bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncertain Benefit: The Public Policy of Approving Smallpox Vaccine Research
Authors: Quigley Rosemary B 
Published: December 2008

Without an accurate assessment of the prospect of bioterrorist attack, it is especially challenging to evaluate the protocols for testing smallpox vaccines in the pediatric population. Usual regulatory mechanisms cannot shepherd research protocols with benefits that can only be characterized as “uncertain” in the face of more than minimal risk. When a protocol is placed in a government forum for analysis, the public has a unique opportunity to debate the balancing of research risks and benefits on behalf of children who are unable to assent to research themselves, as well as to express views about vaccination policy broadly. This model for review of pediatric research that may be without benefit will be especially important as challenging studies of various vaccines against a range of infectious properties, such as anthrax and severe acute respiratory syndrome (SARS), emerge.
Enhancing Public Confidence in Vaccines Through Independent Oversight of Postlicensure Vaccine Safety
Authors: Salmon Daniel A. , Moulton Lawrence H. , Halsey Neal A. 
Published: December 2008

The National Immunization Program of the Centers for Disease Control and Prevention is responsible for controlling infectious diseases through vaccination, but the program also plays a key role in postlicensure vaccine safety assessment. The time has come to separate postlicensure vaccine safety assessment from vaccine risk management as recommended by the National Research Council of the National Academy of Sciences. The National Transportation Safety Board offers a useful model for developing an independent National Vaccine Safety Board that would have the authority to leverage resources and expertise of various government agencies, academia, and industry to oversee postlicensure vaccine safety investigations. Such a board would have been useful in recent vaccine safety concerns, and its independence from government programs would ensure optimal vaccine safety and enhance public confidence in vaccines.
Racial/Ethnic Disparities in Preschool Immunizations: United States, 1996–2001
Authors: Chu Susan Y. , Barker Lawrence E. , Smith Philip J. 
Published: December 2008

Objectives. We examined current racial/ethnic differences in immunization coverage rates among US preschool children. Methods. Using National Immunization Survey data from 1996 through 2001, we compared vaccination coverage rates between non-Hispanic White, non-Hispanic Black, Hispanic, and Asian preschool children. Results. During the 6-year study period, the immunization coverage gap between White and Black children widened by an average of 1.1% each year, and the gap between White and Hispanic children widened by an average of 0.5% each year. The gap between White and Asian children narrowed by an average of 0.8% each year. Conclusions. Racial/ethnic disparities in preschool immunization coverage rates have increased significantly among some groups; critical improvements in identifying, understanding, and addressing race/ethnicity-specific health care differences are needed to achieve the Healthy People 2010 goal of eliminating disparities.
Vaccine Risk Perception Among Reporters of Autism After Vaccination: Vaccine Adverse Event Reporting System 1990–2001
Authors: Woo Emily Jane , Ball Robert , Bostrom Ann , Shadomy Sean V. , Ball Leslie K. , Evans Geoffrey , Braun Miles 
Published: December 2008

Objectives. We investigated vaccine risk perception among reporters of autism to the Vaccine Adverse Event Reporting System (VAERS). Methods. We conducted structured interviews with 124 parents who reported autism and related disorders to VAERS from 1990 to 2001 and compared results with those of a published survey of parents in the general population. Results. Respondents perceived vaccine-preventable diseases as less serious than did other parents. Only 15% of respondents deemed immunization extremely important for children’s health; two thirds had withheld vaccines from their children. Conclusions. Views of parents who believe vaccines injured their children differ significantly from those of the general population regarding the benefits of immunization. Understanding the factors that shape this perspective can improve communication among vaccine providers, policymakers, and parents/patients.
“Street Medicine”: Collaborating With a Faith-Based Organization to Screen At-Risk Youths for Sexually Transmitted Diseases
Authors: Moss Nicholas J. , Gallaread Alonzo , Siller Jacqueline , Klausner Jeffrey D. 
Published: December 2008

Chlamydia and gonorrhea rates among African American youths in San Francisco are far higher than those among young people of the city’s other racial and ethnic groups. A geographically targeted sexually transmitted disease education and screening intervention performed in collaboration with a local faith-based organization was able to screen hundreds of at-risk youths. The screened individuals included friends and sex partners from an extensive social-sexual network that transcended the boundaries of the target population. The intervention also provided an excellent opportunity to practice “street medicine,” in which all screening and treatment was effectively conducted in the field.
HIV Topical Microbicides: Steer the Ship or Run Aground
Authors: Gross Michael 
Published: December 2008

Six HIV candidate microbicides are scheduled to enter 6 large-scale effectiveness trials in the next year. The selection of products for testing and the design of this group of trials should be reconsidered to provide an answer to a key question now before the field: Does a sulfonated polyanion, delivered intravaginally as a gel, block HIV attachment to target cells with sufficient potency to protect women from sexually acquired HIV infection? Paradoxically, entering more candidates into more trials may confuse or compromise efforts to identify an effective product. Instead, a single trial of the most promising product(s) best serves the current candidates while also preserving resources needed to promptly advance innovative new protective concepts into future large-scale trials.
Ethical Challenges in Preparing for Bioterrorism: Barriers Within the Health Care System
Authors: Wynia Matthew K. , Gostin Lawrence O. 
Published: December 2008

Preparedness for bioterrorism poses significant ethical challenges. Although public health ethics and preparedness have received attention recently, health care ethics must also be considered. In epidemics, the health care system assists public health in 3 tasks: detection, containment, and treatment. Detection might fail if all patients do not have access to care, or if physicians do not understand their obligation to report infectious diseases to public health authorities. Containment might fail if physicians view themselves only as advocates for individual patients, ignoring their social obligations as health professionals. Treatment might fail if physicians do not accept their professional duty to treat patients during epidemics. Each of these potential ethical barriers to preparedness must be addressed by physicians and society.
Asthma Inhalers in Schools: Rights of Students with Asthma to a Free Appropriate Education
Authors: Jones Sherry Everett , Wheeler Lani 
Published: December 2008

Students who possess and self-administer their asthma medications can prevent or reduce the severity of asthma episodes. In many states, laws or policies allow students to possess and self-administer asthma medications at school. In the absence of a state or local law or policy allowing public school students to possess inhalers and selfmedicate to treat asthma, 3 federal statutes may require public schools to permit the carrying of such medications by students: the Individuals With Disabilities Education Act, Section 504 of the Rehabilitation Act of 1973, and Title II of the Americans with Disabilities Act. Local policies and procedures can be based on these federal laws to ensure that students with asthma can take their medicines as needed.
Characterizing Perceived Police Violence: Implications for Public Health
Authors: Cooper Hannah , Moore Lisa , Gruskin Sofia , Krieger Nancy 
Published: December 2008

Despite growing recognition of violence’s health consequences and the World Health Organization’s recent classification of police officers’ excessive use of force as a form of violence, public health investigators have produced scant research characterizing police-perpetrated abuse. Using qualitative data from a study of a police drug crackdown in 2000 in 1 New York City police precinct, we explored 40 injection drug using and 25 non–drug using precinct residents’ perceptions of and experiences with police-perpetrated abuse. Participants, particularly injection drug users and non–drug using men, reported police physical, psychological, and sexual violence and neglect; they often associated this abuse with crackdown-related tactics and perceived officer prejudice. We recommend that public health research address the prevalence, nature, and public health implications of police violence.
Psychosocial Characteristics of New York City HIV-Infected Women Before and After the Advent of HAART
Authors: Siegel Karolynn , Karus Daniel , Dean Laura 
Published: December 2008

Objectives. We compared level of psychosocial distress of HIV-infected women living in New York City before the advent of highly active antiretroviral therapy (HAART) with level of psychosocial distress reported by women living with the disease after the use of HAART became widespread. Methods. Data were from HIV-positive New York City women aged 18 to 50 years, enrolled through outreach and self-referral. We compared scores on measures of psychological state and psychosocial adjustment to illness of 74 women interviewed in 1994–1996 with scores of a matched group of 74 women interviewed in 2000–2002. Results. A significant difference between groups was found only with regard to adjustment to illness in their domestic environment, with poorer adjustment reported, on average, by women in the 2000–2002 sample. Conclusions. Although new treatments have significantly improved the physical health of those living with HIV/AIDS, no evidence was found that these treatments significantly improved psychological health for women, regardless of history of protease inhibitor use.
Efficacy of a Woman-Focused Intervention to Reduce HIV Risk and Increase Self-Sufficiency Among African American Crack Abusers
Authors: Wechsberg Wendee M. , Lam Wendy K. K. , Zule William A. , Bobashev Georgiy 
Published: December 2008

Objectives. This study compares 3- and 6-month outcomes of a woman-focused HIV intervention for crack abusers, a revised National Institute on Drug Abuse standard intervention, and a control group. Methods. Out-of-drug-treatment African American women (n = 620) who use crack participated in a randomized field experiment. Risk behavior, employment, and housing status were assessed with linear and logistic regression. Results. All groups significantly reduced crack use and high-risk sex at each follow-up, but only woman-focused intervention participants consistently improved employment and housing status. Compared with control subjects at 6 months, woman-focused intervention participants were least likely to engage in unprotected sex; revised standard intervention women reported greatest reductions in crack use. Conclusions. A woman-focused intervention can successfully reduce risk and facilitate employment and housing and may effectively reduce the frequency of unprotected sex in the longer term.
Modeling the Effects of Different Infant Feeding Strategies on Infant Survival and Mother-to-Child Transmission of HIV
Authors: Ross Jay S. , Labbok Miriam H. 
Published: December 2008

Objectives. We investigated how, under various conditions, the risk of mother-to-child transmission of HIV through breastfeeding compares with the risk of death from artificial feeding. Methods. We developed a spreadsheet simulation model to predict HIV-free survival during 7 age intervals from 0 to 24 months for 5 different infant feeding scenarios in resource-poor settings. Results. Compared with artificial feeding, breastfeeding during the first 6 months by HIV-positive mothers increases HIV-free survival by 32 per 1000 live births. After 6 months, as the age-specific mortality rate and risk of death caused by replacement feeding both decline, replacement feeding appears to be safer. Conclusions. Under conditions common in countries with high HIV prevalence, replacement feeding by HIV-infected mothers should not be generally encouraged until after the infant is approximately 6 months old.
Prevalence and Incidence of HIV, Hepatitis B Virus, and Hepatitis C Virus Infections Among Males in Rhode Island Prisons
Authors: Macalino Grace E. , Vlahov David , Sanford-Colby Stephanie , Patel Sarju , Sabin Keith , Salas Christopher , Rich Josiah D. 
Published: December 2008

Objectives. We evaluated prevalence and intraprison incidence of HIV, hepatitis B virus, and hepatitis C virus infections among male prison inmates. Methods. We observed intake prevalence for 4269 sentenced inmates at the Rhode Island Adult Correctional Institute between 1998 and 2000 and incidence among 446 continuously incarcerated inmates (incarcerated for 12 months or more). Results. HIV, hepatitis B virus, and hepatitis C virus prevalences were 1.8%, 20.2%, and 23.1%, respectively. Infections were significantly associated with injection drug use (odds ratio = 10.1, 7.9, and 32.4). Incidence per 100 person-years was 0 for HIV, 2.7 for HBV, and 0.4 for HCV. Conclusions. High infection prevalence among inmates represents a significant community health issue. General disease prevention efforts must include prevention within correctional facilities. The high observed intraprison incidence of HBV underscores the need to vaccinate prison populations.
Evaluating the Effectiveness of Public Health Leadership Training: The NEPHLI Experience
Authors: Saleh Shadi S. , Williams Dwight , Balougan Modinat 
Published: December 2008

Objectives. We assessed the effect of public health leadership training on the capacity of public health leaders to perform competencies derived from the list of “Ten Essential Public Health Services” presented in 1994 by the steering committee of the Public Health Functions Project. Methods. Graduating scholars of the Northeast Public Health Leadership Institute were surveyed to determine differences in skill level in 15 competency areas before and after training. Surveys were completed after program completion. Results. The training program improved the skill levels of participants in all 15 competency areas. A relation also was detected between the frequency of use of the competency and the improvement experienced. Conclusions. Public health leadership training programs are effective in improving the skills of public health workers.
Physician Assistants as Providers of Surgically Induced Abortion Services
Authors: Goldman Marlene B. , Occhiuto Jane S. , Peterson Laura E. , Zapka Jane G. , Palmer R. Heather 
Published: December 2008

Objectives. We compared complication rates after surgical abortions performed by physician assistants with rates after abortions performed by physicians. Methods. A 2-year prospective cohort study of women undergoing surgically induced abortion was conducted. Ninety-one percent of eligible women (1363) were enrolled. Results. Total complication rates were 22.0 per 1000 procedures (95% confidence interval [CI] = 11.9, 39.2) performed by physician assistants and 23.3 per 1000 procedures (95% CI = 14.5, 36.8) performed by physicians (P = .88). The most common complication that occurred during physician assistant–performed procedures was incomplete abortion; during physician-performed procedures the most common complication was infection not requiring hospitalization. A history of pelvic inflammatory disease was associated with an increased risk of total complications (odds ratio = 2.1; 95% CI = 1.1, 4.1). Conclusions. Surgical abortion services provided by experienced physician assistants were comparable in safety and efficacy to those provided by physicians.
Racial/Ethnic Differences in the Prevalence of Depressive Symptoms Among Middle-Aged Women: The Study of Women’s Health Across the Nation (SWAN)
Authors: Bromberger Joyce T. , Harlow Sioban , Avis Nancy , Kravitz Howard M. , Cordal Adriana 
Published: December 2008

Objectives. We examined racial/ethnic differences in significant depressive symptoms among middle-aged women before and after adjustment for socioeconomic, health-related, and psychosocial characteristics. Methods. Racial/ethnic differences in unadjusted and adjusted prevalence of significant depressive symptoms (score ≥ 16 on the Center for Epidemiologic Studies Depression [CES-D] Scale) were assessed with univariate and multiple logistic regressions. Results. Twenty-four percent of the sample had a CES-D score of 16 or higher. Unadjusted prevalence varied by race/ethnicity (P < .0001). After adjustment for covariates, racial/ethnic differences overall were no longer significant. Conclusions. Hispanic and African American women had the highest odds, and Chinese and Japanese women had the lowest odds, for a CES-D score of 16 or higher. This variation is in part because of health-related and psychosocial factors that are linked to socioeconomic status.
Association Between Childhood Socioeconomic Status and Coronary Heart Disease Risk Among Postmenopausal Women: Findings From the British Women's Heart and Health Study
Authors: Lawlor Debbie A. , Smith George Davey , Ebrahim Shah 
Published: December 2008

Objectives. We assessed the association between childhood socioeconomic status (SES) and coronary heart disease among postmenopausal women. Methods. We conducted a cross-sectional analysis of 3444 women aged 60 to 79 years. Results. There was an independent linear association between childhood and adult SES and coronary heart disease. The association between childhood SES and coronary heart disease was attenuated when we adjusted for insulin resistance syndrome, adult smoking, physical activity, biomarkers of childhood nutrition, and passive smoking. Conclusions. The association between adverse childhood SES and coronary heart disease is in part mediated through insulin resistance, which may be influenced by poor childhood nutrition, and in part through the association between childhood SES and adult behavioral risk factors.
Weapons in the Lives of Battered Women
Authors: Sorenson Susan B. , Wiebe Douglas J. 
Published: December 2008

Objectives. We assessed weapon use in intimate partner violence and perspectives on hypothetical firearm policies. Methods. We conducted structured in-person interviews with 417 women in 67 battered women’s shelters. Results. Words, hands/fists, and feet were the most common weapons used against and by battered women. About one third of the battered women had a firearm in the home. In two thirds of these households, the intimate partner used the gun(s) against the woman, usually threatening to shoot/kill her (71.4%) or to shoot at her (5.1%). Most battered women thought spousal notification/consultation regarding gun purchase would be useful and that a personalized firearm (“smart gun”) in the home would make things worse. Conclusions. A wide range of objects are used as weapons against intimate partners. Firearms, especially handguns, are more common in the homes of battered women than in households in the general population.
The Potential Protective Effect of Youth Assets on Adolescent Alcohol and Drug Use
Authors: Oman Roy F. , Vesely Sara , Aspy Cheryl B. , McLeroy Kenneth R. , Rodine Sharon , Marshall LaDonna 
Published: December 2008

Objectives. We examined the association between adolescent alcohol and drug use and 9 youth assets in a low-income, inner-city population. Methods. An in-person survey of 1350 adolescents and parents assessed youth assets and risk behaviors. We analyzed data with χ2 tests and logistic regression analyses. Results. When we controlled for appropriate variables, there were significant positive relationships between several youth assets and nonuse of alcohol and drugs. Furthermore, youths who possessed all of the statistically significant youth assets were 4.44 times more likely to report nonuse of alcohol and 5.41 times more likely to report nonuse of drugs compared with youths who possessed fewer youth assets. Conclusions. Our study supports the view that specific youth assets may protect youths from alcohol and drug use.
Health Care System Changes and Reported Musculoskeletal Disorders Among Registered Nurses
Authors: Lipscomb Jane , Trinkoff Alison , Brady Barbara , Geiger-Brown Jeanne 
Published: December 2008

Objectives. We evaluated the impact of health care system changes on nurses’ health, and we studied reported musculoskeletal disorders associated with these changes. Methods. This cross-sectional study (n = 1163) defined a musculoskeletal disorder case as moderate pain that lasted at least 1 week or occurred monthly during the past year. Nurses were asked about changes in the health care system in the past year, and responses to 12 changes were summed and were categorized as low, moderate, or high changes. Results. When the changes were summed, the adjusted odds ratios for musculoskeletal disorders for more than 6 versus 0 to 1 changes were (1) neck: 4.45 (95% confidence interval [CI] = 1.97, 10.08), (2) shoulder: 2.63 (95% CI = 1.17, 5.91), and (3) back: 3.42 (95% CI = 1.61, 7.27). Conclusions. The adverse impact on health caused by the changing health care system must be addressed to prevent further injuries among nurses.
Function and Response of Nursing Facilities During Community Disaster
Authors: Saliba Debra , Buchanan Joan , Kington Raynard S. 
Published: December 2008

Objectives. We sought to describe the role and function of nursing facilities after disaster. Methods. We surveyed administrators at 144 widely dispersed nursing facilities after the Los Angeles Northridge earthquake. Results. Of the 113 (78%) nursing facilities that responded (11 365 beds), 23 sustained severe damage, 5 closed (625 beds), and 72 lost vital services. Of 87 nursing facilities implementing disaster plans, 56 cited problems that plans did not adequately address, including absent staff, communication problems, and insufficient water and generator fuel. Fifty-nine (52%) reported disaster-related admissions from hospitals, nursing facilities, and community residences. Nursing facilities received limited postdisaster assistance. Five months after the earthquake, only half of inadequate nursing facility disaster plans had been revised. Conclusions. Despite considerable disaster-related stresses, nursing facilities met important community needs. To optimize disaster response, communitywide disaster plans should incorporate nursing facilities.
Graphic Canadian Cigarette Warning Labels and Adverse Outcomes: Evidence from Canadian Smokers
Authors: Hammond David , Fong Geoffrey T. , McDonald Paul W. , Brown K. Stephen , Cameron Roy 
Published: December 2008

Objectives. We assessed the impact of graphic Canadian cigarette warning labels. Methods. We used a longitudinal telephone survey of 616 adult smokers. Results. Approximately one fifth of participants reported smoking less as a result of the labels; only 1% reported smoking more. Although participants reported negative emotional responses to the warnings including fear (44%) and disgust (58%), smokers who reported greater negative emotion were more likely to have quit, attempted to quit, or reduced their smoking 3 months later. Participants who attempted to avoid the warnings (30%) were no less likely to think about the warnings or engage in cessation behavior at follow-up. Conclusions. Policymakers should not be reluctant to introduce vivid or graphic warnings for fear of adverse outcomes.