bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Contribution of Expanding Portion Sizes to the US Obesity Epidemic
Authors: Young Lisa R. , Nestle Marion 
Published: December 2008

Objectives. Because larger food portions could be contributing to the increasing prevalence of overweight and obesity, this study was designed to weigh samples of marketplace foods, identify historical changes in the sizes of those foods, and compare current portions with federal standards. Methods. We obtained information about current portions from manufacturers or from direct weighing; we obtained information about past portions from manufacturers or contemporary publications. Results. Marketplace food portions have increased in size and now exceed federal standards. Portion sizes began to grow in the 1970s, rose sharply in the 1980s, and have continued in parallel with increasing body weights. Conclusions. Because energy content increases with portion size, educational and other public health efforts to address obesity should focus on the need for people to consume smaller portions.
Childhood Vaccination Providers in the United States
Authors: LeBaron Charles W. , Lyons Bridget , Massoudi Mehran , Stevenson John 
Published: December 2008

Objectives. This study sought to provide a characterization of US childhood vaccination providers. Methods. The state was used as the analytic unit in examining 1997 data from the National Immunization Survey and the Vaccines for Children program, state immunization reports, and natality records. Results. Overall, 57% of children were vaccinated in the private sector, 18% were vaccinated in the public sector, and 25% were vaccinated by a mixture of providers. Of the 50 883 immunization sites, 81% were private and 19% public. Average patient load was 77 infants per site. Private-sector patient loads were lower than public-sector loads. Conclusions. US childhood vaccination provider capacity is adequate. Efforts to raise coverage rates should focus on increasing preventive care use among children, improving the vaccination performance of providers, and ensuring continuity of care.
Recognition of Osteoporosis by Primary Care Physicians
Authors: Gehlbach Stephen H. , Fournier Maureen , Bigelow Carol 
Published: December 2008

Objectives. This study explored the recognition and treatment of osteoporosis and vertebral fracture among older women by primary care physicians. Methods. Data from the National Ambulatory Medical Care Survey from 1993 to 1997 were examined for evidence of diagnosis and treatment of osteoporosis or vertebral fracture during visits by White women 60 years and older to primary care physicians. Results. Fewer than 2% of the women received diagnoses of osteoporosis or vertebral fracture, although expected prevalence is 20% to 30%. Appropriate drug treatment, including antiresorptive agents and calcium and vitamin D, was offered to only 36% of the diagnosed patients. Conclusions. Few cases of osteoporosis or vertebral fracture in older women are being diagnosed and treated by primary care physicians.
Unrecognized HIV Infection Among Patients Attending Sexually Transmitted Disease Clinics
Authors: Weinstock Hillard , Dale Monica , Linley Laurie , Gwinn Marta 
Published: December 2008

Objectives. This study examined voluntary HIV testing rates in sexually transmitted disease (STD) clinics. Methods. Anonymous, unlinked surveys of HIV seroprevalence and medical chart abstractions were conducted in 28 STD clinics in 14 US cities in 1997. Results. Among the 52 260 patients included in the anonymous HIV serosurveys, voluntary HIV testing rates by clinic ranged from 30% to 99% (median = 58%). Patients not tested were more likely to be HIV infected than were patients who were tested, even after those with documented HIV infection were excluded, regardless of demographic characteristics, risk group, or STD diagnosis. Conclusions. HIV infection is unrecognized in substantial numbers of patients with HIV infection visiting STD clinics. Efforts are needed to increase HIV testing and counseling of all patients visiting these clinics.
Effects of Iron Supplementation on Maternal Hematologic Status in Pregnancy
Authors: Sloan Nancy L. , Jordan Elizabeth , Winikoff Beverly 
Published: December 2008

Objectives. Prenatal iron supplementation has been the standard recommendation for reducing maternal anemia in developing countries for the past 30 years. This article reviews the efficacy of iron supplementation on hemoglobin levels in pregnant women in developing countries. Methods. Data from randomized controlled trials published between 1966 and 1998 were pooled. Meta-analyses of the relative change in maternal hemoglobin associated with iron supplementation were stratified by initial hemoglobin levels, duration of supplementation, and daily gestational supplement dose and supplementation with other nutrients. Results. Iron supplementation raises hemoglobin levels. Its effects are dose dependent and are related to initial hematologic status. The extent to which iron supplementation can reduce maternal anemia is unclear. Conclusions. The extent to which maternal hemoglobin levels can be increased by recommended prenatal supplementation is limited and has uncertain physiological benefits. Other approaches, including food fortification and prevention and treatment of other causes of anemia, require methodologically rigorous evaluation to find effective answers to this global problem.
The Global HIV/AIDS Pandemic, Structural Inequalities, and the Politics of International Health
Authors: Parker Richard 
Published: December 2008

In spite of recent advances in treatment and care available in most developed countries, the HIV/AIDS pandemic continues to spread throughout the developing world. Structural inequalities continue to fuel the epidemic in all societies, and HIV infection has increasingly been concentrated in the poorest, most marginalized sectors of society in all countries. The relationship between HIV/AIDS and social and economic development has therefore become a central point in policy discussions about the most effective responses to the epidemic. Important progress has been made in recent United Nations initiatives. Maintaining long-term commitment to initiatives such as the Global Fund to Fight AIDS, Tuberculosis and Malaria is especially important in the wake of September 11 and ensuing events, which threaten to redirect necessary resources to seemingly more urgent security concerns.
HIV-Related Stigma and Knowledge in the United States: Prevalence and Trends, 1991–1999
Authors: Herek Gregory M. , Capitanio John P. , Widaman Keith F. 
Published: December 2008

Objectives. This study assessed the prevalence of AIDS stigma and misinformation about HIV transmission in 1997 and 1999 and examined trends in stigma in the United States during the 1990s. Methods. Telephone surveys with national probability samples of English-speaking adults were conducted in the period 1996 to 1997 (n = 1309) and in 1998 to 1999 (n = 669). Findings were compared with results from a similar 1991 survey. Results. Overt expressions of stigma declined throughout the 1990s, with support for its most extreme and coercive forms (e.g., quarantine) at very low levels by 1999. However, inaccurate beliefs about the risks posed by casual social contact increased, as did the belief that people with AIDS (PWAs) deserve their illness. In 1999, approximately one third of respondents expressed discomfort and negative feelings toward PWAs. Conclusions. Although support for extremely punitive policies toward PWAs has declined, AIDS remains a stigmatized condition in the United States. The persistence of discomfort with PWAs, blame directed at PWAs for their condition, and misapprehensions about casual social contact are cause for continuing concern and should be addressed in HIV prevention and education programs. (Am J Public Health. 2002;92:371–377)
Changes in HIV Seroprevalence and Related Behaviors Among Male Injection Drug Users Who Do and Do Not Have Sex With Men: New York City, 1990–1999
Authors: Maslow Carey B. , Friedman Samuel R. , Perlis Theresa E. , Rockwell Russell , Des Jarlais Don C. 
Published: December 2008

Objectives. This study examined HIV prevalence and risk behaviors among male injection drug users (IDUs) who have sex with men and among other male IDUs. Methods. Male IDUs were interviewed and tested for HIV at a detoxification clinic during 1990 to 1994 and 1995 to 1999. Analyses compared male IDUs who do and do not have sex with men within and between periods. Results. Initially, HIV seroprevalence and risk behaviors were higher among IDUs who have sex with men. Seroprevalence (initially 60.5% vs 48.3%) declined approximately 15% in both groups, remaining higher among those who have sex with men. Generally, injection prevalence, but not sexual risk behaviors, declined. Conclusions. Male IDUs who have sex with men are more likely to engage in higher-risk behaviors and to be HIV infected. Improved intervention approaches for male IDUs who have sex with men are needed. (Am J Public Health. 2002;92:382–384)
Age-Specific Seroprevalence of HIV, Hepatitis B Virus, and Hepatitis C Virus Infection Among Injection Drug Users Admitted to Drug Treatment in 6 US Cities
Authors: Murrill Christopher S. , Weeks Howard , Castrucci Brian C. , Weinstock Hillard S. , Bell Beth P. , Spruill Catherine , Gwinn Marta 
Published: December 2008

Objectives. This study measured age-specific seroprevalence of HIV, hepatitis B virus, and hepatitis C virus (HCV) infection among injection drug users (IDUs) admitted to drug treatment programs in 6 US cities. Methods. Remnant sera collected from persons entering treatment with a history of illicit drug injection were tested for antibodies to HIV, hepatitis C (anti-HCV), and hepatitis B core antigen (anti-HBc). Results. Prevalence of anti-HBc and anti-HCV increased with age and reached 80% to 100% among older IDUs in all 6 cities. Although overall age-specific HIV prevalence was lower than anti-HCV or anti-HBc, this prevalence was greater in the Northeast than in the Midwest and West. Conclusions. The need continues for effective primary prevention programs among IDUs specifically targeting young persons who have recently started to inject drugs. (Am J Public Health. 2002;92:385–387)
When the Caregiver Needs Care: The Plight of Vulnerable Caregivers
Authors: Navaie-Waliser Maryam , Feldman Penny H. , Gould David A. , Levine Carol , Kuerbis Alexis N. , Donelan Karen 
Published: December 2008

Objectives. This study examined the characteristics, activities, and challenges of high-risk informal caregivers. Methods. Telephone interviews were conducted with a nationally representative cross-section of 1002 informal caregivers. Vulnerable caregivers with poor health or a serious health condition were compared with nonvulnerable caregivers. Results. Thirty-six percent of caregivers were vulnerable. Compared with nonvulnerable caregivers, vulnerable caregivers were more likely to have difficulty providing care, to provide higher-intensity care, to report that their physical health had suffered since becoming a caregiver, to be aged 65 years or older, to be married, and to have less than 12 years of education. Conclusions. Reliance on informal caregivers without considering the caregiver's ability to provide care can create a stressful and potentially unsafe environment for the caregiver and the care recipient.
Spatial Variability in Toxicity Indicators Used to Rank Chemical Risks
Authors: Cutter Susan L. , Scott Michael S. , Hill Arleen A. 
Published: December 2008

Objectives. This study used 6 different measures of toxicity to explore spatial and statistical variations in relative risk indicators of Toxic Release Inventory emissions. Methods. Statistical and spatial correlations between the 6 indices were computed for individual South Carolina facilities. Results. Although the 6 toxicity indices are not highly correlated in theory, they have more commonality in practice. There was significant spatial variation in the indices by individual facility level. Conclusions. Environmental justice researchers must be cognizant of differences in toxicity indices because the choice of the toxicity measure can alter (statistically and spatially) the results of equity analyses and lead to erroneous conclusions. (Am J Public Health. 2002;92:420-422)
Effect on Smoking Cessation of Switching Nicotine Replacement Therapy to Over-the-Counter Status
Authors: Thorndike Anne N. , Biener Lois , Rigotti Nancy A. 
Published: December 2008

Objectives. This study examined whether the change in nicotine replacement therapy sales from prescription to over the counter (OTC) status affected smoking cessation. Methods. We used the 1993–1999 Massachusetts Tobacco Surveys to compare data from adult current smokers and recent quitters before and after the OTC switch. Results. No significant change over time occurred in the proportion of smokers who used nicotine replacement therapy at a quit attempt in the past year (20.1% pre-OTC vs 21.4% post-OTC), made a quit attempt in the past year (48.1% vs 45.2%), or quit smoking in the past year (8.1% vs 11.1%). Fewer non-Whites used nicotine replacement therapy after the switch (20.7% pre-OTC vs 3.2% post-OTC, P = .002), but the proportion of Whites using nicotine replacement therapy did not change significantly (20.6% vs 24.0%). Conclusions. We observed no increase in Massachusetts smokers' rates of using nicotine replacement therapy, making a quit attempt, or stopping smoking after nicotine replacement therapy became available for OTC sale. There appear to be other barriers to the use of nicotine replacement therapy besides visiting a physician, especially among minority smokers. (Am J Public Health. 2002;92:437–442)
Reconceptualizing Native Women's Health: An “Indigenist” Stress-Coping Model
Authors: Walters Karina L. , Simoni Jane M. 
Published: December 2008

This commentary presents an “indigenist” model of Native women's health, a stress-coping paradigm that situates Native women's health within the larger context of their status as a colonized people. The model is grounded in empirical evidence that traumas such as the “soul wound” of historical and contemporary discrimination among Native women influence health and mental health outcomes. The preliminary model also incorporates cultural resilience, including as moderators identity, enculturation, spiritual coping, and traditional healing practices. Current epidemiological data on Native women's general health and mental health are reconsidered within the framework of this model.
Public Health Needs and Scientific Opportunities in Research on Latinas
Authors: Amaro Hortensia , de la Torre Adela 
Published: December 2008

Much of the research on women's health has not deepened our understanding of health issues affecting Latinas. Yet integration of research on Latinas into the women's health agenda is important for at least 2 reasons. First, critical public health issues facing Latinas must be better understood if effective interventions designed to eliminate racial and ethnic disparities in health are to be developed and implemented. Second, studies on the health of Latinas represent unique opportunities to advance scientific understandings of underlying processes relevant to the health of other populations. Such research can further our knowledge of the processes underlying cultural adaptation and negotiation of changing sex roles and how these issues affect the health of women. Critical research and empirical approaches that help us to understand how race, ethnicity, sex, and class shape the health of Latinas will inform broader public health issues.
Spirituality and Health for Women of Color
Authors: Musgrave Catherine F. , Allen Carol Easley , Allen Gregory J. 
Published: December 2008

Spirituality among African American and Hispanic women has been associated with a variety of positive health outcomes. The purposes of this commentary are (1) to define spirituality, comparing it with religiosity, and briefly examine the historical, cultural, and contextual roots of spirituality among women of color; (2) to explore research data that support a relationship between spirituality and health, particularly among women of color; and (3) to present several examples of how spirituality may enhance public health interventions designed to promote health and prevention.
Relation Between Racial Discrimination, Social Class, and Health Among Ethnic Minority Groups
Authors: Karlsen Saffron , Nazroo James Y. 
Published: December 2008

Objectives. This study explored associations between racism, social class, and health among ethnic minority people in England and Wales. Methods. We conducted a series of regression analyses on cross-sectional data from the Fourth National Survey of Ethnic Minorities to explore the relation between different indicators of racism and health and household occupational class. Results. Marked independent associations existed between reported experience of racism and perceptions of Britain as a “racist society,” household social class, age, sex, and various mental and physical health indicators. These associations showed reasonable consistency across the different ethnic groups. Conclusions. The different ways in which racism may manifest itself (as interpersonal violence, institutional discrimination, or socioeconomic disadvantage) all have independent detrimental effects on health, regardless of the health indicator used.
HIV-Associated Histories, Perceptions, and Practices Among Low-Income African American Women: Does Rural Residence Matter?
Authors: Crosby Richard A. , Yarber William L. , DiClemente Ralph J. , Wingood Gina M. , Meyerson Beth 
Published: December 2008

Objectives. This study compared HIV-associated sexual health history, risk perceptions, and sexual risk behaviors of low-income rural and nonrural African American women. Methods. A cross-sectional statewide survey of African American women (n = 571) attending federally funded Special Supplemental Nutrition Program for Women, Infants, and Children clinics was conducted. Results. Adjusted analyses indicated that rural women were more likely to report not being counseled about HIV during pregnancy (P = .001), that a sex partner had not been tested for HIV (P = .005), no preferred method of prevention because they did not worry about sexually transmitted diseases (P = .02), not using condoms (P = .009), and a belief that their partner was HIV negative, despite lack of testing (P = .04). Conclusions. This study provided initial evidence that low-income rural African American women are an important population for HIV prevention programs.
Does a History of Trauma Contribute to HIV Risk for Women of Color? Implications for Prevention and Policy
Authors: Wyatt Gail E. , Myers Hector F. , Williams John K. , Kitchen Christina Ramirez , Loeb Tamra , Carmona Jennifer Vargas , Wyatt Lacey E. , Chin Dorothy , Presley Nicole 
Published: December 2008

Objectives. We investigated history of abuse and other HIV-related risk factors in a community sample of 490 HIV-positive and HIV-negative African American, European American, and Latina women. Methods. Baseline interviews were analyzed, and logistic regressions were used to identify predictors of risk for positive HIV serostatus overall and by racial/ethnic group. Results. Race/ethnicity was not an independent predictor of HIV-related risk, and few racial/ethnic differences in risk factors for HIV were seen. Regardless of race/ethnicity, HIV-positive women had more sexual partners, more sexually transmitted diseases, and more severe histories of abuse than did HIV-negative women. Trauma history was a general risk factor for women, irrespective of race/ethnicity. Conclusions. Limited material resources, exposure to violence, and high-risk sexual behaviors were the best predictors of HIV risk.
The Anthrax Vaccine Program: An Analysis of the CDC's Recommendations for Vaccine Use
Authors: Nass Meryl 
Published: December 2008

The anthrax vaccine was never proved to be safe and effective. It is one cause of Gulf War illnesses, and recent vaccinees report symptoms resembling Gulf War illnesses. The vaccine's production has been substandard. Without adequate evaluation, the Food and Drug Administration recently approved (retrospectively) significant changes made to the vaccine's composition since 1990. The vaccine's mandatory use for inhalation anthrax is “off-label.” A skewed review of the vaccine literature by the Centers for Disease Control and Prevention (CDC) led to remunerative collaborative research with the army, involving civilian volunteers. Despite acknowledging possible fetal harm, the CDC offered the vaccine to children and pregnant women. New trends could weaken prelicensure efficacy and safety review of medical products intended for biodefense and avoid manufacturer liability for their use.
Rethinking McKeown: The Relationship Between Public Health and Social Change
Authors: Szreter Simon 
Published: December 2008

Thomas McKeown was a rhetorically powerful critic, from the inside, of the medical profession's mid-20th-century love affair with curative and scientific medicine. He emphasized instead the importance of economic growth, rising living standards, and improved nutrition as the primary sources of most historical improvements in the health of developed nations. This interpretation failed to emphasize the simultaneous historical importance of an accompanying redistributive social philosophy and practical politics, which has characterized the public health movement from its 19th-century origins. Consequently, the current generation of public health practitioners are having to reconstruct such a politics and practice following its virtual dismantlement during the last 2 decades of the 20th century.
Making Better Babies: Public Health and Race Betterment in Indiana, 1920–1935
Authors: Stern Alexandra Minna 
Published: December 2008

In 1920, Indiana's Division of Infant and Child Hygiene inaugurated its first Better Babies Contest at the state fair. For the next 12 years, these contests were the centerpiece of a dynamic infant and maternal welfare program that took shape in Indiana during the decade of the federal Sheppard–Towner act. More than just a lively spectacle for fairgoers, these contests brought public health, “race betterment,” and animal breeding together in a unique manner. This article describes one of the most popular expressions of public health and race betterment in rural America. It also raises questions about the intersections between hereditarian and medical conceptions of human improvement during the early 20th century, especially with respect to child breeding and rearing.
Challenges Faced by Homeless Sexual Minorities: Comparison of Gay, Lesbian, Bisexual, and Transgender Homeless Adolescents With Their Heterosexual Counterparts
Authors: Cochran Bryan N. , Stewart Angela J. , Ginzler Joshua A. , Cauce Ana Mari 
Published: December 2008

Objectives. The goal of this study was to identify differences between gay, lesbian, bisexual, and transgender (GLBT) homeless youths and their heterosexual counterparts in terms of physical and mental health difficulties. Methods. A sample of 84 GLBT adolescents was matched in regard to age and self-reported gender with 84 heterosexual adolescents. The 2 samples were compared on a variety of psychosocial variables. Results. GLBT adolescents left home more frequently, were victimized more often, used highly addictive substances more frequently, had higher rates of psychopathology, and had more sexual partners than heterosexual adolescents. Conclusions. Homeless youths who identify themselves as members of sexual minority groups are at increased risk for negative outcomes. Recommendations for treatment programs and implications for public health are discussed.