bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical Care and Alcohol Use after Testing Hepatitis C Antibody Positive at STD Clinic and HIV Test Site Screening Programs
Authors: Mark Karen E. , Murray Paula J. , Callahan David B. , Gunn Robert A. 
Published: July 2017

Objectives. The Centers for Disease Control and Prevention recommend screening individuals at risk for hepatitis C virus (HCV) infection. However, few published data describe outcomes of individuals with antibody to HCV (anti-HCV) identified through screening programs. The purpose of this study was to assess rates of medical evaluation and HCV treatment, change in alcohol consumption, and barriers to medical care after testing anti-HCV positive through a public screening program. Methods. Anti-HCV positive individuals identified through San Diego sexually transmitted disease (STD) clinics and an HIV test site screening program were informed of positive test results, provided education and referral, and contacted by telephone three, six, and ≥12 months later. Results. From September 1, 1999, to December 31, 2001, 411 anti-HCV positive individuals were newly identified, of whom 286 (70%) could be contacted ≥ three months after receipt of test results (median length [range] of follow-up 14 [3–35] months). Of these 286, 156 (55%) reported having received a medical evaluation, of whom 19 (12%) began HCV treatment. Of 132 who reported drinking alcohol before diagnosis, 100 (76%) reported drinking less after diagnosis. Individuals with medical insurance at diagnosis were more likely than those without insurance to obtain a medical evaluation during follow-up (75 [68%] of 111 vs. 70 [45%] of 155; p<0.001). Among those who did not obtain an evaluation, the most commonly reported reason was lack of insurance. Conclusions. Only about half of newly identified anti-HCV positive individuals received a medical evaluation, although 76% reported drinking less alcohol. Identifying ways to improve medical access for those who are anti-HCV positive could improve the effectiveness of screening programs.
Vaccination in Juvenile Correctional Facilities: State Practices, Hepatitis B, and the Impact on Anticipated Sexually Transmitted Infection Vaccines
Authors: Tedeschi Sara K. , Bonney Loida E. , Manalo Rosario , Mayer Kenneth H. , Shepardson Susan , Rich Josiah D. , Lally Michelle A. 
Published: July 2017

Objectives. Juvenile correctional facilities are an ideal setting to provide preventive vaccines to adolescents who are at risk. In many instances of incarceration, facilities overcome the need for parental consent by making young people wards of the state and the state providing consent. The authors investigated current state practices for administering hepatitis B vaccine to incarcerated adolescents. These may impact the delivery of anticipated sexually transmitted infection (STI) vaccines to incarcerated adolescents. Methods. From June to August 2004, interviews were conducted with state Immunization Program Managers by telephone about hepatitis B vaccination and consent policies in juvenile correctional facilities. Results. Forty-five states were able to provide information about hepatitis B immunization in publicly funded juvenile correctional facilities. Forty-one of the 45 states offered hepatitis B vaccine to adolescents who were sentenced and thereby considered to be wards of the state. Of those 41 states, 20 also made hepatitis B vaccine easily accessible to detained adolescents (no parental consent required). Those 20 states considered detained adolescents as wards of the state ( n=13), or allowed them to self-consent for the vaccine ( n=7). Conclusions. Most states offer hepatitis B vaccination to sentenced adolescents in correctional facilities. Just over half of these states also vaccinate detained adolescents. Juvenile correctional facilities have experience administering vaccines, and this might allow for expansion of vaccination services when new STI vaccines become available. Still, there are major barriers to universal vaccination of incarcerated adolescents, including the issue of consent.
Limited Spending: An Analysis of Correctional Expenditures on Antiretrovirals for HIV-Infected Prisoners
Authors: Zaller Nick , Thurmond Portia , Rich Josiah D. 
Published: July 2017

Objective. Correctional facilities provide a critical opportunity to treat and manage human immunodeficiency virus (HIV) and HIV-related complications among inmates. Inmates bear a higher HIV burden than the general population, and many have never received HIV care prior to incarceration. The standard of care in the community and in corrections for the treatment of HIV is highly active antiretroviral therapy (HAART). This study evaluated U.S. correctional expenditures for antiretrovirals (ARVs) and compared them to the estimated need for ARVs among HIV-infected prisoners in the U.S. to treat this population successfully. Methods. The total number of HIV-infected prisoners in the United States was estimated using Bureau of Justice Statistics data. The National Sales Perspectives Audit, Combined Retail and Nonretail, July 1999 to December 2004 was used to estimate correctional ARV expenditures in 2004. Both measures were used to calculate treatment costs for ARV therapy. Results. The analysis demonstrates that, in 2004, total ARV sales represented only 29% of the total necessary to treat all HAART eligible inmates with known HIV infection. Conclusion. There is a substantial unmet need for ARVs in correctional health care. Although many barriers exist to treating all eligible HIV-infected prisoners, treatment reduces costs associated with HIV-related complications and may encourage linkage to HIV care in the community. Treatment of all eligible HIV-infected inmates should be a public health priority.
The National down Syndrome Project: Design and Implementation
Authors: Freeman Sallie B. , Allen Emily G. , Oxford-Wright Cindy L. , Tinker Stuart W. , Druschel Charlotte , Hobbs Charlotte A. , O'Leary Leslie A. , Romitti Paul A. , Royle Marjorie H. , Torfs Claudine P. , Sherman Stephanie L. 
Published: July 2017

Objective. The National Down Syndrome Project (NDSP), based at Emory University in Atlanta, Georgia, represents a multi-site, population-based, case-control study with two major aims: ( 1) to identify molecular and epidemiological factors contributing to chromosome nondisjunction and the consequent packaging of an extra chromosome into an egg or sperm, and ( 2) to identify risk factors for Down syndrome-associated birth defects. Methods. The six national sites represent approximately 11% of U.S. births. Cases were newborns with Down syndrome (trisomy 21), and controls were infants without major birth defects randomly selected from the same birth populations. Biological samples were collected from case infants and their parents, and genetic markers were typed to determine the parental origin of chromosome 21 nondisjunction. Each site interviewed parents of case and control infants addressing pregnancy, medical and family history, occupation, and exposures. Sites collected medical information on case infants. Results. The NDSP enrolled 907 infants as cases and 977 infants as controls (participation rates: 60.7% for cases; 56.9% for controls). Participation rates varied widely by site as did important demographic factors such as maternal age, race, and education. Nondisjunction during oogenesis accounted for 93.2% of the cases. Errors in spermatogenesis were found in 4.1%, and 2.7% were post-zygotic errors. Conclusions. This exceptional compilation of questionnaire, clinical, and molecular data makes the NDSP a unique resource for ongoing studies of the etiology and phenotypic consequences of trisomy 21. The combined approach increases study power by defining subgroups of cases by the origin of nondisjunction. This report describes the design and successful implementation of the NDSP.
Growth Promoting Antibiotics in Food Animal Production: An Economic Analysis
Authors: Graham Jay P. , Boland John J. , Silbergeld Ellen 
Published: July 2017

Objective. Considerable controversy persists regarding the use of human antibiotics to promote growth in animals raised for food. The authors examined the economic effect of removing antibiotics used for growth promotion in commercial broiler chickens. Methods. The authors utilized data published by the Perdue company, the fourth largest poultry producer in the United States, in which a non-randomized controlled trial of growth-promoting antibiotic (GPA) use was conducted with seven million broiler chickens to evaluate the impact of removing GPAs on production. Results. Positive production changes were associated with GPA use, but were insufficient to offset the cost of the antibiotics. The net effect of using GPAs was a lost value of $0.0093 per chicken (about 0.45% of total cost). Based upon these data, the authors found no basis for the claim that the use of GPAs lowers the cost of production. Note that this study does not include veterinary cost changes or changes in performance variability associated with the removal of GPAs. Conclusions. This economic analysis is the first study to the authors' knowledge utilizing large-scale empirical data collected by U.S. industry, in which it is demonstrated that the use of GPAs in poultry production is associated with economic losses to the producers. These data are of considerable importance in the ongoing national debate concerning the continued use of antibiotics for growth promotion of food animals. Based on the industry study and the resulting economic impact, the use of GPAs in U.S. poultry production should be reconsidered.
Childhood Lead Poisoning Prevention Activities within Michigan Local Public Health Departments
Authors: Kemper Alex R. , Uren Rebecca L. , Hudson Sharon R. 
Published: July 2017

Objective. Local public health departments have a wide array of responsibilities, including coordinating childhood lead poisoning prevention activities. This study was conducted in an effort to understand how local public health officers prioritized lead poisoning prevention activities and the barriers to the delivery of childhood lead poisoning prevention services delivered through local health departments. Methods. A telephone survey was conducted of health officers in Michigan, a state with a high burden of environmental lead. Analysis included Spearman rank correlation and Fisher's exact test. Results. No association was found between the local risk of lead poisoning and the priority placed by local health departments on lead poisoning prevention activities. Similarly, there was no association between the local risk of lead poisoning and the availability of services. Only 60% of local health departments offered blood lead testing, environmental investigation, and case management. Most (74%) believed that lead poisoning is inadequately addressed within the area served by their local health department. Conclusion. New strategies of providing lead poisoning prevention activities are needed to achieve the federal and state goals of eliminating childhood lead poisoning over the next decade.
Veterans Using and Uninsured Veterans Not Using Veterans Affairs (VA) Health Care
Authors: Nelson Karin M. , Starkebaum Gordon A. , Reiber Gayle E. 
Published: July 2017

Objectives. The objectives of this study were to: ( 1) examine veteran reliance on health services provided by the Veterans Health Administration (VA), ( 2) describe the characteristics of veterans who receive VA care, and ( 3) report rates of uninsurance among veterans and characteristics of uninsured veterans. Methods. The authors analyzed data from the 2000 Behavioral Risk Factor Surveillance System. Using bivariate and multivariate analyses, the association of veteran's demographic characteristics, health insurance coverage, and use of VA services were examined. Veterans not reporting VA coverage and having no other source of health insurance were considered uninsured. Results. Among veteran respondents, 6.2% reported receiving all of their health care at the VA, 6.9% reported receiving some of their health care at the VA, and 86.9% did not use VA health care. Poor, less-educated, and minority veterans were more likely to receive all of their health care at the VA. Veterans younger than age 65 who utilized the VA for all of their health care also reported coverage with either private insurance (42.6%) or Medicare (36.3%). Of the veterans younger than age 65, 8.6% (population estimate: 1.3 million individuals) were uninsured. Uninsured veterans were less likely to be able to afford a doctor or see a doctor within the last year. Conclusions. Veterans who utilized the VA for all of their health care were more likely to be from disadvantaged groups. A large number of veterans who could use VA services were uninsured. They should be targeted for VA enrollment given the detrimental clinical effects of being uninsured.
Developing Competencies for Applied Epidemiology: From Process to Product
Authors: Birkhead Guthrie S. , Davies Jac , Miner Kathleen , Lemmings Jennifer , Koo Denise 
Published: July 2017

Objectives. We developed competencies for applied epidemiologic practice by using a process that is based on existing competency frameworks, that engages professionals in academic and applied epidemiology at all governmental levels (local, state, and federal), and that provides ample opportunity for input from practicing epidemiologists throughout the U.S. Methods. The model set of core public health competencies, consisting of eight core domains of public health practice, developed in 2001 by the Council on Linkages Between Academia and Public Health Practice, were adopted as the foundation of the Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs). A panel of experts was convened and met over a period of 20 months to develop a draft set of AECs. Drafts were presented at the annual meetings of the Council of State and Territorial Epidemiologists (CSTE) and the American Public Health Association. Input and comments were also solicited from practicing epidemiologists and 14 national organizations representing epidemiology and public health. Results. In all, we developed 149 competency statements across the eight domains of public health practice and four tiers of applied epidemiologic practice. In addition, sub- and sub-subcompetency statements were developed to increase the document's specificity. During the process, >800 comments from all governmental and academic levels and tiers of epidemiology practice were considered for the final statements. Conclusions. The AECs are available for use in improving the training for and skill levels of practicing applied epidemiologists and should also be useful for educators, employers, and supervisors. Both CDC and CSTE plan to evaluate their implementation and usefulness in providing information for future competency development.
Measuring Health Behaviors and Landline Telephones: Potential Coverage Bias in a Low-Income, Rural Population
Authors: Shebl Fatma , Poppell Carolyn F. , Zhan Min , Dwyer Diane M. , Hopkins Annette B. , Groves Carmela , Reed Faye , Devadason C. , Steinberger Eileen K. 
Published: July 2017

Objectives. Population-based landline telephone surveys are potentially biased due to inclusion of only people with landline telephones. This article examined the degree of telephone coverage bias in a low-income population. Methods. The Charles County Cancer Survey (CCCS) was conducted to evaluate cancer screening practices and risk behaviors among low-income, rural residents of Charles County, Maryland. We conducted face-to-face interviews with 502 residents aged 18 years and older. We compared the prevalence of health behaviors and cancer screening tests for those with and without landline telephones. We calculated the difference between whole sample estimates and estimates for only those respondents with landline telephones to quantify the magnitude of telephone coverage bias. Results. Of 499 respondents who gave information on telephone use, 80 (16%) did not have landline telephones. We found differences between those with and without landline telephones for race/ethnicity, health-care access, insurance coverage, and several types of cancer screening. The absolute coverage bias ranged up to 6.5 percentage points. Simulation scenarios showed the magnitude of telephone coverage bias decreases as the percent of the population with landline telephone coverage increases, and as landline telephone coverage increases, the estimates from a landline telephone survey would approximate the estimates from a face-to-face survey. Conclusions. Our findings highlighted the need for targeted face-to-face surveys to supplement telephone surveys to more fully characterize hard-to-reach subpopulations. Our findings also indicated that landline telephone-based surveys continue to offer a cost-effective method for conducting large-scale population studies in support of policy and public health decision-making.
Postpartum Smoking Relapse and Secondhand Smoke
Authors: Ashford Kristin B. , Hahn Ellen , Hall Lynne , Rayens Mary Kay , Noland Melody 
Published: July 2017

Objective. There has been an abundance of research evaluating prenatal and postnatal smoking abstinence programs. However, few researchers have tested postpartum relapse interventions that address secondhand smoke (SHS) exposure. Pregnant women exposed to SHS are more likely to relapse. This article explores the similarities and differences among postpartum interventions that incorporate SHS education. Generating knowledge about the components of postpartum relapse prevention interventions that do and do not achieve prolongation of abstinence is integral to the development of effective SHS interventions that help women achieve lifelong abstinence. Methods. We used a methodological review of 11 randomized, controlled trials testing the efficacy of relapse prevention interventions that address SHS exposure. We compared intervention strength, biomarker validation of home smoking and SHS, as well as abstinence and relapse rates. We examined three predictors of postpartum relapse: ( 1) partner smoking in the home, ( 2) adoption of home smoking restrictions, and ( 3) motivation/confidence to remain abstinent. Results. Findings revealed a need for more comprehensive SHS interventions and a clear delineation of abstinence/relapse terminology. Biomarker validation of home smoking and SHS was primarily measured by self-report, passive nicotine monitors, and hair nicotine levels. Furthermore, studies using nurse- and pediatrician-led interventions resulted in the lowest relapse rates. Conclusion. A comprehensive intervention that specifically prioritizes parental education on the health effects of SHS on the family, empowerment of the mother and family members to remain abstinent and adopt a smoke-free home smoking policy, and partner influence on smoking could result in a significant reduction in postpartum relapse rates.
Infant Bed-Sharing Practices and Associated Risk Factors among Births and Infant Deaths in Alaska
Authors: Blabey Margaret H. , Gessner Bradford D. 
Published: July 2017

Objective. The Alaska Division of Public Health has stated that infants may safely share a bed for sleeping if this occurs with a nonsmoking, unimpaired caregiver on a standard, adult, non-water mattress. Because this policy is contrary to recent national recommendations that discourage any bed sharing, we examined 13 years of Alaskan infant deaths that occurred while bed sharing to assess the contribution of known risk factors. Methods. We examined vital records, medical records, autopsy reports, and first responder reports for 93% of Alaskan infant deaths that occurred between 1992 and 2004. We examined deaths while bed sharing for risk factors including sleeping with a non-caregiver, prone position, maternal tobacco use, impairment of a bed-sharing partner, and an unsafe sleep surface. We used Pregnancy Risk Assessment Monitoring System data to describe bed-sharing practices among all live births in Alaska during 1996–2003. Results. Thirteen percent ( n=126) of deaths occurred while bed sharing; 99% of these had at least one associated risk factor, including maternal tobacco use (75%) and sleeping with an impaired person (43%). Frequent bed sharing was reported for 38% of Alaskan infants. Among these, 60% of mothers reported no risk factors; the remaining 40% reported substance use, smoking, high levels of alcohol use, or most often placing their infant prone for sleeping. Conclusions. Almost all bed-sharing deaths occurred in association with other risk factors despite the finding that most women reporting frequent bed sharing had no risk factors; this suggests that bed sharing alone does not increase the risk of infant death.
Colorectal Cancer Screening among Users of County Health Centers and Users of Private Physician Practices
Authors: Messina Catherine R. , Lane Dorothy S. , Colson Roberto C. 
Published: July 2017

Objective. We examined use of colorectal cancer (CRC) screening exam modalities among county health centers and private physician offices, where both were located in the same geographic area. Methods. We surveyed 500 county health center registrants and 570 private physician patients, aged 52–75 years. We administered telephone surveys during 2004 to examine relationships among sociodemographic characteristics; perceived barriers to screening with fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy; and self-reported receipt of each exam. Results. FOBT was more frequent among county health center registrants; sigmoidoscopy and colonoscopy were more frequent among private physician patients ( p<0.001). County health center registrants less frequently cited no physician recommendation as a barrier to FOBT, but more frequently cited no recommendation as a barrier to sigmoidoscopy and colonoscopy, compared with private physician patients ( p ≤0.02). Among county health center registrants, better health insurance coverage was associated with lower odds of FOBT and higher odds of screening endoscopy; perceived barriers were associated with lower odds of screening ( p<0.02). Among private physician patients, we noted an association between perceived barriers to screening and lower odds of any screening ( p<0.001). Conclusions. Overall, CRC screening among county health center and private physician patient samples compared favorably with overall New York and U.S. rates. Although prior studies using national data suggested that screening rates were equivalent in county health center and private physician primary care settings, we found exam-specific differences in patient-reported screening endoscopy among our two patient samples. Understanding factors that contribute to differences in CRC screening between primary care settings is important for ensuring equal access to CRC screening options for all patients.