bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using a Health in All Policies Approach to Address Social Determinants of Sexually Transmitted Disease Inequities in the Context of Community Change and Redevelopment
Authors: Avey Holly , Fuller Elizabeth , Branscomb Jane , Cheung Karen , Reed Phillip Jackson , Wong Naima , Henderson Michael , Williams Samantha 
Published: January 2017

Objectives. We used a Health in All Policies (HiAP) framework to determine what data, policy, and community efficacy opportunities exist for improving sexual health and reducing sexually transmitted diseases (STDs) in an area surrounding an Army base undergoing redevelopment in Atlanta, Georgia. Methods. We conducted a literature review, consulted with experts, mapped social determinants in the community, conducted key informant interviews with community leaders to explore policy solutions, used Photovoice with community members to identify neighborhood assets, and shared data with all stakeholder groups to solicit engagement for next steps. Results. We identified the following HiAP-relevant determinants of STD inequities in the literature: education, employment, male incarceration, drug and alcohol marketing, and social capital. Quantitative data confirmed challenges in education, employment, and male incarceration in the area. Interviews identified policy opportunities such as educational funding ratios, Community Hire Agreements, code and law enforcement, addiction and mental health resources, lighting for safety, and a nonemergency public safety number. Photovoice participants identified community assets to protect including family-owned businesses, green spaces, gathering places, public transportation resources, historical sites, and architectural elements. Stakeholder feedback provided numerous opportunities for next steps. Conclusions. This study contributes to the HiAP literature by providing an innovative mixed-methods design that locates social determinants of STDs within a geographic context, identifies policy solutions from local leaders, highlights community assets through the lens of place attachment, and engages stakeholders in identifying next steps. Findings from this study could inform other redevelopments, community-based studies of STDs, and HiAP efforts.
Missed Opportunities for Concurrent HIV-STD Testing in an Academic Emergency Department
Authors: Klein Pamela W. , Martin Ian B.K. , Quinlivan Evelyn B. , Gay Cynthia L. , Leone Peter A. 
Published: January 2017

Objectives. We evaluated emergency department (ED) provider adherence to guidelines for concurrent HIV-sexually transmitted disease (STD) testing within an expanded HIV testing program and assessed demographic and clinical factors associated with concurrent HIV-STD testing. Methods. We examined concurrent HIV-STD testing in a suburban academic ED with a targeted, expanded HIV testing program. Patients aged 18–64 years who were tested for syphilis, gonorrhea, or chlamydia in 2009 were evaluated for concurrent HIV testing. We analyzed demographic and clinical factors associated with concurrent HIV-STD testing using multivariate logistic regression with a robust variance estimator or, where applicable, exact logistic regression. Results. Only 28.3% of patients tested for syphilis, 3.8% tested for gonorrhea, and 3.8% tested for chlamydia were concurrently tested for HIV during an ED visit. Concurrent HIV-syphilis testing was more likely among younger patients aged 25–34 years (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.78, 2.10) and patients with STD-related chief complaints at triage (AOR=11.47, 95% CI 5.49, 25.06). Concurrent HIV-gonorrhea/chlamydia testing was more likely among men (gonorrhea: AOR=3.98, 95% CI 2.25, 7.02; chlamydia: AOR=3.25, 95% CI 1.80, 5.86) and less likely among patients with STD-related chief complaints at triage (gonorrhea: AOR=0.31, 95% CI 0.13, 0.82; chlamydia: AOR=0.21, 95% CI 0.09, 0.50). Conclusions. Concurrent HIV-STD testing in an academic ED remains low. Systematic interventions that remove the decision-making burden of ordering an HIV test from providers may increase HIV testing in this high-risk population of suspected STD patients.
The Effect of Case Rate and Coinfection Rate on the Positive Predictive Value of a Registry Data-Matching Algorithm
Authors: Xia Qiang , Braunstein Sarah L. , Stadelmann Laura E. , Pathela Preeti , Torian Lucia V. 
Published: January 2017

Objective. Statistical modeling has suggested that the prevalence of false matches in data matching declines as the events become rarer or the number of matches increases. We examined the effect of case rate and coinfection rate in the population on the positive predictive value (PPV) of a matching algorithm for HIV/AIDS and sexually transmitted disease (STD) surveillance registry data. Methods. We used LinkPlus™, a probabilistic data-matching program, to match HIV/AIDS cases diagnosed in New York City (NYC) from 1981 to March 31, 2012, and reported to the NYC HIV/AIDS surveillance registry against syphilis and chlamydia cases diagnosed in NYC from January 1 to June 30, 2010, and reported to the NYC STD registry. Match results were manually reviewed to determine true matches. Results. With an agreement/disagreement comparison score cutoff value of 10.0, LinkPlus identified 3,013 matches, of which 1,582 were determined to be true by manual review. PPV varied greatly in subpopulations with different case rates and coinfection rates. PPV was the highest (91.6%) in male syphilis cases, who had a relatively low case rate but a high HIV coinfection rate, and lowest (18.0%) in female chlamydia cases, who had a high case rate but a low HIV coinfection rate. When the cutoff value was increased to 15.0, PPVs in male syphilis and female chlamydia cases increased to 98.3% and 90.5%, respectively. Conclusions. Case rates and coinfection rates have a significant effect on the PPV of a registry data-matching algorithm: PPV decreases as the case rate increases and coinfection rate decreases. Before conducting registry data matching, program staff should assess the case rate and coinfection rate of the population included in the data matching and select an appropriate matching algorithm.
Changes in Immunization Program Managers' Perceptions of Programs' Functional Capabilities during and after Vaccine Shortages and pH1N1
Authors: Moriarty Leah F. , Omer Saad B. , Seib Katherine , Chamberlain Allison , Wells Katelyn , Whitney Ellen , Berkelman Ruth , Bednarczyk Robert A. 
Published: January 2017

Objectives. We surveyed U.S. immunization program managers (IPMs) as part of a project to improve public health preparedness against future emergencies by leveraging the immunization system. We examined immunization program policy and Immunization Information System (IIS) functionality changes as a result of the Haemophilus influenzae type B (Hib) vaccine shortage and pandemic influenza A(H1N1) (pH1N1). Evaluating changes in immunization program functionalities and policies following emergency response situations will assist in planning for future vaccine-related emergencies. Methods. We administered three consecutive surveys to IPMs from 64 state, city, and territorial jurisdictions in 2009, 2010, and 2012. We compared IPMs' responses across either two or three years (e.g., changes in response or consistent responses across years) using McNemar's test. Results. Immunization programs maintained increases in functionality related to communication systems with health-care providers during this period. Immunization programs often did not maintain changes to IIS functionalities made from 2009 to 2010 (e.g., identifying high-risk and priority populations, tracking adverse events, and mapping disease risk) in the post-pandemic period (2010–2012). About half of IPMs reporting additional IIS functionality in identifying high-risk populations from 2009 to 2010 reported no longer having this function in 2012. There was an 18% decline in respondents reporting geographic information systems risk-mapping capability in IIS from 2010 to 2012. Conclusions. Because of the Hib vaccine shortage and pH1N1, immunization program needs and efforts changed to address evolving situations. The lack of sustained increases in resources or system functions after the pandemic highlights the need for comprehensive, sustainable public health emergency preparedness systems and related resources.
Local Health Department Planning for a Radiological Emergency: An Application of the AHP2 Tool to Emergency Preparedness Prioritization
Authors: Dalnoki-Veress F. , McKallagat Chris , Klebesadal Amy 
Published: January 2017

Objective. We tested the Analytical Hierarchy Process tool for its use in public health to identify potential gaps in emergency preparedness by local health departments (LHDs) in California and Hawaii during a radiological emergency. Methods. We developed a dedicated tool called All-Hazards Preparedness Squared (AHP2) that can be used by those who are responsible for all-hazards preparedness planning and response to guide them while making strategic decisions both in preparing for and responding to a slow-moving incident while it is unfolding. The tool is an Internet-based survey that can be distributed among teams responsible for emergency preparedness and response. Twenty-eight participants from 16 LHDs in California and Hawaii responsible for coordinating preparedness and response in a radiological emergency participated in using the tool in 2013. We used the data to compare the perceived importance of different elements of preparedness among participants and identify gaps in preparedness of their organizations for meeting the challenges presented by a radiological incident. Results. Clarity of information and transfer of information (to and from agency to public, state, and federal partners) were public health officials' dominant concerns while responding to an emergency. Participants also found that there were gaps in the adequacy of training and awareness of the chain of command during a radiological emergency. Conclusion. This preliminary study indicates that the AHP2 tool could be used for decision making in all-hazards preparedness planning and response.
Inspection Frequency, Sociodemographic Factors, and Food Safety Violations in Chain and Nonchain Restaurants, Philadelphia, Pennsylvania, 2013-2014
Authors: Leinwand Sarah E. , Glanz Karen , Keenan Brendan T. , Branas Charles C. 
Published: January 2017

Objectives: We explored how restaurant inspection frequency and restaurant neighborhood sociodemographic characteristics are related to food safety inspection outcomes in chain and nonchain restaurants to better understand external factors that may influence inspection outcomes. Methods: We categorized the results of restaurant inspections in Philadelphia, Pennsylvania, in 2013 and 2014 by restaurant type (chain or nonchain), inspection frequency (1, 2, or ≥3 per 2-year study period), and violation type (total number of violations, foodborne-illness risk factor violation, or good retail practice violation). We collected 2013 US Census block group sociodemographic data for each restaurant neighborhood. We used nested mixed-effects regression analyses to determine the association between restaurant inspection frequency and inspection violations, as well as between inspection violations and restaurant neighborhood sociodemographic variables, stratified by restaurant type. Results: Compared with nonchain restaurants, chain restaurants had significantly fewer total violations per inspection (mean [SD]: 6.5 [4.6] vs 9.6 [6.8] violations, P < .001). For nonchain restaurants, an increase from 1 to 2 inspections resulted in 0.8 ( P < .001) fewer mean violations per inspection, and an increase from 1 to ≥3 inspections resulted in 1.6 ( P < .001) fewer mean violations; this association was not seen in chain restaurants. For nonchain restaurants, a higher proportion of black residents in a restaurant neighborhood was associated with 0.6 ( P < .001) fewer mean foodborne-illness risk factor violations but 1.0 ( P < .001) more mean good retail practice violations per inspection. Conclusions: A risk-based stratified approach to restaurant food safety inspection frequency, based on whether or not restaurants are part of chains, could reduce the frequency of violations, particularly in restaurants with the most violations.
Trilucent Breast Implants — A Personal Review of the Current Controversies (May 1999)
Authors: Mcgregor J. C. 
Published: January 2017

Trilucent (“Soya Bean”) breast implants were marketed as a safe alternative to silicon implants. Following their use in the UK for the past four years, a reassessment of this has currently been announced (March 1999) and further implantation has been suspended by the Trilucent company in conjunction with the MDA (Medical Devices Agency). This has been the result of some reports of adverse reactions to the triglyceride filling material when the implant ruptures. All patients with trilucent implants were advised to return to their respective surgeons for review and advice. A personal review has been undertaken by the author of this paper. The results obtained are discussed. The majority of patients were concerned, but were happy with cosmetic results, and did not at present wish their implants removed. None appeared as yet to have had serious complications that could be attributed to the implants.
The Presentation of Bronchial Carcinoma
Authors: le Roux B. T. 
Published: January 2017

Bronchial carcinoma in 4,000 patients investigated over a 15-year period, presented in these ways: With some or all of the cardinal symptoms of respiratory disease (68%). Daily haemoptysis, and recurrent febrile respiratory illness with complete or incomplete recovery between episodes, were two manners of presentation particularly suggestive of the diagnosis of bronchial carcinoma. Without symptoms and because of an abnormality detected on a chest radiograph made for routine purposes (5%). With evidence of extension of or metastases from bronchial carcinoma without respiratory symptoms or with respiratory symptoms long accepted and not recently changed (13%). Evidence of extension of bronchial carcinoma was established by investigation in 45 per cent of the whole series. With non-specific symptoms such as loss of weight or dyspepsia and without respiratory symptoms (12%). With unusual symptoms which were not respiratory or with the humoral or neural concomitants of bronchial carcinoma such as hypertrophic pulmonary osteoarthropathy without, or with only unobtrusive respiratory symptoms (2%). The incidence of bronchial carcinoma amongst coal miners in the South East Region of Scotland may be disproportionately high.
Ectopic Pregnancy in Nairobi, Kenya
Authors: Maley C. A. , Auma S. 
Published: January 2017

One hundred and nineteen cases of ectopic pregnancy treated in the Department of Gynaecology, Kenyatta National Hospital, Nairobi, are described. Ectopic pregnancy accounted for almost one third of the abdominal operations performed in the department. Pelvic inflammatory disease seemed to be the cause of this high incidence. Culdocentesis proved useful for diagnosis, but should be employed with caution in a population in whom pelvic sepsis is common. The value and safety of auto-transfusion is emphasised.
Renin, Angiotensin and Aldosterone in Human Pregnancy and the Menstrual Cycle
Authors: Robertson J. I. S. , Weir R. J. , Düsterdieck G. O. , Fraser R. , Tree M. 
Published: January 2017

Aldosterone secretion is frequently, although not invariably, increased above the normal non-pregnant range in normal pregnancy. Substantial increases in plasma aldosterone concentration have also been demonstrated as early as the sixteenth week. In pregnancy, aldosterone secretion rate responds in the usual way to changes in sodium intake. Plasma renin concentration is frequently, but not invariably, raised above the normal non-pregnant range. Plasma renin-substrate is consistently raised in pregnancy. Plasma angiotensin II has also been shown usually to be raised in a series of pregnant women. A significant positive correlation has been shown between the maternal plasma aldosterone concentration and the product of the concurrent plasma renin and renin-substrate concentrations. This suggests that the increased plasma aldosterone in pregnancy is the consequence of an increase in circulating angiotensin II, which in turn is related to the level of both renin and its substrate in maternal blood. For these reasons, estimations of renin activity in pregnancy are of dubious value. The increased renin, angiotensin and aldosterone concentrations may represent a tendency to maternal sodium depletion, probably mainly a consequence of the increased glomerular filtration rate. It is possible that the nausea and other symptoms of early pregnancy may be a consequence of this tendency to sodium depletion, with its attendant hormonal changes. In ‘pre-eclampsia’, renin and aldosterone values are generally slightly lower than in normal pregnancy. Human chorion can apparently synthesize renin independently of the kidney. The physiological significance of this remains at present obscure, but it seems unlikely that this source contributes much, if at all, to the often elevated maternal plasma renin. Plasma renin, renin-activity and angiotensin II concentrations, and aldosterone secretion are increased in the luteal phase of the menstrual cycle.
Combined Carbimazole-131I Treatment for Thyrotoxicosis
Authors: McDougall J. R. , Greig W. R. 
Published: January 2017

A sequential therapeutic regime was prescribed for 74 thyrotoxic patients. Every patient received carbimazole in conventional doses for 20 weeks; the average time to obtain control was 10.2 weeks. The patients although older than those usually treated with antithyroid drugs (range 38–68 years) showed no difference in the expected rate of control or in the recognised incidence of side effects. Following the carbimazole therapy the patients were alternatively allotted to receive standard or low (50% of standard) doses of 131I, the individual doses being calculated from simple formulae. After the radio-iodine all of the patients were treated with carbimazole for a further 20 weeks. Review of the patients after completion of the trial and subsequent follow up without therapy shows that 42.1 per cent of the standard dose group remain euthyroid after one therapy dose of 131I, 36.8 per cent have relapsed and 21.1 per cent have become hypothyroid. In the low dose group 44.4 per cent are euthyroid, 47.2 per cent have had a recurrence and 8.4 per cent have become hypothyroid. The results are discussed in the light of current views about the treatment of thyrotoxicosis with drugs and with radioactive iodine.
Pulmonary Artery Calcification
Authors: Philp T. 
Published: January 2017

Pulmonary artery calcification detected radiologically is invariably associated with the Eisenmenger Syndrome. Its appearance is relatively uncommon and 4 further cases are described. It is suggested that the relative rarity of the cases of pulmonary artery calcification in this syndrome is due to the fact that the majority of patients die before the age of 40 years. If there is associated calcification in the arch of the aorta the reversed shunt is likely to be at ductus level. If such calcification is absent from the aorta the shunt is more likely to be at ventricular or atrial level.
The Hazards of Ocean Cruises for the Elderly and Infirm
Authors: Cameron D. C. 
Published: January 2017

It is the responsibility of all doctors to be aware of the risks of sea cruises and to advise individual patients about such hazards. It is wrong to send patients with fatal illnesses for a last ‘happy fling’ as the result is often far from that intended. Shipping lines have the responsibility of maintaining adequate medical staff and improving equipment. A supervised air flight to a stable environment may be better advice and enable the patient's life to be richer and happier in this final period. In spite of these reservations, sea travel can be a rewarding experience for elderly but healthy people.
Erythromycin Resistance in Neonatal Staphylococcal Infection: A Long-Term Survey
Authors: Forfar J. O. 
Published: January 2017

Twenty years ago staphylococcal infection was a major problem among newborn infants in hospitals. Hygienic measures had not proved very effective and the use of antibiotics, although clearly open to question, seemed a possible method of control. Erythromycin, a new antibiotic effective against staphylococci, had just been introduced but reports from the United States suggested that resistance could occur within months of usage. In trials in two hospitals in which erythromycin was not being used elsewhere, erythromycin resistance developed but took years to do so. The longer the period of usage was extended the greater the resistance. Withdrawal of the drug resulted ultimately in the disappearance of resistance. The resistant staphylococci spread throughout the hospital. The staphylococcal infection rate in the units where erythromycin was used did not fall but the mortality rate from staphylococcal infection did.
Non Calculous Cholecystitis: An 8 Year Review of Cases Treated by Elective Cholecystectomy
Authors: Jones A. G. , Blair D. W. 
Published: January 2017

From a total of 248 cases of cholecystectomy, 36 were found to be without stones. These cases of acalculous cholecystitis have been reviewed with regard to signs, symptoms and radiological investigations. The complications of operative treatment have been documented and the etiology of the condition discussed. As a result of favourable outcome of operative treatment in these patients, it is suggested that surgery should be considered even in the absence of positive radiological findings at an earlier date.
Screening by Culture for the Detection of Gonorrhoea in Women
Authors: Young H. , Harris A. B. , Urquhart D. , Robertson D. H. H. 
Published: January 2017

The number of gonoccal infections detected by each of three sets of diagnostic cultures from the urethra, cervix, rectum and occasionally the throat, were Calculated for 1976 when Thayer Martin (TM) medium was used and for 1977 when Modified New York City (MNYC) medium was used. In [1977, 98.7 per cent (451/457) of the total infections diagnosed were confirmed by culture compared with 88.3 per cent (324/367) of infections diagnosed in 1976 (P<0.001). The first set of diagnostic tests detected 97.6 per cent (440/451) of culture-positive infections in 1977 compared with only 88.9 per cent (228/324) in 1976 (P<0.001). The efficiency of screening with a single endocervical culture was also calculated. This procedure would have detected 90.2 per cent (407/451) of culture-positive infections in 1977 when MNYC medium was used compared with only 78.1 per cent (253/324) in 1976 when TM medium was used (P<0.001). It is suggested that the statistically significant improvement in the culture results for 1977 resulted from the introduction of MNYC medium since all other diagnostic procedures were identical to those in 1976. Other advantages associated with the use of MNYC medium are discussed.
The Validity of Emergency Recommendations for Compulsory Psychiatric Care
Authors: Masterton G. , Newlands C. A. , Timbury G. C. 
Published: January 2017

Retrospective scrutiny of the documents authorising 240 consecutive emergency detentions to a Glasgow psychiatric hospital over a three-year period revealed that 15 per cent were incorrectly completed. Fourteen documents (5.8%) failed to meet a list ofminimum requirements supplied by the Central Legal Office and were therefore invalid. Invalid documentation was associated with a failure to use the recommended form. In practice, these documents were recognised at the hospital of detention and patients were either properly detained, informally admitted, or in three cases, discharged. It is suggested that doctors who make Emergency Recommendations without using the printedform should always discuss the wording oftheir letter with the receiving psychiatrist who should in turn be familiar with the six minimum requirements of the Central Legal Office.