bluuebunny/crossref_metadata_2025_split huggingface dataset:
Taking the “Guest” Work Out of School-Health Interagency Partnerships
Authors: Mandel Leslie A. 
Published: January 2017

Objective. School-based health centers (SBHCs) have proliferated rapidly, demonstrated success in health outcomes and access, and gained national recognition. Despite these accomplishments, organizational dissimilarities exist among health and school systems that are potentially leading to SBHC partnership barriers. This study sought to determine how partnering agencies promote cooperation and manage conflict across institutional boundaries. Methods. Utilizing case study methods, we conducted semistructured interviews of 55 stakeholders involved in program operations from four Massachusetts SBHCs. All had similar characteristics, yet based on a state-level rating system, two had successful interagency partnerships and two were experiencing difficulties. Results. Success designation played a role in how sites managed conflict and promoted understanding and cooperation. Data also revealed similarities such as frequent use of the term “guest” by all study subjects when describing SBHCs. School representatives stated that as guests, SBHCs should adhere to school rules. Health representatives assumed that as guests, they were not full partners and could be asked to leave. Successful sites were less likely to perceive themselves as guests. At successful sites, guest terminology also dissipated over time and evolved into interdependence and cooperation among school-health interagency partners. Conclusion. Viewing SBHCs as guests creates a tenuous partnership that may be counterproductive to SBHC growth and sustainability. Given current levels of public interest in education, SBHCs may afford enhanced attention to youth health. Additional financial and training resources are needed to build the common purpose that will encourage the formation and sustainability of strong, interdependent school-health partnerships.
Trends in Tuberculosis Mortality in the United States, 1990–2006: A Population-Based Case-Control Study
Authors: Jung Richard S. , Bennion Jonathan R. , Sorvillo Frank , Bellomy Amy 
Published: January 2017

Objective. We assessed demographic and temporal trends of tuberculosis (TB)-related deaths in the United States and examined associated comorbidities listed on death certificates. Methods. We analyzed TB-related mortality from 1990 through 2006 by examining multiple-cause-of-death data from the National Center for Health Statistics. We assessed age-adjusted mortality rates, secular trends, associations with demographic variables, and comorbid conditions. Results. From 1990 through 2006, TB was reported as a cause of death among 53,505 people in the U.S. with a combined overall mean age-adjusted mortality rate of 1.16 per 100,000 person-years. The age-adjusted TB mortality rate declined from 2.22 per 100,000 person-years in 1990 to 0.47 per 100,000 person-years in 2006, demonstrating mean annual decline of about 10%. People aged 75 years and older; males; foreign-born people; and those of Hispanic, Asian, black, and Native American race/ethnicity had comparatively elevated TB-related mortality rates. The mortality rate in foreign-born people was more than two times higher than in U.S.-born people. About 89% of deaths among people of Asian race/ethnicity and nearly 50% among black people were foreign-born individuals. Human immunodeficiency virus and selected autoimmune diseases were more common in TB-related deaths. Conclusions. TB mortality decreased substantially from 1990 through 2006, but remains an important cause of preventable mortality. The observed decrease was more pronounced among U.S.-born people than among foreign-born people. Disparities in TB-related mortality and the identification of important comorbid conditions can inform strategies targeting subpopulations at increased risk for fatal TB infection.
Heightened Risk of Fire Deaths among Older African Americans and Native Americans
Authors: Bishai David , Lee Sunmin 
Published: January 2017

Objective. We examined disparities in burn and fire injuries by age and race/ethnicity to identify disparities during the life course. Methods. Burn and fire mortality rates were disaggregated by five-year age groups, gender, and race/ethnicity from 1999 to 2004. Results. Compared with non-Hispanic white people, Native American and African American people older than 55 years of age experienced a higher risk of death from fires and burns. The rate ratio of burn/fire deaths for African Americans compared with white people was 3.14 (95% confidence interval [CI] 2.98, 3.31) for those aged 55 years and older. The corresponding rate ratio for Native Americans compared with white people was 1.93 (95% CI 1.49, 2.46) for those aged 55 years and older. Conclusion. The especially heightened risk among minority seniors could reflect living arrangements that place them at higher risk. Heightened fire risks for minority seniors require broad attention and the development of effective interventions.
Prognostic Factors Associated with Hepatitis C Disease: A Case-Control Study Utilizing U.S. Multiple-Cause-of-Death Data
Authors: Wise Matthew , Finelli Lyn , Sorvillo Frank 
Published: January 2017

Objectives. Hepatitis C, an important cause of premature mortality, is the most common chronic bloodborne infection in the United States. The severity of disease is strongly affected by a number of other medical conditions and health behaviors. We sought to estimate the association of several exposures with hepatitis C on death certificates. Methods. We enrolled 63,189 hepatitis C deaths as cases in a case-control study using multiple-cause-of-death data for the U.S. from 1999 to 2004. Three control groups were assembled from all remaining deaths with no mention of hepatitis C, including a random sample of all deaths, digestive disease deaths, and circulatory disease deaths. Results. Hepatitis B, human immunodeficiency virus (HIV), hemochromatosis, and alcohol use were all strongly associated with hepatitis C, even after controlling for confounding variables. The simultaneous presence of many of these exposures had a synergistic association with hepatitis C being listed as a cause of death. Hepatitis B, HIV, and alcohol use were recorded among 6.4%, 10.5%, and 18.2% of case deaths, respectively. Conclusions. The strong association of alcohol use, HIV, and hepatitis B with hepatitis C, as well as the frequent occurrence of these conditions, indicates that targeted interventions for mitigating the potential effect of these exposures may present an efficient means of limiting progression of hepatitis C-related liver disease and reducing the population burden of hepatitis C mortality.
Television and Video Game Viewing and its Association with Substance Use by Kentucky Elementary School Students, 2006
Authors: Armstrong Kia E. , Bush Heather M. , Jones Jeff 
Published: January 2017

Objective. We sought to determine if the number of hours elementary school students viewed television (TV) and video games is associated with substance use. Methods. We distributed the California Healthy Kids Survey Elementary School Questionnaire to elementary schools in Kentucky in 2006. A total of 4,691 students, primarily fourth and fifth graders, completed the survey. The students provided responses to questions on topics such as drug use, alcohol use, TV and video game viewing time, and their home life. We analyzed the survey using Chi-square tests and logistic regression. Results. Approximately one-third of respondents indicated substance use, which was defined as alcohol use, illegal drug use, smoking/tobacco use, or sniffing solvents. Significantly more children (28% of those watching ≥3 hours of TV/video games compared with 20% of those watching greater than zero but ≤2 hours of TV/video games) reported alcohol use ( p<0.05). Similar results were seen for sniffing solvents, with 9% of those watching ≥3 hours of TV/video games reporting they sniffed solvents compared with 4% who watched TV/video games for greater than zero but ≤2 hours ( p<0.05). The results of the logistic regression indicated that the odds of drinking alcohol (odds ratio [OR] = 1.48, 95% confidence interval [CI] 1.23, 1.79) and sniffing solvents (OR=1.97, 95% CI 1.42, 2.75) were significantly higher for those watching ≥3 hours of TV/video games compared with those who watched TV/video games for greater than zero but ≤2 hours. Conclusions. The hours of TV and video games viewed were associated with alcohol use and sniffing solvents for our sample. However, limitations exist due to the inability to separate TV viewing from video game viewing.
Hyperendemic H. Pylori and Tapeworm Infections in a U.S.-Mexico Border Population
Authors: Cardenas Victor M. , Mena Kristina D. , Ortiz Melchor , Karri Sitrulasi , Variyam Easwaran , Behravesh Casey Barton , Snowden Karen F. , Flisser Ana , Bristol John R. , Mayberry Lillian F. , Ortega Ynes R. , Fukuda Yoshihiro , Campos Armando , Graham David Y. 
Published: January 2017

Objective. A higher incidence of infectious disease has been documented in U.S. regions bordering Mexico compared with non-border areas. We assessed the prevalence of important gastrointestinal infections in Ciudad Juarez, Mexico, and El Paso, Texas, the largest binational community along the U.S.-Mexico border. Methods. Fecal specimens from a sample of the asymptomatic population representing all ages were tested for Helicobacter pylori (H. pylori), Cryptosporidium spp., Giardia spp., and other intestinal parasitic pathogens using flotation, immunoassays, and/or polymerase chain reaction. We also measured indicators of microbiological contamination of drinking water, hands of food preparers, and kitchen surfaces. Results. Overall, of the 386 participants, H. pylori was present in 38.2%, Taenia spp. in 3.3%, Giardia spp. in 2.7%, Cryptosporidium spp. in 1.9%, Entamoeba dispar in 1.3%, and Ascaris lumbricoides and Necator americanus in 0.3% of the study subjects; Cyclospora spp. and Entamoeba histolytica were not found. H. pylori infection was associated with handwashing (prevalence ratio [PR] = 1.3, 95% confidence interval [CI] 1.0, 1.8). Taenia spp. was found more often on the U.S. side (PR=8.6, 95% CI 2.3, 30.8). We did not find an association between these infections and the occurrence of total coliforms or fecal coliforms on kitchen surfaces. In addition, Escherichia coli was not found in any drinking water sample. Conclusion. The study results indicated that H. pylori and Taenia spp. infections may be highly prevalent along the U.S.-Mexico border. Additional research is necessary to adequately characterize the prevalence, as well as determine whether interventions that reduce these infections are warranted.
Achievement of Healthy People 2010 Objective for Adult Pneumococcal Vaccination in an American Indian Community
Authors: Traeger Marc S. , Say Kenneth R. , Hastings Verna , Yost David A. 
Published: January 2017

Objective. Streptococcus pneumoniae ( S. pneumoniae) causes significant mortality throughout the United States and greater mortality among American Indian/Alaska Natives. Vaccination reduces S. pneumoniae illness. We describe the methods used to achieve the Healthy People 2010 coverage rate goals for adult pneumococcal vaccine among those at high risk for severe disease in this population. Methods. We implemented a pneumococcal vaccination project to bolster coverage followed by an ongoing multidisciplinary program. We used community, home, inpatient, and outpatient vaccinations without financial barriers together with data improvement, staff and patient education, standing orders, and electronic and printed vaccination reminders. We reviewed local and national coverage rates and queried our electronic database to determine coverage rates. Results. In 2007, pneumococcal vaccination coverage rates among people ≥65 years of age and among high-risk people aged 18–64 years were 96.0% and 61.2%, respectively, exceeding Healthy People 2010 goals. Government Performance and Results Act analyses reports revealed a 2.7-fold increase (36.0% to 98.0%) of coverage from 2000 to 2007 among people ≥65 years of age at Whiteriver Service Unit in Whiteriver, Arizona. Conclusions. We achieved pneumococcal vaccination rates in targeted groups of an American Indian population that reached Healthy People 2010 goals and were higher than rates in other U.S. populations. Our program may be a useful model for other communities attempting to meet Healthy People 2010 goals.
Characteristics of Pesticide-Related Hospitalizations, Louisiana, 1998–2007
Authors: Badakhsh Roshan , Lackovic Michelle , Ratard Raoult 
Published: January 2017

Objective. Pesticides are widely used on agricultural crops and in homes, workplaces, and public spaces. Exposure to pesticides can cause acute and chronic health effects. We analyzed data from the Louisiana Hospital Inpatient Discharge Database from 1998 through 2007 to characterize hospitalizations involving pesticides. Methods. Data for the study period consisted of 384 pesticide-related hospitalizations. We used demographic information and diagnosis codes for analysis. Results. Males consistently had higher hospitalization rates than females ( p=0.0073). Children aged 0–4 years had the highest pesticide-related hospitalization rate of all age groups (2.69 hospitalizations per 100,000); children aged 5–9 years had the lowest rate (0.36 hospitalizations per 100,000). Compared with adults, children had a higher rate of disinfectant exposure (15% vs. 5%; odds ratio [OR] = 3.41, 95% confidence interval [CI] 1.61, 7.21; p=0.0008) and rodenticide exposure (14% vs. 2%; OR=8.55, 95% CI 3.07, 23.78; p<0.0001). Rural parishes (counties) were more likely than urban parishes to have higher pesticide hospitalization rates (OR=4.72, 95% CI 2.34, 9.54; p<0.0001). Intentional poisonings accounted for 27% of cases. Only eight cases were coded as work-related. Conclusions. Analyzing pesticide-related hospitalization data provides important information about some of the most severe pesticide poisoning cases. Significant findings include the elevated rate of hospitalizations among young children and men, and the large proportion of self-inflicted poisonings. Health departments and health-care providers may use these findings to target outreach and prevention activities.
Prevalence of High-Risk HPV Types and Abnormal Cervical Cytology in American Indian/Alaska Native Women, 2003–2005
Authors: Alfonsi Grace A. , Datta S. Deblina , Mickiewicz Theresa , Koutsky Laura A. , Ghanem Khalil , Hagensee Michael , Kerndt Peter , Hsu Katherine , Weinstock Hillard , Shlay Judith C. 
Published: January 2017

Objectives. We described prevalence estimates of high-risk human papillomavirus (HR-HPV), HPV types 16 and 18, and abnormal Papanicolaou (Pap) smear tests among American Indian/Alaska Native (AI/AN) women compared with women of other races/ethnicities. Methods. A total of 9,706 women presenting for cervical screening in a sentinel network of 26 clinics (sexually transmitted disease, family planning, and primary care) received Pap smears and HR-HPV type-specific testing. We compared characteristics of 291 women self-identified as AI/AN with other racial/ethnic minority groups. Results. In our population, AI/AN and non-Hispanic white (NHW women had similar age- and clinic-adjusted prevalences of HR-HPV (29.1%, 95% confidence interval [CI] 23.9, 34.3 for AI/AN women vs. 25.8%, 95% CI 24.4, 27.2 for NHW women), HPV 16 and 18 (6.7%, 95% CI 3.9, 9.6 for AI/AN women vs. 8.8%, 95% CI 7.9, 9.7 for NHW women), and abnormal Pap smear test results (16%, 95% CI 11.7, 20.3 for AI/AN women vs. 14.9%, 95% CI 13.7, 16.0 for NHW women). AI/AN women had a higher prevalence of HR-HPV than Hispanic women, and a similar prevalence of HPV 16 and 18 as compared with Hispanic and African American women. Conclusions. We could not demonstrate differences in the prevalence of HR-HPV, HPV 16 and 18, or abnormal Pap smear test results between AI/AN and NHW women. This finding should improve confidence in the benefit of HPV vaccine and Pap smear screening in the AI/AN population as an effective strategy to reduce rates of cervical cancer.
Trends in Hospitalizations with Antibiotic-Resistant Infections: U.S., 1997–2006
Authors: Mainous Arch G. , Diaz Vanessa A. , Matheson Eric M. , Gregorie Seth H. , Hueston William J. 
Published: January 2017

Objectives. Antibiotic resistance is a significant global problem, but the trends in prevalence and impact of antibiotic resistance in hospitalizations in the United States are unclear. We evaluated the trends in hospitalizations associated with antibiotic-resistant infections in U.S. hospitals from 1997 to 2006. Methods. We analyzed the National Hospital Discharge Survey (NHDS) during 1997–2006 (unweighted n=3.3 million hospitalizations; weighted n=370.3 million hospitalizations) and examined trends in prevalence of hospitalizations with antibiotic-resistant infections, length of stay, and discharge status. Results. The number of infection-related hospitalizations with antibiotic resistance increased 359% during the 10-year period, from 37,005 in 1997 to 169,985 in 2006. The steepest rise was seen among individuals <18 years of age. The mean age of individuals with infection-related hospitalizations that had antibiotic-resistant infections decreased substantially, from 65.7 years (standard error [SE] = 2.01) in 1997 to 44.2 years (SE = 1.47) in 2006. As the proportion of patients with antibiotic-resistant infections who did not have insurance increased, the length of stay for those hospitalizations had a corresponding decrease (r=0.91, p<0.01). Conclusions. Antibiotic-resistant infections are becoming increasingly commonplace in hospitalizations in the U.S., with a steady upward trend between 1997 and 2006. Antibiotic-resistant infections are increasingly being seen in younger patients and those without health insurance.
Health Selection among Migrants from Mexico to the U.S.: Childhood Predictors of Adult Physical and Mental Health
Authors: Breslau Joshua , Borges Guilherme , Tancredi Daniel J. , Saito Naomi , Anderson Heather , Kravitz Richard , Hinton Ladson , Aguilar-Gaxiola Sergio , Mora Maria-Elena Medina 
Published: January 2017

Objectives. We tested whether positive selection on childhood predictors of adult mental and physical health contributed to health advantages of Mexican-born immigrants to the United States relative to U.S.-born Mexican Americans. Methods. We combined data from surveys conducted during 2000–2003 in Mexico and the U.S. with the same structured interview. We examined retrospective reports of childhood (i.e., <16 years of age) predictors of adult health—education, height, childhood physical illness, childhood mental health, early substance use, and childhood adversities—as predictors of migration from Mexico to the U.S. at ≥16 years of age. We estimated overall selection by comparing migrants to all non-migrants. We also examined selection at the family (members of families of migrants vs. members of families without a migrant) and individual (migrants vs. non-migrants within families of migrants) levels. Results. Distinguishing between family and individual selection revealed evidence of positive health selection that is obscured in the overall selection model. In particular, respondents in families with migrants were more likely to have ≥12 years of education (odds ratio [OR] = 1.60) and be in the tallest height quartile (OR=1.72) than respondents in families without migrants. At both the family and individual levels, migrants are disadvantaged on mental health profiles, including a higher prevalence of conduct problems, phobic fears, and early substance use. Conclusions. Positive health selection may contribute to physical health advantages among Mexican immigrants in the U.S. relative to their U.S.-born descendants. Mental health advantages likely reflect a lower prevalence of psychiatric disorders in Mexico, rather than protective factors that distinguish migrants.
Prospectively Assessed Posttraumatic Stress Disorder and Associated Physical Activity
Authors: LeardMann Cynthia A. , Kelton Molly L. , Smith Besa , Littman Alyson J. , Boyko Edward J. , Wells Timothy S. , Smith Tyler C. ,   For the Millennium Cohort Study Team
Published: January 2017

Objectives. We examined the association of physical activity with prospectively assessed posttraumatic stress disorder (PTSD) symptoms in a military cohort. Methods. Using baseline and follow-up questionnaire data from a large prospective study of U.S. service members, we applied multivariable logistic regression to examine the adjusted odds of new-onset and persistent PTSD symptoms associated with light/moderate physical activity, vigorous physical activity, and strength training at follow-up. Results. Of the 38,883 participants, 89.4% reported engaging in at least 30 minutes of physical activity per week. At follow-up, those who reported proportionately less physical activity were more likely to screen positive for PTSD. Vigorous physical activity had the most consistent relationship with PTSD. Those who reported at least 20 minutes of vigorous physical activity twice weekly had significantly decreased odds for new-onset (odds ratio [OR] = 0.58, 95% confidence interval [CI] 0.49, 0.70) and persistent (OR=0.59, 95% CI 0.42, 0.83) PTSD symptoms. Conclusions. Engagement in physical activity, especially vigorous activity, is significantly associated with decreased odds of PTSD symptoms among U.S. service members. While further longitudinal research is necessary, a physical activity component may be valuable to PTSD treatment and prevention programs.
Policy Implications of First-Dollar Coverage: A Qualitative Examination from the Payer Perspective
Authors: Shortridge Emily F. , Moore Jonathan R. , Whitmore Heidi , O'Grady Michael J. , Shen Angela K. 
Published: January 2017

Objectives. Immunization against potentially life-threatening illnesses for children and adults has proved to be one of the great public health successes of the 20th century and is extremely cost-effective. The Patient Protection and Affordable Care Act includes a number of provisions to increase coverage and access to immunizations for the consumer, including a provision for health plans to cover all Advisory Committee on Immunization Practices-recommended vaccines at first dollar, or without cost sharing. In this study, we examined payers' perspectives on first-dollar coverage of vaccines and strategies to improve vaccination rates. Methods. This was a qualitative study, using a literature review and semistructured expert interviews with payers. Results. Four key themes emerged, including (7) the cost implications of the first-dollar change; (2) the importance of examining barriers to children, adolescents, and adults separately to focus interventions more strategically; (3) the importance of provider knowledge and education in increasing immunization; and (4) the effect of first-dollar coverage on those who decline vaccination for personal reasons. Conclusions. We determined that, while reducing financial barriers through first-dollar coverage is an important first step to increasing immunization rates, there are structural and cultural barriers that also will require collaborative, strategic work among all vaccine stakeholders.