bluuebunny/crossref_metadata_2025_split huggingface dataset:
Giving Everyone the Health of the Educated: An Examination of Whether Social Change Would Save More Lives Than Medical Advances
Authors: Woolf Steven H. , Johnson Robert E. , Phillips Robert L. , Philipsen Maike 
Published: March 2007

Objectives. Social determinants of health, such as inadequate education, contribute greatly to mortality rates. We examined whether correcting the social conditions that account for excess deaths among individuals with inadequate education might save more lives than medical advances (e.g., new drugs and devices). Methods. Using US vital statistics data for 1996 through 2002, we applied indirect standardization techniques to estimate the maximum number of averted deaths attributable to medical advances and the number of deaths that would have been averted if mortality rates among adults with lesser education had been the same as those among college-educated adults. Results. Medical advances averted a maximum of 178193 deaths during the study period. Correcting disparities in education-associated mortality rates would have saved 1369335 lives during the same period, a ratio of 8:1. Conclusions. Higher mortality rates among individuals with inadequate education reflect a complex causal pathway and the influence of confounding variables. Formidable efforts at social change would be necessary to eliminate disparities, but the changes would save more lives than would society’s current heavy investment in medical advances. Spending large sums of money on such advances at the expense of social change may be jeopardizing public health.
Firearm Injuries: Epidemic Then, Endemic Now
Authors: Christoffel Katherine Kaufer 
Published: March 2007

There has been a transition in US firearm injuries from an epidemic phase (mid-1980s to early 1990s) to an endemic one (since the mid-1990s). Endemic US firearm injuries merit public health attention because they exact an ongoing toll, may give rise to new epidemic outbreaks, and can foster firearm injuries in other parts of the world. The endemic period is a good time for the development of ongoing prevention approaches, including assessment and monitoring of local risk factors over time and application of proven measures to reduce these risk factors, development of means to address changing circumstances, and ongoing professional and public education designed to weave firearm injury prevention into the fabric of public health work and everyday life.
Effective Lay Health Worker Outreach and Media-Based Education for Promoting Cervical Cancer Screening Among Vietnamese American Women
Authors: Mock Jeremiah , McPhee Stephen J. , Nguyen Thoa , Wong Ching , Doan Hiep , Lai Ky Q. , Nguyen Kim H. , Nguyen Tung T. , Bui-Tong Ngoc 
Published: March 2007

Objectives. We sought to promote cervical cancer screening among Vietnamese American women in Santa Clara County, Calif. Methods. In 2001–2004, we recruited and randomized 1005 Vietnamese American women into 2 groups: lay health worker outreach plus media-based education (combined intervention) or media-based education only. Lay health workers met with the combined intervention group twice over 3 to 4 months to promote Papanicolaou (Pap) testing. We used questionnaires to measure changes in awareness, knowledge, and Pap testing. Results. Testing increased among women in both the combined intervention (65.8% to 81.8%; P<.001) and media-only (70.1% to 75.5%; P<.001) groups, but significantly more in the combined intervention group (P=.001). Among women never previously screened, significantly more women in the combined intervention group (46.0%) than in the media-only group (27.1%) obtained tests (P<.001). Significantly more women in the combined intervention group obtained their first Pap test or obtained one after an interval of more than 1 year (became up-to-date; 45.7% to 67.3%, respectively; P<.001) than did those in the media-only group (50.9% to 55.7%, respectively; P=.035). Conclusions. Combined intervention motivated more Vietnamese American women to obtain their first Pap tests and to become up-to-date than did media education alone.
Dentists’ Management of the Diabetic Patient: Contrasting Generalists and Specialists
Authors: Kunzel Carol , Lalla Evanthia , Lamster Ira 
Published: March 2007

Objectives. We measured and contrasted general dentists’ and periodontists’ involvement in 3 areas of managing diabetic patients—assessment of health status, discussion of pertinent issues, and active management of patients—and identified and contrasted predictors of active management of diabetic patients. Methods. We conducted a cross-sectional mail survey of random samples of general dentists and periodontists in the northeastern United States during fall 2002, using lists from the 2001 American Dental Directory and the 2002 American Academy of Periodontology Directory. Responses were received from 105 of 132 eligible general dentists (response rate=80%) and from 103 of 142 eligible periodontists (response rate=73%). Results. Confidence, involvement with colleagues and medical experts, and professional responsibility were influential predictors of active management for periodontists (R2=0.46, P<.001). Variables pertaining to patient relations were significant predictors for general dentists (R2=0.55, P<.001). Conclusions. Our findings permitted us to assess and compare general dentists’ and periodontists’ behavior in 3 realms—assessment of diabetic patients’ health status, discussion of pertinent issues, and active management of diabetic patients—and to identify components of potentially effective targeted interventions aimed at increasing specialists’ and generalist dentists’ involvement in the active management of diabetic patients.
The Role of Genetics in the Provision of Essential Public Health Services
Authors: Wang Grace , Watts Carolyn 
Published: March 2007

States include genetics services among their public health programs, but budget shortfalls raise the question, is genetics an essential part of public health? We used the Essential Services of Public Health consensus statement and data from state genetics plans to analyze states’ public health genetics programs. Public health genetics programs fulfill public health obligations: birth defects surveillance and prevention programs protect against environmental hazards, newborn screening programs prevent injuries, and clinical genetics programs ensure the quality and accessibility of health services. These programs fulfill obligations by providing 4 essential public health services, and they could direct future efforts toward privacy policies, research on communications, and rigorous evaluations.
Patient Confidentiality in the Research Use of Clinical Medical Databases
Authors: Krishna Rajeev , Kelleher Kelly , Stahlberg Eric 
Published: March 2007

Electronic medical record keeping has led to increased interest in analyzing historical patient data to improve care delivery. Such research use of patient data, however, raises concerns about confidentiality and institutional liability. Institutional review boards must balance patient data security with a researcher’s ability to explore potentially important clinical relationships. We considered the issues involved when patient records from health care institutions are used in medical research. We also explored current regulations on patient confidentiality, the need for identifying information in research, and the effectiveness of deidentification and data security. We will present an algorithm for researchers to use to think about the data security needs of their research, and we will introduce a vocabulary for documenting these techniques in proposals and publications.
Effects on Outpatient and Emergency Mental Health Care of Strict Medicaid Early Periodic Screening, Diagnosis, and Treatment Enforcement
Authors: Snowden Lonnie R. , Masland Mary C. , Wallace Neal T. , Evans-Cuellar Allison 
Published: March 2007

We investigated enforcement of mental health benefits provided by California Medicaid’s Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Enforcement, compelled by a consumer-driven lawsuit, resulted in an almost 4-fold funding increase over a 5-year period. We evaluated the impact of enforcement on outpatient treatment intensity (number of visits per child) and rates of emergency care treatment. Using fixed-effects regression, we examined the number of outpatient mental health visits per client and the percentage of all clients using crisis care across 53 autonomous California county mental health plans over 32 three-month periods (quarters; emergency crisis care rates) and 36 quarters (out-patient mental health visits). Enforcement of EPSDT benefits in accordance with federal law produced favorable changes in patterns of mental health service use, consistent with policy aims.
Neurobiology and Pharmacotherapy of Obsessive‐Compulsive Disorder
Authors: Rapoport Judith L. , Inoff‐Germain Gale 
Published: March 2007

Abstract
Obsessive‐compulsive disorder (OCD) is characterized by the presence of unwanted, senseless, intrusive and distressing thoughts, urges and images (obsessions) and/or repetitive behaviors (compulsions). While classified as an anxiety disorder in DSM‐IV, OCD is given a separate chapter here as the clinical phenomenology, drug treatment response, family studies, and brain imaging data support a separate neurobiological classification for this disorder and a distinct neuropharmacologic profile as well. Our current understanding of its underlying neurobiology as well as the state of treatment for OCD is provided through a selective review of OCD‐related (1) brain imaging studies, (2) genetic studies, (3) animal models, (4) psychopharmacology, including immunomodulatory treatment, and (5) experimental non‐pharmacological treatments such as neurosurgery, transcranial magnetic stimulation, and deep brain stimulation.
Opiates and Addiction
Authors: Vocci Frank J. 
Published: March 2007

Abstract
Abuse of and dependence on opiates is associated with significant morbidity and mortality. It is a worldwide problem, with millions of people directly involved. In addition to the risks posed with the abusc of opiates, the common practice of injection drug use (and to a lesser extent, sexual relationships with injection drug users), results in significant risk of contracting Acquired Immune Deficiency Syndrome and Hepatitis C infections. l the past 10 years, the abuse pattern of opiates in the United States has changed in two ways: the heroin purity has increasing, facilitating use by the intranasal and pulmonary routes, and abuse of prescription opiates has increased. More adolescents are abusing opiates, resulting in a greater need for treatment. Prescription opiate abusers primarily use the oral route of administration but about one in eight moves onto injection practices. The geographic distribution of abuse suggests that the greatest problem with abuse of prescription opiates is in nonmetropolitan areas, forming a new challenge for the treatment system. Responses to increased treatment demands in the United States can be met by the newest pharmacotherapies, buprenorphine (SUBUTEX) and buprenorphinelnaloxone (SUBOXONE), which can be prescribed by qualified physicians. Additionally, the increased use of methadone in “office‐based practice” would be a second approach to increase treatment capacity. Finally, non‐opiate medications are the current focus ofresearch in the management of opiate abuse and dependence disorders. These medications could be used as both adjuncts to agonist pharmacothcorapy or as “stand alone” therapies.
Function and Pharmacology of Circadian Clocks
Authors: Lundkvist Gabriella B. , Block Gene D. 
Published: March 2007

Abstract

Biological timing systems are complex structures in higher organisms, generating biological and physiological functions with a periodicity of approximately 24 h. Knowledge of the structure and function of biological clocks has emerged from research on both invertebrate and vertebrate models. In humans, the master clock is located in the hypothalamus in the brain. Daily rhythms such as the sleep–wake cycle and hormonal rhythms can be modulated and disturbed by a number of pharmacological compounds. Drug therapy can be administered in a circadian fashion (
chronopharmacology
), thus taking into account the powerful circadian impact on drug toxicity and efficacy. This review will describe circadian systems and pharmacological impact on the timing structures.
Hypocretin/Orexin System
Authors: Sutcliffe J. Gregor , de Lecea Luis 
Published: March 2007

Abstract
The hypocretins (also called the orexins) are excitatory neurotransmitters produced in a few thousand neurons of the lateral hypothalamus. Two G protein‐coupled receptors for the hypocretins have different distributions within the CNS and differential affinities for the two hypocretin peptides. Hypocretins efferents project to areas within the posterior hypothalamus that are implicated in feeding behaviors and hormone secretion. Hypocretin fibers also project to diverse targets in other brain regions and the spinal cord, including several areas implicated in cardiovascular function and sleep‐wake regulation. Administration of the hypocretins stimulates food intake, affects blood pressure, hormone secretion and locomotor activity, and increases wakefulness while suppressing rapid eye movement (REM) sleep. Narcolepsy is a disorder of the hypocretin system. One aspect of hypocretin activity is the direct excitation of cholinergic forebrain neurons, brainstem monoaminergic REM‐off neurons in the locus coeruleus and dorsal raphe nucleus, and histaminergic tuberomammillary nucleus, which together suppress slow‐wave sleep. The hypocretins also modulate the activity of cholinergic REM‐on neurons in the brainstem, which gate REM entry.
Pharmacology of Inflammation
Authors: Espejo Carmen , Martin Roland 
Published: March 2007

Abstract
Inflammatory reactions in the central nervous systems (CNS), that is neuroinflammation, are involved in a number of acute and chronic pathological conditions ranging from stroke to multiple sclerosis and chronic neurodegenerative processes such as Alzheimer's disease. The CNS is considered an immunoprivileged site and differs in many aspects from peripheral tissues with respect to accessibility for immune cells and humoral factors, local antigen presenting cells and biological characteristics of resident cells such as neurons and glia. As a result, neuroinflammation, particularly when it runs a chronic course, differs in numerous aspects from such processes outside the brain. Besides the involvement of neuroinflammation in CNS tissue damage, inflammatory processes may also be beneficial for tissue repair. Here, we describe the factors contributing to the CNS immune privilege, the cellular and humor components that participate in neuroinflammation, the interactions between immune system and CNS, and focus on the pharmacological strategies to treat neuroinflammation.
Domestic violence and psychopathic traits: distinguishing the antisocial batterer from other antisocial offenders
Authors: Swogger Marc T. , Walsh Zach , Kosson David S. 
Published: March 2007

AbstractThe proliferation of specialized domestic batterer treatment programs suggests that batterers differ from other offenders in important ways. The psychopathic personality represents a constellation of personality traits, which may be relevant to the differentiation of batterers from other offenders. In a sample of 172 county jail inmates, we examined whether antisocial batterers can be distinguished from the larger pool of antisocial offenders on the basis of the four‐facet model of psychopathy identified for the Psychopathy Checklist‐Revised (PCL‐R). Batterer/non‐batterer status was positively related to the PCL‐R affective facet and negatively related to the lifestyle facet, but there was no significant relationship between PCL‐R total scores and this criterion. Results suggest that antisocial batterers are characterized by deficient affective experience and by reduced impulsivity and irresponsibility compared with other antisocial offenders. Implications are discussed in light of specialized treatments for batterers. Aggr. Behav. 33:1–8, 2007. © 2007 Wiley‐Liss, Inc.
Violent video game play impacts facial emotion recognition
Authors: Kirsh Steven J. , Mounts Jeffrey R.W. 
Published: March 2007

AbstractThis study assessed the speed of recognition of facial emotional expressions (happy and angry) as a function of violent video game play. Color photos of calm facial expressions morphed to either an angry or a happy facial expression. Participants were asked to make a speeded identification of the emotion (happiness or anger) during the morph. Typically, happy faces are identified faster than angry faces (the happy‐face advantage). Results indicated that playing a violent video game led to a reduction in the happy face advantage. Implications of these findings are discussed with respect to the current models of aggressive behavior. Aggr. Behav. 33:353–358, 2007. © 2007 Wiley‐Liss, Inc.
Musculoskeletal work disability for clinicians: Time course and effectiveness of a specialized intervention program by diagnosis
Authors: Abásolo Lydia , Carmona Loreto , Hernández‐García César , Lajas Cristina , Loza Estíbaliz , Blanco Margarita , Candelas Gloria , Fernández‐Gutiérrez Benjamín , Jover Juan A. 
Published: March 2007

AbstractObjectiveTo evaluate how an intervention program modifies the clinical course of work disability in musculoskeletal diagnoses.MethodsAll patients with temporary work disability related to musculoskeletal disorders (MSDs) in 3 health districts of Madrid, Spain were randomized into standard care (control group) or the intervention group. Intervention consisted of a specific program, run by rheumatologists, following detailed proceedings. Inclusion and followup lasted 12 months each. According to the cause, every temporary work disability episode was classified into 11 syndrome categories. For each we calculated efficacy, as the difference between groups in the number of days on sick leave per temporary work disability episode; relative efficacy, or the percentage of days saved in the intervention group; and time of maximum program effect. Analyses were performed on an intent‐to‐treat basis. Survival techniques were run and results were expressed as the hazard ratio (HR) in the intervention versus control group.ResultsA total of 13,077 patients were included, generating 16,297 temporary work disability episodes. The most frequent cause was back pain. Temporary work disability episodes were significantly shorter in the intervention group than in the controls in all syndrome categories except knee pain (excluding osteoarthritis). Program relative efficacy varied from 28–72%. The program was highly efficacious in carpal tunnel syndrome (HR 2.09, 95% confidence interval [95% CI] 1.17–3.75), peripheral osteoarthritis (HR 1.58, 95% CI 1.14–2.19), and inflammatory diseases (HR 1.52, 95% CI 1.09–2.12). The maximum effect of the program always took place within the first 2 months.ConclusionThe implementation of this type of specialist‐run, protocol‐based early intervention program would be very beneficial in the treatment of patients with work disability related to MSDs, except for those with knee pain (excluding osteoarthritis).
Differences in outcomes of obese women and men undergoing primary total hip arthroplasty
Authors: Lübbeke Anne , Stern Richard , Garavaglia Guido , Zurcher Line , Hoffmeyer Pierre 
Published: March 2007

AbstractObjectiveTo evaluate the effect of obesity on the incidence of main complications (infection, dislocation, and revision), functional outcome, and patient satisfaction 5 years after primary total hip arthroplasty (THA), and to determine whether results differ between obese women and men.MethodsWe conducted a hospital‐based prospective cohort study including patients who underwent primary THA (2,495 hips) between 1996 and 2005. We used rates and rate ratios to compare the incidence of main complications in obese and nonobese patients, and we stratified the data for sex. Functional outcome was measured using the Harris Hip Score and Western Ontario and McMaster Universities Osteoarthritis Index.ResultsThe adjusted incidence rate ratio for infection (obese versus nonobese) was 4.4 (95% confidence interval [95% CI] 1.8, 10.8). Obesity substantially increased the infection rate in women (incidence rate ratio comparing obese with nonobese women 16.1; 95% CI 3.4, 75.7), whereas obesity appeared to have no effect in men (incidence rate ratio 1.0; 95% CI 0.2, 5.3). The adjusted incidence rate ratio for dislocation (obese versus nonobese) was 2.4 (95% CI 1.4, 4.2), with a higher rate increase in obese women. A total of 817 patients had a 5‐year clinical followup visit. Functional outcome and satisfaction were slightly lower in obese women partly due to higher complication rates. No difference was seen in men.ConclusionPrimary THA is a successful intervention in obese patients, but physician and patient must be aware of increased complications, particularly in women.
Hydrocephalus and macrocephaly: New manifestations of neonatal lupus erythematosus
Authors: Boros Christina A. , Spence Dawn , Blaser Susan , Silverman Earl D. 
Published: March 2007

AbstractObjectiveNeurologic involvement has been reported to occur in infants with neonatal lupus erythematosus (NLE), although the significance of these findings is unknown. The purpose of this study was to determine if hydrocephalus/macrocephaly is a manifestation of NLE.MethodsInfants from the Hospital for Sick Children in Toronto, Canada whose mothers had anti‐Ro antibodies were followed prospectively. A total of 87 infants were seen in the study period (1999–2004). The maternal autoantibody status of all infants was documented, and all infants underwent full clinical examination at each visit.ResultsOf the 87 infants, 47 had NLE. Five of the 47 infants with NLE and 2 of the healthy infants had hydrocephalus, resulting in a prevalence of 8.0% (95% confidence interval 4.0–15.0%) in the entire cohort. This is significantly higher than the prevalence in the general population of 0.048–0.081%. Head circumference measurements of infants in the Toronto cohort were largest between 12–24 months of age (Z score difference = 0.71, P = 0.008).ConclusionWe suggest that hydrocephalus and macrocephaly are manifestations of NLE and that infants born to mothers with anti‐Ro antibodies should be carefully monitored for hydrocephalus as part of their routine physical examination.