bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ischemic Heart Disease and Ambient Air Pollution of Particulate Matter 2.5 in 51 Counties in the U.S.
Authors: Balluz Lina , Wen Xiao-Jun , Town Machell , Shire Jeffrey D. , Qualter Judy , Mokdad Ali 
Published: July 2017

Objective. Ischemic heart disease (IHD) is one of the most common health threats to the adult population of the U.S. and other countries. The objective of this study was to examine the association between exposure to elevated annual average levels of Particulate matter 2.5 (PM2.5) air quality index (AQI) and IHD in the general population. Methods. We combined data from the Behavioral Risk Factor Surveillance System and the U.S Environmental Protection Agency air quality database. We analyzed the data using SUDAAN software to adjust the effects of sampling bias, weights, and design effects. Results. The prevalence of IHD was 9.6% among respondents who were exposed to an annual average level of PM2.5 AQI >60 compared with 5.9% among respondents exposed to an annual average PM2.5 AQI ≤60. The respondents with higher levels of PM2.5 AQI exposure were more likely to have IHD (adjusted odds ratio 5 1.72, 95% confidence interval 1.11, 2.66) than respondents with lower levels of exposure after adjusting for age, gender, race/ethnicity, education, smoking, body mass index, diabetes, hypertension, and hypercholesterolemia. Conclusions. Our study suggested that exposure to relatively higher levels of average annual PM2.5 AQI may increase the likelihood of IHD. In addition to encouraging health-related behavioral changes to reduce IHD, efforts should also focus on implementing appropriate measures to reduce exposure to unhealthy AQI levels.
Differences among U.S. States in Estimating the Number of People Living with HIV/AIDS: Impact on Allocation of Federal Ryan White Funding
Authors: Nash Denis , Andreopoulos Evie , Horowitz Deborah , Sohler Nancy , Vlahov David 
Published: July 2017

Objective. We assessed the impact of differing laboratory reporting scenarios on the completeness of estimates of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) in the U.S., which are used to guide allocation of federal Ryan White funds. Methods. We conducted a four-year simulation study using clinical and laboratory data on 1,337 HIV-positive women, including 477 (36%) who did not have AIDS at baseline. We estimated the completeness of HIV (non-AIDS) case ascertainment for three laboratory reporting scenarios: CD4<200 cells/μL and detectable viral load (Scenario A); CD4<500 cells/μL and no viral load reporting (Scenario B); and CD4<500 cells/μL and detectable viral load (Scenario C). Results. Each scenario resulted in an increasing proportion of HIV (non-AIDS) cases being ascertained over time, with Scenario C yielding the highest by Year 4 (Year 1: 69.0%, Year 4: 88.1%), followed by Scenario A (Year 1: 63.3%, Year 4: 84.5%), and Scenario B (Year 1: 43.0%, Year 4: 67.7%). Overall completeness of PLWHA ascertainment after four years was highest for Scenario C (95.8%), followed by Scenario A (94.5%), and Scenario B (88.5%). Conclusions. Differences in laboratory reporting regulations lead to substantial variations in the completeness of PLWHA estimates, and may penalize jurisdictions that are most successful at treating HIV/AIDS patients or those with weak or incomplete HIV/AIDS surveillance systems.
Respiratory Protection Programs for Firefighters: A Survey of Practices for the State of Kentucky
Authors: Easterling Gregory H. , Prince Scott 
Published: July 2017

Objective. Firefighters play a crucial role as first responders in a variety of situations that can expose them to respiratory hazards. To ensure their safety and health, fire departments should have a respiratory protection program in place for all firefighters. A survey of Kentucky fire departments was conducted to assess their respiratory protection practices, barriers to program implementation, and medical evaluation programs. Method. A 21-question survey assessing respiratory practices during the previous 12 months was mailed to all Kentucky fire departments. Results. A 62% survey response rate was achieved, with 116 of Kentucky's 120 counties returning at least one survey. All respondents indicated they were utilizing some type of respiratory protection, but only 37% indicated they had a written respiratory protection program. Compensation status and department sizes were found to be significant variables ( p<0.01) in determining if a fire department had a written respiratory protection program. Lack of funding (48%) and lack of understanding (39%) were cited as the greatest barriers to program implementation. Only 51% indicated they require their firefighters to receive a fit testing of their respirator, and 23% indicated they had a health-care provider who reviewed medical questionnaires or provided medical evaluations. Conclusion. This survey indicates that many Kentucky fire departments are not meeting the legal and voluntary respiratory protection standards and guidelines, and demonstrates the need for improved education and funding to ensure that firefighters are adequately protected from respiratory hazards. This is particularly applicable to small rural volunteer departments, which had the greatest gap in compliance.
Impact of a Smoke-Free Hospital Campus Policy on Employee and Consumer Behavior
Authors: Wheeler J. Gary , Pulley LeaVonne , Felix Holly C. , Bursac Zoran , Siddiqui Nadia J. , Stewart M. Kathryn , Mays Glen P. , Gauss C. Heath 
Published: July 2017

Objective. Although smoke-free hospital campuses can provide a strong health message and protect patients, they are few in number due to employee retention and public relations concerns. We evaluated the effects of implementing a clean air policy on employee attitudes, recruitment, and retention; hospital utilization; and consumer satisfaction in 2003 through 2005. Methods. We conducted research at a university hospital campus with supplemental data from an affiliated hospital campus. Our evaluation included (1) measurement of employee attitudes during the year before and year after policy implementation using a cross-sectional, anonymous survey; (2) focus group discussions held with supervisors and security personnel; and (3) key informant interviews conducted with administrators. Secondary analysis included review of employment records and exit interviews, and monitoring of hospital utilization and patient satisfaction data. Results. Employee attitudes toward the policy were supportive (83.3%) at both institutions and increased significantly (89.8%) at post-test at the university hospital campus. Qualitatively, administrator and supervisor attitudes were similarly favorable. There was no evidence on either campus of an increase in employee separations or a decrease in new hiring after the policy was implemented. On neither campus was there a change in bed occupancy or mean daily census. Standard measures of consumer satisfaction were also unchanged at both sites. Conclusion. A campus-wide smoke-free policy had no detrimental effect on measures of employee or consumer attitudes or behaviors.
Energy and Public Health: The Challenge of Peak Petroleum
Authors: Frumkin Howard , Hess Jeremy , Vindigni Stephen 
Published: July 2017

Petroleum is a unique and essential energy source, used as the principal fuel for transportation, in producing many chemicals, and for numerous other purposes. Global petroleum production is expected to reach a maximum in the near future and to decline thereafter, a phenomenon known as “peak petroleum.” This article reviews petroleum geology and uses, describes the phenomenon of peak petroleum, and reviews the scientific literature on the timing of this transition. It then discusses how peak petroleum may affect public health and health care, by reference to four areas: medical supplies and equipment, transportation, energy generation, and food production. Finally, it suggests strategies for anticipating and preparing for peak petroleum, both general public health preparedness strategies and actions specific to the four expected health system impacts.
PTSD Prevalence, Associated Exposures, and Functional Health Outcomes in a Large, Population-Based Military Cohort
Authors: Smith Tyler C. , Wingard Deborah L. , Ryan Margaret A.K. , Kritz-Silverstein Donna , Slymen Donald J. , Sallis James F. ,   for the Millennium Cohort Study Team
Published: July 2017

Objectives. Posttraumatic stress disorder (PTSD) results from experiencing or witnessing traumatic, life-threatening events including combat-related experiences. The purpose of this study was to investigate the prevalence of PTSD symptoms and diagnosis, self-reported exposures, and functional health in a large cross-section of the U.S. military. Methods. This study used baseline Millennium Cohort data (July 2001 to June 2003) of 75,156 U.S. military members to assess the population-based prevalence of PTSD symptoms, self-reported exposures, and functional health as measured by the Medical Outcomes Study Short Form 36-Item Health Survey for Veterans (SF-36V). Results. PTSD diagnosis without current symptoms was reported by 953 respondents (1.2%, weighted), 1,490 respondents (2.1%, weighted) reported no diagnosis but reported PTSD symptoms, and 287 respondents (0.4%, weighted) reported diagnosis and current symptoms. Self-reported exposure to chemical or biological warfare agents, protective countermeasures, or hearing alarms were associated with PTSD symptoms independent of other combat-like exposures. Physical health was similar among those with PTSD diagnosis and current PTSD symptoms. However, compared with the overall cohort, lower mental health summary means for those reporting current PTSD symptoms (mean 5 27.8), current symptoms and diagnosis (mean = 24.6), and diagnosis without current symptoms (mean = 47.5) were found. Conclusions. Results suggest a 2.0% prevalence of PTSD symptoms without diagnosis and that self-reported threatening exposures were significantly associated with PTSD symptoms. Mental and physical health scores of those with current PTSD symptoms appear diminished, but suggest a return to cohort levels with resolution of PTSD symptoms.
Does Influenza Transmission Occur from Asymptomatic Infection or Prior to Symptom Onset?
Authors: Patrozou Eleni , Mermel Leonard A. 
Published: July 2017

A better understanding of transmission dynamics is essential in influenza pandemic planning. If a substantial proportion of transmissions were to occur during the presymptomatic phase or from asymptomatic individuals, then infection control measures such as contact tracing and quarantine of exposures would be of limited value. Infectiousness has been inferred based on the presence of influenza in the upper respiratory tract rather than from transmission experiments. Although asymptomatic individuals may shed influenza virus, studies have not determined if such people effectively transmit influenza. We performed a systematic review of published studies describing the relationship between viral shedding and disease transmission. Based on the available literature, we found that there is scant, if any, evidence that asymptomatic or presymptomatic individuals play an important role in influenza transmission. As such, recent articles concerning pandemic planning, some using transmission modeling, may have overestimated the effect of presymptomatic or asymptomatic influenza transmission. More definitive transmission studies are sorely needed.
Gender-Specific Mental and Behavioral Outcomes among Physically Abused High-Risk Seventh-Grade Youths
Authors: Logan Joseph E. , Leeb Rebecca T. , Barker Lawrence E. 
Published: July 2017

Objective. Research has shown that physical abuse during childhood (early PA) is associated with various mental and behavioral problems in adolescence. However, there is little research on the differences in these associations by gender among youths residing in high-risk communities. This study investigated gender differences in the relationship between early PA and various internalizing (e.g., thoughts of suicide or victimization) and externalizing (e.g., perpetration of violence) behaviors. Methods. A cross-sectional study was conducted using survey data (collected in 2004) provided by 1,484 seventh-grade youths residing in a high-risk community (83% participated). Students were considered victims of early PA if they reported experiencing abuse prior to age 10 years. Prevalence ratios (PRs) were calculated to estimate the association between early PA and various outcomes (e.g., suicidality, victimization, violence, and illegal drug use), adjusting for race/ethnicity and other forms of abuse. Poisson regression with robust variance estimates was used to estimate the PRs and test for early PA-gender interaction. Results. Early PA was positively associated with suicidality, illegal drug use, and victimization with no significant differences by gender. The association between early PA and criminal behavior was significantly higher for females; the association between early PA and peer violence perpetration was significantly higher for males (interaction term PA*gender was significant at the p≤0.005 level). Conclusions. Young high-risk adolescents who experienced early PA may need counseling or other services (e.g., home visitation) to help prevent suicidality, victimization, violence perpetration, criminal behavior, and illegal drug use. Furthermore, male victims may need more attention in the area of violence prevention; female victims may need particular attention with regard to preventing criminal behavior.
Club Drug Use and Dependence among Young Adults Recruited through Time-Space Sampling
Authors: Parsons Jeffrey T. , Grov Christian , Kelly Brian C. 
Published: July 2017

Objectives. Ketamine, methylenedioxymethamphetamine (MDMA/ecstasy), cocaine, gamma-hydroxybutyrate (GHB), methamphetamine, and d-lysergic acid diethylamide (LSD/acid) have been identified as “club drugs” because of their link to club culture among young adults. Yet little is known about users' demographic differences in the prevalence of club drugs. This study sought to provide a comprehensive profile of users' demographic differences in prevalence of club drug use and dependence. Methods. Using time-space sampling, a stratified sample of 400 18- to 29-year-old club-going young adults was recruited into the Club Drugs and Health Project. Results. Though participants reported using an array of club drugs, almost all participants (90.0%) were cocaine users. Although there were several sexual orientation and gender differences in recent drug exposure, patterns of use (measured in days) were fairly similar across gender, sexual orientation, and age. Finally, a majority of individuals (58.5%) met or exceeded criteria for club drug dependence, with most (61.7%) indicating cocaine was the one drug causing them significant problems. Conclusions. Cocaine is a major drug in club culture. It is essential to develop culturally appropriate drug education and prevention initiatives for young adults using club drugs.
Assessing Mediation in HIV Intervention Studies
Authors: Hardnett Felicia P. , Pals Sherri L. , Borkowf Craig B. , Parsons Jeffrey , Gomez Cynthia , O'Leary Ann 
Published: July 2017

Objectives. A mediator is a psychosocial construct that is targeted by an intervention to bring about behavior change. Recent literature suggests that a widely used approach for assessing mediation, namely the causal steps method, can be severely statistically underpowered. This article describes three standard methods for assessing mediation: causal steps, difference in coefficients, and product of coefficients. We also demonstrate the use of asymmetric confidence limits (ACLs) in testing mediation. Methods. We compared the results obtained by ACL construction with results obtained based on the causal steps and product of coefficients approaches to analyze data from the Seropositive Urban Men's Intervention Trial. Results. ACL construction uncovered previously unidentified mediating factors. We also identified a marginally significant suppressor, which means that, with regard to this factor, the intervention had effects that were opposite from the desired direction. Conclusions. ACLs are preferred for this type of analysis because of their statistical power and because they are informative regardless of whether the intervention has a significant effect on the outcome. Furthermore, ACLs present the size of the mediating effect rather than just a binary decision regarding significance.
Trends in Neisseria Gonorrhoeae Incidence among HIV-Negative and HIV-Positive Men in Washington State, 1996–2007
Authors: Stenger Mark R. , Courogen Maria T. , Carr Jason B. 
Published: July 2017

Objectives. We assessed population-level trends in human immunodeficiency virus (HIV) and Neisseria gonorrhoeae co-infection among adult males in Washington State between 1996 and 2007. Methods. Population-based categorical disease surveillance registries for gonorrhea and for HIV were electronically matched and merged at the record level and incidence rates were calculated for reported HIV-positive and presumed HIV-negative men. Results. The incidence of gonorrhea infection increased significantly among both HIV-positive and presumed HIV-negative men from 1996 to 2005, and this trend has recently reversed for both groups. The annual incidence rate of gonorrhea among HIV-positive men was found to be higher in all years than among men presumed to be HIV-negative. Conclusions. Inequality in the burden of gonorrhea by HIV-infection status suggests continuing sexual risk-taking among HIV-positive men as well as possible barriers to diagnosis, treatment, and partner services. This inequality may also reflect significant differences in gonorrhea burden among men who have sex with men as well as by HIV status. Monitoring emergent secular trends in population-level HIV/sexually transmitted infection comorbidity through registry matching is an achievable strategy for developing an evidence base to inform program collaboration and service integration efforts aimed at providing more comprehensive disease prevention services.
Assessment of the Association of Chlamydia Trachomatis Infection and Adverse Perinatal Outcomes with the Use of Population-Based Chlamydia Case Report Registries and Birth Records
Authors: Chow Joan M. , Kang Mi-Suk , Samuel Michael C. , Bolan Gail 
Published: July 2017

Objective. We assessed the relationship between Chlamydia trachomatis (CT) infections identified during pregnancy and adverse perinatal birth outcomes (including premature rupture of membranes, preterm delivery, and low birthweight) by matching CT reports and birth records. Methods. We merged California birth records from 1997, 1998, and 1999 with California CT reports from the same years to determine the proportion of birth records matched to a female CT report, using maternal last name, first name, date of birth, and county of residence. We used logistic regression to assess the crude and adjusted association between a CT report less than 10 months before the birth record date and premature rupture of membranes, preterm delivery, and low birthweight. These results were adjusted for age, race/ethnicity, level of education, and prenatal care. Results. Of 675,786 birth records and 101,296 female CT reports, 14,039 women had a CT case report and a birth record; 10,917 birth records (1.6%) were matched to a CT report during pregnancy, and 10,940 (10.8%) of CT reports were matched to a birth record date 10 months after date of diagnosis/report. For premature rupture of membranes, the adjusted odds ratio (AOR) was 1.2, 95% confidence interval (CI) 1.0, 1.3; for low birthweight, the AOR was 1.2, 95% CI 1.1, 1.3. The reduction in birthweight associated with prenatal CT infection was 31.7 grams. Conclusions. The increased risk of adverse perinatal outcomes associated with prenatal CT infection supports current prenatal CT screening guidelines. Matching of surveillance and vital statistics data sources was an efficient method to assess this association.
Integration of Surveillance for STDs, HIV, Hepatitis, and TB: A Survey of U.S. STD Control Programs
Authors: Dowell Deborah , Gaffga Nicholas H. , Weinstock Hillard , Peterman Thomas A. 
Published: July 2017

Objectives. Integration of surveillance for sexually transmitted diseases (STDs), human immunodeficiency virus (HIV), hepatitis, and tuberculosis (TB) may improve disease prevention and control. We determined the extent of surveillance integration in these programs, the benefits of integration, and barriers to increased integration. Methods. We e-mailed a survey to the 58 federally funded local and state STD control programs and followed up with phone interviews of nine program representatives. Results. The response rate was 81%. Many had compared infections by population subgroup for STDs and HIV (89%), STDs and hepatitis (53%), or STDs and TB (28%). Most (74%) had examined co-infections with HIV and STDs at the individual level and entered STD and HIV surveillance data into the same database (54%). All respondents thought some integration would be useful. Many (72%) used integrated data to disseminate information or change program strategies. The most commonly reported barriers to integration were policies preventing work with HIV data (85%) and incompatible databases (59%). Conclusions. Most STD control programs in the United States have some experience integrating surveillance data, but the degree of integration varies widely. Specific barriers to further integration were identified. The Centers for Disease Control and Prevention can help address these barriers by facilitating access to information and sharing technical solutions. Local and state programs can continue advancing surveillance integration by improving understanding of where integrated data are needed, increasing the use of available data, and pressing for appropriate and secure data sharing.
Improving Surveillance of Sexually Transmitted Diseases through Geocoded Morbidity Assignment
Authors: Stover Jeffrey A. , Kheirallah Khalid A. , Delcher Philip Christopher , Dolan Carrie B. , Johnson LaShonda 
Published: July 2017

Objectives. We assessed the added value of using a geocoderto improve sexually transmitted disease (STD) surveillance data and decision support through redistribution of inaccurately assigned morbidity in Richmond, Virginia. Methods. Virginia initiated geocoding of STD data as a data quality tool in 2002. Geocoded output files were assessed and discordant proportions of reported gonorrhea and chlamydia morbidity were reassigned appropriately for the city of Richmond, Chesterfield County, and Henrico County (2002 to 2006). We used Chi-square analysis to compare assignment proportions and calculated crude odds ratios for 2006 data to estimate increased case reassignment likelihood. Results. From 2002 to 2006, 149,229 cases of gonorrhea and chlamydia were reported within the Commonwealth of Virginia. Of the reported morbidity, 81% of cases ( n=120,875) were successfully geocoded; 7% ( n=8,461) of geocoded addresses were reassigned. Approximately 76% ( n=6,412) of all reassigned cases occurred within Richmond and Chesterfield and Henrico counties. In 2006, 84% ( n=654) of reassigned cases in this tri-city/county area were initially reported as Richmond morbidity. Data quality improvements reduced Richmond's artificially inflated morbidity by 18% and increased Chesterfield and Henrico morbidity by 17% and 55%, respectively. Richmond morbidity was three times more likely to be reassigned than Chesterfield cases (odds ratio [OR] = 2.93, 95% confidence interval [CI] 2.21, 3.90), and two times more likely than Henrico cases (OR=2.12, 95% CI 1.63, 2.76). Richmond's number one national rank for STD rates was reduced beginning in 2002. Conclusions. Declining rates of STDs were statistically associated with geocoded morbidity reassignments. Implementation of this data quality business process has improved epidemiologic analyses, prevention planning, and assessment of resource allocations. The reduction in Richmond's national STD rankings is indicative of the effect geocoding can have on surveillance data.