bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alleged B. Anthracis Exposure Claims in a Workers' Compensation Setting
Authors: Jewell Gregory , Dunning Kari , Lockey James E. 
Published: January 2017

Objectives. Workers' compensation insurance in some states may not provide coverage for medical evaluation costs of workplace exposures related to potential bioterrorism acts if there is no diagnosed illness or disease. Personal insurance also may not provide coverage for these exposures occurring at the workplace. Governmental entities, insurers, and employers need to consider how to address such situations and the associated costs. The objective of this study was to examine characteristics of workers and total costs associated with workers' compensation claims alleging potential exposure to the bioterrorism organism B. anthracis. Methods. We examined 192 claims referred for review to the Ohio Bureau of Workers' Compensation (OBWC) from October 10, 2001, through December 20, 2004. Results. Although some cases came from out-of-state areas where B. anthracis exposure was known to exist, no Ohio claim was associated with true B. anthracis exposure or B. anthracis-related illness. Of the 155 eligible claims, 126 included medical costs averaging $219 and ranging from $24 to $3,126. There was no difference in mean cost for government and non-government employees ( p=0.202 Wilcoxon). Conclusions. The number of claims and associated medical costs for evaluation and treatment of potential workplace exposure to B. anthracis were relatively small. These results can be attributed to several factors, including no documented B. anthracis exposures and disease in Ohio and prompt transmission of recommended diagnostic and prophylactic treatment protocols to physicians. How employers, insurers, and jurisdictions address payment for evaluation and treatment of potential or documented exposures resulting from a potential terrorism-related event should be addressed proactively.
Measles Immunization Coverage Determined by Serology and Immunization Record from Children in Two Chicago Communities
Authors: Watson John T. , Ramirez Enrique , Evens Anne , Bellini William J. , Johnson Hope , Morita Julie 
Published: January 2017

Objectives. We compared the prevalence of measles immunization determined by serology with the prevalence of measles immunization determined by immunization records, and identified factors predictive of measles immunization among a sample of children from two Chicago communities. Methods. We collected demographic information and blood specimens from a sample of children aged 12–71 months in two Chicago communities at risk for low measles immunization coverage levels. We collected immunization information from provider records, parent-held records, and the statewide immunization registry. We compared evidence of immunization determined by serology with evidence of immunization from these three sources of immunization records. Results. The sample of children from the two communities had serologic measles immunity levels of 85% and 90%. Significantly fewer children had evidence of immunization by record in both communities (45% and 63%, respectively). Conclusions. Immunization coverage levels determined using immunization records were significantly lower than immunization coverage determined using serology. A fully populated immunization registry used by all immunization providers could prevent the problems of record loss and scatter.
The Use of AAP-Recommended Disciplinary Practice Guidelines among African American Caregivers of Children in Head Start Programs
Authors: Horn Ivor B. , Lewin Amy , Turner-Musa Jocelyn , Edwards Mark C. , Joseph Jill G. 
Published: January 2017

Objective. The American Academy of Pediatrics (AAP) recommends that parents not use harsh disciplinary practices. Previous studies have characterized the disciplinary practices of African American parents as harsh, with reliance on more aggressive techniques not currently recommended by the AAP. However, recent research has indicated more disciplinary practice diversity among African Americans. This study describes factors associated with the use of AAP-recommended disciplinary practices among lower-income African American caregivers of children in Head Start. Methods. Subjects were caregivers of children at three Head Start sites. Participants were eligible for inclusion if the biological mother, biological father, or target child was identified as African American. Using consensus methods, responses to the Parental Discipline Methods Interview (PDMI) were described as consistent or inconsistent with AAP guidelines regarding use of negative disciplinary practices (e.g., spanking, yelling). Caregivers avoiding any of these inconsistent methods were referred to as “adherent.” Results. “Adherent” caregivers were older (32.5 years vs. 30.4 years) and had more education (86.0% vs. 75.4% high school graduates). They were also less likely to report that their child had behavioral problems (12.9% vs. 25.2%) or deficient social skills (1.7% vs. 8.0%). Conclusions. Lower-income African American caregivers were more likely to use disciplinary practices consistent with AAP guidelines if they had higher levels of education and were living in an urban setting. Caregivers describing their child as having fewer behavior problems, better social skills, or themselves as less stressed were also more likely to be “adherent.”
Do the Same Houses Poison Many Children? An Investigation of Lead Poisoning in Rochester, New York, 1993–2004
Authors: Korfmacher Katrina Smith , Kuholski Kate 
Published: January 2017

Objectives. In several cities, researchers have found that a discrete number of properties owned by a small number of owners house multiple lead poisoned children over time. The purpose of this study was to determine whether or not a small number of properties were implicated in the poisoning of multiple children in Rochester, New York, between 1993 and 2004. Methods. We analyzed the patterns of ownership and repeated positive environmental investigations (i.e., documented lead hazards) in homes of lead poisoned children using county health department data during a 12-year period. Results. A small percentage (14.8%) of properties in which the health department found a lead hazard had previously documented lead hazards. When a second positive investigation occurred, the average elapsed time between investigations was a little less than three years. Only four property owners owned more than two properties that had multiple positive investigations. Conclusions. In some cities, a small number of properties or property owners provide housing for a large percentage of lead poisoned children. However, this situation is not universal. In Rochester, a relatively small percentage of homes that housed a child with an elevated blood lead level have a history of housing lead poisoned children. In cities like Rochester, lead hazard reduction resources should focus on high-risk housing stock determined by factors such as age, value, and condition, rather than on those with a prior record of housing lead poisoned children.
Using Social Network Analysis to Understand Missouri's System of Public Health Emergency Planners
Authors: Harris Jenine K. , Clements Bruce 
Published: January 2017

Objectives. Effective response to large-scale public health threats requires well-coordinated efforts among individuals and agencies. While guidance is available to help states put emergency planning programs into place, little has been done to evaluate the human infrastructure that facilitates successful implementation of these programs. This study examined the human infrastructure of the Missouri public health emergency planning system in 2006. Methods. The Center for Emergency Response and Terrorism (CERT) at the Missouri Department of Health and Senior Services has responsibility for planning, guiding, and funding statewide emergency response activities. Thirty-two public health emergency planners working primarily in county health departments contract with CERT to support statewide preparedness. We surveyed the planners to determine whom they communicate with, work with, seek expertise from, and exchange guidance with regarding emergency preparedness in Missouri. Results. Most planners communicated regularly with planners in their region but seldom with planners outside their region. Planners also reported working with an average of 12 local entities (e.g., emergency management, hospitals/clinics). Planners identified the following leaders in Missouri's public health emergency preparedness system: local public health emergency planners, state epidemiologists, the state vaccine and grant coordinator, regional public health emergency planners, State Emergency Management Agency area coordinators, the state Strategic National Stockpile coordinator, and Federal Bureau of Investigation Weapons of Mass Destruction coordinators. Generally, planners listed few federal-level or private-sector individuals in their emergency preparedness networks. Conclusions. While Missouri public health emergency planners maintain large and varied emergency preparedness networks, there are opportunities for strengthening existing ties and seeking additional connections.
Validity of Self-Reported Varicella Disease History in Pregnant Women Attending Prenatal Clinics
Authors: Watson Barbara , Civen Rachel , Reynolds Meredith , Heath Karl , Perella Dana , Carbajal Tina , Mascola Laurene , Jumaan Aisha , Zimmerman Laura , James Abike , Quashi Carlene , Schmid Scott 
Published: January 2017

Objective. The purpose of this study was to assess the validity of self-reported history for varicella disease relative to serological evidence of varicella immunity in pregnant women attending antenatal care at clinics located in two diverse geographical locations in the U.S. (Antelope Valley, California, and Philadelphia) with high varicella vaccination coverage. Methods. Pregnant women attending prenatal care appointments who needed blood drawn as part of their routine care were eligible to participate. Self-reported varicella disease history was obtained via questionnaire. Varicella serostatus was determined using a whole-cell enzyme-linked immunosorbent assay to test for varicella zoster virus-specific immunoglobulin G (VZV IgG) antibodies. Results. Of the 309 study participants from Antelope Valley and the 528 participants from Philadelphia who self-reported having had chickenpox disease, 308 (99.7%; 95% confidence interval [CI]: 98.2, 100) and 517 (97.9%; 95% CI: 96.3, 99.0), respectively, had serological evidence of immunity to varicella. Only 6.8% (95% CI: 3.9, 11.0) and 17.4% (95% CI: 13.1, 22.5) of women who self-reported having a negative or uncertain varicella disease history in Antelope Valley and Philadelphia, respectively, were seronegative for varicella antibodies. Conclusion. Despite the dramatic changes in the epidemiology of varicella that have occurred since 1995 due to the introduction and subsequent widespread use of the varicella vaccine, self-reported history of varicella continues to be a strong predictor of VZV IgG antibodies in pregnant women. Negative or uncertain history remains poorly predictive of negative serostatus.
Using Google Earth as an Innovative Tool for Community Mapping
Authors: Lefer Theodore B. , Anderson Matthew R. , Fornari Alice , Lambert Anastasia , Fletcher Jason , Baquero Maria 
Published: January 2017

Maps are used to track diseases and illustrate the social context of health problems. However, commercial mapping software requires special training. This article illustrates how nonspecialists used Google Earth™, a free program, to create community maps. The Bronx, New York, is characterized by high levels of obesity and diabetes. Residents and medical students measured the variety and quality of food and exercise sources around a residency training clinic and a student-run free clinic, using Google Earth to create maps with minimal assistance. Locations were identified using street addresses or simply by pointing to them on a map. Maps can be shared via e-mail, viewed online with Google Earth or Google Maps, and the data can be incorporated into other mapping software.
Maternal Obesity and Risk of Infant Death Based on Florida Birth Records for 2004
Authors: Thompson Daniel R. , Clark Cheryl L. , Wood Betsy , Zeni Mary Beth 
Published: January 2017

Objective. The purpose of this study was to assess the relationship between pre-pregnancy maternal obesity and risk of infant death. Methods. In March 2004, maternal height and pre-pregnancy weight were added to the data collected on the Florida birth certificate. Using birth records linked to infant deaths, these data were used to assess the relationship between pre-pregnancy maternal obesity, as measured by body mass index, and infant death. Results. Pre-pregnancy maternal obesity was associated with increased odds of infant death. The increased risk was found with and without adjustments for maternal race, marital status, age, education, trimester prenatal care began, first birth, and tobacco use. Conclusion. There is a substantial and significant association between prepregnancy maternal obesity and infant death.
Access and Utilization Patterns of School-Based Health Centers at Urban and Rural Elementary and Middle Schools
Authors: Wade Terrance J. , Mansour Mona E. , Guo Jeff J. , Huentelman Tracy , Line Kristin , Keller Kathryn N. 
Published: January 2017

Objective. We examined patterns of enrollment, use, and frequency of use in school-based health centers (SBHCs), as well as the referral, diagnosis, and disposition of SBHC visits among newly implemented SBHCs. Methods. Four rural and four urban school districts implementing SBHCs were examined from 2000 to 2003. Total school enrollment for students was 13,046. SBHC enrollment and medical encounter data were tracked using a Web-based medical database. Descriptive analyses were conducted to evaluate primary care access and utilization patterns. Results. A total of 7,460 (57.2%) students were enrolled in their SBHCs, of which 4,426 used the SBHC at least once for a total of 14,050 visits. SBHC enrollment was greater in urban districts but rate of utilization was higher in rural districts. Black students, students with public or no health insurance, and students with asthma or attention deficit disorder had higher enrollment and utilization. Rural parents referred more children to SBHCs than urban parents. Teachers referred more students who were black, had asthma, had no public or health insurance, or had acute-type health issues. Total visits increased during the three years, with the largest increase in mental health services. Students who were younger, white, attended rural schools, had public or health insurance, or had infections were more likely to be sent home. Those with chronic conditions and visits for mental health were more likely to be returned to class. Conclusion. Utilization patterns suggest improved access to needed health care for disadvantaged children. SBHCs are an important part of the safety net for the populations they are intended to serve.
Planning and Sustaining a School-Based Health Center: Cost and Revenue Findings from Oregon
Authors: Nystrom Robert J. , Prata Adriana 
Published: January 2017

Objective. Research concerning school-based health center (SBHC) costs and revenues is limited. This article discusses Oregon's SBHC State Program Office methodology and findings regarding costs and revenues for planning and operating Oregon SBHCs. Methods. A variety of data sources and case studies conducted in five Oregon SBHC systems were used to calculate startup and annual operations costs. All Oregon SBHCs completed a survey providing 2005–2006 revenue data. Revenue data were further linked to 2005–2006 client utilization data, such as the number and age of unduplicated clients, public and private insurance status, and medical sponsor type. Results. Startup costs for Oregon SBHCs depended largely on the status of available space. Median, minimum, and maximum annual operations costs were calculated for core, intermediate, and expanded models of service delivery, and depended mostly on provider hours and types. Centers with federally qualified health center medical sponsors rely heavily on revenue from billing public insurance programs. Billing revenue depends on the percent of uninsured visits. School socioeconomic indicators such as the percent of students eligible for free and reduced lunch may be good indicators for the percent of student clients with public insurance. Conclusions. The methodology employed may encourage other state SBHC agencies or organizations to adopt research designs to collect and analyze cost and revenue data. On a practical level, the findings provide state and local policy makers and communities planning SBHCs with preliminary estimates for the costs of startup and annual operations, and some understanding of income sources and billing revenue projections.
Impact of School-Based Health Centers on Students with Mental Health Problems
Authors: Guo Jeff J. , Wade Terrance J. , Keller Kathryn N. 
Published: January 2017

Objectives. School-based health centers (SBHCs) play an increasingly major role in providing mental health services for students. This study evaluated the impact of SBHCs on mental health-care services and psychosocial health-related quality of life (HRQOL). Methods. Four SBHC intervention and two matched non-SBHC school districts were examined from 1997 to 2003. The SBHC intervention began in 2000. Data included child and parent pediatric HRQOL and Ohio Medicaid claims. A longitudinal quasi-experimental time-series repeated measures design was used for this study, involving analysis of covariance to assess health costs and regression analyses for HRQOL scores. Results. After the SBHC program, proportions of students accessing mental health-care services for urban and rural SBHC intervention schools increased 5.6% (χ2=39.361, p<0.0001) and 5.9% (χ2=5.545, p<0.0001), respectively, compared with increases of 2.6% (χ2=2.670, p=0.1023) and 0.2% (χ2=0.006, p=0.9361) for urban and rural non-SBHC schools, respectively. Using data from 109 students with mental health problems based on Medicaid claims, the study found SBHC students had significantly lower total health-care costs (F=5.524, p=0.005) and lower costs of mental health services (F=4.820, p=0.010) compared with non-SBHC students. While improvements over time in HRQOL for SBHC students compared with non-SBHC students and students from non-SBHC schools were observed, only some were statistically significant. Conclusions. SBHC programs increase the proportion of students who receive mental health services and may improve pediatric HRQOL. SBHC students with mental health problems had lower total Medicaid reimbursements compared with non-SBHC students.
Process Evaluation of an In-School Anti-Tobacco Media Campaign in Louisiana
Authors: Hong Traci , Johnson Carolyn C. , Myers Leann , Boris Neil , Brewer Dixye , Webber Larry S. 
Published: January 2017

Objectives. In light of challenges imposed by the changing media landscape and decreasing classroom time available for health interventions, new approaches are needed to disseminate anti-tobacco messages to adolescents. This study reported process evaluation of an in-school three-year anti-tobacco media campaign conducted in 10 schools in Louisiana. Methods. Over three years, 10 schools received an in-school anti-tobacco media campaign. The media campaign was one intervention component of the Acadiana Coalition of Teens against Tobacco. Campaign measures were tracked over the campaign's three-year duration. The campaign and evaluation were designed to target the students as they progressed through high school. The number of students who completed the surveys were 1,823 in Year 1, 1,552 in Year 2, and 1,390 in Year 3. Schools eligible for participation were publicly funded schools with no magnet or special populations and within a two-hour driving distance of the New Orleans study office. Results. In a self-report survey (Year 1, n=1,823; Year 2, n=1,552; Year 3, n=1,390), more than 75% and 50% of students reported being exposed to posters and public service announcements, respectively. Recognition of campaign theme was more than 80%. Almost half of respondents reported that the posters were interesting, one-third reported that the posters prevented them from smoking, and 10% reported that the posters encouraged them to cease smoking. Stock media posters had a significantly higher affective reaction than the customized media posters. Conclusion. Findings suggest that in-school media programs are useful and should be considered as a viable approach to health education for adolescents.
Using Gaming Simulation to Evaluate Bioterrorism and Emergency Readiness Education
Authors: Olson Debra K. , Scheller Amy , Larson Susan , Lindeke Linda , Edwardson Sandra 
Published: January 2017

Objective. We performed an outcome evaluation of the impact of public health preparedness training as a group comparison posttest design to determine the differences in the way individuals who had participated in training performed in a simulated emergency. Methods. The Experimental Group 1 included students who had graduated from or were currently enrolled in the bioterrorism and emergency readiness (BT/ER) curriculum at the University of Minnesota School of Public Health. The comparison groups included individuals who had access to the Internet and were aware of the 2006 online simulation Disaster in Franklin County: A Public Health Simulation. The evaluation process employed surveys and the gaming simulation as sources for primary data. Results. Participants in the BT/ER curriculum ( p=0.0001) and other participants completing at least 45 hours of training in the past year ( p=0.0001) demonstrated higher effectiveness scores (accuracy of chosen responses within the simulation) than participants who did not report significant amounts of training. Conclusions. This evaluation research demonstrated that training is significantly associated with better performance in a simulated emergency using gaming technology.
Cancer-Related Disparities and Opportunities for Intervention in Northern Plains American Indian Communities
Authors: Watanabe-Galloway Shinobu , Flom Nicole , Xu Liyan , Duran (Rosebud Sioux) Tinka , Frerichs Leah , Kennedy Favian , Smith Corey B. , Jaiyeola Adeola O. 
Published: January 2017

Objectives. We examined behavioral trends associated with cancer risk and cancer screening use from 1997 through 2006 among American Indians/Alaska Natives (AI/ANs) in the Northern Plains region (North Dakota, South Dakota, Nebraska, and Iowa) of the United States. We also examined disparities between that population and non-Hispanic white (NHW) people in the Northern Plains and AI/ANs in other regions. Methods. We analyzed Behavioral Risk Factor Surveillance System data from the Centers for Disease Control and Prevention for 1997–2000 and 2003–2006. We used age-adjusted Wald Chi-square tests to test the difference between these two periods for AI/ANs and the difference between AI/ANs and NHW people during 2003–2006. Results. There was no statistically significant improvement among AI/ANs in the Northern Plains region for behaviors associated with cancer risk or cancer screening use, and there was a significant increase in the obesity rate. The prevalence of binge drinking, obesity, and smoking among AI/ANs in the Northern Plains was significantly higher than among NHW people in the same region and among AI/AN populations in other regions. Although the percentage of cancer screening use was similar for all three groups, the use of sigmoidoscopy/colonoscopy was significantly lower among the Northern Plains AI/ANs than among NHW people. Conclusion. These results indicate a need for increased efforts to close the gaps in cancer health disparities between AI/ANs and the general population. Future efforts should focus not only on individual-level changes, but also on system-level changes to build infrastructure to promote healthy living and to increase access to cancer screening.