bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating the Link Between Gun Possession and Gun Assault
Authors: Branas Charles C. , Richmond Therese S. , Culhane Dennis P. , Ten Have Thomas R. , Wiebe Douglas J. 
Published: September 2009

Objectives. We investigated the possible relationship between being shot in an assault and possession of a gun at the time.Methods. We enrolled 677 case participants that had been shot in an assault and 684 population-based control participants within Philadelphia, PA, from 2003 to 2006. We adjusted odds ratios for confounding variables.Results. After adjustment, individuals in possession of a gun were 4.46 (P < .05) times more likely to be shot in an assault than those not in possession. Among gun assaults where the victim had at least some chance to resist, this adjusted odds ratio increased to 5.45 (P < .05).Conclusions. On average, guns did not protect those who possessed them from being shot in an assault. Although successful defensive gun uses occur each year, the probability of success may be low for civilian gun users in urban areas. Such users should reconsider their possession of guns or, at least, understand that regular possession necessitates careful safety countermeasures.
Social-Environmental Factors and Protective Sexual Behavior Among Sex Workers: The Encontros Intervention in Brazil
Authors: Lippman Sheri A. , Donini Angela , Díaz Juan , Chinaglia Magda , Reingold Arthur , Kerrigan Deanna 
Published: September 2009

Objectives. We sought to determine the association of social–environmental factors with condom use and sexually transmitted infections (STIs) among 420 sex workers participating in an STI/HIV prevention study in Corumbá, Brazil, to inform future intervention efforts. Methods. Participants provided urine samples for polymerase chain reaction testing of chlamydia and gonorrhea and responded to multi-item scales addressing perceived social cohesion, participation in networks, and access to and management of resources. We conducted multivariate log-linear and negative binomial regression analyses of these data. Results. Increased social cohesion was inversely associated with number of unprotected sex acts in the preceding week among women (adjusted incidence rate ratio [IRR] = 0.80; P < .01), and there was a marginal association among men (adjusted IRR = 0.41; P = .08). Women's increased participation in social networks was associated with a decrease in frequency of unprotected sex acts (adjusted IRR = 0.83; P = .04), as was men's access to and management of social and material resources (IRR = 0.15; P = .01). Social–environmental factors were not associated with STIs. Conclusions. The social context within which populations negotiate sexual behaviors is associated with condom use. Future efforts to prevent STI/HIV should incorporate strategies to modify the social environment.
Stroke Mortality Among Alaska Native People
Authors: Horner Ronnie D. , Day Gretchen M. , Lanier Anne P. , Provost Ellen M. , Hamel Rebecca D. , Trimble Brian A. 
Published: September 2009

Objectives. We aimed to describe the epidemiology of stroke among Alaska Natives, which is essential for designing effective stroke prevention and intervention efforts for this population. Methods. We conducted an analysis of death certificate data for the state of Alaska for the period 1984 to 2003, comparing age-standardized stroke mortality rates among Alaska Natives residing in Alaska vs US Whites by age category, gender, stroke type, and time. Results. Compared with US Whites, Alaska Natives had significantly elevated stroke mortality from 1994 to 2003 but not from 1984 to 1993. Alaska Native women of all age groups and Alaska Native men younger than 45 years of age had the highest risk, although the rates for those younger than 65 years were statistically imprecise. Over the 20-year study period, the stroke mortality rate was stable for Alaska Natives but declined for US Whites. Conclusions. Stroke mortality is higher among Alaska Natives, especially women, than among US Whites. Over the past 20 years, there has not been a significant decline in stroke mortality among Alaska Natives.
The Sonoma Water Evaluation Trial: A Randomized Drinking Water Intervention Trial to Reduce Gastrointestinal Illness in Older Adults
Authors: Colford John M. , Hilton Joan F. , Wright Catherine C. , Arnold Benjamin F. , Saha Sona , Wade Timothy J. , Scott James , Eisenberg Joseph N.S. 
Published: September 2009

Objectives. We estimated the relative rate of highly credible gastrointestinal illness (HCGI) per year associated with active versus sham household water filtration devices among older adults in a community receiving tap water meeting current US standards. Methods. We conducted a randomized, triple-blinded, crossover trial in 714 households (988 individuals), which used active and sham water filtration devices for 6 months each. We estimated the annual incidence rate ratio of HCGI episodes and the longitudinal prevalence ratio of HCGI days at population and individual levels with a generalized estimating equation (GEE) and generalized linear mixed models (GLMMs), respectively, adjusted for covariates associated with outcome. Results. The incidence rate ratios (active versus sham) were 0.88 (95% confidence interval [CI] = 0.77, 1.00) and 0.85 (95% CI = 0.76, 0.94) HCGI episodes per year estimated by GEE and GLMM models, respectively. The corresponding longitudinal prevalence ratios were 0.88 (95% CI = 0.74, 1.05) and 0.84 (95% CI = 0.78, 0.90) HCGI days per person per year. Conclusions. We observed reductions in population- and individual-level measures of HCGI associated with use of the active filtration device. These findings suggest the need for further research on the impact of drinking water on the health of sensitive subpopulations.
Medication Prescribing Practices for Older Prisoners in the Texas Prison System
Authors: Williams Brie A. , Baillargeon Jacques G. , Lindquist Karla , Walter Louise C. , Covinsky Kenneth E. , Whitson Heather E. , Steinman Michael A. 
Published: September 2009

Objectives. We sought to assess appropriateness of medication prescribing for older Texas prisoners.Methods. In this 12-month cross-sectional study of 13 117 prisoners (aged ≥ 55 years), we assessed medication use with Zhan criteria and compared our results to prior studies of community prescribing. We assessed use of indicated medications with 6 Assessing Care of Vulnerable Elders indicators.Results. Inappropriate medications were prescribed to a third of older prisoners; half of inappropriate use was attributable to over-the-counter antihistamines. When these antihistamines were excluded, inappropriate use dropped to 14% (≥ 55 years) and 17% (≥ 65 years), equivalent to rates in a Department of Veterans Affairs study (17%) and lower than rates in a health maintenance organization study (26%). Median rate of indicated medication use for the 6 indicators was 80% (range = 12%–95%); gastrointestinal prophylaxis for patients on nonsteroidal anti-inflammatories at high risk for gastrointestinal bleed constituted the lowest rate.Conclusions. Medication prescribing for older prisoners in Texas was similar to that for older community adults. However, overuse of antihistamines and underuse of gastrointestinal prophylaxis suggests a need for education of prison health care providers in appropriate prescribing practices for older adults.
Association Between Widowhood and Risk of Diagnosis With a Sexually Transmitted Infection in Older Adults
Authors: Smith Kirsten P. , Christakis Nicholas A. 
Published: September 2009

Objectives. We assessed whether widowhood is associated with risk of diagnosis with a sexually transmitted infection (STI) among older adults in the United States and whether the associations observed in men differed before and after the introduction of sildenafil, the first oral erectile dysfunction medication approved by the Food and Drug Administration. Methods. We used Cox proportional hazards regression to analyze the time to first STI diagnosis in a random sample of married, Medicare-eligible couples aged 67 to 99 years in 1993 (N = 420 790 couples). Results. Twenty-one percent of male and 43% of female participants lost a spouse during the 9-year study period. Only 0.65% of men and 0.97% of women were diagnosed with an STI. Widowhood was associated with an increased risk of STI diagnosis for men only, with the largest effects found 0.5 to 1 year after a wife's death. Effects for men were larger after the introduction of sildenafil. Conclusions. Widowhood in older men, but not women, increased the risk for STIs, especially in the postsildenafil era. Clinicians should address sexual health issues with older patients, especially bereaved men taking erectile dysfunction medications.
Childhood Socioeconomic Position and Disability in Later Life: Results of the Health and Retirement Study
Authors: Bowen Mary Elizabeth , González Hector M. 
Published: September 2009

Objectives. We used a life course approach to assess the ways in which childhood socioeconomic position may be associated with disability in later life. Methods. We used longitudinal data from the nationally representative Health and Retirement Study (1998–2006) to examine associations between parental education, paternal occupation, and disabilities relating to activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Results. Respondents whose fathers had low levels of education and those whose fathers were absent or had died while they were growing up were at increased risk of disability in later life, net of social, behavioral, and pathological health risks in adulthood. Social mobility and health behaviors were also important factors in the association between low childhood socioeconomic position and ADL and IADL disabilities. Conclusions. Our findings highlight the need for policies and programs aimed at improving the well-being of both children and families. A renewed commitment to such initiatives may help reduce health care costs and the need for people to use health and social services in later life.
Implementing Evidence-Based Practice in Community Mental Health Agencies: A Multiple Stakeholder Analysis
Authors: Aarons Gregory A. , Wells Rebecca S. , Zagursky Karen , Fettes Danielle L. , Palinkas Lawrence A. 
Published: September 2009

Objectives. We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies. Methods. Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers. Results. Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups. Conclusions. Implementation of EBP is a complex process. Cross-system–level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns.
Eliminating Health Disparities Through Transdisciplinary Research, Cross-Agency Collaboration, and Public Participation
Authors: Rashid Jamila R. , Spengler Robert F. , Wagner Robin M. , Melanson Cindi , Skillen Elizabeth L. , Mays Robert A. , Heurtin-Roberts Suzanne , Long Judith A. 
Published: September 2009

Despite efforts to the contrary, disparities in health and health care persist in the United States. To solve this problem, federal agencies representing different disciplines and perspectives are collaborating on a variety of transdisciplinary research initiatives. The most recent of these initiatives was launched in 2006 when the Centers for Disease Control and Prevention's Office of Public Health Research and the Department of Health and Human Services’ Office of Minority Health brought together federal partners representing a variety of disciplines to form the Federal Collaboration on Health Disparities Research (FCHDR). FCHDR collaborates with a wide variety of federal and nonfederal partners to support and disseminate research that aims to reduce or eliminate disparities in health and health care. Given the complexity involved in eliminating health disparities, there is a need for more transdisciplinary, collaborative research, and facilitating that research is FCHDR's mission.
The Benefits of Risk Factor Prevention in Americans Aged 51 Years and Older
Authors: Goldman Dana P. , Zheng Yuhui , Girosi Federico , Michaud Pierre-Carl , Olshansky S. Jay , Cutler David , Rowe John W. 
Published: September 2009

Objectives. We assessed the potential health and economic benefits of reducing common risk factors in older Americans.Methods. A dynamic simulation model tracked a national cohort of persons 51 and 52 years of age to project their health and medical spending in prevention scenarios for diabetes, hypertension, obesity, and smoking.Results. The gain in life span from successful treatment of a person aged 51 or 52 years for obesity would be 0.85 years; for hypertension, 2.05 years; and for diabetes, 3.17 years. A 51- or 52-year-old person who quit smoking would gain 3.44 years. Despite living longer, those successfully treated for obesity, hypertension, or diabetes would have lower lifetime medical spending, exclusive of prevention costs. Smoking cessation would lead to increased lifetime spending. We used traditional valuations for a life-year to calculate that successful treatments would be worth, per capita, $198 018 (diabetes), $137 964 (hypertension), $118 946 (smoking), and $51 750 (obesity).Conclusions. Effective prevention could substantially improve the health of older Americans, and—despite increases in longevity—such benefits could be achieved with little or no additional lifetime medical spending.
Associations of Supported Treadmill Stepping With Walking Attainment in Preterm and Full-Term Infants
Authors: Luo Hong-Ji , Chen Pei-Shan , Hsieh Wu-Shiun , Lin Kwan-Hwa , Lu Tung-Wu , Chen Wei J. , Jeng Suh-Fang 
Published: September 2009

BackgroundTreadmill training in supported stepping has been used as part of rehabilitation programs for children with neurodevelopmental problems to facilitate earlier onset of walking. However, information concerning the developmental continuity between supported stepping and walking is limited.ObjectiveThe aims of this study were to longitudinally examine supported stepping in preterm and full-term infants and to explore the step parameters associated with walking attainment.DesignA cohort study with a longitudinal follow-up design was used.MethodsTwenty-nine preterm infants and 20 full-term infants were examined bimonthly with supported stepping on a treadmill from 7 months of age until walking attainment or 18 months of corrected age. The associations between step variables and walking outcome were examined using Cox proportional hazard regression and logistic regression.ResultsWalking attainment for preterm infants was later than for full-term infants (median=12.8 versus 11 months, respectively). The percentage of alternating steps, hip-knee correlation, hip-ankle correlation, and asymmetry ratio (AR) of stance time of stepping movement from 7 to 9 months of corrected age were found to be associated with age of walking attainment in all infants. Manifestation of at least 3 of 4 step features (ie, ≥80% alternating steps, ≤.37 hip-knee correlation, ≥.73 hip-ankle correlation, and ≤1.40 AR of stance time) at 7 months predicted walking attainment prior to 11 months of corrected age (accuracy=75%–77%). Failure to achieve such competencies at 7 or 9 months of corrected age was predictive of failure in walking attainment by 15 months (accuracy=72%–98%).LimitationsThe limitations of this study included a small sample size and commencement of stepping assessment as early as 7 months of corrected age.ConclusionsThe emergence of walking may involve cooperation of alternating pattern generation, interjoint coordination, and interlimb coordination in supported stepping in preterm and full-term infants. The identified step predictors may assist clinicians in designing appropriate treadmill training programs for those infants with delayed walking.
Academic Difficulty and Program-Level Variables Predict Performance on the National Physical Therapy Examination for Licensure: A Population-Based Cohort Study
Authors: Riddle Daniel L. , Utzman Ralph R. , Jewell Dianne V. , Pearson Stephanie , Kong Xiangrong 
Published: September 2009

Background
Several factors have been shown to influence first-time pass rates on the National Physical Therapy Examination (NPTE). It is unclear to what extent academic difficulty experienced by students in a physical therapist education program may affect NPTE pass rates. The effects of institutional status (public or private) and Carnegie Classification on NPTE pass rates also are unknown.

Objective
The aim of this study was to quantify the odds of failure on the NPTE for students experiencing academic difficulty and for institutional status and Carnegie Classification.

Design
This investigation was a retrospective population-based cohort study.

Methods
Quota sampling was used to recruit a random sample of 20 professional physical therapist education programs across the United States. Individual student demographic, preadmission, and academic performance data were collected, as were data on program-level variables and data indicating pass/fail performance on the NPTE. A generalized linear mixed-effects logistic regression model was used to adjust for confounding factors and to describe relationships among the key predictor variables—academic difficulty, institutional status, and Carnegie Classification—and the dependent variable, NPTE performance.

Results
Academic difficulty during a student's professional training was an independent predictor for NPTE failure. The odds of students who had academic difficulty (relative to students who did not experience academic difficulty) failing the NPTE were 5.89 (95% confidence interval=4.06–8.93). The odds of NPTE failure also varied depending on institutional status and Carnegie Classification.

Limitations
The findings related to Carnegie Classification and institutional status should be considered preliminary.

Conclusions
Student performance on the NPTE was influenced by multiple factors, but the most important, potentially modifiable risk factor for poor NPTE performance likely is academic difficulty during professional training.
Efficacy of silver-bearing external ventricular drainage catheters: a retrospective analysis
Authors: Fichtner Jens , Güresir Erdem , Seifert Volker , Raabe Andreas 
Published: September 2009

Object
Catheter-related infection of CSF is a potentially life-threatening complication of external ventricular drainage (EVD). When using EVD catheters, contact between the ventricular system and skin surface occurs and CSF infection is possible. The aim of this analysis was to compare the efficacy of silver-bearing EVD catheters for reducing the incidence of infection with standard nonimpregnated EVD catheters in neurosurgical patients with acute hydrocephalus.

Methods
Two hundred thirty-one consecutive patients were retrospectively reviewed. Of these, 164 were enrolled in the final analysis. Six patient charts were incomplete or missing, 15 patients were excluded because of catheter insertion within the previous 30 days, 6 because of a suspected CSF infection before ventriculostomy, 7 because the catheter was removed < 24 hours after insertion, and 33 patients because of the requirement of bilateral ventriculostomy. The control group with standard nonimpregnated EVD catheters consisted of 90 patients. The study group with silver-bearing EVDs consisted of 74 patients. For assessing the primary outcome, the authors recorded all CSF samples and liquor cell counts routinely obtained in sterile fashion. After removal of the catheters, they also reviewed microbiology reports of the removed catheters to assess colonization of the catheter tips.

Results
The occurrence of a positive CSF culture, colonization of the catheter tip, or liquor pleocytosis (white blood cell count > 4/μl) was ~ 2 times less in the study group with silver-bearing EVD catheters than that in the control group (18.9% compared with 33.7%, p = 0.04). Positive CSF cultures alone occurred 2 times less frequently for microorganisms in the study group (2.7% compared with 4.7%, p = 0.55). Silver-bearing catheters were 4 times less likely to become colonized as nonimpregnated EVDs (1.4% compared with 5.8%, p = 0.14). Liquor pleocytosis was half as likely in the study group (17.6% compared with 30.2%, p = 0.06).

Conclusions
Although of limited sample size and thus underpowered for subgroup analysis, this analysis indicates that EVD catheters impregnated with silver nanoparticles and an insoluble silver salt may reduce the risk of catheter-related infections in neurosurgical patients.
Radiosurgery for large-volume (> 10 cm3) benign meningiomas
Authors: Bledsoe Jonathan M. , Link Michael J. , Stafford Scott L. , Park Paul J. , Pollock Bruce E. 
Published: September 2009

Object
Stereotactic radiosurgery (SRS) has proven to be a safe and effective treatment for many patients with intracranial meningiomas. Nevertheless, the morbidity associated with radiosurgery of larger meningiomas is poorly understood.

Methods
The authors performed a retrospective review of 116 patients who underwent SRS for meningiomas (WHO Grade I) > 10 cm3 between 1990 and 2007, with a minimum follow-up of 12 months. Patients with atypical or malignant meningiomas and those who received prior radiotherapy were excluded. The average tumor volume was 17.5 cm3 (range 10.1–48.6 cm3); the average tumor margin dose was 15.1 Gy (range 12–18 Gy); and the mean follow-up duration was 70.1 months (range 12–199 months).

Results
Tumor control was 99% at 3 years and 92% at 7 years after radiosurgery. Thirty complications after radiosurgery were noted in 27 patients (23%), including 7 cases of seizures, 6 cases of hemiparesis, 5 cases of trigeminal injury, 4 cases of headaches, 3 cases of diplopia, 2 cases each of cerebral infarction and ataxia, and 1 case of hearing loss. Patients with supratentorial tumors experienced a higher complication rate compared with patients with skull base tumors (44% compared with 18%) (hazard ratio 2.9, 95% CI 1.3–6.7, p = 0.01).

Conclusions
The morbidity associated with SRS for patients with benign meningiomas > 10 cm3 is greater for supratentorial tumors compared with skull base tumors. Whereas radiosurgery is relatively safe for patients with large-volume skull base meningiomas, resection should remain the primary disease management for the majority of patients with large-volume supratentorial meningiomas.