Tracey E. , Young Mary
Published: December 2008

Objectives. This study examined longitudinal trends in use of highly active antiretroviral therapy (HAART) among a cohort of HIV-positive participants in the Women's Interagency HIV Study.

Methods. Beginning in 1994, 1690 HIV-positive women reported detailed information about their use of antiretroviral therapy at 6-month study visits. Multivariate logistic and Cox regression analyses were used to estimate the likelihood of antiretroviral therapy and HAART use among women with study visits preceding and following HAART availability.

Results. Before the availability of HAART, the cohort's likelihood of any antiretroviral therapy use was associated with clinical indicators (CD4 count, viral load, symptom presence) as well as behavioral factors (abstaining from drug and alcohol use, participating in clinical trials). After HAART became commercially available, newly emerging predictors included college education, private insurance, absence of injection drug use history, and not being African American.

Conclusions. After the penetration of HAART into this cohort, additional differences emerged between HAART users and nonusers. These findings can inform public health efforts to enhance women's access to the most effective types of therapy.
Income Inequality and Mortality in US Counties: Does Minority Racial Concentration Matter?
Authors: McLaughlin Diane K. , Stokes C. Shannon
Published: December 2008

This study examined (1) the relationship between income inequality and mortality among all counties in the contiguous United States to ascertain whether the relationships found for states and metropolitan areas extend to smaller geographic units and (2) the influence of minority racial concentration on the inequality–mortality linkage.

Methods. This county-level ecologic analysis used data from the Compressed Mortality Files and the US Census. Weighted least squares regression models of age-, sex-, and race-adjusted county mortality rates were estimated to examine the additive and interactive effects of income inequality and minority racial concentration.

Results. Higher income inequality at the county level was significantly associated with higher total mortality. Higher minority racial concentration also was significantly related to higher mortality and interacted with income inequality.

Conclusions. The relationship between income inequality and mortality is robust for counties in the United States. Minority concentration interacts with income inequality, resulting in higher mortality in counties with low inequality and a high percentage of Blacks than in counties with high inequality and a high percentage of Blacks.
Holistic Health Care for Native Women: An Integrated Model
Authors: Napoli Maria
Published: December 2008

Providing health care services to Native women has become a challenge owing to the severity of illness—in particular, diabetes, alcoholism, and arthritis—in this group today. If comprehensive health care is to be offered, coordination of services between health and mental health practitioners is needed.

Gathering together to support each other has been a traditional custom for Native women. An integrated health care model is discussed that offers Native women an opportunity to deal with the challenge of mental health and health issues through traditional activities, enhancing their physical and spiritual health and receiving education while creating an atmosphere of empowerment and mutual support.
Auricular Acupuncture, Education, and Smoking Cessation: A Randomized, Sham-Controlled Trial
Authors: Bier Ian D. , Wilson Jeffrey , Studt Pat , Shakleton Mary
Published: December 2008

Objectives. This study examined the effect of acupuncture alone and in combination with education on smoking cessation and cigarette consumption.

Methods. We prospectively studied 141 adults in a quasi-factorial design using acupuncture, sham acupuncture, and education.

Results. All groups showed significant reductions in smoking and posttreatment cigarette consumption, with the combined acupuncture–education group showing the greatest effect from treatment. The trend continued in follow-up; however, significant differences were not maintained. Greater pack-year history (i.e. the number of years smoking multiplied by baseline number of cigarettes smoked per year, divided by 20 cigarettes per pack) negatively correlated with treatment effect. Trend analysis suggested 20 pack-years as the cutoff point for this correlation.

Conclusions. Acupuncture and education, alone and in combination, significantly reduce smoking; however, combined they show a significantly greater effect, as seen in subjects with a greater pack-year history.
Acupuncture Outcomes, Expectations, Patient–Provider Relationship, and the Placebo Effect: Implications for Health Promotion
Authors: So Dominicus W.
Published: December 2008

Objectives. To explore whether treatment outcomes are associated with a patient’s degree of general hopefulness, expectations regarding treatment, attributions of health status, beliefs about mind–body dualism, and patient–provider relationship factors, I studied acupuncture patients’ goal attainment.

Methods. Sixty-two acupuncture patients were interviewed before and after acupuncture regarding goal attainment, mind–body beliefs, hopefulness, and attributions of health status. Demographics, acupuncture treatment, and health care usage information was also collected. Acupuncturists provided 3 months of treatment.

Results. Patients reported treatment goal attainment from acupuncture. Their perceived outcomes were not associated with previous treatment, patient demographics, or the expected and actual numbers of needle insertion. Successful outcomes were related positively to number of different CAM treatments used in the past year but negatively to patients’ expectations and the “Powerful Others” health locus of control dimension.

Conclusions. Perceived acupuncture outcomes seem not to be related to placebo effects and patient expectations, but rather to client–practitioner relationship factors. (Am J Public Health. 2002;92:1662–1667)
Alternative Mental Health Services: The Role of the Black Church in the South
Authors: Blank Michael B. , Mahmood Marcus , Fox Jeanne C. , Guterbock Thomas
Published: December 2008

Objectives. This study determined the extent to which churches in the South were providing mental health and social services to congregations and had established linkages with formal systems of care.

Methods. A computer-assisted telephone interview (CATI) survey was conducted with pastors from 269 Southern churches.

Results. Black churches reported providing many more services than did White churches, regardless of urban or rural location. Few links between churches and formal provider systems were found, irrespective of the location—urban or rural—or racial composition of the churches.

Conclusions. Results are discussed in terms of the potential for linking faith communities and formal systems of care, given the centrality of the Black church in historical context.
The Community-Oriented Primary Care Experience in the United Kingdom
Authors: Gillam Stephen , Schamroth Alan
Published: December 2008

The UK National Health Service has long delivered public health programs through primary care. However, attempts to promote Sidney Kark’s model of community-oriented primary care (COPC), based on general practice populations, have made only limited headway.

Recent policy developments give COPC new resonance. Currently, primary care trusts are assuming responsibility for improving the health of the populations they serve, and personal medical service pilots are tailoring primary care to local needs under local contracts.

COPC has yielded training packages and frameworks that can assist these new organizations in developing public health skills and understanding among a wide range of primary care professionals.
Variability and Vulnerability at the Ecological Level: Implications for Understanding the Social Determinants of Health
Authors: Karpati Adam , Galea Sandro , Awerbuch Tamara , Levins Richard
Published: December 2008

Objectives. We examined variability in disease rates to gain understanding of the complex interactions between contextual socioeconomic factors and health.

Methods. We compared mortality rates between New York and California counties in the lowest and highest quartiles of socioeconomic status (SES), assessed rate variability between counties for various outcomes, and examined correlations between outcomes’ sensitivity to SES and their variability.

Results. Outcomes with mortality rates that differed most by county SES were among those whose variability across counties was high (e.g., AIDS, homicide, cirrhosis). Lower-SES counties manifested greater variability among outcome measures.

Conclusions. Differences in health outcome variability reflect differences in SES impact on health. Health variability at the ecological level might reflect the impact of stressors on vulnerable populations. (Am J Public Health. 2002;92:1768–1772)
The Impact of Government Policies and Neighborhood Characteristics on Teenage Sexual Activity and Contraceptive Use
Authors: Averett Susan L. , Rees Daniel I. , Argys Laura M.
Published: December 2008

Objectives. This study sought to examine the effects of government policies and neighborhood characteristics on adolescent female sexual behavior to better inform future public policy decisions.

Methods. Using a bivariate probit model and National Survey of Family Growth data on women aged 15 through 19 years, we estimated the probabilities of their being sexually active and, if sexually active, of their using contraceptives.

Results. Variables measuring the cost of obtaining an abortion are not good predictors of sexual activity or contraceptive use. However, the relationship between family planning availability and contraceptive use is statistically significant at conventional levels.

Conclusions. Policymakers seem to have little leverage with regard to influencing the decision to become sexually active, although increased access to family planning services may encourage responsible contraceptive behavior. Neighborhood context is an important determinant of adolescent female sexual behavior.
Provision of Sexual Health Services to Adolescent Enrollees in Medicaid Managed Care
Authors: Lafferty William E. , Downey Lois , Holan Christine M. , Lind Alice , Kassler William , Tao Guoyu , Irwin Kathleen L.
Published: December 2008

Objectives. This Seattle project measured sexual health services provided to 1112 Medicaid managed care enrollees aged 14 to 18 years.

Methods. Three health maintenance organizations (HMOs) that provide Medicaid services for a capitated rate agreed to participate. These included a non-profit staff-model HMO, a for-profit independent practice association (IPA), and a non-profit alliance of community clinics. Analyses used health maintenance organizations’ administrative data, chart reviews, and Medicaid encounter data.

Results. Health maintenance organizations provided primary care to 54% and well care to 20% of Medicaid enrollees. Girls were more likely than boys to have their sexual history taken or to be given condom counseling. Only 27% of sexually active girls were tested for chlamydia, with significantly lower rates of testing among those who spoke English as a second language. The nonprofit staff-model plan outperformed the for-profit independent practice association on most measures.

Conclusions. Substantial room for improvement exists in sexual health services delivery to adolescent Medicaid managed care enrollees.
STD Screening, Testing, Case Reporting, and Clinical and Partner Notification Practices: A National Survey of US Physicians
Authors: St. Lawrence Janet S. , Montaño Daniel E. , Kasprzyk Danuta , Phillips William R. , Armstrong Keira , Leichliter Jami S.
Published: December 2008

Objectives. This study presents results from a national survey of US physicians that assessed screening, case reporting, partner management, and clinical practices for syphilis, gonorrhea, chlamydia, and HIV infection.

Methods. Surveys were mailed to a random sample of 7300 physicians to assess screening, testing, reporting, and partner notification for syphilis, gonorrhea, chlamydia, and HIV.

Results. Fewer than one third of physicians routinely screened men or women (pregnant or nonpregnant) for STDs. Case reporting was lowest for chlamydia (37%), intermediate for gonorrhea (44%), and higher for syphilis, HIV, and AIDS (53%–57%). Physicians instructed patients to notify their partners (82%–89%) or the health department (25%–34%) rather than doing so themselves.

Conclusions. STD screening levels are well below practice guidelines for women and virtually nonexistent for men. Case reporting levels are below those legally mandated; physicians rely instead on patients for partner notification. Health departments must increase collaboration with private physicians to improve the quality of STD care.
HIV Infection and Pregnancy Status Among Adults Attending Voluntary Counseling and Testing in 2 Developing Countries
Authors: Forsyth Andrew D. , Coates Thomas J. , Grinstead Olga A. , Sangiwa Gloria , Balmer Donald , Kamenga Munkolenkole C. , Gregorich Steven E.
Published: December 2008

Objectives. This study investigated the impact of HIV voluntary counseling and testing (VCT) on reproduction planning among 1634 adults in 2 sub-Saharan countries.

Methods. Data were obtained from a multisite randomized controlled trial.

Results. At 6 months post-VCT, the women more likely to be pregnant were younger (odds ratio [OR] = 2.5; 95% confidence interval [CI] = 1.0, 6.5), not using contraceptives (OR = 0.1; 95% CI = 0.1, 0.3), and HIV infected (OR = 3.0; 95% CI = 1.3, 7.0). An interaction emerged linking pregnancy intention at baseline and HIV serostatus with pregnancy at follow-up (OR = 0.1; 95% CI = .0, 0.4) Partner pregnancy rates did not differ by HIV serostatus among men.

Conclusions. HIV diagnosis may influence reproduction planning for women but not for men.
A Reexamination of Smoking Before, During, and After Pregnancy
Authors: Kahn Robert S. , Certain Laura , Whitaker Robert C.
Published: December 2008

Objectives. This study examined the patterns and correlates of maternal smoking before, during, and after pregnancy.

Methods. We examined socioeconomic, demographic, and clinical risk factors associated with maternal smoking in a nationally representative cohort of women (n = 8285) who were surveyed 17 ± 5 months and again 35 ± 5 months after delivery.

Results. Smoking rates among women with a college degree decreased 30% from before pregnancy to 35 months postpartum but did not change among the least educated women. Risk factors clustered, and a gradient linked the number of risk factors (0, 2, 4) to the percentage smoking (6%, 31%, 58%, P < .0001).

Conclusions. The period of pregnancy and early parenthood is associated with worsening education-related disparities in smoking as well as substantial clustering of risk factors. These observations could influence the targeting and design of maternal smoking interventions.
The Relationship Between Periodontal Disease Attributes and Helicobacter pylori Infection Among Adults in the United States
Authors: Dye Bruce A. , Kruszon-Moran Deanna , McQuillan Geraldine
Published: December 2008

Objectives. We investigated the relationship between Helicobacter pylori infection and abnormal periodontal conditions.

Methods. Data from the first phase of the third National Health and Nutrition Examination Survey were used. A total of 4504 participants aged 20 to 59 years who completed a periodontal examination and tested positive for H. pylori antibodies were examined.

Results. Periodontal pockets with a depth of 5 mm or more were associated with increased odds of H. pylori seropositivity (odds ratio [OR] = 1.47; 95% confidence interval [CI] = 1.12, 1.94) after adjustment for sociodemographic factors. This association is comparable to the independent effects of poverty on H. pylori (OR = 1.54; 95% CI = 1.10, 2.16).

Conclusions. Poor periodontal health, characterized by advanced periodontal pockets, may be associated with H. pylori infection in adults, independent of poverty status.
Relationship Between Children’s Dental Needs and Dental Care Utilization: United States, 1988–1994
Authors: Vargas Clemencia M. , Ronzio Cynthia R.
Published: December 2008

Objectives. This study describes the relationship between dental needs and dental care utilization among children.

Methods. Data from the third National Health and Nutrition Examination Survey (1988-1994) were used to analyze dental care needs and dental care utilization.

Results. Younger children with perceived needs (needs perceived by the child or responsible adult) were more likely to be episodic users of dental care than children without perceived needs. Younger children with normative needs (defined by the presence of untreated caries diagnosed by a dentist) were less likely to be regular users. Older children with perceived or normative needs were more likely to be episodic users and less likely to have had a previous-year visit than children with no needs.

Conclusions. Despite their presence, dental needs do not drive dental care use among children, and children’s dental care utilization is inadequate.
A Program to Increase Seat Belt Use Along the Texas–Mexico Border
Authors: Cohn Lawrence D. , Hernandez Delia , Byrd Theresa , Cortes Miguel
Published: December 2008

A school-based, bilingual intervention was developed to increase seat belt use among families living along the Texas–Mexico border. The intervention sought to increase seat belt use by changing perceived norms within the community (i.e., making the nonuse of seat belts less socially acceptable). The intervention was implemented in more than 110 classrooms and involved more than 2100 children. Blind coding, validity checks, and reliability estimates contributed to a rigorous program evaluation. Seat belt use increased by 10% among children riding in the front seat of motor vehicles in the intervention community, as compared with a small but nonsignificant decline in use among control community children. Seat belt use among drivers did not increase.
HIV Testing Policy and Serious Mental Illness
Authors: Walkup James , Satriano James , Barry Danielle , Sadler Pablo , Cournos Francine
Published: December 2008

Objectives. Using opinion data from experts, we examined the context of the argument for mandatory testing of psychiatric patients.

Methods. Vignettes were distributed to experts on HIV and mental illness. Respondents were asked to provide appropriateness ratings for different hypothetical clinical decisions regarding HIV management.

Results. Respondents were reluctant to impose testing without informed consent in most circumstances. The presence of risk factors or danger to another increased appropriateness ratings modestly.

Conclusions. Despite experts’ tendency to emphasize individual rights, public reluctance to mandate testing is unlikely to extend to people with serious mental illness. No argument for mandatory testing can be persuasive if improved voluntary testing can achieve adequate detection rates. Voluntary testing protocols should be studied to determine which successfully identify infected individuals.
Community-Based Trial to Prevent Drug Use Among Youths in Yunnan, China
Authors: Wu Zunyou , Detels Roger , Zhang Jiapeng , Li Virginia , Li Jianhua
Published: December 2008

Objectives. This study evaluated a community-based program in China to prevent initiation of drug use in young men.

Methods. Similar intervention and control areas were selected. Village leaders, teachers, and women and youth leaders were recruited to participate in the program. Community activities were organized and intervention activities in schools were implemented. Incidence of new drug users was estimated.

Results. There was a 2.7-fold greater reduction in drug use initiation in the intervention area (1.59% vs 0.60%). Reduction was highest among males aged 15 to 19, single men, illiterate men, and the Jingpo minority. HIV/AIDS knowledge and attitudes and recognition of drug problems were all significantly better in the intervention area.

Conclusions. Community-based intervention programs to prevent drug use can be successful in rural areas of China.
Battering Victimization Among a Probability-Based Sample of Men Who Have Sex With Men
Authors: Greenwood Gregory L. , Relf Michael V. , Huang Bu , Pollack Lance M. , Canchola Jesse A. , Catania Joseph A.
Published: December 2008

Objectives. This study measured the prevalence of battering victimization (i.e., experience of psychological/symbolic, physical, and sexual battering) among men who have sex with men (MSM) and identified characteristics of these men.

Methods. A probability-based sample of 2881 MSM living in 4 cities completed telephone interviews between 1996 and 1998.

Results. Prevalence estimates were 34% for psychological/symbolic battering, 22% for physical battering, and 5% for sexual battering. The strongest demographic correlate independently associated with all forms of battering was age 40 or younger, whereas education and HIV serostatus were associated with physical and psychological/symbolic violence.

Conclusions. Rates of battering victimization among urban MSM are substantially higher than among heterosexual men and possibly heterosexual women. Public health efforts directed toward addressing intimate partner battering among these men are needed.
Childhood Vaccine Purchase Costs in the Public Sector: Past Trends, Future Expectations
Authors: Davis Matthew M. , Zimmerman Jessica L. , Wheeler John R. C. , Freed Gary L.
Published: December 2008

Objectives. We examined recent public-sector trends in childhood vaccine costs and estimated future costs.

Methods. We used public-sector price data to calculate vaccine purchase cost per child for children aged 0 to 6 years from 1975 to 2001. We fit a linear regression model to historical data and then used it to project costs per child from 2002 to 2020, adjusted to 2001 US dollars.

Results. Controlling for inflation, the cost of vaccine purchase per child climbed from $10 in 1975 to $385 in 2001. The cost of vaccine purchase in the year 2020 following recommendation of 7 additional vaccines is estimated to be $1225 per child (95% confidence interval = $891, $1559).

Conclusions. The cost per child for recommended vaccines at public-sector prices may triple over the next 2 decades. These projections have implications for vaccine financing at federal and state levels.
Rates of Household Firearm Ownership and Homicide Across US Regions and States, 1988–1997
Authors: Miller Matthew , Azrael Deborah , Hemenway David
Published: December 2008

Objectives. In this study we explored the association between rates of household firearm ownership and homicide across the United States, by age groups.

Methods. We used cross-sectional time-series data (1988–1997) to estimate the association between rates of household firearm ownership and homicide.

Results. In region- and state-level analyses, a robust association between rates of household firearm ownership and homicide was found. Regionally, the association exists for victims aged 5 to 14 years and those 35 years and older. At the state level, the association exists for every age group over age 5, even after controlling for poverty, urbanization, unemployment, alcohol consumption, and nonlethal violent crime.

Conclusions. Although our study cannot determine causation, we found that in areas where household firearm ownership rates were higher, a disproportionately large number of people died from homicide.
Knowledge of, Attitudes Toward, and Experience of Complementary and Alternative Medicine in Western Medicine– and Oriental Medicine–Trained Physicians in Korea
Authors: Lee Sang-Il , Khang Young-Ho , Lee Moo-Song , Kang Weechang
Published: December 2008

Objectives. We compared knowledge of, attitudes toward, and experience with complementary and alternative medicine (CAM) among Western medicine–trained doctors (WMDs) and Oriental medicine–trained doctors (OMDs).

Methods. In Korea, 502 WMDs and 500 OMDs were interviewed with a structured questionnaire.

Results. OMDs held more favorable attitudes toward CAM than did WMDs. OMDs possessed a deeper understanding of and greater experience with CAM. OMDs more readily endorsed health beliefs congruent with CAM.

Conclusions. In the future, CAM can be more readily used by OMDs than by WMDs. Because evidence for the effectiveness of CAM remains sparse, more research is needed for the prudent use of CAM in Korea. An education and training system for potential CAM providers remains to be developed.
AIDS-Related Risk Among Adolescent Males Who Have Sex With Males, Females, or Both: Evidence From a Statewide Survey
Authors: Goodenow Carol , Netherland Julie , Szalacha Laura
Published: December 2008

Objectives. This study examined the prevalence of AIDS-related risk behaviors among adolescent males with female, male, and both-sex sexual partners and explored factors related to these behaviors.

Methods. Three waves of a population-based survey provided data on male high school students: 3065 with only female sexual partners, 94 with only male partners, and 108 with both. Logistic regression analyses were used to examine AIDS-related outcomes.

Results. Youths with any same-sex experience reported less school AIDS education. Bisexual experience predicted multiple sexual partners, unprotected intercourse, sexually transmitted disease, and injection drug use. School AIDS education and condom instruction predicted less AIDS-related risk.

Conclusions. Bisexually active adolescent males report especially high levels of AIDS risk behavior. School-based AIDS prevention should address the needs of all sexually active youths.
Avoiding the Boomerang: Testing the Relative Effectiveness of Antidrug Public Service Announcements Before a National Campaign
Authors: Fishbein Martin , Hall-Jamieson Kathleen , Zimmer Eric , von Haeften Ina , Nabi Robin
Published: December 2008

Objectives. This study examined the relative perceived effectiveness of 30 antidrug public service announcements (PSAs) and assessed the extent to which judgments of effectiveness are related to judgments of realism, amount learned, and positive and negative emotional responses.

Methods. Data were obtained from 3608 students in grades 5 through 12 in 10 schools. The ethnically diverse sample was 50.8% male. Students in 5 experimental conditions viewed sets of 6 antidrug PSAs and filled out a brief evaluation questionnaire following each PSA. Those in the control condition viewed a non–drug-related television program.

Results. The relative perceived effectiveness of the 30 PSAs varied considerably. Sixteen were rated as significantly more effective, and 6 as significantly less effective, than the control program. Relative rated effectiveness was highly related to realism (r = .87), amount learned (r = .88), negative emotion (r = .87), and positive emotion (r = –.35).

Conclusions. Evaluative research is necessary to prevent broadcast of PSAs that could have a negative impact. PSAs should point out the negative consequences of drug use behavior rather than telling adolescents to “just say no.”
The Contribution of Expanding Portion Sizes to the US Obesity Epidemic
Authors: Young Lisa R. , Nestle Marion
Published: December 2008

Objectives. Because larger food portions could be contributing to the increasing prevalence of overweight and obesity, this study was designed to weigh samples of marketplace foods, identify historical changes in the sizes of those foods, and compare current portions with federal standards.

Methods. We obtained information about current portions from manufacturers or from direct weighing; we obtained information about past portions from manufacturers or contemporary publications.

Results. Marketplace food portions have increased in size and now exceed federal standards. Portion sizes began to grow in the 1970s, rose sharply in the 1980s, and have continued in parallel with increasing body weights.

Conclusions. Because energy content increases with portion size, educational and other public health efforts to address obesity should focus on the need for people to consume smaller portions.
Childhood Vaccination Providers in the United States
Authors: LeBaron Charles W. , Lyons Bridget , Massoudi Mehran , Stevenson John
Published: December 2008

Objectives. This study sought to provide a characterization of US childhood vaccination providers.

Methods. The state was used as the analytic unit in examining 1997 data from the National Immunization Survey and the Vaccines for Children program, state immunization reports, and natality records.

Results. Overall, 57% of children were vaccinated in the private sector, 18% were vaccinated in the public sector, and 25% were vaccinated by a mixture of providers. Of the 50 883 immunization sites, 81% were private and 19% public. Average patient load was 77 infants per site. Private-sector patient loads were lower than public-sector loads.

Conclusions. US childhood vaccination provider capacity is adequate. Efforts to raise coverage rates should focus on increasing preventive care use among children, improving the vaccination performance of providers, and ensuring continuity of care.
Recognition of Osteoporosis by Primary Care Physicians
Authors: Gehlbach Stephen H. , Fournier Maureen , Bigelow Carol
Published: December 2008

Objectives. This study explored the recognition and treatment of osteoporosis and vertebral fracture among older women by primary care physicians.

Methods. Data from the National Ambulatory Medical Care Survey from 1993 to 1997 were examined for evidence of diagnosis and treatment of osteoporosis or vertebral fracture during visits by White women 60 years and older to primary care physicians.

Results. Fewer than 2% of the women received diagnoses of osteoporosis or vertebral fracture, although expected prevalence is 20% to 30%. Appropriate drug treatment, including antiresorptive agents and calcium and vitamin D, was offered to only 36% of the diagnosed patients.

Conclusions. Few cases of osteoporosis or vertebral fracture in older women are being diagnosed and treated by primary care physicians.
Unrecognized HIV Infection Among Patients Attending Sexually Transmitted Disease Clinics
Authors: Weinstock Hillard , Dale Monica , Linley Laurie , Gwinn Marta
Published: December 2008

Objectives. This study examined voluntary HIV testing rates in sexually transmitted disease (STD) clinics.

Methods. Anonymous, unlinked surveys of HIV seroprevalence and medical chart abstractions were conducted in 28 STD clinics in 14 US cities in 1997.

Results. Among the 52 260 patients included in the anonymous HIV serosurveys, voluntary HIV testing rates by clinic ranged from 30% to 99% (median = 58%). Patients not tested were more likely to be HIV infected than were patients who were tested, even after those with documented HIV infection were excluded, regardless of demographic characteristics, risk group, or STD diagnosis.

Conclusions. HIV infection is unrecognized in substantial numbers of patients with HIV infection visiting STD clinics. Efforts are needed to increase HIV testing and counseling of all patients visiting these clinics.
Effects of Iron Supplementation on Maternal Hematologic Status in Pregnancy
Authors: Sloan Nancy L. , Jordan Elizabeth , Winikoff Beverly
Published: December 2008

Objectives. Prenatal iron supplementation has been the standard recommendation for reducing maternal anemia in developing countries for the past 30 years. This article reviews the efficacy of iron supplementation on hemoglobin levels in pregnant women in developing countries.

Methods. Data from randomized controlled trials published between 1966 and 1998 were pooled. Meta-analyses of the relative change in maternal hemoglobin associated with iron supplementation were stratified by initial hemoglobin levels, duration of supplementation, and daily gestational supplement dose and supplementation with other nutrients.

Results. Iron supplementation raises hemoglobin levels. Its effects are dose dependent and are related to initial hematologic status. The extent to which iron supplementation can reduce maternal anemia is unclear.

Conclusions. The extent to which maternal hemoglobin levels can be increased by recommended prenatal supplementation is limited and has uncertain physiological benefits. Other approaches, including food fortification and prevention and treatment of other causes of anemia, require methodologically rigorous evaluation to find effective answers to this global problem.
The Global HIV/AIDS Pandemic, Structural Inequalities, and the Politics of International Health
Authors: Parker Richard
Published: December 2008

In spite of recent advances in treatment and care available in most developed countries, the HIV/AIDS pandemic continues to spread throughout the developing world.

Structural inequalities continue to fuel the epidemic in all societies, and HIV infection has increasingly been concentrated in the poorest, most marginalized sectors of society in all countries. The relationship between HIV/AIDS and social and economic development has therefore become a central point in policy discussions about the most effective responses to the epidemic.

Important progress has been made in recent United Nations initiatives. Maintaining long-term commitment to initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria is especially important in the wake of September 11 and ensuing events, which threaten to redirect necessary resources to seemingly more urgent security concerns.
Corporate Speech and the Constitution: The Deregulation of Tobacco Advertising
Authors: Gostin Lawrence O.
Published: December 2008

In a series of recent cases, the Supreme Court has given businesses powerful new First Amendment rights to advertise hazardous products. Most recently, in Lorillard Tobacco Co v Reilly (121 SCt 2404 [2001]), the court invalidated Massachusetts regulations intended to reduce underage smoking. The future prospects for commercial speech regulation appear dim, but the reasoning in commercial speech cases is supported by only a plurality of the court. A different First Amendment theory should recognize the importance of population health and the low value of corporate speech. In particular, a future court should consider the low informational value of tobacco advertising, the availability of alternative channels of communication, the unlawful practice of targeting minors, and the magnitude of the social harms.
HIV-Related Stigma and Knowledge in the United States: Prevalence and Trends, 1991–1999
Authors: Herek Gregory M. , Capitanio John P. , Widaman Keith F.
Published: December 2008

Objectives. This study assessed the prevalence of AIDS stigma and misinformation about HIV transmission in 1997 and 1999 and examined trends in stigma in the United States during the 1990s.

Methods. Telephone surveys with national probability samples of English-speaking adults were conducted in the period 1996 to 1997 (n = 1309) and in 1998 to 1999 (n = 669). Findings were compared with results from a similar 1991 survey.

Results. Overt expressions of stigma declined throughout the 1990s, with support for its most extreme and coercive forms (e.g., quarantine) at very low levels by 1999. However, inaccurate beliefs about the risks posed by casual social contact increased, as did the belief that people with AIDS (PWAs) deserve their illness. In 1999, approximately one third of respondents expressed discomfort and negative feelings toward PWAs.

Conclusions. Although support for extremely punitive policies toward PWAs has declined, AIDS remains a stigmatized condition in the United States. The persistence of discomfort with PWAs, blame directed at PWAs for their condition, and misapprehensions about casual social contact are cause for continuing concern and should be addressed in HIV prevention and education programs. (Am J Public Health. 2002;92:371–377)
Changes in HIV Seroprevalence and Related Behaviors Among Male Injection Drug Users Who Do and Do Not Have Sex With Men: New York City, 1990–1999
Authors: Maslow Carey B. , Friedman Samuel R. , Perlis Theresa E. , Rockwell Russell , Des Jarlais Don C.
Published: December 2008

Objectives. This study examined HIV prevalence and risk behaviors among male injection drug users (IDUs) who have sex with men and among other male IDUs.

Methods. Male IDUs were interviewed and tested for HIV at a detoxification clinic during 1990 to 1994 and 1995 to 1999. Analyses compared male IDUs who do and do not have sex with men within and between periods.

Results. Initially, HIV seroprevalence and risk behaviors were higher among IDUs who have sex with men. Seroprevalence (initially 60.5% vs 48.3%) declined approximately 15% in both groups, remaining higher among those who have sex with men. Generally, injection prevalence, but not sexual risk behaviors, declined.

Conclusions. Male IDUs who have sex with men are more likely to engage in higher-risk behaviors and to be HIV infected. Improved intervention approaches for male IDUs who have sex with men are needed. (Am J Public Health. 2002;92:382–384)