bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression and Hip Fracture Risk: The NHANES I Epidemiologic Follow-up Study
Authors: Mussolino Michael E. 
Published: January 2017

Objective. Since hip fracture is the most devastating consequence of osteoporosis from a public health standpoint, addressing whether depression is predictive of fracture risk is important. The purpose of this study is to determine whether individuals with high depressive symptomatology are more likely to suffer an osteoporotic hip fracture than subjects with intermediate or low depressive symptomatology. Methods. Data from the first National Health and Nutrition Examination Survey (NHANES I) were obtained from a nationally representative sample of noninstitutionalized civilians. A cohort aged 25 through 74 at baseline (1971–1975) was observed through 1992. Subjects were followed-up for a maximum of 22 years. Included in the analyses were 6,195 white and black subjects. Ninety-five percent of the original cohort completed the study. Hospital records and death certificates were used to identify a total of 122 hip fracture cases. Results. In an unadjusted Cox proportional hazards regression model for all individuals, depression was predictive of hip fracture (hazard ratio [HR] = 1.90; 95% confidence interval [CI] = 1.13, 3.21; p=0.016). In a multivariate proportional hazards model controlling for ( 1) age at baseline, ( 2) gender, ( 3) race, ( 4) body mass index, ( 5) smoking status, ( 6) alcohol consumption, and ( 7) physical activity level, high depressive symptomatology remained predictive of hip fracture (HR=1.70; 95% CI=0.99, 2.91; p=0.055). Conclusions. This study gives evidence of a prospective association between depression and hip fracture. Additional studies are needed to verify these findings and to elucidate the pathways for the effects of depression on hip fracture incidence.
Effect of Release from Prison and Re-Incarceration on the Viral Loads of HIV-Infected Individuals
Authors: Stephenson Becky L. , Wohl David A. , Golin Carol E. , Tien Hsiao-Chuan , Stewart Paul , Kaplan Andrew H. 
Published: January 2017

Objectives. The purpose of this study was to determine the effect of release from prison and subsequent re-incarceration on the viral loads of HIV-infected individuals receiving highly active antiretroviral therapy (HAART). Methods. Fifteen re-incarcerated HIV-infected prisoners on HAART were identified from a retrospective cohort of HIV-infected prison inmates released from January 1, 1997, to August 31, 1999. The re-incarcerated prisoners were matched (1:2) to 30 HIV-infected incarcerated prisoners on HAART who remained incarcerated during the re-incarcerated participants' release time period. The outcomes measured were plasma HIV RNA levels, CD4+ lymphocyte counts, percentage of re-incarcerated and incarcerated participants with plasma HIV RNA levels <400 copies/mL, and the median change in plasma HIV RNA levels of the re-incarcerated and incarcerated participants at the end of the study. Results. At the beginning of the study, 8/15 re-incarcerated participants had plasma HIV RNA levels <400 copies/mL, compared with 15/30 incarcerated participants. At the end of the study, only three of those eight re-incarcerated participants had plasma HIV RNA levels <400 copies/mL, compared with 14/15 incarcerated participants ( p=0.0086). The median change in plasma HIV RNA levels of the re-incarcerated participants was 1.29 log10 copies/mL (interquartile range 0.04 to 1.70), compared with −0.03 log10 copies/mL (interquartile range −0.65 to 0.09) in the incarcerated participants ( p=0.0183). Conclusions. Release from prison was associated with a deleterious effect on virological and immunological outcomes. These data suggest that comprehensive discharge planning efforts are required to make certain that HIV-infected inmates receive access to quality care following incarceration.
Date of First Positive HIV Test: Reliability of Information Collected for HIV/AIDS Surveillance in the United States
Authors: Hall H. Irene , Li Jianmin , Campsmith Michael , Sweeney Patricia , Lee Lisa M. 
Published: January 2017

Objectives. This study examined the reliability of the first positive HIV test date reported in the U.S. HIV/AIDS Reporting System (HARS). This date is essential to determine case counts for resource allocation for HIV treatment and prevention efforts. Methods. The dates of first positive HIV tests reported by individuals with HIV in an interview survey conducted in 16 states ( n=16,394, interviewed 1995–2002) were compared with the dates of HIV diagnosis reported to HARS. The percentage of agreement for the year of diagnosis and the weighed kappa ( k) with 95% confidence intervals (CIs) was calculated. Results. Self-reported year of diagnosis agreed with the year of diagnosis in HARS for 56% of date pairs ( k=0.69; 95% CI 0.68, 0.70); 30% reported an earlier diagnosis year. Agreement differed by sex, age, race, exposure, and reason or place of testing ( p<.01). Lower agreement was found when the self-reported diagnostic test was anonymous ( k=0.57; 95% CI 0.52, 0.62) compared with confidential tests ( k=0.66; 95% CI 0.64, 0.68). Lower agreement was also found for cases first reported with AIDS ( k=0.58; 95% CI 0.55, 0.62) compared with cases first reported with HIV not AIDS ( k=0.71; 95% CI 0.70, 0.73) as well as for participants interviewed three years or more after their HARS diagnosis date ( k=0.55; 95% CI 0.52, 0.57) compared with those interviewed within one year ( k=0.62; 95% CI 0.61, 0.63). More than 20% of participants in almost all groups, however, reported earlier diagnosis years than those recorded in HARS. Conclusion. As many as 30% of HIV diagnoses may have occurred earlier than recorded in HARS. Additional studies need to determine mechanisms to adequately capture diagnosis dates in HARS.
Results from a State-Based Surveillance System for Carbon Monoxide Poisoning
Authors: Graber Judith M. , Smith Andrew E. 
Published: January 2017

Objectives. The purpose of this study was to describe results from a pilot surveillance system for carbon monoxide poisoning—a significant yet preventable public health issue for which most public health agencies do not conduct routine public health surveillance. Methods. The authors developed a rate-based statewide surveillance system. Cases were identified using the 1998 Council of State and Territorial Epidemiologists' case definition in hospital discharges, emergency department and hospital outpatient visits, and mortality data. Intentional and fire-related injuries were excluded. The system was supplemented with qualitative information from newspaper articles. Annual, age, and sex-specific incidence rates were estimated. Exposure source/setting was described using E-codes; occupational setting was assessed by combining E-codes and payer code. Cases occurring during a disaster-related power outage in January 1998 were compared with cases identified during routine surveillance from 1999 through 2003. Results. During the five years of routine surveillance, 740 cases were identified; 47 (6.4%) were hospitalized, 442 (59.7%) were seen in an emergency department, and 251 (34.3%) were seen in another outpatient setting. More cases were observed in fall/winter; 23.1% of patients aged 16 or older were classified as exposed in an occupational setting. Among disaster-related cases, more were older (≥65 years of age; 11.9% vs. 4.2%) and female (61.6% vs. 45.3%); and fewer were in occupational settings (1.8% vs. 23.1%). Conclusions. Establishing state-based public health surveillance for CO poisoning is feasible and essential for guiding prevention and control efforts. The finding that more than 20% of cases were classified as occupational should be investigated further.
Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002
Authors: Klevens R. Monina , Edwards Jonathan R. , Richards Chesley L. , Horan Teresa C. , Gaynes Robert P. , Pollock Daniel A. , Cardo Denise M. 
Published: January 2017

Objective. The purpose of this study was to provide a national estimate of the number of healthcare-associated infections (HAI) and deaths in United States hospitals. Methods. No single source of nationally representative data on HAIs is currently available. The authors used a multi-step approach and three data sources. The main source of data was the National Nosocomial Infections Surveillance (NNIS) system, data from 1990–2002, conducted by the Centers for Disease Control and Prevention. Data from the National Hospital Discharge Survey (for 2002) and the American Hospital Association Survey (for 2000) were used to supplement NNIS data. The percentage of patients with an HAI whose death was determined to be caused or associated with the HAI from NNIS data was used to estimate the number of deaths. Results. In 2002, the estimated number of HAIs in U.S. hospitals, adjusted to include federal facilities, was approximately 1.7 million: 33,269 HAIs among newborns in high-risk nurseries, 19,059 among newborns in well-baby nurseries, 417,946 among adults and children in ICUs, and 1,266,851 among adults and children outside of ICUs. The estimated deaths associated with HAIs in U.S. hospitals were 98,987: of these, 35,967 were for pneumonia, 30,665 for bloodstream infections, 13,088 for urinary tract infections, 8,205 for surgical site infections, and 11,062 for infections of other sites. Conclusion. HAIs in hospitals are a significant cause of morbidity and mortality in the United States. The method described for estimating the number of HAIs makes the best use of existing data at the national level.
The Public's Preparedness for Hurricanes in Four Affected Regions
Authors: Blendon Robert J. , Benson John M. , DesRoches Catherine M. , Lyon-Daniel Katherine , Mitchell Elizabeth W. , Pollard William E. 
Published: January 2017

Objectives. The purpose of this article is to look at how prepared people in communities outside the main areas devastated by Hurricanes Katrina and Rita thought they were for those storms and for major hurricanes in the near future, what factors were related to why people did not evacuate, and what concerns people had in communities that took in evacuees from the hurricanes. Methods. Telephone interviews were conducted with randomly selected adults in Baton Rouge, Houston, Dallas, and Mississippi/Alabama (excluding the immediate Gulf Coast) to assess respondents' knowledge, attitudes, and behaviors about hurricane preparedness and response to Hurricanes Katrina and Rita. Results. The surveys found a sizeable proportion of respondents who might not, for a number of reasons, comply with future orders to evacuate. A substantial proportion reported that they were not prepared for another major hurricane and indicated a desire for more information about how to prepare for future hurricanes. In communities that reported taking in large numbers of evacuees, residents expressed concern about the impact of the evacuees on their community. Conclusion. Evacuating communities involves a number of concrete problems that were not adequately addressed in the cases of Hurricanes Katrina and Rita. Responses to these surveys indicate a need for more comprehensive hurricane disaster planning.
Extending Medicaid Coverage for Family Planning Services: Alabama's First Four Years
Authors: Bronstein Janet M. , Vosel Annie , George Sherry K. , Freeman Charlena , Payne Leigh Anne 
Published: January 2017

Objectives. This study examines whether Alabama's Medicaid family planning demonstration program reaches a different segment of the population than the health department-based Title X family planning program, whether service use rates differ across clients using care within and outside of the Title X provider system, and whether additional risk assessment and care coordination services provided by health department personnel increase the likelihood that family planning clients return for follow-up visits over time. Methods. Administrative data from four years of operation of the program were used to examine characteristics of the clientele, differences in services used across provider types included in the program, and the impact of risk assessments and care coordination on return visit rates. Results. The number of family planning service users increased dramatically over the four-year period, but were more similar demographically to Title X clients than to Medicaid maternity clients. Growth was greatest among clients of non-Title X providers. Newly covered services, including risk assessments and care coordination, were available mostly to Title X clients, and these services were associated with a greater likelihood that clients returned for care in subsequent years. Conclusion. Expanded provider networks can increase the number of low income women using family planning services while risk assessment and care coordination can improve the effectiveness of these services. However, enhanced services may not be equally available across provider systems. Additional outreach efforts are needed to reach women eligible for publicly supported family planning services who are not currently using these services.
Prevalence of Residential Smoke Alarms and Fire Escape Plans in the U.S.: Results from the Second Injury Control and Risk Survey (ICARIS-2)
Authors: Ballesteros Michael F. , Kresnow Marcie-Jo 
Published: January 2017

Objectives. This study was conducted to estimate ( 1) the proportion of U.S. homes with installed smoke alarms and fire escape plans, and ( 2) the frequency of testing home smoke alarms and of practicing the fire escape plans. Methods. The authors analyzed data on smoke alarms and fire escape plans from a national cross-sectional random-digit dialed telephone survey of 9,684 households. Results. Ninety-five percent of surveyed households reported at least one installed smoke alarm and 52% had a fire escape plan. The prevalence of alarms varied by educational level, income, and the presence of a child in the home. Only 15% tested their alarms once a month and only 16% of homes with an escape plan reported practicing it every six months. Conclusion. While smoke alarm prevalence in U.S. homes is high, only half of homes have a fire escape plan. Additional emphasis is needed on testing of installed smoke alarms and on preparedness for fire escape plans.
Zoonoses Likely to Be Used in Bioterrorism
Authors: Ryan C. Patrick 
Published: January 2017

Bioterrorism is the deliberate release of viruses, bacteria, or other agents used to cause illness or death in people, animals, or plants. Only modest microbiologic skills are needed to produce and effectively use biologic weapons. And biological warfare has afflicted campaigns throughout military history, at times playing an important role in determining their outcomes. There is a long list of potential pathogens for use by terrorists, but only a few are easy to prepare and disperse. Of the infectious diseases, the vast majority are zoonoses. The Centers for Disease Control and Prevention's highest-priority bioterrorism agents are in Category A. The only disease that does not affect animals in Category A is smallpox, which was eliminated by a worldwide vaccination program in the late 1970s. Because these diseases can infect animals and humans, the medical and veterinary communities should work closely together in clinical, public health, and research settings.
Animals as Early Detectors of Bioevents: Veterinary Tools and a Framework for Animal-Human Integrated Zoonotic Disease Surveillance
Authors: Gubernot Diane M. , Boyer Benita L. , Moses Marina S. 
Published: January 2017

The threat of bioterrorism and emerging infectious diseases has prompted various public health agencies to recommend enhanced surveillance activities to supplement existing surveillance plans. The majority of emerging infectious diseases and bioterrorist agents are zoonotic. Animals are more sensitive to certain biological agents, and their use as clinical sentinels, as a means of early detection, is warranted. This article provides design methods for a local integrated zoonotic surveillance plan and materials developed for veterinarians to assist in the early detection of bioevents. Zoonotic surveillance in the U.S. is currently too limited and compartmentalized for broader public health objectives. To rapidly detect and respond to bioevents, collaboration and cooperation among various agencies at the federal, state, and local levels must be enhanced and maintained. Co-analysis of animal and human diseases may facilitate the response to infectious disease events and limit morbidity and mortality in both animal and human populations.
Multivitamin Use in Pregnant and Nonpregnant Women: Results from the Behavioral Risk Factor Surveillance System
Authors: Sullivan Kevin M. , Ford Earl S. , Azrak M. Fuad , Mokdad Ali H. 
Published: January 2017

Objective. Relatively few studies have investigated characteristics associated with multivitamin use in pregnant women in the U.S. We examined multivitamin use among pregnant and nonpregnant women of childbearing age, in relation to socioeconomic factors, demographic data, health behaviors, and health status. Methods. This investigation used 2004 data from the Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional study of noninstitutionalized adults aged 18 years or older. Analyses were limited to women 18 to 44 years of age in states and territories where questions about multivitamin use were asked. Results. Overall, 78% of pregnant women reported multivitamin use, compared with 47% of women who were not pregnant. Using logistic regression, two factors were found to be significantly associated with multivitamin use in pregnant women: income and marital status. Among nonpregnant women, the significant predictors were age, income, physical activity, education level, desire for a child in the near future, race/ethnicity, body mass index, and cigarette smoking status. Conclusion. We found differences in the reported use of multivitamins between pregnant and nonpregnant women of childbearing age as well as predictors of use.
The Challenge of Multisite Epidemiologic Studies in Diverse Populations: Design and Implementation of a 22-Site Study of Tuberculosis in Foreign-Born People
Authors: Davidow Amy L. , Katz Dolly , Reves Randall , Bethel James , Ngong Lolem ,   Tuberculosis Epidemiologic Studies Consortium
Published: January 2017

Objectives. We designed a population-based study of the epidemiology of tuberculosis among foreign-born people in the U.S. and Canada. Challenges included standardizing recruitment and data entry at 22 sites, enrolling individuals who did not speak English and may be undocumented, and obtaining clearance from 36 institutional review boards (IRBs). Methods. We used stratified sampling to recruit patients through the Tuberculosis Epidemiologic Studies Consortium, a research consortium funded by the Centers for Disease Control and Prevention. Because recruitment sites were overseen by more than 30 local IRBs, we developed a simple process to designate a central IRB. We translated instruments into 10 main languages, arranged for fast translation of consent “short forms” into other languages, used one telephone interpretation service at all sites, and provided extensive interviewer training including mock interviews with simulated patients. Results. We interviewed 1,696 participants in 19 states and provinces. Participants from 99 countries were interviewed in 40 languages. Twenty-three percent did not speak English at all; 64% needed an interpreter. More than 20% of participants reported they were undocumented. Participants' age, gender, and birthplaces were broadly similar to the target populations. One-third of local IRBs used the central IRB. Conclusions. Special confidentiality protections, substantial resources for translation and interpretation, and a centralized IRB made possible the recruitment of a representative sample of foreign-born people. The approaches may be applicable to studies of other diseases in multinational populations in the U.S. and Canada.
HIV Testing and Referral to Care in U.S. Hospitals Prior to 2006: Results from a National Survey
Authors: Torres Gretchen Williams , Yonek Juliet , Pickreign Jeremy , Whitmore Heidi , Hasnain-Wynia Romana 
Published: January 2017

Objectives. We sought to provide a benchmark for human immunodeficiency virus (HIV) testing availability and practices in U.S. hospitals prior to the Centers for Disease Control and Prevention's (CDC's) 2006 revised recommendations. Methods. We conducted a survey of nonfederal general hospitals in the U.S. in 2004. Chi-square tests detected significant associations with hospital characteristics. Questionnaires were completed electronically via a secure Internet site or on paper. Nonresponse analysis was conducted and data were weighted to adjust for nonresponse. Results. HIV testing (on the basis of clinical symptoms or behavioral risk factors) was available in more than half of hospital inpatient units (62%), employee health departments (58%), and emergency departments (57%). Twenty-three percent offered routine screening (testing for people in a defined population regardless of clinical symptoms or behavioral risk), most commonly in labor and delivery. Teaching status, region, size, and type of metropolitan area were associated with the availability of HIV testing and routine screening ( p<0.01). Hospitals used a variety of methods to link patients to care: referral to a hospital-based clinic (36%); on-site, same-day evaluation (35%); and referral to an unaffiliated HIV or community clinic (42%). Conclusions. Hospitals offered HIV testing on the basis of clinical suspicion or risk, but were far from meeting CDC's current recommendation to routinely test all patients aged 13 to 64. Hospital size, teaching status, and geographic location were associated with HIV testing availability and testing practices. Our understanding of current practice identifies opportunities for public health action at the practitioner, organization, and systems levels.
Risk Factors for Mumps at a University with a Large Mumps Outbreak
Authors: Huang Angela S. , Cortese Margaret M. , Curns Aaron T. , Bitsko Rebecca H. , Jordan Hannah T. , Soud Fatma , Villalon-Gomez Jose , Denning Patricia M. , Ens Kim A. , Hanson Gail R. , Dayan Gustavo H. 
Published: January 2017

Objectives. Routine measles-mumps-rubella (MMR) vaccine use has greatly decreased the incidence of mumps in the U.S. However, a resurgence of mumps occurred in 2006. We investigated the large outbreak at a university and assessed risk factors for disease. Methods. We described the outbreak and conducted a case-control study. We interviewed case students (identified from student health service and health department records) and control students (selected from a randomly ordered administrative list) and assessed their vaccination status. We compared case students with ≥2 MMR doses and control students with ≥2 MMR doses in univariate and multivariate analyses. Results. The mean age of the 174 case students was 20.9 years; 65% were women. Ninety-seven case students and 147 control students were enrolled in the study. Two-dose MMR coverage was 99% among case and control students with complete records. Only 33% of case students reported exposure to someone with mumps. Case students were more likely than control students to be aged 18 to 19 years (vs. aged 22 years, adjusted odds ratio [AOR] = 5.55; 95% confidence interval [CI] 2.09, 14.74), to report exposure to mumps (AOR=2.31, 95% CI 1.13, 4.73), and to have worked/volunteered on campus (AOR=2.91, 95% CI 1.33, 6.33). Also, women in dormitories had increased odds of mumps compared with men in dormitories. Conclusion. High two-dose MMR coverage was not sufficient to prevent the outbreak. Further study is needed to better understand the effects of dormitory residency and gender on mumps transmission. Clinicians should be vigilant for mumps in young adults presenting with parotitis regardless of immunization history.