bluuebunny/crossref_metadata_2025_split huggingface dataset:
Who are California's Late HIV Testers? An Analysis of State AIDS Surveillance Data, 2000–2006
Authors: Tang Janet J. , Levy Vivian , Hernandez Maria Teresa 
Published: January 2017

Objectives. Late HIV testing leads to preventable, severe clinical and public health outcomes. California, lacking a mature HIV surveillance system, has been excluded from documented analyses of late HIV testers in the United States. We identified factors associated with late HIV testing in the California AIDS surveillance data to inform programs of HIV testing and access to treatment. Methods. We analyzed data from California AIDS cases diagnosed between 2000 and 2006 and reported through November 1, 2007. Late testers were people diagnosed with HIV within 12 months before their AIDS diagnosis. We identified factors significantly associated with late HIV testing using multivariable logistic regression. Results. Among 28,382 AIDS cases, 61.2% were late HIV testers. Late testing was significantly associated with those ≥35 years of age, heterosexual contact or unknown/other reported transmission risk, and being born outside of the U.S. When further classified by country of birth, people born in Mexico were most likely to be HIV late testers who progressed to AIDS. Conclusions. Our findings support wider implementation of opt-out HIV testing and HIV testing based in emergency departments. Services for HIV testing and treatment should be inclusive of all populations, but especially targeted to populations that may have more limited access.
Age as an Independent Risk Factor for Intensive Care Unit Admission or Death Due to 2009 Pandemic Influenza A(H1N1) Virus Infection
Authors: Nickel Katelin B. , Marsden-Haug Nicola , Lofy Kathryn H. , Turnberg Wayne L. , Rietberg Krista , Lloyd Jennifer K. , Marfin Anthony A. 
Published: January 2017

Objective. This study evaluated risk factors for intensive care unit (ICU) admission or death among people hospitalized with 2009 pandemic influenza A (pH1N1) virus infection. Methods. We based analyses on data collected in Washington State from April 27 to September 18, 2009, on deceased or hospitalized people with laboratory-confirmed pH1N1 infection reported by health-care providers and hospitals as part of enhanced public health surveillance. We used bivariate analyses and multivariable logistic regression to identify risk factors associated with ICU admission or death due to pH1N1. Results. We identified 123 patients admitted to the hospital but not an ICU and 61 patients who were admitted to an ICU or died. Independent of high-risk medical conditions, both older age and delayed time to hospital admission were identified as risk factors for ICU admission or death due to pH1N1. Specifically, the odds of ICU admission or death were 4.44 times greater among adults aged 18–49 years (95% confidence interval [CI] 1.97, 10.02) and 5.93 times greater among adults aged 50–64 years (95% CI 2.24, 15.65) compared with pediatric patients <18 years of age. Likewise, hospitalized cases admitted more than two days after illness onset had 2.17 times higher odds of ICU admission or death than those admitted within two days of illness onset (95% CI 1.10,4.25). Conclusion. Although certain medical conditions clearly influence the need for hospitalization among people infected with pH1N1 virus, older age and delayed time to admission each played an independent role in the progression to ICU admission or death among hospitalized patients.
Health Impact in New York City during the Northeastern Blackout of 2003
Authors: Lin Shao , Fletcher Barbara A. , Luo Ming , Chinery Robert , Hwang Syni-An 
Published: January 2017

Objective. This study assessed the health effects of the 2003 Northeastern blackout, the largest one in history, on mortality and hospital admissions due to respiratory, cardiovascular, and renal diseases in New York City (NYC), and compared the disease patterns and sociodemographic profiles of cases during the blackout with those on control days. Method. We investigated the effects of the blackout on health using incidence rate ratios to compare the disease on blackout days (August 14 and 15, 2003) with those on normal and comparably hot days (controls). Normal days were defined as summer days (June-August) between the 25th and 75th percentiles of maximum temperature during 1991–2004. Comparably hot days were days with maximum temperatures in the same range as that of the blackout days. We evaluated the interactive effects of demographics and the blackout using a case-only design. Results. We found that mortality and respiratory hospital admissions in NYC increased significantly (two- to eightfold) during the blackout, but cardiovascular and renal hospitalizations did not. The most striking increases occurred among elderly, female, and chronic bronchitis admissions. We identified stronger effects during the blackout than on comparably hot days. In contrast to the pattern observed for comparably hot days, higher socioeconomic status groups were more likely to be hospitalized during the blackout. Conclusions. This study suggests that power outages may have important health impacts, even stronger than the effects of heat alone. The findings provide some direction for future emergency planning and public health preparedness.
Increasing Inner-City Adult Influenza Vaccination Rates: A Randomized Controlled Trial
Authors: Humiston Sharon G. , Bennett Nancy M. , Long Christine , Eberly Shirley , Arvelo Lourdes , Stankaitis Joseph , Szilagyi Peter G. 
Published: January 2017

Objectives. In a population of seniors served by urban primary care centers, we evaluated the effect of the practice-based intervention on influenza immunization rates and disparities in vaccination rates by race/ethnicity and insurance status. Methods. A randomized controlled trial during 2003–2004 tested patient tracking/recall/outreach and provider prompts on improving influenza immunization rates. Patients aged ≥65 years in six large inner-city primary care practices were randomly allocated to study or control group. Influenza immunization coverage was measured prior to enrollment and on the end date. Results. At study end, immunization rates were greater for the intervention group than for the control group (64% vs. 22%, p<0.0001). When controlling for other factors, the intervention group was more than six times as likely to receive influenza vaccine. The intervention was effective across gender, race/ethnicity, age, and insurance subgroups. Among the intervention group, 3.5% of African Americans and 3.2% of white people refused influenza immunization. Conclusions. Patient tracking/recall/outreach and provider prompts were intensive but successful approaches to increasing seasonal influenza immunization rates among this group of inner-city seniors.
Assessing the Relationship between Seasonal and H1N1 Influenza Vaccination Status in Michigan Children, 2009–2010
Authors: Boulton Matthew L. , Grossman Alyse M. , Potter Rachel , Vranesich Patricia A. , Clayton Joshua 
Published: January 2017

Objectives. To examine the relationship between the outcome of vaccination for H1N1 influenza and receipt of seasonal influenza vaccine in Michigan children during the 2009–2010 season, we examined the influenza vaccination status of all Michigan residents aged six months to 18 years who were enrolled in the Michigan Care Improvement Registry. Methods. We calculated descriptive statistics for dichotomous and categorical variables, including numbers of children vaccinated with either influenza A (H1N1) monovalent vaccine and/or seasonal influenza vaccine, gender, race/ethnicity, provider type, moved-or-gone-elsewhere (MOGE) status, and vaccine type. We used logistic regression, adjusting for potential confounders and effect modifiers (age and MOGE status), to calculate odds ratios associated with H1N1 vaccine status (vaccinated vs. unvaccinated). Results. Michigan children who were vaccinated for seasonal influenza from August 1, 2009, to February 27, 2010, were 6.26 (95% confidence interval 6.18, 6.34) times as likely as children who were unvaccinated for seasonal influenza to be vaccinated with H1N1 2009 monovalent vaccine. Private health-care providers administered 91% of the seasonal influenza vaccine and 59% of the H1N1 vaccine. Conclusions. Increasing seasonal influenza vaccination campaign efforts could also benefit pandemic influenza vaccination efforts. Special educational outreach to parents regarding the importance of influenza vaccination for all children, regardless of age, may be needed. Stocking and offering traditional seasonal vaccine with pandemic-specific vaccine may aid in increasing immunization uptake. Efforts should be made to ensure that private providers are supplied with adequate pandemic vaccine as part of preparedness planning.
The Swiss National Vaccination Coverage Survey, 2005–2007
Authors: Lang Phung , Zimmermann Hanspeter , Piller Ursula , Steffen Robert , Hatz Christoph 
Published: January 2017

Objectives. We described the results from the Swiss National Vaccination Coverage Survey (SNVCS) 2005–2007, a survey designed to monitor immunization coverage of children and adolescents residing in Switzerland in each canton within a three-year period. Methods. The SNVCS is a cross-sectional survey using a two-stage sampling design targeting children aged 2, 8, and 16 years. Families of selected children were contacted by mail and telephone. Coverage was determined via vaccination cards or vaccination summary forms. Results. A total of 25 out of 26 cantons participated in the survey, with 8,286 respondents for children aged 24–35 months, 10,314 respondents for children aged 8 years, and 9,301 respondents for teenagers aged 16 years. Compared with data from 1999–2003, coverage estimates for toddlers remained unchanged for diphtheria, tetanus, pertussis, poliomyelitis, and Haemophilus influenzae type b vaccines at three doses, but increased five percentage points to 86%–87% for measles-mumps-rubella at one dose and was 71% at two doses. Coverage for measles, mumps, and rubella were 89%–90% at one dose and 75% at two doses for 8-year-olds, and 94% and 76% for the two dosages, respectively, for 16-year-olds. Linguistic region and nationality were highly correlated with being vaccinated against measles for the two younger age groups. Conclusion. Despite the increase in vaccine coverage, measles vaccination is still low, and the World Health Organization goal to eliminate measles by 2010 was not achieved in Switzerland. More efforts are needed by the cantons and the central government to increase vaccination coverage.
Vaccination Coverage among U.S. Children Aged 19–35 Months Entitled by the Vaccines for Children Program, 2009
Authors: Smith Philip J. , Lindley Megan C. , Rodewald Lance E. 
Published: January 2017

Objectives. Following the measles outbreaks of the late 1980s and early 1990s, vaccination coverage was found to be low nationally, and there were pockets of underimmunized children primarily in inner cities. We described the percentage and demographics of children who were entitled to the Vaccines for Children (VFC) program in 2009 and evaluated whether Healthy People 2010 (HP 2010) vaccination coverage objectives of 90% were achieved among these children. Methods. We analyzed data from 16,967 children aged 19–35 months sampled by the National Immunization Survey in 2009. VFC-entitled children included children who were ( 1) on Medicaid, ( 2) not covered by health insurance, ( 3) of American Indian/Alaska Native race/ethnicity, or ( 4) covered by private health insurance that did not pay all of the costs of vaccines, but who were vaccinated at a Federally Qualified Health Center or a Rural Health Center. Results. An estimated 49.7% of all children aged 19–35 months were entitled to VFC vaccines. Compared with children who did not qualify for VFC, the VFC-entitled children were significantly more likely to be Hispanic or non-Hispanic black; to have a mother who was widowed, divorced, separated, or never married; and to live in a household with an annual income below the federal poverty level. Mothers of VFC-entitled children were significantly less likely to have some college experience or to be college graduates. Of nine vaccines analyzed, two vaccines—polio at 91.7% and hepatitis B at 92.2%—achieved the HP 2010 90% coverage objective for VFC-entitled children, and four others, including measles-mumps-rubella at 88.8%, achieved greater than 80% coverage. Conclusions. Today, children with demographic characteristics like those of children who were at the epicenter of the measles outbreaks two decades ago are entitled to VFC vaccines at no cost, and have achieved high vaccination coverage levels.
Vaccination Coverage among U.S. Adolescents Aged 13–17 Years Eligible for the Vaccines for Children Program, 2009
Authors: Lindley Megan C. , Smith Philip J. , Rodewald Lance E. 
Published: January 2017

Objectives. We compared ( 1) characteristics of adolescents who are and are not entitled to receive free vaccines from the Vaccines for Children (VFC) program and ( 2) vaccination coverage with meningococcal conjugate (MCV4), quadrivalent human papillomavirus (HPV4), and tetanus-diphtheria-acellular pertussis (Tdap) vaccines among VFC-eligible and non-VFC-eligible adolescents. Methods. We analyzed data from the 2009 National Immunization Survey-Teen, a nationally representative, random-digit-dialed survey of households with adolescents aged 13–17 years ( n=20,066). Differences in sociodemographic characteristics and provider-reported vaccination coverage were evaluated using t-tests. Results. Overall, 32.1% (±1.2%) of adolescents were VFC-eligible. VFC-eligible adolescents were significantly less likely than non-VFC-eligible adolescents to be white and to live in suburban areas, and more likely to live in poverty and to have younger and less educated mothers. Nationally, coverage among non-VFC-eligible adolescents was 57.1% (±1.5%) for ≥1 dose of Tdap, 55.4% (±1.5%) for ≥1 dose of MCV4, and 43.2% (±2.2%) for ≥1 dose of HPV4. Coverage among VFC-eligible adolescents was 52.5% (±2.4%) for ≥1 dose of Tdap, 50.1% (±2.4%) for ≥1 dose of MCV4, and 46.6% (±3.5%) for ≥1 dose of HPV4. Only 27.5% (±1.8%) of non-VFC-eligible adolescents and 25.0% (±2.9%) of VFC-eligible adolescents received ≥3 doses of HPV4. Vaccination coverage was significantly higher among non-VFC-eligible adolescents for Tdap and MCV4, but not for one-dose or three-dose HPV4. Conclusions. Coverage with some recommended vaccines is lower among VFC-eligible adolescents compared with non-VFC-eligible adolescents. Continued monitoring of adolescent vaccination rates, particularly among VFC-eligible populations, is needed to ensure that all adolescents receive all routinely recommended vaccines.
Obesity among Chronically Homeless Adults: Is it a Problem?
Authors: Tsai Jack , Rosenheck Robert A. 
Published: January 2017

Objective. We examined rates of obesity and associated characteristics in the chronically homeless population to explore how a range of factors, including sociodemographics, housing, food source, physical and mental health, and health service use, were related to being overweight or obese. Methods. We conducted multivariate regression analyses on a community sample of 436 chronically homeless adults across 11 U.S. cities to examine the prevalence of obesity. Results. The majority (57%) of chronically homeless adults were overweight or obese Chronically homeless adults who were female or Hispanic appeared to be at particular risk for obesity There were few differences on physical and mental health by weight group Although overweight and obese chronically homeless adults were more likely to discuss exercise with a health-care provider, they reported engaging in less exercise than those who were underweight or normal weight. Conclusion. these findings underscore the need for greater attention to obesity in chronically homeless adults and demonstrate a food insecurity-obesity paradox or poverty-obesity link.
Uptake of Meningococcal Vaccine in Arizona Schoolchildren after Implementation of School-Entry Immunization Requirements
Authors: Simpson Jennifer E. , Hills Rebecca A. , Allwes Deborah , Rasmussen Lisa 
Published: January 2017

Objectives. Meningitis and bacteremia due to Neisseria meningitidis are rare but potentially deadly diseases that can be prevented with immunization Beginning in 2008, Arizona school immunization requirements were amended to include immunization of children aged 11 years or older with meningococcal vaccine before entering the sixth grade We describe patterns in meningococcal vaccine uptake surrounding these school-entry requirement changes in Arizona. Methods. We used immunization records from the Arizona State Immunization Information System (ASIIS) to compare immunization rates in 11- and 12-year-olds We used principal component analysis and hierarchical cluster analysis to identify and analyze demographic variables reported by the 2010 U.S. Census. Results. Adolescent meningococcal immunization rates in Arizona increased after implementation of statewide school-entry immunization requirements The increase in meningococcal vaccination rates among 11- and 12-year-olds from 2007 to 2008 was statistically significant ( p<0.0001) All demographic groups had significantly higher odds of on-schedule vaccination after the school-entry requirement change (odds ratio range = 5.57 to 12.81, p<0.0001) County demographic factors that were associated with lower odds of on-schedule vaccination included higher poverty, more children younger than 18 years of age, fewer high school graduates, and a higher proportion of Native Americans. Conclusions. This analysis suggests that implementation of school immunization requirements resulted in increased meningococcal vaccination rates in Arizona, with degree of response varying by demographic profile. ASIIS was useful for assessing changes in immunization rates over time Further study is required to identify methods to control for population overestimates in registry data.
Source of Parental Reports of Child Height and Weight during Phone Interviews and Influence on Obesity Prevalence Estimates among Children Aged 3–17 Years
Authors: Skinner Asheley Cockrell , Miles Donna , Perrin Eliana M. , Coyne-Beasley Tamera , Ford Carol 
Published: January 2017

Objective. We compared parental reports of children's height and weight when the values were estimated vs parent-measured to determine how these reports influence the estimated prevalence of childhood obesity. Methods. In the 2007 and 2008 North Carolina Child Health Assessment and Monitoring Program surveys, parents reported height and weight for children aged 3–17 years When parents reported the values were not measured (by doctor, school, or home), they were asked to measure their child and were later called back. We categorized body mass index status using standard CDC definitions, and we used Chi-square tests and the Stuart-Maxwell test of marginal homogeneity to examine reporting differences. Results. About 80% ( n=509) of the 638 parents who reported an unmeasured height and/or weight participated in a callback and provided updated measures. Children originally classified as obese were subsequently classified as obese (67%), overweight (13%), and healthy weight (19%) An estimated 28% of younger children (<10 years of age) vs. 6% of older children (aged ≥10 years) were reclassified on callback. Having parents who guessed the height and weight of their children and then reported updated values did not significantly change the overall population estimates of obesity. Conclusion. Our findings demonstrate that using parent-reported height and weight values may be sufficient to provide reasonable estimates of obesity prevalence Systematically asking the source of height and weight information may help improve how it is applied to research of the prevalence of childhood obesity when gold-standard measurements are not available.
Interrogating gendered inequality in educational attainment in India
Authors: Alam Mohd. Sanjeer 
Published: January 2017

The educational system in India is highly stratified across gender, caste, class, region and religion. However, gender remains the most pervasive axis of educational stratification and disparities in India despite recognition of large societal benefits accruing to women and several proactive constitutional/legal measures over last six decades. Most of the literature on gender inequality in education deals with literacy and access to elementary education and are descriptive/narrative in nature. Moreover, girls and women are often treated as a monolithic category overlooking their multiple locations teasing a simplistic framework to unravel gender inequality in education at various levels and underlying factors causing such inequalities. Drawing both from secondary data and field-based research in differently located sites in terms of developmental parameters in rural Bihar, this paper tries to capture gender disparity in a multi-dimensional and nuanced analytical framework locating it in a larger socio-economic context.
Gendered political exclusion: Crucial implications for Indian democracy
Authors: Kumar Sanjay , Rai Praveen 
Published: January 2017

Based on primary and secondary sources, this paper attempts to ascertain the underlying patterns and themes of women's political participation and their levels of inclusion or exclusion from the political process. A balance sheet of gender participation in formal politics reveals that there has been marked increase in voting turnout and election campaigning among women although they still continue to be excluded from legislative bodies at national and state level and deprived from key decision making positions in government and political parties. Field-based research shows ‘interest in polities’ as the key determinant and one of the best predictors of women's levels of political participation. Among other factors that seem to determine the intensity of women's formal participation in politics, ‘media exposure’-proxy for awareness-emerges as important variable. The key areas that need to be addressed for improving political participation of women and inclusion in the political process are affirmative action, better representation in legislative bodies and political parties, particularly in the decision making bodies as well as cabinet berths in government at centre and state level in partnership with civil society.