bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent Incarceration Independently Associated with Syringe Sharing by Injection Drug Users
Authors: Wood Evan , Li Kathy , Small Will , Montaner Julio S. , Schechter Martin T. , Kerr Thomas 
Published: July 2017

Objectives. Few prospective studies are available on the relationship between incarceration and HIV risk among injection drug users (IDUs). The authors evaluated self-reported rates of syringe sharing and incarceration among a cohort of IDUs. Methods. This study analyzed syringe lending by HIV-infected IDUs and syringe borrowing by HIV-negative IDUs among participants enrolled in the Vancouver Injection Drug Users Study (VIDUS). Since serial measures for each individual were available, variables potentially associated with each outcome (syringe lending and borrowing) were evaluated using generalized estimating equations for binary outcomes. Results. The study sample consisted of 1,475 IDUs who were enrolled into the VIDUS cohort from May 1996 through May 2002. At baseline, 1,123 (76%) reported a history of incarceration since they first began injecting drugs. Of these individuals, 351 (31%) reported at baseline that they had injected drugs while incarcerated. Among 318 baseline HIV-infected IDUs, having been incarcerated in the six months prior to each interview remained independently associated with syringe lending during the same period (adjusted odds ratio [OR] = 1.33; 95% confidence interval [CI] 1.06, 1.69; p=0.015). Similarly, among the 1,157 baseline HIV-negative IDUs, having been incarcerated in the six months prior to each interview remained independently associated with reporting syringe borrowing during the same period (adjusted OR=1.26; 95% CI 1.12, 1.44; p<0.001). Conclusions. Incarceration was independently associated with risky needle sharing for HIV-infected and HIV-negative IDUs. This evidence of HIV risk behavior should reinforce public health concerns about the high rates of incarceration among IDUs.
Risk Factors for Lead Poisoning among Cuban Refugee Children
Authors: Trepka Mary Jo , Pekovic Vukosava , Santana Juan Carlos , Zhang Guoyan 
Published: July 2017

Objectives. This study was designed to explore whether parental activities such as repairing cars, welding, and rebuilding car batteries are risk factors for lead poisoning among Cuban refugee children in Miami-Dade County. Methods. The authors performed a cross-sectional study of 479 children aged 12–83 months who had lived in Cuba during the six months prior to immigrating to the U.S. Lead levels were obtained, and parents provided information on demographics, home/neighborhood environment in Cuba prior to immigration, family/occupational factors prior to immigration, and child behavior factors. Results. Of 479 children, 30 (6.3%) had elevated blood lead levels (EBLLs), defined as ⩾10 μg/dL, based on the Centers for Disease Control and Prevention action level. In multivariate analysis, racial/ethnic identification other than white, living in a home built after 1979, car repair in the home or yard, eating paint chips, and male sex were independently associated with EBLL. Conclusions. Risk factors for lead poisoning among immigrant children may differ from those among U.S.-born children. Screening of immigrant children who may have been exposed in their country of origin and education of immigrant parents about lead exposure hazards associated with activities such as car repair should be considered in the design of lead poisoning prevention and control programs.
Expanding Tuberculosis Case Detection by Screening Household Contacts
Authors: Becerra Mercedes C. , Pachao-Torreblanca Iliana F. , Bayona Jaime , Celi Rosa , Shin Sonya S. , Kim Jim Yong , Farmer Paul E. , Murray Megan 
Published: July 2017

Objectives. Tuberculosis (TB) case detection remains low in many countries, compromising the efficacy of TB control efforts. Current global TB control policy emphasizes case finding through sputum smear microscopy for patients who self-report to primary health centers. Our objective was to assess the feasibility and yield of a simple active case finding strategy in a high incidence population in northern Lima, Peru. Methods. We implemented this pilot strategy in one health center's catchment area. Health workers visited household contacts of new TB case subjects to identify symptomatic individuals and collect sputum for screening. Neighboring households were screened in the same manner. Secondary analyses measured risk of TB by ( 1) sputum smear status of the index case subject, ( 2) compliance with testing, and ( 3) risk factors for disease detected through active contact tracing in contrast to self-report. Results. The TB prevalence detected through combined active and passive case finding among 1,094 household contacts was 0.91% (914 per 100,000), much higher than with passive case finding alone (0.18%; 183 per 100,000; p=0.02). Among 2,258 neighbors, the combined strategy detected a TB prevalence of 0.22% (221 per 100,000) in contrast to 0.08% (80 per 100,000) detected through passive case finding alone ( p=0.25). Risk factors for being diagnosed through active case finding in contrast with self-report included age >55 years (odds ratio [OR]=5.5; 95% confidence interval [CI] 1.2, 22.8) and female gender (OR=3.9; 95% CI 0.99, 22.3). Conclusions. Risk of active TB among symptomatic household contacts of active case subjects in this community is very high. Results suggest that contact tracing in such settings may be a powerful means of improving case detection rates for active TB disease.
Invasive Cervical Cancer among American Indian Women in the Northern Plains, 1994–1998: Incidence, Mortality, and Missed Opportunities
Authors: Leman Richard F. , Espey David , Cobb Nathaniel 
Published: July 2017

Objectives. Cervical cancer mortality rates among the American Indian and Alaska Native (AI/AN) population in North and South Dakota were five times the national average (15.6 per 100,000 vs. 3.1 per 100,000, age adjusted) when last evaluated (from 1989 through 1993). Our goals were to update the AI/AN population cervical cancer mortality rates and to present incidence rates for AI/AN women in the region. Methods. We reviewed charts for women diagnosed with invasive cervical cancer at Indian Health Service (IHS) facilities in North and South Dakota from 1994 through 1998 and collected information about cervical cancer screening and treatment history. Incidence and mortality rates were standardized to the 1970 U.S. population. Results. Twenty-one cases of invasive cervical cancer and eight deaths were identified. Annualized incidence and mortality rates were 11.5 per 100,000 and 4.5 per 100 000. These compare with national all-race/ethnicity rates of 8.5 per 100,000 and 2.7 per 100,000 for incidence and mortality. Fifteen (71%) of 21 cases were diagnosed due to symptoms. Conclusions. While cervical cancer mortality rates have declined, incidence and mortality rates among AI/AN women remain higher than in the general U.S. population. Increased use of pap tests and careful follow-up of abnormal results should be aggressively promoted among AI/AN women in North and South Dakota.
Improved Program Activities are Associated with Decreasing Tuberculosis Incidence in the United States
Authors: Lobato Mark N. , Wang Yong-Cheng , Becerra Jose E. , Simone Patricia M. , Castro Kenneth G. 
Published: July 2017

Objective. This study was conducted to determine whether improvements in tuberculosis (TB) program activities correlate with incident TB cases. Methods. National TB surveillance data and program data from patients with pulmonary and laryngeal TB and their contacts were collected. These data were analyzed using regression models to assess the association between changes in incident TB cases and indicators of program performance (a time series of percent changes in program indices). Results. A total of 1,361,113 contacts exposed to 150,668 TB patients were identified through contact investigations. From 1987 to 1992 (the period of TB resurgence and antedating increased funding), there was a decline in several measures used by TB programs for outcomes of contact investigations. From 1993 to 1998 (the period after increases in TB funds), there was an observable improvement in the program indices. Four program indices for contacts and two for TB cases (directly observed therapy and completion of therapy) were statistically associated ( p≤0.01) with the decline in TB incident cases. Conclusions. These analyses suggest that expanded TB program activities resulted in the reduction in national TB cases and underscore the importance of treatment completion for TB disease and latent TB infection. Based on these results, we propose that further improvements in these activities will accelerate the decline of TB in the United States.
Riskier than We Thought: Revised Estimates of Noncontracepting Women Risking Unintended Pregnancy
Authors: Gaydos Laura M.D. , Hogue Carol J. Rowland , Kramer Michael R. 
Published: July 2017

Objectives. Risk-taking is defined as non-use of contraception among sexually active women who do not desire pregnancy. The published National Survey of Family Growth (NSFG) definition of risk of unintended pregnancy includes sterilized women and women relying on partner sterilization in the statistic. However, this inclusion skews percentages of risk-taking women to appear smaller than is realistic since sterilized women face minimal risk of pregnancy. The objective of this study was to obtain realistic estimates of risk-taking behavior to identify groups at special need for improved services. Methods. In calculating risk-taking statistics, sterilized women and women relying on partner sterilization are removed from both the numerator and denominator. The numerator includes all non-contracepting women who believe that they are fecund. The authors calculated the proportion of risk-taking women for various age, ethnic, and marital status groups. Results. Overall, 14.0% of sexually active, fecund women are risk-taking. Except for teenagers, who do not use sterilization, the proportions of risk takers are higher than the NSFG estimates of proportion of women at risk of unintended pregnancy in all groups. Differences in risk estimates ranged from 0.4% to 10.7%, with the greatest differences seen among formerly married and Hispanic black women. Conclusions. These results indicate that published NSFG percentages of adult women at risk of unintended pregnancy underestimate risk-taking behavior for groups previously thought to be at lower risk of unintended pregnancy.
Use of Public School Immunization Data to Determine Community-Level Immunization Coverage
Authors: Ramirez Enrique , Bulim Igor D. , Kraus John M. , Morita Julie 
Published: July 2017

Objectives. To evaluate whether immunization data collected on a child's entry into kindergarten, i.e., Chicago Public School Immunization Data (PSID), was comparable to coverage levels determined by the National Immunization Survey (NIS) and to use these data to identify community areas with consistently low immunization coverage. Methods. The Chicago Department of Public Health obtained four years of PSID (2000–2003); these data included demographic information, home address, and immunization records. Coverage levels were determined in two ways: ( 1) one dose of measles-containing vaccine (MCV) and ( 2) four doses of diphtheria and tetanus toxoids and pertussis vaccine, three doses of poliovirus vaccine, and one dose of measles-containing vaccine (the 4:3:1 series), stratified by racial/ethnic group; these levels were compared to NIS estimates for the respective time periods. We used geographic information system software to illustrate variations in coverage levels between distinct community areas within Chicago. Results. Year 2000 MCV coverage levels determined from PSID closely approximated NIS estimates (84.6% vs. 87.2% ± 4.6%, respectively). MCV coverage levels determined by race/ethnicity from PSID were within the 95% confidence intervals (CI) for all racial categories (white, 89.5% vs. 92.2% ± 6.4%; black, 79.0% vs. 83.5% ± 9.4%; Hispanic, 89.5% vs. 87.5% ± 5.8%). Comparison of PSID and NIS 4:3:1 coverage levels revealed similar findings. For each study year, PSID identified 12 community areas with consistently low MCV coverage levels, i.e., <80%. Conclusions. PSID closely approximated NIS coverage estimates for MCV and 4:3:1 immunization. These methods can be used by state and city health departments to identify and direct resources to communities at greatest need.
Assessing Intimate Partner Violence in Health Care Settings Leads to Women's Receipt of Interventions and Improved Health
Authors: McCloskey Laura A. , Lichter Erika , Williams Corrine , Gerber Megan , Wittenberg Eve , Ganz Michael 
Published: July 2017

Objective. This study investigated whether disclosure of violence to health care providers and the receipt of interventions relate to women's exit from an abusive relationship and to their improved health. Methods. A volunteer sample of 132 women outpatients who described intimate partner violence during the preceding year were recruited from multiple hospital departments and community agencies in suburban and urban metropolitan Boston. Through in-person interviews, women provided information on demographics, past year exposure to violence, past year receipt of interventions, and whether they disclosed partner violence to their health care provider. They also described their past month health status with the 12-Item Short-Form Health Survey and further questions. Results. Of the 132 women, 44% had exited the abusive relationship. Among those who were no longer with their partner, 55% received a domestic violence intervention (e.g. advocacy, shelter, restraining order), compared with 37% of those who remained with their partner. Talking to their health care provider about the abuse increased women's likelihood of using an intervention (odds ratio [OR]=3.9). Those who received interventions were more likely to subsequently exit (OR=2.6) and women no longer with the abuser reported better physical health based on SF-12 summary scores ( p=0.05) than women who stayed. Conclusions. Health care providers may make positive contributions to women's access to intimate partner violence services. Intimate partner violence interventions relate to women's reduced exposure to violence and better health.
Judgments about Intimate Partner Violence: A Statewide Survey about Immigrants
Authors: Sorenson Susan B. 
Published: July 2017

Objectives. The purpose of this research was to: ( 1) examine judgments about immigrants who are victims of and assailants in intimate partner violence, and ( 2) assess whether immigrants to the U.S., a diverse and growing population, know that intimate partner violence is illegal in the United States and their judgments about what sanctions, if any, should follow. Methods. A random-digit-dial telephone survey was conducted in four languages with 3,679 California adults. There were roughly comparable numbers of white, black, Latino, Korean American, Vietnamese American, and other Asian American participants; 60.1% were born outside the U.S. An experimental vignette design was used to vary victim, assailant, and contextual factors about incidents of intimate partner violence and to assess respondents' judgments about the behavior and what should be done about it. Multivariate analyses were conducted to examine the independent effect of these predictor variables and characteristics of the respondents. Results. Respondent judgments about whether an incident of intimate partner violence was wrong, illegal, or about what sanctions should follow were not related to nativity of either the victim or the assailant. Immigrant respondents differed from native-born respondents on two outcomes: immigrants were more likely to think that the behavior was illegal and that guns should be removed from the assailant. Conclusions. Concerns that immigrants do not know that intimate partner violence is illegal in the U.S. are largely misplaced—immigrants know it soon after their arrival in the U.S. In addition, it appears that a cultural defense regarding domestic violence is not likely to sway others.
The New Mexico Clinical Prevention Initiative: A Statewide Prevention Partnership
Authors: Espey David K. , Baum Susan L. , Jung Ann Moore , Kozoll Richard L. 
Published: July 2017

The New Mexico Department of Health and the New Mexico Medical Society invited organizations to participate in an initiative to promote clinical preventive services. The Clinical Preventive Initiative (CPI) focuses on the following interventions based on burden of illness, preventability of the condition, cost, current level of services, availability of leadership, and programmatic support: adult pneumococcal vaccination, tobacco use prevention and cessation, mammography screening, colorectal cancer screening, healthier weight, screening and treatment for chlamydia and gonorrhea, screening and intervention for problem drinking, childhood immunization, and prevention of unintended pregnancy. Specific workgroups plan and implement interventions directed at New Mexico medical practices, practitioners, and health-care systems. Several state measures suggest effectiveness of CPI efforts. CPI is a successful public-private collaboration providing an active forum for statewide clinical prevention policy development, an effective mechanism to achieve greater awareness of prevention and improved delivery of preventive services.
Racially Disproportionate Admission Rates for Ambulatory Care Sensitive Conditions in North Carolina
Authors: Howard Daniel L. , Hakeem Farrukh B. , Njue Christopher , Carey Timothy , Jallah Yhenneko 
Published: July 2017

Objective. This study examines race variations in quality of care through the proxy of ambulatory care sensitive (ACS) conditions. Hospital admission rates for eight ACS conditions were examined for African American and white Medicare beneficiaries in North Carolina. Temporal variations for ACS were also examined. Method. Enrollment and inpatient claims files from the Centers for Medicare and Medicaid Services (CMS) for a 1999–2002 cohort who were aged 65 years or older in 1999 were examined. Descriptive statistics were computed for each year. Cochran-Mantel Haenszel tests were performed to assess differences in the admission rates for both individual and aggregate ACS conditions controlling for time. The Cochran-Armitage test for trend was used to evaluate changes in admission rates over time. Results. African Americans had higher admission rates for five of the eight ACS conditions. The highest rates were for diabetes among African Americans (odds ratio [OR]=2.86; 95% confidence interval [CI] [2.73, 2.99]) and adult asthma (OR=1.51; 95% CI [1.43, 1.61]). African Americans tended to have lower ACS admission rates than white patients for chronic obstructive pulmonary disease (OR=0.67; 95% CI [0.65, 0.69]); bacterial pneumonia (OR=0.86; 95% CI [0.84, 0.89]), and angina (OR=0.90; 95% CI [0.84, 0.97]). Conclusions. Using the ACS proxy for quality of health care as applied to examining race and ethnicity is a promising approach, though challenges remain. Admissions for ACS conditions between African American and white patients differ, but it is unclear why. This exploratory study must lead to an examination of social, economic, historical, and cultural factors for preventive, remedial, and beneficial policy initiatives.
Operational Evaluation of High-Throughput Community-Based Mass Prophylaxis Using Just-in-Time Training
Authors: Spitzer James D. , Hupert Nathaniel , Duckart Jonathan , Xiong Wei 
Published: July 2017

Community-based mass prophylaxis is a core public health operational competency, but staffing needs may overwhelm the local trained health workforce. Just-in-time (JIT) training of emergency staff and computer modeling of workforce requirements represent two complementary approaches to address this logistical problem. Multnomah County, Oregon, conducted a high-throughput point of dispensing (POD) exercise to test JIT training and computer modeling to validate POD staffing estimates. The POD had 84% non-health-care worker staff and processed 500 patients per hour. Post-exercise modeling replicated observed staff utilization levels and queue formation, including development and amelioration of a large medical evaluation queue caused by lengthy processing times and understaffing in the first half-hour of the exercise. The exercise confirmed the feasibility of using JIT training for high-throughput antibiotic dispensing clinics staffed largely by nonmedical professionals. Patient processing times varied over the course of the exercise, with important implications for both staff reallocation and future POD modeling efforts. Overall underutilization of staff revealed the opportunity for greater efficiencies and even higher future throughputs.
Volume of Tobacco Advertising in African American Markets: Systematic Review and Meta-Analysis
Authors: Primack Brian A. , Bost James E. , Land Stephanie R. , Fine Michael J. 
Published: July 2017

Objective. African Americans currently bear the greatest burden of morbidity and mortality due to smoking, and exposure to pro-tobacco media messages predicts smoking. This study compared the concentration (proportion of media messages that are for tobacco) and density (pro-tobacco media messages per person) of pro-tobacco media messages between African American and Caucasian markets. Methods. We searched Medline (1966 to June 2006), PsychINFO (1974 to June 2006), and CINAHL (1982 to June 2006) for studies from peer-reviewed journals directly comparing the volume of pro-tobacco media messages in African American and Caucasian markets. From each study, we extracted the number of total media messages, the number of tobacco-related messages, and the number of residents living in each market area. We calculated the concentration and density of tobacco advertising in each market. Results. Out of 131 studies identified, 11 met eligibility criteria, including seven comparing billboard/signage in African American and Caucasian markets and four comparing magazine advertising in African American and Caucasian markets. Meta-analysis estimated a pooled odds ratio of 1.7 (95% confidence interval [CI] 1.1, 2.6) for a given billboard being smoking-related in African American vs. Caucasian market areas (i.e., concentration). The pooled rate ratio of the density of smoking-related billboards was 2.6 (95% CI 1.5, 4.7) in African American vs. Caucasian market areas. Magazine data were insufficient for meta-analysis. Conclusion. Available data indicated that African Americans are exposed to a higher volume of pro-tobacco advertising in terms of both concentration and density. These findings have important implications for research, policy measures, and educational interventions involving racial disparities due to tobacco.