bluuebunny/crossref_metadata_2025_split huggingface dataset:
Underuse of Screening Sigmoidoscopy and Colonoscopy in a Large Cohort of US Adults
Authors: Chao Ann , Connell Cari J. , Cokkinides Vilma , Jacobs Eric J. , Calle Eugenia E. , Thun Michael J. 
Published: December 2008

Objectives. We examined the prevalence of endoscopy (sigmoidoscopy or colonoscopy) by indication and by demographic and lifestyle factors. Methods. We analyzed cross-sectional data collected in 1997 from participants aged 50 years and older in the Cancer Prevention Study (CPS) II Nutrition Cohort. Results. Fifty-eight percent of men and 51% of women reported ever having undergone endoscopy; only 42% of men and 31% of women reported endoscopy for screening rather than for disease diagnosis or follow-up. Prevalence varied by demographic and lifestyle factors. Conclusions. Efforts to increase colorectal cancer screening need to target women, all persons aged 50–64 years, and those with colorectal cancer risk factors. Future studies should distinguish endoscopy for screening from procedures for disease diagnosis and follow-up to avoid overestimating screening compliance.
Neighborhood Context and Mortality Among Older Mexican Americans: Is There a Barrio Advantage?
Authors: Eschbach Karl , Ostir Glenn V. , Patel Kushang V. , Markides Kyriakos S. , Goodwin James S. 
Published: December 2008

Objectives. We examined whether Mexican Americans living in high-density Mexican American neighborhoods experience increased morbidity and mortality compared with the rates observed among Mexican Americans living in low-density areas. Methods. We conducted a prospective analysis of a cohort of 3050 Mexican Americans aged 65 years or older. We examined prevalence of 6 medical conditions and survival over 7 years of follow-up in relation to percentage of Mexican Americans in the census tract. Results. With adjustment for covariates, odds for disease prevalence among older Mexican Americans as a function of percentage of Mexican Americans in the census tract were 0.33 (95% confidence interval [CI]=0.16, 0.71) for stroke, 0.28 (95% CI= 0.11, 0.70) for cancer, and 0.31 (95% CI=0.10, 0.98) for hip fracture. The hazard ratio for all-cause mortality over 7 years’ follow-up was 0.64 (95% CI=0.42, 0.96). Conclusions. Sociocultural advantages conferred on Mexican Americans by living in high-density Mexican American neighborhoods outweigh the disadvantages conferred by the high poverty of those neighborhoods.
The ORIGINS of Primary Health Care and SELECTIVE Primary Health Care
Authors: Cueto Marcos 
Published: December 2008

I present a historical study of the role played by the World Health Organization and UNICEF in the emergence and diffusion of the concept of primary health care during the late 1970s and early 1980s. I have analyzed these organizations’ political context, their leaders, the methodologies and technologies associated with the primary health care perspective, and the debates on the meaning of primary health care.These debates led to the development of an alternative, more restricted approach, known as selective primary health care. My study examined library and archival sources; I cite examples from Latin America.
Human Testing of Pesticides: Ethical and Scientific Considerations
Authors: Lockwood Alan H. 
Published: December 2008

I reviewed ethical and scientific aspects of 6 human pesticide-dosing studies submitted to the Environmental Protection Agency (EPA) for consideration during the pesticide reregistration process. All had serious ethical or scientific deficiencies—or both—including unacceptable informed consent procedures, unmanaged financial conflicts of interest, inadequate statistical power, inappropriate test methods and endpoints, and distorted results. Given today’s knowledge of the effects of pesticides, there is no assurance that any such study can be completely free of short-term risks, long-term risks, or both. Therefore, there is no basis for allowing pesticide studies to continue or for using them during the pesticide reregistration process. An EPA committee that is free from political and financial conflicts of interest should review this practice.
Patient Race/Ethnicity and Quality of Patient–Physician Communication During Medical Visits
Authors: Johnson Rachel L. , Roter Debra , Powe Neil R. , Cooper Lisa A. 
Published: December 2008

Objectives. We examined the association between patient race/ethnicity and patient–physician communication during medical visits. Methods. We used audiotape and questionnaire data collected in 1998 and 2002 to determine whether the quality of medical-visit communication differs among African American versus White patients. We analyzed data from 458 African American and White patients who visited 61 physicians in the Baltimore, Md–Washington, DC–Northern Virginia metropolitan area. Outcome measures that assessed the communication process, patient-centeredness, and emotional tone (affect) of the medical visit were derived from audiotapes coded by independent raters. Results. Physicians were 23% more verbally dominant and engaged in 33% less patient-centered communication with African American patients than with White patients. Furthermore, both African American patients and their physicians exhibited lower levels of positive affect than White patients and their physicians did. Conclusions. Patient–physician communication during medical visits differs among African American versus White patients. Interventions that increase physicians’ patient-centeredness and awareness of affective cues with African Americans patients and that activate African American patients to participate in their health care are important strategies for addressing racial/ethnic disparities in health care.
Unemployment and Early Cause-Specific Mortality: A Study Based on the Swedish Twin Registry
Authors: Voss Margaretha , Nylén Lotta , Floderus Birgitta , Diderichsen Finn , Terry Paul D. 
Published: December 2008

Objectives. We investigated the association between unemployment and early cause-specific mortality to determine whether the relationship was modified by other risk indicators. Methods. Female and male twins (n=20632) were followed with regard to mortality from 1973 through 1996. Questionnaire data from 1973 were used to obtain information on experience of unemployment and on social, behavioral, health, and personality characteristics. Results. Unemployment was associated with an increased risk of suicide and death from undetermined causes. Low education, personality characteristics, use of sleeping pills or tranquilizers, and serious or long-lasting illness tended to strengthen the association between unemployment and early mortality. Conclusions. An increased risk of death from external causes implies a need for support for those experiencing unemployment, particularly susceptible individuals.
Effect of Local Restaurant Smoking Regulations on Environmental Tobacco Smoke Exposure Among Youths
Authors: Siegel Michael , Albers Alison B. , Cheng Debbie M. , Biener Lois , Rigotti Nancy A. 
Published: December 2008

Objectives. We examined the effect of local restaurant smoking regulations on restaurant environmental tobacco smoke exposure among youths. Methods. We interviewed 3863 Massachusetts youths aged 12–17 years and ascertained how often they saw smokers in restaurants in their town. We assessed the effect of local restaurant smoking regulation strength on nonexposure to environmental tobacco smoke (seeing smokers never or only rarely). Results. Compared with youths from towns with weak regulations, youths from towns with medium-strength regulations had 1.4 times the odds (odds ratio = 1.36; 95% confidence interval = 1.12, 1.65) and youths from towns with strong regulations had twice the odds (odds ratio = 2.03; 95% confidence interval = 1.64, 2.52) of reporting nonexposure. Conclusions. Strong local restaurant smoking regulations are associated with reduced environmental tobacco smoke exposure among youths
Young Adults: Vulnerable New Targets of Tobacco Marketing
Authors: Biener Lois , Albers Alison B. 
Published: December 2008

Objectives. We examined young adult smoking patterns and receptivity to cigarette advertising to assess vulnerability to tobacco marketing strategies.Methods. We obtained data from a telephone survey of 12 072 Massachusetts adults.Results. Smokers aged 18 to 30 years were more likely than older adults to smoke only occasionally and to consume fewer than 10 cigarettes per day. They also were more receptive to cigarette marketing and were more likely to be frequent patrons of bars and clubs.Conclusions. Many young adult smokers are in the initiation phase of smoking and are likely to undergo a transition to either nonsmoking or heavier smoking. If unimpeded by regulation, tobacco promotion in bars and clubs is likely to lead to increased adult smoking prevalence.
Confronting the Challenges in Reconnecting Urban Planning and Public Health
Authors: Corburn Jason 
Published: December 2008

Although public health and urban planning emerged with the common goal of preventing urban outbreaks of infectious disease, there is little overlap between the fields today. The separation of the fields has contributed to uncoordinated efforts to address the health of urban populations and a general failure to recognize the links between, for example, the built environment and health disparities facing low-income populations and people of color. I review the historic connections and lack thereof between urban planning and public health, highlight some challenges facing efforts to recouple the fields, and suggest that insights from ecosocial theory and environmental justice offer a preliminary framework for reconnecting the fields around a social justice agenda.
Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis
Authors: Tsemberis Sam , Gulcur Leyla , Nakae Maria 
Published: December 2008

Objectives. We examined the longitudinal effects of a Housing First program for homeless, mentally ill individuals’ on those individuals’ consumer choice, housing stability, substance use, treatment utilization, and psychiatric symptoms. Methods. Two hundred twenty-five participants were randomly assigned to receive housing contingent on treatment and sobriety (control) or to receive immediate housing without treatment prerequisites (experimental). Interviews were conducted every 6 months for 24 months. Results. The experimental group obtained housing earlier, remained stably housed, and reported higher perceived choice. Utilization of substance abuse treatment was significantly higher for the control group, but no differences were found in substance use or psychiatric symptoms. Conclusions. Participants in the Housing First program were able to obtain and maintain independent housing without compromising psychiatric or substance abuse symptoms.
Professional and Hospital DISCRIMINATION and the US Court of Appeals Fourth Circuit 1956–1967
Authors: Reynolds P. Preston 
Published: December 2008

A series of court cases litigated by the National Association for the Advancement of Colored People Legal Defense and Education Fund between 1956 and 1967 laid the foundation for elimination of overt discrimination in hospitals and professional associations. The landmark case, Simkins v Moses H. Cone Memorial Hospital (1963), challenged the use of public funds to expand segregated hospital care. The second case, Cypress v Newport News Hospital Association (1967), reaffirmed the federal government’s application of Medicare certification guidelines to force hospitals to open up patient admissions, education programs, and staff privileges to all citizens and physicians. Pursuit of a legal strategy against racist policies was an essential element in a national campaign to eliminate discrimination in health care delivery in the United States.
Dental Care Use and Self-Reported Dental Problems in Relation to Pregnancy
Authors: Lydon-Rochelle Mona T. , Krakowiak Paula , Hujoel Philippe P. , Peters Riley M. 
Published: December 2008

Objectives. We examined the relationships between risk factors amenable to intervention and the likelihood of dental care use during pregnancy. Methods. We used data from the Washington State Department of Health’s Pregnancy Risk Assessment Monitoring System. Results. Of the women surveyed, 58% reported no dental care during their pregnancy. Among women with no dental problems, those not receiving dental care were at markedly increased risk of having received no counseling on oral health care, being overweight, and using tobacco. Among women who received dental care, those with dental problems were more likely to have lower incomes and Medicaid coverage than those without dental problems. Conclusions. There is a need for enhanced education and training of maternity care providers concerning oral health in pregnancy.
Use of Preventive Services by Men Enrolled in Medicare+Choice Plans
Authors: Morales Leo S. , Rogowski Jeannette , Freedman Vicki A. , Wickstrom Steven L. , Adams John L. , Escarce José J. 
Published: December 2008

Objectives. We examined the effect of demographic and socioeconomic factors on use of preventive services (prostate-specific antigen testing, colorectal cancer screening, and influenza vaccination) among elderly men enrolled in 2 Medicare+Choice health plans. Methods. Data were derived from administrative files and a survey of 1915 male enrollees. We used multivariate logistic regression to assess the effects of enrollee characteristics on preventive service use. Results. Age, marital status, educational attainment, and household wealth were associated with receipt of one or more preventive services. However, the effects of these variables were substantially attenuated relative to earlier studies of Medicare. Conclusions. Some Medicare HMOs have been successful in attenuating racial and socioeconomic disparities in the use of preventive services by older men.
Vitamin C Deficiency and Depletion in the United States: The Third National Health and Nutrition Examination Survey, 1988 to 1994
Authors: Hampl Jeffrey S , Taylor Christopher A. , Johnston Carol S. 
Published: December 2008

Objectives. We sought to determine prevalence rates of vitamin C deficiency and depletion in the United States. Methods. We used data from the Third National Health and Nutrition Examination Survey to assess intake of dietary, supplemental, and serum vitamin C. Results. Mean intakes and serum levels of vitamin C were normal; however, vitamin C deficiency and depletion were common (occurring among 5%–17% and 13%–23% of respondents, respectively). Smokers, those who did not use supplements, and non-Hispanic Black males had elevated risks of vitamin C deficiency, while Mexican Americans had lower risks. Conclusions. Health professionals should recommend consumption of vegetables and fruits rich in vitamin C and should recommend supplementation for individuals at risk of vitamin C deficiency.
Measuring the Prevalence of Overweight in Texas Schoolchildren
Authors: Hoelscher Deanna M. , Day R. Sue , Lee Eun Sul , Frankowski Ralph F. , Kelder Steven H. , Ward Jerri L. , Scheurer Michael E. 
Published: December 2008

Objectives. We describe results from year 1 of a surveillance system to monitor body mass index in children at the state level. Methods. A sample of 6630 children attending Texas public schools, weighted to represent 4th, 8th, and 11th grades within race/ethnic subpopulations, was assessed. Body mass index was calculated from measured height and weight; demographic information was obtained from a questionnaire. Results. Prevalence of overweight was 22.4%, 19.2%, and 15.5% for 4th-, 8th-, and 11th-grade students, respectively. Overweight prevalence was highest among Hispanic boys (29.5%–32.6%), fourth-grade Hispanic girls (26.7%), and fourth- and eighth-grade African American girls (30.8% and 23.1%, respectively). Eleventh-grade White/other girls had the lowest prevalence of overweight (5.5%). Conclusions. These data confirm the increasing prevalence of overweight among US children, especially among Hispanic and African American students compared to White/other students and fourth-grade students relative to 8th- and 11th-grade students.
Availability and Perceived Effectiveness of Public Health Activities in the Nation’s Most Populous Communities
Authors: Mays Glen P. , Halverson Paul K. , Baker Edward L. , Stevens Rachel , Vann Julie J. 
Published: December 2008

Objectives. We examined the availability and perceived effectiveness of 20 basic public health activities in the communities where most Americans reside. Methods. A self-administered questionnaire was mailed to the 497 directors of US local health departments serving at least 100 000 residents. Results. On average, two thirds of the 20 public health activities were performed in the local jurisdictions surveyed, and the perceived effectiveness rating averaged 35% of the maximum possible. In multivariate models, availability of public health activities varied significantly according to population size, socioeconomic measures, local health department spending, and presence of local boards of health. Conclusions. Local public health capacity varies widely across the nation’s most populous communities, highlighting the need for targeted improvement efforts.
All-Cause and Cause-Specific Mortality by Socioeconomic Status Among Employed Persons in 27 US States, 1984–1997
Authors: Steenland Kyle , Hu Sherry , Walker James 
Published: December 2008

Objectives. We investigated mortality differences according to socioeconomic status (SES) for employed persons in 27 states during 1984–1997. Methods. SES was determined for persons aged 35–64 years according to the “usual occupation” listed on their death certificates. We used US Census denominator data. Results. For all-cause mortality, rate ratios from lowest to highest SES quartile for men and women were 2.02, 1.69, 1.25, and 1.00 and 1.29, 1.01, 1.07, and 1.00, respectively. Percentage of all deaths attributable to being in the lowest 3 SES quartiles was 27%. Inverse SES gradients were strong for most major causes of death except breast cancer and colorectal cancer. Heart disease mortality for highest and lowest SES quartiles dropped 45% and 25%, respectively, between 1984 and 1997. Conclusions. Mortality differences by SES were sustained through the 1990s and are increasing for men.
What Patients Expect From Complementary Therapy: A Qualitative Study
Authors: Richardson Janet 
Published: December 2008

Objectives. Complementary and alternative therapies have become popular with patients in Western countries. Studies have suggested motivations for patients’ choosing a wide range of complementary therapies. Data on the expectations of patients who use complementary therapy are limited. We assessed the expectations of patients who use complementary therapy. Methods. Patients attending a British National Health Service (NHS) outpatient department that provided acupuncture, osteopathy, and homoeopathy were asked to complete a qualitative survey. Results. Patients expected symptom relief, information, a holistic approach, improved quality of life, self-help advice, and wide availability of such therapies on the NHS. Conclusions. Physicians’ understanding of patients’ expectations of complementary therapies will help patients make appropriate and realistic treatment choices.
Getting the Science Right and Doing the Right Science in Vaccine Safety
Authors: Bernier Roger , Midthun Karen 
Published: December 2008

Because of the potential for conflicts of interest, Salmon et al. propose in this issue the creation of an independent vaccine safety board to assume responsibility for assessing the safety of licensed vaccines. We believe that the current system at the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) facilitates needed interactions between those involved in risk assessment and risk management, provides substantial safeguards against conflicts of interest, and results in sound decisions. The CDC, given its role in promoting immunization, may be perceived to have a greater potential conflict and plans to review its vaccine safety activities. Both agencies recognize the importance of transparency in considering vaccine safety and welcome the opportunity to work with the public and the medical community to improve the quality of scientific information and decisionmaking.
The Standard of Care Debate: Can Research in Developing Countries Be Both Ethical and Responsive to Those Countries’ Health Needs?
Authors: Wendler David , Emanuel Ezekiel J. , Lie Reidar K. 
Published: December 2008

To avoid exploitaiton of host communities, many commentators argue that subjects must receive the best methods available worldwide. Others worry that this requirement may block important research intended to improve health care, especially in developing countries. To resolve this dilemma, we propose a framework for the conditions under which it is acceptable to provide subjects with less than the best methods. Specifically, institutional review boards should assume a default of requiring the “worldwide best” methods, meaning the best methods available anywhere in the world, in all cases. However, institutional review boards should be willing to grant exceptions to this default for research studies that satisfy the following 4 conditions: (1) scientific necessity, (2) relevance for the host community, (3) sufficient host community benefit, and (4) subject and host community nonmaleficence.
A Middle School Immunization Law Rapidly and Substantially Increases Immunization Coverage Among Adolescents
Authors: Averhoff Francisco , Linton Leslie , Peddecord K. Michael , Edwards Christine , Wang Wendy , Fishbein Daniel 
Published: December 2008

Objectives. This study assessed the effectiveness of a middle school vaccination requirement for raising second-dose measles, mumps, and rubella vaccine and hepatitis B vaccine coverage among adolescents. Methods. Random-digit-dialed telephone surveys were conducted before (1998) and after (1999) the implementation of a vaccination requirement for entry into the seventh grade in San Diego, Calif. Results. Vaccination coverage was higher among children subject to the vaccination requirement (seventh-grade students; 60%) than among fifth- and sixth-grade students 1 year before the requirement (13%, P < .001), and 8th- through 12th-grade students not subject to the requirement (27%, P < .0001). Conclusions. Middle school–entry vaccination requirements can rapidly and substantially raise vaccination coverage among students subject to the law.
Hepatitis A Incidence and Hepatitis A Vaccination Among American Indians and Alaska Natives, 1990–2001
Authors: Bialek Stephanie R. , Thoroughman Douglas A. , Hu Diana , Simard Edgar P. , Chattin Jody , Cheek Jim , Bell Beth P. 
Published: December 2008

Objectives. We assessed the effect on trends in hepatitis A incidence of the 1996 recommendation for routine hepatitis A vaccination of American Indian/Alaska Native (AIAN) children. Methods. We examined trends in hepatitis A incidence among AIAN peoples during 1990–2001 and vaccination coverage levels among children on the largest American Indian reservation. Results. Hepatitis A rates among AIANs declined 20-fold during 1997–2001. Declines in hepatitis A incidence occurred among AIANs in reservation and metropolitan areas. Among 1956 children living on the Navajo Nation whose medical records were reviewed, 1508 (77.1%) had received at least one dose of hepatitis A vaccine, and 1020 (52.1%) had completed the vaccine series. Conclusions. Hepatitis A rates among AIAN peoples have declined dramatically coincident with implementation of routine hepatitis A vaccination of AIAN children.