Template-Type: ReDIF-Article 1.0 Title: Smoke detector legislation: Its effect on owner-occupied homes Journal: American Journal of Public Health Author-Name: McLoughlin, E. Author-Name: Marchone, M. Author-Name: Hanger, S.L. Author-Name: German, P.S. Author-Name: Baker, S.P. Year: 1985 Volume: 75 Issue: 8 Pages: 858-862 Abstract: Montgomery County, Maryland was the first major jurisdiction to pass a law requiring smoke detectors in all homes. Smoke detector coverage in the county was evaluated five years after the law's implementation and compared to the coverage in neighboring Fairfax County, Virginia, which has no such law. Firefighters visited 651 randomy selected owner-occupied homes and tested each detector. While a similar percentage of homes in Montgomery and Fairfax counties complied with detector codes (42% vs 44%, respectively), Montgomery County had a significantly lower percentage of homes with no working detectors (17% vs 30%) and with no detectors at all (6% vs 16%). In general, Montgomery County residents complied with what they believed the law required, but lacked knowledge of the law's details. New homes where building codes required detectors and homes where owners assumed that detectors were required by law were likely to have working detectors. Analyses of 12 years of fire data suggest that as a county approaches complete detector coverage, the risk of residential fire deaths decreases. An essentially unenforced law seems to be obeyed because it conforms to community values. Handle: RePEc:aph:ajpbhl:1985:75:8:858-862_7 Template-Type: ReDIF-Article 1.0 Title: Public health then and now: an historical repository. Journal: American Journal of Public Health Author-Name: Rosenkrantz, B.G. Year: 1985 Volume: 75 Issue: 12 Pages: 1376 Handle: RePEc:aph:ajpbhl:1985:75:12:1376_8 Template-Type: ReDIF-Article 1.0 Title: Moist heat inactivation of Cryptosporidium sp. Journal: American Journal of Public Health Author-Name: Anderson, B.C. Year: 1985 Volume: 75 Issue: 12 Pages: 1433-1434 Abstract: Cryptosporidia that were infective for infant mice were subjected to various moist heat treatments and subsequently tested in infant mice for infectivity. Warming from 9°C to 55°C over a period of 15 to 20 minutes neutralized infectivity in calf feces, cecal contents, and ileal scrapings. Inocula held at 45°C for 5 to 20 minutes lost its infectivity. These results suggest that pasteurization of raw milk, circumstantially incriminated in cryptosporidial transmission, would neutralize cryptosporidial infectivity. Handle: RePEc:aph:ajpbhl:1985:75:12:1433-1434_0 Template-Type: ReDIF-Article 1.0 Title: A cross-cultural comparison of health status values Journal: American Journal of Public Health Author-Name: Patrick, D.L. Author-Name: Sittampalam, Y. Author-Name: Somerville, S.M. Author-Name: Carter, W.B. Author-Name: Bergner, M. Year: 1985 Volume: 75 Issue: 12 Pages: 1402-1407 Abstract: The extent to which the values attached to health states are similar in different cultures or social groups is important for understanding health and illness behaviors and for developing standardized health status measures. A cross-cultural study was conducted to compare the health status values obtained in a United States population (Seattle, Washington) with those from another English-speaking culture (London, England) on the Sickness Impact Profile, a standardized measure composed of 136 items. London judges rated the severity of dysfunction described in each item on an equal interval scale using the same methods of scaling and analysis employed in the Seattle study. A regression of English mean item values on US mean values yielded a slope of 1.00 and an intercept of -0.07, indicating that judges gave strikingly similar ratings to most items. Agreement was higher at the more severe end of the dysfunction continuum than at the least severe end, a finding consistent with the notion that what constitutes health is more difficult to define than what constitutes illness. While a universal conception of dysfunction may exist in English-speaking societies, the social and cultural determinants of health status values deserve more systematic study. Handle: RePEc:aph:ajpbhl:1985:75:12:1402-1407_5 Template-Type: ReDIF-Article 1.0 Title: Health practices and incident disability among the elderly Journal: American Journal of Public Health Author-Name: Branch, L.G. Year: 1985 Volume: 75 Issue: 12 Pages: 1436-1439 Abstract: This investigation examines the relationships between certain personal health practices and point-incident physical limitations over a five-year period among initially physically robust elders living in the communities. Slowed down physical activites (for elderly women) and a history of cigarette smoking (for elderly men) achieved associations with subsequent physical limitations; no firm associations between current lifestyle practices and onset of disability could be demonstrated. Handle: RePEc:aph:ajpbhl:1985:75:12:1436-1439_4 Template-Type: ReDIF-Article 1.0 Title: Fluorides, facts and fanatics: Public health advocacy shouldn't stop at the courthouse door Journal: American Journal of Public Health Author-Name: Christoffel, T. Year: 1985 Volume: 75 Issue: 8 Pages: 888-891 Abstract: Despite the clear evidence and the strong support of dental and public health professionals, fluoridation of public water supplies remains under continual attack by some extremely vocal groups which are associated with the political far right and/or with various unorthodox health claims. Handle: RePEc:aph:ajpbhl:1985:75:8:888-891_6 Template-Type: ReDIF-Article 1.0 Title: Childhood injuries in North Carolina: A statewide analysis of hospitalizations and deaths Journal: American Journal of Public Health Author-Name: Runyan, C.W. Author-Name: Kotch, J.B. Author-Name: Margolis, L.H. Author-Name: Buescher, P.A. Year: 1985 Volume: 75 Issue: 12 Pages: 1429-1432 Abstract: We report the nature and causes of childhood injuries leading to hospitalization or death in North Carolina. Based on an 89 per cent sample of 1980 hospital discharges of children between 0 and 19 years of age, the overall annual rate of trauma-related hospitalizations was 80 per 10,000. The rate varied from 119 per 10,000 for the 15-19 year age group to 56 per 10,000 for children between ages 5 and 9. Hospitalization rates are lower than those reported elsewhere, although death rates, based on a seven-year period, are higher in the data reported here. Potential reasons for these differences are suggested. Handle: RePEc:aph:ajpbhl:1985:75:12:1429-1432_0 Template-Type: ReDIF-Article 1.0 Title: Diphtheria in the United States, 1971-81 Journal: American Journal of Public Health Author-Name: Chen, R.T. Author-Name: Broome, C.V. Author-Name: Weinstein, R.A. Author-Name: Weaver, R. Author-Name: Tsai, T.F. Year: 1985 Volume: 75 Issue: 12 Pages: 1393-1397 Abstract: After a decade-long resurgence, including a large cutaneous diphtheria outbreak in Washington State, the diphtheria incidence rate in the United States reached its lowest recorded level ever in 1980 - two patients (0.01 case per million). Mortality paralleled the decline in incidence rate. Only 143 of the 3,141 US counties reported noncutaneous diphtheria patients during 1971-81; most were located with the West. The highest attack rates were experienced by children less than 15 years old (0.8 case per million) and by American Indians (22.6 cases per million). Persons immunized with three or more doses of diphtheria toxoid had a lower death-to-case ratio (1.3 per cent) than totally unimmunized persons (13.4 per cent). The reasons for the dramatic decline in diphtheria incidence rates are unclear, although it has been postulated that the gene for producing diphtheria toxin may be lost from organisms in highly immunized populations. Significant proportions of the adult and elderly populations are susceptible to diphtheria. Continuation of primary immunization with increased emphasis on the routine use of tetanus and diphtheria toxoids (Td) boosters in adults should ensure that diphtheria will remain largely a scourge of the past. Handle: RePEc:aph:ajpbhl:1985:75:12:1393-1397_9 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of urinary tract infection: II. Diet, clothing, and urination habits Journal: American Journal of Public Health Author-Name: Foxman, B. Author-Name: Frerichs, R.R. Year: 1985 Volume: 75 Issue: 11 Pages: 1314-1317 Abstract: Although several health habits and behaviors are commonly cited in medical and nursing textbooks as potential causes of urinary tract infection (UTI) in women, few have been studied in a systematic fashion. In a case-control study, we evaluated the associations between UTI and the most commonly mentioned risk factors: urination habits, diet, clothing, and soaps. Because sexual intercourse and diaphragm use increase the risk of UTI, we assessed the effect of health habits and behaviors controlling for these two risk factors. Women with initial UTI were compared with controls with no UTI history; women with a second UTI were compared to those with initial UTI. For the 25 initial cases, 19 secondary cases, and 181 controls enrolled in the study from a university health service, we found using tampons and drinking soft drinks to be moderately associated (RR ≥ 1.4) with both initial and recurrent UTI. Although several other individual habits had only small associations with UTI, several of these behaviors together might substantially increase risk of initial or recurring UTI. Handle: RePEc:aph:ajpbhl:1985:75:11:1314-1317_0 Template-Type: ReDIF-Article 1.0 Title: The rise in medical care expenditures in Japan, trends in disease patterns: 1977-81 Journal: American Journal of Public Health Author-Name: Kawamura, N. Author-Name: Gotoda, Y. Author-Name: Yoshikura, H. Year: 1985 Volume: 75 Issue: 12 Pages: 1442-1444 Abstract: In Japan, the nationwide cost of medical care is increasing rapidly. Analysis of data from the Japanese health insurance system shows that costs are not rising for all diagnoses and that it is diseases requiring hospitalization and expensive medical treatments that have been responsible for the rising cost of medical care. Handle: RePEc:aph:ajpbhl:1985:75:12:1442-1444_2 Template-Type: ReDIF-Article 1.0 Title: Causes of death among female chemists Journal: American Journal of Public Health Author-Name: Walrath, J. Author-Name: Li, F.P. Author-Name: Hoar, S.K. Author-Name: Mead, M.W. Author-Name: Fraumeni Jr., J.F. Year: 1985 Volume: 75 Issue: 8 Pages: 883-884 Abstract: A mortality odds ratio analysis of cause of death among 347 White female members of the American Chemical Society (ACS) revealed a five-fold excess of suicide, notably by cyanide poisoning. Risk was also elevated for all cancers combined and for cancers of the breast, ovary, stomach, pancreas, and lymphatic and hematopoietic system. The excess breast and ovary cancer deaths were limited to unmarried women. Handle: RePEc:aph:ajpbhl:1985:75:8:883-884_7 Template-Type: ReDIF-Article 1.0 Title: Maternal serum AFP: educating physicians and the public. Journal: American Journal of Public Health Author-Name: Annas, G.J. Author-Name: Elias, S. Year: 1985 Volume: 75 Issue: 12 Pages: 1374-1375 Handle: RePEc:aph:ajpbhl:1985:75:12:1374-1375_8 Template-Type: ReDIF-Article 1.0 Title: New derivatives of the Streptomyces temperate phase φC31 useful for the cloning and functional analysis of Streptomyces DNA Journal: American Journal of Public Health Author-Name: Slaby, A.R. Author-Name: Drizd, T. Year: 1985 Volume: 75 Issue: 8 Pages: 878-880 Abstract: The circumcision status of boys aged 12 through 17 years (born from 1949 to 1958) from a sample cohort of the National Health Examination Survey (NHES) cycle III, conducted from 1966-70, was analyzed. Over three-fourths of the cohort had been circumcised, reflecting circumcision practices in the 1950s. Prevalence of circumcision was more common in Whites, in families with higher income, and higher educated heads of household. Circumcision prevalence was the lowest in the South and highest in the Midwest. More recent national data are not available. Handle: RePEc:aph:ajpbhl:1985:75:8:878-880_7 Template-Type: ReDIF-Article 1.0 Title: Age- and sex-specific prevalence of scoliosis and the value of school screening programs Journal: American Journal of Public Health Author-Name: Morais, T. Author-Name: Bernier, M. Author-Name: Turcotte, F. Year: 1985 Volume: 75 Issue: 12 Pages: 1377-1380 Abstract: A prevalence study of idiopathic scoliosis was conducted among 29,195 children of a community health district in the province of Quebec. The study was designed to determine whether a permanent screening program for idiopathic scoliosis was justified. The prevalence of the condition among school children aged 8 to 15 years was 42.0 per 1,000 in the screened population, 51.9 per 1,000 among girls, and 32.0 per 1,000 among boys. The positive predictive value of the bending test is estimated as 42.8 per cent for scolioses of 5° or more; it is only 6.4 per cent when curves of 15° or more are considered. The average cost of finding one child with a scoliosis of 5° or more is $194. Mass screening for idiopathic scoliosis does not seem to be justified in the present state of knowledge of the disease. Handle: RePEc:aph:ajpbhl:1985:75:12:1377-1380_3 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of urinary tract infection: I. Diaphragm use and sexual intercourse Journal: American Journal of Public Health Author-Name: Foxman, B. Author-Name: Frerichs, R.R. Year: 1985 Volume: 75 Issue: 11 Pages: 1308-1313 Abstract: In the present case-control study of college-aged women, we examined the associations of sexual intercourse and diaphragm use with primary and secondary urinary tract infection (UTI), and measured the treatment and functional costs of primary, secondary, and recurrent UTI. All of the cases but only half of the controls had engaged in sexual intercourse during the past four weeks. When compared to using oral contraceptives, diaphragm use was associated with both first attack UTI (when compared with controls) and second attack UTI (when compared to women with primary UTI) even after controlling for frequency of sexual intercourse (Primary UTI: RR(MH) = 3.5; 95% CI: 0.9, 13.0; Secondary UTI: RR(MH) = 2.2; 95% CI: 0.3, 15.4). Women with all types of UTI reported 6.1 symptom days, 2.4 restricted-activity days, 1.6 office visits and laboratory tests, and spent $62 for treatment of UTI, based on prices of a subsidized student health service. Handle: RePEc:aph:ajpbhl:1985:75:11:1308-1313_3 Template-Type: ReDIF-Article 1.0 Title: Rocky Mountain spotted fever acquired in Florida, 1973-83 Journal: American Journal of Public Health Author-Name: Sacks, J.J. Author-Name: Janowski, H.T. Year: 1985 Volume: 75 Issue: 12 Pages: 1422-1424 Abstract: From 1973 to 1983, 49 Florida residents were reported with confirmed Rocky Mountain spotted fever (RMSF), 25 of whom were considered to have had Florida-acquired disease. Although there was no history of tick exposure for six of these 25 persons, all had contact with dogs or outdoor activities during the incubation period. The tick vectors of RMSF are widely distributed throughout Florida. We conclude that RMSF, although rare in Florida, can be acquired in the state. Handle: RePEc:aph:ajpbhl:1985:75:12:1422-1424_6 Template-Type: ReDIF-Article 1.0 Title: Lipid, kilocalorie, and selected mineral intakes of rural black schoolgirls Journal: American Journal of Public Health Author-Name: Steele, M.F. Author-Name: Gallagher, M.L. Year: 1985 Volume: 75 Issue: 11 Pages: 1323-1324 Abstract: Dietary intakes of nutrients implicated in cardiovascular disease were studied in 143 Black females, age 9 years. Dietary recall interviews were conducted and data compared with recommendations of several authoritative groups. A majority of subjects reported intakes: exceeding recommendations for total fat, saturated fat, and sodium; within recommendations for potassium and cholesterol; and below recommendations for kilocalories. Handle: RePEc:aph:ajpbhl:1985:75:11:1323-1324_2 Template-Type: ReDIF-Article 1.0 Title: A priority system model for sanitation management in food service establishments Journal: American Journal of Public Health Author-Name: Wodi, B.E. Author-Name: Mill, R.A. Year: 1985 Volume: 75 Issue: 12 Pages: 1398-1401 Abstract: We set out to develop a sanitation management scheme that will enable health regulatory authorities to utilize available personnel more effciently in the regulation of the food service industry given the current budgetary and manpower constraints. Previous analyses of the Annual Food Service Establishment Sanitation Inspection Summary records from a large County Department of Health for fiscal years 1979, 1980 and 1981 indicated a cut-off point at about two to four visits for a productive follow-up sanitation inspection of food service establishments. Revisits after this point seemed counter-productive. Revisits of up to 13 times in establishments and a high uninspection rate of others were noted. The above data, the population at risk for each establishment (generated by a prescribed method), and various control criteria were integrated into the model. Application of the model to a sample of 82 food service establishments was successful in ensuring that those operations that pose high risk to patrons are given priority in a sanitation management program while also facilitating the inspection of all food service establishments within a jurisdiction at some point. Handle: RePEc:aph:ajpbhl:1985:75:12:1398-1401_0 Template-Type: ReDIF-Article 1.0 Title: Public health nursing comes of age Journal: American Journal of Public Health Author-Name: Roberts, D.E. Author-Name: Heinrich, J. Year: 1985 Volume: 75 Issue: 10 Pages: 1162-1172 Abstract: A decade ago, the World Health Organization's Committee on Community Health Nursing defined the emerging role of public health nursing in primary health care.(1) The report focused attention on untapped nursing potentials and added impetus to the dynamic movement that had begun 10 years earlier with the first Child Health Nurse Practitioner. By 1974, public health nursing had come a long way since the early 1930s, when it was struggling to assert itself as a full-fledged member of the public health system while coping with differences both within the profession and within the organizational structure of practice. Although the importance of specialized preparation for home visiting had been recognized from the beginning, the majority of nurses in service had little or no academic preparation in public health. And, as Wilkerson points out,(2) the shifting of service from the voluntary visiting nurse structure to the official agency not only relegated decision making for nursing services to health officers, it splintered general nursing into preventive and sick care and fomented rivalry between 'visiting' and 'public health' nurses which further undermined the possibility of comprehensive health care. Handle: RePEc:aph:ajpbhl:1985:75:10:1162-1172_9 Template-Type: ReDIF-Article 1.0 Title: Physician use by the elderly over an eight-year period Journal: American Journal of Public Health Author-Name: Mossey, J.M. Author-Name: Shapiro, E. Year: 1985 Volume: 75 Issue: 11 Pages: 1333-1334 Abstract: Investigation of ambulatory use of physicians by older persons over an eight-year period reveals that 60 per cent visited physicians with similar frequency for six or more years; 22 per cent regularly made two or less visits and 14 per cent made seven or more visits each year. Analyses reveal cohort effects rather than age effects to be of primary importance in determining an individual's regular pattern of physician use. Handle: RePEc:aph:ajpbhl:1985:75:11:1333-1334_1 Template-Type: ReDIF-Article 1.0 Title: Health status of survivors of cardiac arrest and of myocardial infarction controls Journal: American Journal of Public Health Author-Name: Bergner, L. Author-Name: Hallstrom, A.P. Author-Name: Bergner, M. Author-Name: Eisenberg, M.S. Author-Name: Cobb, L.A. Year: 1985 Volume: 75 Issue: 11 Pages: 1321-1323 Abstract: We interviewed 308 survivors of out-of-hospital cardiac arrest and matched controls who had suffered a myocardial infarction. The Sickness Impact Profile (SIP) scores of controls were somewhat lower (better) than those of cases, but responses of cases and controls to additional questions about stair climbing, irritability and mood were virtually identical. Half as many (18 per cent) controls as cases (38 per cent) reported poorer memory function, nevertheless, 63 per cent of cases and 79 per cent of controls who had been working outside the home at the time of the event were employed at the time of the interview. Handle: RePEc:aph:ajpbhl:1985:75:11:1321-1323_4 Template-Type: ReDIF-Article 1.0 Title: Comments on sterilization methods in China. Journal: American Journal of Public Health Author-Name: Potts, M. Author-Name: Chi, I.C. Author-Name: Lippes, J. Year: 1985 Volume: 75 Issue: 12 Pages: 1451 Handle: RePEc:aph:ajpbhl:1985:75:12:1451_0 Template-Type: ReDIF-Article 1.0 Title: Psychological consequences of infestation of the dwelling unit Journal: American Journal of Public Health Author-Name: Zahner, G.E.P. Author-Name: Kasl, S.V. Author-Name: White, M. Author-Name: Will, J.C. Year: 1985 Volume: 75 Issue: 11 Pages: 1303-1307 Abstract: Interview data from a three-wave panel study of the impact of the residential environment upon the psychological well-being of 337 minority women were used to examine the effects of household infestation upon self-reported depression, phobic anxiety, somatization, hostility, and anomia. The findings of cross-sectional and change analyses over the three waves of data point to a stable relationship between rat infestation and a single dimension of psychological well-being, somatization. Handle: RePEc:aph:ajpbhl:1985:75:11:1303-1307_3 Template-Type: ReDIF-Article 1.0 Title: Surveillance needs for occupational health Journal: American Journal of Public Health Author-Name: Wegman, D.H. Author-Name: Froines, J.R. Year: 1985 Volume: 75 Issue: 11 Pages: 1259-1261 Handle: RePEc:aph:ajpbhl:1985:75:11:1259-1261_3 Template-Type: ReDIF-Article 1.0 Title: Ohio consortium for major organ transplantation. Journal: American Journal of Public Health Author-Name: Jackson, D.L. Year: 1985 Volume: 75 Issue: 12 Pages: 1450 Handle: RePEc:aph:ajpbhl:1985:75:12:1450_0 Template-Type: ReDIF-Article 1.0 Title: Using computers to identify complications after surgery Journal: American Journal of Public Health Author-Name: Roos Jr., L.L. Author-Name: Cageorge, S.M. Author-Name: Austen, E. Author-Name: Lohr, K.N. Year: 1985 Volume: 75 Issue: 11 Pages: 1288-1295 Abstract: We used the Health Services Commission data from Manitoba, Canada to identify complications resulting from hysterectomy, cholecystectomy, and prostatectomy which led to hospital readmissions. For each procedure, two specialists independently judged whether the readmissions were for surgery-related complications on the basis of liberally interpreted literature guidelines. Then, each pair of physicians met to resolve differences; only complications agreed upon by physicians were retained in our computer-based analysis. The analysis was done in three steps: algorithms were developed using guidelines from the literature, physician input, and 1974 hospital claims; these were then modified using 1975 data; finally, the algorithms were tested with 1976 data. The computerized algorithms developed were compared with the clinical decisions of physician panels. The results showed high specificity, sensitivity, and predictive value. Given the increasing availability of routinely collected data bases, the possibilities for inexpensively monitoring the outcomes of different providers and institutions are appealing. More extensive validation and application of the methodology to a greater number of procedures are necessary to implement such a program. Handle: RePEc:aph:ajpbhl:1985:75:11:1288-1295_0 Template-Type: ReDIF-Article 1.0 Title: Leaded gasoline article criticized. Journal: American Journal of Public Health Author-Name: Lynam, D.R. Author-Name: Meyers, G.B. Author-Name: Ter Haar, G.L. Year: 1985 Volume: 75 Issue: 12 Pages: 1452-1453 Handle: RePEc:aph:ajpbhl:1985:75:12:1452-1453_5 Template-Type: ReDIF-Article 1.0 Title: Aging and generational effects on drinking behaviors in men: Results from the normative aging study Journal: American Journal of Public Health Author-Name: Glynn, R.J. Author-Name: Bouchard, G.R. Author-Name: LoCastro, J.S. Author-Name: Laird, N.M. Year: 1985 Volume: 75 Issue: 12 Pages: 1413-1419 Abstract: The effects of aging on alcohol consumption behaviors are unclear because of confounding with period and cohort effects. In 1973, 1,859 male participants in the Normative Aging Study, born between 1892 and 1945, described their drinking behaviors by responding to a mailed questionnaire. In 1982, 1,713 of the participants in this study responded to a similar questionnaire. We used multivariate techniques, adjusting regression coefficients for the correlations between repeated responses of the same individuals, to assess the effects of birth cohort and aging on mean alcohol consumption level, on the prevalence of problems with drinking, and on the prevalence of averaging three or more drinks per day. Older men drank significantly less than younger men at both times yet there was no tendency for men to decrease their consumption levels over time. Each successively older birth cohort had a prevalence of problems with drinking estimated to be 0.037 lower than the prevalence of the next youngest cohort (95 per cent confidence interval: 0.029-0.045), yet there was no decrease in drinking problems over nine years. Interpretation of these findings requires consideration of the changes in attitudes as well as the increases in per capita consumption occurring in the United States throughout the 1970s. Results suggest that aging is not as important a factor in changes in drinking behaviors as generational or attitudinal changes. Handle: RePEc:aph:ajpbhl:1985:75:12:1413-1419_6 Template-Type: ReDIF-Article 1.0 Title: Should prisoners be immunized against hepatitis B? Journal: American Journal of Public Health Author-Name: Decker, M.D. Author-Name: Schaffner, W. Year: 1985 Volume: 75 Issue: 10 Pages: 1134-1135 Abstract: We would urge public health officials to consider the development, in coordination with correctional authorities, of programs which would offer hepatitis B screening and immunization to those prisoners judged to be at highest risk of infection. Specific funding for such programs must be sought; prison directors cannot be expected to use their limited resources for a program motivated by general public health, rather than correctional, considerations. Such a program would not only prevent the medical and social costs of hepatitis B among the targeted group itself, but may also reduce transmission among the general population of intravenous drug users and society at large. Handle: RePEc:aph:ajpbhl:1985:75:10:1134-1135_6 Template-Type: ReDIF-Article 1.0 Title: The alchemy of mental health policy: Homelessness and the fourth cycle of reform Journal: American Journal of Public Health Author-Name: Goldman, H.H. Author-Name: Morrissey, J.P. Year: 1985 Volume: 75 Issue: 7 Pages: 727-731 Abstract: This paper examines a fourth cycle of reform emerging in the past decade in response to the failures of community mental health and deinstitutionalization. The new reform advocates creating community support systems, a broad network of mental health and social welfare services for care of the chronically mentally ill in noninstitutional settings. This reform movement is different because it directly addresses the needs of the chronically mentally ill rather than promising to prevent chronicity through the early treatment of acute cases and because it recognizes the problem of the chronically mentally ill as a public health and social welfare problem. The breadth of this mandate, however, is threatened by shrinking health and welfare resources and by a growing expectation that it will solve the problem of homelessness. Handle: RePEc:aph:ajpbhl:1985:75:7:727-731_4 Template-Type: ReDIF-Article 1.0 Title: The public/private mix in the funding and delivery of health services: An international survey Journal: American Journal of Public Health Author-Name: Navarro, V. Year: 1985 Volume: 75 Issue: 11 Pages: 1318-1320 Abstract: Two recently published international surveys show that industrialized Western countries with the greatest government funding and administration of health services have the greatest population coverage and the lowest administrative costs. Countries with central government administration and fiscal controls have the greatest ability to control health care expenditures. Current United States focus on the private sector may be misplaced. Handle: RePEc:aph:ajpbhl:1985:75:11:1318-1320_6 Template-Type: ReDIF-Article 1.0 Title: AIDS and sexual behavior in gay men. Journal: American Journal of Public Health Author-Name: Handsfield, H.H. Year: 1985 Volume: 75 Issue: 12 Pages: 1449-1450 Handle: RePEc:aph:ajpbhl:1985:75:12:1449-1450_0 Template-Type: ReDIF-Article 1.0 Title: Utilization of case definitions and laboratory reporting in the surveillance of notifiable communicable diseases in the United States Journal: American Journal of Public Health Author-Name: Sacks, J.J. Year: 1985 Volume: 75 Issue: 12 Pages: 1420-1422 Abstract: In 1984, questionnaires were sent to the chief epidemiologist in all 50 states, Puerto Rico, and Washington DC, with a 100 per cent response rate. There were substantial variations in case definitions of reportable diseases, criteria for counting as a case, and sources of surveillance. Laboratory reporting of any notifiable condition is mandated by 54 per cent of jurisdictions. These differences in ascertainment and case-counting practice constitute potential sources of error in national surveillance data on communicable diseases. Handle: RePEc:aph:ajpbhl:1985:75:12:1420-1422_7 Template-Type: ReDIF-Article 1.0 Title: Self-reported physical health practices and health care utilization: Findings from the National Health Interview Survey Journal: American Journal of Public Health Author-Name: Wetzler, H.P. Author-Name: Cruess, D.F. Year: 1985 Volume: 75 Issue: 11 Pages: 1329-1330 Abstract: Cross-sectional physical health practice and health care utilization data from the 1977 National Health Interview Survey were analyzed. After adjusting for the effects of age, sex, race, income, education, and marital status, there were significant relationships between hours of sleep and both doctor visits and hospital days; increased physical activity was asssociated with fewer doctor visits. Prospective intervention studies are needed to determine whether changes in health practices will lead to decreased utilization. Handle: RePEc:aph:ajpbhl:1985:75:11:1329-1330_4 Template-Type: ReDIF-Article 1.0 Title: Prevalence of dental mottling in school-aged lifetime residents of 16 Texas communities Journal: American Journal of Public Health Author-Name: Butler, W.J. Author-Name: Segreto, V. Author-Name: Collins, E. Year: 1985 Volume: 75 Issue: 12 Pages: 1408-1412 Abstract: The severity of dental mottling in 2,592 school-aged, lifetime residents of 16 Texas communities was investigated in 1980-81 to identify factors associated with mottling and to construct a prediction model for the prevalence of mottling. The communities were selected to obtain a wide range of levels of fluoride in the drinking water. The children within each of the communities were contacted through their schools and received a dental examination to assess the severity of mottling. Information on demographic, dental health practice, and other candidate predictor variables was obtained from a questionnaire completed by a parent. A number of water quality measurements were also recorded for each community. White and Spanish-surname children had about the same prevalence of mottling while Blacks had a higher prevalence, odds ratio (OR) = 2.3, 95% confidence interval = 1.4, 3.7. Children from homes which had air conditioning had a lower prevalence of mottling (OR = .6, (0.4, 0.8)). The use of fluoride toothpaste or drops and the number of fluoride treatments were almost identical among those who did and did not develop moderate mottling. In addition to fluoride, total dissolved solids and zine were water quality variables associated with mottling. Handle: RePEc:aph:ajpbhl:1985:75:12:1408-1412_4 Template-Type: ReDIF-Article 1.0 Title: Scoliosis screening: a pause in the chase. Journal: American Journal of Public Health Author-Name: Berwick, D.M. Year: 1985 Volume: 75 Issue: 12 Pages: 1373-1374 Handle: RePEc:aph:ajpbhl:1985:75:12:1373-1374_3 Template-Type: ReDIF-Article 1.0 Title: Mortality among workers exposed to coal tar pitch volatiles and welding emissions: An exercise in epidemiologic triage Journal: American Journal of Public Health Author-Name: Silverstein, M. Author-Name: Maizlish, N. Author-Name: Park, R. Author-Name: Mirer, F. Year: 1985 Volume: 75 Issue: 11 Pages: 1283-1287 Abstract: The United Automobile Workers International Union has established a system of epidemiologic triage to evaluate patterns of mortality among groups of union members. In response to worker concerns, the Union examined mortality at a metal stamping plant, using a method which linked pension records with the State of Michigan computerized death registry. The observed proportion of malignant neoplasms was nearly twice that expected (95% Confidence Limits 1.36, 2.62). Two- to five-fold excess proportional mortality from cancer of the digestive organs, lung cancer, and leukemia accounted for most of the overall excess. Strong associations were found between lung and digestive organ cancer and employment as maintenance welders or millwrights in the plant (odds ratios > 10). High levels of six polycyclic aromatic hydrocarbons with mutagenic and carcinogenic properties were found during hot coal tar application to wood block floors, work conducted by the high-risk groups. These levels were substantially reduced following the purchase of new tar pots. The example demonstrates that epidemiologic tools can play a valuable role in occupational health decision making, but care must be taken to avoid mechanical reliance on quantitative testing and to acknowledge the important role of social and political value judgments in the establishment of responsible public policy. Handle: RePEc:aph:ajpbhl:1985:75:11:1283-1287_3 Template-Type: ReDIF-Article 1.0 Title: What participants understand about a maternal serum alpha-fetoprotein screening program Journal: American Journal of Public Health Author-Name: Faden, R.R. Author-Name: Chwalow, A.J. Author-Name: Orel-Crosby, E. Author-Name: Holtzman, N.A. Author-Name: Chase, G.A. Author-Name: Leonard, C.O. Year: 1985 Volume: 75 Issue: 12 Pages: 1381-1384 Abstract: We investigated the knowledge of pregnant women participating in a maternal serum alphafetoprotein (MSAFP) screening program for the detection of neural tube defects (NTDs) in the fetus. Women participating in the screening program scored higher on two knowledge tests than a comparison group of pregnant women who were not offered screening. However, there were substantial gaps in the knowledge base of women in the program, as measured by one of the tests. Women did not misinterpret a negative test result to mean that the test had identified a potential problem with the fetus; instead, there is a suggestion that they tended to interpret a negative result too positively, as an assurance that the baby was healthy in all respects. Handle: RePEc:aph:ajpbhl:1985:75:12:1381-1384_1 Template-Type: ReDIF-Article 1.0 Title: A profile of the self-poisoner in Michigan Journal: American Journal of Public Health Author-Name: Bouknight, R. Author-Name: Alguire, P. Author-Name: Lofgren, R. Author-Name: Hoppe, R. Year: 1985 Volume: 75 Issue: 12 Pages: 1435-1436 Abstract: We reviewed the charts of all patients (160) ages 15 and older discharged in 1981 from the four hospitals in Lansing, Michigan with a diagnosis of overdose. Females predominated (65 per cent) and the median age was 27 years. The most common reason for intentional self-poisoning was 'significant-other' conflict (54.5 per cent), followed by family conflict and financial problems. Benzodiazepines were most commonly used followed by acetylsalicylic acid and ethanol. Handle: RePEc:aph:ajpbhl:1985:75:12:1435-1436_8 Template-Type: ReDIF-Article 1.0 Title: State certificate-of-need programs: The current status Journal: American Journal of Public Health Author-Name: Simpson, J.B. Year: 1985 Volume: 75 Issue: 10 Pages: 1225-1229 Abstract: Whether or not federal funding continues, it appears that a substantial number of states will retain certificate-of-need programs since CON regulation continues to satisfy a wide range of state policy roles. However, it also appears that several states may abandon the program in the absence of federal requirements to retain it, in favor of efforts to promote more competitive health service markets. This might well be a fortuitous development. Like any regulatory program that intervenes in the market to accomplish some social good, the need for CON programs ought to be continuously evaluated, and the scope of the program tailored to meet specific, concrete, and current purposes. This is difficult to do when all states adopt a nationally mandated program. The repeal of the program in some jurisdictions would offer a natural experiment to measure the impact of the presence or absence of certificate-of-need on the direction and scope of health facility expenditures. Handle: RePEc:aph:ajpbhl:1985:75:10:1225-1229_1 Template-Type: ReDIF-Article 1.0 Title: Diabetes and renal mortality in the United States Journal: American Journal of Public Health Author-Name: Geiss, L.S. Author-Name: Herman, W.H. Author-Name: Teutsch, S.M. Year: 1985 Volume: 75 Issue: 11 Pages: 1325-1326 Abstract: The risk of renal death is examined in the United States population 15 years of age and older with and without diabetes. The renal mortality rate is 174.6 per 100,000 among people with diabetes and 42.5 per 100,000 among people without diabetes. The relative risk of renal mortality is 4.1 for diabetics, age-adjusted relative risk, 2.6. The risk of renal mortality is highest in young people with diabetes. Rates of renal mortality are higher than previously believed among Whites with diabetes and among women with diabetes. Handle: RePEc:aph:ajpbhl:1985:75:11:1325-1326_8 Template-Type: ReDIF-Article 1.0 Title: A three-state study of waterborne disease surveillance techniques Journal: American Journal of Public Health Author-Name: Harter, L. Author-Name: Frost, F. Author-Name: Vogt, R. Author-Name: Little, A.A. Author-Name: Hopkins, R. Author-Name: Gaspard, B. Author-Name: Lippy, E.C. Year: 1985 Volume: 75 Issue: 11 Pages: 1327-1328 Abstract: For a two-year period, the states of Colorado, Vermont and Washington tested the effectiveness of ten surveillance methods for identifying waterborne disease. Nine were active surveillance methods, soliciting illness reports; one was passive, relying on voluntary disease reporting. One waterborne disease outbreak was identified through use of the nine active methods, while 14 were reported through the passive surveillance method. The presence of coliform bacteria during routine water testing was not related to illness in the community. Handle: RePEc:aph:ajpbhl:1985:75:11:1327-1328_0 Template-Type: ReDIF-Article 1.0 Title: Mandating health insurance benefits in the private sector: A decision for state legislatures Journal: American Journal of Public Health Author-Name: Glantz, L.H. Year: 1985 Volume: 75 Issue: 11 Pages: 1344-1346 Handle: RePEc:aph:ajpbhl:1985:75:11:1344-1346_6 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of human rabies post-exposure prophylaxis at the US naval facility, Subic Bay, Philippines Journal: American Journal of Public Health Author-Name: Dembert, M.L. Author-Name: Lawrence, W.B. Author-Name: Weinberg, W.G. Author-Name: Granger, D.D. Author-Name: Sanderson, R.D. Author-Name: Garst, P.D. Author-Name: Eighmy, J.J. Author-Name: Wells, T.E. Year: 1985 Volume: 75 Issue: 12 Pages: 1440-1441 Abstract: Data collected during 1984 from an active animal rabies surveillance system and human rabies post-exposure prophylaxis program at the US Naval Hospital, Subic Bay Naval Facility, Philippines revealed that potential rabies exposure, most commonly from dog bites or scratches, was reported for 311 US military and civilian personnel and four Filipino employees working on the facility. Seventy-nine persons (25 per cent) required complete post-exposure prophylaxis. Brain tissue from two captured dogs implicated in attacks was subsequently found to be positive for rabies antigen on fluorescent antibody testing. Handle: RePEc:aph:ajpbhl:1985:75:12:1440-1441_4 Template-Type: ReDIF-Article 1.0 Title: Determinants of medical record access for an epidemiologic study Journal: American Journal of Public Health Author-Name: Savitz, D.A. Author-Name: Grace, C. Year: 1985 Volume: 75 Issue: 12 Pages: 1425-1426 Abstract: Hospital record access is often needed for epidemiologic research. In a recent study, 26 Denver-area hospitals were contacted for permission to review records. The review process, the decision regarding access, and hospital characteristics were analyzed. Hospitals with a review committee, larger hospitals, and those which reached a decision rapidly were most likely to grant access. The results may provide guidance to investigators planning studies requiring review of hospital records. Handle: RePEc:aph:ajpbhl:1985:75:12:1425-1426_9 Template-Type: ReDIF-Article 1.0 Title: Interviewing physicians: The effect of improved response rate Journal: American Journal of Public Health Author-Name: Berk, M.L. Year: 1985 Volume: 75 Issue: 11 Pages: 1338-1340 Abstract: This analysis of data from the Physicians' Practice Survey indicates that estimates made from early responders closely approximate those obtained at the conclusion of a longer field period. Handle: RePEc:aph:ajpbhl:1985:75:11:1338-1340_6 Template-Type: ReDIF-Article 1.0 Title: Child maltreatment and smoking during pregnancy. Journal: American Journal of Public Health Author-Name: Pascoe, J.M. Year: 1985 Volume: 75 Issue: 12 Pages: 1452 Handle: RePEc:aph:ajpbhl:1985:75:12:1452_7 Template-Type: ReDIF-Article 1.0 Title: Caffeine-containing beverages and premenstrual syndrome in young women Journal: American Journal of Public Health Author-Name: Rossignol McK., A. Year: 1985 Volume: 75 Issue: 11 Pages: 1335-1337 Abstract: I evaluated the hypothesis that consumption of caffeine-containing beverages causes premenstrual syndrome by studying 295 college sophomores. Data about premenstrual syndrome and beverage consumption were collected by a self-administered questionnaire. Analysis of the data revealed that consumption of caffeine-containing beverages is strongly related to the presence and severity of premenstrual syndrome and that the effects exist for most of the premenstrual symptoms studied. Handle: RePEc:aph:ajpbhl:1985:75:11:1335-1337_7 Template-Type: ReDIF-Article 1.0 Title: A demonstration of lack of variability among six tuberculin skin test readers Journal: American Journal of Public Health Author-Name: Perez-Stable, E. Author-Name: Slutkin, G. Year: 1985 Volume: 75 Issue: 11 Pages: 1341-1343 Abstract: The variability of tuberculin skin test readings among six trained and experienced readers was evaluated using a modified sliding caliper method. Each of 537 tests were read independently by two readers. There were 23 disagreements between paired readers resulting in an overall interobserver reliability of 95.7 per cent. In 82 per cent of the paired readings the results were different by 2 mm or less. The observer lack of variability was likely due to the training and experience of the readers. Handle: RePEc:aph:ajpbhl:1985:75:11:1341-1343_5 Template-Type: ReDIF-Article 1.0 Title: Measuring the accuracy of vital status data in cohort studies Journal: American Journal of Public Health Author-Name: Fett, M.J. Year: 1985 Volume: 75 Issue: 12 Pages: 1385-1388 Abstract: To measure the quality of vital status data in a retrospective cohort study of mortality among former servicemen of the Vietnam Conflict era, test subjects of independently determined vital status were included among study subjects during vital status ascertainment procedures. This allowed for differentiation between vital status 'unknown' and incorrect assignment of vital status, and enabled measurement of the quality of both live and deceased vital status data. Four parameters based on sensitivity and specificity were used to express the quality of vital status data. The deceased specificity rate was 100 per cent, the deceased sensitivity rate was 95.7 per cent, the live specificity rate was 98.5 per cent, and the live sensitivity rate was 95.4 per cent. Using models of misclassification, the estimated death rate was found to be most sensitive to changes in the deceased specificity rate, indicating that emphasis should be given to minimizing incorrect ascertainment of truly alive subjects as deceased when developing vital status ascertainment procedures. Handle: RePEc:aph:ajpbhl:1985:75:12:1385-1388_5 Template-Type: ReDIF-Article 1.0 Title: The effectiveness of smoking cessation methods for smokers in public health maternity clinics: A randomized trial Journal: American Journal of Public Health Author-Name: Windsor, R.A. Author-Name: Cutter, G. Author-Name: Morris, J. Author-Name: Reese, Y. Author-Name: Manzella, B. Author-Name: Bartlett, E.E. Author-Name: Samuelson, C. Author-Name: Spanos, D. Year: 1985 Volume: 75 Issue: 12 Pages: 1389-1392 Abstract: Little insight is available in the literature on how best to assist the pregnant smoker in public health maternity clinics to quit during pregnancy. A randomized pretest/posttest experiment was used to evaluate the effectiveness of two different self-help cessation methods. Three hundred and nine pregnant women from three public health maternity clinics were assigned randomly to one of three groups with one-third assigned to each: a control group; a group receiving the American Lung Association's Freedom From Smoking Manual; and those receiving A Pregnant Woman's Self-Help Guide to Quit Smoking. Using a saliva thiocyanate (SCN) and behavioral report at mid-pregnancy and end of pregnancy to confirm cessation or reduction, 2 per cent in the control group quit and 7 per cent reduced their SCN levels substantially. Of the women assigned to the ALA method, 6 per cent quit and 14 per cent reduced their SCN levels substantially. Of the women who used the Guide, 14 per cent quit and 17 per cent reduced their SCN levels substantially. Results of this trial indicate that health education methods tailored to the pregnant smoker are more effective in changing smoking behavior than the standard clinic information and advice to quit and/or the use of smoking cessation methods not tailored to the needs of the pregnant smoker. Handle: RePEc:aph:ajpbhl:1985:75:12:1389-1392_6 Template-Type: ReDIF-Article 1.0 Title: Sex eduation and sexual experience among adolescents Journal: American Journal of Public Health Author-Name: Furstenberg Jr., F.F. Author-Name: Moore, K.A. Author-Name: Peterson, J.L. Year: 1985 Volume: 75 Issue: 11 Pages: 1331-1332 Abstract: This paper examines the association between sex education and adolescent sexual behavior. Data from the 1981 National Survey of Children show that 15- and 16-year-olds who have been exposed to sex education are less likely to be sexually experienced, and are neither more nor less likely to discuss sex with parents at home. Retrospective or longitudinal data are needed to more directly test the casual link between sex education and experience. Handle: RePEc:aph:ajpbhl:1985:75:11:1331-1332_7 Template-Type: ReDIF-Article 1.0 Title: Physicians' beliefs about the importance of 25 health promoting behaviors Journal: American Journal of Public Health Author-Name: Sobal, J. Author-Name: Valente, C.M. Author-Name: Muncie Jr., H.L. Author-Name: Levine, D.M. Author-Name: Deforge, B.R. Year: 1985 Volume: 75 Issue: 12 Pages: 1427-1428 Abstract: A mail survey of 1,040 primary care physicians in Maryland examined their beliefs about the importance of 25 behaviors for promoting the health of the average person. Physician consensus existed across specialties in rating most health behaviors as very important and few as very unimportant. Eliminating smoking was most important and taking vitamin supplements least important. Handle: RePEc:aph:ajpbhl:1985:75:12:1427-1428_4 Template-Type: ReDIF-Article 1.0 Title: The barefoot doctor: Shanghai county revisited Journal: American Journal of Public Health Author-Name: Koplan, J.P. Author-Name: Hinman, A.R. Author-Name: Parker, R.L. Author-Name: Gong, Y.L. Author-Name: Yang, M.D. Year: 1985 Volume: 75 Issue: 7 Pages: 768-770 Abstract: Since a 1981 review of health status and health services in Shanghai County, there have been considerable social and economic changes in the People's Republic of China. A major question currently is the impact of the new economic 'responsibility system', which was introduced in 1982, on the cooperative health structure and the 'barefoot doctors' (BFDs). Investigators in other areas of China have reported the collapse of the cooperative systems and a shift in the role of the BFDs as a result of incentives for them to spend more time in agricultural production. In Shanghai county, however, BFDs continue essentially full time as before, salaried by the brigade, with fee-for-service charges prohibited. Recent evidence from Shanghai County shows that the health care system and those who direct it can remain flexible and respond positively to changes in the social, economic, and political structures. Handle: RePEc:aph:ajpbhl:1985:75:7:768-770_4 Template-Type: ReDIF-Article 1.0 Title: A seroprevalence survey of hepatitis B markers among Haitians in a southwest Florida farming community Journal: American Journal of Public Health Author-Name: Malison, M.D. Author-Name: Kane, M.A. Author-Name: Johnson, J.M. Author-Name: Schable, C.A. Author-Name: Gridley, M.J. Author-Name: Polkowski, J. Year: 1985 Volume: 75 Issue: 9 Pages: 1094-1095 Abstract: We determined the seroprevalence of hepatitis B virus markers among 123 Haitian mothers and children in a southwest Florida farming community. Fifty-five per cent of mothers had one or more markers including two who were HBsAg positive. Only seven (10 per cent) children had markers; none were HBsAg positive. Pregnant Haitian women should be screened for HBsAg and infants born to those who are positive should receive immunoprophylaxis. Medical, dental, and laboratory workers caring for Haitian patients should also receive hepatitis B vaccine. Handle: RePEc:aph:ajpbhl:1985:75:9:1094-1095_6 Template-Type: ReDIF-Article 1.0 Title: Incidence of hepatitis B in the penitentiary of New Mexico Journal: American Journal of Public Health Author-Name: Hull, H.F. Author-Name: Lyons, L.H. Author-Name: Mann, J.M. Author-Name: Hadler, S.C. Author-Name: Steece, R. Author-Name: Skeels, M.R. Year: 1985 Volume: 75 Issue: 10 Pages: 1213-1214 Abstract: A study was conducted to determine the incidence of hepatitis B (HB) in a prison population. Forty-seven per cent of 455 male prisoners had evidence of past HB infection. HB seropositivity was most strongly correlated with: 1) a history of IV drug abuse; 2) age; 3) total time in any prison; and 4) race. During a one-year study period there were no clinical cases of HB in the prison and the seroconversion rate was 0.8% among prisoners still incarcerated. Handle: RePEc:aph:ajpbhl:1985:75:10:1213-1214_6 Template-Type: ReDIF-Article 1.0 Title: Seroepidemiology of Q fever among domestic animals in Nova Scotia Journal: American Journal of Public Health Author-Name: Marrie, T.J. Author-Name: van Buren, J. Author-Name: Fraser, J. Author-Name: Haldane, E.V. Author-Name: Faulkner, R.S. Author-Name: Williams, J.C. Author-Name: Kwan, C. Year: 1985 Volume: 75 Issue: 7 Pages: 763-766 Abstract: We used the indirect microimmunofluorescence test to determine the presence of antibodies in sheep, cattle, goat, cat, and dog sera to phase I and II Coxiella burnetii antigens in Nova Scotia. Only 6.7% of the 329 sheep tested had antibodies to phase II antigen and none had antibodies to phase I. Of 29 goats tested, 7% and 3.5% had antibodies to phase II and phase I antigens, respectively. In contrast, 23.8% of the 214 cattle tested had antibodies to phase II antigen, and 24.2% had antibodies to phase I antigen; 24.1% of 216 cats tested had antibodies to phase II antigen and 6% had antibodies to phase I antigen. None of the 447 dogs tested had antibodies detected. We conclude that cattle and cats may be reservoirs for human Q fever in Nova Scotia. Handle: RePEc:aph:ajpbhl:1985:75:7:763-766_5 Template-Type: ReDIF-Article 1.0 Title: Edentulism and oral health problems among elderly rural lowans: The Iowa 65+ rural health study Journal: American Journal of Public Health Author-Name: Hunt, R.J. Author-Name: Beck, J.D. Author-Name: Lemke, J.H. Author-Name: Kohout, F.J. Author-Name: Wallace, R.B. Year: 1985 Volume: 75 Issue: 10 Pages: 1177-1181 Abstract: A household health interview survey of 3,673 noninstitutionalized people aged 65 and over in two rural Iowa counties included questions about loss of teeth, use of dentures, and presence of oral health problems. Edentulism rates were 10-15% lower than those found a decade earlier in national health surveys. A log-linear analysis found that the best demographic predictors of edentulism were education, age, and marital status. Spouses tended to be of similar dentition status, i.e., both edentulous or both dentate. No association was found between the loss of teeth and prevalence of digestive problems. Only 7% of the edentulous people felt they needed to visit a dentist, even though 70% had not seen one for over five years. About 40% had dentures that were over 20 years old, with half of these being over 30 years old. Many dentures were loose and causing soreness in the mouth or difficulty in eating. These elderly people appeared to expect some problems with dentures and oral pain and accepted them without feeling a need to seek treatment. Handle: RePEc:aph:ajpbhl:1985:75:10:1177-1181_4 Template-Type: ReDIF-Article 1.0 Title: Multidisciplinary treatment of obesity with a protein-sparing modified fast: Results in 668 outpatients Journal: American Journal of Public Health Author-Name: Palgi, A. Author-Name: Read, J.L. Author-Name: Greenberg, I. Author-Name: Hoefer, M.A. Author-Name: Bistrian, B.R. Author-Name: Blackburn, G.L. Year: 1985 Volume: 75 Issue: 10 Pages: 1190-1194 Abstract: Six hundred sixty-eight obese outpatients, 71% (± 34) in excess of ideal weight, were enrolled in a multidisciplinary weight control program. The major components of the program included nutrition, education, behavior modification, and exercise. Rapid weight loss was accomplished using a very low calorie (less than 800 kcal) ketogenic diet. Patients adhered to the protein sparing modified fast (PSMF) for 17 ± 12 weeks and averaged 9 ± 17 weeks in a refeeding/maintenance program. Mean weight loss was 47 ± 29 lb (21 ± 13 kg) at the point of minimum weight and 41 ± 29 lb (19 ± 13 kg) at the end of the maintenance period. Systolic and diastolic blood pressure and serum triglycerides fell significantly in men and women. Success in weight loss was greatest in the heaviest patients, those who adhered the longest to the PSMF, and those who stayed the longest in the maintenance program. Handle: RePEc:aph:ajpbhl:1985:75:10:1190-1194_3 Template-Type: ReDIF-Article 1.0 Title: Hepatitis B in Wisconsin male prisoners: Considerations for serologic screening and vaccination Journal: American Journal of Public Health Author-Name: Anda, R.F. Author-Name: Perlman, S.B. Author-Name: D'Alessio, D.J. Author-Name: Davis, J.P. Author-Name: Dodson, V.N. Year: 1985 Volume: 75 Issue: 10 Pages: 1182-1185 Abstract: To develop a protocol for prevention of hepatitis B virus (HBV) transmission in Wisconsin prisons, we interviewed 619 male prisoners at incarceration to obtain information on hepatitis B risk factors. We defined previous infections by the presence of hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs), or antibody to hepatitis B core antigen (anti-HBc). Logistic regression was used to develop a model of relative risk (RR) of HBV infection. Use of illicit intravenous (IV) drugs was the most important risk factor because of a high prevalence of IV drug use and an RR which ranged from 2.93-7.47. Other important risk factors were: prior hepatitis or jaundice (RR = 6.28), race (RR = 2.54 for Blacks, RR = 3.28 for Latinos), transfusion (RR = 3.00), and age. Previous imprisonment was not an independent risk factor for HBV, hence selective serologic screening and vaccination of prisoners are justified rather than mass screening and vaccination. Based upon prevalence of hepatitis B markers in subgroups, it is necessary to screen prisoners with prior hepatitis or jaundice, prior transfusion, and users of IV drugs. The identification of HBsAg carriers by such screening could prevent infection of 'household' contacts. Users of IV drugs who are susceptible to HBV infection should be vaccinated. The remaining prisoners constitute a low-risk group for HBV infection and do not require serologic screening or vaccination. Handle: RePEc:aph:ajpbhl:1985:75:10:1182-1185_6 Template-Type: ReDIF-Article 1.0 Title: Comments on withdrawal of artificial feeding. Journal: American Journal of Public Health Author-Name: Olins, N.J. Year: 1985 Volume: 75 Issue: 11 Pages: 1347-1348 Handle: RePEc:aph:ajpbhl:1985:75:11:1347-1348_3 Template-Type: ReDIF-Article 1.0 Title: William H. Park (1863-1939): his laboratory and his legacy. Journal: American Journal of Public Health Author-Name: Schaeffer, M. Year: 1985 Volume: 75 Issue: 11 Pages: 1296-1302 Handle: RePEc:aph:ajpbhl:1985:75:11:1296-1302_4 Template-Type: ReDIF-Article 1.0 Title: Survey questionnaire salience. Journal: American Journal of Public Health Author-Name: Grembowski, D. Year: 1985 Volume: 75 Issue: 11 Pages: 1350 Handle: RePEc:aph:ajpbhl:1985:75:11:1350_4 Template-Type: ReDIF-Article 1.0 Title: Setting goals and priorities. 1984 Presidential Address. Journal: American Journal of Public Health Author-Name: Addiss, S.S. Year: 1985 Volume: 75 Issue: 11 Pages: 1276-1280 Handle: RePEc:aph:ajpbhl:1985:75:11:1276-1280_8 Template-Type: ReDIF-Article 1.0 Title: Medical audit by claims data? Journal: American Journal of Public Health Author-Name: Bunker, J.P. Author-Name: Fowles, J. Year: 1985 Volume: 75 Issue: 11 Pages: 1261-1262 Handle: RePEc:aph:ajpbhl:1985:75:11:1261-1262_1 Template-Type: ReDIF-Article 1.0 Title: On risks, costs of sterilization. Journal: American Journal of Public Health Author-Name: Grimes, D.A. Author-Name: Peterson, H.B. Year: 1985 Volume: 75 Issue: 10 Pages: 1230 Handle: RePEc:aph:ajpbhl:1985:75:10:1230_8 Template-Type: ReDIF-Article 1.0 Title: PCB exposure from fluorescent lights. Journal: American Journal of Public Health Author-Name: Harris, M.G. Year: 1985 Volume: 75 Issue: 8 Pages: 892 Handle: RePEc:aph:ajpbhl:1985:75:8:892_4 Template-Type: ReDIF-Article 1.0 Title: Auto seat belts: good prenatal, postpartum, and infant care. Journal: American Journal of Public Health Author-Name: Attico, N.B. Author-Name: Smith 3rd., R.J. Author-Name: FitzPatrick, M.B. Author-Name: Keneally, M. Author-Name: Friedman, M.A. Year: 1985 Volume: 75 Issue: 8 Pages: 892-893 Handle: RePEc:aph:ajpbhl:1985:75:8:892-893_6 Template-Type: ReDIF-Article 1.0 Title: On rationing organ transplantation. Journal: American Journal of Public Health Author-Name: Neuspiel, D.R. Year: 1985 Volume: 75 Issue: 8 Pages: 893-894 Handle: RePEc:aph:ajpbhl:1985:75:8:893-894_1 Template-Type: ReDIF-Article 1.0 Title: Auto safety regulation variable: a reply to Robertson. Journal: American Journal of Public Health Author-Name: Orr, L. Year: 1985 Volume: 75 Issue: 7 Pages: 789-790 Handle: RePEc:aph:ajpbhl:1985:75:7:789-790_0 Template-Type: ReDIF-Article 1.0 Title: An important clinical approach in detecting the fragile X syndrome. Journal: American Journal of Public Health Author-Name: Milunsky, A. Year: 1985 Volume: 75 Issue: 7 Pages: 715-716 Handle: RePEc:aph:ajpbhl:1985:75:7:715-716_6 Template-Type: ReDIF-Article 1.0 Title: Abortion: the divisive issue. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1985 Volume: 75 Issue: 7 Pages: 714-715 Handle: RePEc:aph:ajpbhl:1985:75:7:714-715_6 Template-Type: ReDIF-Article 1.0 Title: Costs of not eradicating measles. Journal: American Journal of Public Health Author-Name: Hinman, A.R. Author-Name: Bart, K.J. Author-Name: Hopkins, D.R. Year: 1985 Volume: 75 Issue: 7 Pages: 713-714 Handle: RePEc:aph:ajpbhl:1985:75:7:713-714_5 Template-Type: ReDIF-Article 1.0 Title: Mortality risk factors in the elderly. Journal: American Journal of Public Health Author-Name: Kripke, D.F. Author-Name: Wingard, D. Year: 1985 Volume: 75 Issue: 7 Pages: 788-789 Handle: RePEc:aph:ajpbhl:1985:75:7:788-789_6 Template-Type: ReDIF-Article 1.0 Title: Unsupervised children in motor vehicles. Journal: American Journal of Public Health Author-Name: Kelly, P.C. Author-Name: Weir, M.R. Author-Name: Atkinson, A.W. Year: 1985 Volume: 75 Issue: 6 Pages: 690 Handle: RePEc:aph:ajpbhl:1985:75:6:690_4 Template-Type: ReDIF-Article 1.0 Title: Sterilization methods in China. Journal: American Journal of Public Health Author-Name: Bullough, V.L. Author-Name: Bullough, B. Year: 1985 Volume: 75 Issue: 6 Pages: 689 Handle: RePEc:aph:ajpbhl:1985:75:6:689_0 Template-Type: ReDIF-Article 1.0 Title: Whither goeth the model standards? Journal: American Journal of Public Health Author-Name: Hardy Jr., G.E. Year: 1985 Volume: 75 Issue: 6 Pages: 588-589 Handle: RePEc:aph:ajpbhl:1985:75:6:588-589_6 Template-Type: ReDIF-Article 1.0 Title: Tuberculosis screening. Journal: American Journal of Public Health Author-Name: Abeles, H. Year: 1985 Volume: 75 Issue: 5 Pages: 568-569 Handle: RePEc:aph:ajpbhl:1985:75:5:568-569_8 Template-Type: ReDIF-Article 1.0 Title: The scope of occupational health in developing countries. Journal: American Journal of Public Health Author-Name: Mendes, R. Year: 1985 Volume: 75 Issue: 5 Pages: 467-468 Handle: RePEc:aph:ajpbhl:1985:75:5:467-468_8 Template-Type: ReDIF-Article 1.0 Title: Infant feeding and gastrointestinal illness. Journal: American Journal of Public Health Author-Name: Fomon, S.J. Year: 1985 Volume: 75 Issue: 5 Pages: 468-469 Handle: RePEc:aph:ajpbhl:1985:75:5:468-469_0 Template-Type: ReDIF-Article 1.0 Title: A window on the past: the position of the client in twentieth century public health thought and practice. Journal: American Journal of Public Health Author-Name: Muller, C. Year: 1985 Volume: 75 Issue: 5 Pages: 470-476 Abstract: Citing articles from the American Journal of Public Health and some other publications, Muller looks at the influence that events and changing social values have had on public health professionals' views of their clients in the twentieth century United States. Conclusions about the roles that inheritance, environment, and poverty play in determining personal health and interaction with health systems were often based on culturally-biased assumptions and racial prejudice. Although more scientific and enlightened views occasionally appeared early in the literature, it was not until the 1970s that the detrimental effects of racism and inequality on the clients of public programs were widely acknowledged. Muller warns that the attitudes of the past could resurface, and calls for vigilance in light of the justifications given for the recent budget cuts and program reorganizations. Handle: RePEc:aph:ajpbhl:1985:75:5:470-476_2 Template-Type: ReDIF-Article 1.0 Title: Weighted regression analyses found incorrect. Journal: American Journal of Public Health Author-Name: Markush, R.E. Year: 1985 Volume: 75 Issue: 4 Pages: 413 Handle: RePEc:aph:ajpbhl:1985:75:4:413_6 Template-Type: ReDIF-Article 1.0 Title: "One man's meat, another man's poison": two chapters in the history of public health. Journal: American Journal of Public Health Author-Name: Ozonoff, D. Year: 1985 Volume: 75 Issue: 4 Pages: 338-340 Handle: RePEc:aph:ajpbhl:1985:75:4:338-340_8 Template-Type: ReDIF-Article 1.0 Title: Science and policy making. Journal: American Journal of Public Health Author-Name: Rothman, K.J. Author-Name: Poole, C. Year: 1985 Volume: 75 Issue: 4 Pages: 340-341 Handle: RePEc:aph:ajpbhl:1985:75:4:340-341_4 Template-Type: ReDIF-Article 1.0 Title: A 'gift of God'?: The public health controversy over leaded gasoline during the 1920s. Journal: American Journal of Public Health Author-Name: Rosner, D. Author-Name: Markowitz, G. Year: 1985 Volume: 75 Issue: 4 Pages: 344-352 Handle: RePEc:aph:ajpbhl:1985:75:4:344-352_2 Template-Type: ReDIF-Article 1.0 Title: Life expectancies recalculated. Journal: American Journal of Public Health Author-Name: Taylor, R. Year: 1985 Volume: 75 Issue: 4 Pages: 414 Handle: RePEc:aph:ajpbhl:1985:75:4:414_0 Template-Type: ReDIF-Article 1.0 Title: Prior publication, an ethical issue. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1985 Volume: 75 Issue: 4 Pages: 341-343 Handle: RePEc:aph:ajpbhl:1985:75:4:341-343_3 Template-Type: ReDIF-Article 1.0 Title: Handbook: Radiation safety in shelters. Journal: American Journal of Public Health Author-Name: Evdokimoff, V.N. Year: 1985 Volume: 75 Issue: 4 Pages: 414 Handle: RePEc:aph:ajpbhl:1985:75:4:414_3 Template-Type: ReDIF-Article 1.0 Title: Impacting on drunk driving. Journal: American Journal of Public Health Author-Name: Delaney Jr., T.J. Year: 1985 Volume: 75 Issue: 4 Pages: 413-414 Handle: RePEc:aph:ajpbhl:1985:75:4:413-414_2 Template-Type: ReDIF-Article 1.0 Title: One-fifth of 1983 US births by cesarean section. Journal: American Journal of Public Health Author-Name: Taffel, S.M. Author-Name: Placek, P.J. Author-Name: Moien, M. Year: 1985 Volume: 75 Issue: 2 Pages: 190 Abstract: In November 1984, the Governing Council of the American Public Health Association (APHA) released this position paper on disclosure of occupational health hazards. The Council's action was prompted by the Occupational Health and Safety Administration's (OSHA's) promulgation of a national right-to-know standard that would pre-empt stronger state and local laws protecting an employee's right to be told about hazardous materials in the workplace. The APHA document outlines the dimensions of the toxic substances problem in the United States; argues the need for right-to-know laws; defines the roles of OSHA, unions, and local coalitions for workplace safety; and criticizes the Federal Hazard Communication Standard. Lists of ten essential components of a national right-to-know policy and of four actions the APHA will take to further the worker's right-to-know conclude the paper. Handle: RePEc:aph:ajpbhl:1985:75:2:190_9 Template-Type: ReDIF-Article 1.0 Title: Public health nursing: In sickness or in health? Journal: American Journal of Public Health Author-Name: Buhler-Wilkerson, K. Year: 1985 Volume: 75 Issue: 10 Pages: 1155-1161 Abstract: Public health nursing began in the United States as a small undertaking in which a few wealthy women hired one or two nurses to visit the sick poor in their homes. By 1910, the work of these nurses had expanded to include a variety of preventive programs. While most preventive programs originated with voluntary organizations, such as the visiting nurse societies, they were eventually taken over either by boards of education or health departments. As a consequence of the new division that resulted, sick nursing would increasingly become the sole domain of the voluntary organizations, while the teaching of prevention would become the responsibility of public agencies. By examining the history of public health nursing between 1900-30, this article considers why a movement that might have been significant in delivering comprehensive health care to the American public failed to reach its potential. Handle: RePEc:aph:ajpbhl:1985:75:10:1155-1161_6 Template-Type: ReDIF-Article 1.0 Title: Injury reduction by mandatory child passenger safety laws Journal: American Journal of Public Health Author-Name: Agran, P.F. Author-Name: Wehrle, P.F. Year: 1985 Volume: 75 Issue: 2 Pages: 128-129 DOI: 10.2105/AJPH.75.2.128 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.128 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.128_4 Template-Type: ReDIF-Article 1.0 Title: Non-fatal suicidal and life-threatening behavior among 13- to 17-year old adolescents seeking emergency medical care Journal: American Journal of Public Health Author-Name: Deykin, E.Y. Author-Name: Perlow, R. Author-Name: McNamarra, J. Year: 1985 Volume: 75 Issue: 1 Pages: 90-92 DOI: 10.2105/AJPH.75.1.90 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.90 Abstract: In suicidal behavior emergency room admissions of 13- to 17-year olds at the Brockton Hospital (Massachusetts), females predominated over males by almost two to one. For subclassification of life-threatening behaviors, frequency was about the same for males and females, but fur suicide attempts and suicide gestures, female frequency was two to four time that of males. Repeat episodes of self-inflicted injury were more common among females. The type of the initial episode was a powerful predictor of a repeat occurrence. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.90_0 Template-Type: ReDIF-Article 1.0 Title: Standards for local public health services: Where stand the states? Journal: American Journal of Public Health Author-Name: Schaefer, M. Author-Name: Abrantes, A. Year: 1985 Volume: 75 Issue: 6 Pages: 649-650 DOI: 10.2105/AJPH.75.6.649 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.649 Abstract: Of the 47 states that participated in a 1983 survey of State Health Departments, 30 were found to have public health standards in place or started. Most states' standards emphasize the range of services to be provided, but substantial variations were found in how standards are formulated, adopted, and used by state and local agencies. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.649_7 Template-Type: ReDIF-Article 1.0 Title: Does a vegeterian diet reduce the occurrence of diabetes? Journal: American Journal of Public Health Author-Name: Snowdon, D.A. Author-Name: Phillips, R.L. Year: 1985 Volume: 75 Issue: 5 Pages: 507-512 Abstract: We propose the hypothesis that a vegetarian diet reduces the risk of developing diabetes. Findings that have generated this hypothesis are from a population of 25,698 adult White Seventh-day Adventists identified in 1960. During 21 years of follow-up, the risk of diabetes as an underlying cause of death in Adventists was approximately one-half the risk for all US Whites. Within the male Adventist population, vegetarians had a substantially lower risk than non-vegetarians of diabetes as an underlying or contributing cause of death. Within both the male and female Adventist populations, the prevalence of self-reported diabetes also was lower in vegetarians than in non-vegetarians. The associations observed between diabetes and meat consumption were apparently not due to confounding by over- or under-weight, other selected dietary factors, or physical activity. All of the associations between meat consumption and diabetes were stronger in males than in females. Handle: RePEc:aph:ajpbhl:1985:75:5:507-512_8 Template-Type: ReDIF-Article 1.0 Title: Patterns of contraceptive method of use by California family planning clinic clients, 1976-84 Journal: American Journal of Public Health Author-Name: Aved, B.M. Year: 1985 Volume: 75 Issue: 10 Pages: 1210-1212 Abstract: Trends in contraceptive method of use by California family planning clients, 1976-84, are reviewed. Although use of foam and condoms doubled from 1976 to 1980 and was sustained, interest peaked but markedly declined for the diaphragm. Oral contraceptive (OC) use declined overall and most notably for older women, but there are indications in 1983 and 1984 of a slight OC 'come back'. Older women were more likely to choose methods free from medical side effects than were younger women. Handle: RePEc:aph:ajpbhl:1985:75:10:1210-1212_3 Template-Type: ReDIF-Article 1.0 Title: An evaluation of subsidized rural primary care programs: IV. Impact of the rural hospital on clinic self-sufficiency Journal: American Journal of Public Health Author-Name: McLaughlin, C.P. Author-Name: Ricketts, T.C. Author-Name: Freund, D.A. Author-Name: Sheps, C.G. Year: 1985 Volume: 75 Issue: 7 Pages: 749-753 Abstract: Subsidized rural clinics and providers have long depended on the rural hospital for the care of some of their patients; the hospital has also been a source of revenue for these providers and programs. We studied a representative national sample of 116 subsidized rural clinics, focusing on the impact on rural clinic costs and revenues of the use of the hospital by the clinics' providers. Both clinic costs and revenue are reduced by the use of the hospital by rural practice providers, but costs are lowered to a greater extent than revenues, thereby enhancing the financial self-sufficiency of the subsidized clinic. The cost savings affect all aspects of clinic operation, but especially laboratory costs, community services costs, and administrative costs. The dependence of these rural clinics on the hospital indicates that the condition of subsidized rural clinics would be worsened by decreased availability of hospital services. Handle: RePEc:aph:ajpbhl:1985:75:7:749-753_1 Template-Type: ReDIF-Article 1.0 Title: Coital and non-coital sexual behaviors of White and Black adolescents Journal: American Journal of Public Health Author-Name: Smith, E.A. Author-Name: Udry, J.R. Year: 1985 Volume: 75 Issue: 10 Pages: 1200-1203 Abstract: As part of a longitudinal study of young adolescents, data were collected in 1980 on the non-coital and coital sexual experiences of male and female adolescents who ranged in age from 12 to 15 at the time of the initial contact. The follow-up data were collected two years later. Both a Guttman'scale analysis and a longitudinal analysis of these data indicate different sexual patterns between White and Black teens; Whites are more likely than Blacks to engage in a predictable series of non-coital behaviors for a period of time before their first intercourse experience. Of the sexual behaviors studied, the pre-coital experiences of Black teens were less predictable and often involved only necking. These differences in sexual norms offer a partial explanation for the different pregnancy rates between these two groups. They also suggest that sexual and contraceptive education and counseling need to be cognizant of these differences since pre-coital experience may function as both a mechanism to prolong abstinence and to promote a gradual acceptance of one's sexuality. Handle: RePEc:aph:ajpbhl:1985:75:10:1200-1203_4 Template-Type: ReDIF-Article 1.0 Title: Fashion and freedom: When artificial feeding should be withdrawn Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1985 Volume: 75 Issue: 6 Pages: 685-688 DOI: 10.2105/AJPH.75.6.685 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.685 Abstract: Appellate courts in three states have now ruled that there is no legal difference between artificial feeding and any other medical treatment and that therefore feeding may be refused by a competent patient or, in appropriate circumstances, by the family or guardian of an incompetent patient. Annas discusses the ethical and legal problems presented by these cases--California's Barber v. Superior Court, New Jersey's In re Conroy, and Massachusetts' In re Hier. He concludes that statutes are needed that would enhance the rights of competent individuals to refuse any treatment and to execute a living will or assign a durable power of attorney. Legislation is also needed to protect incompetents by providing a mechanism for legal guardians to refuse treatment. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.685_6 Template-Type: ReDIF-Article 1.0 Title: WIC prenatal participation and its relationship to newborn Medicaid costs in Missouri: A cost/benefit analysis Journal: American Journal of Public Health Author-Name: Schramm, W.F. Year: 1985 Volume: 75 Issue: 8 Pages: 851-857 Abstract: The primary purpose of this study was to determine if WIC prenatal participation is associated with a reduction in Medicaid costs within 30 days after birth, and, if so, whether the reduction in Medicaid costs is greater than the WIC costs for these women. This evaluation of WIC was performed using 7,628 Missouri Medicaid records matched with their corresponding 1980 birth records. This file was then divided into a WIC group containing 1,883 records and a non-WIC comparison group of 5,745 records. WIC participation was found to be associated with the reduction in Medicaid newborn costs of about $100 per participant (95% confidence interval $43,153); mother's Medicaid costs were not affected. For every dollar spent on WIC, about 83c in Medicaid costs within 30 days of birth were apparently saved according to the results of this study (95% confidence interval $.40, $1.30). Reductions in low birthweight rates and NICU admission rates among WIC infants provided two possible reasons for the reduced Medicaid costs associated with WIC food supplementation. As WIC food costs increased, both mean birthweight and newborn Medicaid savings also increased. Because of possible inconsistencies in the data, similar studies are needed in other states. Handle: RePEc:aph:ajpbhl:1985:75:8:851-857_2 Template-Type: ReDIF-Article 1.0 Title: Nutritional status of men attending a soup kitchen: A pilot study Journal: American Journal of Public Health Author-Name: Laven, G.T. Author-Name: Brown, K.C. Year: 1985 Volume: 75 Issue: 8 Pages: 875-878 Abstract: Nutritional status and socioeconomic characteristics of 49 men attending a soup kitchen in a residential neighborhood of Birmingham, Alabama were determined by interview, anthropometry and laboratory assays. Laboratory or anthropometric evidence of nutrient deficiency was present in 94% of the subjects. Deficiency of ascorbate (63%), folate (35%), and thiamin (29%) was higher in these men than in either patients or presumably healthy adults. Since soup kitchen meals provided insufficient vitamin C and folate, additional sources of these nutrients should be provided. Handle: RePEc:aph:ajpbhl:1985:75:8:875-878_0 Template-Type: ReDIF-Article 1.0 Title: Referrals by traditional birth attendants in northeast Brazil Journal: American Journal of Public Health Author-Name: Janowitz, B. Author-Name: Wallace, S. Author-Name: Araujo, G. Author-Name: Araujo, L. Year: 1985 Volume: 75 Issue: 7 Pages: 745-748 Abstract: Between October 1980 and July 1981, 1,878 women were attended by traditional birth attendants (TBAs) at four obstetric units in rural areas surrounding the city of Fortaleza in northeast Brazil. Of these women, 232 (12.4%) were referred to a hospital in Fortaleza for delivery. The most important indicators for referral to hospital were: presence of an antenatal problem, complication of labor, or malpresentation. Based on record review, 65 referred women with none of these conditions were classified as low risk and 42 women not referred were classified as high risk (at least one such condition present). Of 1,878 deliveries, 32 (17 per 1,000) terminated as fetal deaths, and 12 infants died before discharge from hospital or obstetric unit (6 per 1,000). The death rate was much higher for the high-risk cases (156 per 1,000 referrals, 95 for nonreferrals). Although some women may have been inappropriately referred while others who should have been were not referred, the system of referral has allowed TBAs to attend uncomplicated deliveries and to refer women with complications. Handle: RePEc:aph:ajpbhl:1985:75:7:745-748_5 Template-Type: ReDIF-Article 1.0 Title: Does race affect hospital use? Journal: American Journal of Public Health Author-Name: Wilson, P.A. Author-Name: Griffith, J.R. Author-Name: Tedeschi, P.J. Year: 1985 Volume: 75 Issue: 3 Pages: 263-269 DOI: 10.2105/AJPH.75.3.263 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.263 Abstract: Based on 1980 hospital discharges in areas in the State of Michigan, with substantial Black populations, Blacks use approximately 50 per cent more hospital care than Whites, but about half this difference is associated with use in specific communities which affects both White and Black use. Black use is not associated with community size, per cent of Blacks, or available beds and doctors. After controlling for mortality and socioeconomic status, a small statistically non-significant difference in race-specific use remains for 23 Michigan communities. The elimination of race as an explainer of hospital use suggests progress in assuring equal access to hospitals, but differences in poverty, mortality, and some specifics of use remain. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.263_7 Template-Type: ReDIF-Article 1.0 Title: I.S. Falk, the Committee on the Costs of Medical Care, and the drive for National Health Insurance Journal: American Journal of Public Health Author-Name: Roemer, M.I. Year: 1985 Volume: 75 Issue: 8 Pages: 841-848 Handle: RePEc:aph:ajpbhl:1985:75:8:841-848_4 Template-Type: ReDIF-Article 1.0 Title: Dental health and public policy: The social impact of dental disease Journal: American Journal of Public Health Author-Name: Reisine, S.T. Year: 1985 Volume: 75 Issue: 1 Pages: 27-30 DOI: 10.2105/AJPH.75.1.27 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.27 Abstract: This paper analyzes the potential of using measures of social function as health indicators in dental research. It discusses existing methodologies and presents findings from a cross-section of studies that adopt a social function perspective in the investigation of oral health status. While the literature in this area is small, much of the research concerns disability days associated with dental problems. The United States National Health Interverview Survey reported in 1981 that 4.87 million dental conditions caused 17.7 million days of restricted activity, 6.73 million days of bed disability, and 7.05 million days of work loss. Other reports suggest that these data may be underestimates due to the National Health Survey's definition of disability days. Several other studies have found work loss to affect from 15 per cent to 33 per cent of samples studied resulting in many more work loss days than reported by the National Health Survey. Our study concludes that traditional measures of oral health status - such as decayed, missing, and filled teeth and the periodontal index - should be linked to measures of social outcome in order to place dental conditions within the broader context of health status in terms that are relevant to policy makers. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.27_7 Template-Type: ReDIF-Article 1.0 Title: A simple language-based acculturation scale for Mexican Americans: Validation and application to health care research Journal: American Journal of Public Health Author-Name: Deyo, R.A. Author-Name: Diehl, A.K. Author-Name: Hazuda, H. Author-Name: Stern, M.P. Year: 1985 Volume: 75 Issue: 1 Pages: 51-55 DOI: 10.2105/AJPH.75.1.51 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.51 Abstract: A simple scale for quantifying English use among Mexican Americans was constructed from four brief questions which proved to have excellent scaling characteristics by Guttman Scalogram Analysis in two independent data sets. Construct validity was established by significant asociations of the scale with ethnicity, place of birth, generation within the United States, and type of neighborhood. Highly significant associations were found between scale scores and use of oral contraceptives, parity, 'fatalism' regarding health, and attitudes toward folk healers. These associations remained significant (though weak) after controlling for education and family income. The language scale thus appears to be reliable and valid, to be capable of distinguishing meaningful subsets among the Mexican American population, and to be applicable to health care investigation. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.51_0 Template-Type: ReDIF-Article 1.0 Title: Firearm-related fatalities: An epidemiologic assessment of violent death Journal: American Journal of Public Health Author-Name: Alexander, G.R. Author-Name: Massey, R.M. Author-Name: Gibbs, T. Author-Name: Altekruse, J.M. Year: 1985 Volume: 75 Issue: 2 Pages: 165-168 DOI: 10.2105/AJPH.75.2.165 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.165 Abstract: This study examines 1970-78 South Carolina firearm fatalities utilizing vital record data. During this period, 5,808 firearm deaths, classified as accident, homicide, suicide, or undetermined, were reported with an average annual fatality rate of 23.35 deaths per 100,000 estimated population. Firearm fatalities in South Carolina were the sixth leading cause of death in 1975 and accounted for 2.9 per cent of all deaths to residents. A significant period decline in the firearm fatality rate was observed and was attributed mainly to decreases in the non-White rate. In 1978, the fatality rate for non-Whites (18.5) fell below the rate for Whites (19.1) for the first time in the years investigated. Firearm deaths represent a major community health problem and, as such, warrant attention and direct involvement by state and local health professionals. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.165_7 Template-Type: ReDIF-Article 1.0 Title: Limitations of provider interventions in hypertension quality assurance Journal: American Journal of Public Health Author-Name: Winickoff, R.N. Author-Name: Wilner, S. Author-Name: Neisuler, R. Author-Name: Barnett, G.O. Year: 1985 Volume: 75 Issue: 1 Pages: 43-46 DOI: 10.2105/AJPH.75.1.43 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.43 Abstract: In an institutional quality assurance program in hypertension, performance of tests, control of blood pressure, and follow-up were monitored through a computer program that was developed to audit records in an automated record system. Two types of feedback previously shown to be effective were provided quarterly for a period of one year to experimental providers. For all hypertensives considered together, there were no differences between scores of Experimental and Control providers based on percentage of patients meeting pre-set criteria in testing - 87% vs 87% -, blood prssure control - 58% vs 59% -, or follow-up - 79% vs 77%. Only small but significant differences occurred in the subgroup of moderate to severe hypertensives. There appear to be limitations to what can be accomplished through hypertension quality assurance interventions directed at providers of care in this institutional setting. Interventions designed to deal directly with patients whose blood pressures are uncontrolled may be more effective. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.43_1 Template-Type: ReDIF-Article 1.0 Title: The immediate and subsequent outcomes of nursing home care Journal: American Journal of Public Health Author-Name: Lewis, M.A. Author-Name: Kane, R.L. Author-Name: Cretin, S. Author-Name: Clark, V. Year: 1985 Volume: 75 Issue: 7 Pages: 758-762 Abstract: To determine the relationship between admission status and subsequent outcomes, 563 patients discharged during 1980 from 24 nursing homes were followed through 1982. Only 28% of patients were discharged to their homes. Reconstructed life histories of 529 discharges for the two-year follow-up revealed only 38 persons (7.2%) were alive and at home; of these, 36 had been initially discharged to their homes. Four hundred and one persons (75.8%) were dead. Mental orientation, urinary continence, functional status, hip fracture, and diagnoses associated with dementia were found to be significant predictors of outcome status after discharge and at follow-up. Social support had only a modest effect on the former outcomes. Handle: RePEc:aph:ajpbhl:1985:75:7:758-762_4 Template-Type: ReDIF-Article 1.0 Title: Good medical care in nursing homes Journal: American Journal of Public Health Author-Name: Golodetz, A. Year: 1985 Volume: 75 Issue: 3 Pages: 227 Handle: RePEc:aph:ajpbhl:1985:75:3:227_6 Template-Type: ReDIF-Article 1.0 Title: Leptospiral exposure in Detroit rodent control workers Journal: American Journal of Public Health Author-Name: Demers, R.Y. Author-Name: Frank, R. Author-Name: Demers, P. Author-Name: Clay, M. Year: 1985 Volume: 75 Issue: 9 Pages: 1090-1091 Abstract: Antibody levels to L. icterohemorrhagiae of rodent control workers and two control groups were compared with antibodies against five other leptospiral serotypes carried predominantly by species other than rats. Rodent control workers contact urban rats, 77 per cent of which are carriers of leptospiral organisms. Rodent control workers had higher antibody levels against L. icterohemorrhagiae than control groups (OR 4.37, 99 per cent CI = 3.0, 6.3 and OR 11.08, 99 per cent CI = 5.6, 22). Antibodies against the other five serotypes were almost non-existent in the study group. Handle: RePEc:aph:ajpbhl:1985:75:9:1090-1091_3 Template-Type: ReDIF-Article 1.0 Title: Improving frequency and proficiency of breast self-examination: Effectiveness of an education program Journal: American Journal of Public Health Author-Name: Mamon, J.A. Author-Name: Zapka, J.G. Year: 1985 Volume: 75 Issue: 6 Pages: 618-624 DOI: 10.2105/AJPH.75.6.618 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.618 Abstract: A randomized trial to improve breast self-examination (BSE) performance among college-age women was developed and results evaluated at a large public university. The major intervention was a BSE group education session conducted in classroom and workshop settings. The pre-intervention and 6-months-after experimental-control comparisons show that: current performance of BSE increased by 26%, bi-monthly or more often BSE performance increased by 29%, and performance proficiency improved by 22%. A change index, adjusting for each group's level on these three measures at pre-intervention, showed higher levels of change; 57%, 36%, and 28%, respectively. A significantly larger proportion of women in the experimental group discussed BSE with others than women in the control groups. The 'talked to' mothers, compared to the 'not talked to' mothers performed BSE more regularly, in more positions, and spent more time on the examination. The results from this study suggest that properly targeted educational programs can significantly improve early detection behaviors in women. In addition, the evaluation protocol defined proficiency measures and validated measurement tools. Subsequent studies need to examine the relation of proficiency measures to detection of abnormality and subsequent effect on morbidity and mortality, so that the debate about BSE efficacy can be scientifically addressed. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.618_3 Template-Type: ReDIF-Article 1.0 Title: The influence of client-provider relationships on teenage women's subsequent use of contraception Journal: American Journal of Public Health Author-Name: Nathanson, C.A. Author-Name: Becker, M.H. Year: 1985 Volume: 75 Issue: 1 Pages: 33-38 DOI: 10.2105/AJPH.75.1.33 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.33 Abstract: This paper describes the relationships of selected dimensions of nurse-client interaction in county health department family planning clinics to the subsequent contraceptive use of the clinic's unmarried teenage clients. The subjects for the study are the clients and professional staff of 78 clinics: 2,900 eligible clients making their first contraceptive visit and 338 clinic staff nurses. Results of interviews demonstrate that client and staff expectations and interactions are significant predictors of adherence to a contraceptive regimen; under circumstances where clients anticipate, and staff employ, authoritative guidance in helping the clients to select a contraceptive method, clinic mean levels of contraceptive use are substantially increased. Overall, 40 per cent of clinic variation in contraceptive compliance is explained by the interaction dimensions and other aspects of clinic organization addressed in this paper. Implications of these results for the structuring of family planning clinic programs directed toward teenage women are briefly considered. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.33_4 Template-Type: ReDIF-Article 1.0 Title: Skills intervention to prevent cigarette smoking among adolescents Journal: American Journal of Public Health Author-Name: Schinke, S.P. Author-Name: Gilchrist, L.D. Author-Name: Snow, W.H. Year: 1985 Volume: 75 Issue: 6 Pages: 665-667 DOI: 10.2105/AJPH.75.6.665 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.665 Abstract: Skills intervention to prevent cigarette smoking was evaluated with 689 adolescents. At 24-month follow-up, youths who received health information and skills intervention had lower intentions to smoke and less cigarette use than youths who received health information alone and youths who received no intervention. Conclusions about the effects of skills intervention are strengthened by the common preparation and random assignment of intervention leaders and by process measurement data. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.665_3 Template-Type: ReDIF-Article 1.0 Title: An outbreak of foodborne hepatitis A showing a relationship between dose and incubation period Journal: American Journal of Public Health Author-Name: Istre, G.R. Author-Name: Hopkins, R.S. Year: 1985 Volume: 75 Issue: 3 Pages: 280-281 DOI: 10.2105/AJPH.75.3.280 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.280 Abstract: Seven of eleven persons who attended a picnic developed symptoms of hepatitis A, two and a half to five weeks later. The epidemiologically implicated source was tuna salad, served in sandwiches and prepared by the index case. The number of sandwiches consumed was inversely related to the incubation period. This phenonemon may explain some of the variability of incubation periods for hepatitis A. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.280_8 Template-Type: ReDIF-Article 1.0 Title: Studies of migrant populations Journal: American Journal of Public Health Author-Name: Haenszel, W. Year: 1985 Volume: 75 Issue: 3 Pages: 225-226 DOI: 10.2105/AJPH.75.3.225 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.225 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.225_4 Template-Type: ReDIF-Article 1.0 Title: Cancer risk in adulthood from early life exposure to parents' smoking Journal: American Journal of Public Health Author-Name: Sandler, D.P. Author-Name: Everson, R.B. Author-Name: Wilcox, A.J. Author-Name: Browder, J.P. Year: 1985 Volume: 75 Issue: 5 Pages: 487-492 DOI: 10.2105/AJPH.75.5.487 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.487 Abstract: We obtained data on smoking by parents from 438 cancer cases and 470 controls to investigate whether cancer risk in adult life is related to transplacental or childhood exposure to cigarette smoke. Cancer cases were between ages 15 and 59 at time of diagnosis. All sites but basal cell cancer of the skin were included. Cancer risk was increased 50 per cent among offspring of men who smoked. Increased risk associated with father's smoking was not explained by demographic factors, social class, or individual smoking habits, and was not limited to known smoking related sites. Relative risk (RR) estimates associated with father's smoking tended to be greatest for smokers, males, and non-Whites. There was only a slight increase in overall cancer risk associated with maternal smoking. Mother's and father's smoking were both associated with risk for hematopoietic cancers, and a dose-response relationship was seen. The RR for hematopoietic cancers increased from 1.7 when only one parent smoked to 4.6 when both parents smoked. Although they should be considered tentative, study findings suggest a long-term hazard from transplacental or childhood passive exposure to cigarette smoke. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.487_8 Template-Type: ReDIF-Article 1.0 Title: Public opinion about doctors' pay Journal: American Journal of Public Health Author-Name: Ross, C.E. Author-Name: Lauritsen, J. Year: 1985 Volume: 75 Issue: 6 Pages: 668-670 DOI: 10.2105/AJPH.75.6.668 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.668 Abstract: Public opinion about doctors' incomes was examined in a national random sample of 843 respondents; 70.1% of those questioned felt physicians are overpaid. There was a high degree of agreement among various groups that physicians are overpaid, but older people and Whites were more likely to think so than younger people and other ethnic groups. People who believe that the United States is characterized by unequal educational opportunity, unfair income distribution, and limited resources were also more likely to think physicians are overpaid. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.668_6 Template-Type: ReDIF-Article 1.0 Title: Supports, stressors, and depressive symptoms in low-income mothers of young children Journal: American Journal of Public Health Author-Name: Hall, L.A. Author-Name: Williams, C.A. Author-Name: Greenberg, R.S. Year: 1985 Volume: 75 Issue: 5 Pages: 518-522 DOI: 10.2105/AJPH.75.5.518 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.518 Abstract: We investigated the association of social supports and stresses with depressive symptoms in a sample of 111 predominantly low-income mothers of young children. The prevalence of high depressive symptoms, as measured by the Center for Epidemiologic Studies-Depression Scale (CES-D), was 48 per cent. Among unmarried women, everyday stressors were strongly associated with depressive symptoms, while life events were weakly related. Associations between these variables were not found for married women. Comparing the relative importance of two different types of support - the quality of primary intimate relationships, and the social network - only the quality of the husband-intimate relationship was associated with CES-D scores among married women, whereas the social network demonstrated a moderate, inverse association with CES-D scores among unemployed women. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.518_0 Template-Type: ReDIF-Article 1.0 Title: Regionalization of medical care Journal: American Journal of Public Health Author-Name: Luft, H.S. Year: 1985 Volume: 75 Issue: 2 Pages: 125-126 DOI: 10.2105/AJPH.75.2.125 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.125 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.125_4 Template-Type: ReDIF-Article 1.0 Title: Meningitis: Describing the community health problem Journal: American Journal of Public Health Author-Name: Skoch, M.G. Author-Name: Walling, A.D. Year: 1985 Volume: 75 Issue: 5 Pages: 550-552 DOI: 10.2105/AJPH.75.5.550 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.550 Abstract: We identified all 391 cases of meningitis hospitalized in a metropolitan community (population 367,094) over a four-year period to assess incidence, morbidity, and mortality. The crude incidence rate was 27 per 100,000 person years; the incidence rate for children under 5 years of age was 174 per 100,000 person years. The case fatality rate was 3 per cent. Bacterial organisms were identified in 33 per cent of all cases, with H. influenzae most commonly observed (53 per cent). Only 16 per cent of hospitalized cases were known to the county health department. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.550_2 Template-Type: ReDIF-Article 1.0 Title: Psychoneuroses among Mexican Americans and other Whites: Prevalence and caseness Journal: American Journal of Public Health Author-Name: Vega, W.A. Author-Name: Kolody, B. Author-Name: Warheit, G. Year: 1985 Volume: 75 Issue: 5 Pages: 523-527 DOI: 10.2105/AJPH.75.5.523 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.523 Abstract: This paper reports the findings from an epidemiological survey conducted in California using the Health Opinion Survey (HOS), a measure of psychoneuroticism, as well as other scales and inventories. Uncontrolled results indicate that Mexican Americans have higher symptom and case levels, but that these differences are found primarily among marginally acculturated and immigrant respondents. HOS caseness levels were 15.4 for Spanish-speaking Mexican Americans, 6.6 for English-speaking Mexican Americans, and 5.5 for other Whites. Joint effects of ethnicity for sex, age, education, and marital status were substantial, however there were differences in caseness between Spanish-speaking Mexican Americans, English-speaking Mexican Americans, and other Whites on four measures of psychological distress. The results indicate the importance of acculturation-related factors, including educational attainment, language preference, and nativity for predicting symptomatology among Mexican Americans. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.523_4 Template-Type: ReDIF-Article 1.0 Title: The use of comparability ratios to adjust hospital trend data Journal: American Journal of Public Health Author-Name: Gee, S.C. Author-Name: Page, W.F. Year: 1985 Volume: 75 Issue: 1 Pages: 81-82 DOI: 10.2105/AJPH.75.1.81 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.81 Abstract: Hospital trend data may be affected by changes in diagnostic coding schemes. We studied the change from ICDA-8 (I-8) to ICD-9-CM (I-9) in a sample of roughly 13,600 double-coded Veterans Administration hospital diagnoses. Comparability ratios were computed and used to adjust trend data which overlap the time period when the shift from I-8 to I-9 occurred. With this adjustment for change in diagnostic coding scheme, apparent diagnostic trends are substantially altered. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.81_9 Template-Type: ReDIF-Article 1.0 Title: Florence Nightingale on public health nursing Journal: American Journal of Public Health Author-Name: Monteiro, L.A. Year: 1985 Volume: 75 Issue: 2 Pages: 181-185 Abstract: Florence Nightingale, in addition to her role in initiating nursing education programs, was also involved in developing nursing for the sick poor at home and in workhouses through her work for poor law and workhouse reform of the 1860s. Her writings on public health nursing - 11 items that were written during a space of more than 30 years - emphasize the need for special training for public health nurses, the importance of sanitation and disease prevention through the nurse's teaching of the sick poor, and the demoralizing nature of poverty and pauperization. Handle: RePEc:aph:ajpbhl:1985:75:2:181-185_7 Template-Type: ReDIF-Article 1.0 Title: Delegation of expanded functions to dental assistants and hygienists Journal: American Journal of Public Health Author-Name: Chapko, M.K. Author-Name: Milgrom, P. Author-Name: Bergner, M. Author-Name: Conrad, D. Author-Name: Skalabrin, N. Year: 1985 Volume: 75 Issue: 1 Pages: 61-65 DOI: 10.2105/AJPH.75.1.61 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.61 Abstract: One hundred and twenty-six dental offices in Washington State kept a record of each time and expanded function was performed by the dentist, hygienist, or assistant. There were five two-week recording periods starting in February 1979 and ending in February 1981. Consistent with increasing productivity, dentists most frequently delegate tasks to dental assistants rather than dental hygienists and delegate an individual task consistently if it is delegated at all. For tasks that may be delegated to the assistant, a relationship was found between the per cent of dentists delegating an individual task and the amount of the dentist's time that is freed through delegating that task. From the perspective of quality of care, the per cent of dentists who delegate a task was inversely related to the complexity of the task. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.61_7 Template-Type: ReDIF-Article 1.0 Title: Public opinion on and potential demand for vasectomy in semi-rural Guatemala Journal: American Journal of Public Health Author-Name: Santiso, R. Author-Name: Bertrand, J.T. Author-Name: Pineda, M.A. Author-Name: Guerra, S. Year: 1985 Volume: 75 Issue: 1 Pages: 73-75 DOI: 10.2105/AJPH.75.1.73 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.73 Abstract: In this study of 1,600 men aged 25-50 from semi-rural Guatemala, three-fourths had heard of vasectomy. Among these, 54 per cent approved of it. However, the survey reveals a widespread lack of knowledge regarding the procedure, as well as negative perceptions or doubts about its effect on sexual performance, ability to do hard work, health, and manhood. One-fourth of the respondents who knew of vasectomy and who desired no more children expressed interest in having the operation, a finding which raises questions as to the potential (unrecognized) demand for vasectomy in other developing countries. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.73_3 Template-Type: ReDIF-Article 1.0 Title: A randomized controlled study of a home health care team Journal: American Journal of Public Health Author-Name: Zimmer, J.G. Author-Name: Groth-Juncker, A. Author-Name: McCusker, J. Year: 1985 Volume: 75 Issue: 2 Pages: 134-141 DOI: 10.2105/AJPH.75.2.134 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.134 Abstract: This report describes the findings of a randomized study of a new team approach to home care for homebound chronically or terminally ill elderly. The team includes a physician, nurse practitioner, and social worker delivering primary health care in the patient's home, including physician house calls. Weekly team conferences assure coordination of patient care. The team is available for emergency consultation through a 24-hour telephone service. The team physician attends to the patient during necessary hospitalizations. This approach was evaluated in a randomized experimental design study measuring its impact on health care utilization, functional changes in patients, and patient and caretaker satisfaction. The team patients had fewer hospitalizations, nursing home admissions, and outpatients visits than the controls. They were more often able to die at home, if this was their wish. As expected, they used more in-home services, measured in weighted cost figures; their overall cost was lower than their controls, but the difference was not statistically significant. Their functional abilities did not change differently from the controls, but they, and especially their informal caretakers in the home, expressed significantly higher satisfaction with the care received. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.134_7 Template-Type: ReDIF-Article 1.0 Title: Industry invites regulation: The passage of the Pure Food and Drug Act of 1906 Journal: American Journal of Public Health Author-Name: Barkan, I.D. Year: 1985 Volume: 75 Issue: 1 Pages: 18-26 DOI: 10.2105/AJPH.75.1.18 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.18 Abstract: Ending its 27-year stranglehold on proposals for federal pure food and drug legislation, Congress passed the Pure Food and Drug Act and its companion bill, the Meal Inspection Act, on June 30, 1906. An unprecedented convergence of consumer, scientific, and industrial support in 1906 prompted such action; most industries even planned for it, hoping regulation would restore the competitiveness of their products on weak foreign and domestic markets. The ways in which these interests converged, and the reasons therefor, suggest a change in their relationship to each other and with the federal government as America headed into the twentieth century. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.18_8 Template-Type: ReDIF-Article 1.0 Title: The elderly's private insurance coverage of nursing home care Journal: American Journal of Public Health Author-Name: Cafferata, G.L. Year: 1985 Volume: 75 Issue: 6 Pages: 655-656 DOI: 10.2105/AJPH.75.6.655 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.655 Abstract: About 40% of Medicare beneficiaries had private insurance coverage of skilled nursing facilities (SNF) in 1977. Data from the 1977 National Medical Care Expenditure Survey show that among such persons, about 85% had full coverage of Medicare's Part A copayments for days 21-100 but only 15.7% had maximum coverage of at least 365 days of care or a benefit of $100,000 or more. The most comprehensive benefits are found among persons with middle or high incomes; more generous first-dollar coverage is found in the North Central and South regions, and more generous maximums in the West. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.655_1 Template-Type: ReDIF-Article 1.0 Title: VMA mass screening program of neuroblastoma for infants in Nagoya City, Japan Journal: American Journal of Public Health Author-Name: Kodama, K. Author-Name: Nakata, T. Author-Name: Ishii, J. Author-Name: Mitani, K. Author-Name: Tsunooka, H. Author-Name: Masaoka, A. Author-Name: Aoyama, M. Year: 1985 Volume: 75 Issue: 2 Pages: 173-175 DOI: 10.2105/AJPH.75.2.173 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.173 Abstract: In Nagoya City, Japan, VMA mass screening for detection of neuroblastoma has been performed since 1977. Filter paper strips wetted with urine are mailed to a central laboratory. Positive tests are followed up by more definitive testing. Of the 20,053 urine samples of 6-month-old infants tested, January 1977 to March 1983, five asymptomatic infants with neuroblastoma have been discovered. All have been treated and are alive as of January 1984. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.173_7 Template-Type: ReDIF-Article 1.0 Title: Epidemics in Renaissance Florence Journal: American Journal of Public Health Author-Name: Morrison, A.S. Author-Name: Kirshner, J. Author-Name: Molho, A. Year: 1985 Volume: 75 Issue: 5 Pages: 528-535 DOI: 10.2105/AJPH.75.5.528 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.528 Abstract: Epidemics and mortality in 15th and 16th century Florence, Italy, were investigated by use of records of the government-sponsored Dowry Fund. These records contain the date of birth, date of investment, and date of dowry payment or death of 19,000 girls and women. Major epidemics ('plagues') occurred repeatedly. The most severe were in 1430, 1437-38, 1449-50, 1478-79, and 1527-31. Annual death rates of girls enrolled in the Dowry Fund increased by 5 to 10 times in each of these periods. During the last period, at least 20-25 per cent of the population of Florence is likely to have died. Recurrent epidemics accounted for 38 per cent of the total mortality experienced by girls enrolled in the Dowry Fund. The frequency of serious epidemics diminished with the passage of time, and overall mortality declined by about 10 per cent over the 15th and 16th centuries. Epidemic mortality was not consistently related to age. The effects of epidemics were most severe in the summer and autumn. Non-epidemic mortality was also greater in the summer and autumn than in the winter and spring. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.528_0 Template-Type: ReDIF-Article 1.0 Title: Selected perinatal factors and child abuse Journal: American Journal of Public Health Author-Name: Benedict, M.I. Author-Name: White, R.B. Year: 1985 Volume: 75 Issue: 7 Pages: 780-781 Abstract: A matched pair case-control study was conducted to compare birthweights, gestations, and length of hospital stay (LOS) of 532 children subsequently reported as physically abused with comparable data from a group of control children matched on age, sex, race, and maternal education. Our results indicated a moderate association between both low birthweight and very short gestation with physical abuse. Results for LOS were inconclusive. Handle: RePEc:aph:ajpbhl:1985:75:7:780-781_8 Template-Type: ReDIF-Article 1.0 Title: Cesarean delivery in Northeast region of Brazil, 1978-80 Journal: American Journal of Public Health Author-Name: Janowitz, B. Author-Name: Rodrigues, W. Author-Name: Covington, D.L. Author-Name: Arruda, J.M. Author-Name: Morris, L. Year: 1985 Volume: 75 Issue: 5 Pages: 560-562 DOI: 10.2105/AJPH.75.5.560 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.560 Abstract: This study presents information on cesarean section rates for the last baby born to 1,746 women in Northeast Brazil between January 1978 and the date of a 1980 household survey. For hospital deliveries, the c-section rate is 19 per cent. Rates were highest in the major urban areas and lowest in rural areas. Within residence categories, the section rate was related directly to education, early prenatal care, and delivery in private hospitals. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.560_9 Template-Type: ReDIF-Article 1.0 Title: The emerging relevance of antitrust laws to the delivery of health care Journal: American Journal of Public Health Author-Name: Wing, K.R. Year: 1985 Volume: 75 Issue: 4 Pages: 407-411 DOI: 10.2105/AJPH.75.4.407 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.407 Abstract: Until relatively recently, antitrust enforcement in the delivery of health care was virtually non-existent. Not even 15 years ago, many legal observers might have concluded that the professional services of medical care providers were exempted from the federal antitrust laws altogether; or that many providers were engaged in local activities beyond the reach of federal interstate commerce jurisdiction. Even 10 years ago, many providers were arguing that collective agreements among potential competitors were not only sound public policy, but also that such concerted activities were actively encouraged by various federal laws. Today, however, the enforcement of the federal antitrust is an integral part of the complicated legal environment of American health care delivery. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.407_5 Template-Type: ReDIF-Article 1.0 Title: Patterns of site-specific displacement in cancer mortality among migrants: The Chinese in the United States Journal: American Journal of Public Health Author-Name: King, H. Author-Name: Li, J.Y. Author-Name: Locke, F.B. Author-Name: Pollack, E.S. Author-Name: Tu, J.T. Year: 1985 Volume: 75 Issue: 3 Pages: 237-242 DOI: 10.2105/AJPH.75.3.237 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.237 Abstract: Taking advantage of the information gathered for the 1975 National Mortality Survey in China, this paper compares the levels of cancer mortality among foreign-born and United States-born Chinese around 1970 with those of the communities of origin of the majority of Chinese migrants to the US. Age-adjusted rates indicate two distinctive site-specific patterns among US Chinese: a downward trend for cancers of high risk among Guangdong and Hong Kong Chinese (nasopharynx, esophagus, liver, uterus, and perhaps stomach) and an upward trend for those sites of low risk among Chinese in Guangdong and Hong Kong (colon, lung, leukemia, and female breast). Further field studies are needed with emphasis on the birthplace of migrants and environmental changes in host countries. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.237_8 Template-Type: ReDIF-Article 1.0 Title: Physicians' attitudes and practices toward CPR training in family members of patients with coronary heart disease Journal: American Journal of Public Health Author-Name: Goldberg, R.J. Author-Name: DeCosimo, D. Author-Name: St Louis, P. Author-Name: Gore, J.M. Author-Name: Ockene, J.K. Author-Name: Dalen, J.E. Year: 1985 Volume: 75 Issue: 3 Pages: 281-283 DOI: 10.2105/AJPH.75.3.281 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.281 Abstract: A survey of 482 physicians practicing in central and western Massachusetts was carried out to examine attitudes and reported practices toward cardiopulmonary resuscitation (CPR) training for family members of patients with coronary heart disease (CHD). Seventy-nine per cent of physicians felt that CPR training was important for the family members of patients with CHD yet only 6 per cent actually provided information about CPR to families. Further studies are indicated to determine why physician behavior is at odds with their stated beliefs and to guide appropriate remedial action. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.281_8 Template-Type: ReDIF-Article 1.0 Title: A controlled evaluation of rural regional perinatal care: Impact on mortality and morbidity Journal: American Journal of Public Health Author-Name: Siegel, E. Author-Name: Gillings, D. Author-Name: Campbell, S. Author-Name: Guild, P. Year: 1985 Volume: 75 Issue: 3 Pages: 246-253 DOI: 10.2105/AJPH.75.3.246 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.246 Abstract: The impact of a rural regional perinatal care (RPC) program was assessed by a quasi-experimental, controlled, population-based design. Outcome measures included changes in five-year average fetal and neonatal mortality rates as well as short-term obstetric and newborn morbidity. Declines in fetal and neonatal as well as birthweight specific mortality rates were observed for both pilot and control regions, for both races, and especially for 1501-2500 g infants. However, comparisons of preprogram (1966-74) and postprogram (1975-80) average yearly changes showed no statistically significant differences between regions. While the incidence of prenatal morbidity was the same for both regions, intrapartum and newborn morbidity significantly favored the pilot region. These results were difficult to interpret. Program relevant implications of the findings in relation to rural RPC in North Carolina are discussed. Specific benefits appeared to be associated with the development of two high-risk maternity clinics and a Level II center capability in the pilot region. The importance of community support and public/private sector cooperation relation to RPC is noted. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.246_5 Template-Type: ReDIF-Article 1.0 Title: Mental disorders among physical disability determination patients Journal: American Journal of Public Health Author-Name: Leeper, J.D. Author-Name: Badger, L.W. Author-Name: Milo, T. Year: 1985 Volume: 75 Issue: 1 Pages: 78-79 DOI: 10.2105/AJPH.75.1.78 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.78 Abstract: Persons claiming physical disability who were evaluated at a primary care health center in a small southern city were administered the Diagnostic Interview Schedule. Fifty-six per cent of the 43 patients were found to have one or more psychiatric disorders. The relationship between physical disability and psychiatric disorders needs to be recognized in the disability evaluation system. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.78_4 Template-Type: ReDIF-Article 1.0 Title: Grassroots environmentalism under legal attack: Dandelions, pesticides, and a neighbor's right-to-know Journal: American Journal of Public Health Author-Name: Christoffel, T. Year: 1985 Volume: 75 Issue: 5 Pages: 565-567 DOI: 10.2105/AJPH.75.5.565 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.565 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.565_9 Template-Type: ReDIF-Article 1.0 Title: The effects of denturism on denture prices Journal: American Journal of Public Health Author-Name: Rosenstein, D.I. Author-Name: Empey, G. Author-Name: Chiodo, G.T. Author-Name: Phillips, D. Year: 1985 Volume: 75 Issue: 6 Pages: 671-672 DOI: 10.2105/AJPH.75.6.671 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.671 Abstract: In 1978, the country's first denturism initiative was passed in Oregon, legalizing the independent construction of dentures by non-dentists. The major campaign issue was the effect denturism would have on the cost of dentures. A review of Oregon dental insurance data shows that the costs of dentures, which had been rising at the same rate as other dental services, had a much lower rate of increase after passage of the denturism initiative. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.671_2 Template-Type: ReDIF-Article 1.0 Title: Motor vehicle related injury on the bridges between Montreal and the South Shore of the St. Lawrence River, 1978-1982 Journal: American Journal of Public Health Author-Name: Brown, B.P. Author-Name: Salmi, L.R. Author-Name: Lecours, S. Author-Name: Battista, R.N. Year: 1985 Volume: 75 Issue: 8 Pages: 871-874 Abstract: The injury experience related to motor vehicle crashes on four bridges and one tunnel in Montreal, Quebec, Canada, from 1978 to 1982, are described. Particular attention is given to the Jacques Cartier Bridge, publicly perceived as being excessively dangerous. Data from the Quebec Automobile Insurance Board and police reports confirm an excess of deaths (19/34; rate ratio = 4.5) and severe injuries (69/109; rate ratio = 6.2) on the Jacques Cartier Bridge, and the association of 74% of the fatalities and 64% of the severe-injury cases on this bridge with a single curve. Crashes follow a consistent pattern; vehicles fail to negotiate the curve and strike vehicles moving in the opposite direction. The demonstrated association between crashes and design factors provides a basis for identifying effective remedial and preventive measures. Handle: RePEc:aph:ajpbhl:1985:75:8:871-874_5 Template-Type: ReDIF-Article 1.0 Title: Assessment of salt use at the table: Comparison of observed and reported behavior Journal: American Journal of Public Health Author-Name: Mittelmark, M.B. Author-Name: Sternberg, B. Year: 1985 Volume: 75 Issue: 10 Pages: 1215-1216 Abstract: Observations were made of salt added during meals. Nineteen per cent of 211 participants salted before tasting food, 18% salted after tasting, and 2% salted both before and after tasting. Of those who self-reported 'never' to salt food before tasting, 6% were observed to do so. Of those who reported never to salt after tasting, 3% did so. Results support the conclusion that self-reported abstinence from use of table salt is strongly correlated with actual behavior. Handle: RePEc:aph:ajpbhl:1985:75:10:1215-1216_7 Template-Type: ReDIF-Article 1.0 Title: The secret of maternal and child health Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1985 Volume: 75 Issue: 6 Pages: 585-587 DOI: 10.2105/AJPH.75.6.585 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.585 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.585_2 Template-Type: ReDIF-Article 1.0 Title: Giant steps and baby steps: Toward child health Journal: American Journal of Public Health Author-Name: Starfield, B. Year: 1985 Volume: 75 Issue: 6 Pages: 599-604 DOI: 10.2105/AJPH.75.6.599 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.599 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.599_5 Template-Type: ReDIF-Article 1.0 Title: Asbestos disease in family contacts of shipyard workers Journal: American Journal of Public Health Author-Name: Kilburn, K.H. Author-Name: Lilis, R. Author-Name: Anderson, H.A. Author-Name: Boylen, C.T. Author-Name: Einstein, H.E. Author-Name: Johnson, S.J. Author-Name: Warshaw, R. Year: 1985 Volume: 75 Issue: 6 Pages: 615-617 DOI: 10.2105/AJPH.75.6.615 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.615 Abstract: Radiologic signs of pulmonary asbestos disease were found in 11.3% of 274 wives of shipyard workers who were 20 or more years from initial hiring-on in shipyards in Los Angeles County. Asbestosis was also found in 7.6% of 79 sons and 2.1% of 140 daughters of these workers. The wives, sons, and daughters were without occupational exposure. Comparable radiographic signs were not found in comparison groups. It is probable that asbestos exposure in the household places these family members at risk for mesothelioma and lung cancer. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.615_4 Template-Type: ReDIF-Article 1.0 Title: Infant formulas and gastrointestinal illness Journal: American Journal of Public Health Author-Name: Koopman, J.S. Author-Name: Turkish, V.J. Author-Name: Monto, A.S. Year: 1985 Volume: 75 Issue: 5 Pages: 477-480 DOI: 10.2105/AJPH.75.5.477 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.477 Abstract: Infants under age one in a pediatric practice were followed prospectively, and the determinants of acute gastrointestinal illness were evaluated in case-control pairs, matched by birth month. The risk of acute gastrointestinal illness in infants receiving formula was six times greater than in infants receiving breast milk and 2.5 times greater than in infants receiving cow milk. In the second six months of life, infants on formula had 0.38 more gastrointestinal illness episodes per child than infants on cow milk. Episodes without rotavirus or bacterial agents accounted for most of the increased risk of formula. The increased risk could not be explained by iron fortification of the formulas, prescription of non-milk based formulas to high-risk infants, case ascertainment bias, control selection bias, or numerous control factors. Non-antibody anti-infection properties found in cow milk are one possible explanation for these findings. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.477_0 Template-Type: ReDIF-Article 1.0 Title: The cost and effectiveness of school-based preventive dental care Journal: American Journal of Public Health Author-Name: Klein, S.P. Author-Name: Bohannan, H.M. Author-Name: Bell, R.M. Author-Name: Disney, J.A. Author-Name: Foch, C.B. Author-Name: Graves, R.C. Year: 1985 Volume: 75 Issue: 4 Pages: 382-391 DOI: 10.2105/AJPH.75.4.382 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.382 Abstract: The National Preventive Dentistry Demonstration Program assessed the cost and effectiveness of various types and combinations of school-based preventive dental care procedures. The program involved 20,052 first, second, and fifth graders from five fluoridated and five nonfluoridated communities. These children were examined at baseline and assigned to one of six treatment regimens. Four years later, 9,566 members of this group were examined again. Analyses of their dental examination data showed that dental health lessons, brushing and flossing, fluoride tablets and mouthrinsing, and professionally applied topical fluorides were not effective in reducing a substantial amount of dental decay, even when all of these procedures were used together. Occlusal sealants prevented one to two carious surfaces in four years. Children who were especially susceptible to decay did not benefit appreciably more from any of the preventive measures than did children in general. Annual direct per capita costs were $23 for sealant or fluoride prophy/gel applications and $3.29 for fluoride mouthrinsing. Communal water fluoridation was reaffirmed as the most cost-effective means of reducing tooth decay in children. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.382_2 Template-Type: ReDIF-Article 1.0 Title: Without guns, do people kill people? Journal: American Journal of Public Health Author-Name: Baker, S.P. Year: 1985 Volume: 75 Issue: 6 Pages: 587-588 DOI: 10.2105/AJPH.75.6.587 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.587 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.587_7 Template-Type: ReDIF-Article 1.0 Title: Motorcycle headlight-use laws and fatal motorcycle crashes in the US, 1975-83 Journal: American Journal of Public Health Author-Name: Zador, P.L. Year: 1985 Volume: 75 Issue: 5 Pages: 543-546 DOI: 10.2105/AJPH.75.5.543 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.543 Abstract: Fatal motorcycle crashes in the United States from 1975 to 1983 were analyzed. In the 14 states that had motorcycle headlight-use laws during the study period, about 600 daytime crashes of the type included in the study were prevented by these laws. This reduction corresponds to a 13 per cent reduction in fatal daytime crashes and to an average reduction of about five fatal crashes per year for each of the 14 states. About 30 states did not have motorcycle daytime headlight laws in effect during the study period. If all of these states had such laws, in an average year, approximately 140 additional fatal motorcycle crashes would have been prevented. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.543_4 Template-Type: ReDIF-Article 1.0 Title: Insuring preventive dental care: Are sealants included? Journal: American Journal of Public Health Author-Name: Glasrud, P.H. Year: 1985 Volume: 75 Issue: 3 Pages: 285-286 DOI: 10.2105/AJPH.75.3.285 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.285 Abstract: Lack of third-party reimbursement for pit and fissure sealants has been cited as a barrier preventing increased adoption rates. The extent to which commercial insurance companies and Blue Cross/Blue Shield Associations provide reimbursement for dental sealants is examined with data from a telephone survey. Results indicate that the majority of such third-party payers did not provide reimbursement for sealants. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.285_7 Template-Type: ReDIF-Article 1.0 Title: The incidence of duodenal and gastric ulcers in a large Health Maintenance Organization Journal: American Journal of Public Health Author-Name: Kurata, J.H. Author-Name: Honda, G.D. Author-Name: Frankl, H. Year: 1985 Volume: 75 Issue: 6 Pages: 625-629 DOI: 10.2105/AJPH.75.6.625 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.625 Abstract: We report the incidence of peptic ulcers (duodenal, pyloric canal, gastric, and combined) verified by radiologic, endoscopic, or surgical evidence in a large Health Maintenance Organization (HMO) in Los Angeles, California. For members age 15 and above, the peptic ulcer incidence rate was 0.86 per 1,000 person-years (p-y) (males 1.10, females 0.63). The male to female sex ratio was 1.7. Two hundred twenty-two duodenal, 17 pyloric canal, 89 gastric, and 21 combined first-time diagnosed ulcer cases were located. For duodenal and pyloric canal ulcer, the incidence rate for members age 15 and above was 0.58 per 1,000 p-y (males 0.76, females 0.40). For gastric ulcer, the incidence rate for members age 15 and above was 0.21 per 1,000 p-y (males 0.23, females 0.18). The combined ulcer rate was 0.05 per 1,000 p-y (males 0.07, females 0.02). Gastric ulcer rates were two times higher in 1980 than in 1977. Peptic ulcer age-specific incidence rates increased with age. Incidence rates were much lower than those reported in previous studies, but the gastric to duodenal ulcer ratio and the age and sex relation to ulcer incidence were similar to those previously reported. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.625_7 Template-Type: ReDIF-Article 1.0 Title: A prospective study of swimming-related illness I. Swimming-associated health risk Journal: American Journal of Public Health Author-Name: Seyfried, P.L. Author-Name: Tobin, R.S. Author-Name: Brown, N.E. Author-Name: Ness, P.F. Year: 1985 Volume: 75 Issue: 9 Pages: 1068-1070 Abstract: During the summer of 1980, both swimmers and nonswimmers were enlisted in a prospective epidemiological study to determine the relationship between swimming, water-quality, and the incidence of illness. Results of 4,537 telephone follow-up interviews showed that crude morbidity rates were 69.6 per 1,000 swimmers versus 29.5 per 1,000 nonswimmers. Swimmers experienced respiratory ailments most frequently, followed by gastrointestinal, eye, ear, skin, and allergenic symptoms, respectively. Handle: RePEc:aph:ajpbhl:1985:75:9:1068-1070_8 Template-Type: ReDIF-Article 1.0 Title: I.S. Falk and the challenge of facts Journal: American Journal of Public Health Author-Name: Stevens, R. Year: 1985 Volume: 75 Issue: 8 Pages: 827-828 Handle: RePEc:aph:ajpbhl:1985:75:8:827-828_3 Template-Type: ReDIF-Article 1.0 Title: The public and the pill: Is the pill making a comeback? Journal: American Journal of Public Health Author-Name: Forrest, J.D. Year: 1985 Volume: 75 Issue: 10 Pages: 1131-1132 Handle: RePEc:aph:ajpbhl:1985:75:10:1131-1132_3 Template-Type: ReDIF-Article 1.0 Title: Public health aspects of mental health: The last 75 years of the American Journal of Public Health Journal: American Journal of Public Health Author-Name: Williams, C.L. Author-Name: Westermeyer, J. Year: 1985 Volume: 75 Issue: 7 Pages: 722-725 Abstract: The American Journal of Public Health has reflected the relationship of public health to the field of mental health over its 75-year history. The earliest volumes of the Journal addressed movements and concerns within public mental health. Quantitative analysis of mental health articles shows wide fluctuations over the last 75 years, probably due to variations in federal funding for mental health research. Topical emphases in the Journal have included social issues and improved mental health, the contributions of epidemiological studies, and technological advances in prevention and treatment. Handle: RePEc:aph:ajpbhl:1985:75:7:722-725_8 Template-Type: ReDIF-Article 1.0 Title: Cancer incidence rates among Blacks in urban and rural Georgia, 1978-82 Journal: American Journal of Public Health Author-Name: Greenberg, R.S. Author-Name: Stevens, J.A. Author-Name: Whitaker, J.P. Year: 1985 Volume: 75 Issue: 6 Pages: 683-684 DOI: 10.2105/AJPH.75.6.683 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.683 Abstract: The records of the Atlanta Cancer Surveillance Center were reviewed for all incident cases of cancer diagnosed among Black residents of the catchment areas during calendar years 1978 through 1982. The resultant age-adjusted overall cancer incidence rates for urban Blacks were greater than those for rural Blacks. The largest urban excess was found for cancers of the buccal cavity and pharynx. Urban residence also was associated with lung and prostate cancers among males, and pancreatic cancers among females. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.683_7 Template-Type: ReDIF-Article 1.0 Title: Psychiatric epidemiology and epidemiological psychiatry Journal: American Journal of Public Health Author-Name: Shepherd, M. Year: 1985 Volume: 75 Issue: 3 Pages: 275-276 DOI: 10.2105/AJPH.75.3.275 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.275 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.275_2 Template-Type: ReDIF-Article 1.0 Title: Effects of unemployment on mental and physical health Journal: American Journal of Public Health Author-Name: Linn, M.W. Author-Name: Sandifer, R. Author-Name: Stein, S. Year: 1985 Volume: 75 Issue: 5 Pages: 502-506 DOI: 10.2105/AJPH.75.5.502 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.502 Abstract: From a prospective study of the impact of stress on health in 300 men assessed every six months, men who became unemployed after entering the study were compared with an equal number, matched for age and race, who continued to work. Psychological and health data after unemployment were compared between the two groups by multivariate analysis of variance and covariance. After unemployment, symptoms of somatization, depression, and anxiety were significantly greater in the unemployed than employed. Large standard deviations on self-esteem scores in the unemployed group suggested that some men coped better than others with job-loss stress. Further analysis showed those with higher esteem had more support from family and friends than did those with low self-esteem. Furthermore, unemployed men made significantly more visits to their physicians, took more medications, and spent more days in bed sick than did employed individuals even though the number of diagnoses in the two groups were similar. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.502_8 Template-Type: ReDIF-Article 1.0 Title: Bathtub-related drownings in the United States, 1979-81 Journal: American Journal of Public Health Author-Name: Budnick, L.D. Author-Name: Ross, D.A. Year: 1985 Volume: 75 Issue: 6 Pages: 630-633 DOI: 10.2105/AJPH.75.6.630 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.630 Abstract: We analyzed National Center for Health Statistics data on drownings in bathtubs and Consumer Product Safety Commission data on bathtub-related injuries for the years 1979-80 and 1979-81, respectively. Seven hundred ten persons drowned in bathtubs in 1979 and 1980, for a crude mortality rate of 1.6 per million persons per year. Although there was an excess of deaths in the spring, there was no important seasonal trend. Mortality rates in the Pacific and Mountain states were higher than in other states. Persons at the extremes of age were at greatest risk of death, with mortality rates of 5-6 per million per year. Black males aged 20-64 years had substantially elevated mortality rates compared to White males. The prevalence of personal risk indicators varied with age, with a frequent history of being left unattended among children less than 5 years old, a frequent history of seizures among persons 5-39 years old, a frequent history of alcohol or drug use among persons 40-59 years old, and frequent evidence of having fallen among those at least 60 years old. Bathtubs are potentially dangerous, and the prevention of drownings in them can be approached through a combination of passive and active strategies. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.630_8 Template-Type: ReDIF-Article 1.0 Title: Seating patterns on the Washington, DC Metro Rail System Journal: American Journal of Public Health Author-Name: Trinkoff, A.M. Year: 1985 Volume: 75 Issue: 6 Pages: 657-658 DOI: 10.2105/AJPH.75.6.657 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.657 Abstract: Research on human tolerance in crashes has found that rear-facing seating offers increased protection over forward seating. However, rearward seats are only available in limited settings. In this study, passengers were observed and seating preferences recorded on the Washington Metropolitan Rail System (Metro). Only 25% of adults faced rearward compared to 66% of children. Since children appear willing to face rearward, rear-facing seating in school buses and other vehicles might be acceptable to them and provide safety benefits as well. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.657_3 Template-Type: ReDIF-Article 1.0 Title: Utilization of dental services in the United States and an insured population Journal: American Journal of Public Health Author-Name: Grembowski, D. Author-Name: Conrad, D. Author-Name: Milgrom, P. Year: 1985 Volume: 75 Issue: 1 Pages: 87-89 DOI: 10.2105/AJPH.75.1.87 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.87 Abstract: Dental service utilization rates among 1.2 million Pennsylvania Blue Shield dental insureds are compared to rates in the US population. Insurance appears to stimulate the utilization of dental services above national norms; children appear to be a major beneficiary of insurance's incentive effect on dental service use. The implications of these findings for health planners and dental insurance providers are discussed. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.87_1 Template-Type: ReDIF-Article 1.0 Title: AIDS and sexual behavior reported by gay men in San Francisco Journal: American Journal of Public Health Author-Name: McKusick, L. Author-Name: Horstman, W. Author-Name: Coates, T.J. Year: 1985 Volume: 75 Issue: 5 Pages: 493-496 DOI: 10.2105/AJPH.75.5.493 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.493 Abstract: In November 1983, we surveyed 655 gay men in San Francisco regarding their sexual practices during the previous month and the same month one year ago. The sample was selected to include men in situations that would lead to high risk of sexual activities related to AIDS (acquired immune deficiency syndrome) transmission (i.e., men frequenting bathhouses and gay bars) as well as men in low-risk situations (those going to neither place and men in primary relationships). The Bath group showed little change in frequency of bathhouse use and in number of sexual partners from that location. The other groups showed substantial reductions in frequency of sexual contacts from bars, baths, T-rooms, or parks. Men in monogamous relationships showed little change in sexual behavior within their relationships. Men in non-monogamous relationships and men not in relationships reported substantial reductions in high-risk sexual activity, but not a corresponding increase in low-risk sexual behavior. Knowledge of health guidelines was quite high, but this knowledge had no relation to sexual behavior. Using sex to release tension, use of sex to express gay identity, and knowledge of persons with AIDS in the advanced stages of disease were related to frequency and type of sexual behavior. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.493_0 Template-Type: ReDIF-Article 1.0 Title: Correlates of depressive symptoms among a select population of Black men Journal: American Journal of Public Health Author-Name: Gary, L.E. Year: 1985 Volume: 75 Issue: 10 Pages: 1220-1222 Abstract: This study was undertaken to provide information on the impact of demographic factors, stressful life events, and sociocultural patterns on depressive symptomatology among 142 noninstitutionalized Black men. The findings indicate that age, family income, household size, employment status, and conflict between the sexes were related to the presence of depressive symptoms. When controls were introduced, only family income and conflict between the sexes were correlates of depressive symptoms among Black men in this study. Handle: RePEc:aph:ajpbhl:1985:75:10:1220-1222_3 Template-Type: ReDIF-Article 1.0 Title: Vehicular carbon monoxide screening: Identification in a cross-cultural setting of a substantial public health risk factor Journal: American Journal of Public Health Author-Name: Williams, R.L. Year: 1985 Volume: 75 Issue: 1 Pages: 85-86 DOI: 10.2105/AJPH.75.1.85 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.85 Abstract: A community program of screening and education for prevention of vehicular carbon monoxide (CO) poisoning among a high-risk population in a cross-cultural setting is presented. The program was developed after two infant deaths in separate incidents of vehicular CO poisoning. The results of the screening show 18.6 per cent of vehicles exceeding the Environmental Protection Agency eight-hour standard for CO exposure, and 2.6 per cent exceeding the one-hour standard. Extension of such programs to other high-risk populations is recommended. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.85_1 Template-Type: ReDIF-Article 1.0 Title: Fragile X syndrome: A public health concern Journal: American Journal of Public Health Author-Name: Trusler, S. Author-Name: Beatty-DeSana, J. Year: 1985 Volume: 75 Issue: 7 Pages: 771-772 Abstract: This study was designed to test for the fragile X syndrome [fra(X)] in institutionalized male patients with non-specific mental retardation, referral patients, and relatives of fra(X) patients. Thirty-one of 91 (34%) subjects tested were positive for the fra(X) chromosome; relatives had the largest percentage of positives. The data reflect the value of this test for detecting families having potential carriers who can benefit from genetic counseling. Handle: RePEc:aph:ajpbhl:1985:75:7:771-772_3 Template-Type: ReDIF-Article 1.0 Title: Home care for the ill elderly. Who benefits? Journal: American Journal of Public Health Author-Name: Haug, M.R. Year: 1985 Volume: 75 Issue: 2 Pages: 127-128 Handle: RePEc:aph:ajpbhl:1985:75:2:127-128_7 Template-Type: ReDIF-Article 1.0 Title: The origin and development of maternal and child health programs in the United States Journal: American Journal of Public Health Author-Name: Lesser, A.J. Year: 1985 Volume: 75 Issue: 6 Pages: 590-598 DOI: 10.2105/AJPH.75.6.590 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.590 Abstract: In this paper, emphasis will be given to major policy issues which were met in the development and administration of the maternal and child health programs authorized by Title V of the Social Security Act. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.590_2 Template-Type: ReDIF-Article 1.0 Title: Two successive outbreaks of clostridium perfringens at a state correctional institution Journal: American Journal of Public Health Author-Name: Tavris, D.R. Author-Name: Murphy, R.P. Author-Name: Jolley, J.W. Author-Name: Harmon, S.M. Author-Name: Williams, C. Author-Name: Brumback, C.L. Year: 1985 Volume: 75 Issue: 3 Pages: 287-288 DOI: 10.2105/AJPH.75.3.287 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.287 Abstract: An outbreak of acute gastrointestinal illness of short duration involving 100 inmates at a correctional institution followed a similar outbreak among the same population by eight days. Clostridium perfringens was the specific etiology in both outbreaks; the vehicle was roast beef in the first outbreak, ham in the second. Direct observation of food handling practices revealed that the meats were not cooled quickly enough following cooking; not reheated adequately prior to serving, and; held at improper temperatures prior to serving. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.287_4 Template-Type: ReDIF-Article 1.0 Title: Biomedical applications of cotinine quantitation in smoking related research Journal: American Journal of Public Health Author-Name: Sepkovic, D.W. Author-Name: Haley, N.J. Year: 1985 Volume: 75 Issue: 6 Pages: 663-665 DOI: 10.2105/AJPH.75.6.663 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.663 Abstract: Two studies were undertaken to assess the variability of cotinine concentrations in different biological fluids and to determine the most desirable fluid to use for specific experimental protocols. For protocols validating smoking cessation, plasma or urinary cotinine determinations provided the most accurate indicators of compliance. In studies where smokers switched from high yield to low yield cigarettes, plasma cotinine determinations were good indicators of smoker behavior. Correct interpretation of smoker status is dependent on the biological fluid selected for cotinine analysis. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.663_8 Template-Type: ReDIF-Article 1.0 Title: An assessment of the California child restraint requirement Journal: American Journal of Public Health Author-Name: Guerin, D. Author-Name: MacKinnon, D.P. Year: 1985 Volume: 75 Issue: 2 Pages: 142-144 Abstract: To evaluate the California Child Passenger Restraint Law requiring children under four years of age to be transported in car seats, we examined monthly injury and fatality levels from January 1978 to December 1983 for children 0-3 and 4-7 years of age using Box-Jenkins time series models. A significant 8.36 per cent reduction in injuries was found for the 0-3 year old age group, but no significant reduction in injuries was found for 4-7 year olds. No significant reduction in fatalities was found for either age group. A similar analysis of injuries and fatalities in Texas, a state without a car seat law, showed no significant reductions in either injuries or fatalities. There was no change in the number of California 0-3 year olds in the years after the law was enacted. Handle: RePEc:aph:ajpbhl:1985:75:2:142-144_1 Template-Type: ReDIF-Article 1.0 Title: Self-reported pelvic inflammatory disease in the US: A common occurrence Journal: American Journal of Public Health Author-Name: Aral, S.O. Author-Name: Mosher, W.D. Author-Name: Cates Jr., W. Year: 1985 Volume: 75 Issue: 10 Pages: 1216-1218 Abstract: Based on a nationally representative sample of American women of reproductive age, in 1982, one in seven reported having had pelvic inflammatory disease (PID). One in ten had received ambulatory care, and one in 25 were hospitalized for PID. A two-fold race differential was observed in self-reported history of PID. One in four Blacks compared to one in eight Whites reported having received treatment for this condition sometime in the past. The previous history of PID, especially in the older age groups, reflects the combined effect of secular trends in PID incidence and temporal changes in diagnostic and treatment practices. Handle: RePEc:aph:ajpbhl:1985:75:10:1216-1218_5 Template-Type: ReDIF-Article 1.0 Title: Killing with kindness: Why the FDA need not certify drugs used for execution safe and effective Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1985 Volume: 75 Issue: 9 Pages: 1096-1099 Abstract: In 1977, Texas and Oklahoma became the first states to legalize administration of the death penalty by lethal injection; by late 1985, 14 other states had followed suit. Opponents of the death penalty petitioned the Food and Drug Administration in 1980 to declare drugs specified for use in executions as "not approved," and to prevent their use for that purpose. When the FDA denied their request, the petitioners took legal action against the agency, eventually arguing their case before the U.S. Supreme Court, which ruled against them in Heckler v. Chaney (1985). Annas discusses the Court's action, which dealt only with the judicial reviewability under federal statute of the FDA's decision not to exercise its authority over the use of drugs in interstate commerce. He notes that, by dealing only with procedural issues, the Court avoided ruling on the death penalty itself. Handle: RePEc:aph:ajpbhl:1985:75:9:1096-1099_6 Template-Type: ReDIF-Article 1.0 Title: Mortality patterns in the modernized Pacific Island nation of Nauru Journal: American Journal of Public Health Author-Name: Taylor, R. Author-Name: Thoma, K. Year: 1985 Volume: 75 Issue: 2 Pages: 149-155 DOI: 10.2105/AJPH.75.2.149 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.149 Abstract: Nauru is a small phosphate-rich independent island country situated in the Central Pacific. The population is Micronesian and was estimated to be 4,680 in mid-1981. An analysis of mortality data for the years 1976-81 indicates a high adult male mortality due to accidents, injuries, cardiovascular disease, and diabetes. The life expectancy estimate at birth for men was 49 years, and for women 62 years. The male life expectancy is among the lowest in the region. The considerable adult male mortality appears to be related to the rapidly acquired affluence and the ready availability of motorcycles, cars, imported foods, tobacco, and alcohol. The data suggest that modernization of the economy in Pacific Island nations can lead to new and serious public health problems. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.149_2 Template-Type: ReDIF-Article 1.0 Title: Duffy antigens and hypertension in a Black population Journal: American Journal of Public Health Author-Name: Miller, J.M. Author-Name: Miller, J.M. Year: 1985 Volume: 75 Issue: 5 Pages: 558-559 DOI: 10.2105/AJPH.75.5.558 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.558 Abstract: Skin color and social class have been suggested as reasons to explain the greater prevalence of hypertension in Blacks as compared to Whites. The presence of Duffy red blood cell proteins, a measure of 'whiteness' in Blacks, was unrelated to the presence of elevated blood pressure in 722 Black hospital patients. The finding suggests that social class rather than skin color is associated with the greater prevalence of hypertension in Blacks. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.558_0 Template-Type: ReDIF-Article 1.0 Title: Serologic survey of rotavirus, Norwalk agent and Prototheca wickerhamii in wastewater workers Journal: American Journal of Public Health Author-Name: Clark, C.S. Author-Name: Linnemann Jr., C.C. Author-Name: Gartside, P.S. Author-Name: Phair, J.P. Author-Name: Blacklow, N. Author-Name: Zeiss, C.R. Year: 1985 Volume: 75 Issue: 1 Pages: 83-85 DOI: 10.2105/AJPH.75.1.83 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.83 Abstract: Analysis of paired sera from 48 wastewater workers and controls who reported gastrointestinal illness did not reveal any excess of seroconversions to Norwalk agent or to rotavirus. Inexperienced wastewater-exposed workers had higher levels of antibody in Norwalk agent than did experienced and control workers and those with high and medium aerosol exposure had higher titres than those in the low aerosol category. Analysis for Prototheca antibody titres was essentially negative. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.83_2 Template-Type: ReDIF-Article 1.0 Title: Self-management education of children with asthma: AIR WISE Journal: American Journal of Public Health Author-Name: McNabb, W.L. Author-Name: Wilson-Pessano, S.R. Author-Name: Hughes, G.W. Author-Name: Scamagas, P. Year: 1985 Volume: 75 Issue: 10 Pages: 1219-1220 Abstract: This study was conducted to test the efficacy of AIR WISE, an individually administered asthma self-management program. Subjects were paired and randomly assigned to either an experimental group (N=7) or a control group (N=7). The frequency of experimental group emergency visits, analyzed over a 12-month posttreatment period, was substantially less than those of the control group, supporting the hypothesis that AIR WISE is effective in high-utilizer children through improved self-management. Handle: RePEc:aph:ajpbhl:1985:75:10:1219-1220_1 Template-Type: ReDIF-Article 1.0 Title: Sodium in drinking water in South Carolina Journal: American Journal of Public Health Author-Name: Lackland, D.T. Author-Name: Weinrich, M.C. Author-Name: Wheeler, F.C. Author-Name: Shepard, D.M. Year: 1985 Volume: 75 Issue: 7 Pages: 772-774 Abstract: The potential contribution of drinking water sodium to total consumption and to blood pressure levels is explored in a South Carolina survey. Most (96%) of the population was served by drinking water containing <100 mg/l Na (median 14.8 mg/l). For households with water sources containing ≥100 mg/l Na, drinking water accounted for approximately 8.5% of total estimated consumption. After adjustment for age, sex, race, body mass index, education, and dietary sodium, a negative association between diastolic blood pressure and drinking water sodium levels was found. Handle: RePEc:aph:ajpbhl:1985:75:7:772-774_1 Template-Type: ReDIF-Article 1.0 Title: Further evidence on the value of the WIC program Journal: American Journal of Public Health Author-Name: Rush, D. Year: 1985 Volume: 75 Issue: 8 Pages: 828-829 Handle: RePEc:aph:ajpbhl:1985:75:8:828-829_6 Template-Type: ReDIF-Article 1.0 Title: Benefits, risks and costs of immunization for measles, mumps and rubella Journal: American Journal of Public Health Author-Name: White, C.C. Author-Name: Koplan, J.P. Author-Name: Orenstein, W.A. Year: 1985 Volume: 75 Issue: 7 Pages: 739-744 Abstract: For a single year, 1983, we compared the actual and estimated morbidity, mortality, and costs attributable to measles, mumps, and rubella with having or not having a childhood immunization program using the combined measles-mumps-rubella (MMR) vaccine. Without an immunization program, an estimated 3,325,000 cases of measles would occur as compared to 2,872 actual cases in 1983 with a program. Instead of an expected 1.5 million rubella cases annually, there were only 3,816 actual cases. Mumps cases were lowered from an expected 2.1 million to 32,850 actual cases. Comparable reductions in disease-associated complications, sequelae, and deaths are gained with an immunization program. Without a vaccination program, disease costs would have been almost $1.4 billion. Based on the actual incidence of disease in 1983, costs were estimated to be approximately $14.5 million. Expenditures for immunization, including vaccine administration costs and the costs associated with vaccine reactions, totaled $96 million. The resulting benefit-cost ratio for the MMR immunization program is approximately 14:1. The savings realized due to the use of combination rather than single antigen vaccine total nearly $60 million. Handle: RePEc:aph:ajpbhl:1985:75:7:739-744_4 Template-Type: ReDIF-Article 1.0 Title: The origins of American psychiatric epidemiology Journal: American Journal of Public Health Author-Name: Grob, G.N. Year: 1985 Volume: 75 Issue: 3 Pages: 229-236 DOI: 10.2105/AJPH.75.3.229 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.229 Abstract: Psychiatric epidemiology developed relatively late (as compared with epidemiology generally). Nineteenth century psychiatrists, although avid collectors of statistics, did not use such data in any systematic manner. The impetus for the creation of an epidemiology of mental illness came from the work of late nineteenth century social scientists concerned with understanding individual and social behavior and applying their findings to social problems. Initially they helped to create the modern census, which represented a radical faith that quantitative research, when merged with adminisrative rationality, could replace politics. During and after the 1920s, the demographic analysis of the institutionalized mentally ill population expanded sharply; by the late 1930s and 1940s psychiatric epidemiologists had begun to study the role of socioenvironmental variables and the incidence of mental illness in the community. Twentieth century psychiatric epidemiologists, however, faced a severe intellectual problem; their work rested on a descriptive rather than an etiological nosology. Consequently, the results of epidemiological studies in psychiatry often differed precisely because of variations in the design of studies and classification systems as well as the subjective observations of the investigators themselves. The ensuing disagreements among those involved in the epidemiologic study of mental illness were a natural consequence. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.229_7 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of a tuberculosis outbreak in a South Carolina junior high school Journal: American Journal of Public Health Author-Name: Sacks, J.J. Author-Name: Brenner, E.R. Author-Name: Breeden, D.C. Author-Name: Anders, H.M. Author-Name: Parker, R.L. Year: 1985 Volume: 75 Issue: 4 Pages: 361-365 DOI: 10.2105/AJPH.75.4.361 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.361 Abstract: A 13-year-old, female, seventh-grade student (the index patient) was found to have smear-positive, cavitary, pulmonary tuberculosis. Epidemiologic and contact investigation, involving skin testing over 900 people, revealed a 40 per cent tuberculin reactor rate for persons in the junior high school she attended compared to a 2 per cent rate for control schools. Repeat skin testing of initial non-reactors identified an additional 3 per cent of infected school children. School teachers showed a seven-fold increase in the prevalence of positive skin-test reactions following the outbreak. Tuberculin-reactor rates for seventh graders were substantially higher than for eighth graders. The more classes shared with the index patient, the higher the probability of being a reactor. Among students who shared no classes with the index patient, the highest rates of tuberculin reactions were found for those who had entered a classroom immediately after the index patient had left it. Evidence of transmission on the school bus and in the church choir was also suggested. Six secondary cases (three pulmonary) resulted from the outbreak. Identical phage types from the index and secondary patients suggest that this was a common-source outbreak. Follow-up of students who had left school during the term proved useful in determining when transmission began. The index case was found to be a missed contact of a previously identified case of tuberculosis. Since household contacts are at high risk for developing active disease, there is a need for meticulous and complete investigation and preventive therapy for all such persons, especially children. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.361_5 Template-Type: ReDIF-Article 1.0 Title: Contraceptive usage during lactation: Analysis of 1973 and 1976 National Survey of Family Growth: I. Age and race Journal: American Journal of Public Health Author-Name: Labbok, M. Author-Name: Ford, K. Author-Name: Gray, R.H. Year: 1985 Volume: 75 Issue: 1 Pages: 75-77 DOI: 10.2105/AJPH.75.1.75 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.75 Abstract: Data from the National Survey of Family Growth are analyzed to estimate the prevalence of contraceptive use during lactation. Approximately 20 per cent of lactating women were sexually active and did not use a method in months two through six, postpartum. Among method users, the largest proportion chose barrier methods but 14 per cent used oral contraceptives in the early postpartum period. Between 1973 and 1976 there was an increase in the percentage of women who utilized a contraceptive method during lactation and a decrease in the per cent using oral contraceptives. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.75_7 Template-Type: ReDIF-Article 1.0 Title: Prescribing practices among nurse practitioners in adult and family health Journal: American Journal of Public Health Author-Name: Batey, M. Author-Name: Holland, J.M. Year: 1985 Volume: 75 Issue: 3 Pages: 258-262 DOI: 10.2105/AJPH.75.3.258 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.258 Abstract: Data derived through log recordings of 89 nurse practitioners (NPs) in adult/family practice on 7,086 prescriptions issued during 890 clinical days were analyzed to describe prescribing practices of NPs who held prescriptive authority from the licensing regulatory boards of five western states. results showed drug utilization to be similar to physician prescribing data, and intensity of prescribing to be less than that of physicians. The distributions of prescriptions by drug category and in relation to health problems underlying prescriptions are reported. Confidence with prescribing by type of drugs was parallel to incidence of prescriptions within drug category. Physician consultation prior to prescribing occurred with highest incidence for health problems treated with least frequently prescribed drugs. Physician consultation or referral was reported for 14.3 per cent of prescriptions. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.258_2 Template-Type: ReDIF-Article 1.0 Title: Mortality patterns of New York State Vietnam veterans Journal: American Journal of Public Health Author-Name: Lawrence, C.E. Author-Name: Reilly, A.A. Author-Name: Quickenton, P. Author-Name: Greenwald, P. Author-Name: Page, W.F. Author-Name: Kuntz, A.J. Year: 1985 Volume: 75 Issue: 3 Pages: 277-279 DOI: 10.2105/AJPH.75.3.277 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.277 Abstract: Mortality odds ratios (MORs) comparing veterans with Vietnam service who died in New York State to veterans of the Vietnam era with no Vietnam service were estimated (n = 1,496). The most elevated MORs and their confidence intervals were nonmotor vehicular injuries of transport (MOR = 2.18, (1.19, 3.96)), other accidents and burns (MOR = 1.37, (0.95, 1.98)), and homicide (MOR = 1.59, (0.86, 2.94). Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.277_5 Template-Type: ReDIF-Article 1.0 Title: Emergency CPR instruction via telephone Journal: American Journal of Public Health Author-Name: Eisenberg, M.S. Author-Name: Hallstrom, A.P. Author-Name: Carter, W.B. Author-Name: Cummins, R.O. Author-Name: Bergner, L. Author-Name: Pierce, J. Year: 1985 Volume: 75 Issue: 1 Pages: 47-50 DOI: 10.2105/AJPH.75.1.47 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.47 Abstract: We initiated a program of telephone CPR (cardiopulmonary resuscitation) instruction provided by emergency dispatchers to increase the percentage of bystander-initiated CPR for out-of-hospital cardiac arrest. Cardiac arrests in King County, Washington were studied for 20 months before and after the telephone CPR program began. Bystander-initiated CPR increased from 86 of 191 (45 per cent) cardiac arrests before the program to 143 of 255 (56 per cent) cardiac arrests after the program. During the after period, 58 patients received CPR as a result of telephone instruction, 12 out of whom were discharged. We estimate that four lives may have been saved by the program. A review of hospital records revealed no excess morbidity in the group of patients receiving dispatcher-assisted CPR. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.47_2 Template-Type: ReDIF-Article 1.0 Title: Credentialing of diagnostic X-ray technologists: A question of public health impact Journal: American Journal of Public Health Author-Name: Audet, M.F. Author-Name: Johnson, D.W. Year: 1985 Volume: 75 Issue: 3 Pages: 270-274 DOI: 10.2105/AJPH.75.3.270 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.270 Abstract: This paper presents estimates of the number of diagnostic x-ray examinations performed in the United States, the population dose delivered, the percentage of that dose contributed by credentialed and noncredentialed operators, and one measure of performance: collimation of the x-ray beam. An estimated 82 per cent of medical x-ray examinations are performed by voluntarily certified (ARRT or ARCRT) operators. These procedures contribute 90 per cent of the radiation dose to the population. Data from the Nationwide Evaluation of X-ray Trends (NEXT program indicate that certified operators collimate the x-ray beam somewhat better than noncertified for chest examinations. They also indicate that differences in collimation practices may be attributed to the type of facility as well as to the credentials of the operators. One-third of the medical x-ray machines are in states presently requiring licensure of operators. It appears from these estimates that instituting operator licensure in the remaining states may reduce population dose by a maximum of one or two per cent. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.270_9 Template-Type: ReDIF-Article 1.0 Title: Public health and environment Journal: American Journal of Public Health Author-Name: Wolman, A. Year: 1985 Volume: 75 Issue: 9 Pages: 1049-1051 Handle: RePEc:aph:ajpbhl:1985:75:9:1049-1051_9 Template-Type: ReDIF-Article 1.0 Title: Community coverage in a rural, church-based, hypertension screening program in Edgecombe County, North Carolina Journal: American Journal of Public Health Author-Name: Strogatz, D.S. Author-Name: James, S.A. Author-Name: Elliott, D. Author-Name: Ramsey, D. Author-Name: Cutchin, L.M. Author-Name: Ibrahim, M.A. Year: 1985 Volume: 75 Issue: 4 Pages: 401-402 DOI: 10.2105/AJPH.75.4.401 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.401 Abstract: In a rural, church-based hypertension program in Edgecombe County, North Carolina, screening of the congregations was complemented by a community outreach component targeted at 18-60 year old males, a group at higher risk for untreated hypertension. Compared with its estimated frequency in the community, untreated hypertension was as common in the church congregations and somewhat less prevalent than expected among outreach screenees. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.401_4 Template-Type: ReDIF-Article 1.0 Title: Fiber intake and childhood appendicitis Journal: American Journal of Public Health Author-Name: Brender, J.D. Author-Name: Weiss, N.S. Author-Name: Koepsell, T.D. Author-Name: Marcuse, E.K. Year: 1985 Volume: 75 Issue: 4 Pages: 399-400 DOI: 10.2105/AJPH.75.4.399 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.399 Abstract: Parents of 135 children with appendicitis and of 212 comparison children were interviewed about their children's diet. Children in the upper two quartiles of fiber intake were estimated to have a 30 per cent lower risk of appendicitis than children in the lowest quartile. Estimated risk of appendicitis decreased as monthly intake of whole-grain foods increased. Children 7 to 18 years of age who had an intake of whole-grain foods in the upper fiftieth percentile were estimated to have a 50 per cent lower risk of appendicitis. This reduction in risk was not observed in the group of children less than 7 years of age. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.399_4 Template-Type: ReDIF-Article 1.0 Title: The oral health of older Americans Journal: American Journal of Public Health Author-Name: Burt, B.A. Year: 1985 Volume: 75 Issue: 10 Pages: 1133-1134 Handle: RePEc:aph:ajpbhl:1985:75:10:1133-1134_4 Template-Type: ReDIF-Article 1.0 Title: Human and sylvatic Trypanosoma cruzi infection in California Journal: American Journal of Public Health Author-Name: Navin, T.R. Author-Name: Roberto, R.R. Author-Name: Juranek, D.D. Author-Name: Limpakarnjanarat, K. Author-Name: Mortenson, E.W. Author-Name: Clover, J.R. Author-Name: Yescott, R.E. Author-Name: Taclindo, C. Author-Name: Steurer, F. Author-Name: Allain, D. Year: 1985 Volume: 75 Issue: 4 Pages: 366-369 DOI: 10.2105/AJPH.75.4.366 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.366 Abstract: In August 1982, a 56-year-old woman from Lake Don Pedro, California, developed acute Chagas' disease (American trypanosomiasis). She had not traveled to areas outside the United States with endemic Chagas' disease, she had never received blood transfusions, and she did not use intravenous drugs. Trypanosoma cruzi cultured from the patient's blood had isoenzyme patterns and growth characteristics similar to T. cruzi belonging to zymodeme Z1. Triatoma protracta (a vector of Trypanosoma cruzi) infected with T. cruzi were found near the patient's home, a trypanosome resembling T. cruzi was cultured from the blood of two of 19 ground squirrels (Spermophilus beecheyi), and six of 10 dogs had antibody to T. cruzi. A serosurvey of three groups of California residents revealed antibody to T. cruzi by complement fixation in six of 237 (2.5 per cent) individuals living near the patient and in 12 of 1,706 (0.7 per cent) individuals living in a community 20 miles northeast of the patient's home, but in only one of 637 (0.2 per cent) blood donors from the San Francisco Bay area. This is the first case of indigenously acquired Chagas' disease reported from California and the first case recognized in the United States since 1955. This investigation suggests that transmission of sylvatic Trypanosoma cruzi infection to humans occurs in California but that Chagas' disease in humans is rare. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.366_3 Template-Type: ReDIF-Article 1.0 Title: Campylobacter jejuni infections on college campuses: A national survey Journal: American Journal of Public Health Author-Name: Tauxe, R.V. Author-Name: Deming, M.S. Author-Name: Blake, P.A. Year: 1985 Volume: 75 Issue: 6 Pages: 659-660 DOI: 10.2105/AJPH.75.6.659 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.659 Abstract: We surveyed 303 colleges and universities to determine the frequency of isolations of Campylobacter jejuni and other enteric bacterial pathogens. Campylobacter cultures could be obtained at 74%; 10% of stool cultures yielded Campylobacter, which was isolated 10 and 46 times more frequently than Salmonella and Shigella, respectively. The incidence of diagnosed Campylobacter infections was 1.3 per 10,000 enrolled students per month. Intercollegiate variation was not explained by differences in gender composition, the proportion of students living off-campus, or geographic characteristics of the campus. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.659_0 Template-Type: ReDIF-Article 1.0 Title: Control definition in case-control studies of ectopic pregnancy Journal: American Journal of Public Health Author-Name: Weiss, N.S. Author-Name: Daling, J.R. Author-Name: Chow, W.H. Year: 1985 Volume: 75 Issue: 1 Pages: 67-68 DOI: 10.2105/AJPH.75.1.67 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.67 Abstract: In case-control studies of ectopic pregnancy, the optimal sampling frame for control selection is influenced heavily by the hypothesis being tested. The selection of women completing an intrauterine pregnancy, a common choice for a control group in studies to date, is appropriate only if the hypothesis does not relate to exposures that selectively prevent an intrauterine pregnancy (e.g., use of an intrauterine device (IUD) at the time of conception). Even for other exposures, the selection of such women can yield misleading results if the exposure is related to the likelihood of completion of the intrauterine pregnancy. On the other hand, the selection of nonpregnant women as controls, while permitting a valid evaluation of the risk associated with exposure such as the use of an IUD, can introduce a substantial degree of incomparability between cases and controls with regard to other contraceptive practices and their correlates. Whichever of the two sampling frames that is chosen, an appreciation of these potential biases can lead to ways of tailoring the selection of individual controls to minimize the magnitude of the bias. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.67_3 Template-Type: ReDIF-Article 1.0 Title: Hypertension prevalence among Penobscot Indians of Indian Island, Maine Journal: American Journal of Public Health Author-Name: Deprez, R.D. Author-Name: Miller, E. Author-Name: Hart, S.K. Year: 1985 Volume: 75 Issue: 6 Pages: 653-654 DOI: 10.2105/AJPH.75.6.653 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.653 Abstract: Prevalence of hypertension, measured on a random sample of Penobscot Indian adults on reservation in Maine, was 23%. Only 50% of the hypertensive Penobscots were aware of their condition. Among those treated with antihypertensive medications, 56% were controlled. When compared to a statewide sample of Maine adults, the prevalence of hypertension among Penobscots was similar but awareness was significantly lower. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.653_1 Template-Type: ReDIF-Article 1.0 Title: A waterborne outbreak of hepatitis A in Meade County, Kentucky Journal: American Journal of Public Health Author-Name: Bergeisen, G.H. Author-Name: Hinds, M.W. Author-Name: Skaggs, J.W. Year: 1985 Volume: 75 Issue: 2 Pages: 161-164 DOI: 10.2105/AJPH.75.2.161 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.161 Abstract: In November 1982, Meade County, Kentucky health officials noted a sudden increase in the incidence of hepatitis A. Using a standardized interview of 73 cases (68 serologically confirmed), and 85 controls (all negative for antibody to hepatitis A virus), the most important risk factor identified was household use of untreated water from a single spring. A dose-response relationship was found for consumption of unboiled spring water. Water samples taken from the spring during the outbreak were contaminated with fecal coliforms. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.161_8 Template-Type: ReDIF-Article 1.0 Title: Hospital falls: A persistent problem Journal: American Journal of Public Health Author-Name: Morgan, V.R. Author-Name: Mathison, J.H. Author-Name: Rice, J.C. Author-Name: Clemmer, D.I. Year: 1985 Volume: 75 Issue: 7 Pages: 775-777 Abstract: During a 22-month period in 1981-82, 250 falls were recorded at a 152-bed acute care specialty hospital in a United States metropolitan area. Rates were highest for patients age 65 years and older and for patients admitted with mental disorders. Patients who had fallen once had a subsequent fall rate of 91.7 per 1,000 patients compared to an overall rate of 18.7 for first falls. Half the falls occurred in or en route to the private bathroom attached to each room. Only three falls resulted in injury sufficient to prolong hospital stay. Handle: RePEc:aph:ajpbhl:1985:75:7:775-777_0 Template-Type: ReDIF-Article 1.0 Title: The difference between date of suicidal act and recorded death certificate date in 204 consecutive suicides Journal: American Journal of Public Health Author-Name: Rich, C.L. Author-Name: Young, D. Author-Name: Fowler, R.C. Author-Name: Rosenfeld, S.K.S. Year: 1985 Volume: 75 Issue: 7 Pages: 778-779 Abstract: The date of death recorded on death certificates (DCD) was compared to the date of the suicidal act (DA) in a consecutive series of 204 suicides. The DA was known to be the same as the DCD in only 46% of the cases. The DA was different from the DCD in 22% of the cases. The difference between the DA and DCD should be taken into consideration in the analysis of temporal trends. Handle: RePEc:aph:ajpbhl:1985:75:7:778-779_0 Template-Type: ReDIF-Article 1.0 Title: Pattern of alcohol use associated with self-identified problem drinking Journal: American Journal of Public Health Author-Name: Sanchez-Craig, M. Author-Name: Israel, Y. Year: 1985 Volume: 75 Issue: 2 Pages: 178-180 DOI: 10.2105/AJPH.75.2.178 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.178 Abstract: To estimate the pattern and level of alcohol consumption leading to problem drinking, the drinking histories of 70 early stage problem drinkers were examined. An average consumption of four drinks (54 g/ethanol), on an average of three days/week, was the pattern that best separated the phase when patients were problem free from the phase when their drinking led to problems. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.178_4 Template-Type: ReDIF-Article 1.0 Title: Imported measles outbreak in a university Journal: American Journal of Public Health Author-Name: Narain, J.P. Author-Name: Farrell, J.B. Author-Name: Lofgren, J.P. Author-Name: Gunn, R.A. Year: 1985 Volume: 75 Issue: 4 Pages: 397-398 DOI: 10.2105/AJPH.75.4.397 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.397 Abstract: In 1981, a measles outbreak in an Arkansas university involved 16 students and four persons who were contacts of these students. The first two cases were in students who recently returned from Honduras. Of the 16 students with measles, 12 had significant gastrointestinal symptoms: five had elevated liver transaminase, and eight were hospitalized. Only two of the students were considered adequately immunized. A voluntary immunization clinic held on the university campus resulted in 67 per cent of 3,076 students being vaccinated. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.397_3 Template-Type: ReDIF-Article 1.0 Title: Working life of New York state physicians, 1980 Journal: American Journal of Public Health Author-Name: Jow-Ching Tu, E. Year: 1985 Volume: 75 Issue: 5 Pages: 553-555 Abstract: Physicans' working life tables are constructed to summarize the New York State physican's activity patterns. Male physicans could be expected to spend 47.0 years in full-time activity, 65 per cent of their total lifetime. Female physicans could be expected to spend 41.3 years, 53 per cent of their total lifetime, in full-time activity. Full-time activity refers to working 30 hours or more per week in clinical practice, research, teaching, or other professional activity. Handle: RePEc:aph:ajpbhl:1985:75:5:553-555_3 Template-Type: ReDIF-Article 1.0 Title: School-based preventive dental care: A different view Journal: American Journal of Public Health Author-Name: Rebich Jr., T. Year: 1985 Volume: 75 Issue: 4 Pages: 392-394 DOI: 10.2105/AJPH.75.4.392 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.392 Abstract: The purpose of the study, as presented in their initial proposal (5/10/76) was to provide data on the effectiveness of already validated preventive dentistry procedures when applied in various combinations by appropriate dental, auxiliary and school personnel. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.392_5 Template-Type: ReDIF-Article 1.0 Title: Waterborne disease in Colorado: Three years' surveillance and 18 outbreaks Journal: American Journal of Public Health Author-Name: Hopkins, R.S. Author-Name: Shillam, P. Author-Name: Gaspard, B. Author-Name: Eisnach, L. Author-Name: Karlin, R.J. Year: 1985 Volume: 75 Issue: 3 Pages: 254-257 DOI: 10.2105/AJPH.75.3.254 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.254 Abstract: The Colorado Department of Health conducted intensive surveillance for waterborne diseases during the three-year period July 1, 1980-June 30, 1983. Eighteen outbreaks of waterborne illness were investigated. Outbreaks involved from 15 to 1,500 ill persons. Giardia lamblia was confirmed or suspected as the agent in nine outbreaks, rotavirus in one, and no agent could be identified in eight. Seventeen outbreaks occurred on surface-water systems; none of these had adequate chemical pretreatment and filtration. Investigation of water systems exhibiting positive coliform results during the first year detected no outbreaks. Activities important to effective surveillance included educational outreach programs to local health agencies, physicians and the public, and the designation of one individual to whom all water-related public complaints and health department inquiries were directed. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.254_0 Template-Type: ReDIF-Article 1.0 Title: Economic development and occupational health in Latin America: New directions for public health in less developed countries Journal: American Journal of Public Health Author-Name: Michaels, D. Author-Name: Barrera, C. Author-Name: Gacharna, M.G. Year: 1985 Volume: 75 Issue: 5 Pages: 536-542 DOI: 10.2105/AJPH.75.5.536 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.536 Abstract: Occupational Health is increasingly recognized as an area of importance in Latin American public health. In the agricultural sector of the region, the concentration of arable land into large holdings devoted to the production of export crops has resulted in the formation of a large migrant work force and greatly increased use of pesticides. The manufacturing sector of Latin America had grown rapidly in size and importance. Throughout the continent, increasing numbers of workers are employed in high-hazard industrial jobs. Limited studies of occupational disease in agriculture, mining, and manufacturing suggest that there is a high prevalence of work-related illness in the populations at risk. Trade unions are generally weak, and the high rate of unemployment and underemployment render occupational health a low priority for many workers. Engineering controls and personal protective equipment are unknown or inadequate in many industries, and there is a shortage of trained occupational health professionals in the region. Steps are being taken by many Latin American governments to begin to address this problem. Needed are: increased worker and professional training; a uniform set of exposure standards; control of multinational marketing and usage of hazardous substances; the development of technical equipment appropriate for local use and increased research on occupational exposure in populations in less developed countries. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.536_0 Template-Type: ReDIF-Article 1.0 Title: Moving the 'standards movement' Journal: American Journal of Public Health Author-Name: Schaefer, M. Year: 1985 Volume: 75 Issue: 6 Pages: 645-648 DOI: 10.2105/AJPH.75.6.645 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.645 Abstract: Substantial variations found in state implementation of public health service standards were partially explained by information collected from State Health Departments. A number of structural factors, particularly the distribution of service and supervisory responsibilities between state and local agencies, produce role and tactical differences in the process of standards implementation. Patterns and philosophies of intergovernmental finding were also reported to be critical to the process. In that these and related factors have their roots in political decisions, attention to internal and external political constraints is believed to be important to progress on standards implementation. Finally, the extent of variation reported raises the issue of the degree to which a common paradigm of public health exists and guides practice in state and local communities. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.645_5 Template-Type: ReDIF-Article 1.0 Title: Home refinishing, lead paint, and infant blood lead levels Journal: American Journal of Public Health Author-Name: Rabinowitz, M. Author-Name: Leviton, A. Author-Name: Bellinger, D. Year: 1985 Volume: 75 Issue: 4 Pages: 403-404 DOI: 10.2105/AJPH.75.4.403 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.403 Abstract: We measured the blood lead levels of 249 infants semi-annually from birth to two years of age; we sampled the home paint and recorded any recent home refinishing activity. Mean blood lead from birth to age 2 years did not vary systematically with age but did correlate significantly with the amount of lead in the indoor paint (p < .01). Refinishing activity in homes with high lead paint was associated with elevations of blood lead averaging 69 per cent. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.403_5 Template-Type: ReDIF-Article 1.0 Title: Oral disease and quality of life Journal: American Journal of Public Health Author-Name: Nikias, M. Year: 1985 Volume: 75 Issue: 1 Pages: 11-12 DOI: 10.2105/AJPH.75.1.11 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.11 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.11_4 Template-Type: ReDIF-Article 1.0 Title: Interpersonal violence: Patterns in a Danish community Journal: American Journal of Public Health Author-Name: Hedeboe, J. Author-Name: Charles, A.V. Author-Name: Nielsen, J. Author-Name: Grymer, F. Author-Name: Møller, B.N. Author-Name: Møller-Madson, B. Author-Name: Jensen, S.E. Year: 1985 Volume: 75 Issue: 6 Pages: 651-653 DOI: 10.2105/AJPH.75.6.651 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.651 Abstract: We studied all cases of assault with violence (1,639) in a Danish population of 275,000 over a 1-year period. Most victims were young men. The incidence rose during evenings, nights and weekends, and assaults were often seen in or around bars and restaurants. Women accounted for 64% of all victims of assault in the home. Influence of alcohol was identified in 43% of all cases. The fist was the most frequent agent of assault; use of firearms was a very rare act of violence but was associated with death in 3 out of 5 cases. There were 10 deaths in all. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.651_8 Template-Type: ReDIF-Article 1.0 Title: On whirlpool spa maintenance. Journal: American Journal of Public Health Author-Name: Vogt, R.L. Author-Name: Witherell, L.E. Year: 1985 Volume: 75 Issue: 1 Pages: 97 Handle: RePEc:aph:ajpbhl:1985:75:1:97_5 Template-Type: ReDIF-Article 1.0 Title: Medical examination of school entrants: Later school problems and absenteeism of attenders and non-attenders Journal: American Journal of Public Health Author-Name: Mowat, D.L. Author-Name: White, C. Year: 1985 Volume: 75 Issue: 4 Pages: 395-396 DOI: 10.2105/AJPH.75.4.395 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.395 Abstract: Children who were scheduled for medical examination before entering school were followed in school one or two years later. Non-attenders had a two-fold risk of repeating grades, special class placement, referral for speech/language problems, teacher-reported learning or behavior problems, failure of vision or hearing screening, and transfer between schools. Absenteeism was also significantly more common. Children not brought in for preventive health care are at greater risk than others for difficulties in school. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.395_3 Template-Type: ReDIF-Article 1.0 Title: The teaching of occupational health in United States medical schools: Five-year follow-up of an initial survey Journal: American Journal of Public Health Author-Name: Levy, B.S. Year: 1985 Volume: 75 Issue: 1 Pages: 79-80 DOI: 10.2105/AJPH.75.1.79 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.79 Abstract: A survey of 111 of the 127 United States medical schools revealed that 73 (66 per cent) specifically taught occupational health during the 1982-83 academic year, compared to 50 per cent in 1977-78. Occupational health was a required part of the curriculum in 54 per cent of the schools compared to 30 per cent in 1977-78. However, the median required curriculum time for occupational health was four hours during both academic years. Increased attention needs to be given to occupational health in medical school curricula. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.79_4 Template-Type: ReDIF-Article 1.0 Title: Physicians and the teaching of breast self-examination: Implications from a survey at a university teaching hospital Journal: American Journal of Public Health Author-Name: O'Malley, M.S. Author-Name: Fletcher, S.W. Author-Name: Bunce, L.A. Year: 1985 Volume: 75 Issue: 6 Pages: 673-675 DOI: 10.2105/AJPH.75.6.673 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.673 Abstract: We surveyed 80 physicians from 4 specialties (Family Medicine, General Medicine, General Surgery, Ob-Gyn) to investigate how they taught breast self-examination (BSE). Only half reported personally teaching BSE. Few MDs reported routinely using techniques to assess BSE competency. Most (72%) claimed no formal training in teaching BSE; 10% claimed no training at all. Techniques used to teach BSE may vary, and physicians may lack the training to teach BSE. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.673_7 Template-Type: ReDIF-Article 1.0 Title: Benefit-cost analysis of active surveillance of primary care physicians for hepatitis A Journal: American Journal of Public Health Author-Name: Hinds, M.W. Author-Name: Skaggs, J.W. Author-Name: Bergeisen, G.H. Year: 1985 Volume: 75 Issue: 2 Pages: 176-177 DOI: 10.2105/AJPH.75.2.176 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.176 Abstract: We identified two random samples of 216 primary care physicians each. In one sample, we made weekly telephone contact for active hepatitis A (HA) surveillance; in the other, we made no such contact (passive surveillance). Appropriate county health departments were notified whenever we identified a HA case by active surveillance. Active surveillance was associated with a 2.8-fold increase in reported HA cases compared to passive surveillance. The estimated benefit: cost ratio active/passive surveillance was 2.5:1. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.176_7 Template-Type: ReDIF-Article 1.0 Title: A prospective study of swimming-related illness II. Morbidity and the microbiological quality of water Journal: American Journal of Public Health Author-Name: Seyfried, P.L. Author-Name: Tobin, R.S. Author-Name: Brown, N.E. Author-Name: Ness, P.F. Year: 1985 Volume: 75 Issue: 9 Pages: 1071-1075 Abstract: A prospective cohort epidemiological-microbiological study was carried out at 10 beaches in Ontario, Canada. Lake water and sediment samples collected at the beaches were analyzed for fecal coliforms, fecal streptococci, heterotrophic bacteria, Pseudomonas aeruginosa, and total staphylococci. Mean fecal coliform levels in the surface water of the lakes were accepted guidelines. Bacterial densities were found to be approximately 10 times higher in the sediment than in the corresponding surface water samples. Morbidity among swimmers was shown to be related to staphylococcal counts, to fecal coliform levels, and, somewhat less strongly, to fecal streptococcal counts. Total staphylococci appeared to be more consistent indicators for predicting total morbidity rates among swimmers. Handle: RePEc:aph:ajpbhl:1985:75:9:1071-1075_7 Template-Type: ReDIF-Article 1.0 Title: Premarital rubella vaccination program Journal: American Journal of Public Health Author-Name: Vogt, R.L. Author-Name: Clark, S.W. Year: 1985 Volume: 75 Issue: 9 Pages: 1088-1089 Abstract: A two-year Vermont program identified 494 (7 per cent) of 6,982 premarital female serologies that were seronegative (<1:8) to rubella by hemagglutination inhibition (HI) titer. All 494 susceptible patients and their physicians were notified of their results by letter. The State Health Department received reports that a total of 194 (39 per cent) of the susceptible patients had received rubella vaccinations as a result of their notifications. Intensive follow-up of susceptible appears to be important factor in the success of premarital rubella screening programs. Handle: RePEc:aph:ajpbhl:1985:75:9:1088-1089_7 Template-Type: ReDIF-Article 1.0 Title: Government regulation of occupational safety: Underground coal mine accidents 1973-75 Journal: American Journal of Public Health Author-Name: Boden, L.I. Year: 1985 Volume: 75 Issue: 5 Pages: 497-501 DOI: 10.2105/AJPH.75.5.497 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.497 Abstract: The purpose of this paper is to determine the influence of federal mine safety inspections on underground coal mine accidents. An economic incentives model is developed to relate federal enforcement activities to accident rates. The determinants of accident rates are analyzed for 535 coal mines during the period 1973-75. Estimates based on these data when applied to the model indicate that increasing inspections by 25 per cent would have produced a 13 per cent decline in fatal accidents and an 18 per cent decline in disabling accidents. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.497_3 Template-Type: ReDIF-Article 1.0 Title: Disabled adults in sheltered employment: An assessment of dental needs and costs Journal: American Journal of Public Health Author-Name: Strauss, R.P. Author-Name: Hairfield, W.M. Author-Name: George, M.C. Year: 1985 Volume: 75 Issue: 6 Pages: 661-663 DOI: 10.2105/AJPH.75.6.661 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.661 Abstract: In this dental survey of a multi-disability sheltered industry, 233 adults were examined. When compared to adjusted North Carolina values, the workers exhibited poorer oral hygiene with higher rates and severity of periodontal disease. DMF-T totals were equal to those statewide; however, workers had more decayed and fewer missing teeth. Significant unmet restorative and prosthodontic needs were found. Treatment cost estimates at 1983 fees were $421 per capita, with a median fee of $240. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.661_0 Template-Type: ReDIF-Article 1.0 Title: Prenatal care and pregnancy outcomes during the recession: The Washington State experience Journal: American Journal of Public Health Author-Name: Fisher, E.S. Author-Name: LoGerfo, J.P. Author-Name: Daling, J.R. Year: 1985 Volume: 75 Issue: 8 Pages: 866-869 Abstract: To determine whether changes in prenatal care utilization and adverse pregnancy outcomes occurred among poor residents of Washington State during the recent recession, we examined all births occurring from 1980 to 1983 to women in the poorest census tracts of the three major metropolitan counties in Washington State (N = 15,735). A comparison sample consisted of all births occurring in the highest income census tracts (N = 16,295). Because the impact of the recession was hypothesized to be greatest in 1982, rates in 1982 were compared with rates in 1980. The proportion of births receiving late or no prenatal care increased in both the low-income tracts (6.2% to 8.2%) and the high-income tracts (1.6% to 2.3%). The proportion of low birthweight infants increased only in the low-income tracts (6.3% to 7.4%). The prevalence of maternal anemia (hematocrit < 30) also increased only in the low-income tracts (0.7% to 1.7%). While we were unable to ascertain the financial status of the individuals who suffered the adverse outcomes, the findings for the low-income census tracts are consistent with the hypothesis that an increase in adverse pregnancy outcomes occurred among the poor in Washington State during the recent recession. Handle: RePEc:aph:ajpbhl:1985:75:8:866-869_4 Template-Type: ReDIF-Article 1.0 Title: Microbiologic indicators of health risks associated with swimming Journal: American Journal of Public Health Author-Name: Favero, M.S. Year: 1985 Volume: 75 Issue: 9 Pages: 1051-1054 Handle: RePEc:aph:ajpbhl:1985:75:9:1051-1054_3 Template-Type: ReDIF-Article 1.0 Title: Reinstitution of diet therapy in PKU patients from twenty-two US clinics Journal: American Journal of Public Health Author-Name: Schuett, V.E. Author-Name: Brown, E.S. Author-Name: Michals, K. Year: 1985 Volume: 75 Issue: 1 Pages: 39-42 DOI: 10.2105/AJPH.75.1.39 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.39 Abstract: In a nationwide survey we found 72 PKU (phenylketonuria) patients who had terminated diet but later returned to diet. Sixty-one patients resumed diet due to clinical problems. Age at initial diet discontinuation ranged from three to 20 years. The most prevalent problems reported were poor school performance, and mood and/or behavior changes. Following diet reinstitution, only positive changes were noted for 42 patients, no changes for 19 patients, and 11 had one or more negative changes. Improvements and blood phenylalanine levels were not significantly correlated, but only 11 patients maintained levels < 10 mg/dl. The number of improvements was significantly correlated with length of time on diet (p < 0.001). After a median of 10 months on diet, 22 patients had again discontinued due to poor diet control, lack of motivation, poor formula tolerance, lack of apparent benefits and/or changes for the worse. Median time on diet for the 50 second-time continuers was two years nine months. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.39_9 Template-Type: ReDIF-Article 1.0 Title: Neurologic dysfunction from exposure to 2-t-butylazo-2-hydroxy-5-methylhexane (BHMH): A new occupational neuropathy Journal: American Journal of Public Health Author-Name: Horan, J.M. Author-Name: Kurt, T.L. Author-Name: Landrigan, P.J. Author-Name: Melius, J.M. Author-Name: Singal, M. Year: 1985 Volume: 75 Issue: 5 Pages: 513-517 DOI: 10.2105/AJPH.75.5.513 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.513 Abstract: Seven cases of subacute central and peripheral neurologic dysfunction developed in 18 workers employed in the manufacture of reinforced plastic bathtubs. Cases were characterized by weight loss, dizziness, paresthesias, muscle weakness, incontinence, memory loss, and loss of peripheral, color, and night vision. Neuropathies began distally, involved both sensory and motor function, and were associated with prolonged sensory latency, muscle fibrillation, and reduced number of functioning motor units. One patient developed posterior lenticular cataracts. Slow improvement occurred on removal from exposure, but residual neuropathies persisted for as long as two years. Epidemiologic investigation disclosed that the first case developed approximately two weeks after introduction of a new plastic foaming agent, 2-t-butylazo-2-hydroxy-5-methylhexane (BHMH). All cases occurred in workers exposed directly to BHMH. No new cases developed after use of BHMH was discontinued. A survey of the firm which produced BHMH and of 68 user firms found two additional clusters of mild neuropathy which may have been caused by BHMH. BHMH was withdrawn from distribution following discovery of these cases. Subsequently, BHMH has been shown in rats to be a potent neurotoxin. Adequate premarket testing could have averted this outbreak. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.513_5 Template-Type: ReDIF-Article 1.0 Title: Drug product selection: The Florida experience revisited Journal: American Journal of Public Health Author-Name: Clouse, E.H. Author-Name: McCormick, W.C. Author-Name: Angorn, R.A. Author-Name: Kimberlin, C.L. Author-Name: Bradham, D.D. Year: 1985 Volume: 75 Issue: 3 Pages: 283-284 DOI: 10.2105/AJPH.75.3.283 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.283 Abstract: The comparison of drug product selection rates determined approximately one year and four years after passage of Florida's Drug Product Selection (DPS) Law indicates very little change in the product selection and brand interchange behaviors of Florida pharmacists. Lack of adequate guidelines from the state and the liability concerns of pharmacists appeared to limit an expected increase in the state DPS rate. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.283_7 Template-Type: ReDIF-Article 1.0 Title: Identification and immunization of medical students susceptible to measles and rubella: A nationwide survey Journal: American Journal of Public Health Author-Name: Murray, D.L. Author-Name: Weatherly, M.R. Author-Name: Sperling, J.L. Author-Name: Farquhar, L.J. Year: 1985 Volume: 75 Issue: 5 Pages: 556-557 DOI: 10.2105/AJPH.75.5.556 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.556 Abstract: Responses to a questionnaire regarding student immunization from 101 of 129 allopathic medical schools (78.3 per cent) indicated that 16 schools (15.8 per cent) do not request historical information or perform serologic tests on their students. Only 47 of 85 schools (55.3 per cent), who do screen students, utilize antibody titers. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.556_8 Template-Type: ReDIF-Article 1.0 Title: Variability among state Crippled Children's Service Programs: Pluralism thrives Journal: American Journal of Public Health Author-Name: Ireys, H.T. Author-Name: Hauck, R.J.-P. Author-Name: Perrin, J.M. Year: 1985 Volume: 75 Issue: 4 Pages: 375-381 DOI: 10.2105/AJPH.75.4.375 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.375 Abstract: The authors review the history of the Crippled Children's Service (CCS) program and report results of a survey of state CCS programs conducted in 1981. The results of the survey document extensive variability among state programs in respect to several indices, including numbers of children served, conditions covered, and services provided. With few exceptions, selected organizational, economic and demographic variables fail to correlate significantly with the variation of these indices. The strongest correlation, .40 (p < .02), is between percentage of children served and program per capita expenditures, suggesting that relatively wealthier programs tend to serve more children. Furthermore, analyses of the survey results show that mean coverage by CCS programs of surgical disorders is significantly greater than mean coverage of medical disorders or behavioral disorders (p < .001). The findings of this study underscore the considerable influence of historical and leadership variables on the functioning of state CCS programs. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.375_8 Template-Type: ReDIF-Article 1.0 Title: When the frame is part of the picture Journal: American Journal of Public Health Author-Name: Van Itallie, T.B. Year: 1985 Volume: 75 Issue: 9 Pages: 1054-1055 Handle: RePEc:aph:ajpbhl:1985:75:9:1054-1055_9 Template-Type: ReDIF-Article 1.0 Title: Does participation in prenatal courses lead to heavier babies? Journal: American Journal of Public Health Author-Name: Robitaille, Y. Author-Name: Kramer, M.S. Year: 1985 Volume: 75 Issue: 10 Pages: 1186-1189 Abstract: In a prospective epidemiologic survey of 1,676 primiparous women delivering in four Montreal hospitals during an eight-month period, we studied the impact of prenatal courses on birthweight, maternal weight gain, and cigarette smoking. Women who participated in prenatal courses were older and of higher socioeconomic status and were less likely to be smokers than non-participants. After adjustment for these differences, newborns of course participants had similar mean birthweights compared to those of non-participants (3286 grams vs 3271 grams), and the difference for maternal weight gain was substantially reduced. Most of the reduction in cigarette consumption occurred during the first three months of pregnancy, even among later participants, suggesting that something other than prenatal courses influenced cigarette smoking reduction in course participants. We conclude that as far as the birthweight objective is concerned, the format and content of prenatal courses (as currently constituted in the Montreal region) require re-examination, and new ideas and interventions need to be developed and tested. Handle: RePEc:aph:ajpbhl:1985:75:10:1186-1189_4 Template-Type: ReDIF-Article 1.0 Title: Pursuing longevity: Delay vs elimination of degenerative diseases Journal: American Journal of Public Health Author-Name: Olshansky, S.J. Year: 1985 Volume: 75 Issue: 7 Pages: 754-757 Abstract: Using a new model which allows for projection of mortality change resulting from preventive health care measures, prospective changes in longevity for the resident United States population in 1978 were compared with projections of longevity gains occurring under a standard single cause- elimination model. Results indicate that equal or greater gains accrue from the prevention or delay of several major degenerative diseases, than from the complete elimination of some single major degenerative diseases. Observed declines in mortality from 1960 to 1978 have resulted in gains in longevity equivalent to the successful elimination of some major degenerative diseases. Handle: RePEc:aph:ajpbhl:1985:75:7:754-757_0 Template-Type: ReDIF-Article 1.0 Title: The effects of respondent rules on health survey reports Journal: American Journal of Public Health Author-Name: Mathiowetz, N.A. Author-Name: Groves, R.M. Year: 1985 Volume: 75 Issue: 6 Pages: 639-644 DOI: 10.2105/AJPH.75.6.639 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.639 Abstract: Survey researchers believe that self reports, in general, are more accurate than reports obtained by proxy. This paper focuses on the reassessment of previous self/proxy comparisons and presents findings from a telephone adaptation of the National Health Interview Survey (NHIS) designed to investigate response error associated with self and proxy reports. Unlike previous studies in which the type of report is confounded with characteristics of the population home at the time of the interview, the design of this study (random allocation to self or proxy report) allows comparison of reports from similar populations. The results show that when self response is limited to a randomly selected respondent, the self respondents report fewer health events for themselves versus for others in their household. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.639_5 Template-Type: ReDIF-Article 1.0 Title: Comparative risks and costs of male and female sterilization Journal: American Journal of Public Health Author-Name: Smith, G.L. Author-Name: Taylor, G.P. Author-Name: Smith, K.F. Year: 1985 Volume: 75 Issue: 4 Pages: 370-374 DOI: 10.2105/AJPH.75.4.370 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.370 Abstract: Couples who are considering elective sterilization should compare the risks and costs of male and female sterilization procedures as part of the decision process. Morbidity, mortality, failure rates, and short-term costs associated with male and female sterilization procedures were estimated from data available in previous case series. Male sterilization procedures were found to have zero attributable deaths and significantly less major complications when compared to female sterilization procedures. No less than 14 deaths a year can be attributed to female sterilization procedures in the US. Male and female sterilization procedures have efficacy rates that are not significantly different from each other. The short-term costs of female sterilization are 3.0 to 4.1 times that of vasectomy. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.370_7 Template-Type: ReDIF-Article 1.0 Title: Methodologic issues in evaluating stop smoking programs Journal: American Journal of Public Health Author-Name: Midanik, L.T. Author-Name: Polen, M.R. Author-Name: Hunkeler, E.M. Author-Name: Tekawa, I.S. Author-Name: Soghikian, K. Year: 1985 Volume: 75 Issue: 6 Pages: 634-638 DOI: 10.2105/AJPH.75.6.634 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.634 Abstract: Three methodologic issues (definitions of smoking, period of follow-up, compositions of study group) were assessed in 426 persons 5 years after participation in a stop smoking program of a prepaid medical plan. When smoking was defined by measurement interval or by type or amount of tobacco smoked, smoking rates varied only slightly. Little information was gained by extending the follow-up period beyond the first year. However, study group composition (as defined by attendance at program sessions) had a pronounced effect on smoking rates. Those who attended fewer sessions were more likely to smoke during the follow-up period. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.634_9 Template-Type: ReDIF-Article 1.0 Title: Cost-benefit analysis of a thalassemia disease prevention program Journal: American Journal of Public Health Author-Name: Ostrowsky, J.T. Author-Name: Lippman, A. Author-Name: Scriver, C.R. Year: 1985 Volume: 75 Issue: 7 Pages: 732-736 Abstract: We offer an economic perspective on prevention of β- thalassemia disease by means of genetic screening and prenatal diagnosis in an established program in Quebec province. The program screens 80% of at-risk persons in the high- risk communities, provides diagnosis to 75% of at-risk couples, and prevented two-thirds of new cases in the period of study. We measured the additional costs, in 1981 Canadian dollars, of medical and public health resources, both incurred and avoided, resulting from use of these prevention services. The total direct cost per case prevented in the program is less than the cost for a single year of treatment for an individual with the disease. Sensitivity analysis accommodating demographic assumptions, participation rates, and discounting rates indicates that, even at rates of marriage, endogamy, and participation lower than observed in the current program, treatment costs will still exceed prevention costs when discounting is set at conventional rates of 4% and 8%. Cost effectiveness of the program is confirmed. Handle: RePEc:aph:ajpbhl:1985:75:7:732-736_2 Template-Type: ReDIF-Article 1.0 Title: Genital herpes: Does knowledge lead to action? Journal: American Journal of Public Health Author-Name: Aral, S.O. Author-Name: Cates Jr., W. Author-Name: Jenkins, W.C. Year: 1985 Volume: 75 Issue: 1 Pages: 69-71 DOI: 10.2105/AJPH.75.1.69 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.69 Abstract: We analyzed data from a national telephone survey to determine whether awareness of the herpes epidemic led to changes in sexual behavior. Of those surveyed, 67 per cent heard about herpes only within the last two years. More importantly, 45 per cent of individuals perceiving themselves to be at risk stated they had changed their behavior as a result of this perception. Among those never married, 60 per cent stated they were willing to modify their lives to avoid genital herpes. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.69_3 Template-Type: ReDIF-Article 1.0 Title: Motorcycle headlight-use laws: A contrasting view Journal: American Journal of Public Health Author-Name: Muller, A. Year: 1985 Volume: 75 Issue: 5 Pages: 547-549 DOI: 10.2105/AJPH.75.5.547 File-URL: http://hdl.handle.net/10.2105/AJPH.75.5.547 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.5.547_0 Template-Type: ReDIF-Article 1.0 Title: Smoking behavior among US Latinos: An emerging challenge for public health Journal: American Journal of Public Health Author-Name: Marcus, A.C. Author-Name: Crane, L.A. Year: 1985 Volume: 75 Issue: 2 Pages: 169-172 DOI: 10.2105/AJPH.75.2.169 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.169 Abstract: In this paper we review evidence on smoking and lung cancer among Latinos, including findings from several unpublished studies and technical reports. Recent surveys of smoking behavior in California, Texas, and New Mexico indicate a notable sex difference in smoking among Latinos, with Latino males smoking at least as frequently as White males, while Latino females report smoking rates considerably lower than White females. Our analysis of the 1979 and 1980 National Health Interview Surveys corroborates this finding and also indicates that this pattern holds true for subgroups of the Latino population, including country of origin. Taken together, these findings suggest that among Latino males rates of lung cancer and other cigarette-linked diseases may increase in the near future. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.169_4 Template-Type: ReDIF-Article 1.0 Title: Regulating the introduction of heart and liver transplantation Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1985 Volume: 75 Issue: 1 Pages: 93-95 DOI: 10.2105/AJPH.75.1.93 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.93 Abstract: Recommendations for state policy regarding heart and liver transplants by the Massachusetts Task Force on Organ Transplantation are presented and discussed. The Task Force, a broad-based group established to examine the social issues involved in organ transplantation, proposed a phased approach of limited transplantation for 2 or 3 years during which data would be collected on the program's clinical, social, economic, and ethical aspects. The Task Force also recommended the use of mechanisms, such as restrictions on allowable exceptional costs and requirements for determination of need; institutional review board monitoring; development of patient selection criteria based on reasonable probability of survival and rehabilitation; and guidelines for a coordinated consortium approach to preserve the high quality of care and decrease the need for capital expansion. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.93_8 Template-Type: ReDIF-Article 1.0 Title: Medicare and President Reagan's second term Journal: American Journal of Public Health Author-Name: Wing, K.R. Year: 1985 Volume: 75 Issue: 7 Pages: 782-784 Handle: RePEc:aph:ajpbhl:1985:75:7:782-784_2 Template-Type: ReDIF-Article 1.0 Title: An exploration of somatization among Asian refugees and immigrants in primary care Journal: American Journal of Public Health Author-Name: Lin, E.H.B. Author-Name: Carter, W.B. Author-Name: Kleinman, A.M. Year: 1985 Volume: 75 Issue: 9 Pages: 1080-1084 Abstract: The clinical records of Chinese, Filipino, Vietnamese, Laotian, and Mien patients in primary care were reviewed to determine the prevalence of somatization, its associated patient characteristics, and the manifested illness behavior. Patients in this study were generally poor, unemployed, and spoke little English. Somatization accounted for 35 per cent of illness visits. These visits were also more costly. Refugees had a higher rate of somatization (42.7 per cent) than immigrants (27.1 per cent). Although sociodemographic characteristics did not strongly differentiate patients with somatization from others, ethnicity and indicators of decreased resources such as large households with low income, households headed by single women, or a limited English proficiency were associated with somatization in certain ethnic groups. Somatization is thus an important health problem among Asian refugees and immigrants. Handle: RePEc:aph:ajpbhl:1985:75:9:1080-1084_5 Template-Type: ReDIF-Article 1.0 Title: Cigarette smoking and lung cancer in 'Hispanic' Whites and other Whites in New Mexico Journal: American Journal of Public Health Author-Name: Humble, C.G. Author-Name: Samet, J.M. Author-Name: Pathak, D.R. Author-Name: Skipper, B.J. Year: 1985 Volume: 75 Issue: 2 Pages: 145-148 DOI: 10.2105/AJPH.75.2.145 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.145 Abstract: A population-based case-control study of lung cancer was performed in New Mexico to explain the differing patterns of lung cancer ocurrence in the state's 'Hispanic' Whites and other Whites. From 1980 through 1982, interviews were completed with 521 cases and 769 controls. In the male controls, the prevalence of current and previous cigarette usage was similar in the two ethnic groups, but Hispanics smoked fewer cigarettes daily. In the female controls, a lower percentage of Hispanics had ever smoked and their usual consumption was less than that of other White women. Older Hispanic female smokers had used hand-rolled cigarettes for an average of 8.8 years, whereas other White women of the same age had used this type for less than one-half year. Both stratified and multiple logistic analysis showed comparable risks of lung cancer in Hispanic White and other White smokers. There was no evidence of interaction between ethnicity and cigarette smoking. These analyses imply that the differences in lung cancer incidence between New Mexico's Hispanic Whites and other Whites are largely explained by the patterns of cigarette smoking of these two groups. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.145_1 Template-Type: ReDIF-Article 1.0 Title: Yield of routine annual laboratory screening in the institutionalized elderly Journal: American Journal of Public Health Author-Name: Domoto, K. Author-Name: Ben, R. Author-Name: Wei, J.Y. Author-Name: Pass, T.M. Author-Name: Komaroff, A.L. Year: 1985 Volume: 75 Issue: 3 Pages: 243-245 DOI: 10.2105/AJPH.75.3.243 File-URL: http://hdl.handle.net/10.2105/AJPH.75.3.243 Abstract: We examined the yield of a battery of 19 screening laboratory tests performed routinely in 70 functionally intact patients, averaging 82.6 years of age and residing of a chronic care facility. The 70 patients underwent 3,903 screening tests (70 admission batteries and 156 batteries at annual intervals). Twenty per cent of the admission test results and 17 per cent of all subsequent annual test results were 'abnormal'. 'New abnormal' results (previously unknown to the responsible physicians) occurred primarily in five of the 19 screening tests; they were found in 13 per cent of all admission screening tests and in 6 per cent of all annual tests. However, many of the 'new abnormalities' were only minimally outside the normal range, and only 26 (0.7 per cent) led to further diagnostic evaluation. Of these 26, only four (0.1 per cent of all tests ordered) led to changes in patient management, none of which benefited the patient in an important way. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.3.243_7 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic evaluation of screening for risk factors: Application to genetic screening Journal: American Journal of Public Health Author-Name: Khoury, M.J. Author-Name: Newill, C.A. Author-Name: Chase, G.A. Year: 1985 Volume: 75 Issue: 10 Pages: 1204-1208 Abstract: To assess the usefulness of screening for risk factors, we derived arithmetic relationships between screening parameters (sensitivity, specificity, and positive predictive value PPV) and risk factor frequency, disease frequency and relative risk. We evaluated these relationships in the special case of genetic markers and disease susceptibility. It can be shown that even in the face of very large relative risks, sensitivity and positive predictive value are affected by the relative magnitude of disease and genetic marker frequences. When the genetic marker is less frequent than the disease, PPV increases with increasing relative risk but sensitivity remains low. When the genetic marker is more frequent than the disease, sensitivity increases with increasing relative risk but PPV remains low. When marker and disease frequencies are equal, both PPV and sensitivity increase with increasing relative risks, but very high relative risks (> 100) have to be obtained for rare diseases. Depending on the goals of the screening program, these relationships can be used to predict the relative magnitudes of false positives (low PPV) and false negatives (low sensitivity). This approach can be generalized to evaluate nongenetic risk factors in screening programs as well. Handle: RePEc:aph:ajpbhl:1985:75:10:1204-1208_0 Template-Type: ReDIF-Article 1.0 Title: Contemporary table salt practices and blood pressure Journal: American Journal of Public Health Author-Name: Phillips, K. Author-Name: Holm, K. Author-Name: Wu, A.C. Year: 1985 Volume: 75 Issue: 4 Pages: 405-406 DOI: 10.2105/AJPH.75.4.405 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.405 Abstract: Salt intake of 978 subjects when compared to 1954 data demonstrated a trend toward the decreased use of table salt. When hypertensives in treatment were excluded, persons reporting low salt use had higher mean systolic and diastolic blood pressures than those reporting high salt use. These findings were the reverse of the relationships found in 1954. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.405_2 Template-Type: ReDIF-Article 1.0 Title: Declining perinatal mortality in a region of Finland, 1968-82 Journal: American Journal of Public Health Author-Name: Piekkala, P. Author-Name: Erkkola, R. Author-Name: Kero, P. Author-Name: Tenovuo, A. Author-Name: Sillanpää, M. Year: 1985 Volume: 75 Issue: 2 Pages: 156-160 DOI: 10.2105/AJPH.75.2.156 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.156 Abstract: Perinatal mortality (PNM) in the catchment area of the University Central Hospital of Turku (UCHT), Finland, was investigated during a 15-year period from 1968 to 1982. During the study period, 82,151 babies were born, there were 531 fetal deaths and 505 cases of early neonatal death. The PNM rate declined during the study period from 17.9 in 1968 to 7.0 in 1982, or from 14.8 to 4.6 when infants weighing less than 1000 grams were excluded. Significant declines occurred in PNM due to maternal illness, placental and umbilical cord complications, other asphyxias and respiratory distress syndrome. We believe the centralization of obstetric and neonatal services for risk cases, the introduction of modern obstetric and neonatal management, and continuing education of personnel at every level of maternity and neonatal care accounted for the decline. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.156_5 Template-Type: ReDIF-Article 1.0 Title: Risk for cutaneous melanoma in recent Connecticut birth cohorts Journal: American Journal of Public Health Author-Name: Roush, G.C. Author-Name: Schymura, M.J. Author-Name: Holford, T.R. Year: 1985 Volume: 75 Issue: 6 Pages: 679-682 DOI: 10.2105/AJPH.75.6.679 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.679 Abstract: Mortality trends suggest that increases in Connecticut incidence for cutaneous melanoma (CM) equal or under estimate increases for the entire country. One-sixth of CM in Connecticut occurs under age 35. In the 1955 birth cohort, modeled incidence rates per 100,000 age-adjusted to the 1960 US population are 38.2 in males and 28.9 in females. These estimated rates for CM rival those for colon cancer (now the third most common malignancy in the United States) and have special implications for young adults. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.679_1 Template-Type: ReDIF-Article 1.0 Title: Dog and cat ownership among suicides and matched controls Journal: American Journal of Public Health Author-Name: Helsing, K.J. Author-Name: Monk, M. Year: 1985 Volume: 75 Issue: 10 Pages: 1223-1224 Abstract: In Washington County, Maryland, ownership of cats and/or dogs was compared among 48 residents who committed suicide in the years 1975-83 and 96 living controls matched to the suicides by race, sex, and date of birth. Another comparison used as controls persons of same race, sex, and age who died of causes other than suicide in the same year as the suicide. No material association between pet ownership and suicide was observed. Handle: RePEc:aph:ajpbhl:1985:75:10:1223-1224_8 Template-Type: ReDIF-Article 1.0 Title: The prevalence of Toxocara species ova in backyards and gardens of Baltimore, Maryland Journal: American Journal of Public Health Author-Name: Childs, J.E. Year: 1985 Volume: 75 Issue: 9 Pages: 1092-1094 Abstract: Toxocara species ova were found in 16 of 146 (11 per cent) soil samples collected from backyards and gardens of private residences within Baltimore City. The recovery rate of parasite ova was similar for households regardless of their grouping by pet ownership characteristics or the presence of visible animal feces. The findings demonstrate the common occurrence of these eggs in locations likely to be important in the transmission of visceral larva migrans. Handle: RePEc:aph:ajpbhl:1985:75:9:1092-1094_4 Template-Type: ReDIF-Article 1.0 Title: Industrial wastes and public health: Some historical notes, Part 1, 1876-1932 Journal: American Journal of Public Health Author-Name: Tarr, J.A. Year: 1985 Volume: 75 Issue: 9 Pages: 1059-1067 Abstract: This article has focused on the relatively low priority accorded industrial wastes compared to human wastes by the public health community in the period from 1876 through 1932. The critical reason for this prioritization was the potential for acute health effects from human wastes as compared with the belief that industrial wastes had only indirect effects. State departments of health normally only responded to industrial wastes when they endangered the potable nature of water supplies or interfered with water and sewage treatment processes. Within the public health community, however, a relatively small group of interdiscplinary professionals argued for attention to the indirect health effects of industrial wastes and their impacts on the total stream environment. In conjunction with other groups interested in clean streams - such as sportsmen and manufacturers who required high quality process water - they pushed for a broader state legislative mandate in regard to pollution control. Some states created new bureaus or boards with responsibilioty for industrial wastes and the larger stream environment but the attack on industrial pollution remained limited in this period. The final significant development regarding industrial pollution and public health concerned the formulation by Streeter-Phelps of the Public Health Service of a theory of stream purification with a set of general quantitative indicators. This application was of particular importance in regard to the high-oxygen consuming nature of organic industrial wastes and the wide variety of effluents that existed. Industrial wastes constituted what Harvey Brooks, in his essay 'Science Indicators and Science Priorities' calls a very 'messy' research problem - one that does 'not lend itself to elegant and widely applicable generalizations'. These characteristics tended to retard and complicate research concerning control and reduction and to make their regulation difficult. The Streeter-Phelps model enhanced the possibility of successful control by circumventing the heterogeneous nature of organic industrial effluents. But just as the earlier health-based approach to water pollution had limitations in regard to many other characteristics of stream quality, the focus on DO and BOD was restricted in regard to other features of industrial wastes. These indicator limitations were most obvious in regard to inorganic effluents. They would also become apparent in connection with many of the new chemical compounds that would be produced during and after World War II. The use of any particular set of indicators whether for environmental or social phenomena reflects a definition of the problem that often defines the scope of the attack on that problem. Effective public policy is dependent on accurate indicators and the indicators themselves legitimate the need for policy. The immediate post-war generations would witness an analytical revolution in regard to analyzing and identifying trace elements of various industrial wastes in water supply that made evident the need for new indicators in regard to industrial wastes and led to some of the discoveries and controversies in environmental health today. Handle: RePEc:aph:ajpbhl:1985:75:9:1059-1067_6 Template-Type: ReDIF-Article 1.0 Title: Health care attitudes and experiences during gynecologic care among lesbians and bisexuals Journal: American Journal of Public Health Author-Name: Smith, E.M. Author-Name: Johnson, S.R. Author-Name: Guenther, S.M. Year: 1985 Volume: 75 Issue: 9 Pages: 1085-1087 Abstract: Bisexuals (N = 424) and lesbians (N = 1,921) were surveyed regarding their sources of gynecologic care, utilization patterns, openness with physicians, and assessment of quality of care. About 40 per cent of each group believed that physician knowledge about their sexual preference would hinder the quality of medical care and about as many believed that it would have no effect. About one-third in each group had not disclosed their sexual behavior although they desired to do so. Physicians rarely requested this information. A lesbian physician was overwhelmingly preferred for gynecologic care (96 per cent), particularly for problems with sexual functioning. Previous satisfaction with gynecologic care was most often described as 'adequate', but almost as often as 'variable' and 'poor'. Data suggest that quality, utilization, and medical outcomes of gynecologic care to this group would be improved if physicians would communicate greater awareness of sexual orientation in a nonprejudicial manner and ensure confidentiality. Handle: RePEc:aph:ajpbhl:1985:75:9:1085-1087_9 Template-Type: ReDIF-Article 1.0 Title: Bladder cancer risk among auto and truck mechanics and chemically related occupations Journal: American Journal of Public Health Author-Name: Smith, E.M. Author-Name: Miller, E.R. Author-Name: Woolson, R.F. Author-Name: Brown, C.K. Year: 1985 Volume: 75 Issue: 8 Pages: 881-883 Abstract: Male participants in the NCI National Bladder Cancer study were evaluated for risks in auto and truck mechanic and in chemically related exposure occupations compared with those who had never worked in these areas. In nonsmokers the adjusted rate ratios (RR) for mechanics equalled 1.33, (95% CI 0.77, 2.31). The adjusted RR in the nonsmoker chemically related group was 1.53 (95% CI 1.13, 2.07). Duration of exposure as a mechanic was not clearly associated with bladder cancer risk regardless of smoking status. Handle: RePEc:aph:ajpbhl:1985:75:8:881-883_5 Template-Type: ReDIF-Article 1.0 Title: Severity of illness within DRGs: Impact on prospective payment Journal: American Journal of Public Health Author-Name: Horn, S.D. Author-Name: Sharkey, P.D. Author-Name: Chambers, A.F. Author-Name: Horn, R.A. Year: 1985 Volume: 75 Issue: 10 Pages: 1195-1199 Abstract: This study compares the financial impact of a Diagnosis Related Group (DRG) prospective payment system with that of a Severity of Illness-adjusted DRG prospective payment system. The data base of about 106,000 discharges is from 15 hospitals, all of which had a Health Care Financing Administration (HCFA) DRG case mix index greater than 1. In order to pool the data over the 15 hospitals, all charges were converted to costs, normalized to Fiscal Year 1983, and adjusted for medical education and wage levels. The findings showed that, for the study population as a whole, DRGs explained 28% of the variability in resource use per case while Severity of Illness-adjusted DRGs explained 61% of the variability in resource use per case. When we simulated prospective payment systems based on DRGs and on Severity-adjusted DRGs, we found that the financial impact of the two systems differed by very little in some hospitals and by as much as 35% of total operating costs in other hospitals. Thus, even with a data set that is relatively homogeneous (with respect to the HCFA DRG case mix index definition of hospitals), we found substantial inequities in payment when DRGs were not adjusted for Severity of Illness. These findings suggest that, with a more representative set of hospitals, the difference between unadjusted and Severity-adjusted DRG-based prospective payment could be greater than 35% of a hospital's total operating costs. Handle: RePEc:aph:ajpbhl:1985:75:10:1195-1199_8 Template-Type: ReDIF-Article 1.0 Title: Estimates of C. immitis infection by skin test reactivity in an endemic community Journal: American Journal of Public Health Author-Name: Dodge, R.R. Author-Name: Lebowitz, M.D. Author-Name: Barbee, R. Author-Name: Burrows, B. Year: 1985 Volume: 75 Issue: 8 Pages: 863-865 Abstract: This report is a comparison of two delayed hypersensitivity skin test reagents, coccidioidin and Spherulin®, available for detection of prior infection by Coccidioides immitis. Coccidioidin proved to be a somewhat more sensitive reagent (33.4% positive, vs 29.6% for Spherulin®). This difference persisted in the subjects when grouped by age, sex, exposure history, or history of coccidioidomycosis. Skin test reactivity to both reagents declined with age. Independent of exposure history coccidiodin detected 7.3% of the subjects who were not detected by Spherulin®; Spherulin® detected prior infection in only 3.5% of the subjects not detected by coccidioidin. These results differ from those of previously reported studies. Handle: RePEc:aph:ajpbhl:1985:75:8:863-865_1 Template-Type: ReDIF-Article 1.0 Title: Prevalence and trends in oral contraceptive use in premenopausal females ages 12-54 years, United States, 1971-80 Journal: American Journal of Public Health Author-Name: Russell-Briefel, R. Author-Name: Ezzati, T. Author-Name: Perlman, J. Year: 1985 Volume: 75 Issue: 10 Pages: 1173-1176 Abstract: Data from the second National Health and Nutrition Examination Survey (NHANES II) were analyzed to estimate the prevalence of oral contraceptive use in the United States, 1976-80. The overall unadjusted prevalence of oral contraceptive use was 16.7% for premenopausal females ages 12-54 years (19.2% for ages 15-44 years). Approximately 8.7 million females (95% confidence interval, 6.9-10.5 million) were oral contraceptive users at the midpoint of NHANES II (March 1978). Comparison to the NHANES I, conducted in 1971-74, indicated a stable number of overall oral contraceptive users in the US population during the 1970s, with shifts in certain age groups: oral contraceptive use increased for females ages 12-19 years and decreased for females ages 20-49 years. The overall age-adjusted prevalences indicated a 2% (95% CI, 0.2-3.8%) decline in oral contraceptive use from the early to the late 1970s. The NHANES provides comparative data and supports findings from another national survey showing a decrease in the per cent of females using oral contraceptives during 1973-82. Trends in oral contraceptive use are also presented by race, poverty level, rural-urban residence, marital status, and education level. Handle: RePEc:aph:ajpbhl:1985:75:10:1173-1176_8 Template-Type: ReDIF-Article 1.0 Title: The centralization of operations and access to treatment: Total hip replacement in Manitoba Journal: American Journal of Public Health Author-Name: Roos, N.P. Author-Name: Lyttle, D. Year: 1985 Volume: 75 Issue: 2 Pages: 130-133 DOI: 10.2105/AJPH.75.2.130 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.130 Abstract: The impact of centralized facilities on access to care was tested by studying total hip arthroplasty in the Province of Manitoba, Canada. Data from the Manitoba Health Services Commission, which insures costs of all medical services in the Province, show that the availability of this surgical procedure has increased steadily over the 1973-78 period at a rate similar to that elsewhere in North America. Although Manitoba's population is geographically dispersed, specialized orthopedic services are concentrated in two urban centers. No important difference in access to care for this condition was found between urban center residents and residents distant from the surgical facilities. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.130_6 Template-Type: ReDIF-Article 1.0 Title: An analysis of economic costs associated with an outbreak of typhoid fever Journal: American Journal of Public Health Author-Name: Shandera, W.X. Author-Name: Taylor, J.P. Author-Name: Betz, T.G. Author-Name: Blake, P.A. Year: 1985 Volume: 75 Issue: 1 Pages: 71-73 DOI: 10.2105/AJPH.75.1.71 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.71 Abstract: We examined the costs of a typhoid fever outbreak caused by exposures to contaminated food over a 47-day period at a restaurant. For the 49 respondents, the patient-related costs ($215,548) were primarily medical expenses ($183,902) and lost income or productivity ($28,603). The estimated patient-related costs for all 80 outbreak-associated cases was $351,920. Had contaminated food continued to be served, the prevention-related costs ($36,500) would have been offset by patient-related costs ($7,488/day) within 5 days. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.71_9 Template-Type: ReDIF-Article 1.0 Title: The Edgecomb County High Blood Pressure Control Program: III. Social support, social stressors, and treatment dropout Journal: American Journal of Public Health Author-Name: Williams, C.A. Author-Name: Beresford, S.A.A. Author-Name: James, S.A. Year: 1985 Volume: 75 Issue: 5 Pages: 483-486 Abstract: In a hypertension prevalence survey of a stratified random sample of 1,000 households, 2,030 adults (aged 18 years and over) were interviewed and information on psychosocial variables collected. Among 359 hypertensives, there was a consistent relationship between indicators of difficulty in the social environment and dropout from treatment in women. Compared to those who remained in treatment, women who dropped out can be characterized as having less social support on the job, having less perceived spouse approval (if married), having a lower level of perceived access to supportive resources, and being more likely to report feeling pushed most or all of the time if they are homemakers. Relationships between indicators of social support and dropout from treatment in men were found only with support on the job, and for White men, with perceived friend approval. Handle: RePEc:aph:ajpbhl:1985:75:5:483-486_0 Template-Type: ReDIF-Article 1.0 Title: Cigarette smoking, herpes simplex virus type 2 infection, and cervical abnormalities Journal: American Journal of Public Health Author-Name: Mayberry, R.M. Year: 1985 Volume: 75 Issue: 6 Pages: 676-678 DOI: 10.2105/AJPH.75.6.676 File-URL: http://hdl.handle.net/10.2105/AJPH.75.6.676 Abstract: In a case-control study, we investigated the relation of cigarette smoking and genital herpes virus infection to cervical abnormalities. Although cases and controls differed according to several factors, multiple logistic analyses indicated that age, education, and cigarette smoking were the only independent risk factors for histologically confirmed disease. Relative risk estimates were 1.92 and 3.68 for past and current smokers, respectively. The results indicated that smoking and genital herpes infection did not interact in the risk of cervical abnormality. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.6.676_0 Template-Type: ReDIF-Article 1.0 Title: Do the new metropolitan life insurance weight-height tables correctly assess body frame and body fat relationships? Journal: American Journal of Public Health Author-Name: Himes, J.H. Author-Name: Bouchard, C. Year: 1985 Volume: 75 Issue: 9 Pages: 1076-1079 Abstract: The 1983 Metropolitan weight-height tables include elbow breadth as a measure of frame size. Such tables assume that frame measures provide an estimate of fat free mass and have little or no associations with body fat. These assumptions were evaluated in 437 Canadian adults for six frame measures by their associations with total body measures of fat and fat free mass. All six frame measures were similarly correlated with fat free mass, even when associations with height were taken into account. Wrist and ankle breadths were not associated with total body fat, while shoulder, elbow, hip, and knee breadths were so associated. Thus wrist and ankle breadths satisfy the assumptions inherent in the frame-weight-height tables better than elbow breadth and the other frame measures investigated. Handle: RePEc:aph:ajpbhl:1985:75:9:1076-1079_1 Template-Type: ReDIF-Article 1.0 Title: Child abuse incidence and reporting by hospitals: Significance of severity, class, and race Journal: American Journal of Public Health Author-Name: Hampton, R.L. Author-Name: Newberger, E.H. Year: 1985 Volume: 75 Issue: 1 Pages: 56-60 DOI: 10.2105/AJPH.75.1.56 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.56 Abstract: Estimates from the National Study of the Incidence and Severity of Child Abuse and Neglect suggest that hospitals recognized over 77,000 cases of child abuse between May 3, 1979, and April 30, 1980. Compared to other agencies in the sample, hospitals identified children who were younger, Black, lived in urban areas, and had more serious injuries. Hospitals failed to report to child protection agencies almost half of the cases that met the study's definition of abuse. Discriminant analysis revealed that income, mother's role in abuse, emotional abuse, race, maternal employment, and sexual abuse distinguished the reported from the unreported cases. Disproportionate numbers of unreported cases were victims of emotional abuse and came from families of higher income. Their mothers were more often White and more often alleged to be responsible for the injuries. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.56_0 Template-Type: ReDIF-Article 1.0 Title: Driver licensing age and lifestyles of 16 year olds Journal: American Journal of Public Health Author-Name: Preusser, D.F. Author-Name: Williams, A.F. Author-Name: Lund, A.K. Year: 1985 Volume: 75 Issue: 4 Pages: 358-360 DOI: 10.2105/AJPH.75.4.358 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.358 Abstract: The relationship of driver licensure rate differences to 16 year old lifestyles was assessed by surveying 15 and 16 year olds in New York, Michigan, and New Jersey. Michigan 16 year olds reported the highest rates of licensure (56 per cent), whereas New York (14 per cent licensed) and New Jersey (2 per cent licensed) had much lower rates. Teenagers in Michigan reported greater decreases in use of bicycles and reliance on parents and relatives for transportation but, for the most part, the differences in 16 year old licensure and mobility were not reflected in lifestyle differences. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.358_5 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic evidence and motor vehicle policy making Journal: American Journal of Public Health Author-Name: Runyan, C.W. Author-Name: Earp, J.A.L. Year: 1985 Volume: 75 Issue: 4 Pages: 354-357 DOI: 10.2105/AJPH.75.4.354 File-URL: http://hdl.handle.net/10.2105/AJPH.75.4.354 Abstract: After being randomly assigned to receive policy effectiveness information expressed as attributable benefit, attributable risk, or relative risk, 318 graduate students were asked to indicate their preferences for the current voluntary seat belt use policy, a mandatory seat belt policy, or mandatory passive restraints. A control group received no data. Exposure to effectiveness information (any type) was significantly associated with favoring either mandatory seat belts or passive restraints over the current policy. Those exposed to attributable benefit or risk data were more apt to make proregulatory choices than subjects exposed to relative risk data. Attitudes toward government regulation and specific views about personal freedom and policy effectiveness were also found to be significant predictors of policy preference. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.4.354_8 Template-Type: ReDIF-Article 1.0 Title: A time for new thinking about teenage pregnancy Journal: American Journal of Public Health Author-Name: Dryfoos, J.G. Year: 1985 Volume: 75 Issue: 1 Pages: 13-14 DOI: 10.2105/AJPH.75.1.13 File-URL: http://hdl.handle.net/10.2105/AJPH.75.1.13 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.1.13_0 Template-Type: ReDIF-Article 1.0 Title: The prostitute, the playboy, and the poet: Rationing schemes for organ transplantation Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1985 Volume: 75 Issue: 2 Pages: 187-189 DOI: 10.2105/AJPH.75.2.187 File-URL: http://hdl.handle.net/10.2105/AJPH.75.2.187 Abstract: The author describes four general approaches to choosing among potential candidates for heart and liver transplants: the market approach, the committee selection process, a lottery scheme, and the "customary" approach of leaving the decision to the physician. Annas maintains that a socially acceptable approach must be fair, efficient, and based on the values of human equality and respect for life. He proposes a combination scheme in which there would be an initial medical screening of candidates, perhaps with review of the initial decision by an ethics committee that has significant public input. Selection from the candidate pool would then be made on a first-come first-served basis, with provision for individuals in imminent danger of death to "jump" the queue. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.75.2.187_8 Template-Type: ReDIF-Article 1.0 Title: The 'trickle-down' theory--is that any way to make policy? Journal: American Journal of Public Health Author-Name: Budetti, P.P. Year: 1984 Volume: 74 Issue: 12 Pages: 1303-1304 Handle: RePEc:aph:ajpbhl:1984:74:12:1303-1304_1 Template-Type: ReDIF-Article 1.0 Title: On mental health services by HMOs. Journal: American Journal of Public Health Author-Name: Cheifetz, D.I. Author-Name: Salloway, J.C. Year: 1984 Volume: 74 Issue: 12 Pages: 1420-1421 Handle: RePEc:aph:ajpbhl:1984:74:12:1420-1421_7 Template-Type: ReDIF-Article 1.0 Title: The California automated mortality linkage system (CAMLIS) Journal: American Journal of Public Health Author-Name: Abellano, M.G. Author-Name: Petersen, G.R. Author-Name: Petitti, D.B. Author-Name: Smith, R.E. Year: 1984 Volume: 74 Issue: 12 Pages: 1324-1330 Abstract: The California Automated Mortality Linkage System (CAMLIS), established in 1981 to facilitate the conduct of follow-up studies in the State of California, employs a combination of deterministic and probabilistic linkage decision criteria to perform the death clearance function. The system was evaluated against four traditional death clearance procedures and the performance of each procedure measured in terms of measures of sensitivity and specificity. Only one procedure was associated with a specificity lower than 0.99; for that one, the specificity was 0.93. There was much greater fluctuation in the observed sensitivity of 0.97 versus 0.79 for the Social Security Administration. A comparison against the National Death Index (NDI) produced sensitivities of 0.89 for CAMLIS and 0.94 for the NDI. An assessment of manual search procedures using a file of Japanese names produced a CAMLIS sensitivity measure of 0.92 compared with 0.93 for the manual search. Another manual search procedure using microfiche copies of the state death index produced a CAMLIS sensitivity of 0.97; in this evaluation, the sensitivity of the manual search was defined in 1.0. Another measure of performance of a death clearance procedure is its predictive value in identifying a person who has died; CAMLIS generated predictive values in these evaluations that ranged from 0.93 through 0.99, contrasted with the NDI value of 0.59. Handle: RePEc:aph:ajpbhl:1984:74:12:1324-1330_8 Template-Type: ReDIF-Article 1.0 Title: Patients attitudes toward physician consent in epidemiologic research Journal: American Journal of Public Health Author-Name: Chase Boring, C. Author-Name: Brockman, E. Author-Name: Causey, N. Year: 1984 Volume: 74 Issue: 12 Pages: 1406-1408 Abstract: Attitudes of patients toward the necessity of physician consent in epidemiologic studies were assessed. Questionnaires were mailed to women with breast, endometrial and ovarian cancers who had previously participated in a personal interview study (N = 692). Of respondents (N = 514), only 2 per cent would have preferred their physician to have withheld approval, and half considered physician permission necessary. Thirty-five per cent reported that their doctor talked to them about the study prior to the interview. Implications of including physician consent in study protocols are discussed. Handle: RePEc:aph:ajpbhl:1984:74:12:1406-1408_8 Template-Type: ReDIF-Article 1.0 Title: Why the British courts rejected the American doctrine of informed consent Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1984 Volume: 74 Issue: 11 Pages: 1286-1288 Abstract: In 1984 the English Civil Court of Appeals in Sidaway v. Bethlem Royal Hospital rejected the American doctrine of informed consent, in which the measure of disclosure is based on the patient's need to know, and reasserted the British paternalistic concept based on standard medical practice. Annas analyzes the justices' reasoning and concludes that it was based primarily on misinformation concerning the effect of informed consent on the incidence of malpractice litigation in the U.S. and on a misunderstanding of how the concepts of duty and causation were applied in Canterbury v. Spence. He urges British physicians, even in the absence of a legal mandate, to obtain an informed consent that promotes autonomy and rational decision making and thus strengthens the physician patient relationship. Handle: RePEc:aph:ajpbhl:1984:74:11:1286-1288_1 Template-Type: ReDIF-Article 1.0 Title: A survey of patient sources of prescription drug information Journal: American Journal of Public Health Author-Name: Morris, L.A. Author-Name: Grossman, R. Author-Name: Barkdoll, G.L. Author-Name: Gordon, E. Author-Name: Soviero, C. Year: 1984 Volume: 74 Issue: 10 Pages: 1161-1162 Abstract: A national telephone survey of 1,104 adults who had recently obtained a new prescription was undertaken to determine the nature and amount of drug information obtained. Sixty percent stated that physicians provided directions for use information with the pharmacy reported as about half as active. Only 3 to 6 per cent said they asked the physician or pharmacist for information. However, one in six responders said they looked up the prescription in a drug reference book such as the Physicians Desk Reference. Handle: RePEc:aph:ajpbhl:1984:74:10:1161-1162_8 Template-Type: ReDIF-Article 1.0 Title: The usefulness of the Denver developmental screening test to predict kindergarten problems in a general community population Journal: American Journal of Public Health Author-Name: Cadman, D. Author-Name: Chambers, L.W. Author-Name: Walter, S.D. Author-Name: Feldman, W. Author-Name: Smith, K. Author-Name: Ferguson, R. Year: 1984 Volume: 74 Issue: 10 Pages: 1093-1097 Abstract: The Denver Developmental Screening Test (DDST) was administered to 2,569 children five to seven months prior to starting kindergarten in September 1980 in a geographically well-defined community. The test was administered by trained public health nurses. At the end of the 1980-1981 school year, all 163 kindergarten teachers in the area completed a rating form for each child in their class. The rating form determined global ratings of: 1) learning abilities; 2) classroom behavior; 3) amount of special attention required ; and 4) referrals to special education services outside the classroom. The specificity of the DDST in predicting kindergarten teacher ratings was 99 per cent for all areas. Test sensitivity varied from 5 per cent to 10 per cent in detecting problems in the four areas. The predictive values of a positive test varied from 31 per cent for behavior problems to 62 per cent for extra attention required in the classroom. Negative test predictive values varied from 79 per cent to 93 per cent. These results based on kindergarten teacher ratings suggest that, because of the low sensitivity and modest predictive value, the DDST may be relatively inefficient to use in a school entry screening program in a general community population of children. Handle: RePEc:aph:ajpbhl:1984:74:10:1093-1097_7 Template-Type: ReDIF-Article 1.0 Title: Formaldehyde vapor in mobile homes: A cross sectional survey of concentrations and irritant effects Journal: American Journal of Public Health Author-Name: Hanrahan, L.P. Author-Name: Dally, K.A. Author-Name: Anderson, H.A. Author-Name: Kanarek, M.S. Author-Name: Rankin, J. Year: 1984 Volume: 74 Issue: 9 Pages: 1026-1027 Abstract: Sixty-five Wisconsin mobile home households volunteered for an assessment of indoor formaldehyde gas. Sixty-one teenage and adult occupants completed health questionnaires. Formaldehyde concentrations ranged from < 0.10 to 0.80 ppm, with the risk of ocular discomfort showing a positive dose-response relationship. Handle: RePEc:aph:ajpbhl:1984:74:9:1026-1027_8 Template-Type: ReDIF-Article 1.0 Title: Needs assessment under the Maternal and Child Health Services Block Grant: Massachusetts Journal: American Journal of Public Health Author-Name: Guyer, B. Author-Name: Schor, L. Author-Name: Messenger, K.P. Author-Name: Prenney, B. Author-Name: Evans, F. Year: 1984 Volume: 74 Issue: 9 Pages: 1014-1019 Abstract: The Massachusetts maternal and child health (MCH) agency has developed a needs assessment process which includes four components: a statistical measure of need based on indirect, proxy health and social indicators; clinical standards for services to be provided; an advisory process which guides decision making and involves constituency groups; and a management system for implementing funds distribution, namely open competitive bidding in response to a Request for Proposals. In Fiscal Years 1982 and 1983, the process was applied statewide in the distribution of primary prenatal (MIC) and pediatric (C & Y) care services and lead poisoning prevention projects. Both processes resulted in clearer definitions of services to be provided under contract to the state as well as redistribution of funds to serve localities that had previously received no resources. Although the needs assessment process does not provide a direct measure of unmet need in a complex system of private and public services, it can be used to advocate for increased MCH funding and guide the distribution of new MCH service dollars. Handle: RePEc:aph:ajpbhl:1984:74:9:1014-1019_9 Template-Type: ReDIF-Article 1.0 Title: Obesity prognosis: A longitudinal study of children from the age of 6 months to 9 years Journal: American Journal of Public Health Author-Name: Shapiro, L.R. Author-Name: Crawford, P.B. Author-Name: Clark, M.J. Author-Name: Pearson, D.L. Author-Name: Raz, J. Author-Name: Huenemann, R.L. Year: 1984 Volume: 74 Issue: 9 Pages: 968-972 Abstract: The development of body fatness and leanness is examined in an ongoing prospective nutrition and growth study. Individual skinfold thickness, relative weights, weight gains, activity levels, and caloric intakes were examined at seven ages between 6 months and 9 years. Changes in body fatness in this group of children provide evidence that the obese infant usually does not become the obese child. Weight gain in infancy is also a poor predictor of 9-year old obesity. Changes from obese to non-obese or lean are often not linear. There is evidence that impending or actual obesity begins at ages 6 to 9 years with some predictability provided as early as age 2 years for girls, age 3 years for boys. Handle: RePEc:aph:ajpbhl:1984:74:9:968-972_5 Template-Type: ReDIF-Article 1.0 Title: A study of pregnancy outcomes in a maternity center and a tertiary care hospital Journal: American Journal of Public Health Author-Name: Baruffi, G. Author-Name: Dellinger Jr., W.S. Author-Name: Stobino, D.M. Author-Name: Rudolph, A. Author-Name: Timmons, R.Y. Author-Name: Ross, A. Year: 1984 Volume: 74 Issue: 9 Pages: 973-978 Abstract: This study compares 796 pregnancy outcomes at a maternity center (BMC) with 804 hospital (TJUH) pregnancy outcomes. The samples of pregnant women from the participating institutions were matched on sociodemographic characteristics; analysis of outcomes was performed controlling for medical-obstetric risk. Differences between the institutions were found mainly among women with low intrapartum risk. For these women, neonatal morbidity and length of infant nursery stay were lower at BMC than at TJUH. The percentage of infants with one-minute Apgar scores < 7 or requiring resuscitation at birth was greater at BMC, but the percentage of infants with five-minute Apgar scores < 7 as well as neonatal mortality rates did not differ between the two institutions. The number of women with intrapartum or postpartum fever was too small to permit comparison. The study results suggest that care delivered at BMC is safe with regard to the evaluative criteria used. Handle: RePEc:aph:ajpbhl:1984:74:9:973-978_7 Template-Type: ReDIF-Article 1.0 Title: Relation of football injuries to exposure time. Journal: American Journal of Public Health Author-Name: Schor, S.S. Year: 1984 Volume: 74 Issue: 10 Pages: 1169-1171 Handle: RePEc:aph:ajpbhl:1984:74:10:1169-1171_1 Template-Type: ReDIF-Article 1.0 Title: Interpreting trends in vital statistics. Journal: American Journal of Public Health Author-Name: Imrey, H.H. Year: 1984 Volume: 74 Issue: 10 Pages: 1169 Handle: RePEc:aph:ajpbhl:1984:74:10:1169_6 Template-Type: ReDIF-Article 1.0 Title: Reliability of the DDST in predicting later problems. Journal: American Journal of Public Health Author-Name: Sontheimer, D. Author-Name: Duprat, M. Author-Name: Frankenburg, W.K. Year: 1984 Volume: 74 Issue: 10 Pages: 1171-1172 Handle: RePEc:aph:ajpbhl:1984:74:10:1171-1172_3 Template-Type: ReDIF-Article 1.0 Title: Social support networks: some added dimensions. Journal: American Journal of Public Health Author-Name: Huessy, H.R. Year: 1984 Volume: 74 Issue: 10 Pages: 1169 Handle: RePEc:aph:ajpbhl:1984:74:10:1169_3 Template-Type: ReDIF-Article 1.0 Title: On trends in childhood disability. Journal: American Journal of Public Health Author-Name: Reich, P. Author-Name: Epstein, A. Author-Name: Peisch, R. Author-Name: Tramel, J. Author-Name: Schwartz, S. Author-Name: Skryness, E. Year: 1984 Volume: 74 Issue: 10 Pages: 1168-1169 Handle: RePEc:aph:ajpbhl:1984:74:10:1168-1169_1 Template-Type: ReDIF-Article 1.0 Title: Comment on water supply and health in developing countries. Journal: American Journal of Public Health Author-Name: Walsh, J.A. Year: 1984 Volume: 74 Issue: 10 Pages: 1167-1168 Handle: RePEc:aph:ajpbhl:1984:74:10:1167-1168_0 Template-Type: ReDIF-Article 1.0 Title: An outbreak of community-acquired Legionnaires' disease pneumonia Journal: American Journal of Public Health Author-Name: Helms, C.M. Author-Name: Wintermeyer, L.A. Author-Name: Zeitler, R.R. Author-Name: Larew, R.E. Author-Name: Massanari, R.M. Author-Name: Hall, N.H. Author-Name: Hausler Jr., W.J. Author-Name: Johnson, W. Year: 1984 Volume: 74 Issue: 8 Pages: 835-836 Abstract: In October 1981, an outbreak of 29 cases of community-acquired pneumonia occurred among adult residents of Johnson County, Iowa. Retrospective study revealed 12 cases (41 per cent) had laboratory evidence of Legionnaire's disease (LD). No significant differences in clinical or epidemiological features were found between LD cases and the other pneumonias in the outbreak. All LD cases received erythromycin; one case died for a case-fatality rate of 8 per cent. The outbreak's focus could not be identified. Handle: RePEc:aph:ajpbhl:1984:74:8:835-836_8 Template-Type: ReDIF-Article 1.0 Title: An epidemiologic study of gypsy moth rash Journal: American Journal of Public Health Author-Name: Tuthill, R.W. Author-Name: Canada, A.T. Author-Name: Wilcock, K. Author-Name: Etkind, P.H. Author-Name: O'Dell, T.M. Author-Name: Shama, S.K. Year: 1984 Volume: 74 Issue: 8 Pages: 799-803 Abstract: In 1981, outbreaks of itchy skin rashes were reported accompanying the heavy infestation of gypsy moths (GM) in the Northeastern United States. The rash problem was widespread and a considerable public annoyance. In the spring of 1982, during the period of greatest contact with the caterpillars, a telephone survey was carried out in a highly infested community (HI) and a minimally infested community (LO). Information was collected from 1,000 persons, representing more than 90 per cent of those selected for study. The one-week risk of rash was 10.4 per cent in the HI area and 1.6 per cent in the LO area, for a risk ratio (RR) of 6.5. The occurrence of rash was strongly related to a history of having had a rash in the previous year or having had a caterpillar crawl on the affected area. The combination of both factors additively increased the risk of rash. Hay fever and hanging the wash outside were other related variables. History of allergies other than hay fever since childhood and the use of insecticides were unrelated to rash occurrence. Handle: RePEc:aph:ajpbhl:1984:74:8:799-803_3 Template-Type: ReDIF-Article 1.0 Title: A focused approach to quality of care assessment in family planning Journal: American Journal of Public Health Author-Name: Hirschhorn, N. Author-Name: Goldy, A.S. Author-Name: Plager, B. Author-Name: Bell, P. Author-Name: Brier, J. Author-Name: Parenteau, T. Author-Name: McIntosh, E.N. Author-Name: Robbins, J. Year: 1984 Volume: 74 Issue: 8 Pages: 825-829 Abstract: An approach to quality of care assessment for family planning based on management-by-objectives has been tested in 18 clinics. Key indicator standards were developed by the family planning agencies themselves and objective survey instruments designed to measure performance against the standards. Results were made available quickly to each clinic and led to operational changes in the majority, with evidence of improved performance and willingness to use evaluation of care as a means for clinic management. Analyses of the aggregated data showed wide variations in performance over several indices of care. Handle: RePEc:aph:ajpbhl:1984:74:8:825-829_0 Template-Type: ReDIF-Article 1.0 Title: On effects of high-voltage transmission lines. Journal: American Journal of Public Health Author-Name: Banks, R.S. Year: 1984 Volume: 74 Issue: 9 Pages: 1042-1043 Handle: RePEc:aph:ajpbhl:1984:74:9:1042-1043_6 Template-Type: ReDIF-Article 1.0 Title: Increasing returns of physician surveys. Journal: American Journal of Public Health Author-Name: Sallis, J.F. Author-Name: Fortmann, S.P. Author-Name: Solomon, D.S. Author-Name: Farquhar, J.W. Year: 1984 Volume: 74 Issue: 9 Pages: 1043 Handle: RePEc:aph:ajpbhl:1984:74:9:1043_8 Template-Type: ReDIF-Article 1.0 Title: COSH: a grass-roots public health movement. Journal: American Journal of Public Health Author-Name: Levenstein, C. Author-Name: Boden, L.I. Author-Name: Wegman, D.H. Year: 1984 Volume: 74 Issue: 9 Pages: 964-965 Handle: RePEc:aph:ajpbhl:1984:74:9:964-965_9 Template-Type: ReDIF-Article 1.0 Title: Intergovernmental relationships: a delicate balance. Journal: American Journal of Public Health Author-Name: Klerman, L.V. Year: 1984 Volume: 74 Issue: 9 Pages: 965-967 Handle: RePEc:aph:ajpbhl:1984:74:9:965-967_2 Template-Type: ReDIF-Article 1.0 Title: The environment returns to the health department. Journal: American Journal of Public Health Author-Name: Novick, L.F. Year: 1984 Volume: 74 Issue: 9 Pages: 963-964 Handle: RePEc:aph:ajpbhl:1984:74:9:963-964_9 Template-Type: ReDIF-Article 1.0 Title: Effects of home blood pressure measurement on long-term BP control Journal: American Journal of Public Health Author-Name: Stahl, S.M. Author-Name: Kelley, C.R. Author-Name: Neill, P.J. Author-Name: Grim, C.E. Author-Name: Mamlin, J. Year: 1984 Volume: 74 Issue: 7 Pages: 704-709 Abstract: This research reports level of blood pressure control and ability to maintain newly discovered hypertensives in a municipal hospital setting by use of family- and self-monitored home blood pressure units. Three hundred ninety-six patients were randomized into family- and self-monitored blood pressure groups and a control group. Findings indicate that the use of either self- or family-read cuffs is effective in the first six months of treatment in lowering blood pressures. The data are suggestive of a beneficial effect of the use of cuffs for up to 18 months; however, with additional time in the study, no differences in the level of blood pressure control could be demonstrated between groups. The use of family-monitored blood pressure cuffs produces a lower drop-out rate than does the use of no cuff. The effect on drop outs is substantial for the first year of treatment, but beyond 12 months, the family-read cuff is also more effective than no cuff in reducing drop outs. Handle: RePEc:aph:ajpbhl:1984:74:7:704-709_1 Template-Type: ReDIF-Article 1.0 Title: A pseudo-outbreak of influenza A associated with use of laboratory stock strain Journal: American Journal of Public Health Author-Name: Budnick, L.D. Author-Name: Moll, M.E. Author-Name: Hull, H.F. Author-Name: Mann, J.M. Author-Name: Kendal, A.P. Year: 1984 Volume: 74 Issue: 6 Pages: 607-609 Abstract: In November 1982, when influenza type A(H3N2) viruses were spreading in the United States, influenza A(H1N1) viruses were reportedly isolated from 10 hospitalized patients in New Mexico, only two of whom had influenza-like illnesses. Reference stock influenza A/Fort Monmouth (FM0/1/47(H1N1) virus had been used to prepare fluorescent antibody slides in the laboratory reporting the isolates. After investigation, is was concluded that the isolates from the patients' cultures were a result of laboratory contamination. When an unexpected cluster of unusual virus isolates is reported, the possibility of laboratory contamination should be considered. Handle: RePEc:aph:ajpbhl:1984:74:6:607-609_3 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic investigation of a Yersinia camp outbreak linked to a food handler Journal: American Journal of Public Health Author-Name: Morse, D.L. Author-Name: Shayegani, M. Author-Name: Gallo, R.J. Year: 1984 Volume: 74 Issue: 6 Pages: 589-592 Abstract: In July 1981, an outbreak of gastroenteritis occurred at a summer diet camp. Of the 455 campers and staff, 35 per cent developed an illness characterized by abdominal pain, fever, diarrhea, and/or nausea and vomiting. A total of 53 per cent experienced abdominal pain. Seven persons were hospitalized, five of whom had appendectomies. Yersinia enterocolitica serogroup 0:8 was isolated from 37 (54 per cent) of 69 persons examined, including the camp cook and three assistants. An epidemiologic investigation demonstrated that illness was associated with consumption of reconstituted powdered milk and/or chow mein. Y. Enterocolitica serogroup 0:8 was subsequently isolated from milk, the milk dispenser, and leftover chow mein. Information obtained during the investigation suggested that the Yersinia had been introduced by a food handler during food-processing procedures. Handle: RePEc:aph:ajpbhl:1984:74:6:589-592_2 Template-Type: ReDIF-Article 1.0 Title: The relationship between weight-height indices and the triceps skinfold measure among children age 5 to 12 Journal: American Journal of Public Health Author-Name: Michielutte, R. Author-Name: Diseker, R.A. Author-Name: Corbett, W.T. Author-Name: Schey, H.M. Author-Name: Ureda, J.R. Year: 1984 Volume: 74 Issue: 6 Pages: 604-606 Abstract: This study examines several weight for height indices - Quetelet's index W/H2, W/H. and Rohrer's index W/H3 - for their appropriateness in estimating adiposity among young children. Data were obtained for a sample of 1,668 children age 5-12 residing in Forsyth County, North Carolina. Although W/H2 was found to be the most useful of these indices, the results suggest that no index, including the tricep skinfold measure, can be considered completely satisfactory in estimating adiposity among children. Handle: RePEc:aph:ajpbhl:1984:74:6:604-606_7 Template-Type: ReDIF-Article 1.0 Title: Consumption of 'low-yield' cigarettes: Its frequency and relationship to serum thiocyanate Journal: American Journal of Public Health Author-Name: Folsom, A.R. Author-Name: Pechacek, T.F. Author-Name: de Gaudemaris, R. Author-Name: Luepker, R.V. Author-Name: Jacobs Jr., D.R. Author-Name: Gillum, R.F. Year: 1984 Volume: 74 Issue: 6 Pages: 564-568 Abstract: To determine the use of possible health risks of low-yield cigarettes, we ascertained the cigarette brands and serum thiocyanate (SCN) levels of 2.561 adult smokers (age 25-74) in population-based samples of seven upper Midwestern communities during 1980-82. Brands were coded according to December 1981 Federal Trade Commission (FTC) rating for 'tar', nicotine, and carbon monoxide (CO). Compared to 1980 data from the National Center for Health Statistics for the United States as a whole, a greater proportion of smokers in these communities smoked low-yield brands. More people with higher education than lesser and more women than man smoked low-yield cigarettes. Greater proportions of older people (65-75 years) than younger people (< 65 years) smoked cigarettes in the highest and lowest brand yield categories. SCN, adjusted for number of cigarettes smoked and for sex, was only weakly associated with brand ratings for 'tar' (r = + .12), nicotine (R = + .11), and CO (r = + .15). Furthermore, the gradient in SCN between lowest and highest quintiles of brand strength was less than 16 per cent - much lower than the 300-500 per cent gradient in smoke components implied by FTC rating. These data add to the evidence that smoking low-yield cigarettes may not be significantly less hazardous than smoking high-yield brands. Handle: RePEc:aph:ajpbhl:1984:74:6:564-568_6 Template-Type: ReDIF-Article 1.0 Title: The limits of cost-effectiveness. Journal: American Journal of Public Health Author-Name: Vladeck, B.C. Year: 1984 Volume: 74 Issue: 7 Pages: 652-653 Handle: RePEc:aph:ajpbhl:1984:74:7:652-653_7 Template-Type: ReDIF-Article 1.0 Title: On declining adult mortality in the US. Journal: American Journal of Public Health Author-Name: Gruchow, H.W. Year: 1984 Volume: 74 Issue: 7 Pages: 730-731 Handle: RePEc:aph:ajpbhl:1984:74:7:730-731_8 Template-Type: ReDIF-Article 1.0 Title: Use of hospital discharge diagnosis in case-control studies. Journal: American Journal of Public Health Author-Name: Jick, H. Year: 1984 Volume: 74 Issue: 7 Pages: 730 Handle: RePEc:aph:ajpbhl:1984:74:7:730_6 Template-Type: ReDIF-Article 1.0 Title: Whirlpool spa-associated infections: are we really in hot water? Journal: American Journal of Public Health Author-Name: Favero, M.S. Year: 1984 Volume: 74 Issue: 7 Pages: 653-655 Handle: RePEc:aph:ajpbhl:1984:74:7:653-655_2 Template-Type: ReDIF-Article 1.0 Title: The natural history of adolescent drug use. Journal: American Journal of Public Health Author-Name: Robins, L.N. Year: 1984 Volume: 74 Issue: 7 Pages: 656-657 Handle: RePEc:aph:ajpbhl:1984:74:7:656-657_7 Template-Type: ReDIF-Article 1.0 Title: Low-sodium, high-potassium diet: Feasibility and acceptability in a normotensive population Journal: American Journal of Public Health Author-Name: Jeffery, R.W. Author-Name: Pirie, P.L. Author-Name: Elmer, P.J. Author-Name: Bjornson-Benson, W.M. Author-Name: Mullenbach, V.A. Author-Name: Kurth, C.L. Author-Name: Johnson, S.L. Year: 1984 Volume: 74 Issue: 5 Pages: 492-494 Abstract: Sixty-nine normotensive volunteers participated in an eight-week study to test the feasibility and acceptability of two low-sodium (< 70 mEq), high-potassium (> 100 mEq) diets. The diet groups differed only in the use of KCl salt substitute. Both dietary groups were able to reduce sodium and increase potassium intake compared to the control group. Urine sodium excretion decreased in the diet groups but no change was observed in potassium. Potassium chloride salt substitute was not used as recommended, suggesting its unacceptability. Handle: RePEc:aph:ajpbhl:1984:74:5:492-494_9 Template-Type: ReDIF-Article 1.0 Title: Fetal loss and work in a waste water treatment plant Journal: American Journal of Public Health Author-Name: Morgan, R.W. Author-Name: Kheifets, L. Author-Name: Obrinsky, D.L. Author-Name: Whorton, M.D. Author-Name: Foliart, D.E. Year: 1984 Volume: 74 Issue: 5 Pages: 499-501 Abstract: We investigated pregnancy outcomes in 101 wives of workers employed in a waste water treatment plant (WWTP), and verified fetal losses by hospital records. Paternal work histories were compiled and each of the 210 pregnancies was assigned a paternal exposure category. The relative risk of fetal loss was increased when paternal exposure to the WWTP occurred around the time of conception. Handle: RePEc:aph:ajpbhl:1984:74:5:499-501_6 Template-Type: ReDIF-Article 1.0 Title: Elevated levels of carbon monoxide in the patient compartment of ambulances Journal: American Journal of Public Health Author-Name: Iglewicz, R. Author-Name: Rosenman, K.D. Author-Name: Iglewicz, B. Author-Name: O'Leary, K. Author-Name: Hockemeier, R. Year: 1984 Volume: 74 Issue: 5 Pages: 511-512 Abstract: Six hundred and ninety New Jersey ambulances were monitored for carbon monoxide (CO); 27 per cent had CO levels of 10 ppm or more greater than ambient air in the breathing zone of the patient. Twenty-nine of these ambulances had levels of at least 35 ppm greater than ambient air. Results indicate that a CO exposure problem exists in ambulances. Handle: RePEc:aph:ajpbhl:1984:74:5:511-512_7 Template-Type: ReDIF-Article 1.0 Title: Health status of survivors of out-of-hospital cardiac arrest six months later Journal: American Journal of Public Health Author-Name: Bergner, L. Author-Name: Bergner, M. Author-Name: Hallstrom, A.P. Author-Name: Eisenberg, M. Author-Name: Cobb, L.A. Year: 1984 Volume: 74 Issue: 5 Pages: 508-510 Abstract: The health status of long-term survivors of out-of-hospital cardiac arrest was studied six months after the event. Although Sickness Impact Profile scores for arrest survivors were higher (worse) than scores of enrollees in a prepaid closed panel health plan, in most cases problems of survivors were not incapacitating. Approximately three-fifths of survivors reported same or better memory function and stair climbing ability compared to that at time of arrest. Three-fifths of those who had been working continued to do so. Handle: RePEc:aph:ajpbhl:1984:74:5:508-510_5 Template-Type: ReDIF-Article 1.0 Title: United States cancer reporting laws: Structure and utility Journal: American Journal of Public Health Author-Name: Enterline, J.P. Author-Name: Kammer, A. Author-Name: Gold, E.B. Author-Name: Lenhard Jr., R. Author-Name: Powell, G.C. Year: 1984 Volume: 74 Issue: 5 Pages: 449-452 Abstract: Authorities in 52 United States jurisdictions were contacted to determine the existence and structure of cancer reporting laws and registration systems. Of the 52 US reporting areas examined: 30 (58 per cent) had a law requiring cancer reporting; 36 (69 per cent) of the reporting areas had at least one centralized cancer registry covering a geographically defined population. Among the 30 areas with cancer reporting laws, 26 had population-based registries; of the 22 areas with no cancer reporting law, 10 had a population-based registry. Among the 30 areas with cancer reporting laws, 12 required one reporting source (hospital, physician, laboratory), 11 required two reporting sources, four required three reporting sources, two areas gave the health department the authority to designate reporting sources, and one did not specify any reporting source. While 11 of the laws provided legal protection for both the data provider and the cancer patient, eight did not specify any such legal protection. While 13 laws made provisions for research uses of cancer reporting data, 17 did not do so. None of the laws had ever been legally tested at or beyond the State Appelate Court level. Handle: RePEc:aph:ajpbhl:1984:74:5:449-452_9 Template-Type: ReDIF-Article 1.0 Title: The Edgecombe county (NC) high blood pressure control program: II. Barriers to the use of medical care among hypertensives Journal: American Journal of Public Health Author-Name: James, S.A. Author-Name: Wagner, E.H. Author-Name: Strogatz, D.S. Author-Name: Beresford, S.A. Author-Name: Kleinbaum, D.G. Author-Name: Williams, C.A. Author-Name: Cutchin, L.M. Author-Name: Ibrahim, M.A. Year: 1984 Volume: 74 Issue: 5 Pages: 468-472 Abstract: As the initial step in a five-year project to improve control of high blood pressure in Edgecombe County, North Carolina, a survey was conducted in 1980 to determine the prevalence of hypertension and to identify factors which might constitute barriers to the use of medical care by hypertensives. This report summarizes the findings for the 539 hypertensives identified through the baseline survey. In general, Black hypertensives reported more access problems than Whites. Within race, however, males and females differed very little on selected measures of potential access to medical care. Among women, lower scores on potential access were strongly associated with being untreated, whereas for men, concerns about the safety of anti-hypertensive drug therapy were associated with being unaware. On a summary measure of the actual use of medical care in response to symptoms, both male and female treated hypertensives scored higher than their untreated counterparts. The implications of these and other findings for community-based blood pressure control activities are discussed. Handle: RePEc:aph:ajpbhl:1984:74:5:468-472_9 Template-Type: ReDIF-Article 1.0 Title: Citizen cardiopulmonary resuscitation training and use in a metropolitan area: The Minnesota heart survey Journal: American Journal of Public Health Author-Name: Murphy, R.J. Author-Name: Luepker, R.V. Author-Name: Jacobs Jr., D.R. Author-Name: Gillum, R.F. Author-Name: Folsom, A.R. Author-Name: Blackburn, H. Year: 1984 Volume: 74 Issue: 5 Pages: 513-515 Abstract: To assess the prevalence and utility of citizen cardiopulmonary resuscitation (CPR) training, a systematic population-based sample of Minneapolis-St. Paul area adults, age 25-74 years, was interviewed in 1980-81. Twenty-three per cent were CPR trained. Of these, 13 per cent have encountered out-of-hospital cardiac arrests and 38 per cent reported using their skills in such an emergency. Most of those performing out-of-hospital CPR (59 per cent) were health professionals. Only 19 per cent of trainees have maintained their certification by retraining within one year. Handle: RePEc:aph:ajpbhl:1984:74:5:513-515_2 Template-Type: ReDIF-Article 1.0 Title: Patient transfers: Medical practice as social triage Journal: American Journal of Public Health Author-Name: Himmelstein, D.U. Author-Name: Woolhandler, S. Author-Name: Harnly, M. Author-Name: Bader, M.B. Author-Name: Silber, R. Author-Name: Backer, H.D. Author-Name: Jones, A.A. Year: 1984 Volume: 74 Issue: 5 Pages: 494-497 Abstract: We studied 458 consecutive patient transfers from 14 private hospitals to a public hospital emergency room during a six-month period. The transferred patients were predominantly male, young, and uninsured, and included large numbers of minority group members. We established criteria to identify patients at high risk for adverse effects of transfer and reviewed the clinical records of the 103 patients meeting these criteria. We judged that transfer resulted in substandard care for 33 of these patients, either because they were at risk for life-threatening complications in transit or because urgently needed diagnosis or therapy was delayed. In the community studied, transfer is a common and potentially dangerous medical intervention which appears to reinforce racial and class inequalities of access to medical care. Handle: RePEc:aph:ajpbhl:1984:74:5:494-497_8 Template-Type: ReDIF-Article 1.0 Title: Is it possible to evaluate the IPO project? Journal: American Journal of Public Health Author-Name: Strobino, D.M. Year: 1984 Volume: 74 Issue: 6 Pages: 541-542 Handle: RePEc:aph:ajpbhl:1984:74:6:541-542_6 Template-Type: ReDIF-Article 1.0 Title: Occupation/industry of parents on birth certificates. Journal: American Journal of Public Health Author-Name: Brockert, J.E. Year: 1984 Volume: 74 Issue: 6 Pages: 623 Handle: RePEc:aph:ajpbhl:1984:74:6:623_1 Template-Type: ReDIF-Article 1.0 Title: On religious affiliation of mothers relinquishing their newborns. Journal: American Journal of Public Health Author-Name: Boer, H.R. Year: 1984 Volume: 74 Issue: 6 Pages: 623 Handle: RePEc:aph:ajpbhl:1984:74:6:623_0 Template-Type: ReDIF-Article 1.0 Title: On homicide in children and adolescents. Journal: American Journal of Public Health Author-Name: Goldenring, J.M. Year: 1984 Volume: 74 Issue: 6 Pages: 623-624 Handle: RePEc:aph:ajpbhl:1984:74:6:623-624_7 Template-Type: ReDIF-Article 1.0 Title: Prevalence of overweight and weight loss behavior in a metropolitan adult population: The Minnesota heart survey Journal: American Journal of Public Health Author-Name: Jeffery, R.W. Author-Name: Folsom, A.R. Author-Name: Luepker, R.V. Author-Name: Jacobs, D.R. Author-Name: Gillum, R.F. Author-Name: Taylor, H.L. Author-Name: Blackburn, H. Year: 1984 Volume: 74 Issue: 4 Pages: 349-352 Abstract: Data from two major surveys, conducted in Minneapolis-St. Paul metropolitan area in 1973-74 and 1980-81, were used to estimate the prevalence of overweight. In 1980-81, weight history and the prevalance of dieting behaviors were also obtained. The prevalence of overweight was greater in the 1980-81 survey than in 1973-74. Increases were observed in all ages in women, but only in the 40-59 year age ranges in men. In 1980-81, dieting to control weight was widely reported by both sexes, even among those who had never been overweight. Of those who reported having been overweight, approximately one-third reported they had successfully reduced. More men than women reported having been overweight, but more women reported having dieted to lose weight. Formal weight reduction programs were used much more by women than men. Although most dieting attempts consisted of balanced, reduced calorie regimens, a significant percentage were 'fad' types, whose nutritional safety may be questioned. Overall, contrary to findings based on clinical populations, weight reducing efforts often appear to be successful. Nevertheless, overweight remains a significant public health problem in this community. Handle: RePEc:aph:ajpbhl:1984:74:4:349-352_6 Template-Type: ReDIF-Article 1.0 Title: Coronary heart disease mortality trends in Minnesota, 1960-80: The Minnesota heart survey Journal: American Journal of Public Health Author-Name: Gillum, R.F. Author-Name: Hannan, P.J. Author-Name: Prineas, R.J. Author-Name: Jacobs Jr., D.R. Author-Name: Gomez-Marin, O. Author-Name: Luepker, R.V. Author-Name: Baxter, J. Author-Name: Kottke, T.E. Author-Name: Blackburn, H. Year: 1984 Volume: 74 Issue: 4 Pages: 360-362 Abstract: Age-adjusted mortality rates and trends from coronary heart disease (CHD) in Minnesota for the years 1960 to 1980 differed among eight health service areas. Regression of ten socio-economic and demographic factors and intensive care and coronary care unit beds on area CHD mortality levels revealed a significant positive association only for levels of welfare income-maintenance assistance with CHD mortality levels; there were no associations with trends. Further studies are needed to explain variation within states of CHD mortality rate levels and trends. Handle: RePEc:aph:ajpbhl:1984:74:4:360-362_3 Template-Type: ReDIF-Article 1.0 Title: The transfer of polychlorinated biphenyls (PCBs) and polybrominated biphenyls (PBBs) across the human placenta and into maternal milk Journal: American Journal of Public Health Author-Name: Jacobson, J.L. Author-Name: Fein, G.G. Author-Name: Jacobson, S.W. Author-Name: Schwartz, P.M. Author-Name: Dowler, J.K. Year: 1984 Volume: 74 Issue: 4 Pages: 378-379 Abstract: Cord serum and maternal milk levels of polychlorinated biphenyls (PCBs) and polybrominated biphenyls (PBBs) were examined in relation to maternal serum levels. Maternal serum levels were significantly higher than cord serum levels for both types of compounds. Placental passage was indicated by significant maternal to cord serum correlations for both PCBs (r = .42) and PBBs (r = .81). Correlations between maternal serum and milk levels were similar. Higher PBB correlations were probably due to greater reliability in the measurement of PBB levels in serum and milk. Handle: RePEc:aph:ajpbhl:1984:74:4:378-379_9 Template-Type: ReDIF-Article 1.0 Title: Re: Spontaneous abortions following Three Mile Island accident. Journal: American Journal of Public Health Author-Name: Johnson, C.J. Year: 1984 Volume: 74 Issue: 5 Pages: 520 Handle: RePEc:aph:ajpbhl:1984:74:5:520_6 Template-Type: ReDIF-Article 1.0 Title: Asbestos contamination of vermiculite. Journal: American Journal of Public Health Author-Name: Hayward, S.B. Author-Name: Smith, G.R. Year: 1984 Volume: 74 Issue: 5 Pages: 519-520 Handle: RePEc:aph:ajpbhl:1984:74:5:519-520_6 Template-Type: ReDIF-Article 1.0 Title: A community waterborne gastroenteritis outbreak: Evidence for rotavirus as the agent Journal: American Journal of Public Health Author-Name: Hopkins, R.S. Author-Name: Gaspard, G.B. Author-Name: Williams Jr., F.P. Author-Name: Karlin, R.J. Author-Name: Cukor, G. Author-Name: Blacklow, N.R. Year: 1984 Volume: 74 Issue: 3 Pages: 263-265 Abstract: A community waterborne nonbacterial gastroenteritis outbreak occurred in Eagle-Vail, Colorado in March 1981. Illness (defined as vomiting and/or diarrhea) was statistically associated with water consumption (χ2 for linear trend = 7.07, p < .005). Five of seven persons associated with the outbreak were infected with rotavirus as shown by virus detection or serological methods. Bacterial pathogens, Giardia lamblia, and Norwalk virus were excluded as responsible agents. Rotavirus should be looked for as a cause of waterborne outbreaks. Handle: RePEc:aph:ajpbhl:1984:74:3:263-265_9 Template-Type: ReDIF-Article 1.0 Title: Group A meningococcal disease in skid rows: Epidemiology and implications for control Journal: American Journal of Public Health Author-Name: Filice, G.A. Author-Name: Englender, S.J. Author-Name: Jacobson, J.A. Author-Name: Jourden, J.L. Author-Name: Burns, D.A. Author-Name: Gregory, D. Author-Name: Counts, G.W. Author-Name: Griffiss, J.M. Author-Name: Fraser, D.W. Year: 1984 Volume: 74 Issue: 3 Pages: 253-254 Abstract: Interviews conducted during outbreaks of group A meningococcal disease in skid row communities suggested that heavy alcohol use was associated with increased risk of disease. Frequent moving within skid row and from one skid row to another was characteristic of a subpopulation with increased risk of disease and may have facilitated spread within and between skid rows. The observations discussed herein have important implications for control of communicable diseases in and near skid rows. Handle: RePEc:aph:ajpbhl:1984:74:3:253-254_3 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic studies of immigrants urged. Journal: American Journal of Public Health Author-Name: Goldenring, J. Author-Name: Davis, J. Year: 1984 Volume: 74 Issue: 4 Pages: 393 Handle: RePEc:aph:ajpbhl:1984:74:4:393_2 Template-Type: ReDIF-Article 1.0 Title: Test for assessing tar/nicotine yields. Journal: American Journal of Public Health Author-Name: Devitt, G. Author-Name: West, R.J. Author-Name: Jarvis, M. Year: 1984 Volume: 74 Issue: 4 Pages: 391 Handle: RePEc:aph:ajpbhl:1984:74:4:391_7 Template-Type: ReDIF-Article 1.0 Title: On variability in children's BP measurements. Journal: American Journal of Public Health Author-Name: Grossman, N. Year: 1984 Volume: 74 Issue: 4 Pages: 392-393 Handle: RePEc:aph:ajpbhl:1984:74:4:392-393_3 Template-Type: ReDIF-Article 1.0 Title: Modified EPA algorithm needed re: Asbestos in schools. Journal: American Journal of Public Health Author-Name: Kern, D. Year: 1984 Volume: 74 Issue: 4 Pages: 391-392 Handle: RePEc:aph:ajpbhl:1984:74:4:391-392_8 Template-Type: ReDIF-Article 1.0 Title: Utilization of medical care following the Three Mile Island crisis Journal: American Journal of Public Health Author-Name: Houts, P.S. Author-Name: Hu, T.W. Author-Name: Henderson, R.A. Author-Name: Cleary, P.D. Author-Name: Tokuhata, G. Year: 1984 Volume: 74 Issue: 2 Pages: 140-142 Abstract: Four studies are reported on how utilization of primary health care was affected by the Three Mile Island (TMI) crisis and subsequent distress experienced by persons living in the vicinity of the plant. The studies concerned: 1) Blue Cross-Blue Shield records of claims by primary care physicians in the vicinity of TMI; 2) utilization rates in a family practice located near the facility; 3) interviews with persons living within five miles of TMI following the crisis; and 4) responses to a questionnaire by primary care physicians practicing within 25 miles of TMI. All four studies indicated only slight increases in utilization rates during the year following the crisis. One study found that persons who were upset during the crisis tended to be high practice utilizers both before and after the crisis. These results suggest that, while patterns of physician utilization prior to the TMI crisis predicted emotional response during the crisis, the impact of the TMI crisis on subsequent physician utilization was small. Handle: RePEc:aph:ajpbhl:1984:74:2:140-142_9 Template-Type: ReDIF-Article 1.0 Title: The dimensions of health outcomes: A cross-validated examination of health status measurement Journal: American Journal of Public Health Author-Name: Brown, J.H. Author-Name: Kazis, L.E. Author-Name: Spitz, P.W. Author-Name: Gertman, P. Author-Name: Fries, J.F. Author-Name: Meenan, R.F. Year: 1984 Volume: 74 Issue: 2 Pages: 159-161 Abstract: Two independently developed patient outcome measurement instruments were administered to forty-eight subjects with rheumatoid arthritis using a random cross-over design. The independent estimates of physical disability and pain are highly correlated. Each instrument displayed highly significant relationships with global health, providing evidence for convergent validity. The results demonstrate that health status is composed of at least three major dimensions: physical disability, psychological disability, and pain. Handle: RePEc:aph:ajpbhl:1984:74:2:159-161_7 Template-Type: ReDIF-Article 1.0 Title: Giardiasis in an infant and toddler swim class Journal: American Journal of Public Health Author-Name: Harter, L. Author-Name: Frost, F. Author-Name: Grunenfelder, G. Author-Name: Perkins-Jones, K. Author-Name: Libby, J. Year: 1984 Volume: 74 Issue: 2 Pages: 155-156 Abstract: A Giardia infected Washington State child was found to participate in an infant and toddler swim class. A stool survey of 70 child participants revealed a 61 per cent prevalence of Giardia infection. Also, 39 per cent of 53 mothers and 28 per cent of 21 fathers were Giardia positive. None of the non-swimming playmates were positive. Thirty-five per cent of 23 children exposed only at a better maintained pool to which the classes had been moved four weeks prior to the survey were positive. No evidence of transmission to non-swim class pool users was found. Handle: RePEc:aph:ajpbhl:1984:74:2:155-156_9 Template-Type: ReDIF-Article 1.0 Title: Health promotion for educators: Impact on health behaviors, satisfaction, and general well-being Journal: American Journal of Public Health Author-Name: Blair, S.N. Author-Name: Collingwood, T.R. Author-Name: Reynolds, R. Author-Name: Smith, M. Author-Name: Hagan, R.D. Author-Name: Sterling, C.L. Year: 1984 Volume: 74 Issue: 2 Pages: 147-149 Abstract: A random sample of 117 teachers in three treatment schools and one control school participated in a health survey at the beginning and end of the spring semester. Teachers in the treatment schools participated in a 10-week health promotion program which emphasized exercise, stress management, and nutrition. Comparison of pre- and post-survey data indicated that teachers in the treatment schools increased their participation in vigorous exercise, improved their physical fitness, lost weight, lowered their blood pressure, reported a higher level of general well-being, and were better able to handle job stress. Handle: RePEc:aph:ajpbhl:1984:74:2:147-149_1 Template-Type: ReDIF-Article 1.0 Title: Long-term effect of vasectomy on coronary heart disease Journal: American Journal of Public Health Author-Name: Perrin, E.B. Author-Name: Woods, J.S. Author-Name: Namekata, T. Author-Name: Yagi, J. Author-Name: Bruce, R.A. Author-Name: Hofer, V. Year: 1984 Volume: 74 Issue: 2 Pages: 128-132 Abstract: We investigated the association between coronary heart disease (CHD) and vasectomy in a population of 10,632 men who were under surveillance for multiple CHD risk factors during participation in a university-based exercise testing program. We conducted a mail survey with telephone follow-up to determine the vasectomy status of individuals in the population. Responses were obtained from 6,159 individuals. The 4,944 males on whom information was complete enough to be included in the multivariate analysis comprised the study population. Among the 1,383 (28 per cent) vasectomized males in the study population, the interval from vasectomy to the time of the survey ranged from less than one year to 37 years with a mean duration of 15 years. Although increased relative risks for CHD were found to be associated with family history of CHD, high blood pressure and smoking in this population, the relative risk of CHD associated with vasectomy was not increased in general, nor was it increased when the vasectomized males were classified by time since vasectomy. Likewise, serum antisperm-antibody titers were not predictive of CHD among vasectomized men. These studies support the findings from previous investigations of populations with shorter average post-vasectomy experience in which vasectomy has been shown to be unassociated with altered risk of CHD in humans. Handle: RePEc:aph:ajpbhl:1984:74:2:128-132_6 Template-Type: ReDIF-Article 1.0 Title: New and newer enteric pathogens: stages in our knowledge. Journal: American Journal of Public Health Author-Name: Holmberg, S.D. Author-Name: Feldman, R.A. Year: 1984 Volume: 74 Issue: 3 Pages: 205-207 Handle: RePEc:aph:ajpbhl:1984:74:3:205-207_4 Template-Type: ReDIF-Article 1.0 Title: Effect of coding changes on ulcer incidence trends. Journal: American Journal of Public Health Author-Name: Vogt, T.M. Author-Name: Johnson, R.E. Year: 1984 Volume: 74 Issue: 3 Pages: 271-272 Handle: RePEc:aph:ajpbhl:1984:74:3:271-272_2 Template-Type: ReDIF-Article 1.0 Title: Investigation of a waterborne outbreak of giardiasis using serologic testing by IFA. Journal: American Journal of Public Health Author-Name: Vogt, R.L. Author-Name: Little, A.A. Author-Name: Spitalny, K.C. Author-Name: Visvesvara, G. Year: 1984 Volume: 74 Issue: 3 Pages: 272 Handle: RePEc:aph:ajpbhl:1984:74:3:272_1 Template-Type: ReDIF-Article 1.0 Title: Hysterectomies in one Canadian province: A new lood at risks and benefits Journal: American Journal of Public Health Author-Name: Roos, N.P. Year: 1984 Volume: 74 Issue: 1 Pages: 39-46 Abstract: This paper assesses the risks and benefits associated with hysterectomy by comparing the age-adjusted health care usage patterns of all women receiving hysterectomy in the Province of Manitoba in 1974 during the two years before and the two years after surgery with those of women undergoing cholecystectomy, and with those of an age and sex matched population sample. Less than half of the women have dilation and curretage of the uterus prior to hysterectomy, despite the fact that menstrual disorders are the most frequent problem bringing women to the physician's office. Despite a low mortality rate, there is a significant risk (40 per 1,000 cases) of complications requiring hospital readmission during the two years after hysterectomy and associated repair procedures. Although women visit their physician less frequently with gynecologic problems after surgery, they visit more frequently for physiological problems, urinary tract infections, and menopausal symptoms. Both before and after surgery women visit the physicians more frequently than do the age-matched comparison groups. Handle: RePEc:aph:ajpbhl:1984:74:1:39-46_4 Template-Type: ReDIF-Article 1.0 Title: Design and methods in a multi-center case-control interview study Journal: American Journal of Public Health Author-Name: Hartge, P. Author-Name: Cahill, J.I. Author-Name: West, D. Author-Name: Hauck, M. Author-Name: Austin, D. Author-Name: Silverman, D. Author-Name: Hoover, R. Year: 1984 Volume: 74 Issue: 1 Pages: 52-56 Abstract: We concluded a case-control study in ten areas of the United States in which a total of 2,982 bladder cancer patients and 5,782 population controls were interviewed. We employed a variety of existing and new techniques to reduce bias and to monitor the quality of data collected. We review here many of the design elements and field methods that can be generally applied in epidemiologic studies, particularly multi-center interview studies, and explain the reasons for our selection of the methods, instruments, and procedures used. Handle: RePEc:aph:ajpbhl:1984:74:1:52-56_8 Template-Type: ReDIF-Article 1.0 Title: Use of ambulatory care services in three provider plans: Interactions between patient characteristics and plans Journal: American Journal of Public Health Author-Name: Diehr, P. Author-Name: Martin, D.P. Author-Name: Price, K.F. Author-Name: Friedlander, L.J. Author-Name: Richardson, W.C. Author-Name: Riedel, D.C. Year: 1984 Volume: 74 Issue: 1 Pages: 47-51 Abstract: A previous study of low-income enrollees in a closed-panel health maintenance organization (HMO) and a Blue Cross/Blue Shield (BC/BS) plan showed that the effect on the use of health services of the age, sex, health status, previous health care use, race, and family size of the enrollees was different in the two plans. We have replicated this study using the same two provider plans but studying a different group of white collar, middle class enrollees. A third plan, an experimental independent practice association (IPA), was also available for analysis. Utilization was defined as use (yes/no) and the quantity of use for those who used services (in standardized dollars). Significant interactions were detected between plan and all of the independent variables but race. The use of services in the HMO was least affected by enrollees' characteristics (age, sex, race, health status, prior use, family size) and use was most sensitive to patient characteristics in BC. In some respects, the IPA was more like the HMO and in other respects more like the BC/BS plan. Handle: RePEc:aph:ajpbhl:1984:74:1:47-51_2 Template-Type: ReDIF-Article 1.0 Title: Firearms, legislation, and suicide prevention. Journal: American Journal of Public Health Author-Name: Westermeyer, J. Year: 1984 Volume: 74 Issue: 2 Pages: 108 Handle: RePEc:aph:ajpbhl:1984:74:2:108_0 Template-Type: ReDIF-Article 1.0 Title: When to welcome a new measure. Journal: American Journal of Public Health Author-Name: Kasl, S.V. Year: 1984 Volume: 74 Issue: 2 Pages: 106-108 Handle: RePEc:aph:ajpbhl:1984:74:2:106-108_9 Template-Type: ReDIF-Article 1.0 Title: International health: Academic specialty or humanitarian service? Journal: American Journal of Public Health Author-Name: Koch-Weser, D. Year: 1984 Volume: 74 Issue: 5 Pages: 430-431 Handle: RePEc:aph:ajpbhl:1984:74:5:430-431_7 Template-Type: ReDIF-Article 1.0 Title: Birth complication reporting: The effect of birth certificate design Journal: American Journal of Public Health Author-Name: Frost, F. Author-Name: Starzyk, P. Author-Name: George, S. Author-Name: Mclaughlin, J.F. Year: 1984 Volume: 74 Issue: 5 Pages: 505-506 Abstract: The completeness of reporting of selected birth complications and congenital malformations on the Washington State birth certificate was estimated by comparing the total occurrences reported on birth certificates to the totals reported in hospital records. Two time periods were studied (1977-78 and 1980-81 before and after changes in birth certificate design). The design change (inclusion of a series of check boxes for conditions) was found to provide more complete reporting of birth complications. Handle: RePEc:aph:ajpbhl:1984:74:5:505-506_0 Template-Type: ReDIF-Article 1.0 Title: What the vital statistics system can and cannot do Journal: American Journal of Public Health Author-Name: Zemach, R. Year: 1984 Volume: 74 Issue: 8 Pages: 756-758 Abstract: A national study published in this issue of the Journal compares in detail the statistics on maternal mortality published by the National Center for Health Statistics (NCHS) from death records for 1974-78, and records which were identified by state vital records offices as cases of maternal mortality. The authors express concern over the fact that the NCHS data understated the actual number of maternal deaths by 20 per cent or more, and urge a systematic study to determine why 400 deaths in the five-year period were identified by the states, but not classified by NCHS, as maternal deaths. Birth and deaths are registered according to state laws. A state's vital records system is primarily a set of records concerning individual persons, to be used for legal matters: identification; proof of citizenship, age, or death; and evidence of cause of death, if needed to collect insurance. The only content that is really required for legal purposes is the time and place of the vital event, and enough information to uniquely identify the individual who was born or who died. Handle: RePEc:aph:ajpbhl:1984:74:8:756-758_2 Template-Type: ReDIF-Article 1.0 Title: A randomized study of the impact of home health aides on diabetic control and utilization patterns Journal: American Journal of Public Health Author-Name: Hopper, S.V. Author-Name: Miller, J.P. Author-Name: Birge, C. Author-Name: Swift, J. Year: 1984 Volume: 74 Issue: 6 Pages: 600-602 Abstract: Home health aides were offered to half of a group of 227 low-income diabetic clinic patients: in the group offered aides, fasting blood sugar (FBS) declined when compared to control group (10.1 mg/dl vs an increase of 5.1 mg/dl), and missed clinic appointments and emergency room use also decreased. The group of 44, who, upon offer of an aide actually accepted one, showed a significant increase in eye clinic appointments as well as the greatest decline in FBS (13.9 mg/dl). Handle: RePEc:aph:ajpbhl:1984:74:6:600-602_6 Template-Type: ReDIF-Article 1.0 Title: IUD-associated hospitalization in less developed countries Journal: American Journal of Public Health Author-Name: Chi, I.-C. Author-Name: Laufe, L. Author-Name: Rogers, S. Year: 1984 Volume: 74 Issue: 4 Pages: 353-357 Abstract: Data on 11,977 insertions of an intrauteine device (IUD) from 25 collaborating centers in 16 less developed countries (LDCs) were investigated for IUD-associated hospitalizations. These centers maintained regular follow-up and reported at least one hospitalization among their IUD cases. The Lippes Loop, Copper T, Delta Loop, and Delta T were the most commonly used devices, and three-fourths of all devices were inserted in postpartum women. Fifty-five of the 128 reported subsequent hospitalizations were associated with IUD use. Main indications for IUD-associated hospitalization were pelvic infection, bleeding/pain, and method failure. Statistically significant differences were not detected in the three-month gross cumulative rates for hospitalization due to IUD complications by age (< 30 vs 30+), parity (0-1 vs 2+), or device type (Lippes loop and Copper T vs Delta devices vs others). Three types of IUD-associated hospitalization rates were calculated, each involving a margin of error: 1) a Pearl rate of 8.0 per 1,000 women-years of IUD use; 2) a one-year life table rate of 16.3 per 1,000 insertions; and 3) crude rates ranging from 3.2 to 4.6 per 1,000 cases. Handle: RePEc:aph:ajpbhl:1984:74:4:353-357_7 Template-Type: ReDIF-Article 1.0 Title: Recent amendments to the medicaid program: Political implications Journal: American Journal of Public Health Author-Name: Wing --, K.R. Year: 1984 Volume: 74 Issue: 1 Pages: 83-84 Handle: RePEc:aph:ajpbhl:1984:74:1:83-84_1 Template-Type: ReDIF-Article 1.0 Title: Diet policies of PKU clinics in the United States Journal: American Journal of Public Health Author-Name: Schuett, V.E. Author-Name: Brown, E.S. Year: 1984 Volume: 74 Issue: 5 Pages: 501-503 Abstract: About two-thirds of 90 clinics treating phenylketonuria (PKU) now recommend indefinite continuation of a low phenylalanine diet as compared to 1978 when fewer than one-fourth had this policy. The percentage of children maintained on diet has increased markedly for six to eight year-olds. Greater conservatism in clinic diet recommendations likely reflects reports of adverse consequences following diet discontinuation and negative individual clinic experiences. Handle: RePEc:aph:ajpbhl:1984:74:5:501-503_7 Template-Type: ReDIF-Article 1.0 Title: Community health politics: Transition of the Seattle USPHS hospital Journal: American Journal of Public Health Author-Name: Huges, R.G. Author-Name: Tompkins, R.K. Year: 1984 Volume: 74 Issue: 6 Pages: 593-598 Abstract: To achieve transition of the Seattle US Public Health Service Hospital from federal to local control, the community overcame large obstacles: the most difficult was federal preference for closing the hospital rather than incurring additional costs essential for transition. The Washington State Congressional Delegation, local officials, hospital staff, patients and numerous community volunteers - individuals and private organizations - worked together to save the hospital and secure federal resources for its transition. Going through the transition influenced the hospital as it developed a new corporate structure, designed new administrative systems, and prepared to operate in a new environment while facing an uncertain future. The hospital has continued to cope with issues arising from transition, such as operating in a competitive context while reaffirming its community service heritage. Despite the difficulties of transition. Seattle preserved a valuable community health resource. Handle: RePEc:aph:ajpbhl:1984:74:6:593-598_7 Template-Type: ReDIF-Article 1.0 Title: Race, socioeconomic status, and domestic homicide, Atlanta, 1971-72 Journal: American Journal of Public Health Author-Name: Centerwall, B.S. Year: 1984 Volume: 74 Issue: 8 Pages: 813-815 Abstract: It has been assumed that, under comparable socioeconomic conditions, Blacks are more likely than Whites to commit violent acts. To test this assumption, 222 intra-racial domestic homicides (186 Black and 36 White victims) committed in Atlanta, 1971-1972, were subjected to analysis. A domestic homicide was defined as a criminal homicide committed in a residence by a relative or acquaintance of the victim. When Black and White populations were unmatched, the relative risk of intra-racial domestic homicide in Black populations was 5.8 (95 per cent C.I.: 4.3-8.0). When Black and White populations were matched for rates of household crowding, the relative risk of intra-racial domestic homicide in Black populations was no longer significantly elevated (relative risk = 1.2; 95 per cent C.I.: 0.7-2.0). Using rates of household crowding as an index of socioeconomic status, Atlanta Blacks were no more likely to commit domestic homicide than were Whites in comparable socioeconomic circumstances. Further research is needed to determine whether household crowding per se is a risk factor for domestic homicide, independent of socioeconomic status. Handle: RePEc:aph:ajpbhl:1984:74:8:813-815_4 Template-Type: ReDIF-Article 1.0 Title: Feasibility of an extended MPH degree program for fully employed practicing health professionals Journal: American Journal of Public Health Author-Name: Wainwright, R.B. Author-Name: Peterson, M.L. Author-Name: Farrier, J.M. Year: 1984 Volume: 74 Issue: 11 Pages: 1258-1262 DOI: 10.2105/AJPH.74.11.1258 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1258 Abstract: This report describes the first four years of operation of the Extended MPH Degree Program of the University of Washington School of Public Health and Community Medicine and the features that might explain its initial success. The format of the curriculum is radically different from the traditional two-year program of studies leading to the master of public health degree. Over a three-year span of intensive, on-campus courses and seminars, students are able to fulfill all academic and institutional requirements necessary for the MPH degree. Many more applicants have enrolled for the Extended Degree Program than for the regular MPH program. The 94 students who have matriculated into the program are employed mainly in government agencies in eight western states and British Columbia; most have their prior professional training in nursing and medicine with a median of nine years professional experience. The academic performance of these students is comparable to that of regular full-time MPH program students. The administrative, fiscal, and instructional problems raised by such a transformation have been overcome and the demand for the program and our experience to date suggest that extended MPH degree programs are both feasible and desirable. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1258_9 Template-Type: ReDIF-Article 1.0 Title: Medical self-care education for elders: A controlled trial to evaluate impact Journal: American Journal of Public Health Author-Name: Nelson, E.C. Author-Name: McHugo, G. Author-Name: Schnurr, P. Author-Name: Devito, C. Author-Name: Roberts, E. Author-Name: Simmons, J. Author-Name: Zubkoff, W. Year: 1984 Volume: 74 Issue: 12 Pages: 1357-1362 DOI: 10.2105/AJPH.74.12.1357 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1357 Abstract: We conducted a trial to evaluate the impact of medical self-care education on 330 elders whose average age was 71. The test group participated in a 13-session educational intervention with training in clinical medicine, life-style, and use of health services. The comparison group received a two-hour lecture-demonstration. Both groups were assessed pre-intervention, post-intervention, and one year after entry. The results indicate medical self-care instruction: produces substantial improvements, that were sustained for one year, in health knowledge, skills performance, and skills confidence; stimulates many attempts to improve life-style; and generates improvements in life quality. The program had little influence on utilization of medical care or health status. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1357_9 Template-Type: ReDIF-Article 1.0 Title: Two methods of estimating the target population for public maternity services programs Journal: American Journal of Public Health Author-Name: Payne, S.M.C. Author-Name: Strobino, D.M. Year: 1984 Volume: 74 Issue: 2 Pages: 164-166 Abstract: One difficulty in estimating the target population for public health programs is identifying a current and appropriate indicator of the low-income population. Using data from Mississippi and Maryland, we determined that educational attainment of women giving birth is a feasible substitute for census data in estimating the low-income maternity population, and that vital statistics data offer several advantages for estimating the maternity services target population over census data. Handle: RePEc:aph:ajpbhl:1984:74:2:164-166_9 Template-Type: ReDIF-Article 1.0 Title: The benefits of comprehensive care of hemophilia: A five-year study of outcomes Journal: American Journal of Public Health Author-Name: Smith, P.S. Author-Name: Levine, P.H. Year: 1984 Volume: 74 Issue: 6 Pages: 616-617 Abstract: Eleven of 22 federally funded Comprehensive Hemophilia Centers have collected data on outcomes, before and after five years of this program's existence. Improved health, decreased hospitalization, decreased absenteeism, and a decrease in the unemployment rate from 36 per cent to 13 per cent were accompanied by decreased costs of care. In this model of a chronic handicapping illness, the early application of comprehensive care is preferable to the previous emphasis on end-stage rehabilitative efforts. Handle: RePEc:aph:ajpbhl:1984:74:6:616-617_3 Template-Type: ReDIF-Article 1.0 Title: National survey on outbreaks associated with whirlpool spas Journal: American Journal of Public Health Author-Name: Spitalny, K.C. Author-Name: Vogt, R.L. Author-Name: Witherell, L.E. Year: 1984 Volume: 74 Issue: 7 Pages: 725-726 Abstract: A national survey of state epidemiologists sought information on reported outbreaks of illness associated with nonresidential whirlpool spas for the period April 1972-July 1, 1982. Reports were received from 49 states. Of the 74 whirlpool-associated outbreaks reported, 72 were characterized as having patients with papular or pustular rash and two were associated with cases of Pontiac fever. Handle: RePEc:aph:ajpbhl:1984:74:7:725-726_2 Template-Type: ReDIF-Article 1.0 Title: The Edgecombe County high blood pressure control program: I. Correlates of uncontrolled hypertension at baseline Journal: American Journal of Public Health Author-Name: Wagner, E.H. Author-Name: James, S.A. Author-Name: Beresford, S.A.A. Year: 1984 Volume: 74 Issue: 3 Pages: 237-242 Abstract: To guide the planning of a multifacetted hypertension control program in Edgecombe County, North Carolina, a baseline survey of a stratified (by township) random sample of 1,000 households was conducted. All adults (≥18 years) were interviewed and had their blood pressures (BP) measured. Five hundred thirty-nine individuals, 27 per cent of the survey population, had diastolic BP ≥90 mm Hg or were receiving anti-hypertensive drug therapy. The 539 hypertensives were divided into seven subgroups reflecting successive stages in the control of hypertension based on the awareness, treatment, and control of their hypertenson. Unaware hypertensives were further subdivided into three groups according to the recency of their last BP check, and those aware but untreated were subdivided by whether they had previously received treatment. The seven subgroups of hypertensives were compared, separately for women and men, with respect to sociodemographic characteristics, health behaviors, and health status. In general, the progression from undetected hypertension to treatment and control appeared to be associated with being older, female, and White. This progression was further associated with greater educational levels and higher family incomes among women and increasing self-reported morbidity among men. The implications for intervention of these and other described associations are discussed. Handle: RePEc:aph:ajpbhl:1984:74:3:237-242_8 Template-Type: ReDIF-Article 1.0 Title: Consumption of coffee and tea and symptoms of anxiety Journal: American Journal of Public Health Author-Name: Eaton, W.W. Author-Name: McLeod, J. Year: 1984 Volume: 74 Issue: 1 Pages: 66-68 Abstract: The relationship of consumption of coffee or tea to self-reported symptoms of anxiety is examined with data from the detailed examination component of the National Center for Health Statistics Health and Nutrition Examination Survey. Among this nationwide sample of 3,854 respondents, there was no significant association between consumption of coffee or tea and symptoms of anxiety. Handle: RePEc:aph:ajpbhl:1984:74:1:66-68_9 Template-Type: ReDIF-Article 1.0 Title: An analysis of the effects of suicide prevention facilities on suicide rates in the United States Journal: American Journal of Public Health Author-Name: Miller, H.L. Author-Name: Coombs, D.W. Author-Name: Leeper, J.D. Author-Name: Barton, S.N. Year: 1984 Volume: 74 Issue: 4 Pages: 340-343 Abstract: Since the 1960s, there has been a massive effort to reduce suicide mortality in the United States through prevention centers which invite suicidal persons to phone for supportive services. In spite of virtually total lack of evidence concerning the efficacy of these services, they proliferated until, by 1973, nearly every metropolital area in the United States had at least one. Suicide rates increased slightly throughout this time. We studied 1968 through 1973, the years of greatest growth of suicide prevention facilities, comparing suicide rates in counties that added these centers with counties that did not do so. An association of centers with the reduction of suicides in young white females emerged. This finding was replicated on a different set of counties for a different time span. The results are discussed in light of the fact that this group constitutes the major clients of these centers. Handle: RePEc:aph:ajpbhl:1984:74:4:340-343_6 Template-Type: ReDIF-Article 1.0 Title: Hospital use by the elderly in Poland and the United States Journal: American Journal of Public Health Author-Name: Bacon, W.E. Author-Name: Wotjyniak, B. Author-Name: Krzyzanowski, M. Year: 1984 Volume: 74 Issue: 11 Pages: 1220-1226 DOI: 10.2105/AJPH.74.11.1220 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1220 Abstract: Hospital use by elderly patients of Poland and the United States was compared using data from the 1980 General Hospital Morbidity Study (Poland) and the National Hospital Discharge Survey (US). Discharge and days-of-care rates were higher in the US but average lengths of stay were longer in Poland. All three measures increased with advancing age in the US but remained relatively constant or decreased with age in Poland. Although the most frequent causes of hospitalization were similar in the two countries, the characteristic use patterns across age were evident for most frequently occurring disease conditions. The greater use of hospitals in the US is not associated with marked differences between the two countries in health status of the elderly. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1220_9 Template-Type: ReDIF-Article 1.0 Title: Changes in perceived heart disease risk and health during a community-based heart disease prevention program: The North Karelia project Journal: American Journal of Public Health Author-Name: Kottke, T.E. Author-Name: Puska, P. Author-Name: Salonen, J.T. Author-Name: Tuomilehto, J. Author-Name: Nissinen, A. Year: 1984 Volume: 74 Issue: 12 Pages: 1404-1405 DOI: 10.2105/AJPH.74.12.1404 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1404 Abstract: To test whether the cardiovascular disease declines in North Karelia were accompanied by subjective improvements in health, we analyzed responses to two questions about perceived risk of heart disease and health status on independent random population samples surveyed 10 years apart. Age stratified perceived risk of heart disease declined significantly more (p < .01) and age stratified perceived health status improved significantly more in North Karelia than in the reference area (p < .005). Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1404_7 Template-Type: ReDIF-Article 1.0 Title: The association between smoking and sexual behavior among teens in US contraceptive clinics Journal: American Journal of Public Health Author-Name: Zabin, L.S. Year: 1984 Volume: 74 Issue: 3 Pages: 261-263 Abstract: A study of teenage women in 32 contraceptive cinics in the United States shows a strong negative relationship between age of first intercourse and the level of cigarette smoking; the association is strong enough to reverse the usual correlation of smoking and age during the teenage years. Preventive, timely contraceptive behavior is also negatively associated to smoking. These findings suggest that interventions could well be designed and located in settings which take this association into account. Handle: RePEc:aph:ajpbhl:1984:74:3:261-263_0 Template-Type: ReDIF-Article 1.0 Title: The effects of high voltage transmission lines on the health of adjacent resident populations Journal: American Journal of Public Health Author-Name: Haupt, R.C. Author-Name: Nolfi, J.R. Year: 1984 Volume: 74 Issue: 1 Pages: 76-78 Abstract: A community health survey of 438 individuals was taken to detect health problems related to high voltage electrical transmission among an adjacent residential population. Results revealed no significant or consistent relationships between exposure to a high-voltage DC power line and the perceived health problems that were measured. The sample was not, however, large enough to draw statistically significant conclusions regarding possible health effects with a very low incidence. Handle: RePEc:aph:ajpbhl:1984:74:1:76-78_4 Template-Type: ReDIF-Article 1.0 Title: Coffee consumption and risk of fatal cancers Journal: American Journal of Public Health Author-Name: Snowdon, D.A. Author-Name: Phillips, R.L. Year: 1984 Volume: 74 Issue: 8 Pages: 820-823 Abstract: In 1960, the coffee consumption habits and other lifestyle characteristics of 23,912 white Seventh-day Adventists were assessed by questionnaire. Between 1960 and 1980, deaths due to cancer were identified. There were positive associations between coffee consumption and fatal colon and bladder cancer. The group consuming two or more cups of coffee per day had an estimated relative risk (RR) of 1.7 for fatal colon cancer and 2.0 for fatal bladder cancer, compared to the group that consumed less than one cup per day (RR = 1.0). These positive associations were apparently non confounded by age, sex, cigarette smoking, or meat consumption habits. In this study, there were no significant or suggestive associations between coffee consumption and fatal pancreatic, breast, and ovarian cancer, or a combined group of all other cancer sites. Handle: RePEc:aph:ajpbhl:1984:74:8:820-823_9 Template-Type: ReDIF-Article 1.0 Title: Age-specific hysterectomy and oophorectomy prevalence rates and the risks for cancer of the reproductive system Journal: American Journal of Public Health Author-Name: Howe, H.L. Year: 1984 Volume: 74 Issue: 6 Pages: 560-563 Abstract: A sample survey was conducted in 1982 to determine the prevalence of hysterectomy and oophorectomy among upstate New York women, ages 25-74. The effects of this surgery on age-specific estimates of the risk for cancer of the uterus, cervix, and ovary were calculated. Overall, 16.9 per cent of the women reported having had a hysterectomy and 9.9 per cent reported a bilateral oophorectomy. The adjustment for age-specific hysterectomy increased the 1977-1979 average annual incidence rate of cervical and uterine cancer by 21 per cent. In several five-year age categories, the increase reached 54 per cent. The 1977-1979 average annual incidence rate of ovarian cancer increased by 12 per cent after adjusting for age-specific bilateral oophorectomy. The increase reached 29 per cent in one five-year age group. The sample results show a lower prevalence of hysterectomy among women 25 to 40 years old and among women 70 to 74 than estimates based on the application of mathematical models to data on surgical incidence. Handle: RePEc:aph:ajpbhl:1984:74:6:560-563_0 Template-Type: ReDIF-Article 1.0 Title: Users of coin-operated computerized sphygmomanometry and reasons for utilization: A descriptive study Journal: American Journal of Public Health Author-Name: Moore, P.V. Author-Name: Flynn, J.B. Year: 1984 Volume: 74 Issue: 4 Pages: 368-370 Abstract: A sample of 209 users of coin-operated computerized sphygmomanometers were interviewed during randomly selected hours. Follow-up phone contact was made to determine if any health care action was taken as a result of the blood pressure reading. Results suggest that when used in conjunction with the guidance of a physician or nurse, coin-operated computerized blood pressure machines may help individuals be active participants in the control of high blood pressure. Handle: RePEc:aph:ajpbhl:1984:74:4:368-370_0 Template-Type: ReDIF-Article 1.0 Title: Evaluation of tuberculosis control programs: Some national trends Journal: American Journal of Public Health Author-Name: Powell, K.E. Author-Name: Brown, E.D. Author-Name: Seggerson, J.J. Author-Name: Farer, L.S. Year: 1984 Volume: 74 Issue: 4 Pages: 344-348 Abstract: Increasing numbers of tuberculosis control programs compile information about the number, location, bacteriologic status, and chemotherapy status of tuberculosis patients within their jurisdiction. Reports from these programs show that during the 1970s the prevalence of patients requiring supervision decreased three times faster than the incidence of tuberculosis; this decline occurred because low relapse rates among patients who had received adequate therapy allowed the recommended duration of follow-up after completion of therapy to diminish from lifetime to none. The prevalence of patients hospitalized for tuberculosis decreased four times faster than the incidence of tuberculosis because the duration of hospitalization decreased from many months to a few weeks and because a small proportion of patients were hospitalized. Future declines in these two program aspects are expected to be much smaller and should parallel the decline in morbidity more closely. Other measures of program performance have shown a less favorable trend and suggest an impeded flow of information to the health department from other persons or agencies involved in the care of tuberculosis. Handle: RePEc:aph:ajpbhl:1984:74:4:344-348_2 Template-Type: ReDIF-Article 1.0 Title: Family planning in a healthy, married population: Operationalizing the human rights approach in an Israeli health service setting Journal: American Journal of Public Health Author-Name: Block, D.E. Author-Name: Kurtzman, C. Year: 1984 Volume: 74 Issue: 8 Pages: 830-833 Abstract: A community health center in Israel, delivering services to a geographically defined population, attempted to formulate goals for its postpartum family planning service. Taking into account the pronatalist climate in Israel along with the good health status of the population served by this center, it was decided that the community-wide goal of the family planning program was to ensure the rights of couples to decide freely and responsibly on the number and spacing of their children. Specific process and outcome objectives were developed based on helping couples define and clarify their family planning goals, and assisting them to achieve these goals. Preliminary evaluation of the intervention based on the objectives showed that 84.0 per cent of the cohort of women who gave birth in 1980 (n = 212) had specific postpartum planning goals as opposed to 69.0 per cent of women who gave birth in 1977 (n = 242). The percentage of women experiencing unplanned pregnancies during the two years after birth was reduced by 46 per cent in the 1980 cohort (6.1 per cent of the women) as compared with the 1977 cohort (11.2 per cent). Handle: RePEc:aph:ajpbhl:1984:74:8:830-833_2 Template-Type: ReDIF-Article 1.0 Title: An assessment of occupation and industry data from death certificates and hospital medical records for population-based cancer surveillance Journal: American Journal of Public Health Author-Name: Swanson, G.M. Author-Name: Grossbart Schwartz, A. Author-Name: Burrows, R.W. Year: 1984 Volume: 74 Issue: 5 Pages: 464-467 Abstract: This study analyzed 30,194 incident cases and 4,301 death certificates for completeness of occupational reporting. Analysis of data accuracy was based upon a comparison of more than 2,000 death certificates with incident abstracts and 352 death certificates with interview data. Death certificates had a higher proportion with occupation (94.3%) and industry (93.4%) reported than did incident abstracts of hospital medical records (39.0% and 63.5%, respectively). Compared with occupational history data obtained by interview, 76.1% of the death certificates were exact matches for usual occupation and industry. Handle: RePEc:aph:ajpbhl:1984:74:5:464-467_1 Template-Type: ReDIF-Article 1.0 Title: Pneumoconiosis and exposures of dental laboratory technicians Journal: American Journal of Public Health Author-Name: Rom, W.N. Author-Name: Lockey, J.E. Author-Name: Lee, J.S. Author-Name: Kimball, A.C. Author-Name: Bang, K.M. Author-Name: Leaman, H. Author-Name: Johns Jr., R.E. Author-Name: Perrota, D. Author-Name: Gibbons, H.L. Year: 1984 Volume: 74 Issue: 11 Pages: 1252-1257 DOI: 10.2105/AJPH.74.11.1252 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1252 Abstract: One hundred and seventy-eight dental laboratory technicians and 69 non-exposed controls participated in an epidemiological respiratory study. Eight technicians who had a mean of 28 years' grinding nonprecious metal alloys were diagnosed as having a simple pneumoconiosis by chest radiograph. Mean values for per cent predicted FVC and FEV1 were reduced among male nonsmoker technicians compared to male nonsmoker controls; after controlling for age, there was also a reduction in spirometry with increasing work-years. An industrial hygiene survey was conducted in 13 laboratories randomly selected from 42 laboratories stratified by size and type of operation in the Salt Lak City, Utah metropolitan area. Personal exposures to beryllium and cobalt exceeded the Threshold Limit Values (TLVs) in one laboratory. Occupational exposures in dental laboratories need to be controlled to prevent beryllium-related lung disorders as well as simple pneumoconiosis. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1252_9 Template-Type: ReDIF-Article 1.0 Title: Response to David Rush's comments Journal: American Journal of Public Health Author-Name: Kotelchuck, M. Author-Name: Schwartz, J.B. Author-Name: Anderka, M.T. Author-Name: Finison, K.S. Year: 1984 Volume: 74 Issue: 10 Pages: 1146-1148 Handle: RePEc:aph:ajpbhl:1984:74:10:1146-1148_2 Template-Type: ReDIF-Article 1.0 Title: Factors associated with birthweight: An exploration of the roles of prenatal care and length of gestation Journal: American Journal of Public Health Author-Name: Showstack, J.A. Author-Name: Budetti, P.P. Author-Name: Minkler, D. Year: 1984 Volume: 74 Issue: 9 Pages: 1003-1008 Abstract: To assess the association with birthweight of prenatal medical care, length of gestation, and other prenatal factors, birth certificate data were studied for babies born in 1978 to mothers who were residents of Alameda or Contra Costa counties, California. Using multiple regression data analytic techniques, adequate prenatal care (defined by the number of prenatal care visits compared to the length of gestation and month of start of care) was found to be associated with an increase of 197 grams in average birthweight. This effect was even greater for Black infants and infants of short length of gestation. Adding length of gestation to the equation increased significantly the proportion of the variance in birthweight accounted for. For babies of short gestation (≤ 280 days), the addition of length of gestation was associated with a halving of the association of prenatal care with birthweight. The results suggest that researchers need to take into account the nonlinear relationship between length of gestation and birthweight when assessing factors that affect birthweight. Handle: RePEc:aph:ajpbhl:1984:74:9:1003-1008_1 Template-Type: ReDIF-Article 1.0 Title: Animal bites as an occupational hazard among animal control officers Journal: American Journal of Public Health Author-Name: Mann, J.M. Author-Name: Rollag, O.J. Author-Name: Hull, H.F. Author-Name: Montes, J.M. Year: 1984 Volume: 74 Issue: 3 Pages: 255-256 Abstract: One hundred-and-two full-time animal control officers (ACOs) in New Mexico were surveyed to learn about animal bite risks in this little-studied occupational group. The overall bite rate was 2.57 per working-year (175-500 times population-based rate estimates). A 'high risk' ACO subset (seven officers involved in 67 per cent of bite incidents) was discovered. Evaluation of animal bite data can contribute to prevention of occupational injuries among the estimated 10,000 full-time ACOs in this country. Handle: RePEc:aph:ajpbhl:1984:74:3:255-256_2 Template-Type: ReDIF-Article 1.0 Title: Pitfalls in measuring the health status of Mexican Americans: Comparative validity of the English and Spanish sickness impact profile Journal: American Journal of Public Health Author-Name: Deyo, R.A. Year: 1984 Volume: 74 Issue: 6 Pages: 569-573 Abstract: We tested a Spanish translation of the Sickness Impact Profile (SIP) in a clinical study of low back pain, which included non-Hispanic (Group 1). Mexican Americans who used the English SIP (Group II), and Mexican Americans who used the Spanish SIP (group III). The reliability and clinical validity of response by these groups were compared. Internal consistency of responses by all three groups was excellent (Cronbach's alpha for the overall SIP = 93 - .95). When construct validity was tested by correlating SIP scores with several clinical measures of disease severity, however, important differences emerged. Group I responses appeared to be highly valid, while group III responses did not: Group II responses appeared reasonably valid, but intermediate between the other groups. These differences appear unlikely to be due to clinical differences, interviewing, or translational problems and seem to parallel the groups' levels of 'acculturation'. It may be that certain aspects of acculturation, including familiarity with questionnaire research, critically affect the validity of responses to this questionnaire. Handle: RePEc:aph:ajpbhl:1984:74:6:569-573_8 Template-Type: ReDIF-Article 1.0 Title: Active surveillance at local level for communicable disease reporting. Journal: American Journal of Public Health Author-Name: Gunn, R.A. Year: 1984 Volume: 74 Issue: 1 Pages: 85-86 Handle: RePEc:aph:ajpbhl:1984:74:1:85-86_0 Template-Type: ReDIF-Article 1.0 Title: Comparative socio-medical studies of the elderly Journal: American Journal of Public Health Author-Name: Shanas, E. Year: 1984 Volume: 74 Issue: 11 Pages: 1196-1197 DOI: 10.2105/AJPH.74.11.1196 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1196 Abstract: Comparative socio-medical studies of the aging may either reinforce or call into question methods used to meet the health needs of the elderly in any given country. The findings of such studies serve to enlarge the perspective of those policy makers, administrators, and practitioners who must reconcile resources with the growing demands of an elderly population. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1196_0 Template-Type: ReDIF-Article 1.0 Title: The role of motor vehicle crashes in causing certain injuries Journal: American Journal of Public Health Author-Name: Fife, D. Author-Name: Ginsburg, M. Author-Name: Boynton, W. Year: 1984 Volume: 74 Issue: 11 Pages: 1263-1264 DOI: 10.2105/AJPH.74.11.1263 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1263 Abstract: Hospital discharge data from Rhode Island were used to assess the role of motor vehicle crashes in causing several types of serious injuries. Motor vehicle crashes were the cause of injury for approximately two-thirds of patients hospitalized with injuries to the chest organs, liver, and spleen, and approximately one-third of those with traumatic pneumothorax or hemothorax, and injuries to the head, kidney, intestine, distal femur, pelvis, and patella. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1263_7 Template-Type: ReDIF-Article 1.0 Title: Weight loss competitions at the work site: Impact on weight, morale and cost-effectiveness Journal: American Journal of Public Health Author-Name: Brownell, K.D. Author-Name: Cohen, R.Y. Author-Name: Stunkard, A.J. Author-Name: Felix, M.R. Author-Name: Cooley, N.B. Year: 1984 Volume: 74 Issue: 11 Pages: 1283-1285 DOI: 10.2105/AJPH.74.11.1283 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1283 Abstract: Three weight loss competitions were held in business/industrial settings. One competition was between three banks; the other two were within industries, either between employee teams selected at random or between divisions of the industry. Attrition in the competitions was less than 1 per cent and weight loss averaged 5.5 kg. Both employees and management reported positive changes in morale and employee/management relations, and both considered the competition important to the success of the program. The cost-effectiveness ratio ($2.93 per 1 per cent reduction in percentage overweight) is the best yet reported. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1283_7 Template-Type: ReDIF-Article 1.0 Title: Automobile safety regulation: Rebuttal and new data Journal: American Journal of Public Health Author-Name: Robertson, L.S. Year: 1984 Volume: 74 Issue: 12 Pages: 1390-1394 DOI: 10.2105/AJPH.74.12.1390 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1390 Abstract: A respecification of the regression model applied to additional data results in an estimate of about 45,000 lives preserved by regulations during 1975-78, similar to my previous estimates, and 105,000 lives during 1975-1982. The model allows for introduction of new regulations after 1968 and increased compliance. This result is similar to estimates obtained by several investigators using a variety of methods. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1390_2 Template-Type: ReDIF-Article 1.0 Title: Hospital-sponsored primary care: I. Organizational and financial effects Journal: American Journal of Public Health Author-Name: Shortell, S.M. Author-Name: Wickizer, T.M. Author-Name: Wheeler, J.R.C. Year: 1984 Volume: 74 Issue: 8 Pages: 784-791 Abstract: Findings are presented from a seven-year (1976-83) evaluation of the Community Hospital Program (CHP), a national demonstration program sponsored by the Robert Wood Johnson Foundation to assist 54 community hospitals in improving the organization of access to primary care. Upon grant expiration, 66 per cent of hospital-sponsored group practices continued under some form of hospital sponsorship; over 90 per cent developed or were planning to develop spin-off programs; and new physicians were recruited and retained in the community. About 9 per cent of hospital admissions were accounted for by group physicians and grantee hospitals experienced a greater annual increase in their market share of admissions than competing hospitals in the area. While only three of the groups generated sufficient revenue to cover expenses during the grant period, 21 additional groups broke even during the first post-grant year. Productivity and cost per visit compared favorably with most other forms of care. Hospitalization rates from the hospital-sponsored practices were somewhat lower than those for other forms of care. Medical director leadership and involvement and the organization design of the practice were among several key factors associated with higher performing practices. The ability of such joint hospital-physician ventures to meet the needs of the poor and elderly in a time of Medicare and Medicaid cutbacks is discussed along with suggestions for targeting future initiatives in primary care. Handle: RePEc:aph:ajpbhl:1984:74:8:784-791_8 Template-Type: ReDIF-Article 1.0 Title: Behavioral problems among patients in skilled nursing facilities Journal: American Journal of Public Health Author-Name: Zimmer, J.G. Author-Name: Watson, N. Author-Name: Treat, A. Year: 1984 Volume: 74 Issue: 10 Pages: 1118-1121 Abstract: This survey of a 33 per cent random sample (1,139) of 3,456 patients in 42 skilled nursing facilities (SNFs) in upstate New York yielded 64.2 per cent with significant behavioral problems. Of these, 257 (22.6 per cent) of the total sample had what were defined as 'serious' problems (i.e., excluding those with only impaired judgment and/or physical restraint orders). Details of the problem behaviors of this group, their previous history, current management, frequency of psychiatric consultation, and adequacy of documentation were analyzed. Median age was the same as the general SNF population, a slightly lower proportion was female, and, while 66.5 per cent had diagnoses indicating organic brain syndrome, very few had specific psychiatric diagnoses, and only 4.7 per cent had been admitted from a psychiatric facility. The attending physician had noted the behavioral problem in the record in only 9.7 per cent and had requested psychiatric consultation in 14.8 per cent of these 'serious' cases. The need for more staff training in mental health care, and more physician and psychiatric consultative assistance are discussed. Handle: RePEc:aph:ajpbhl:1984:74:10:1118-1121_1 Template-Type: ReDIF-Article 1.0 Title: A methodological note on location-allocation models Journal: American Journal of Public Health Author-Name: Scarpaci, J.L. Year: 1984 Volume: 74 Issue: 10 Pages: 1155-1157 Abstract: Three conditions render the use of standard methodologies inappropriate in solving location-allocation problems. This paper presents one alternative method for assigning an emergency aircraft to one of three hospitals in northern Chile when standard approaches are not suitable. Graph analyses and the demographic potential measures are used in the case presented. The main advantages of this alternative approach are its computational ease and the use more than one method. Handle: RePEc:aph:ajpbhl:1984:74:10:1155-1157_1 Template-Type: ReDIF-Article 1.0 Title: Limiting state regulation of reproductive decisions Journal: American Journal of Public Health Author-Name: Glantz, L.H. Year: 1984 Volume: 74 Issue: 2 Pages: 168-169 Abstract: Two decisions by the U.S. Supreme Court in recent abortion related cases are analyzed for indications of the Court's future direction in this area. In deciding City of Akron v. Akron Center for Reproductive Health and Planned Parenthood of Kansas City v. Ashcroft, the majority of Justices rejected state or city requirements that would place undue or arbitrary burdens on women seeking abortions and on physicians performing them. The author concludes that at present six Justices uphold the Roe v. Wade decision that the states should not interfere in an individual's reproductive decisions, but that three of the Justices appear ready to overrule it. Handle: RePEc:aph:ajpbhl:1984:74:2:168-169_6 Template-Type: ReDIF-Article 1.0 Title: Tetanus immunization of adult members of an HMO Journal: American Journal of Public Health Author-Name: Mullooly, J.P. Year: 1984 Volume: 74 Issue: 8 Pages: 841-842 Abstract: Thirty-nine per cent of 1,900 randomly selected adult Health Plan members received one or more tetanus injections during a 10-year period of continuous eligibility. Age-specific immunization rates decreased from 47 per cent for 20-39 year olds to 28 per cent for those over age 70. Nearly half of the elderly, age 60+, received a booster of tetanus toxoid rather than tetanus-diphtheria toxoids as recommended by the Immunization Practices Advisory Committee of the Centers for Disease Control. Access to care does not appear to be a sufficient condition for achieving recommended levels of immunization, especially among the elderly. Handle: RePEc:aph:ajpbhl:1984:74:8:841-842_0 Template-Type: ReDIF-Article 1.0 Title: Routine pre-exposure rabies prophylaxis: A reassessment Journal: American Journal of Public Health Author-Name: Mann, J.M. Year: 1984 Volume: 74 Issue: 7 Pages: 720-722 Abstract: The rational use of rabies biologics is a difficult challenge. Pre-exposure rabies prophylaxis (PRE-RP) is one important rabies prevention strategy currently recommended by the US Public Health Service for groups considered at high risk of exposure to rabies. However, standard post-exposure rabies prophylaxis (POST-RP) appears equally effective in preventing rabies; PRE-RP still requires a limited vaccination series if a rabies exposure occurs and, at current costs, standard POST-RP may be a less expensive strategy than PRE-RP. For PRE-RP, as with other human rabies prevention strategies, the central problem is to obtain reasonable estimates of actual rabies exposure risks, which provide the rationale for well-designed programs. Handle: RePEc:aph:ajpbhl:1984:74:7:720-722_7 Template-Type: ReDIF-Article 1.0 Title: Putbreak of illness due to volatilized asphalt coming from a malfunctioning fluorescent lighting fixture Journal: American Journal of Public Health Author-Name: Tavris, D.R. Author-Name: Field, L. Author-Name: Brumback, C.L. Year: 1984 Volume: 74 Issue: 6 Pages: 614-615 Abstract: We investigated an outbreak of headache, eye irritation, sore throat, nasal congestion, and nausea in an office complex, ongoing for three months and regularly resolved upon leaving the building. Investigation suggested that the etiology of the illness was malfunctioning fluorescent light ballasts, which overheated and resulted in melting and volatilization of contained asphalt. Correction of the problem resulted in almost complete disappearance of symptoms within two weeks. Handle: RePEc:aph:ajpbhl:1984:74:6:614-615_6 Template-Type: ReDIF-Article 1.0 Title: Infant formula promotion and infant-feeding practices, Bicol region, Philippines Journal: American Journal of Public Health Author-Name: Griffin, C.C. Author-Name: Popkin, B.M. Author-Name: Spicer, D.S. Year: 1984 Volume: 74 Issue: 9 Pages: 992-997 Abstract: A 1978 household survey and a 1981 survey of stores and health facilities document the availability of breast milk substitutes, promotion of infant food and formula through the medical sector, and the effects of such promotion on the infant-feeding practices of mothers in the Bicol region of the Philippines. Breast milk substitutes were universally available in the region. Infant food and formula companies were active in the modern medical sector with promotional efforts that included distributing free formula samples, providing pamphlets and posters, and organizing professional meetings. Industry activities had mixed effects on health professionals' knowledge of breast-feeding and attitudes towards the practice. Activities of multinationals tended not to affect mothers' breast-feeding behavior directly but increased the probability of their introducing breast milk substitutes within the first six months, and thus in practicing a program of mixed feeding. Handle: RePEc:aph:ajpbhl:1984:74:9:992-997_4 Template-Type: ReDIF-Article 1.0 Title: Ethics committees in neonatal care: Substantive protection or procedural diversion? Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1984 Volume: 74 Issue: 8 Pages: 843-845 Abstract: New decision-making procedures will ultimately be judged on the basis of three criteria: accuracy, efficiency, and social acceptability. Ethics committees will probably be as accurate as the current doctor-patient model, and more accurate if they can gather relevant information that might not otherwise be considered; less efficient in terms of time and effort; and worthy of public acceptability only if their primary function is the protection of the infant. If their primary function is protection of the institution, such committees wil serve only to postpone the day of patient-centered reform by temporarily creating the illusion that something is being done to protect vulnerable patients. Experimentation with such committees seems in order; but it is premature to pretend that they can solve the very difficult substantive issues raised by neonatal rescue medicine by simply adding a procedural layer to the decision-making process. The development of substantive standards for decision making remains our first priority. Handle: RePEc:aph:ajpbhl:1984:74:8:843-845_1 Template-Type: ReDIF-Article 1.0 Title: Placement changes in long-term care: Three years' experience Journal: American Journal of Public Health Author-Name: Stark, A.J. Author-Name: Kliewer, E. Author-Name: Gutman, G.M. Author-Name: McCashin, B. Year: 1984 Volume: 74 Issue: 5 Pages: 459-463 Abstract: This paper describes the place and level of care of an urban and a semi-rural health unit for which 1,653 clients began their experience in British Columbia's Long-Term Care (LTC) program and where they were one and three years later. Three years after admission, 54 per cent of 759 clients initially admitted at home to the lowest level of care were still active clients: 25.8 per cent unchanged, 11.3 per cent at home but at a high level of care, 16.9 per cent had moved to facilities, 25.4 per cent had died; the remainder of this group had been discharged from LTC. A similar proportion of the 184 clients admitted to the lowest level of care in facilities were still in the program at the end of three years. In contrast, 25 per cent of those admitted to the highest level of care at home (N = 60) and 14.1 per cent of those admitted to the highest level in facilities (N = 64) remained in the program after three years. The potential of the study data for planning purposes is suggested. Handle: RePEc:aph:ajpbhl:1984:74:5:459-463_9 Template-Type: ReDIF-Article 1.0 Title: Smoking habits of oil refinery employees Journal: American Journal of Public Health Author-Name: Van Peenen, P.F.D. Author-Name: Blanchard, A.G. Author-Name: Wolkonsky, P.M. Year: 1984 Volume: 74 Issue: 12 Pages: 1408-1409 DOI: 10.2105/AJPH.74.12.1408 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1408 Abstract: Smoking habits of White male employees of a large oil company were analyzed. There were only slight differences in smoking habits between refinery and nonrefinery employees. Salaried employees, both at refineries and elsewhere, smoked much less than hourly employees. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1408_9 Template-Type: ReDIF-Article 1.0 Title: Toward a smoke-free society Journal: American Journal of Public Health Author-Name: Ockene, J.K. Year: 1984 Volume: 74 Issue: 11 Pages: 1198-1200 DOI: 10.2105/AJPH.74.11.1198 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1198 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1198_4 Template-Type: ReDIF-Article 1.0 Title: Senile dementia: Public policy and adequate institutional care Journal: American Journal of Public Health Author-Name: Brody, E.M. Author-Name: Powell Lawton, M. Author-Name: Liebowitz, B. Year: 1984 Volume: 74 Issue: 12 Pages: 1381-1383 DOI: 10.2105/AJPH.74.12.1381 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1381 Abstract: Increasing costs of institutional care for the aged have occasioned a variety of government cost containment measures. People with senile dementia of the Alzheimer's type (SDAT) will be the principal group to suffer from cutbacks, SDAD patients are usually eligible for Intermediate Care Facilities (ICFs), rather than Skilled Nursing Facilities (SNFs) and therefore for lower reimbursement. Because such patients require heavy care and are the ones most likely to be Medicaid-dependent, nursing homes are being provided with incentives to prevent admissions. At the same time, community services to aid overburdened caregivers are grossly inadequate. Costs to other parts of the health systems are increased by backups in acute hospitals when nursing home beds cannot be found. SDAT and Medicaid eligibility are the principal causes of such 'administratively necessary' backup days, but in the main Diagnostic Related Groups (DRGs) may close even at that temporary resource. Thus, virtually all avenues of care are shrinking for those who need them most. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1381_8 Template-Type: ReDIF-Article 1.0 Title: The effect of mothers' social support and life changes on the stimulation of their children in the home Journal: American Journal of Public Health Author-Name: Pascoe, J.M. Author-Name: Earp, J.A. Year: 1984 Volume: 74 Issue: 4 Pages: 358-360 Abstract: The relationship between mothers' life changes, social support, and the preschool home environment of their children was analyzed three years after all study children were discharged from a neonatal intensive care unit. The number of reported life changes occurring to mothers since the births of the children in the group was not related to the amount of home stimulation mothers provided their children; however, mothers reporting more social support provided a more stimulating home environment unrelated to the number of life changes. Handle: RePEc:aph:ajpbhl:1984:74:4:358-360_0 Template-Type: ReDIF-Article 1.0 Title: Treated incidence of mental disorders in a prepaid group practice setting Journal: American Journal of Public Health Author-Name: Kessler, L.G. Year: 1984 Volume: 74 Issue: 2 Pages: 152-154 Abstract: We followed a cohort of 7,666 individuals enrolled continuously for five years in a prepaid group practice in Columbia, Maryland. Incidence rates of all diagnosed mental disorders were estimated at approximately 3.7 per cent, lower for adolescents and children (about 3 per cent), higher for adult males aged 20-49 (4.3 per cent), and highest for adult females (5.8 per cent). Diagnoses are primarily for acute mental disorders and show a tendency to recur at fairly high rates. Handle: RePEc:aph:ajpbhl:1984:74:2:152-154_9 Template-Type: ReDIF-Article 1.0 Title: The value of medical care for health promotion Journal: American Journal of Public Health Author-Name: Roemer, M.I. Year: 1984 Volume: 74 Issue: 3 Pages: 243-248 Abstract: A 'rediscovery' of the value of prevention in the 1970s has led to the denigration of medical care, which had been occurring also for other reasons - aversion to high technology, demonstrable abuses, spiraling medical costs, etc. The achievements of prevention in conquering infectious diseases had long been recognized, and preventive strategies in the 1970s and 1980s were beginning to show reductions in mortality from the non-communicable chronic diseases as well. Yet the benefits of medical care in extending life expectancy over recent decades have often been overlooked. The quality of life in the later years has also been substantially improved by effective medical care. Most important, access to medical care has definite value in facilitating the prevention of disease and the promotion of health, both in developing and developed countries. It is too often forgotten that prevention embodies a range of activities, merging from general health promotion through specific disease prevention and early case-detection to rehabilitation and prevention of disability. Medical care, in other words, should not be counterposed to prevention, but rather should be integrated with it for the benefit of both health strategies. Handle: RePEc:aph:ajpbhl:1984:74:3:243-248_8 Template-Type: ReDIF-Article 1.0 Title: Creating a progressive health agenda: 1983 presidential address Journal: American Journal of Public Health Author-Name: Robbins, A. Year: 1984 Volume: 74 Issue: 8 Pages: 775-779 Handle: RePEc:aph:ajpbhl:1984:74:8:775-779_0 Template-Type: ReDIF-Article 1.0 Title: The effect of public controversy on occupational health problems: Byssinosis Journal: American Journal of Public Health Author-Name: Bronstein, J.M. Year: 1984 Volume: 74 Issue: 10 Pages: 1133-1137 Abstract: The effect of the byssinosis controversy on surveillance programs in the cotton textile industry is reviewed. The federally regulated format for industry medical surveillance guarantees neither automative reduction of cotton dust exposure for high-rise workers nor wage retention for workers who are transferred to less dusty job sites. The absence of universal guidelines for worker management, combined with doubt over the severity and prevalence of byssinosis, encourages employers to evaluate medical surveillance programs primarily on the basis of their economic impact. When employers use the programs to control their losses, the potential costs of worker participation are increased. Comparisons with medical surveillance programs in the coal industry suggest that health benefits to workers can be guaranteed in the context of disputes over occupational diseases if industry, labor, and government agencies all participate in program design and operation. Handle: RePEc:aph:ajpbhl:1984:74:10:1133-1137_6 Template-Type: ReDIF-Article 1.0 Title: Occurrence and impact of zoonoses in pet dogs and cats at US Air Force bases Journal: American Journal of Public Health Author-Name: Warner, R.D. Year: 1984 Volume: 74 Issue: 11 Pages: 1239-1243 DOI: 10.2105/AJPH.74.11.1239 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1239 Abstract: A descriptive epidemiologic study was conducted to quantitate the occurrence of zoonoses in pet animals (almost exclusively dogs and cats) at 30 Air Force bases in nine regions of the United States during 1980 and 1981. Reviews of reported cases of pet-associated zoonoses in humans at these bases were included. Occurrence of a zoonotic disease in dogs and cats was expressed as a ratio of reported cases per 100 rabies vaccinations (cs/Crv). Overall, the four zoonoses reported most frequently from these pets were hookworms, roundworms, tapeworms, and fleas. Annual ratios revealed geographic variations: for example, hookworms in dogs and cats in the southeast ranged from 12.3 to 9.4 cs/Crv; in the northern Great Plains, hookworms ranged from 0.9 to 0.4 cs/Crv. Dermatomycoses in the southeast ranged from 1.3 to 1.1 cs/Crv, and in Alaska from 0.3 to 0.2 cs/Crv. Quarterly zoonoses occurrence revealed seasonal variations in several regions. Reports of zoonoses in people from these bases indicated that five less frequent zoonoses in dogs and cats (Microsporum chain dermatomycosis, fleas, Sarcoptes scabiei var canis, Gram-positive bacterial infections, and rabies) presented greater acute threats to humans than did the four most frequent zoonoses reported from their pets. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1239_2 Template-Type: ReDIF-Article 1.0 Title: Increase in relevant data after introduction of a problem-oriented record system in primary pediatric care Journal: American Journal of Public Health Author-Name: Margolis, C.Z. Author-Name: Mendelssohn, I. Author-Name: Barak, N. Author-Name: Beinart, T. Author-Name: Goldsmith, J.R. Year: 1984 Volume: 74 Issue: 12 Pages: 1410-1412 DOI: 10.2105/AJPH.74.12.1410 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1410 Abstract: We determined the effect of the problem list and standard data base components of the problem-oriented record (POR) on kibbutz clinic care. We compared quantity and type of data collected and number of problems identified before and after POR implementation at an experimental clinic with the same variables measured at a similar clinic. Family history, prenatal, natal, nutritional, immunization, environment, review of systems, psychosocial and total data collected, as well as number of chronic problems identified, increased significantly after POR implementation. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1410_0 Template-Type: ReDIF-Article 1.0 Title: Health services, health manpower, and universities in relation to health for all: An historical and future perspective Journal: American Journal of Public Health Author-Name: Bryant, J.H. Year: 1984 Volume: 74 Issue: 7 Pages: 714-719 Abstract: The World Health Organization's goal of Health for All by the Year 2000 (HFA) has become a major force in national and international health policies. This paper deals with some of the historical roots of HFA and describes ways in which the major components of the health sector - health services, manpower, and universities - have evolved and should evolve in the future if they are to support the idea of HFA. One conclusion is that the changes called for in relation to HFA are not simply incremental extensions of previous values, structures, and functions. Rather a radical break with the past is often required. To expect otherwise is to misunderstand how fundamentally the concepts of HFA differ from values that have governed the health sector in the past. A second conclusion is that recent decades have seen a remarkable progression of new ideas and changes in the health sector, so much so that the changes called for by HFA are not so improbable as one might otherwise think. Handle: RePEc:aph:ajpbhl:1984:74:7:714-719_3 Template-Type: ReDIF-Article 1.0 Title: Trends in childhood disability Journal: American Journal of Public Health Author-Name: Newacheck, P.W. Author-Name: Budetti, P.P. Author-Name: McManus, P. Year: 1984 Volume: 74 Issue: 3 Pages: 232-236 Abstract: This article summarizes and analyzes possible explanations for the near doubling, since 1960, of the proportion of children with limitations of activity due to chronic illness as reported in the National health Interview Survey (NHIS). We examine several possible explanations for the upward trend in prevalence including: changes in survey design and procedures; changes in awareness of chronic illness on the part of parents and physicians; and changes in the institutionalized population of disabled children. Our analysis indicates that only a small part of the trend can be explained directly by these factors. Further examination of the NHIS data reveals that the types of limitations of activities now reported are less likely to cause frequent confinement in bed; whether this indicates lesser severity or principally different types of chronic conditions is as yet unclear. Handle: RePEc:aph:ajpbhl:1984:74:3:232-236_4 Template-Type: ReDIF-Article 1.0 Title: District nusing: The cost benefits of a population-based practice Journal: American Journal of Public Health Author-Name: Dreher, M. Year: 1984 Volume: 74 Issue: 10 Pages: 1107-1111 Abstract: This paper presents some serendipitous findings from an ethnohistorical study of of public health nursing in rural New England. In the course of that study, a model of population-based nursing revealed itself that some would condemn as antiquated; it may, however, hold great possibilities for addressing the nation's current and future health problems, particularly health maintenance of the elderly and care of the chronically ill. In keeping with the criteria used to evaluate primary health care, the model is examined for the extent to which it is accessible, available, accountable, acceptable, comprehensive, coordinated, and cost-effective. The policy implications of this model for the organization and financing of community health care are explored. Handle: RePEc:aph:ajpbhl:1984:74:10:1107-1111_0 Template-Type: ReDIF-Article 1.0 Title: The role of skin absorption as a route of exposure for volatile organic compounds (VOCs) in drinking water Journal: American Journal of Public Health Author-Name: Brown, H.S. Author-Name: Bishop, D.R. Author-Name: Rowan, C.A. Year: 1984 Volume: 74 Issue: 5 Pages: 479-484 Abstract: Assessments of drinking water safety rely on the assumption that ingestion represents the principal route of exposure. A review of the experimental literature revealed that skin penetration rates for solvents are remarkably high, and that the stratum corneum is a less effective barrier to penetration than traditionally assumed. Based on published skin absorption rates, we used Fick's law (J(s)(o) = K(p)(o) Δ C(s)(o)) to determine permeability constants for selected compounds. We then calculated dose per kilogram for nine different exposure situations and compared this to the oral dose per kilogram. We found that skin absorption contributed from 29-91 per cent of the total dose, averaging 64 per cent. Dose per kilogram body weight ranged from .0002 mg/kg-.18 mg/kg, with an average of .03 mg/kg. In weak aqueous solutions, flux of the solute is directly proportional to concentration. Laboratory approaches differ markedly from environmental exposures and can underestimate absorption. We conclude that skin absorption of contaminants in drinking water has been underestimated and that ingestion may not constitute the sole or even primary route of exposure. Handle: RePEc:aph:ajpbhl:1984:74:5:479-484_9 Template-Type: ReDIF-Article 1.0 Title: Blood pressure in a population of diabetic persons diagnosed after 30 years of age Journal: American Journal of Public Health Author-Name: Klein, B.E.K. Author-Name: Klein, R. Author-Name: Moss, S.E. Year: 1984 Volume: 74 Issue: 4 Pages: 336-339 Abstract: Blood pressure levels were investigated in a population of diabetic persons who were diagnosed at 30 years of age or older and who received their primary medical care in an 11-county areas in Southern Wisconsin. Prevalence of hypertension in these 5,104 persons was compared with prevalence figures from the Health and Nutrition Examination Survey (HANES) population. Diabetic women had a higher prevalence of hypertension until 65 years of age than did women of similar ages in HANES. The diabetic males had a prevalence of hypertension similar to that of male HANES participants. Mean systolic blood pressures tended to be slightly higher in persons with 'poorest' level of glucose control compared to those whose blood glucose was 'best' controlled. Persons for whom diuretic agents had been prescribed were as likely to have blood glucose values in the 'poorest' levels of control as persons not using diuretics. Handle: RePEc:aph:ajpbhl:1984:74:4:336-339_9 Template-Type: ReDIF-Article 1.0 Title: Evaluation of hospital care in one trauma care system Journal: American Journal of Public Health Author-Name: Spain, D.M. Author-Name: Fox, R.I. Author-Name: Marcus, A. Year: 1984 Volume: 74 Issue: 10 Pages: 1122-1125 Abstract: To evaluate the effectiveness of the trauma care system in the Hudson Valley Emergency Medical Services (EMS) Region, (with no designated regional trauma care center) 421 consecutive trauma autopsy reports for 1979-80 were analyzed. Of the 421 trauma patients, 194 died at the scene (DAS), most from vehicular accidents. The remaining 227 patients were triaged into the EMS system. Ninety-five were dead on arrival (DOA) at medical facilities; of 132 (31 per cent) who arrived alive at hospitals, 35 died in emergency rooms and 97 died later as inpatients. Nearly 60 per cent of the deaths involved brain injuries. A panel of five physician-evaluators examined the pathologist's analysis of those deaths considered to have been possibly preventable and concluded that 10 deaths (7.6 per cent) of in-hospital cases were preventable. The study showed the need for primary prevention of accidents to decrease the number of victims (46 per cent) who died at the scene and those (23 per cent) who were dead on arrival at hospitals. Handle: RePEc:aph:ajpbhl:1984:74:10:1122-1125_9 Template-Type: ReDIF-Article 1.0 Title: Evaluation of the effects of the North Carolina improved pregnancy outcome project: Implications for state-level decision-making Journal: American Journal of Public Health Author-Name: Peoles, M.D. Author-Name: Grimson, R.C. Author-Name: Lacy Daughtry, G. Year: 1984 Volume: 74 Issue: 6 Pages: 547-554 Abstract: This study was designed to assess the effects of the North Carolina Improved Pregnancy Outcome (IPO) Project on use of prenatal care and incidence of low birthweight among its primarily Black registrants. Weighted least squares and stratified analysis procedures were used to scrutinize vital statistics data for subpopulation effects. IPO services were received by 51.7 per cent of Black women in the counties served by the project. For all Black registrants, the risk of receiving less than adequate prenatal care was 55.1 per cent of that of the comparison group. For Black teenage registrants, the risk was even less: 37.2 per cent of that of the comparison groups. Nevertheless, no corresponding effects on the incidence of low birthweight could be detected. The evaluation methods used in this study can be applied to programs for mothers and infants in other locales to generate useful and practical information for state-level decision-making. Handle: RePEc:aph:ajpbhl:1984:74:6:547-554_5 Template-Type: ReDIF-Article 1.0 Title: Yields of tar, nicotine, and carbon monoxide in the sidestream smoke from 15 brands of Canadian cigarettes Journal: American Journal of Public Health Author-Name: Rickert, W.S. Author-Name: Robinson, J.C. Author-Name: Collishaw, N. Year: 1984 Volume: 74 Issue: 3 Pages: 228-231 Abstract: Sidestream smoke yields for 15 brands of cigarettes were determined under conditions where mainstream yields were approximately equal to those used for determining the values which appear on packages of Canadian cigarettes. Sidestream yields of tar, nicotine, and carbon monoxide were much higher than mainstream yields for all brands tested. The average sidestream-to-mainstream ratios for the 15 brands were 3.5, 6.6, and 6.8 for tar, nicotine, and carbon monoxide, respectively. The highest yields of sidestream were obtained from the brands with the lowest mainstream yields. Handle: RePEc:aph:ajpbhl:1984:74:3:228-231_9 Template-Type: ReDIF-Article 1.0 Title: Hepatitis B exposure incidents in community hospitals Journal: American Journal of Public Health Author-Name: Dandoy, S.E. Author-Name: Kirkman-Liff, B.L. Author-Name: Krakowski, F.M. Year: 1984 Volume: 74 Issue: 8 Pages: 804-807 Abstract: To determine the frequency and distribution of potential hepatitis B exposure incidents among employees of community hospitals, a two-year retrospective study and a one-year prospective study were undertaken in Arizona hospitals. The annual rate of exposure incidents was, respectively, 7.9 and 7.7 per 100 employees; 78 per cent of the incidents were needle punctures. The rate of incidents increased significantly with the size of the hospital and decreased in older employees. While the highest risks of incidents were in phlebotomists, surgical technicians, and laboratory technicians, 14 per cent of all exposures occurred in housekeepers and central supply workers. Only 45 per cent of incidents were reported from employees who would normally expect to be targeted to receive hepatitis B vaccine. The post-exposure use of immune globulins (IG and HBIG) increased from 9 per cent of exposures in the retrospective study to 16 per cent during the prospective study. Exposure incidents occurred at the same rates and in the same occupational groups in community hospitals as previously reported from teaching hospitals and medical centers. Handle: RePEc:aph:ajpbhl:1984:74:8:804-807_8 Template-Type: ReDIF-Article 1.0 Title: Consumer demand for patient-oriented pharmacy services Journal: American Journal of Public Health Author-Name: Carroll, N.V. Author-Name: Gagnon, J.P. Year: 1984 Volume: 74 Issue: 6 Pages: 609-611 Abstract: The purpose of this study was to investigate the extent of consumer demand for patient-oriented pharmacy services. Data, collected via a self-administered questionnaire distributed to 300 households, were analyzed using Kruskal's program for additive conjoint analysis. The results indicate substantial consumer demand for making advisory services available on request, moderate demand for provision of patient medication records, and little demand for voluntary provision of advisory services. Handle: RePEc:aph:ajpbhl:1984:74:6:609-611_5 Template-Type: ReDIF-Article 1.0 Title: Maternal age and overdue conceptions Journal: American Journal of Public Health Author-Name: Hendershot, G.E. Year: 1984 Volume: 74 Issue: 1 Pages: 35-38 Abstract: Data from the National Survey of Family Growth, Cycles I and II, are used to describe the level and trend in the incidence of births resulting from pregnancies which began later than desired. Overdue births were about 12 per cent of the total in 1973-75, and the trend was upward, especially among mothers over 25. Pregnancies 12 months or more overdue were more common among mothers over 30 than younger mothers. Analysis of waiting times to conception among women who scheduled intercourse for the monthly fertile period suggests that a decline in fecundity after age 30 may be a factor in overdue births. Handle: RePEc:aph:ajpbhl:1984:74:1:35-38_8 Template-Type: ReDIF-Article 1.0 Title: Geographic patterns of ethnic groups in the United States Journal: American Journal of Public Health Author-Name: Morin, M.M. Author-Name: Williams Pickle, L. Author-Name: Mason, T.J. Year: 1984 Volume: 74 Issue: 2 Pages: 133-139 Abstract: The geographic distributions of 11 major ethnic groups within the United States, based on 1960 census data, are illustrated by computer-generated state economic area maps. The Scandinavian, German, and Russian ethnic groups were similarly concentrated primarily in the North Central region, while the Irish, Polish, Other East European, and South European groups were clustered predominantly in the Northeast. Other ethnic groups had patterns which were different from either of the above. These maps correspond to the atlases of mortality from cancer and other diseases. Handle: RePEc:aph:ajpbhl:1984:74:2:133-139_6 Template-Type: ReDIF-Article 1.0 Title: An evaluation of subsidized rural primary care programs: III. Stress and survival, 1981-82 Journal: American Journal of Public Health Author-Name: Ricketts, T.C. Author-Name: Guild, P.A. Author-Name: Sheps, C.G. Author-Name: Wagner, E.H. Year: 1984 Volume: 74 Issue: 8 Pages: 816-819 Abstract: Surveys of a national sample of 193 subsidized rural primary care programs were conducted in 1981 and 1982 to determine what adaptations the programs might anticipate making given a reduction in their subsidy and what actual changes they made after the implementation of new federal policies and in the face of severe economic recession. During the period between the two surveys, nine of the 193 programs closed. The remaining programs changed elements of their operation, finances, and staffing, but these changes do not, in all cases, appear to be a direct response to subsidy reductions or increases. The programs exhibited adaptiveness and strength in the face of a potentially hostile environment. Handle: RePEc:aph:ajpbhl:1984:74:8:816-819_2 Template-Type: ReDIF-Article 1.0 Title: Fulfillment of patient requests in a general medicine clinic Journal: American Journal of Public Health Author-Name: Uhlmann, R.F. Author-Name: Carter, W.B. Author-Name: Inui, T.S. Year: 1984 Volume: 74 Issue: 3 Pages: 257-258 Abstract: For initial visits to a longitudinal-care internal medicine clinic, we elicited patients' requests for problems to be addressed, measured patients' assessments of request fulfillment, and determined correlates of request fulfillment. Patients rated all requests as fulfilled in 62 of 71 cases (87 per cent). Fewer pre-encounter patient-reported problems, discretionary features of the doctor-patient encounter including more time spent eliciting history of present illness, and greater completeness of laboratory testing were associated with request fulfillment. Handle: RePEc:aph:ajpbhl:1984:74:3:257-258_2 Template-Type: ReDIF-Article 1.0 Title: Effects of parental smoking on medical care utilization by children Journal: American Journal of Public Health Author-Name: Vogt, T.M. Year: 1984 Volume: 74 Issue: 1 Pages: 30-34 Abstract: A household interview survey of 2,582 adult members of the Kaiser-Permanente Medical Care Program of Oregan conducted in 1970-71 contained detailed questions about cigarette smoking patterns. Detailed, computerized medical records were maintained for all inpatient and outpatient care rendered between 1967 and 1974 to the 1,761 children of the interviewed sample. Adjusted for age, family size, socioeconomic status, and duration of Health Plan membership, children in non-smoking households used significantly more outpatient services that did children in smoking households, a relationship largely accounted for by their use of more preventive medical services than by children in smoking households. There were no significant differences in inpatient medical care use and outpatient care use for respiratory illness by children of smoking and non-smoking households. Handle: RePEc:aph:ajpbhl:1984:74:1:30-34_9 Template-Type: ReDIF-Article 1.0 Title: The effectiveness of automobile safety regulation: Evidence from the FARS data Journal: American Journal of Public Health Author-Name: Orr, L.D. Year: 1984 Volume: 74 Issue: 12 Pages: 1384-1389 DOI: 10.2105/AJPH.74.12.1384 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1384 Abstract: In a paper published in the August 1981 issue of this Journal, Leon Robertson attempts to measure the effects of the vehicle safety and occupant protection standards implemented in the 1960s. Data from the Fatal Accident Reporting System are used. Additional statistical analysis with these data reveals a multicollinearity problem that makes the prediction of the effects of regulation uncertain. There is also bias in regression results due to the inappropriate inclusion of truck data in the regressions. Regressions on the car data reveal a lifesaving effect of regulation that, at best, is one-fourth the value reported by Robertson. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1384_2 Template-Type: ReDIF-Article 1.0 Title: Women's drinking and drinking problems: Patterns from a 1981 national survey Journal: American Journal of Public Health Author-Name: Wilsnack, R.W. Author-Name: Wilsnack, S.C. Author-Name: Klassen, A.D. Year: 1984 Volume: 74 Issue: 11 Pages: 1231-1238 DOI: 10.2105/AJPH.74.11.1231 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1231 Abstract: A 1981 national survey of women's drinking interviewed 917 women in the general population, stratified on the basis of screening interviews to include 500 moderate-to-heavy drinkers. The survey found no evidence of any major recent increase in women's drinking, and no evidence of unusually heavy drinking among working wives. Adverse drinking consequences and episodes of extreme drinking were most common among women aged 21-34; women who were unmarried, divorced or separated, or cohabiting; and women with frequent drinkers as spouses or companions. Alcohol-related behavior problems and symptoms of alcohol dependence were closely related to levels of alcohol consumption. Among women averaging one ounce or more of ethanol per day, 45 per cent had driven while intoxicated in the past year, and 36 per cent reported memory lapses while drinking. Women at this consumption level were also more likely to report experiences with depression (61 per cent). Women with extremely high consumption levels were more likely to have histories of obstetrical and gynecological problems. Some women with alcohol-related problems reported periods of temporary abstention, a pattern not studied heretofore. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1231_2 Template-Type: ReDIF-Article 1.0 Title: Nosocomial rabies: Investigations of contacts of human rabies cases associated with a corneal transplant Journal: American Journal of Public Health Author-Name: Anderson, L.J. Author-Name: Williams Jr., L.P. Author-Name: Layde, J.B. Year: 1984 Volume: 74 Issue: 4 Pages: 370-372 Abstract: In October 1978 in Boise, Idaho, a woman died of rabies after receiving a corneal transplant from a man, who in retrospect was also found to have died of rabies. Investigation of 203 contacts of these two patients identified 94 who were felt to have had sufficient risk of exposure to justify being given rabies post-exposure prophylaxis. Nurses, physicians, respiratory therapists, and family members were at greatest risk. We discuss the problems encountered in determining risk of exposure for contacts of humans with rabies. Handle: RePEc:aph:ajpbhl:1984:74:4:370-372_9 Template-Type: ReDIF-Article 1.0 Title: Water supply and health in developing countries: Selective primary health care revisited Journal: American Journal of Public Health Author-Name: Briscoe, J. Year: 1984 Volume: 74 Issue: 9 Pages: 1009-1013 Abstract: The inclusion of water supply and sanitation programs as a component of primary health care (PHC) has been questioned on the basis of calculations of the costs of these programs per infant death averted. In this paper the procedures used in these cost-effectiveness calculations are examined and found to be wanting. The calculations are misleading since gross rather than net costs have been used, and the health impact of these programs underestimated. It is also shown that the methodology used is biased against water supply and sanitation and other programs with multiple outputs. The time constraints facing mothers in implementing PHC programs, as well as the contribution of improved water supplies in alleviating these constraints are outlined. Data are presented to show that, if poor women in developing countries were to choose the mix of activities to be included in PHC programs, improved water supplies would frequently constitute part of that mix. Handle: RePEc:aph:ajpbhl:1984:74:9:1009-1013_9 Template-Type: ReDIF-Article 1.0 Title: WIC participation and preganancy outcomes: Masschusetts statewide evaluation project Journal: American Journal of Public Health Author-Name: Kotelchuck, M. Author-Name: Schwartz, J.B. Author-Name: Anderka, M.T. Author-Name: Finison, K.S. Year: 1984 Volume: 74 Issue: 10 Pages: 1086-1092 Abstract: The effects of WIC prenatal participation were examined using data from the Massachusetts Birth and Death Registry. The birth outcomes of 4,126 pregnant women who participated in the WIC program and gave birth in 1978 were compared to those of 4,126 women individually matched on maternal age, race, parity, education, and marital status who did not participate in WIC. WIC prenatal participants are at greater diagnostic risk for poor pregnancy outcomes compared to all women in the same community. WIC participation is associated with improved pregnancy outcomes, including, a decrease in low birthweight (LBW) incidence (6.9 per cent vs 8.7 per cent) and neonatal mortality (12 vs 35 deaths), an increase in gestational age (40.0 vs 39.7 weeks), and a reduction in adequate prenatal care (3.8 per cent vs 7.0 per cent). Stratification by demographic subpopulations indicates that subpopulations at higher risk (teenage, unmarried, and Hispanic origin women) have more enhanced pregnancy outcomes associated with WIC participation. Stratification by duration of participation indicates that increased participation is associated with enhanced pregnancy outcomes. While these findings suggest that birth outcome differences are a function of WIC participation, other factors which might distinguish between the two groups could also serve as the basis for alternative explanations. Handle: RePEc:aph:ajpbhl:1984:74:10:1086-1092_1 Template-Type: ReDIF-Article 1.0 Title: The incidence of injuries among 87,000 Massachusetts children and adolescents: Results of the 1980-81 statewide childhood injury prevention program surveillance system Journal: American Journal of Public Health Author-Name: Gallagher, S.S. Author-Name: Finison, K. Author-Name: Guyer, B. Author-Name: Goodenough, S. Year: 1984 Volume: 74 Issue: 12 Pages: 1340-1347 DOI: 10.2105/AJPH.74.12.1340 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1340 Abstract: This study describes the incidence of fatal and nonfatal injuries occurring in 87,022 Massachusetts children and adolescents during a one-year period. A surveillance system for injuries at 23 hospitals captured 93 per cent of all discharges for ages 0-19 in the 14 communities under study. Sample data were collected on emergency room visits, hospital admissions, and deaths for all but a few causes of unintentional injuries. The overall incidence was 2.239 per 10,000. The true incidence rates are probably higher than those reported. The ratio of emergency room visits to admission to death was 1,300 to 45 to 1. Injury rates varied considerably by age, sex, cause, and level of severity. Age-specific injury rates were lowest for infants and elementary school age children and highest for toddlers and adolescents. The overall ratio of male to female injury rates was 1.66 to 1. Injuries from falls, sports, and cutting and piercing instruments had a high incidence and low severity. Injuries from motor vehicles, burns, and drownings had lower incidence, but greater severity. Results provide evidence that both morbidity and mortality must be considered when determining priorities for injury prevention. Current prevention efforts must be expanded to target injuries of higher incidence and within the adolescent population. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1340_2 Template-Type: ReDIF-Article 1.0 Title: Personal health practices and mortality among the elderly Journal: American Journal of Public Health Author-Name: Branch, L.G. Author-Name: Jette, A.M. Year: 1984 Volume: 74 Issue: 10 Pages: 1126-1129 Abstract: Research on young and middle-aged adults had demonstrated a correlation between certain personal health practices and reduced mortality. This investigation examines the generalizability of these findings to elders who have survived into their seventh and eighth decades. Using data from the Massachusetts Health Care Panel Study, we examined the association of physical activity, cigarette smoking, hours of sleep, alcohol consumption, and number of meals with five-year mortality rates. For elderly women, never having smoked cigarettes is the only personal health practice that achieves a statistically significant multivariate relationship with lower mortality. None of the personal health practices are related significantly to mortality among elderly men. Handle: RePEc:aph:ajpbhl:1984:74:10:1126-1129_7 Template-Type: ReDIF-Article 1.0 Title: Post-cesarean section insertion of intrauterine devices Journal: American Journal of Public Health Author-Name: Chi, I.-C. Author-Name: Su-Wen, Z. Author-Name: Balogh, S. Author-Name: Ng, K. Year: 1984 Volume: 74 Issue: 11 Pages: 1281-1282 DOI: 10.2105/AJPH.74.11.1281 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1281 Abstract: Among 52 women who delivered by cesarean section in a medical center in Beijing, China and had either a Delta Loop or Delta T intrauterine device (IUD) inserted manually through the incision wound, the expulsion rates were significantly lower than among a comparable group of 147 women who both delivered and had the IUD inserted vaginally (4.1 versus 20.5 per 100 women at six months post-insertion). Since the cesarean delivery rate is increasing worldwide, we deem this preliminary finding important for postpartum contraception programs and urge further studies. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1281_6 Template-Type: ReDIF-Article 1.0 Title: Campylobacter enteritis associated with undercooked barbecued chicken Journal: American Journal of Public Health Author-Name: Istre, G.R. Author-Name: Blaser, M.J. Author-Name: Shillam, P. Author-Name: Hopkins, R.S. Year: 1984 Volume: 74 Issue: 11 Pages: 1265-1267 DOI: 10.2105/AJPH.74.11.1265 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1265 Abstract: An outbreak of Campylobacter enteritis occurred in 1982 among 11 of 15 members and friends of an extended family gathering in Colorado. Median onset for illness, characterized by diarrhea, abdominal cramps, fever and headache, was four days after the party. Illness was associated with eating undercooked chicken. Two ill persons had stool specimens positive for C. jejuni. Eight of ten ill persons tested had Immunoglobulin-M-specific indirect fluorescent antibody (IFA) titers to C. jejuni ≥ 32. IFA titers to C. jejuni peaked within three weeks of exposure and decreased to control levels within three months after exposure. Inadequate cooking of poultry may increase the risk of these infections. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1265_7 Template-Type: ReDIF-Article 1.0 Title: Tubal sterilization in women 15-24 years of age: Demographic trends in the United States, 1970-1980 Journal: American Journal of Public Health Author-Name: Lee, N.C. Author-Name: Dicker, R.C. Author-Name: Hughes, J.M. Author-Name: Duarte-Franco, E.F. Author-Name: Layde, P.M. Year: 1984 Volume: 74 Issue: 12 Pages: 1363-1366 DOI: 10.2105/AJPH.74.12.1363 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1363 Abstract: Between 1970-1980, approximately 942,000 women 15-24 years of age underwent tubal sterilization in the United States. These women represented about 17 per cent of all women ages 15-44 years who underwent tubal sterilization in the United States during this 11-year period. During 1970-1980, sterilization rates rose steadily from three per 1,000 to 11 per 1,000 for women in the 20- to 24-year age group, but remained stable at less than one per 1,000 for women in the 15- to 19-year age group. For each year, rates for Black women were greater than those for White women. Sterilization rates increased over the time period for both currently and previously married women, but remained low for never-married women. Most tubal sterilizations were performed after delivery of an infant. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1363_2 Template-Type: ReDIF-Article 1.0 Title: What does hospice cost? Journal: American Journal of Public Health Author-Name: Birnbaum, H.G. Author-Name: Kidder, D. Year: 1984 Volume: 74 Issue: 7 Pages: 689-697 Abstract: This paper presents the preliminary results of the economic analyses of the National Hospice Study (NHS), mandated by the United States Congress to investigate the implications of including hospice services in Medicare. Data were collected over an 18-month period from approximately 4,000 patients receiving hospice and conventional terminal care in 25 hospices and 12 conventional care sites. Subsequent analysis may lead to changes in the specific results, and some of the differences may be due to confounding variables that cannot be adjusted for. According to these data, hospital based (HB) hospice costs per day are 44 per cent higher than home care (HC) hospice costs per day ($95 versus $66, respectively). In addition, per patient hospice costs are 24 per cent more for patients enrolled in HB than in HC hospices ($5,890 versus $4,758, respectively). The proportional difference between HB and HC in cost per patient is smaller than the cost per day difference due to the shorter average HB length of stay, 62.3 days compared to 72.5 days for HC. Regarding the cost savings of hospice compared to conventional care, HC hospice costs are lower than conventional care costs regardless of length of stay. However, HB costs seem lower than conventional care costs only for patients with lengths of stay less than two months. Hospice and conventional care patients appear to differ with respect to predisposition toward intensive health care utilization. When this difference is explored more thoroughly in subsequent analyses, the estimated cost differential between hospice and conventional care may change. Handle: RePEc:aph:ajpbhl:1984:74:7:689-697_9 Template-Type: ReDIF-Article 1.0 Title: Physician-nurse practitioner interaction patterns in primary care practices Journal: American Journal of Public Health Author-Name: Lamb, G.S. Author-Name: Napodano, R.J. Year: 1984 Volume: 74 Issue: 1 Pages: 26-29 Abstract: A new method is presented which describes and measured the problem-solving and collaborative efforts between physicians and nurse pratitioners on primary care teams. Application of the method would allow the relationship between team interaction and outcomes of health care to be studied. The method relates clinical problem-solving between team members to a measure of collaboration. Team interaction data were collected in a two-stage process for the purpose of tool development and refinement. Six nurse practitioner-physician teams practicing in three primary care settings participated. Audiotapes of team interactions were analyzed for initiation of interaction, character of the decision-making process that led to the interaction between providers, and characteristics of the exchange between physician and nurse practitioner. Inter-rater agreement was 0.80 for scoring of the rationale for interaction and 0.70 for collaborative scores. The findings suggest that this method is an uncomplicated clinically relevant means of allowing professionals in primary care practices to examine their own practice patterns. Trends in the data reveal little interaction between practitioners, and minimal physician initiation of exchange on the team. Handle: RePEc:aph:ajpbhl:1984:74:1:26-29_0 Template-Type: ReDIF-Article 1.0 Title: Changing patterns in mental health service coverage within health maintenance organizations Journal: American Journal of Public Health Author-Name: Levin, B.L. Author-Name: Glasser, J.H. Author-Name: Roberts, R.E. Year: 1984 Volume: 74 Issue: 5 Pages: 453-458 Abstract: This 1982 national survey of all operational health maintenance organizations (HMOs) provides information on the current status of mental health services, benefits, costs, and utilization within HMOs, updating and augmenting a 1978 study. Approximately 94 per cent of the responding HMOs offered mental health service coverage; over one-half (54 per cent) offered alcohol and drug abuse service coverage. The present coverage benefits and utilization of mental health services within HMOs continue to reflect greater variability vis-a-vis other health services within HMOs. Over one-half (57 per cent) of the HMOs provided for 30 days of inpatient mental health coverage (per member per year). Three out of four (77 per cent) of the health plans provided for 20 ambulatory visits (per member per year). The mean mental health hospital utilization rate was 32 days (per 1,000 members per year). The mean mental health ambulatory utilization rate was 0.33 encounters (per member per year). Further studies should investigate the combined influence of organization characteristics, mental health service organization characteristics, and service benefits on the costs and utilization of HMO mental health services. Handle: RePEc:aph:ajpbhl:1984:74:5:453-458_7 Template-Type: ReDIF-Article 1.0 Title: Patterns of drug use from adolescence to young adulthood: I. Periods of risk for initiation, continued use, and discontinuation Journal: American Journal of Public Health Author-Name: Kandel, D.B. Author-Name: Logan, J.A. Year: 1984 Volume: 74 Issue: 7 Pages: 660-666 Abstract: Patterns of initiation, continued use, and decline in drug use are described on the basis of detailed drug histories in a longitudinal cohort representative of former New York State adolescents. In this cohort, the period of major risk for initiation to cigarettes, alcohol, and marijuana, is completed for the most part by age 20, and to illicit drugs other than cocaine by age 21. Those who have not experimented with any of these substances by that age are unlikely to do so thereafter. Initiation into prescribed psychoactive drugs occurs at a later age than for the licit and illicit drugs and continues through the age period covered by the survey. A potential maturational trend in marijuana use in this cohort is apparent with a decline beginning approximately at age 22.5 for most usage patterns. The period of highest marijuana and alcohol usage decline beginning at ages 20-21 and contrast sharply with cigarettes which exhibit climbing rates of highest use through the end of the surveillance period (age 25). Overall patterns are similar for men and women, with men initiating all drugs at higher rates than women, except for prescribed psychoactives. Handle: RePEc:aph:ajpbhl:1984:74:7:660-666_0 Template-Type: ReDIF-Article 1.0 Title: Milk fat and gastrointestinal illness Journal: American Journal of Public Health Author-Name: Koopman, J.S. Author-Name: Turkisk, V.J. Author-Name: Monto, A.S. Author-Name: Thompson, F.E. Author-Name: Isaacson, R.E. Year: 1984 Volume: 74 Issue: 12 Pages: 1371-1373 DOI: 10.2105/AJPH.74.12.1371 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1371 Abstract: The population of a pediatric practice was followed prospectively and determinants of acute gastrointestinal illness were evaluated in a nested age-matched case-control study. Children over age one taking low fat milk as their only milk source in the three weeks prior to illness had five times the risk of a doctor's visit for acute gastrointestinal illness as did children taking only whole milk during the same time period. This increased risk could not be explained by numerous potentially confounding variables or potential biases. There was no indication that the increased risk differed for rotavirus positive or rotavirus negative illness, or that it varied by children's age. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1371_3 Template-Type: ReDIF-Article 1.0 Title: The effects of physicians' training and personality on test ordering for ambulatory patients Journal: American Journal of Public Health Author-Name: Epstein, A.M. Author-Name: Begg, C.B. Author-Name: McNeil, B.J. Year: 1984 Volume: 74 Issue: 11 Pages: 1271-1273 DOI: 10.2105/AJPH.74.11.1271 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1271 Abstract: We studied records of 351 hypertensive patients cared for by 30 internists in private office practice. We correlated the use of outpatient diagnostic tests with personal characteristics of the prescribing physicians. Doctors trained in medical schools with academic orientations used more tests than other physicians. Patterns of use were not strongly related to the number of years since medical school graduation, or physicians 'intolerance of ambiguity' as measured by a standard psychological instrument. These findings suggest that certain types of training may predispose physicians to be high testers. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1271_0 Template-Type: ReDIF-Article 1.0 Title: Practice characteristics of male and female physician assistants Journal: American Journal of Public Health Author-Name: Oliver, D.R. Author-Name: Carter, R.D. Author-Name: Conboy, J.E. Year: 1984 Volume: 74 Issue: 12 Pages: 1398-1400 DOI: 10.2105/AJPH.74.12.1398 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1398 Abstract: In a national survey of 3,294 non-military responding physician assistants, sociodemographic and practice characteristics of male and female physician assistants were compared. Differences by specialty, practice setting, size of community, and hours of work were generally similar in nature, but smaller in magnitude, than those reported for physicians, and may not be of practical significance. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1398_1 Template-Type: ReDIF-Article 1.0 Title: Changing patterns of lung cancer among socio-cultural groups in New York City Journal: American Journal of Public Health Author-Name: Rosenwaike, I. Year: 1984 Volume: 74 Issue: 8 Pages: 839-840 Abstract: Mortality statistics for New York City were used to examine lung cancer trends and differentials among Whites in three major religious groups. The percentage of deaths attributed to lung cancer increased among all groups of females and among all categories of males except those under age 45. The relatively low lung cancer levels among Jewish men observed in earlier studies have continued and are consistent with patterns of smoking reported for socio-cultural groups. Mortality from lung cancer among Jewish women was still relatively higher than for other women at some age grops. Handle: RePEc:aph:ajpbhl:1984:74:8:839-840_9 Template-Type: ReDIF-Article 1.0 Title: The young adult chronic psychiatric patient in an era of deinstitutionalization Journal: American Journal of Public Health Author-Name: Bachrach, L.L. Year: 1984 Volume: 74 Issue: 4 Pages: 382-384 Abstract: Assessments of the consequences of deinstitutionalization tend to focus primarily on observable changes in psychiatric services. Equally critical, and less often noted, are changes in the target population of deinstitutionalization that have accrued as the result of new service initiatives and changing loci of care. Young adult chronic psychiatric patients, a newly emerging service entity, throw into bold relief the problems associated with delivering care to a changing patient population. Handle: RePEc:aph:ajpbhl:1984:74:4:382-384_7 Template-Type: ReDIF-Article 1.0 Title: Thermotolerant non-fecal source Klebsiella pneumoniae: Validity of the fecal coliform test in recreational waters Journal: American Journal of Public Health Author-Name: Caplenas, N.R. Author-Name: Kanarek, M.S. Year: 1984 Volume: 74 Issue: 11 Pages: 1273-1275 DOI: 10.2105/AJPH.74.11.1273 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1273 Abstract: Wisconsin pulp and paper mill processing plants were evaluated for fecal coliform and total Klebsiella (i.e., thermotolerant and thermointolerant) bacterial concentrations. Using the standard fecal coliform test, up to 90 per cent of non-fecal source thermotolerant K. pneumoniae was falsely identified as fecal source bacteria. Since there is a lack of specificity in the currently used standard for fecal coliform evaluation, a more reliable health risk assessment for fecal coliform bacteria is recommended. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1273_7 Template-Type: ReDIF-Article 1.0 Title: Making babies without sex: The law and the profits Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1984 Volume: 74 Issue: 12 Pages: 1415-1417 DOI: 10.2105/AJPH.74.12.1415 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1415 Abstract: Action on three levels is warranted: a model state law designed to clearly define the identity of the legal mother and father of all children, including those born to other than their genetic parents, and outlawing the sale of human embryos, should be drafted and enacted; professional organizations, with public participation, should develop and promulgate guidelines for sound clinical practice; and a national body of experts in law, public policy, science, medicine, and ethics should be established to monitor developments in this area and report annually to Congress and the individual states on the desirability of specific regulation and legislation. At all levels, the primary focus should be on protecting the interests of the children, even if their protection sometimes comes at the expense of some infertile couples. This general policy will also protect the integrity of artificial reproduction itself. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1415_3 Template-Type: ReDIF-Article 1.0 Title: Reliability of two measures of life stress among outpatients at a veterans hospital Journal: American Journal of Public Health Author-Name: Bailey, G.A. Author-Name: Koepsell, T.D. Author-Name: Belcher, D.W. Year: 1984 Volume: 74 Issue: 7 Pages: 723-724 Abstract: To measure test-retest reliability, 38 Veterans Administration clinic patients completed a modification of the Sarason Life Experience Survey (LES) twice within several weeks. Summary scores were found to be more reliable than scores on individual questions. Patients attending the Mental Hygiene Clinic responded less reliably than other patients. The 'stress ladder' - a simple summary score measure - was found to be the most reliable measure of all. Handle: RePEc:aph:ajpbhl:1984:74:7:723-724_9 Template-Type: ReDIF-Article 1.0 Title: Longitudinal study of occurrence of diarrheal disease in day care centers Journal: American Journal of Public Health Author-Name: Sullivan, P. Author-Name: Woodward, W.E. Author-Name: Pickering, L.K. Author-Name: DuPont, H.L. Year: 1984 Volume: 74 Issue: 9 Pages: 987-991 Abstract: Sixty day care centers (DCC) randomly selected from 736 licensed child care facilities in Harris County (Houston), Texas were surveyed for the incidence of diarrhea by periodic visits and weekly telephone calls over two years. A total of 2,708 episodes of diarrhea were reported in 3,800 children under 6 years of age, and 84 cases occurred in center staff. Overal incidence was 0.44 episodes/person/year among children and 0.14 among staff. Attack rates among the 60 DCC ranged from none to 3.64 cases/year in each child. The incidence for children under 36 months of age was 17 times higher than for the older group. Characteristics of DCC associated with higher rates of disease among children were the presence of young, non-bowel trained children, staff who both diapered infants and prepared food on a regular basis, DCC for profit management, and DCC whose only guidelines were provided by the State. The socioeconomic burden associated with DCC disease, its transmission, and control is considerable and needs to be further addressed. Handle: RePEc:aph:ajpbhl:1984:74:9:987-991_3 Template-Type: ReDIF-Article 1.0 Title: Science and social policy Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1984 Volume: 74 Issue: 10 Pages: 1148-1149 Handle: RePEc:aph:ajpbhl:1984:74:10:1148-1149_7 Template-Type: ReDIF-Article 1.0 Title: Peer pressure and risk-taking behaviors in children Journal: American Journal of Public Health Author-Name: Lewis, C.E. Author-Name: Lewis, M.A. Year: 1984 Volume: 74 Issue: 6 Pages: 580-584 Abstract: We asked 771 children in grades 5-8 about the dares or challenges they received from other children. A pilot study estabished categories for classification of the actions proposed ('What did they try to get you to do?'); the techniques utilized ('How did they try to get you to do that?'); and children's responses ('What did you say or do?'). Peer pressure was reported most frequently by 8th grade students. About 50 per cent of the dares encouraged problem behaviors that placed the children (or others) at risk for personal injury, or the potential development of habits hazardous to their health. With increasing age, more occurred in the school environment and fewer involved risk of personal injury. Among 7th and 8th graders, more boys were dared to perform acts of violence, and more girls were challenged to be sexually active. Handle: RePEc:aph:ajpbhl:1984:74:6:580-584_2 Template-Type: ReDIF-Article 1.0 Title: An assessment of the incidence of maternal mortality in the United States Journal: American Journal of Public Health Author-Name: Smith, J.C. Author-Name: Hughes, J.M. Author-Name: Pekow, P.S. Author-Name: Rochat, R.W. Year: 1984 Volume: 74 Issue: 8 Pages: 780-783 Abstract: Recent studies in several states have found that the incidence of maternal mortality is higher than traditional vital statistics reports indicate. Since no comprehensive national study has been done to evaluate the completeness of maternal mortality ascertainment through the national vital statistics reporting system, the Centers for Disease Control (CDC) undertook such a study with the assistance of the National Center for Health Statistics and state health departments. The state health departments provided CDC with death certificates for all pregnancy-related deaths occurring during 1974-78. We reviewed and classified these certificates using both International Classification of Diseases, Adapted, Eighth Revision (ICDA-8) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) maternal death codes. We found that the actual incidence of maternal mortality for 1974-78 was approximately 20 per cent and 30 per cent greater than that published in national vital statistics reports using ICDA-8 and ICD-9-CM, respectively. Handle: RePEc:aph:ajpbhl:1984:74:8:780-783_5 Template-Type: ReDIF-Article 1.0 Title: The incidence of treated end stage renal disease in the Eastern United States: 1973-1979 Journal: American Journal of Public Health Author-Name: Sugimoto, T. Author-Name: Rosansky, S.J. Year: 1984 Volume: 74 Issue: 1 Pages: 14-17 Abstract: Incidence rates of treated end stage renal disease (ESRD) by age, sex, race, and reported primary etiology were analyzed for 20 contiguous Eastern States for the period 1973-1979. For white males and females rates have stabilized at 60 and 40 per million person-years, respectively, since 1977. The incidence rates for Blacks (125 per million person-years in males, and 100 in females in 1979), for hypertensive and diabetic nephropathy patients, and for the 65+ age group continue to increase. Higher incidence rates in males were noted for both races during the entire study period. Blacks had twice as high an incidence of treated ESRD as Whites, primarily due to hypertensive and diabetic nephropathy patients (7 and 2.5 times higher, respectively). Handle: RePEc:aph:ajpbhl:1984:74:1:14-17_4 Template-Type: ReDIF-Article 1.0 Title: Some comments on the Massachusetts WIC evaluation Journal: American Journal of Public Health Author-Name: Rush, D. Year: 1984 Volume: 74 Issue: 10 Pages: 1145-1146 Handle: RePEc:aph:ajpbhl:1984:74:10:1145-1146_6 Template-Type: ReDIF-Article 1.0 Title: Waterborne giardiasis at a mountain resort: Evidence for acquired immunity Journal: American Journal of Public Health Author-Name: Istre, G.R. Author-Name: Dunlop, T.S. Author-Name: Gaspard, G.B. Author-Name: Hopkins, R.S. Year: 1984 Volume: 74 Issue: 6 Pages: 602-604 Abstract: In November 1981, an outbreak of waterborne giardiasis occurred at a popular ski resort in Colorado. Stratification of illness by consumption of municipal tap water showed a striking dose-response, with an attack rate of 42 per cent among persons who drank six or more glasses of water per day. Filtered water samples revealed giardia cysts in specimens both before and after treatment, and several deficiencies were found in the water treatment facility. Residents who had lived in the area >2 years had a lower attack rate for illness than short-term residents. Handle: RePEc:aph:ajpbhl:1984:74:6:602-604_2 Template-Type: ReDIF-Article 1.0 Title: The incentive plan: An approach for modification of physician behavior Journal: American Journal of Public Health Author-Name: Sims, P.D. Author-Name: Cabral, D. Author-Name: Daley, W. Author-Name: Alfano, L. Year: 1984 Volume: 74 Issue: 2 Pages: 150-152 Abstract: Blue Shield of Massachusetts undertook a one-year study in 1981 to determine if a group of obstetrician/gynecologists could be motivated to reduce average length of stay (ALOS) for normal deliveries, cesarean sections, hysterectomies. The group decreased ALOS for all three procedures. Additional studies are required to determine what portion of the decrease in ALOS can be attributed to change in physician behavior. Handle: RePEc:aph:ajpbhl:1984:74:2:150-152_7 Template-Type: ReDIF-Article 1.0 Title: Respiratory impairment and symptoms as predictors of early retirement with disability in US underground coal miners Journal: American Journal of Public Health Author-Name: Ames, R.G. Author-Name: Trent, R.B. Year: 1984 Volume: 74 Issue: 8 Pages: 837-838 Abstract: A five-year prospective study of 1,394 United States underground coal miners was undertaken to study the effects of respiratory impairment on the rate of early retirement with disability (ERD). Using a logistic regression analysis, ERD was found to be related to reported persistent phlegm after adjustment was made for other respiratory symptoms, respiratory function measurements, cigarette smoking, and some demographic characteristics. No prediction of ERD occurred for spirometrically determined measures of respiratory function. The data thus give limited support to the hypothesis that early retirement with disability in underground coal miners can be predicted prospectively by measures of respiratory symptoms. Handle: RePEc:aph:ajpbhl:1984:74:8:837-838_7 Template-Type: ReDIF-Article 1.0 Title: Nonoccupational exposures to indoor air pollutants: A survey of state programs and practices Journal: American Journal of Public Health Author-Name: Bernstein, R.S. Author-Name: Falk, H. Author-Name: Turner, D.R. Author-Name: Melius, J.M. Year: 1984 Volume: 74 Issue: 9 Pages: 1020-1023 Abstract: A national survey of health department activities in 1982 revealed that 32 states (63 per cent) had a program or person(s) responsible for evaluating exposures to one or more nonoccupational indoor air pollutants (NIAPs). Only four states (8 per cent) had existing or proposed NIAP exposure standards. Twenty-nine (57 per cent) of the states had a program to evaluate nonoccupational exposures to formaldehyde, but these varied widely. There is a need for coordinated, consistent approaches to defining and controlling emerging environmental public health problems such as indoor air pollution. Handle: RePEc:aph:ajpbhl:1984:74:9:1020-1023_7 Template-Type: ReDIF-Article 1.0 Title: Feeling bad: Exploring sources of distress among pre-adolescent children Journal: American Journal of Public Health Author-Name: Lewis, C.E. Author-Name: Siegel, J.M. Author-Name: Lewis, M.A. Year: 1984 Volume: 74 Issue: 2 Pages: 117-122 Abstract: Previous studies of stress in childhood have used instruments containing items describing events/conditions thought by adults to be stressful for children. In interviews with 5th- and 6th-grade children, we asked them to describe circumstances that would make or had made them feel bad, nervous, or worried. After pretesting this children's list of items, we administered it to 2,480 5th graders. Subjects ranked how bad they would/did feel if each item happened and, also, how often each had occurred. Children also self-rated their mental health status. There were significant associations between children's ratings of mental health and 'Feel Bad' scores. Girls rated most items significantly higher (more bad) than boys. While there were some sex and racial differences in ratings, the rank orders of items by different subgroups were highly correlated. Factor analysis revealed three dimensions, containing items related to: 1) anxieties surrounding conflict with parents; 2) self-image and peer-group relationships; and 3) geographic mobility. Only five or six of the 20 items represent discrete events (changing schools); the rest represent chronic role strains (being left out of a group, being pressured to get good grades). The consequences of these strains are yet to be determined. Handle: RePEc:aph:ajpbhl:1984:74:2:117-122_6 Template-Type: ReDIF-Article 1.0 Title: Can a time-honored model solve the dilemma of public health nursing? Journal: American Journal of Public Health Author-Name: Wilkerson, K.B. Author-Name: Reverby, S. Year: 1984 Volume: 74 Issue: 10 Pages: 1081-1083 Handle: RePEc:aph:ajpbhl:1984:74:10:1081-1083_1 Template-Type: ReDIF-Article 1.0 Title: Perinatal outcomes among Medicaid recipients in California Journal: American Journal of Public Health Author-Name: Norris, F.D. Author-Name: Williams, R.L. Year: 1984 Volume: 74 Issue: 10 Pages: 1112-1117 Abstract: It is important to document the current status of health outcomes among the medically needy so as to establish baselines to gauge the impact of future program changes. We studied the birth characteristics and perinatal outcomes of women covered by Medicaid in California versus those who were not covered in 1968 and in 1978. Our findings show a high degree of equity and a trend of improvement in perinatal mortality among Medicaid beneficiaries. The results suggest that needy women who are not yet covered by public financing may have a greater risk of adverse pregnancy outcomes. It would thus seem prudent to carefully monitor the impact of any future reductions in public health care expenditures. Handle: RePEc:aph:ajpbhl:1984:74:10:1112-1117_0 Template-Type: ReDIF-Article 1.0 Title: Period, age, and cohort effects on substance use among American youth, 1976-82 Journal: American Journal of Public Health Author-Name: O'Malley, P.M. Author-Name: Bachman, J.G. Author-Name: Johnston, L.D. Year: 1984 Volume: 74 Issue: 7 Pages: 682-688 Abstract: Period, age, and cohort effects on substance use are differentiated for American youth 18 to 24 years old during the period from 1976 to 1982. The data are provided by the Monitoring the Future project, an ongoing study which employs a cohort-sequential design. Weighted least squares regression is used to find plausible and parsimonious models to account for the observed variation in 12 different classes of drugs, both licit and illicit. The point is made that there are no definitive ways to differentiate among the types of effects; thus, any interpretation is open to debate. Period effects involving increased use occurred for cocaine, amphetamines, and methaqualone, while decreases occurred for barbiturates, tranquilizers, and psychedelics other than LSD. Marijuana showed a curvilinear period effect, first increasing then decreasing. Effects of age were more complex. There were increases in the year after high school for daily cigarette use, but not for monthly use. Monthly and daily alcohol use increased with age. A measure of heavy drinking showed a curvilinear trend, first increasing and then decreasing. Annual use of cocaine showed an increase between the ages of 18 and 21. Annual use of narcotics other than heroin showed a linear age decrease. Handle: RePEc:aph:ajpbhl:1984:74:7:682-688_4 Template-Type: ReDIF-Article 1.0 Title: Utility of drug leaflets for elderly consumers Journal: American Journal of Public Health Author-Name: Morris, L.A. Author-Name: Olins, N.J. Year: 1984 Volume: 74 Issue: 2 Pages: 157-158 Abstract: A mail survey of 1,650 elderly consumers evaluated prescription drug leaflets for antihypertensives, tranquilizers, and arthritis medicines. Of those who said they received the leaflet, 95 per cent read it, 76 per cent kept it, and 56 per cent discussed it with another person. Respondents taking antihypertensive medicine were more apt to keep the leaflet and say they learned new information from it. Those taking tranquilizers were less likely to say the leaflet made them feel better about using the drug. Handle: RePEc:aph:ajpbhl:1984:74:2:157-158_9 Template-Type: ReDIF-Article 1.0 Title: Fluoride analyses of patient water supplies requested by North Carolina health professionals Journal: American Journal of Public Health Author-Name: Levy, S.M. Author-Name: Bawden, J.W. Author-Name: Bowden, B.S. Author-Name: Rozier, R.G. Year: 1984 Volume: 74 Issue: 12 Pages: 1412-1414 DOI: 10.2105/AJPH.74.12.1412 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1412 Abstract: The frequencies, patterns, and results of 1,900 patient drinking water assays for fluoride content requested in a six-month period by North Carolina health professionals were determined. Twelve per cent of the samples warranted adjustment from the full dosage fluoride supplement. Less than 3 per cent of physicians and 8 per cent of dentists submitted samples. Water supplies should be tested before a systemic fluoride supplement is prescribed. Either few dentists and physicians in North Carolina test water before prescribing supplements or few prescribe them at all. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1412_1 Template-Type: ReDIF-Article 1.0 Title: Self-help smoking cessation and maintenance programs: A comparative study with 12-month follow-up by the American Lung Association Journal: American Journal of Public Health Author-Name: Davis, A.L. Author-Name: Faust, R. Author-Name: Ordentlich, M. Year: 1984 Volume: 74 Issue: 11 Pages: 1212-1217 DOI: 10.2105/AJPH.74.11.1212 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1212 Abstract: One thousand two hundred thirty seven smokers responding to lung association announcements in five geographic areas were randomly assigned to one of four groups and mailed American Lung Association materials: 1) leaflets (L); 2) leflets plus maintenance manual (L + M); 3) cessation manual (C); and 4) cessation and maintenance manuals (C + M). Five telephone interviews over one year achieved a 95 per cent follow-up completion rate. Nonresponders as well as exclusive cigar and pipe users were classified as smokers. Twenty per cent quit initially, with 5 per cent continually abstinent in (C + M) at 12 months vs 2 per cent in (L) (p < .05). Nonsmoking prevalence rates (no tobacco smoking in the past month), on the other hand, gradually increased after six months; at 12 months those with the maintenance component, (L + M) and (C + M), had higher rates (18 per cent) than (L) (12 per cent) or (C) (15 per cent). Leaflets and manual alone were least cost effective. Rising nonsmoking prevalence rates observed in all groups suggest that successful attempts to quit increased over time and that a contributing factor might have been the follow-up method. Although achieving lower quit rates than methods requiring attendance at a course, the self-help intervention has the advantages of greater availability, flexibility, and in some instances lower cost. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1212_6 Template-Type: ReDIF-Article 1.0 Title: The national profile of access to medical care: Where do we stand? Journal: American Journal of Public Health Author-Name: Aday, L.A. Author-Name: Andersen, R.M. Year: 1984 Volume: 74 Issue: 12 Pages: 1331-1339 DOI: 10.2105/AJPH.74.12.1331 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1331 Abstract: This paper presents analyses of recent national survey data on access to medical care. In particular, information on major access indicators and special problems associated with the economic and political climate of the 1980s collected in a 1982 national telephone survey of 6,610 United States adults and children, representing some 4,802 families, is compared with previous national surveys for key population subgroups - by age, place of residence, income, race, insurance coverage, and type of regular source of care. In general, the findings show that favorable progress has been made, but some inequities continue to persist. Some traditionally disadvantaged groups are more likely to have a regular family doctor, private insurance coverage, have been to a doctor, or had certain preventive tests and procedures than was true for them in the past. On the other hand, compared to the more economically and/or socially advantaged groups in 1982, they have still not 'caught up' entirely. There also is evidence that they may be hardest hit by the exacerbation of the financial barriers to care that result from unemployment, inflation, and cutbacks in health program eligibility and benefits that have characterized the decade of the 1980s. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1331_2 Template-Type: ReDIF-Article 1.0 Title: Predicting changes in perceived health status Journal: American Journal of Public Health Author-Name: Goldstein, M.S. Author-Name: Siegel, J.M. Author-Name: Boyer, R. Year: 1984 Volume: 74 Issue: 6 Pages: 611-614 Abstract: Panel data from the Los Angeles Health Survey (N = 903) were used to examine variables associated with changes in perceived health status over a one-year period. Our findings replicate previous research showing that perceived health status is associated with variations in chronic illness, disability, and the utilization of health services. However, we found that neither positive nor negative changes in perceived health status were related to any indicator of health beliefs or practices or physical health status. The data suggest that single item measures of perceived health status may reflect the individual's sense of long-standing chronic illness. Handle: RePEc:aph:ajpbhl:1984:74:6:611-614_0 Template-Type: ReDIF-Article 1.0 Title: Podiatry: Critical issues in the 1980s Journal: American Journal of Public Health Author-Name: Skipper Jr., J.K. Author-Name: Hughes, J.E. Year: 1984 Volume: 74 Issue: 5 Pages: 507-508 Abstract: As part of a larger study on the place of podiatry within the American health care system, this report suggests four critical issues facing podiatry as an independent health profession in the 1980s. The four concerns are: low visibility and credibility, lack of a strong professional self-image, struggle for more liberal hospital priveleges, and the threat of loss of federal financial support. Handle: RePEc:aph:ajpbhl:1984:74:5:507-508_9 Template-Type: ReDIF-Article 1.0 Title: Maternal reproduction and child survival Journal: American Journal of Public Health Author-Name: Gray, R.H. Year: 1984 Volume: 74 Issue: 10 Pages: 1080-1081 Handle: RePEc:aph:ajpbhl:1984:74:10:1080-1081_9 Template-Type: ReDIF-Article 1.0 Title: Are body mass indices interchangeable in measuring obesity-disease associations? Journal: American Journal of Public Health Author-Name: Lee, J. Author-Name: Kolonel, L.N. Year: 1984 Volume: 74 Issue: 4 Pages: 376-377 Abstract: We examined data on body weight and height from 55 male and 26 female lung cancer cases and up to 10 sex-ethnicity-age matched controls per case from a large prospective cohort. All four body mass indices (W/H, W/H2, W/H3 and W/H(P)) were highly correlated. Conditional logistic regression, using each index as the exposure variable, yielded odds ratios for lung cancer with magnitude and dose-response gradient that were somewhat different among the four indices. These results suggest that the body mass indices are not necessarily interchangeable in measuring obesity-disease associations. Handle: RePEc:aph:ajpbhl:1984:74:4:376-377_0 Template-Type: ReDIF-Article 1.0 Title: Occupational health in the People's Republic of China Journal: American Journal of Public Health Author-Name: Christiani, D.C. Year: 1984 Volume: 74 Issue: 1 Pages: 58-64 Abstract: China's drive to modernize its economy will produce new occupational health problems even as it resolves earlier ones. Well aware of this, Chinese occupational health experts are intensifying efforts to improve workers' health and establish a modern occupational health program. Occupational lung disease, occupational cancer, heavy metal poisoning, industrial chemical poisoning, and physical factor-induced diseases (noise and heat) have all been targeted for expanded research which will serve as a basis for standard setting. Hazard control efforts include engineering controls, particularly in new construction, limited use of personal protective equipment, and expansion of environmental and medical monitoring. Worker education and professional activities have been expanded. International exchanges have been initiated and will prove occupational health a promising area of scientific cooperation. Handle: RePEc:aph:ajpbhl:1984:74:1:58-64_4 Template-Type: ReDIF-Article 1.0 Title: The case Baby Jane Doe: Child abuse or unlawful federal intervention? Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1984 Volume: 74 Issue: 7 Pages: 727-729 Handle: RePEc:aph:ajpbhl:1984:74:7:727-729_9 Template-Type: ReDIF-Article 1.0 Title: Assessment of accuracy of the scoliosis school screening examination Journal: American Journal of Public Health Author-Name: Viviani, G.R. Author-Name: Budgell, L. Author-Name: Dok, C. Author-Name: Tugwell, P. Year: 1984 Volume: 74 Issue: 5 Pages: 497-498 Abstract: Fifteen nurses of comparable training examined six children with normal spines, eight with curves between 10° and 20°, and three with curves over 20°. Nurses correctly classified 78 per cent of normal children, 49 per cent of those with curves between 10° and 20°, and 93 per cent of curves over 20°. The accuracy of the nurses' decision to refer or not to refer was determined to be 75 per cent. The sensitivity and specificity values were calculated as 74 per cent and 78 per cent, respectively. Kappa statistics were calculated to assess the agreement greater than chance of the nurse with x-ray evidence. Overall, there was significant agreement (K = 0.49; p < .001). Handle: RePEc:aph:ajpbhl:1984:74:5:497-498_9 Template-Type: ReDIF-Article 1.0 Title: Consensus methods: Characteristics and guidelines for use Journal: American Journal of Public Health Author-Name: Fink, A. Author-Name: Kosecoff, J. Author-Name: Chassin, M. Author-Name: Brook, R.H. Year: 1984 Volume: 74 Issue: 9 Pages: 979-983 Abstract: Consensus methods are being used increasingly to solve problems in medicine and health. Their main purpose is to define levels of agreement on controversial subjects. Advocates suggest that, when properly employed, consensus strategies can create structured environments in which experts are given the best available information, allowing their solutions to problems to be more justifiable and credible than otherwise. This paper surveys the characteristics of several major methods (Delphi, Nominal Group, and models developed by the National Institutes of Health and Glaser) and provides guidelines for those who want to use the techniques. Among the concerns these guidelines address are selecting problems, choosing members for consensus panels, specifying acceptable levels of agreement, properly using empirical data, obtaining professional and political support, and disseminating results. Handle: RePEc:aph:ajpbhl:1984:74:9:979-983_2 Template-Type: ReDIF-Article 1.0 Title: Endemic Campylobacter jejuni infection in Colorado: Identified risk factors Journal: American Journal of Public Health Author-Name: Hopkins, R.S. Author-Name: Olmsted, R. Author-Name: Istre, G.R. Year: 1984 Volume: 74 Issue: 3 Pages: 249-250 Abstract: A study of persons with laboratory-confirmed sporadic Campylobacter jejuni infection and of controls matched for age and sex in Colorado in the summer of 1981 yielded odds ratio estimates significantly greater than 1 for the following risk factors: drinking raw water (10.74), drinking raw milk (6.93), eating undercooked chicken (2.77) and living in a household with a cat (3.21). Handle: RePEc:aph:ajpbhl:1984:74:3:249-250_7 Template-Type: ReDIF-Article 1.0 Title: Small area statistics: Large statistical problems Journal: American Journal of Public Health Author-Name: Diehr, P. Year: 1984 Volume: 74 Issue: 4 Pages: 313-314 Handle: RePEc:aph:ajpbhl:1984:74:4:313-314_2 Template-Type: ReDIF-Article 1.0 Title: Firearms and suicide in the United States Journal: American Journal of Public Health Author-Name: Markush, R.E. Author-Name: Bartolucci, A.A. Year: 1984 Volume: 74 Issue: 2 Pages: 123-127 Abstract: Regional United States suicide rates in the mid 1970s were associated with the household prevalence of all guns and of pistols. The term 'regional' applies to the nine Census divisions of the four US census regions. A literature review suggests that the relation may be etiologic, and that more definitive studies and pilot programs are needed. Arming may be an etiologic factor common both to individual and to national self-destructive behaviors. Handle: RePEc:aph:ajpbhl:1984:74:2:123-127_0 Template-Type: ReDIF-Article 1.0 Title: Maternal depression in an urban pediatric practice: Implications for health care delivery Journal: American Journal of Public Health Author-Name: Orr, S.T. Author-Name: James, S. Year: 1984 Volume: 74 Issue: 4 Pages: 363-365 Abstract: A scale to measure depressive symptomatology was administered to mothers attending an urban pediatric primary care center. Over 50 percent of the female heads of households were Black or low income and depressed. This suggests that the provider of pediatric primary care should recognize depression and make appropriate referrals or intervention, since depressed mothers may have a diminished ability to respond to the emotional needs of their children. Handle: RePEc:aph:ajpbhl:1984:74:4:363-365_2 Template-Type: ReDIF-Article 1.0 Title: Preventive content of adult primary care: Do generalists and subspecialists differ? Journal: American Journal of Public Health Author-Name: Dietrich, A.J. Author-Name: Goldberg, H. Year: 1984 Volume: 74 Issue: 3 Pages: 223-227 Abstract: We compared preventive care performed by 20 generalists and 20 subspecialists practicing in Santa Clara and San Mateo Counties, California, by auditing charts of adult primary care patients for compliance with recommendations of the Canadian Task Force on the Periodic Health Examination. Generalists and subspecialists both provided 49 per cent of recommended preventive services. The two groups did not differ significantly in performance of any individual service. Performance varied widely within both groups. Of many factors explored, only two were associated with more preventive services: provision of a complete physical examination to the patient, and a physician's belief in the importance of a given service. The 'generalist vs. subspecialist' debate assumes that a physician's specialty classification is an important predictor of behavior. For the performance of preventive care, this was not true in our study. Instead, physicians' beliefs and practice habits may be major determinants of the quality of preventive care provided. These exploratory findings needed confirmation in other settings. Handle: RePEc:aph:ajpbhl:1984:74:3:223-227_2 Template-Type: ReDIF-Article 1.0 Title: Prescriptive authority for nurse practitioners: A comparative study of professional attitudes Journal: American Journal of Public Health Author-Name: Bigbee, J.L. Author-Name: Lundin, S. Author-Name: Corbett, J. Author-Name: Collins, J. Year: 1984 Volume: 74 Issue: 2 Pages: 162-163 Abstract: We assessed the attitudes of Wyoming physicians, pharmacists, nurses, and nurse practitioners about granting prescriptive authority to nurse practitioners. Support for the issue was mixed, with physicians expressing the strongest disagreement. All groups supported limitation of authority to a specific drug formulary, collaborative regulation, and mandatory certification and continuing education if prescriptive authority is granted to nurse practitioners. Handle: RePEc:aph:ajpbhl:1984:74:2:162-163_8 Template-Type: ReDIF-Article 1.0 Title: Polybrominated biphenyls and fetal mortality in Michigan Journal: American Journal of Public Health Author-Name: Humble, C.G. Author-Name: Speizer, F.E. Year: 1984 Volume: 74 Issue: 10 Pages: 1130-1132 Abstract: The contamination of the Michigan food supply by polybrominated biphenyls (PBBs) in the mid-1970s appears to have had little or no impact on fetal mortality. Comparison of fetal death rates among residents of Lower Peninsula counties with a high percentage of quarantined farms and among residents of Upper Peninsula counties with no quarantined farms reveals no important differences in rates or trends after the contamination. Since counts of early spontaneous abortions are lacking, a complete assessment of the possible impact on reproductive outcome cannot be made. Handle: RePEc:aph:ajpbhl:1984:74:10:1130-1132_5 Template-Type: ReDIF-Article 1.0 Title: The supreme court and airbags Journal: American Journal of Public Health Author-Name: Christoffel, T. Year: 1984 Volume: 74 Issue: 3 Pages: 269-270 Handle: RePEc:aph:ajpbhl:1984:74:3:269-270_8 Template-Type: ReDIF-Article 1.0 Title: Polychlorinated biphenyls: Influence on birthweight and gestation Journal: American Journal of Public Health Author-Name: Taylor, P.R. Author-Name: Lawrence, C.E. Author-Name: Hwang, H.L. Author-Name: Paulson, A.S. Year: 1984 Volume: 74 Issue: 10 Pages: 1153-1154 Abstract: Fifty-one infants born to women employed at two capacitor manufacturing facilities with a history of high exposure to polychlorinated biphenyls (PCBs) had a mean birthweight of 153 grams less than that of 337 infants born to women who had worked in low-exposure areas (90 per cent confidence interval, -286 to -20 g); mean gestational age was 6.6 days shorter in the high-exposure infants (90 per cent CI, -10.3 to -2.9 days). After adjusting for gestational age, the difference in birthweight was markedly reduced, indicating that the observed reduction in birthweight was due mainly to shortening of gestational age in the high-exposure group. Handle: RePEc:aph:ajpbhl:1984:74:10:1153-1154_9 Template-Type: ReDIF-Article 1.0 Title: Overutilization of the general hospital emergency room for psychiatric referrals in an Israeli hospital Journal: American Journal of Public Health Author-Name: Vigiser, D. Author-Name: Apter, A. Author-Name: Aviram, U. Author-Name: Maoz, B. Year: 1984 Volume: 74 Issue: 1 Pages: 73-75 Abstract: Consecutive referrals numbering 177 to the psychiatrist in an Israeli general hospital emergency room (ER) over a two-month period were evaluated. Only one-third met our criteria of justifiability. When the general practitioner (GP) was the referral source, we considered only 29 per cent of cases justified as compared to 70 per cent of the self-referrals. A combination of poor understanding by the GP of when to refer urgently, efforts by the GP to bypass clinic waiting lists, and lack of alternative community facilities may have accounted for this finding. Handle: RePEc:aph:ajpbhl:1984:74:1:73-75_7 Template-Type: ReDIF-Article 1.0 Title: Using roadblocks to reduce drunk driving: Public health or law and order? Journal: American Journal of Public Health Author-Name: Christoffel, T. Year: 1984 Volume: 74 Issue: 9 Pages: 1028-1030 Handle: RePEc:aph:ajpbhl:1984:74:9:1028-1030_2 Template-Type: ReDIF-Article 1.0 Title: United States health profesionals in international health work Journal: American Journal of Public Health Author-Name: Baker, T.D. Author-Name: Weisman, C. Author-Name: Piwoz, E. Year: 1984 Volume: 74 Issue: 5 Pages: 438-441 Abstract: This article reports results of a survey of 1,257 potential employers of US health professionals overseas, interviews with informants in international health, an analysis of career patterns of a small group of international health workers, and a review of numbers of health professionals trained in schools of public health for international health work. There are approximately 9,000 US health professionals in the international health field. Doctors (1,400), nurses (1,500) and administrators (900) are the largest groups. Church-related agencies (2,200 people), private voluntary agencies (1,700 people), and universities (1,000 people) are the largest employers. Handle: RePEc:aph:ajpbhl:1984:74:5:438-441_4 Template-Type: ReDIF-Article 1.0 Title: Prevalence of Staphylococcus aureus, phage type 29/52/80, in Michigan Journal: American Journal of Public Health Author-Name: Martin, R. Author-Name: Adcock, M.P. Author-Name: Wentworth, B.B. Year: 1984 Volume: 74 Issue: 4 Pages: 366-367 Abstract: Staphylococcus aureus, phage type 29/52/80, caused an outbreak of infections in Michigan over a period of two years and continues to be the most prevalent type seen. Of 3,752 isolates typed in 1980-81, 25 per cent were this phage type, which was strongly associated with methicillin resistance. Using this phage type as an indicator, we could demonstrate the spread of methicillin resistant staphylococci from Detroit metropolitan hospitals to suburban and, to a lesser extent, to hospitals outside the Detroit area. Handle: RePEc:aph:ajpbhl:1984:74:4:366-367_2 Template-Type: ReDIF-Article 1.0 Title: Health department: Enemy or champion of the people? Journal: American Journal of Public Health Author-Name: Harris, D. Year: 1984 Volume: 74 Issue: 5 Pages: 428-430 Handle: RePEc:aph:ajpbhl:1984:74:5:428-430_4 Template-Type: ReDIF-Article 1.0 Title: Social policy implications of physician shortage areas in Missouri Journal: American Journal of Public Health Author-Name: Hicks, L.L. Year: 1984 Volume: 74 Issue: 12 Pages: 1316-1321 DOI: 10.2105/AJPH.74.12.1316 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1316 Abstract: A model is used to identify counties in Missouri in which the supply of physician services is inadequate to serve the resident population. In the model, a formula is used to assess the gap between the physician services available in a county and the visits which would be required to serve the residents. Incorporated in the model are adjustments for the age and specialty of the physicians and the age and sex of the population. The model is applied to 1976 and 1981 data in order to analyze the changes which have occurred within the state during that time. The results show that in spite of a 34 per cent increase in the number of physicians practicing in Missouri between 1976 and 1981, 24 of the 115 counties in the state experienced a decrease in their ability to serve their resident population adequately. Of these 24 counties, 23 had populations of less than 25,000 and 12 had populations of less than 10,000. A factor magnifying the underservice problem is the sharp increase in the proportion of older physicians located in small, rural counties. In 1981, 47 per cent of the primary care physicians located in counties with less than 10,000 people were aged 60 and over, compared to 34 per cent in 1976. This portends major problems in the future in obtaining replacements. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1316_2 Template-Type: ReDIF-Article 1.0 Title: Patients' therapeutic preferences in an ambulatory care setting Journal: American Journal of Public Health Author-Name: Povar, G.J. Author-Name: Mantell, M. Author-Name: Morris, L.A. Year: 1984 Volume: 74 Issue: 12 Pages: 1395-1397 DOI: 10.2105/AJPH.74.12.1395 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1395 Abstract: One thousand two hundred-fifteen adult outpatients of an urban health maintenance organization completed questionnaires containing four hypothetical clinical situations. Of these patients, 72 per cent preferred a non-drug 'home remedy' when given a choice among that and two different drug options. Risk aversion and willingness to accept current discomfort were stronger than demographic variables in predicting this preference. We conclude that patients informed about the risks and benefits of drug and non-drug therapies will prefer the latter if that option is offered. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1395_5 Template-Type: ReDIF-Article 1.0 Title: Mental health needs associated with Tourette Syndrome Journal: American Journal of Public Health Author-Name: Stefl, M.E. Year: 1984 Volume: 74 Issue: 12 Pages: 1310-1313 DOI: 10.2105/AJPH.74.12.1310 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1310 Abstract: Tourette Syndrome (TS) is an uncommon development disability characterized by repetitive and involuntary verbal and motor tics. A survey of all known affiliates of the Tourette Syndrome Association of Ohio was conducted. A total of 431 questionnaires was returned, and behavioral problems were found to be pervasive in Tourette people. Some 53.1 per cent of the sample had sought some form of counseling for these problems, but this counseling was generally not perceived as being very helpful. Medication was not reported to ameliorate behavioral problems. When compared to a normal population sample, self-ratings of mental health status were low among Tourette persons. Problems experienced by TS persons were aggregated into a Behavioral Problem Scale, which successfully discriminated between levels of need in TS persons. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1310_2 Template-Type: ReDIF-Article 1.0 Title: The baby doe regulations: Governmental intervention in neonatal rescue medicine Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1984 Volume: 74 Issue: 6 Pages: 618-620 Abstract: This first of three articles on federal regulation involving the treatment of handicapped newborns focuses on the two versions of Department of Health and Human Services rules issued in March and July 1983 and known as the "Baby Doe" regulations. Annas reviews events leading up to the first set of rules; the resulting suit by the American Academy of Pediatrics and others; the differences between the original and reissued regulations; and the recommendation that hospitals establish Infant Care Review Committees. He concludes that the regulations have not adequately dealt with the controversial issue of government intervention in difficult treatment decisions. Handle: RePEc:aph:ajpbhl:1984:74:6:618-620_4 Template-Type: ReDIF-Article 1.0 Title: End stage renal disease: How many, how much? Journal: American Journal of Public Health Author-Name: Berg, R.L. Author-Name: Ornt, D.B. Year: 1984 Volume: 74 Issue: 1 Pages: 4-5 Handle: RePEc:aph:ajpbhl:1984:74:1:4-5_4 Template-Type: ReDIF-Article 1.0 Title: Education, consent, and counseling in sickle cell screening programs: Report of a survey Journal: American Journal of Public Health Author-Name: Farfel, M.R. Author-Name: Holtzman, N.A. Year: 1984 Volume: 74 Issue: 4 Pages: 373-375 Abstract: In 1980, we surveyed screening facilities to determine the extent of sickle cell screening and to assess compliance with Maryland regulations. Approximately 52,000 persons were screened per year in Maryland by local health departments, hospitals, primary care centers, correctional facilities, and units dedicated entirely to screening. Thirteen thousand persons were screened without informed consent. Many facilities were deficient in providing education and counseling as well as obtaining informed consent. Units dedicated entirely to screening were most compliant with the state regulations. Handle: RePEc:aph:ajpbhl:1984:74:4:373-375_2 Template-Type: ReDIF-Article 1.0 Title: Italian occupational health: Concepts, conflicts, implications Journal: American Journal of Public Health Author-Name: Reich, M.R. Author-Name: Goldman, R.H. Year: 1984 Volume: 74 Issue: 9 Pages: 1031-1041 Abstract: This paper examines Italy's worker-based model for occupational health, especially its key concepts and its relation to social conflict. It briefly reviews the history of three approaches to occupational health in Italy: university-based, industry-based, and government-based. It then analyzes the worker-based approach, which emerged in the late 1960s and early 1970s as worker groups and trade unions mobilized around new concepts of occupational health. Five key concepts are discussed: the workers' homogeneous group; workers' subjectivity; the use of contract language; the development of local occupational health institutions; and the use of occupational hazard risk maps. The analysis illustrates how the social processes of mobilization and institutionalization affected the ideas and structures of Italian occupational health. Worker mobilization in Italy produced ideological changes in the nation's occupational health system, institutional changes in universities and governments, and legislative changes at national and local levels. The institutionalization of reforms, however, created new conflicts and problems and tended to restrict worker participation and promote expert intervention. The paper concludes with a brief outline of the history of occupational health approaches in the United States and then discusses the implications of the five Italian concepts for US occupational health policy. Handle: RePEc:aph:ajpbhl:1984:74:9:1031-1041_1 Template-Type: ReDIF-Article 1.0 Title: Hysterectomy: Variations in rates across small areas and across physicians' practices Journal: American Journal of Public Health Author-Name: Roos, N.P. Year: 1984 Volume: 74 Issue: 4 Pages: 327-335 Abstract: This analysis focuses on the practice of hysterectomy across 33 hospital catchement areas of one Canadian province, using claims data from the Manitoba health insurance system. Hysterectomy rates varied five-fold across hospital areas. The availability of hospitals and physicians was unrelated to area rates, and there appeared to be no access barriers in the low-rate areas. High-rate areas were characterized by women who visited large numbers of different physicians and by having larger proportions of French, Polish, and Italian residents (ethnic groups which are largely Catholic in Mannitoba). Although women residents of high rate areas made somewhat more visits for gynecologic problems and had many more D&Cs (dilation and curetage of the uterus), it is concluded that this may be due as much to the practice style of physicians treating patients from these areas as to gynecologic need. Residents of high and medium-high rate areas are more likely to have hysterectomy-prone surgeons as their primary physicians. Such physicians appear both more likely to label their patients' conditions as gynecologic in origin and more likely to advise surgical intervention (both D&C and hysterectomy) once such conditions are diagnosed. Thus, a combination of patient and physician characteristics may explain much of the variation in small area hysterectomy rates, rather than narrowly defined medical need. Handle: RePEc:aph:ajpbhl:1984:74:4:327-335_9 Template-Type: ReDIF-Article 1.0 Title: Current tuberculosis screening practices Journal: American Journal of Public Health Author-Name: Snider Jr., D.E. Author-Name: Anderson, H.R. Author-Name: Bentley, S.E. Year: 1984 Volume: 74 Issue: 12 Pages: 1353-1356 DOI: 10.2105/AJPH.74.12.1353 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1353 Abstract: Health department officials in all 50 states and 14 major cities responded to a survey questionnaire designed to obtain information about current tuberculosis screening practices. Persons being screened fell into the groups designated as high risk by the American Thoracic Society (ATS) and the Centers for Disease Control (CDC). The methods used for screening were generally those advocated by ATS, CDC, and the Food and Drug Administration (FDA), although chest radiographs continue to be overused. Screening in about one-half of the groups is mandated by law or regulation. There appears to be some confusion about the circumstances in which 'two-step' tuberculin testing should be used. Data on the productivity and costs of screening activities were very limited. We encourage those responsible for tuberculosis screening programs to evaluate them, discontinue those which are unproductive, and intensify those which are productive. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1353_1 Template-Type: ReDIF-Article 1.0 Title: Women and divorce: Health insurance coverage, utilization, and health care expenditures Journal: American Journal of Public Health Author-Name: Berk, M.L. Author-Name: Taylor, A.K. Year: 1984 Volume: 74 Issue: 11 Pages: 1276-1278 DOI: 10.2105/AJPH.74.11.1276 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1276 Abstract: Estimates from the 1977 National Medical Care Expenditure Survey suggest that divorced women are twice as likely as married women to be uninsured, and also more likely to depend on Medicaid assistance. Divorced women use slightly more health services than married women, but also appear to have somewhat poorer health status. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1276_4 Template-Type: ReDIF-Article 1.0 Title: The participation of Hispanics in US Schools of Public Health, 1975-79 Journal: American Journal of Public Health Author-Name: Trevino, F.M. Author-Name: Montoya, M. Author-Name: Juarez, R.Z. Year: 1984 Volume: 74 Issue: 3 Pages: 251-252 Abstract: Hispanic student and faculty representation at US Schools of Public Health from 1975-1979 was investigated. Findings indicate a substantial underrepresentation of Hispanic students and faculty members at these schools. Hispanic public health graduates were found to be less likely than other graduates to receive an MPH degree or a doctorate. It appears that the University of Puerto Rico graduates one-half of all Hispanic graduates and employs two-thirds of all Hispanic public health faculty. Handle: RePEc:aph:ajpbhl:1984:74:3:251-252_3 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of musculoskeletal impairments and associated disability Journal: American Journal of Public Health Author-Name: Cunningham, L.S. Author-Name: Kelsey, J.L. Year: 1984 Volume: 74 Issue: 6 Pages: 574-579 Abstract: Data from the US Health and Nutrition Examination Survey (HANES I) of 1971-1975 confirm the high prevalence of musculoskeletal impairments among United States adults. Musculoskeletal impairments tend to be more prevalent among older persons, and persons with less education and with lower annual family incomes. Prevalence rates are slightly higher in females than in males, while Whites and non-Whites are affected with almost equal frequency. Among persons reporting a history of musculoskeletal symptoms, those who have some disability tend to be older, non-White, lower education and income, and widowed, separated, or divorced. Persons with multiple parts of the body involved, or reporting that their symptoms are due to accident or injury are also especially likely to report disability. Taken as a whole, the data suggest that medical, social, and economic factors all play a role in determining whether a person with musculoskeletal impairment goes on to develop disability related to his or her impairment. Handle: RePEc:aph:ajpbhl:1984:74:6:574-579_1 Template-Type: ReDIF-Article 1.0 Title: Utilization and cost of ambulatory care services of medicaid recipients, Bronx Journal: American Journal of Public Health Author-Name: Lee, J. Author-Name: Morehead, M.A. Year: 1984 Volume: 74 Issue: 12 Pages: 1367-1370 DOI: 10.2105/AJPH.74.12.1367 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1367 Abstract: The Bronx Professional Standards Review Organization (BPSRO) analyzed 1979-80 ambulatory claims for South Bronx Medicaid recipients. An estimated 87 per cent of Medicaid eligibles were users of care with an average of 11.2 visits a year, compared to an average of 9.8 visits for the Bronx Medicaid population. Shared Health Facilities (Medicaid Mills) were the principle providers of care. Two-thirds of the costs were generated by one-fourth of the patients who made more than 10 visits each a year, BPSRO concluded the South Bronx does not lack health care resources for the Medicaid recipient and that public policy and patients would benefit by concentrating reforms on high utilizers and provision of care for the near poor. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1367_0 Template-Type: ReDIF-Article 1.0 Title: Notification of workers at high risk: An emerging public health problem Journal: American Journal of Public Health Author-Name: Schulte, P.A. Author-Name: Ringen, K. Year: 1984 Volume: 74 Issue: 5 Pages: 485-491 Abstract: During the last two decades, an increasing number of epidemiologic studies have found cohorts of workers to be at high risk of work-related chronic diseases, especially cancers. These studies frequently have led to the broad recognition of occupational hazards and eventually to the prevention of exposures to such hazards. Generally, however, the individual cohort members found to be at high risk have not been notified of study results, and programs of medical intervention or of palliative services directed at these individual workers have not been developed. Recently, the issue of whether or not workers have a right to be notified more directly about known health hazards to which they may have been exposed has emerged as a major, unresolved question in public health policy. Issues of concern include the criteria that should guide notifications; whom, when, and how to notify; and who should pay for notification and follow-up services. This commentary discusses the scientific, ethical, economic, and institutional aspects of worker notification, and describes three new demonstration projects that have provided notification and intervention for workers at high risk of bladder, colon, and lung cancer. Handle: RePEc:aph:ajpbhl:1984:74:5:485-491_0 Template-Type: ReDIF-Article 1.0 Title: Screening for chest disease in college students: Policies of student health services regarding the use of routine screening chest radiographs and tuberculin skin tests Journal: American Journal of Public Health Author-Name: Fager, S.S. Author-Name: Slap, G.B. Author-Name: Kitz, D.S. Author-Name: Eisenberg, J.M. Year: 1984 Volume: 74 Issue: 2 Pages: 143-146 Abstract: We conducted a survey of college health services to determine their policies regarding the use of screening chest radiographs and tuberculin skin tests. Pre-enrollment chest radiographs are prescribed for all incoming students by 24 per cent of the 531 respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 20 per cent, 19 per cent, and 6 per cent, respectively. Periodic chest radiography is conducted for all students by 7 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 22 per cent, 16 per cent, and 8 per cent, respectively. Pre-enrollment tuberculin skin tests are prescribed for all incoming students by 52 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 48 per cent, 29 per cent, and 9 per cent, respectively. Periodic tuberculin skin testing is conducted for all students by 27 per cent of the respondents and for health professions students, foreign students, and intercollegiate athletes only by an additional 48 per cent, 23 per cent, and 16 per cent, respectively. We estimate from these data that 723,000 incoming students in the United States received screening chest radiographs in 1979 with estimated charges totaling between $7 million and $27 million. There may be 0.05 to 0.33 induced cases of lung cancer, leukemia, thyroid cancer, and female breast cancer over a 20-year period among this group of students exposed to ionizing radiation. Handle: RePEc:aph:ajpbhl:1984:74:2:143-146_6 Template-Type: ReDIF-Article 1.0 Title: Citizen action for environmental health: Report on a survey of community organizations Journal: American Journal of Public Health Author-Name: Freudenberg, N. Year: 1984 Volume: 74 Issue: 5 Pages: 444-448 Abstract: A convenience sample of 242 community organizations involved in environmental health issues was surveyed regarding each group's goals, activities, and problems. The 110 groups that replied identified 153 health-threatening hazards including toxic waste dumps, pesticide spraying, and air or water pollution. The most common health conditions which respondents attributed to these hazards were cancer, respiratory problems, birth defects, and reproductive difficulties. The goal identified most frequently was the correction of the specific hazard facing their community. To achieve this aim, groups engaged in a variety of activities including research, public education, demonstrations, lobbying, and legal action. Most groups reported extensive and helpful interactions with scientists or health professionals. Respondents reported problems in obtaining information from local health officials, other government agencies, and industry. A majority of the groups rated their efforts at environmental health protection as being very or somewhat successful. The implications of these findings for local health officials are discussed. Handle: RePEc:aph:ajpbhl:1984:74:5:444-448_7 Template-Type: ReDIF-Article 1.0 Title: Venceremos Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1984 Volume: 74 Issue: 10 Pages: 1083-1084 Handle: RePEc:aph:ajpbhl:1984:74:10:1083-1084_1 Template-Type: ReDIF-Article 1.0 Title: Effects of birth rank, maternal age, birth interval, and sibship size on infant and child mortality: Evidence from 18th and 19th century reproductive histories Journal: American Journal of Public Health Author-Name: Knodel, J. Author-Name: Hermalin, A.I. Year: 1984 Volume: 74 Issue: 10 Pages: 1098-1106 Abstract: There has been a long-standing interest in the effects of maternal age, birth rank, and birth spacing on infant and child mortality. Contradictory inferences about the role of these factors have arisen on occasion because of the absence of adequate controls, the use of cross-sectional or incomplete reproductive histories, and inattention to the effect of family size goals and birth limitation practices. This study analyzes completed reproductive histories for German village populations in the 18th and 19th centuries, a period when deliberate fertility control was largely absent. Our results confirm previous studies of the association of infant mortality with maternal age, although in the present data these differentials are largely limited to neonatal mortality. They also confirm the importance of birth interval as a factor in infant mortality. Sibship size is positively related to infant mortality even when birth rank is controlled. However, once sibship size is controlled, there are no systematic differences in infant and child mortality by birth order. The mechanisms relating sibship size and mortality are explored. Handle: RePEc:aph:ajpbhl:1984:74:10:1098-1106_6 Template-Type: ReDIF-Article 1.0 Title: Exposure-related hypothermia mortality in the United States, 1970-79 Journal: American Journal of Public Health Author-Name: Rango, N. Year: 1984 Volume: 74 Issue: 10 Pages: 1159-1160 Abstract: This study describes exposure-related hypothermia deaths in the United States from 1970 to 1979. Mortality risk from hypothermia increases with age; at all ages, non-White men are at highest risk and White women at lowest risk. Counts of deaths from hypothermia based on information from death certificate data may be understated. Effective social intervention to prevent hypothermia mortality and morbidity requires better public health surveillance and intensive case-finding. Handle: RePEc:aph:ajpbhl:1984:74:10:1159-1160_1 Template-Type: ReDIF-Article 1.0 Title: Changes in the hours worked by physicians, 1970-80 Journal: American Journal of Public Health Author-Name: Freiman, M.P. Author-Name: Marder, W.D. Year: 1984 Volume: 74 Issue: 12 Pages: 1348-1352 DOI: 10.2105/AJPH.74.12.1348 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1348 Abstract: The hours worked by physicians are affected by changes in a number of factors, including attitudes towards labor-leisure tradeoffs, the characteristics of the physician workforce, and the level of demand for medical services. This paper analyzes changes in the hours worked per week by office-based physicians over the decade 1970-80. Overall, there has been a statistically significant decline in hours of approximately 3 per cent, or 1.5 hours per week. This decline was fairly uniform across most physician characteristics, although the decline was greater for those in primary care specialties. Female physicians increased their average hours worked, although this increase was not statistically significant. In terms of the delivery of skilled medical services, the decline in total hours was largely offset by an increase in the percentage of total hours devoted to patient care. The question of whether these trends will continue has important complications for the validity of projections of a physician surplus in the near future. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1348_3 Template-Type: ReDIF-Article 1.0 Title: Mortality among laundry and dry cleaning workers in Oklahoma Journal: American Journal of Public Health Author-Name: Duh, R.-W. Author-Name: Asal, N.R. Year: 1984 Volume: 74 Issue: 11 Pages: 1278-1280 DOI: 10.2105/AJPH.74.11.1278 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1278 Abstract: The mortality experience of 440 laundry and dry cleaning workers for the period 1975-81 was analyzed, using Oklahoma death certificate data. Results did not show an overall increase in total cancer, but an elevated risk was found for homicide, lung cancer, and kidney cancer. A decrease in risk was noted for ischemic heart disease and for breast cancer. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1278_4 Template-Type: ReDIF-Article 1.0 Title: Race and sex differences in hip fracture incidence Journal: American Journal of Public Health Author-Name: Farmer, M.E. Author-Name: White, L.R. Author-Name: Brody, J.A. Author-Name: Bailey, K.R. Year: 1984 Volume: 74 Issue: 12 Pages: 1374-1380 DOI: 10.2105/AJPH.74.12.1374 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1374 Abstract: Incidence rates for hip fracture in the United States were estimated using non-federal hospital discharges from the National Hospital Discharge Survey for the years 1974-1979. Age-specific incidence curves for women and for men showed similar patterns of increase in risk with age, with risks approximately doubling every five years after age 50. Age-specific rates by five-year age groups were compared among the four race-sex groups. No significant differences were observed between Black females, Black males, and White males. In contrast, rates for White females were one and one-half to four times those for Black females after age 40 and were approximately double those for White males after age 50. Analysis based on an independent data source of non-federal hospital discharges in Washington, DC confirmed these relationships. In the Washington study, White women were at twice the risk for hip fracture (controlled for age) compared with Black women and at 2.7 times the risk for hip fracture (controlled for age) compared to White men. No significant differences were observed between Black women and Black men. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1374_8 Template-Type: ReDIF-Article 1.0 Title: Hospital-sponsored primary care: II. Impact on patient access Journal: American Journal of Public Health Author-Name: Aday, L.A. Author-Name: Andersen, R. Author-Name: Loevy, S.S. Author-Name: Kremer, B. Year: 1984 Volume: 74 Issue: 8 Pages: 792-798 Abstract: This article, the second of two, considers the impact of a nationwide demonstration of 53 community hospital sponsored group practices (CHPs). Surveys of a sample of the communities in which the CHPs were introduced suggest that about half of the communities were socioeconomically and, to some extent, medically disadvantaged. The CHPs tended to attract people who had previously not had a regular source of care or who used hospital outpatient departments or emergency rooms, as well as patients of established primary care physicians. Access to care and satisfaction appeared to be as good or better for CHP patients compared to regular patients of physicians in the target areas. The programs did not increase the use of inpatient services, emergency rooms, or hospital outpatient departments. The findings suggest that at present community hospital sponsored group practices would not have a profound effect on access to care if adopted nationally, but that targeted implementation by hospitals in lower income and minority communities can improve patient opportunities for appropriate primary care services. Handle: RePEc:aph:ajpbhl:1984:74:8:792-798_6 Template-Type: ReDIF-Article 1.0 Title: Survey of health department-based environmental epidemiology programs Journal: American Journal of Public Health Author-Name: Lapham, S.C. Author-Name: Castle, S.P. Year: 1984 Volume: 74 Issue: 9 Pages: 1023-1025 Abstract: A survey of state epidemiologists in all 50 states and New York City was conducted between October 1982 and January 1983 to determine which states had existing programs in environmental epidemiology. We identified 29 environmental epidemiology programs with at least one full-time state-funded staff member. The most common areas of responsibility included investigations of indoor air pollution (96 per cent), exposure to toxic or hazardous substances (93 per cent), and pesticide exposures (93 per cent). Handle: RePEc:aph:ajpbhl:1984:74:9:1023-1025_7 Template-Type: ReDIF-Article 1.0 Title: High-risk young mothers: Infant mortality and morbidity in four areas in the United States, 1973-1978 Journal: American Journal of Public Health Author-Name: McCormick, M.C. Author-Name: Shapiro, S. Author-Name: Starfield, B. Year: 1984 Volume: 74 Issue: 1 Pages: 18-23 Abstract: An examination of the changes in infant mortality and morbidity in four regions in the United States has revealed high levels of health problems among the infants of two groups of mothers: those → 17 years and 18-19 year-old multiparas, many of whom began their childbearing under age 18. Despite decreases over the period of observation, neonatal mortality rates remain over one and a half times as high for infants of these mothers as for other mothers, largely due to the relatively high proportion of low birthweight (LBW) infants born to these mothers. Post-neonatal mortality rates also remain high, and may be increasing; this change cannot be explained solely by differences in proportion of LBW infants between these and older mothers. Both the high post-neonatal mortality rates and the type of morbidity experienced by surviving infants is consistent with the socioeconomic disadvantage of young mothers. The data further indicate the limited resources available to these mothers to cope with their children's health needs, and their potential vulnerability to decreases in public programs supporting child health care. Handle: RePEc:aph:ajpbhl:1984:74:1:18-23_4 Template-Type: ReDIF-Article 1.0 Title: A prospective study of functional status among community elders Journal: American Journal of Public Health Author-Name: Branch, L.G. Author-Name: Katz, S. Author-Name: Kniepmann, K. Author-Name: Papsidero, J.A. Year: 1984 Volume: 74 Issue: 3 Pages: 266-268 Abstract: A six-year prospective study provides estimates of functional status (independent, dependent, nursing home resident, or deceased) according to age, gender, and previous functional status for Caucasian elders initially living in the community. Half the cohort had sustained independence for the six years; of those dependent at the beginning, one-fourth to one-third regained independent function within 15 months, and one-fifth regained self-sufficiency within five years. Handle: RePEc:aph:ajpbhl:1984:74:3:266-268_5 Template-Type: ReDIF-Article 1.0 Title: Resource requirements for evaluating ambulatory health care Journal: American Journal of Public Health Author-Name: Thompson, M.S. Author-Name: Palmer, R.H. Author-Name: Rothrock, J.K. Author-Name: Strain, R. Author-Name: Brachman, L.H. Author-Name: Wright, E.A. Year: 1984 Volume: 74 Issue: 11 Pages: 1244-1248 DOI: 10.2105/AJPH.74.11.1244 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1244 Abstract: We implemented the most frequently used form of quality assurance activity: abstracting information on the quality of patient care from medical records and communicating findings to providers in 16 ambulatory care groups. Site providers accepted the evaluation criteria, agreed that deficiencies in care were detected, and, for some medical tasks, effected improvements in care. Direct costs in 1980 dollars for the quality assurance cycle including data system development were $46 per evaluated case. Per-case costs varied considerably among tasks, decreased with larger numbers of cases and as experience grew, and were reduced through computerization. Measured costs were high due to: a demanding research design; our extended accounting of direct, indirect, and induced costs; and the substantial resource requirements of rigorously performed evaluations. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1244_8 Template-Type: ReDIF-Article 1.0 Title: AIDS surveillance and health education: Use of previously described risk factors to identify high-risk homosexuals Journal: American Journal of Public Health Author-Name: Valdiserri, R.O. Author-Name: Brandon, W.R. Author-Name: Lyter, D.W. Year: 1984 Volume: 74 Issue: 3 Pages: 259-260 Abstract: Previously defined 'risk factors' in homosexuals with Kaposi's sarcoma may not be causative of AIDS (acquired immune deficiency syndrome) but are an important tool in identifying segments of the homosexual population who are at increased risk for the development of AIDS and who may benefit from health education and surveillance efforts. The epidemiologic characteristics of such a group of homosexuals from a low incidence area (Pittsburgh, PA) are examined and several factors which may account for differences in incidence are briefly discussed. Handle: RePEc:aph:ajpbhl:1984:74:3:259-260_4 Template-Type: ReDIF-Article 1.0 Title: Patterns of drug use from adolescence to young adulthood: III. Predictors of progression Journal: American Journal of Public Health Author-Name: Yamaguchi, K. Author-Name: Kandel, D.B. Year: 1984 Volume: 74 Issue: 7 Pages: 673-681 Abstract: Possible linkages of influence among classes of drugs in the observed sequential progression from adolescence to young adulthood are investigated through event history analyses. Three stages are examined: initiation to marijuana, to the use of other illicit drugs, and to prescribed psychoactive drugs. The data are based on a follow-up cohort of former adolescents representative of high school students in grade 10 and 11 in New York State who were reinterviewed nine years later at ages 24-25. The sequential order between alcohol and/or cigarettes and marijuana reflects not only the effect of the use of legal drugs on marijuana initiation, but also age effects on onset of these drugs, controlling for individual characteristics measured in adolescence; marijuana use by one's friends in adolescence is an additional important predictor of marijuana initiation. Prior use of marijuana is necessary for progression to other illicit drugs. Multiple factors are involved in the progression to prescribed drugs, with adolescent depressive symptomatology and use of other illicit drugs important for both sexes, and maternal use of psychoactive drugs, dropping out of school, and prior use of marijuana of additional importance for women. Although licit drugs influence initiation into marijuana independently of age effects, it is especially for the progression from marijuana to other illicit drugs that the earlier drug is associated with the progression to a higher stage drug. Handle: RePEc:aph:ajpbhl:1984:74:7:673-681_1 Template-Type: ReDIF-Article 1.0 Title: Strategy and art in automated death searches Journal: American Journal of Public Health Author-Name: Newcombe, H.B. Year: 1984 Volume: 74 Issue: 12 Pages: 1302-1303 DOI: 10.2105/AJPH.74.12.1302 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1302 Abstract: The art of record linkage, as distinct from the theory and general strategy, lies in the choice of the specifics of any refinements. The designer of a linkage procedure wishing to introduce refinements must inevitably explore the options empirically, and quantitatively in some detail using acutal data, before deciding upon some optimum simplification. Although the practice of this art is laborious, experience has shown that substantial improvements in overall discriminating power can, in fact, be achieved as a result of the fine tuning that is possible when the intuitive insights gained from dealing manually with the more difficult linkages are tested quantitatively and used to modify the machine procedures. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1302_7 Template-Type: ReDIF-Article 1.0 Title: Factors associated with adolescent use of family planning clinics Journal: American Journal of Public Health Author-Name: Shea, J.A. Author-Name: Herceg-Baron, R. Author-Name: Furstenberg Jr., F.F. Year: 1984 Volume: 74 Issue: 11 Pages: 1227-1230 DOI: 10.2105/AJPH.74.11.1227 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1227 Abstract: Clinic records were reviewed for a sample of 498 adolescent family planning clients to document clinic use patterns. For a subsample of 359 adolescents, relationships are explored between clinic use and contraceptive use, demographic characteristics, social relationships, and contraceptive attitudes. The average adolescent was observed for 15 months and made 3.5 visits to the clinic. Twenty-two per cent of the adolescents never returned after an initial visit. Revisits tended to occur in three-month intervals. In the first six months, the probability of making the first revisit was .70; the probability of a second revisit was .45. Adolescents whose visit patterns deviated from the routine clinic protocols were more likely to be inconsistent contraceptive users. The single significant correlate of regular clinic use was the adolescents' satisfaction with their contraceptive methods. Service providers should ensure that adolescents select a suitable contraceptive method and closely follow adolescents whose clinic use patterns deviate from standard protocols. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1227_7 Template-Type: ReDIF-Article 1.0 Title: Foreign medical graduates in the 1980s: Trends in specialization Journal: American Journal of Public Health Author-Name: Mick, S.S. Author-Name: Worobey, J.L. Year: 1984 Volume: 74 Issue: 7 Pages: 698-703 Abstract: Secondary analysis of data collected by the American Medical Association and the Graduate Medical Education National Advisory Commitee (GMENAC) suggests that measures to diminish the flow of alien Foreign Medical Graduates (FMGs) into the United States have been less effective than planned. Declining trends in the proportion of FMG house officers in the mid- to late-1970s have recently stabilized around 19 per cent. There has also been a dramatic increase in the number of US citizen Foreign Medical Graduates (USFMGs) in house officer positions. A pattern of alien FMG and USFMG house officer specialization correlates with specialties designated by the GMENAC as shortage areas by 1990 (r = -.49, p < .05). Despite the GMENAC prediction of a surplus of physicians by 1990, differential selection of alien FMGs and USFMGs into shortage specialties may assure their substantial future presence in the US health care system. Handle: RePEc:aph:ajpbhl:1984:74:7:698-703_5 Template-Type: ReDIF-Article 1.0 Title: The case of Karen Silkwood Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1984 Volume: 74 Issue: 5 Pages: 516-518 Handle: RePEc:aph:ajpbhl:1984:74:5:516-518_8 Template-Type: ReDIF-Article 1.0 Title: Knowledge, attitudes and practice regarding vasectomy among residents of Hamilton County, Ohio, 1980 Journal: American Journal of Public Health Author-Name: Huether, C.A. Author-Name: Howe, S. Author-Name: Kelaghan, J. Year: 1984 Volume: 74 Issue: 1 Pages: 79-82 Abstract: A telephone survey of 1,172 Hamilton County, Ohio residents indicated that for ever-married people, 25.1 per cent of those aged 18-45 and 33.8 per cent of those 30-45 had been sterilized. Blacks and Whites had comparable levels of sterilization but, among Blacks, female sterilization was over eight times as common as vasectomy, while for Whites, the ratio was 1.2. Catholics had only one-half the sterilization rate of Protestants. Race, sex, income, and education were all related to knowledge and attitudes toward vasectomy. The need for more information was a major reason cited for not having a vasectomy. Handle: RePEc:aph:ajpbhl:1984:74:1:79-82_8 Template-Type: ReDIF-Article 1.0 Title: Intradermal immunization with human diploid cell rabies vaccine: Serological and clinical responses of immunized persons to intradermal booster vaccination Journal: American Journal of Public Health Author-Name: Burridge, M.J. Author-Name: Sumner, J.W. Author-Name: Baer, G.M. Year: 1984 Volume: 74 Issue: 5 Pages: 502-505 Abstract: Rabies antibody titers ranged from 0-9.3 IU/mL in 117 human volunteers one year after intradermal vaccination with one or two doses of human diploid cell rabies vaccine (HDCV). At that time, each volunteer received one 0.1-mL booster dose of HDCV intradermally. All 117 volunteers showed good anamnestic responses, with antibody titers rising to 0.5-54.3 IU/mL within seven days of booster injection. Vaccine safety was good; only minor reactions were experienced, all of which resolved spontaneously. Handle: RePEc:aph:ajpbhl:1984:74:5:502-505_3 Template-Type: ReDIF-Article 1.0 Title: Validity of the Spanish surname infant mortality rate as a health status indicator for the Mexican American population Journal: American Journal of Public Health Author-Name: Selby, M.L. Author-Name: Lee, E.S. Author-Name: Tuttle, D.M. Author-Name: Loe Jr., H.D. Year: 1984 Volume: 74 Issue: 9 Pages: 998-1002 Abstract: This study assessed the validity of the Spanish surname infant mortality rate as an index of urban Mexican American health status. Neonatal, postneonatal, and risk-factor-specific mortality rates were computed from linked birth and infant death records of the 1974-75 Harris County, Texas, cohort of 68,584 for Spanish surname White, non-Spanish surname White, and Black single live births. Infants of Mexican-born immigrants were distinguished from those of other Spanish surname parents by parental nativity information on birth records. Infants of Mexican immigrants had paradoxically low mortality rates for high birth order, high maternal age, and delayed or absent prenatal care; only infants weighing < 1500 gm showed expected high rates. Findings suggested loss of infant death data compatible with migration and underregistration of deaths. The Spanish surname infant mortality rate may be spuriously low and does not appear to be a valid indicator of Mexican American health status even in an urban, non-border area considered to have excellent birth and death registration. Handle: RePEc:aph:ajpbhl:1984:74:9:998-1002_7 Template-Type: ReDIF-Article 1.0 Title: Willingness to pay for reduction in fatality risk: An exploratory survey Journal: American Journal of Public Health Author-Name: Muller, A. Author-Name: Reutzel, T.J. Year: 1984 Volume: 74 Issue: 8 Pages: 808-812 Abstract: Willingness to pay surveys represent one method for measuring the benefit of health and life saving programs. However, the reliability and validity of survey responses to questions concerning the reduction of fatality or injury risks have been questioned. The results of a survey of 77 senior year undergraduate students show that reasonable appearing and consistent responses to willingness to pay questions on car crash protection can be obtained. However, the implied value of life was over 100 times greater for an unidentified life than for the respondent's own life. Also, no relationship was found between willingness to pay responses and variables reflecting respondent's rational considerations. These paradoxical results seem to be due to the mistaken assumptions that people employ rational considerations when responding to willingness to pay questions and that they are capable of matching their responses with the functional relationship (proportionality) underlying implied value of life calculations. Handle: RePEc:aph:ajpbhl:1984:74:8:808-812_0 Template-Type: ReDIF-Article 1.0 Title: Ambiguities limit the role of nurse practitioners and physician assistants Journal: American Journal of Public Health Author-Name: Weston, J.L. Year: 1984 Volume: 74 Issue: 1 Pages: 6-7 Handle: RePEc:aph:ajpbhl:1984:74:1:6-7_6 Template-Type: ReDIF-Article 1.0 Title: The new educational opportunities for public health professionals Journal: American Journal of Public Health Author-Name: Weiss, R.J. Author-Name: Wotman, S. Year: 1984 Volume: 74 Issue: 11 Pages: 1197-1198 DOI: 10.2105/AJPH.74.11.1197 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1197 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1197_7 Template-Type: ReDIF-Article 1.0 Title: Utilization of child health clinics following introduction of a copayment Journal: American Journal of Public Health Author-Name: Fischer, P.J. Author-Name: Strobino, D.M. Author-Name: Pinckney, C.A. Year: 1984 Volume: 74 Issue: 12 Pages: 1401-1403 DOI: 10.2105/AJPH.74.12.1401 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1401 Abstract: The effect of introduction of a copayment on utilization of well child services was investigated in St. Mary's County, Maryland between 1975 and 1979. Utilization declined between the pre-copayment and post-copayment periods for White and non-White infants under six months of age. The deterrent impact of the copayment suggested by the results may be related to crossover to private care but may also represent a drop in use of preventive services. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1401_6 Template-Type: ReDIF-Article 1.0 Title: The cost of head trauma in Olmsted County, Minnesota, 1970-74 Journal: American Journal of Public Health Author-Name: Grabow, J.D. Author-Name: Offord, K.P. Author-Name: Rieder, M.E. Year: 1984 Volume: 74 Issue: 7 Pages: 710-712 Abstract: A study of the total cost of head injury in Olmsted County, Minnesota, with the costs projected to the United States population, revealed that the annual cost for head trauma in the US can be estimated at approximately $12.5 billion using a 6 per cent discount rate. The nonmedical costs accounted for more than 92 per cent ($11.5 billion) of the total cost, while direct medical costs amounted to $1.0 billion. Handle: RePEc:aph:ajpbhl:1984:74:7:710-712_3 Template-Type: ReDIF-Article 1.0 Title: Comparability ratios by age: Based on deaths of metropolitan policyholders Journal: American Journal of Public Health Author-Name: Bale, G.S. Author-Name: Smith, N.J. Year: 1984 Volume: 74 Issue: 1 Pages: 71-73 Abstract: Comparability ratios based on 42,229 deaths of Metropolitan policyholders in 1979 were computed by age between the 8th and 9th revision ICD codes for 72 selected causes of death. Comparability ratios by age are not available elsewhere. Except for accidents and adverse effects, the comparability ratios for the major causes of death at all ages combined were in close agreement with those computed by the National Center for Health Statistics. Handle: RePEc:aph:ajpbhl:1984:74:1:71-73_5 Template-Type: ReDIF-Article 1.0 Title: Northeastern Ohio trauma study: II. Injury rates by age, sex, and cause Journal: American Journal of Public Health Author-Name: Fife, D. Author-Name: Barancik, J.I. Author-Name: Chatterjee, B.F. Year: 1984 Volume: 74 Issue: 5 Pages: 473-478 Abstract: Using a 1977 sample of emergency department visits in five northeastern Ohio counties, population-based injury rates are tabulated by age, sex, and cause. Case fatality ratios are estimated by comparing these injury rates with population-based mortality rates for 1976-1978. For all age and sex groups, injuries are a major cause of emergency department visits. Falls, striking, cuts, and motor vehicle crashes are the leading causes of injury. Case fatality ratios for motor vehicle crash injuries are considerably higher than those for non-transport injuries. Injury rates and case fatality ratios for males exceed those for females except among the elderly. With increasing age, injury rates decline but the fraction of injuries leading to hospital admission or to fatality rises sharply. Handle: RePEc:aph:ajpbhl:1984:74:5:473-478_0 Template-Type: ReDIF-Article 1.0 Title: Charting the future course for corporate management of health risks Journal: American Journal of Public Health Author-Name: Baram, M.S. Year: 1984 Volume: 74 Issue: 10 Pages: 1163-1166 Handle: RePEc:aph:ajpbhl:1984:74:10:1163-1166_1 Template-Type: ReDIF-Article 1.0 Title: Patterns of drug use from adolescence to young adulthood: II. Sequences of progression Journal: American Journal of Public Health Author-Name: Yamaguchi, K. Author-Name: Kandel, D.B. Year: 1984 Volume: 74 Issue: 7 Pages: 668-672 Abstract: Major pathways of progression among legal, illegal, and medically prescribed psychoactive drugs from adolescence to young adulthood are described. The data are based on a follow-up cohort of former adolescents representative of high school students in grades 10 and 11 in New York State who were reinterviewed nine years later at ages 24-25. Various models of progression are tested for their goodness of fit. The patterns formerly observed in adolescence involving progression from one class of legal drug (either alcohol or cigarettes) to marijuana to the use of other illicit drugs appear in the transitional period into young adult, with an additional stage, that of prescribed psychoactive drugs. Some differences appear between men and women, with cigarettes more important for women than for men in the total progression. Handle: RePEc:aph:ajpbhl:1984:74:7:668-672_1 Template-Type: ReDIF-Article 1.0 Title: Health services reforms in revolutionary Nicaragua Journal: American Journal of Public Health Author-Name: Garfield, R.M. Author-Name: Taboada, E. Year: 1984 Volume: 74 Issue: 10 Pages: 1138-1144 Abstract: Before the Nicaraguan revolution of 1979, access to health services was largely limited to the affluent sectors of the urban population and the minority of workers with social security coverage. Repeated attempts at reform by organized medicine were ineffective. Since the revolution, a tremendous expansion in health services has occurred. The national health system receives approximately one-third of its funds from the social security system. Steadily increasing equity in access is a result of the promotion of primary care, health campaigns involving up to 10 per cent of the general population as volunteers, the use of paramedical aides, and foreign assistance. Private practice nevertheless remains strong. In the coming years, several complex issues must be examined, including: a balance in the number of nurses and doctors trained, the role of private practice, and the relationship of the Ministry of Health to the social security system. Further progress in health reforms may be delayed by the defensive war which Nicaragua is fighting on its northern and southern borders. Despite emergent health problems in the war zones, most of the innovative aspects of the health system remain intact as of this writing. Handle: RePEc:aph:ajpbhl:1984:74:10:1138-1144_2 Template-Type: ReDIF-Article 1.0 Title: Social support and the development of vulnerable children Journal: American Journal of Public Health Author-Name: Shonkoff, J.P. Year: 1984 Volume: 74 Issue: 4 Pages: 310-312 Handle: RePEc:aph:ajpbhl:1984:74:4:310-312_6 Template-Type: ReDIF-Article 1.0 Title: Nurse-midwifery practice in the United States, 1982 Journal: American Journal of Public Health Author-Name: Adams, C.J. Year: 1984 Volume: 74 Issue: 11 Pages: 1267-1270 DOI: 10.2105/AJPH.74.11.1267 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1267 Abstract: During 1982 the American College of Nurse-Midwives conducted a national survey of certified nurse-midwives residing in the Unites States. About 68 per cent of the 1,584 respondents (response rate 76 per cent) were practicing nurse-midwifery. Most of them were providing prenatal and family planning care. The 937 participants who were conducting deliveries reported that they conducted about 1.8 per cent of the estimated 3,704,000 deliveries which took place in the United States during 1982. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1267_5 Template-Type: ReDIF-Article 1.0 Title: Therapeutic abortions following rubella infection in pregnancy: The potential impact on the incidence of congenital rubella syndrome Journal: American Journal of Public Health Author-Name: Serdula, M.K. Author-Name: Marks, J.S. Author-Name: Herrmann, K.L. Author-Name: Orenstein, W.A. Author-Name: Hall, A.D. Author-Name: Bomgaars, M.R. Year: 1984 Volume: 74 Issue: 11 Pages: 1249-1251 DOI: 10.2105/AJPH.74.11.1249 File-URL: http://hdl.handle.net/10.2105/AJPH.74.11.1249 Abstract: In 1977, a large rubella outbreak occurred in Hawaii. Because attack rates were high among women of childbearing age, we conducted extensive surveillance efforts to detect both pregnancies complicated by rubella and cases of congenital rubella syndrom (CRS). Initial surveillance included a survey of physicians and hospitals, review of fetal death and birth certificates, and cord blood screening for rubella-specific IgM of infants born following the epidemic. Two years after the outbreak, the medical community was again surveyed to identify affected children who were missed initially. No case of CRS was identified either shortly after the outbreak or in the ensuing two years. In addition, none of the 5,605 cord serum samples obtained was found to contain rubella-specific IgM antibody. Through active surveillance, we received 12 reports of rubella in pregnant women, of whom 11 elected to terminate their pregnancies. The extensive use of therapeutic abortion by exposed women may have prevented the birth of infants with CRS. Surveillance for rubella-related abortions is an important component in assessing the health impact of rubella in a community. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.11.1249_9 Template-Type: ReDIF-Article 1.0 Title: Playground equipment injuries in a large, urban school district Journal: American Journal of Public Health Author-Name: Boyce, W.T. Author-Name: Sobolewski, S. Author-Name: Sprunger, L.W. Author-Name: Schaefer, C. Year: 1984 Volume: 74 Issue: 9 Pages: 984-986 Abstract: We studied the epidemiologic features of playground equipment-related injuries occurring in a large, urban school district over a two-year period. Nurses in each of the district's 68 elementary schools completed self-coded reporting forms on all injuries meeting standardized criteria. A total of 511 equipment-related injuries were reported, an incidence of 8.9 injuries per 1,000 student-years. One-fourth of the injuries were severe, and climbing equipment was disproportionately represented among playground equipment associated with injuries. Extreme variability was found among school-specific rates of equipment injury, with schools at the two extremes separated by as much as a 40-fold difference in incidence. Two school characteristics - smaller student enrollments and the presence of alternative educational programs - were significantly associated with higher equipment-related injury rates. Handle: RePEc:aph:ajpbhl:1984:74:9:984-986_8 Template-Type: ReDIF-Article 1.0 Title: Prescribing behaviors of primary care nurse practitioners Journal: American Journal of Public Health Author-Name: Rosenaur, J. Author-Name: Stanford, D. Author-Name: Morgan, W. Author-Name: Curtin, B. Year: 1984 Volume: 74 Issue: 1 Pages: 10-13 Abstract: The prescribing practices of 18 primary care nurse practitioners (NPs) with 1,683 patients over a six-month period were examined through a randomly selected audit of over 1,700 prescriptions. The results showed that NPs prescribed a very limited number of well known relatively simple drugs to a young female healthy population. The prescription/visit rate was 0.26. Most drugs were initiated for the first time rather than refilled. There was minimal physician consultation regarding drug use during the visit. The results provide evidence of the ability of nurse practitioners to prescribe drugs and should aid in the further legalization of this aspect of the primary care role. Handle: RePEc:aph:ajpbhl:1984:74:1:10-13_1 Template-Type: ReDIF-Article 1.0 Title: The right to know and the duty to disclose hazard information Journal: American Journal of Public Health Author-Name: Baram, M.S. Year: 1984 Volume: 74 Issue: 4 Pages: 385-390 Abstract: In late 1983, the Occupational Safety and Health Administration (OSHA) promulgated its final rule on "hazard communication," establishing the right of workers in manufacturing industries to information about chemical hazards, and the duty of importers and manufacturers to disclose such information. Baram reviews areas where the new, limited OSHA regulation conflicts with existing local, state, and federal laws, many of which are more stringent and more protective of worker and community health. He suggests steps that could be taken to avoid the extensive litigation that might result from the potential preemptive effect of the new OSHA rule. Handle: RePEc:aph:ajpbhl:1984:74:4:385-390_8 Template-Type: ReDIF-Article 1.0 Title: Effects of maternal education, age, and parity on fetal infant accidents Journal: American Journal of Public Health Author-Name: Wicklund, K. Author-Name: Moss, S. Author-Name: Frost, F. Year: 1984 Volume: 74 Issue: 10 Pages: 1150-1152 Abstract: Accidents are a major cause of death among children. Using computerized linked birth and death record information, this study examined the relationship of selected parental factors to the risk of infant accidental death. The analyses suggest that maternal age and education are inversely related to infant accident mortality while mother's parity is directly related. Accident mortality rate differentials by educational level were more evident for certain categories of accidents. Handle: RePEc:aph:ajpbhl:1984:74:10:1150-1152_8 Template-Type: ReDIF-Article 1.0 Title: Insurance incentives and seat belt use Journal: American Journal of Public Health Author-Name: Robertson, L.S. Year: 1984 Volume: 74 Issue: 10 Pages: 1157-1158 Abstract: In 1983, Nationwide Insurance Company increased compensation payments for its clients injured or killed in a motor vehicle crash while using a seat belt. A survey of belt use was undertaken in the month after all those so insured had been informed of the change. Belt use by drivers insured by Nationwide was not significantly different from that of drivers insured by other companies. The incentive appears to have had no apparent effect on belt use. Handle: RePEc:aph:ajpbhl:1984:74:10:1157-1158_7 Template-Type: ReDIF-Article 1.0 Title: Absence of menopausal effect on hip-fracture occurrence in white females Journal: American Journal of Public Health Author-Name: Brody, J.A. Author-Name: Farmer, M.E. Author-Name: White, L.R. Year: 1984 Volume: 74 Issue: 12 Pages: 1397-1398 DOI: 10.2105/AJPH.74.12.1397 File-URL: http://hdl.handle.net/10.2105/AJPH.74.12.1397 Abstract: The rate of hip fracture among White females rises sharply between ages 40 and 44 and then continues at a constant rate of acceleration doubling every five to six years throughout life with no deviation during, or in the years immediately following, menopause. We suggest that the important role of sex hormones and other factors in osteoporosis commences prior to menopause. A premenopause prevention strategy which postpones the onset of the osteoporotic process by five or six years would be expected to reduce the risk of hip fracture by 50 per cent throughout the remainder of a woman's life. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.74.12.1397_4 Template-Type: ReDIF-Article 1.0 Title: Community hospitals and medical group practice Journal: American Journal of Public Health Author-Name: Madison, D.L. Year: 1984 Volume: 74 Issue: 8 Pages: 759-760 Handle: RePEc:aph:ajpbhl:1984:74:8:759-760_4 Template-Type: ReDIF-Article 1.0 Title: An empiric study of ecological inference Journal: American Journal of Public Health Author-Name: Connor, M.J. Author-Name: Gillings, D. Year: 1984 Volume: 74 Issue: 6 Pages: 555-559 Abstract: Aggregate-level (macro) data are sometimes used when examining healthy care issues. Although they may be more accessible than individual (micro) observations, their interpretation is subject to ecological bias which in most cases is not measurable. This paper examines the implications of using aggregate-level data by conducting two separate analyses (micro and macro). Using as a database hospital episodes of care for the North Carolina Medicare aged population, regression models are developed from an examination of geographic grouping effects to explore the impact of extended care services, skilled nursing facility, and home health agency care on acute care hospital days. Specific problems encountered are: variable definition, collinearity, variance reduction, dilution of effect, spurious correlation, and observation influence. Stronger collinear (correlation among independent variables) relations occur at the macro-level than at the micro-level and spurious macro-correlations result from model specification and definition of interaction effects. Handle: RePEc:aph:ajpbhl:1984:74:6:555-559_9 Template-Type: ReDIF-Article 1.0 Title: Homicide in childhood: A public health problem in need of attention Journal: American Journal of Public Health Author-Name: Christoffel, K.K. Year: 1984 Volume: 74 Issue: 1 Pages: 68-70 Abstract: Homicide is now among the five leading causes of death in childhood, accounting for 1/20 deaths of those <18 years of age. Based on childrens' changing developmental vulnerabilities, it is possible to characterize three subtypes of child homicide - infanticide, fatal child abuse and neglect after infancy, and homicide in the community. Specific approaches to primary prevention include measures to strengthen families and their community support systems, and to educate adults and children concerning appropriate behaviors of children at different ages. Handle: RePEc:aph:ajpbhl:1984:74:1:68-70_6 Template-Type: ReDIF-Article 1.0 Title: Cancer of the breast, colon, ovary, and testis in the United States: Rates 1970-78 from a hospital reporting system Journal: American Journal of Public Health Author-Name: Porter, J.B. Author-Name: Walker, A.M. Author-Name: Jick, H. Year: 1984 Volume: 74 Issue: 6 Pages: 585-588 Abstract: We have explored the use of data from the Commission on professional and Hospital Activities-Professional Activity Study (CPHA-PAS) for ascertaining information on cancer incidence, with regional breakdowns, Extirpative surgical procedures were linked with discharge diagnoses to provide estimates of numbers of incident cases. We calculated incidence rates for four cancers: breast, colon, ovary, and testis. CPHA-PAS inferred rates corresponded closely to those of other reporting systems for breast cancer in most age groups, and for colonic and testicular cancer in some age groups. Ovarian cancer rates were consistently underestimated. We conclude that a cancer incidence reporting scheme based on hospital discharge data can work for certain cancers, and be very inexpensive and efficient. It must, however, be used with care. Handle: RePEc:aph:ajpbhl:1984:74:6:585-588_6 Template-Type: ReDIF-Article 1.0 Title: Evaluation of alternatives in long-term care Journal: American Journal of Public Health Author-Name: Weiler, P.G. Year: 1983 Volume: 73 Issue: 6 Pages: 638-639 Abstract: The magnitude of the issue in long-term care requires that further research be done on alternatives so that policy makers will have a good scientific base to aid in the decision-making process that must also include political and humanitarian factors. Because of the research limitations, the findings may never be as conclusive as some would like. The rule of using the prudent way versus the proven way would seem to apply here. Handle: RePEc:aph:ajpbhl:1983:73:6:638-639_9 Template-Type: ReDIF-Article 1.0 Title: On the feasibility of linking census samples to the National Death Index for epidemiologic studies: A progress report Journal: American Journal of Public Health Author-Name: Rogot, E. Author-Name: Feinleib, M. Author-Name: Ockay, K. Author-Name: Schwartz, S.H. Author-Name: Bilgrad, R. Author-Name: Patterson, J.E. Year: 1983 Volume: 73 Issue: 11 Pages: 1265-1269 Abstract: To test the feasibility of using large national probability samples provided by the US Census Bureau, a pilot project was initiated to link 230,000 Census-type records to the National Death Index (NDI). Using strict precautions to maintain the complete confidentiality of individual records, the Current Population Survey files of one month in 1973 and one month in 1978 were matched by computer to the 1979 NDI file. The basic question to be addressed was whether deaths so obtained are seriously underestimated when there is no Social Security Number (SSN) in the Census record. The search of the NDI file resulted in 5,542 matches of which about 1,800 appear to be 'true positives' representing deaths, the remainder are 'false positives'. Of the deaths, 80 per cent would still have been detected without SSN in the Census record. The main reasons of missing deaths (false negatives) were discrepancies in the year of birth and in the given name. Assuming certain changes in the NDI matching algorithm, the 80 per cent figure could increase to 85 per cent or higher; however, this could also cause significant increases in the number of false positives. The National Heart, Lung and Blood Institute (NHLBI) and Census Bureau staff are currently developing a probabilistic method to eliminate false positives from the NDI output tape. The results of the pilot study indicate that a larger research project is clearly feasible. Handle: RePEc:aph:ajpbhl:1983:73:11:1265-1269_5 Template-Type: ReDIF-Article 1.0 Title: Prevalence of self-reported depressive symptoms in young adolescent Journal: American Journal of Public Health Author-Name: Schoenbach, V.J. Author-Name: Kaplan, B.H. Author-Name: Wagner, E.H. Author-Name: Grimson, R.C. Author-Name: Miller, F.T. Year: 1983 Volume: 73 Issue: 11 Pages: 1281-1287 Abstract: To investigate the significance and measurement of depressive symptoms in young adolescents, 624 junior high school studies were asked to complete the Center for Epidemiologic Studies Depression Scale (CES-D) during home interviews. In 384 usable symptom scales, item-scale correlations (most were above .50), inter-item correlations, coefficient alpha (.85), and patterns of reported symptoms were reasonable. Persistent symptoms were reported more often by Blacks, especially Black males. Prevalence of persistent symptoms in Whites were quite close to reported figures for adults, ranging from 1 per cent to 15 per cent in adolescent males and 2 per cent to 13 per cent in adolescent females. Adolescents reported persistent vegetative symptoms less often and psychosocial symptoms more often. Reports of symptoms without regard to duration were much more frequent in the adolescents, ranging from 18 per cent to 76 per cent in White males, 34 per cent to 76 per cent in White and Black females, and 41 per cent to 85 per cent in Black males. The results support the feasibility of using a self-report symptom scale to measure depressive symptoms in young adolescents. Transient symptoms reported by adolescents probably reflect their stage of development, but persistent symptoms are likely to have social psychiatric importance. Handle: RePEc:aph:ajpbhl:1983:73:11:1281-1287_6 Template-Type: ReDIF-Article 1.0 Title: The contribution of hypertension to mortality in the US: 1968, 1977 Journal: American Journal of Public Health Author-Name: Wing, S. Author-Name: Manton, K.G. Year: 1983 Volume: 73 Issue: 2 Pages: 140-144 Abstract: The contribution of hypertension to total mortality in the United States in 1968 and 1977 is assessed through multiple cause death rates for all mentions of hypertension and the death certificate prevalence of hypertension. Age-adjusted declines in the hypertension death rates were 32.8 per cent for non-white females, 30.4 per cent for non-White males, 30.3 per cent for White females, and 25.2 per cent White males. Declines for younger non-Whites were the greatest, about 50 per cent, although their rates were more than twice the white rates in both years. Death certificate prevalence also declined for all four groups with the greatest (16.5 per cent) for non-white males and the least (10.4 per cent) for White males, who only showed declines at older ages. The age trajectory of death certificate prevalence reached a peak at ages 50-69 for non-Whites and ages 60-79 for Whites, with lower prevalence at the most advanced ages. Large declines in the contribution of hypertension to mortality observed in death certificate data are particularly striking in light of the probability that any bias would be toward better detection and reporting over the 10 years. Handle: RePEc:aph:ajpbhl:1983:73:2:140-144_0 Template-Type: ReDIF-Article 1.0 Title: Providing maternal and child health-family planning services to a large rural population: Results of the Bohol project, Philippines Journal: American Journal of Public Health Author-Name: Williamson, N.E. Author-Name: Parado, J.P. Author-Name: Maturan, E.G. Year: 1983 Volume: 73 Issue: 1 Pages: 62-71 Abstract: The Bohol project (1975-1979) sought to improve maternal and child health and to increase the use of family planning among a rural Philippine population of 400,000. Research indicated that maternal and child health (MCH) services did become more available during the project period and coverage of the priority populations improved. Family planning (FP) use, particularly of less effective methods, increased and fertility declined although some change could have been expected even without the project. Deaths due to neonatal tetanus were almost eliminated but mortality rates did not decline for a number of reasons, including the fact that services were probably not tailored closely enough to local health problems, especially respiratory diseases. The Project showed that it was possible to increase health and family planning services by using low-cost strategies (such as setting up community drug stores) and by employing paramedical workers, in this case, midwives. Preventive MCH-FP services were not overwhelmed by curative services as had been feared. Perhaps the most significant contribution of the Project were the lessons learned about delivering health and family planning services and conducting evaluation research. In general, if developing countries could maintain well-evaluated field laboratories for working out health and family planning delivery approaches before going nationwide, it is likely that time and money would be saved in the long run. Handle: RePEc:aph:ajpbhl:1983:73:1:62-71_1 Template-Type: ReDIF-Article 1.0 Title: Infant botulism in the United States: An epidemiologic study of cases occurring outside of California Journal: American Journal of Public Health Author-Name: Morris Jr., J.G. Author-Name: Snyder, J.D. Author-Name: Wilson, R. Author-Name: Feldman, R.A. Year: 1983 Volume: 73 Issue: 12 Pages: 1385-1388 Abstract: Data were obtained for the 96 hospitalized cases of infant botulism reported to the Centers for Disease Control between 1976-1980 from all states other than California. Forty-one cases were associated with Clostridium botulinum type A, 53 with type B, one with type F, and one with a strain of C. botulinum capable of producing both type B and F toxin. Cases occurred in 25 states; the disease was more common in the western part of the United States, with the highest attack rate reported for Utah and New Mexico. Birth-weights of hospitalized infants with infant botulism tended to be high compared with birth-weights in the United States population. Mothers of infants with infant botulism tended to be older and better educated than mothers in the general population. Seventy percent of infants had been predominantly breast-fed; breast-feeding in type B cases was associated with a significantly older age at onset of illness. Handle: RePEc:aph:ajpbhl:1983:73:12:1385-1388_4 Template-Type: ReDIF-Article 1.0 Title: An evaluation of subsidized rural primary care programs: I. A typology of practice organizations Journal: American Journal of Public Health Author-Name: Sheps, C.G. Author-Name: Wagner, E.H. Author-Name: Schonfeld, W.H. Year: 1983 Volume: 73 Issue: 1 Pages: 48-49 Abstract: The design of a comprehensive evaluation of subsidized rural primary care programs on a large national scale is described. Its major purpose is to derive data whose analysis will answer major policy questions about the factors influencing the outcome of the major types of such programs in different communities. This first paper also delineates a typology which was developed of five principal organizational forms of these programs. This classification appears to provide suitable operational definitions of forms of rural practice as a basis for evaluating the differential impact of alternative types of primary care programs. Handle: RePEc:aph:ajpbhl:1983:73:1:48-49_4 Template-Type: ReDIF-Article 1.0 Title: Predictive value of serologic tests Journal: American Journal of Public Health Author-Name: Hart, G. Year: 1983 Volume: 73 Issue: 11 Pages: 1288-1292 Abstract: An analysis of serologic tests for treponemal disease performed in Australian aboriginal communities is used to illustrate factors influencing the predictive value positive of serologic tests. Simple extrapolation of predictive value estimates, from prevalence, sensitivity, and specificity data, is complicated by variation of specificity between strata of a population, and the weighting of true positive and false positive results produced by the criteria for selecting individuals for testing. The predictive value positive of a particular test is greatest when it is used for incident cases suspected of having a disease, but lower when the same test is used to screen a whole population unless longitudinal data are available to exclude individuals with past disease. Preferential testing of individuals without active disease may produce very low predictive values. Empirical estimation of the predictive value of tests provides objective guidelines for decision making and enables increased predictability by modification of testing criteria. Handle: RePEc:aph:ajpbhl:1983:73:11:1288-1292_7 Template-Type: ReDIF-Article 1.0 Title: Predictors of effectiveness among public health nutritionists Journal: American Journal of Public Health Author-Name: Sims, L.S. Author-Name: Kohli, M. Year: 1983 Volume: 73 Issue: 12 Pages: 1376-1380 Abstract: This study investigated how public health nutrition directors and practitioners each rated the effectiveness of their professional performance. We examined the specific factors which were predictive of each set of effectiveness ratings. Eleven directors supplied the names and the addresses of 226 practitioners, each of whom was mailed a questionnaire. The response rate to the mailing was 84 per cent. Director ratings of practitioners were not significantly related to the self-ratings. Results of multiple regression analysis revealed that the directors had based their evaluation on more 'external' criteria, such as age, being a Registered Dietitian, and possessing an extroverted personality. In contrast, the nutritionists' self-ratings were based on more introspective qualities, including self-perceived innovativeness, and the number of competencies which they felt they were currently performing well. The roles of work environment, nature of supervision, and type of educational preparation need to be assessed in future research. Handle: RePEc:aph:ajpbhl:1983:73:12:1376-1380_2 Template-Type: ReDIF-Article 1.0 Title: Underrecording of infant homicide in the United States Journal: American Journal of Public Health Author-Name: Jason, J. Author-Name: Carpenter, M.M. Author-Name: Tyler Jr., C.W. Year: 1983 Volume: 73 Issue: 2 Pages: 195-197 Abstract: Homicide rates for infants dropped suddenly between 1967 and 1969. The abrupt nature of this decline suggested the change was artifactual. Investigation suggests that two classification revisions instituted at this time were causes of this decline; changes in related codes set forth in the Eighth Revision of the International Classification of Diseases, Adapted, and revision of the standard certificate of death in 1968. Infant homicides may have been disproportionately underrecorded after 1968. Handle: RePEc:aph:ajpbhl:1983:73:2:195-197_8 Template-Type: ReDIF-Article 1.0 Title: Impact of legislation raising the legal drinking age in Massachusetts from 18 to 20 Journal: American Journal of Public Health Author-Name: Hingson, R.W. Author-Name: Scotch, N. Author-Name: Mangione, T. Author-Name: Meyers, A. Author-Name: Glantz, L. Author-Name: Heeren, T. Author-Name: Lin, N. Author-Name: Mucatel, M. Author-Name: Pierce, G. Year: 1983 Volume: 73 Issue: 2 Pages: 163-170 Abstract: On April 16, 1979, Massachusetts raised its legal drinking age from 18 to 20 years. Massachusetts was compared with New York State, exclusive of New York city and Nassau County. New York State retained an 18-year-old drinking age. Random telephone surveys with approximately 1,000 16-19 year olds in each state were undertaken prior to the law's enactment and twice at yearly intervals after the law to assess the law's impact on teenage drinking, driving after drinking, and non-fatal accident involvement. Fatal crash data reported to the US Department of Transportation by each state from April 16, 1976-April 15, 1981 were also analyzed. After the law, although the modes of procuring alcohol changed. No significant changes were observed in Massachusetts relative to New York in the proportion of surveyed teenagers who reported that they drank or in the volume of their consumption. The proportion of teenagers who drove after drinking heavily (six or more drinks at one one time) did not decline in Massachusetts relative to New York. However, the frequency that teenagers reported driving after any drinking declined significantly in Massachusetts. Frequency of teenage driving after marijuana use and non-fatal teenage accidents declined at comparable rates in both states. The numbers of teenage nighttime single vehicle fatal accidents declined more in Massachusetts than New York, in the 18-19 year age group. Overall fatal accident trends among 16-19 year olds in the two states were similar. Handle: RePEc:aph:ajpbhl:1983:73:2:163-170_4 Template-Type: ReDIF-Article 1.0 Title: Health hazards of obesity and weight control in children: A review of the literature Journal: American Journal of Public Health Author-Name: Mallick, M.J. Year: 1983 Volume: 73 Issue: 1 Pages: 78-82 Abstract: A review of literature on the health hazards of obesity and weight control in children indicates: 1) methodological flaws tend to invalidate the assumption that obesity is a risk factor for this age group; 2) weight control by children and adolescents may cause a variety of health problems including retardation of growth, development, mental functioning, and reproductive capacity; and 3) preoccupation with weight control in this society makes it likely that weight control-related-health problems are common phenomena. Further research into the short and long-term consequences of obesity and weight control is necessary before enlightened clinical practice in this area is possible. Handle: RePEc:aph:ajpbhl:1983:73:1:78-82_7 Template-Type: ReDIF-Article 1.0 Title: The role of community volunteers in health interventions: A hypertension screening and follow-up program Journal: American Journal of Public Health Author-Name: Cooke, C.J. Author-Name: Meyers, A. Year: 1983 Volume: 73 Issue: 2 Pages: 193-194 Abstract: Volunteers from a resident health committee in an apartment complex community carried out door-to-door blood pressure screening of residents. Their results were compared with those from a community where a resident health committee conducted central site screenings and with those of a community where nonresident researchers manned a central screening site. Door-to-door screening by community volunteers was significantly more effective than the two central site screening methods which did not differ from each other. Follow-up measures increased the number of hypertensives who reported seeking treatment by 100 per cent. Handle: RePEc:aph:ajpbhl:1983:73:2:193-194_9 Template-Type: ReDIF-Article 1.0 Title: Lead concentrations in inner city soils as a factor in the child lead problem Journal: American Journal of Public Health Author-Name: Mielke, H.W. Author-Name: Anderson, J.C. Author-Name: Berry, K.J. Author-Name: Mielke, P.W. Author-Name: Chaney, R.L. Author-Name: Leech, M. Year: 1983 Volume: 73 Issue: 12 Pages: 1366-1369 Abstract: Soil samples were randomly collected from 422 vegetable gardens in a study area centered in downtown Baltimore, Maryland, and having a radius of 48.28 km (30 miles). The levels of lead, four other metals (cadmium, copper, nickel, and zinc), and pH were measured for each location. The application of multi-response permutation procedures, which are compatible with mapping techniques, reveals that lead (as well as cadmium, copper, nickel, and zinc) is concentrated and ubiquitous within the soils of the inner-city area of Metropolitan Baltimore. The probability values that the concentration of metals occurred by chance alone vary from about 10-15 to 10-23 depending on the metal considered. Our findings pose evironmental and public health issues, especially to children living within the inner-city. Handle: RePEc:aph:ajpbhl:1983:73:12:1366-1369_7 Template-Type: ReDIF-Article 1.0 Title: Variations in minimum licensing age and fatal motor vehicle crashes Journal: American Journal of Public Health Author-Name: Williams, A.F. Author-Name: Karpef, R.S. Author-Name: Zador, P.L. Year: 1983 Volume: 73 Issue: 12 Pages: 1401-1403 Abstract: The effect of differences in the legal minimum licensing age on fatal motor vehicle crashes was studied in New Jersey (age 17), Massachusetts (age 16 1/2 ), and Connecticut (age 16). New Jersey's 17-year-old licensing law was associated with greatly reduced fatal crash involvement. It is estimated that 65 to 85 percent reductions in 16 year-old-driver fatal crash involvement can be expected if the licensing age is increased from 16 to 17 without increasing fatal crash rates at older ages. Handle: RePEc:aph:ajpbhl:1983:73:12:1401-1403_0 Template-Type: ReDIF-Article 1.0 Title: Non-participation in telephone follow-up interviews Journal: American Journal of Public Health Author-Name: Marcus, A.C. Author-Name: Telesky, C.W. Year: 1983 Volume: 73 Issue: 1 Pages: 72-77 Abstract: The present analysis examined sample attrition in a one-year longitudinal health survey that made use of telephone follow-up interviews (N = 1210). Overall, respondent attrition had little impact on the sociodemographic and health status characteristics of the sample at the final interview. However, certain subgroups were statistically less likely to participate in the follow-up interviews, including younger respondents, the non-employed, people from the lower socioeconomic groups, and those who initially rated their health as fair or poor. Reports of physical illness and disability obtained at the initial interview were unrelated to rates of sample attrition. Handle: RePEc:aph:ajpbhl:1983:73:1:72-77_7 Template-Type: ReDIF-Article 1.0 Title: Byssinosis: A role for public health in the face of scientific uncertainty Journal: American Journal of Public Health Author-Name: Wegman, D.H. Author-Name: Levenstein, C. Author-Name: Greaves, I.A. Year: 1983 Volume: 73 Issue: 2 Pages: 188-192 Abstract: Byssinosis, a lung disease caused by cotton dust, has been the subject of recent controversy. Debates over the nature of the disease, possible interactions with cigarette smoking, and the proposed reevaluation of the cotton dust standard by the Occupational Safety and Health Administration have tended to overlook the plight of affected workers and to obscure the most effective means for preventing the disease. The present lack of definitive information is no reason for inaction, nor for depriving disabled workers of adequate financial compensation. In this respect, byssinosis is no different from other public health hazards for which action must often be taken on the basis of incomplete evidence. Handle: RePEc:aph:ajpbhl:1983:73:2:188-192_5 Template-Type: ReDIF-Article 1.0 Title: Adverse reproductive outcomes: The occupational health issue of the 1980s Journal: American Journal of Public Health Author-Name: Whorton, M.D. Year: 1983 Volume: 73 Issue: 1 Pages: 15-16 Handle: RePEc:aph:ajpbhl:1983:73:1:15-16_4 Template-Type: ReDIF-Article 1.0 Title: Establishing efficient interview periods for gonorrhea patients Journal: American Journal of Public Health Author-Name: Starcher III, E.T. Author-Name: Kramer, M.A. Author-Name: Carlota Orduna, B. Author-Name: Lundberg, D.F. Year: 1983 Volume: 73 Issue: 12 Pages: 1381-1384 Abstract: From February through December 1978, venereal disease casefinders in Polk County, Iowa used an expanded interview period of at least 120 days to interview 983 gonorrhea patients for sexual partner information. We grouped patients according to sex and clinical findings and evaluated the percentage of all new cases identified by time intervals within the expanded interview period. Ninety-one per cent of all untreated, infected sexual partners of symptomatic males were identified by using an interview period which spanned the interval from data of treatment to 15 days before symptoms onset. In contrast, the traditional 30-day interview period missed 23 per cent of those untreated, infected partners named by women with pelvic inflammatory disease (PID), 34 percent of those partners named by women with uncomplicated gonorrhea, and 29 percent of those named by asymptomatic men. The Polk County data suggests the importance of basing interview periods upon a patient's sex and clinical presentation. Handle: RePEc:aph:ajpbhl:1983:73:12:1381-1384_3 Template-Type: ReDIF-Article 1.0 Title: Personal versus telephone surveys for collecting household health data at the local level Journal: American Journal of Public Health Author-Name: Weeks, M.F. Author-Name: Kulka, R.A. Author-Name: Lessler, J.T. Author-Name: Whitmore, R.W. Year: 1983 Volume: 73 Issue: 12 Pages: 1389-1394 Abstract: Personal and telephone interview surveys were conducted simultaneously during 1981 in the same area (four counties in the area of Tampa Bay, Florida) and utilizing the same interview schedule. Following completion of the surveys, validity checks were made with the medical providers reported by a subsample of respondents to each mode. The telephone survey yielded a lower response rate but cost less than half the personal interview. There was some evidence of nonresponse bias in the telephone survey, and some relatively minor differences in responses were found between the two modes, but there was no conclusive evidence that the response differences resulted from mode effects. Telephone respondents appeared to be somewhat more accurate in their reporting of visits to medical providers, although accuracy comparisons must be interpreted with caution in view of the disparate success experienced for the two modes in securing permission forms for the release of medical record information. Handle: RePEc:aph:ajpbhl:1983:73:12:1389-1394_1 Template-Type: ReDIF-Article 1.0 Title: Concussion incidences and severity in secondary school varsity football players Journal: American Journal of Public Health Author-Name: Gerberich, S.G. Author-Name: Priest, J.D. Author-Name: Boen, J.R. Author-Name: Straub, C.P. Author-Name: Maxwell, R.E. Year: 1983 Volume: 73 Issue: 12 Pages: 1370-1375 Abstract: The head coaches and players of 103 secondary school football teams in Minnesota were asked to respond to mail questionnaires. Information about injury incidence and concomitant health care provision was elicited. Responses from 3,063 players (81 per cent) yielded a total injury rate of 78 injuries/100 players; 19/100 players reported a concussion experience characterized by loss of consciousness and/or loss of awareness. Of the players who experienced a loss of consciousness, 69 per cent were returned to play the same day. Persistent concussion symptoms were reported as long as six to nine months following the end of the season; six cases involved permanent disabilities. Continued use of illegal techniques of butt-blocking and face-tackling by as many as 40 per cent of the players was associated with apparent increased risks of concussions and concussion symptoms. Players with a prior history of loss of consciousness had a risk of loss of consciousness four times that of the player without a prior history. Handle: RePEc:aph:ajpbhl:1983:73:12:1370-1375_2 Template-Type: ReDIF-Article 1.0 Title: Lessons in surgery for the Third World Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1983 Volume: 73 Issue: 12 Pages: 1359-1360 Handle: RePEc:aph:ajpbhl:1983:73:12:1359-1360_8 Template-Type: ReDIF-Article 1.0 Title: Effects of the Islamic revolution in Iran on medical education: The Shiraz University School of Medicine Journal: American Journal of Public Health Author-Name: Ronaghy, H.A. Author-Name: Simon, H.J. Year: 1983 Volume: 73 Issue: 12 Pages: 1400-1401 Abstract: Some consequences of the Islamic Revolution in Iran on medical education were studied utilizing the Shiraz University School of Medicine. Of the 173 full-time faculty employed in 1978, 108 (63 percent) had left the university by the end of 1982, and 81 (47 percent) had left the country, aggravating the chronic shortage of medical personnel in Iran. Steps taken by the Iranian authorities to counteract these trends have not proven effective. Handle: RePEc:aph:ajpbhl:1983:73:12:1400-1401_9 Template-Type: ReDIF-Article 1.0 Title: Physicians' opinions of expanded clinical pharmacy services Journal: American Journal of Public Health Author-Name: Ritchey, F.J. Author-Name: Raney, M.R. Author-Name: Keith, T.D. Year: 1983 Volume: 73 Issue: 1 Pages: 96-101 Abstract: A statistical interaction model explaining 27 per cent of the variation in physicians' attitudes toward clinical pharmacy among 180 Alabama physicians is presented. Young primary care physicians who prescribe drugs with a low risk of adverse reactions are the most favorable toward pharmacists practising clinical tasks. Older solo-practice physicians who lack exposure to clinical pharmacy are the least favorable. The implications for the wider acceptance of clinical pharmacy are discussed in terms of its resources of professional power. Handle: RePEc:aph:ajpbhl:1983:73:1:96-101_7 Template-Type: ReDIF-Article 1.0 Title: Validity of a survey question as a measure of visual acuity impairment Journal: American Journal of Public Health Author-Name: Hiller, R. Author-Name: Krueger, D.E. Year: 1983 Volume: 73 Issue: 1 Pages: 93-96 Abstract: Survey questions are frequently used to collect data on the prevalence of vision difficulties. The 1971-1972 Health and Nutrition Examination Survey included both a question about 'trouble with your vision even when wearing glasses or contact lenses', and clinical measurement of central distance visual acuity with usual corrective lenses. The question had low sensitivity for impairment of visual acuity, with variation by age and severity of impairment. Sensitivity analyses from other studies are reviewed. Handle: RePEc:aph:ajpbhl:1983:73:1:93-96_1 Template-Type: ReDIF-Article 1.0 Title: Regionalization of surgical services Journal: American Journal of Public Health Author-Name: Peterson, O.L. Author-Name: Bloom, B.S. Year: 1983 Volume: 73 Issue: 2 Pages: 179-183 Abstract: Using data from the Studies on Surgical Services for the United States (SOSSUS), the extent of existing surgical care regionalization was examined in a defined area. Specialist comprised 55 per cent of all physicians who did operations, but performed nearly three-fourths of all operative work. About one-third of the most complex operations (CRV ≥ 30), more than one-fifth of medium complexity (CRV = 20-29), and 14 per cent of low complexity (CRV < 20) were obtained out of county of residence. Nearly one-half of all surgical patients at the university hospital were from other counties; but for those obtaining the most complex operations (CRV ≥ 30), three-fourths of them were from other counties. Thus there was a substantial amount of regionalization of surgical care already existing in this area. Handle: RePEc:aph:ajpbhl:1983:73:2:179-183_8 Template-Type: ReDIF-Article 1.0 Title: Cancer mortality patterns around the San Onofre nuclear power plant, 1960-1978 Journal: American Journal of Public Health Author-Name: Enstrom, J.E. Year: 1983 Volume: 73 Issue: 1 Pages: 83-91 Abstract: Because of the recent concern over possible health effects associated with nuclear power plants, cancer mortality patterns in Southern California have been examined for time periods before the San Onofre nuclear power plant begun commercial operation in 1968 and since then. This is one of America's older plants and is surrounded by major population centers in Orange, Riverside, and San Diego Counties. Infant mortality rates and age-adjusted mortality rates for leukemia, lung cancer, all cancer, and all causes have been calculated and compared for Orange, Riverside, and San Diego Counties, for California, and for the United States during 1960-1978. In addition, childhood leukemia death rates and clusters have been examined in detail in the communities within 25 miles of San Onofre. The cancer and total mortality rates near San Onofre have remained essentially identical to the corresponding rates in California and United States from 1960 to 1978. There have been no significant radiation releases to the population surrounding the San Onofre plant and the cancer rates show no patterns which have been influenced by the presence of the plant. Although no radiogenic health effects would be expected, these results do provide a means of assessing overall mortality trends in the population. Handle: RePEc:aph:ajpbhl:1983:73:1:83-91_2 Template-Type: ReDIF-Article 1.0 Title: Characteristics of joggers among Japanese men in Hawaii Journal: American Journal of Public Health Author-Name: Yamamoto, L. Author-Name: Yano, K. Author-Name: Rhoads, G.G. Year: 1983 Volume: 73 Issue: 2 Pages: 147-152 Abstract: In a population-based cohort of Japanese American men in Hawaii, the 450 joggers differed from 6,171 nonjoggers in being younger, taller, heavier, and more obese; in having larger vital capacity, higher socioeconomic status, and a higher prevalence of certain electrocardiographic abnormalities; and in being more health conscious as demonstrated by less smoking and a higher frequency of special diets. Blood pressure, serum total cholesterol, hematocrit and high density lipoprotein cholesterol (HDL-C) did not differ significantly between the two groups. Multiple regression analysis showed HDL-C to be inversely related to obesity and cigarettes, and directly related to alcohol consumption but to have no relationship to jogging or age. Temporal analyses suggested that initiation of jogging was followed by a reduction in heart rate, but there was no significant change in other measured parameters. Coronary heart disease (CHD) prevalence was increased in joggers, perhaps because the diagnosis of CHD predisposes to this activity. We conclude that jogging has probably had little impact on the health of this cohort. Handle: RePEc:aph:ajpbhl:1983:73:2:147-152_2 Template-Type: ReDIF-Article 1.0 Title: Coffee consumption during pregnancy and selected congenital malformations: A nationwide case-control study Journal: American Journal of Public Health Author-Name: Kurppa, K. Author-Name: Holmberg, P.C. Author-Name: Kuosma, E. Author-Name: Saxen, L. Year: 1983 Volume: 73 Issue: 12 Pages: 1397-1399 Abstract: Finland leads the world in per capital coffee consumption. To evaluate the hypothesis that coffee consumption during pregnancy is teratogenic. 755 pairs of mothers of malformed children and their controls were personally interviewed soon after delivery. After excluding tea drinkers and pairs with inadequate information, the study group included 706 pairs. Study subjects consisted of mothers of children with 112 defects of the central nervous system, 241 orofacial clefts, 210 structural defects of the skeleton, and 143 cardiovascular malformations. The coffee consumption during pregnancy was similar for the mothers of malformed or non-malformed children. The comparison of the mothers drinking at least four cups of coffee a day during pregnancy with those not consuming coffee at all showed a relative risk point estimate of 1.0 with the 95 percent confidence limits of 0.7 and 1.3. Handle: RePEc:aph:ajpbhl:1983:73:12:1397-1399_7 Template-Type: ReDIF-Article 1.0 Title: The establishment of health maintenance organizations: A geographical analysis Journal: American Journal of Public Health Author-Name: Cromley, E.K. Author-Name: Shannon, G.W. Year: 1983 Volume: 73 Issue: 2 Pages: 184-187 Abstract: Seven characteristics of 243 Standard Metropolitan Statistical Areas (SMSAs) were subjected to discriminant analysis to determine whether they distinguish SMSAs where at least one health maintenance orgnaization (HMO) was organized between 1972 and 1980 from SMSAs where no HMO developed. The discriminant function correctly classifies 77 per cent of the metropolitan areas considered. Presence of a medical school, regional location, and SMSA popultion were positively related to HMO establishment. Number of Medicare recipients per 1,000 SMSA residents was not associated with HMO development. Handle: RePEc:aph:ajpbhl:1983:73:2:184-187_0 Template-Type: ReDIF-Article 1.0 Title: Genetic testing in the workplace. Journal: American Journal of Public Health Author-Name: Uzych, L. Year: 1983 Volume: 73 Issue: 12 Pages: 1405 Handle: RePEc:aph:ajpbhl:1983:73:12:1405_4 Template-Type: ReDIF-Article 1.0 Title: Right to refuse treatment and threat to public health. Journal: American Journal of Public Health Author-Name: Redmond, S.R. Year: 1983 Volume: 73 Issue: 12 Pages: 1405-1406 Handle: RePEc:aph:ajpbhl:1983:73:12:1405-1406_0 Template-Type: ReDIF-Article 1.0 Title: Effects of being overweight Journal: American Journal of Public Health Author-Name: Stewart, A.L. Author-Name: Brook, R.H. Year: 1983 Volume: 73 Issue: 2 Pages: 171-178 Abstract: Based on cross sectional data from a general population of 5,817 people aged 14 to 61, objective overweight is compared with perceived overweight, and information is provided on morbidity due to being overweight, and on what people are going to try to lose weight. We found that 10 per cent of this population are moderately overweight and 12 per cent are severely overweight (although 41 per cent perceive they are overweight). Being overweight is associated with poorer functional status (e.g., overweight if given as the main reason for functional limitations by 13 per cent of people with such limitations) and with considerable pain, worry, and restricted activity because of this condition (e.g., 88 per cent of people who believe they are overweight worry at least a little about it). Only about 7 per cent of those who perceive they are overweight are under a doctor's care to lose weight. If physicians wish to assume a larger role in caring for overweight people, the nature of their role must be carefully evaluated. Handle: RePEc:aph:ajpbhl:1983:73:2:171-178_4 Template-Type: ReDIF-Article 1.0 Title: Trends in utilization of prenatal cytogenetic diagnosis by New York State residents in 1979 and 1980 Journal: American Journal of Public Health Author-Name: Hook, E.B. Author-Name: Schreinemachers, D.M. Year: 1983 Volume: 73 Issue: 2 Pages: 198-202 Abstract: It is estimated that 35.3 per cent of pregnant New York State women age 35 or over underwent cytogenetic diagnosis in 1980 as compared to 28.7 per cent in 1979. Rates varied sharply by county. In several small counties far from genetic centers, no 1980 cytogenetic diagnostic studies were reported in women 35 or over while in New York City the rate was 41 per cent. In one county with an active genetic center the rate appears to have plateaued at 30 per cent. Handle: RePEc:aph:ajpbhl:1983:73:2:198-202_6 Template-Type: ReDIF-Article 1.0 Title: Measuring severity of illness: Comparisons across institutions Journal: American Journal of Public Health Author-Name: Horn, S.D. Year: 1983 Volume: 73 Issue: 1 Pages: 25-31 Abstract: Conventional methods for classifying patients with respect to utilization of health care resources are based almost exclusively on diagnostic criteria. We review a new severity of illness index which is genetic to most medical and surgical conditions in a hospital, and which has been found to produce subgroups of patients more homogeneous with respect to hospital resource use (as assessed by total charges, length of stay, routine charges, and laboratory charges) than diagnostic-related groups, staging, and generalized patient management paths. We use the severity of illness groups to compare total charges and length of stay across hospitals. We find that charges and length of stay in an academic teaching hospital are similar to those in community hospitals with and without teaching programs when controlling for severity of illness. Handle: RePEc:aph:ajpbhl:1983:73:1:25-31_3 Template-Type: ReDIF-Article 1.0 Title: Surgeons and operating rooms: Underutilized resources Journal: American Journal of Public Health Author-Name: Gil, A.V. Author-Name: Galarza, M.T. Author-Name: Guerrero, R. Author-Name: de Velez, G.P. Author-Name: Peterson, O.L. Author-Name: Bloom, B.L. Year: 1983 Volume: 73 Issue: 12 Pages: 1361-1365 Abstract: A classification of surgical procedures, based on degree of complexity and the need for facilities and personnel, was applied to all 50,782 surgical interventions performed in the Valle del Cauca, Colombia during 1974. Three-fourths of all operations were of low levels of complexity, and most could be performed on an ambulatory basis with immediate discharge after recovery from anesthesia. Mean numbers of operations per year for surgical specialists and other physicians were 119.7 and 18.1, respectively. The 76 existing operating rooms were utilized only 41.6 per cent of the time. The implications of underutilization of personnel and facilities and low productivity of surgeons are discussed. Handle: RePEc:aph:ajpbhl:1983:73:12:1361-1365_3 Template-Type: ReDIF-Article 1.0 Title: Data requirements to measure progress on the objectives for the nation in health promotion and disease prevention Journal: American Journal of Public Health Author-Name: Green, L.W. Author-Name: Wilson, R.W. Author-Name: Bauer, K.G. Year: 1983 Volume: 73 Issue: 1 Pages: 18-24 Abstract: The Reagan Administration has adopted the policy guidelines developed over the previous few years in the disease prevention and health promotion initiative of the Carter Administration. Broad national consensus had been sought in the formulation of 226 measurable objectives for the decade. We classify the prevention objectives according to their position in an implied causal chain: 1) improved programs, 2) increased public and professional awareness, 3) reduced risk factors, and 4) improved health status. Prior to 1980, the data systems and periodic surveys sponsored by federal agencies and national organizations covered only four of the 42 objectives in the public and professional awareness category, whereas at least half of the objectives in each of the other three categories were covered by available national data sources, mostly federal. Sample surveys are needed to measure the majority of the currently unmeasured objectives in all four categories. Private and state health interview surveys are needed to supplement the federal capacity, especially in the face of federal cutbacks in survey capacity. Handle: RePEc:aph:ajpbhl:1983:73:1:18-24_3 Template-Type: ReDIF-Article 1.0 Title: Worksite smoking cessation programs: A potential for national impact Journal: American Journal of Public Health Author-Name: Stachnik, T. Author-Name: Stoffelmayr, B. Year: 1983 Volume: 73 Issue: 12 Pages: 1395-1396 Abstract: Data from the three pilot studies of small worksite smoking cessation programs demonstrate that programs which appeal to all smokers in an organization, not just those who have stated an interest in achieving cessation, will attract a high percent of smokers and assist an unusually high percent of them to achieve and maintain abstinence. Handle: RePEc:aph:ajpbhl:1983:73:12:1395-1396_4 Template-Type: ReDIF-Article 1.0 Title: Spontaneous abortions in an industrialized community in Finland Journal: American Journal of Public Health Author-Name: Hemminki, K. Author-Name: Kyyronen, P. Author-Name: Niemi, M.L. Year: 1983 Volume: 73 Issue: 1 Pages: 32-37 Abstract: Spontaneous abortions were analyzed in an industrialized Finnish community according to the occupation and workplace of both the women and their husbands. Information about spontaneous abortions and births was obtained from the hospital discharge register, and data about the women and their families were collected from census files. When compared with all women employed outside the home, women who worked at a textile plant (factory A, a clothing manufacturer) had an increased rate of spontaneous abortion (16.7 per cent vs 11.4 per cent). The rate of spontaneous abortions among women employed at factory A differed according to the husband's workplace. The odds ratio for women employed at factory A whose husbands worked at a large metallurgical factory was 3.8 whereas the odds ratio for women whose husbands worked elsewhere was 1.2. Between 1973 and 1976, the rate of spontaneous abortions in this town was consistently lower for the summer period (May-Agust) than for the other periods of the year. Handle: RePEc:aph:ajpbhl:1983:73:1:32-37_9 Template-Type: ReDIF-Article 1.0 Title: The temporal relation between cigarette smoking and pancreatic cancer Journal: American Journal of Public Health Author-Name: Weiss, W. Author-Name: Benarde, M.A. Year: 1983 Volume: 73 Issue: 12 Pages: 1403-1404 Abstract: Temporal trends in US cigarette smoking prevalence rates 1920 to 1978, were related to temporal trends in US pancreatic cancer mortality rates in both sexes. In males, the rise and fall in smoking prevalence was followed by a rise and recent fall in cancer rates. In females, the later rise in smoking prevalence has been accompanied by a rise in cancer rate, and a recent slight decline in smoking rate has been associated with a slowing of the rise in cancer rate. Handle: RePEc:aph:ajpbhl:1983:73:12:1403-1404_0 Template-Type: ReDIF-Article 1.0 Title: Paying hospitals: How does a severity measure help? Journal: American Journal of Public Health Author-Name: Muller, C. Year: 1983 Volume: 73 Issue: 1 Pages: 14-15 Handle: RePEc:aph:ajpbhl:1983:73:1:14-15_1 Template-Type: ReDIF-Article 1.0 Title: Five-year blood pressure control and mortality following health education for hypertensive patients Journal: American Journal of Public Health Author-Name: Morisky, D.E. Author-Name: Levine, D.M. Author-Name: Green, L.W. Author-Name: Shapiro, S. Author-Name: Russell, R.P. Author-Name: Smith, C.R. Year: 1983 Volume: 73 Issue: 2 Pages: 153-162 Abstract: Three health education interventions for urban poor hypertensive patients were introduced sequentially in a randomized factorial design: 1) and exit interview to increase understanding of an compliance with the prescribed regimen; 2) a home visit to encourage a family member to provide support for the patient's regimen; and 3) invitations to small group sessions to increase the patient's confidence and ability to manage his/her problem. Previous evaluation of the initial two-year experience demonstrated a positive effect of the educational program on compliance with the medical treatment and blood pressure control. Data accumulated over an addition three years, including mortality analysis, are now presented. The study group consisted of the same cohort of 400 ambulatory hypertensive outpatients in the eight experimental and control groups. The five-year analysis shows a continuing positive effect on appointment keeping, weight control, and blood pressure control. All-cause life table mortality rate was 57.3 per cent less for the experimental group compared to the control group (12.9/100 vs 30.2/100, p < .05), while the hypertension-related mortality rate was 53.2 per cent less (8.9/100 vs 19.0/100, p < .01). The results from this longitudinal study provide evidence to encourage health practitioners to utilize such educational programs in the long-term management and control of high blood pressure. Handle: RePEc:aph:ajpbhl:1983:73:2:153-162_1 Template-Type: ReDIF-Article 1.0 Title: Can Reagan be indicted for betraying public health? Journal: American Journal of Public Health Author-Name: Robbins, A. Year: 1983 Volume: 73 Issue: 1 Pages: 12-13 Handle: RePEc:aph:ajpbhl:1983:73:1:12-13_5 Template-Type: ReDIF-Article 1.0 Title: Sources of lead in the urban environment Journal: American Journal of Public Health Author-Name: Mahaffey, K.R. Year: 1983 Volume: 73 Issue: 12 Pages: 1357-1358 Handle: RePEc:aph:ajpbhl:1983:73:12:1357-1358_3 Template-Type: ReDIF-Article 1.0 Title: Effects of particulate air pollution on asthmatics Journal: American Journal of Public Health Author-Name: Perry, G.B. Author-Name: Chai, H. Author-Name: Dickey, D.W. Author-Name: Jones, R.H. Author-Name: Kinsman, R.A. Author-Name: Morrill, C.G. Author-Name: Spector, S.L. Author-Name: Weiser, P.C. Year: 1983 Volume: 73 Issue: 1 Pages: 50-56 Abstract: Twenty-four asthmatic subjects in Denver were followed from January through March 1979, a three-month period in which Denver air pollution levels are generally high and variable. Dichotomous, virtual impactor samplers provided daily measurements (μg/m3) of inhaled particulate matter (total mass, sulfates, and nitrates) for coarse (2.5-15 μm in aerodynamic diameter) and fine fractions (<2.5 μm). Carbon monoxide, sulfur dioxide, ozone, temperature, and barometric pressure were also measured. Twice daily measurements of each subject's peak expiratory flow rates, use of as-needed aerosolized bronchodilators, and report of airways obstruction symptoms characteristic of asthma were tested for relationships to air pollutants using a random effects model across subjects. During the time period actually observed, there were very few days in which high levels of suspended particulates were recorded. Of the environmental variables studied, only fine nitrates were associated with increased symptom reports and increased aerosolized bronchodilator usage. Handle: RePEc:aph:ajpbhl:1983:73:1:50-56_6 Template-Type: ReDIF-Article 1.0 Title: Referrals from an emergency room to primary care practices at an urban hospital Journal: American Journal of Public Health Author-Name: Straus, J.H. Author-Name: Orr, S.T. Author-Name: Charney, E. Year: 1983 Volume: 73 Issue: 1 Pages: 57-61 Abstract: Three hundred ninety-eight patients treated in the emergency room for non-urgent complaints who stated that they had no regular source of primary medical care were referred to one of several medical care centers in the areas. Overall, 34 per cent of such patients complied with the referral. Correlates of compliance were: age (very young and very old), patient-perceived health status, medically determined need for follow-up care, and having an appointment made by the emergency room provider. Another group of 500 successfully referred patients became excellent users of the primary care office, complying with requested health maintenance and follow-up visits. However, emergency room utilization by the successfully referred patients did not decrease more than among referred patients who did not enroll in the primary care source. Handle: RePEc:aph:ajpbhl:1983:73:1:57-61_4 Template-Type: ReDIF-Article 1.0 Title: The association of alcohol consumption with outcome of pregnancy Journal: American Journal of Public Health Author-Name: Marbury, M.C. Author-Name: Linn, S. Author-Name: Monson, R. Author-Name: Schoenbaum, S. Author-Name: Stubblefield, P.G. Author-Name: Ryan, K.J. Year: 1983 Volume: 73 Issue: 10 Pages: 1165-1168 Abstract: Patterns of alcohol consumption were assessed in 12,440 pregnant women interviewed at the time of delivery. Only 92 women (0.7%) reported drinking 14 or more drinks per week, with most consuming fewer than 21 drinks per week. In the crude data, alcohol intake of 14 or more drinks per week was associated with a variety of adverse pregnancy outcomes, including low birthweight, gestational age under 37 weeks, stillbirth, and placenta abruptio. After use of logistic regression to control for confounding by demographic characteristics, smoking, parity, and obstetric history, only the association of placenta abruptio with alcohol consumption of 14 or more drinks per week remained statistically significant. With the exception of placenta abruptio, alcohol intake of fewer than 14 drinks per week was not associated with an increased risk of any adverse outcome. No association was seen with congenital malformations at any level of alcohol intake. Handle: RePEc:aph:ajpbhl:1983:73:10:1165-1168_9 Template-Type: ReDIF-Article 1.0 Title: The association of marijuana use with outcome of pregnancy Journal: American Journal of Public Health Author-Name: Linn, S. Author-Name: Schoenbaum, S.C. Author-Name: Monson, R.R. Author-Name: Rosner, R. Author-Name: Stubblefield, P.C. Author-Name: Ryan, K.J. Year: 1983 Volume: 73 Issue: 10 Pages: 1161-1164 Abstract: We analyzed interview and medical record data of 12,424 women to evaluate the relationship between marijuana usage and adverse outcomes of pregnancy. Low birthweight, short gestation, and major malformations occurred more often among offspring of marijuana users. When we used logistic regression to control for demographic characteristics, habits, and medical history data, these relationships were not statistically significant. The odds ratio for the occurrence of major malformations among marijuana users was 1.36, higher than odds ratios for other exogenous variables, and the 95% confidence interval was 0.97-1.91. More data are needed to establish firmly or rule out an association between marijuana usage and major malformations. Until more information is available, women should be advised not to use marijuana during pregnancy. Handle: RePEc:aph:ajpbhl:1983:73:10:1161-1164_8 Template-Type: ReDIF-Article 1.0 Title: Jurisdictional limitations on access to mortality data. Journal: American Journal of Public Health Author-Name: Dunn, J.P. Year: 1983 Volume: 73 Issue: 11 Pages: 1329 Handle: RePEc:aph:ajpbhl:1983:73:11:1329_3 Template-Type: ReDIF-Article 1.0 Title: The 'Right-to-Know' movement. Journal: American Journal of Public Health Author-Name: Bingham, E. Year: 1983 Volume: 73 Issue: 11 Pages: 1302 Abstract: Bingham, former Assistant Secretary for Occupational Safety and Health in the U.S. Department of Labor, comments on the progress of the "right-to-know" movement in worker health since 1980. Failure on the part of the Reagan administration to move quickly forward with a proposal for a hazard identification standard, known as "Right-to-Know, Part II," has been offset by action at the state and local levels. As of August 1983, 10 states had passed right-to-know laws, with legislation pending in others. Bingham attributes this success to several factors and remarks on the effectiveness of local coalitions in solving a national health problem. Handle: RePEc:aph:ajpbhl:1983:73:11:1302_6 Template-Type: ReDIF-Article 1.0 Title: Measurement of family progress in coping with health problems. Journal: American Journal of Public Health Author-Name: Highriter, M.E. Year: 1983 Volume: 73 Issue: 11 Pages: 1248-1250 Handle: RePEc:aph:ajpbhl:1983:73:11:1248-1250_1 Template-Type: ReDIF-Article 1.0 Title: Pretesting of questions in visual acuity surveys. Journal: American Journal of Public Health Author-Name: Rubenstein, R.S. Author-Name: Lohr, K.N. Year: 1983 Volume: 73 Issue: 11 Pages: 1331-1332 Handle: RePEc:aph:ajpbhl:1983:73:11:1331-1332_5 Template-Type: ReDIF-Article 1.0 Title: The National Death Index. Journal: American Journal of Public Health Author-Name: MacMahon, B. Year: 1983 Volume: 73 Issue: 11 Pages: 1247-1248 Handle: RePEc:aph:ajpbhl:1983:73:11:1247-1248_8 Template-Type: ReDIF-Article 1.0 Title: The hazards of exercise. Journal: American Journal of Public Health Author-Name: James, W.H. Year: 1983 Volume: 73 Issue: 11 Pages: 1332 Handle: RePEc:aph:ajpbhl:1983:73:11:1332_6 Template-Type: ReDIF-Article 1.0 Title: Follow-up study: protective immunization in the elderly. Journal: American Journal of Public Health Author-Name: Ruben, F.L. Author-Name: Fireman, P. Year: 1983 Volume: 73 Issue: 11 Pages: 1330 Handle: RePEc:aph:ajpbhl:1983:73:11:1330_6 Template-Type: ReDIF-Article 1.0 Title: Similarities between AIDS and PCM. Journal: American Journal of Public Health Author-Name: Gray, R.H. Year: 1983 Volume: 73 Issue: 11 Pages: 1332 Handle: RePEc:aph:ajpbhl:1983:73:11:1332_8 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic features of Reye syndrome seen in southwestern Pennsylvania 1970-80 Journal: American Journal of Public Health Author-Name: Ruben, F. Author-Name: Streiff, E. Author-Name: Neal, M. Author-Name: Lehberger, L. Author-Name: Hreha, M. Author-Name: Michaels, R. Year: 1983 Volume: 73 Issue: 9 Pages: 1063-1065 Abstract: In 11 years of surveillance in southwestern Pennsylvania there were 97 cases of Reye syndrome. Peak incidence was in February and March, corresponding to periods of influenza A and B activity. Mean age of cases was 7.9 years; 57 per cent were female. Case fatality declined from 55 per cent in 1970-75 to 16 per cent in 1976-80 (p < .001). Influenza was associated with 45 per cent of cases, varicella 19 per cent; the remaining 36 per cent of cases did not occur during periods of influenza activity. Reye syndrome occurred significantly more frequently in suburban and rural areas than in central city (p < .01), more frequently among White persons than Blacks (p < .01), and more frequently in counties where the total population under 17 years was < 25,000 (p < .01). Handle: RePEc:aph:ajpbhl:1983:73:9:1063-1065_7 Template-Type: ReDIF-Article 1.0 Title: Knowledge and attitudes of primary health care personnel concerning mental health problems in developing countries Journal: American Journal of Public Health Author-Name: Ignacio, L.L. Author-Name: de Arango, M.V. Author-Name: Baltazar, J. Author-Name: Busnello, E.D. Author-Name: Climent, C.E. Author-Name: Elhakim, A. Author-Name: Farb, M. Author-Name: Guèye, M. Author-Name: Harding, T.W. Author-Name: Ibrahim, H.H. Author-Name: Murthy, R.S. Author-Name: Wig, N.N. Year: 1983 Volume: 73 Issue: 9 Pages: 1081-1084 Abstract: A semi-structured interview for assessing the knowledge and attitude of health workers concerning mental health problems was applied in seven developing country areas within the context of a World Health Organization coordinated collaborative study. The results indicate a lack of basic mental health training associated with a failure to recognize mental health problems, restricted knowledge concerning psychotropic drug therapy, and an inability to visualize practical forms of mental health care which could be introduced at primary care level. The results were used to design appropriate training programs, and the observations will be repeated to assess the effectiveness of training. Handle: RePEc:aph:ajpbhl:1983:73:9:1081-1084_0 Template-Type: ReDIF-Article 1.0 Title: Sentinel Health Events (Occupational): A basis for physician recognition and public health surveillance Journal: American Journal of Public Health Author-Name: Rutstein, D.D. Author-Name: Mullan, R.J. Author-Name: Frazier, T.M. Author-Name: Halperin, W.E. Author-Name: Melius, J.M. Author-Name: Sestito, J.P. Year: 1983 Volume: 73 Issue: 9 Pages: 1054-1062 Abstract: A Sentinel Health Event (SHE) is a preventable disease, disability, or untimely death whose occurrence serves as a warning signal that the quality of preventive and/or therapeutic medical care may need to be improved. A SHE (Occupational) is a disease, disability, or untimely death which is occupationally related and whose occurrence may: 1) provide the impetus for epidemiologic or industrial hygiene studies; or 2) serve as a warning signal that materials substitution, engineering control, personal protection, or medical care may be required. The present SHE(O) list encompasses 50 disease conditions that are linked to the workplace. Only those conditions are included for which objective documentation of an associated agent, industry, and occupation exists in the scientific literature. The list will serve as a framework for developing a national system for occupational health surveillance that may be applied at the state and local level, and as a guide for practising physicians caring for patients with occupational illnesses. We expect to update the list periodically to accommodate new occupational disease events which meet the criteria for inclusion. Handle: RePEc:aph:ajpbhl:1983:73:9:1054-1062_6 Template-Type: ReDIF-Article 1.0 Title: Illness severity, death, and hospital cost comparisons. Journal: American Journal of Public Health Author-Name: Goss, M.E. Year: 1983 Volume: 73 Issue: 10 Pages: 1215-1216 Handle: RePEc:aph:ajpbhl:1983:73:10:1215-1216_1 Template-Type: ReDIF-Article 1.0 Title: On the cost of repealing motorcycle helmet laws. Journal: American Journal of Public Health Author-Name: Somers, R.L. Year: 1983 Volume: 73 Issue: 10 Pages: 1216 Handle: RePEc:aph:ajpbhl:1983:73:10:1216_6 Template-Type: ReDIF-Article 1.0 Title: Smoking, alcohol and reproduction. Journal: American Journal of Public Health Author-Name: Stein, Z. Author-Name: Kline, J. Year: 1983 Volume: 73 Issue: 10 Pages: 1154-1156 Handle: RePEc:aph:ajpbhl:1983:73:10:1154-1156_8 Template-Type: ReDIF-Article 1.0 Title: Reproductive health of working women. Journal: American Journal of Public Health Author-Name: Saurel-Cubizolles, M.J. Author-Name: Kaminski, M. Year: 1983 Volume: 73 Issue: 10 Pages: 1215 Handle: RePEc:aph:ajpbhl:1983:73:10:1215_4 Template-Type: ReDIF-Article 1.0 Title: Morbidity and mortality from diabetes mellitus: a look at preventable aspects. Journal: American Journal of Public Health Author-Name: Ganda, O.P. Year: 1983 Volume: 73 Issue: 10 Pages: 1156-1158 Handle: RePEc:aph:ajpbhl:1983:73:10:1156-1158_6 Template-Type: ReDIF-Article 1.0 Title: On emphysema among cotton textile workers. Journal: American Journal of Public Health Author-Name: Pratt, P.C. Year: 1983 Volume: 73 Issue: 10 Pages: 1217-1218 Handle: RePEc:aph:ajpbhl:1983:73:10:1217-1218_3 Template-Type: ReDIF-Article 1.0 Title: On newborn sickle cell screening in NYC. Journal: American Journal of Public Health Author-Name: Grossman, L.K. Year: 1983 Volume: 73 Issue: 10 Pages: 1216-1217 Handle: RePEc:aph:ajpbhl:1983:73:10:1216-1217_0 Template-Type: ReDIF-Article 1.0 Title: Cancer and infant mortality around a nuclear power plant. Journal: American Journal of Public Health Author-Name: Johnson, C.J. Year: 1983 Volume: 73 Issue: 10 Pages: 1218-1219 Handle: RePEc:aph:ajpbhl:1983:73:10:1218-1219_5 Template-Type: ReDIF-Article 1.0 Title: Adoption: a public health perspective. Journal: American Journal of Public Health Author-Name: Klerman, L.V. Year: 1983 Volume: 73 Issue: 10 Pages: 1158-1160 Handle: RePEc:aph:ajpbhl:1983:73:10:1158-1160_9 Template-Type: ReDIF-Article 1.0 Title: The Seattle evaluation of computerized drug profiles: Effects on prescribing practices and resource use Journal: American Journal of Public Health Author-Name: Koepsell, T.D. Author-Name: Gurtel, A.L. Author-Name: Diehr, P.H. Author-Name: Temkin, N.R. Author-Name: Helfand, K.H. Author-Name: Gleser, M.A. Author-Name: Tompkins, R.K. Year: 1983 Volume: 73 Issue: 8 Pages: 850-855 Abstract: Since 1979, all outpatient pharmacy transactions at the US Public Health Service Hospital in Seattle have been captured in a computer system which generates a profile of each patient's active and previously used drugs. The authors conducted a controlled trial in which patients were allocated to profile or no-profile groups while the computer continued to collect data on everyone. In all, 41,572 clinic visits made by 6,186 patients were studied. The incidence of preventable drug-drug interactions and redundancies was very low and was unaffected by profiles. For unclear reasons, prescription of two interacting drugs on the same visit was significantly more common for patients with profiles. The duration of drug-drug interaction episodes was significantly shorter for profile group patients, perhaps due to earlier detection of the error on subsequent visits. Profiles had no effect on prescribing volume or coordination of drug refill and visit schedules, but profile group patients made about 5% fewer clinic visits than those in the no-profile group. In this setting, it appears that the prescribing of interacting or redundant drugs is more often due to inadequate provider knowledge than to inaccessible patient-specific drug data. Prevention of such errors would thus require a more active educational or monitoring program. Handle: RePEc:aph:ajpbhl:1983:73:8:850-855_8 Template-Type: ReDIF-Article 1.0 Title: An outbreak of waterborne giardiasis associated with heavy water runoff due to warm weather and volcanic ashfall Journal: American Journal of Public Health Author-Name: Weniger, B.G. Author-Name: Blaser, M.J. Author-Name: Gedrose, J. Author-Name: Lippy, E.C. Author-Name: Juranek, D.D. Year: 1983 Volume: 73 Issue: 8 Pages: 868-872 Abstract: From mid-June through early August 1980, an outbreak of gastrointestinal illness in Red Lodge. Montana affected approximately 780 persons, as estimated from attack rates of 33% and 15% in urban and rural residents, respectively. Giardia lamblia was identified in stool specimens from 51% of 47 persons with a history of untreated gastrointestinal illness and in 13% of 24 specimens from asymptomatic persons (p = .00045, Fisher's Exact Test). The epidemic curve was bimodal with peaks in mid-June and mid-July. Each peak occurred about three weeks after an episode of very heavy water runoff resulting from warm sunney weather and snow darkened by ashfall from the Mt. St. Helens volcanic eruption of May 18, 1980. Unfiltered and inadequately chlorinated surface water was supplied by the city water system, which was implicated as the vehicle of transmission in the outbreak. Water systems providing unfiltered surface water are more likely to become contaminated during periods of heavy water runoff. Handle: RePEc:aph:ajpbhl:1983:73:8:868-872_1 Template-Type: ReDIF-Article 1.0 Title: Effects of a low cholesterol eating plan on plasma lipids: Results of a three-year community study Journal: American Journal of Public Health Author-Name: Reeves, R.S. Author-Name: Foreyt, J.P. Author-Name: Scott, L.W. Author-Name: Mitchell, R.E. Author-Name: Wohlleb, J. Author-Name: Gotto Jr., A.M. Year: 1983 Volume: 73 Issue: 8 Pages: 873-877 Abstract: In an attempt to demonstrate whether individuals with average plasma lipids would accept a diet low in saturated fat and cholesterol, members of a community organization were taught the HELP Your Heart Eating Plan. Results of 282 individuals suggest that reduced dietary cholesterol from selected foods could be sustained for up to 36 months. While both plasma cholesterol and triglycerides fell during a year of instruction, both rose to above initial values by 36 months. Overall, the results suggest that adults may be willing to accept a new style of eating temporarily but are not committed to making permanent dietary changes. Handle: RePEc:aph:ajpbhl:1983:73:8:873-877_9 Template-Type: ReDIF-Article 1.0 Title: Data requirements and the objectives for the nation. Journal: American Journal of Public Health Author-Name: Green, L.W. Author-Name: Bauer, K.G. Year: 1983 Volume: 73 Issue: 9 Pages: 1101-1102 Handle: RePEc:aph:ajpbhl:1983:73:9:1101-1102_8 Template-Type: ReDIF-Article 1.0 Title: De-fusing the symbolic value of smoking. Journal: American Journal of Public Health Author-Name: Gordon, N.P. Year: 1983 Volume: 73 Issue: 9 Pages: 1102 Handle: RePEc:aph:ajpbhl:1983:73:9:1102_9 Template-Type: ReDIF-Article 1.0 Title: Generalizability of jogger study group. Journal: American Journal of Public Health Author-Name: Sachs, M.L. Year: 1983 Volume: 73 Issue: 9 Pages: 1103 Handle: RePEc:aph:ajpbhl:1983:73:9:1103_6 Template-Type: ReDIF-Article 1.0 Title: Northeastern Ohio trauma study: I. Magnitude of the problem Journal: American Journal of Public Health Author-Name: Barancik, J.J. Author-Name: Chatterjee, B.F. Author-Name: Greene, Y.C. Author-Name: Michenzi, E.M. Author-Name: Fife, D. Year: 1983 Volume: 73 Issue: 7 Pages: 746-751 Abstract: This study measured the incidence of cause-specific trauma in the Cleveland and Lorain-Elyria Standard Metropolitan Statistical Areas (SMSAs), population 2.2 million, as reported to hospital emergency departments (ED). Cases were selected according to a stratified probability sampling plan (N = 9268). The participating hospitals accounted for 97.6 per cent of 903,346 ED visits in 1977; 52 per cent of these visits were for trauma (ICDA-8 E800-E999). The trauma incidence rate was 197 per 1,000 population. The six leading causes of injury were: falls, 24.4 per cent; cut/piercing injury, 14.2 per cent; striking or struck by object, 13.8 per cent; motor vehicle collisions (MVC), 11.6 per cent; overexertion/strain, 8.2 per cent; and assault, 4.3 per cent. Only falls, MVCs, and assaults were leading causes of both injury and death. The injury incidence rates for vehicular crashes and assault were 1.4 and 3.8 times higher, respectively, than the official incidence rates for these SMSAs. These differences point to a significant underreporting of data needed for public health decision making. Because data were not collected on cases treated outside the participating hospitals, the incidence rates reported here represent a conservative estimate of the magnitude of the problem. Handle: RePEc:aph:ajpbhl:1983:73:7:746-751_4 Template-Type: ReDIF-Article 1.0 Title: Traveler's diarrhea at sea: Two multi-pathogen outbreaks caused by food eaten on shore visits Journal: American Journal of Public Health Author-Name: Berkelman, R.L. Author-Name: Cohen, M.L. Author-Name: Yashuk, J. Author-Name: Barrett, T. Author-Name: Wells, J.G. Author-Name: Blake, P.A. Year: 1983 Volume: 73 Issue: 7 Pages: 770-772 Abstract: In 1976 and 1981, two outbreaks of gastrointestinal illness aboard cruise ships occurred within 24 hours following onshore visits to Haiti and Mexico, respectively. Three hundred eighty-six of 600 (64 per cent) and 98 of 260 (38 per cent) passengers became ill following luncheons in Port-au-Prince, Haiti, and Cozumel, Mexico. No increase in illness was observed among those passengers who did not attend the onshore luncheons. In both outbreaks, unrefrigerated seafood dishes served at outdoor buffets were epidemiologically incriminated as the vehicles of transmission. Several species of Vibrion, Salmonella, and toxigenic Escherichia coli were recovered from stool specimens of ill passengers in both outbreaks. In addition, invasive Escherichia coli and Shigella were isolated from stool specimens of ill passengers who ate at the Haitian buffet. Previous investigations of outbreaks of gastrointestinal illness aboard cruise ships have implicated exposures on board as the source and have involved only a single pathogen. Handle: RePEc:aph:ajpbhl:1983:73:7:770-772_1 Template-Type: ReDIF-Article 1.0 Title: The epidemiology of heat-related deaths, Texas-1950, 1970-79, and 1980 Journal: American Journal of Public Health Author-Name: Greenberg, J.H. Author-Name: Bromberg, J. Author-Name: Reed, C.M. Author-Name: Gustafson, T.L. Author-Name: Beauchamp, R.A. Year: 1983 Volume: 73 Issue: 7 Pages: 805-807 Abstract: A study of the deaths during a 1980 heat wave in Texas revealed death rates that were highest in males, the elderly, Blacks and those engaged in heavy labor, the latter two factors perhaps reflecting socioeconomic status. The data suggest that persistent high temperatures were related to death to a greater degree than the temperature peaks reached. Higher heat death rates in earlier years are believed to be attributable to the limited availability of air conditioning in those years. Handle: RePEc:aph:ajpbhl:1983:73:7:805-807_8 Template-Type: ReDIF-Article 1.0 Title: Weight and sodium reduction for the prevention of hypertension: A comparison of group treatment and individual counseling Journal: American Journal of Public Health Author-Name: Jeffery, R.W. Author-Name: Gillum, R. Author-Name: Gerber, W.M. Author-Name: Jacobs, D. Author-Name: Elmer, P.J. Author-Name: Prineas, R.J. Year: 1983 Volume: 73 Issue: 6 Pages: 691-693 Abstract: Ninety-three overweight adult males with labile blood pressure elevation participated in an 20-week dietary intervention program to achieve a 10 per cent reduction in body weight and a reduction in dietary sodium intake to 70 milliequivalents per day. By random assignment, half were treated with intensive group treatment procedures and half with individual counseling. Written handouts and assignments were identical, as was the schedule of treatment visits. Both techniques produced significant decreases in weight, sodium intake, calorie intake, and blood pressure. Calorie and sodium knowledge also increased significantly with both intervention approaches. The two treatment modalities did not differ in effectiveness. Handle: RePEc:aph:ajpbhl:1983:73:6:691-693_9 Template-Type: ReDIF-Article 1.0 Title: Cancer and tobacco use by sex partners. Journal: American Journal of Public Health Author-Name: Redmond, S.R. Year: 1983 Volume: 73 Issue: 8 Pages: 922 Handle: RePEc:aph:ajpbhl:1983:73:8:922_6 Template-Type: ReDIF-Article 1.0 Title: Illinois attitudes to seat belts and a seat belt law. Journal: American Journal of Public Health Author-Name: Mortimer, R.G. Year: 1983 Volume: 73 Issue: 8 Pages: 922 Handle: RePEc:aph:ajpbhl:1983:73:8:922_8 Template-Type: ReDIF-Article 1.0 Title: Does perception of life expectancy reflect health knowledge? Journal: American Journal of Public Health Author-Name: Hamermesh, D.S. Author-Name: Hamermesh, F.W. Year: 1983 Volume: 73 Issue: 8 Pages: 911-914 Abstract: Analysis of original survey data shows White male smokers estimate their longevity as four years less than that of nonsmokers, roughly the actuarial difference. Those who do not exercise perceive the same life expectancy as those who exercise, somewhat inconsistent with available information on mortality. Men with long-lived parents and grandparents expect to live 12-18 years longer than those with short-lived forebears, far longer than studies of actual longevity imply. Men who are more than 15 per cent overweight expect to live four years less, a larger impact than the published actuarial difference. Handle: RePEc:aph:ajpbhl:1983:73:8:911-914_1 Template-Type: ReDIF-Article 1.0 Title: Health policy agenda for the American people. Journal: American Journal of Public Health Author-Name: Boyle, J.F. Year: 1983 Volume: 73 Issue: 7 Pages: 814-815 Handle: RePEc:aph:ajpbhl:1983:73:7:814-815_9 Template-Type: ReDIF-Article 1.0 Title: Public money, private control: A case study of hospital financing in Oakland and Berkeley, California Journal: American Journal of Public Health Author-Name: Woolhandler, S. Author-Name: Himmelstein, D.U. Author-Name: Silber, R. Author-Name: Harnly, M. Author-Name: Bader, M. Author-Name: Jones, A.A. Year: 1983 Volume: 73 Issue: 5 Pages: 584-587 Abstract: Government support of public and private hospitals in Oakland and Berkeley, California was investigated. The private hospitals received government subsidies amounting to at least 60 per cent of their total revenues. The dollar amount of the subsidies to private hospitals was four and one-half times greater than government expenditures on the public hospital. In Oakland and Berkeley, as in many cities, public medical services have been reduced while both government health expenditures and private hospital revenues have increased sharply. The private hospitals, although all nominally non-profit, exhibit revenue maximizing behavior which results in socially unjust and medically irrational resource allocation. Funds might be found for public hospitals and clinics, and resources allocated more justly and rationally, if government expenditures in the private sector were brought under greater public security and control. Handle: RePEc:aph:ajpbhl:1983:73:5:584-587_7 Template-Type: ReDIF-Article 1.0 Title: Measles and rubella: Our remaining responsibilities Journal: American Journal of Public Health Author-Name: Doster, S.W. Author-Name: Stetler, H.C. Author-Name: Orenstein, W.A. Author-Name: Bart, K.J. Author-Name: Hinman, A.R. Year: 1983 Volume: 73 Issue: 5 Pages: 490-492 Handle: RePEc:aph:ajpbhl:1983:73:5:490-492_6 Template-Type: ReDIF-Article 1.0 Title: Smoking and carcinoma in situ of the uterine cervix Journal: American Journal of Public Health Author-Name: Lyon, J.L. Author-Name: Gardner, J.W. Author-Name: West, D.W. Author-Name: Stanish, W.M. Author-Name: Hebertson, R.M. Year: 1983 Volume: 73 Issue: 5 Pages: 558-562 Abstract: We carried out a case-control study of 217 cases of in situ carcinoma of the uterine cervix and 243 controls chosen from the general population of Utah. We found a relative risk of 0.3 for cigarette smoking after controlling for sexual and socioeconomic risk factors. The smoking association was strongest in the youngest age group (ages 20-29), reaching seventeenfold, and was weaker in the older age groups. These data suggest that cigarette smoking may be an independent risk factor for cancer of the uterine cervix, after considering sexual behavior and other well-established risk factors. Handle: RePEc:aph:ajpbhl:1983:73:5:558-562_5 Template-Type: ReDIF-Article 1.0 Title: Risk of pregnancy among adolescent schoolgirls participating in a measles mass immunization program Journal: American Journal of Public Health Author-Name: Mann, J.M. Author-Name: Montes, J.M. Author-Name: Hull, H.F. Author-Name: Greenberg, N. Author-Name: Kalishman, N. Author-Name: Pressman, A.E. Author-Name: Kennedy, S.G. Author-Name: Iddings, C.T. Year: 1983 Volume: 73 Issue: 5 Pages: 527-529 Abstract: A large measles vaccination program in the Albuquerque, New Mexico public schools in 1981, conducted according to US Public Health Service guidelines, was studied to determine rates of pregnancy among adolescent vaccinees. Pre-vaccination counseling of 1,922 clinic attendees prevented seven pregnant girls from being vaccinated. Despite counseling, of 1,913 female vaccinees age 13-18 years old, two were pregnant at the time of vaccination (1.05 pregnancies per 1,000 vaccinees) and an additional four girls became pregnant in the three months after vaccination (2.1 pregnancies per 1,000 vaccinees). Data supporting low or absent fetal risks from measles and rubella vaccine, combined with the low pregnancy rate among vaccinees documented in this study, support the reasonableness of the recommended strategy for measles and rubella vaccination of secondary schoolgirls. Handle: RePEc:aph:ajpbhl:1983:73:5:527-529_5 Template-Type: ReDIF-Article 1.0 Title: Third-trimester induced abortion in Georgia, 1979 and 1980 Journal: American Journal of Public Health Author-Name: Spitz, A.M. Author-Name: Lee, N.C. Author-Name: Grimes, D.A. Author-Name: Schoenbucher, A.K. Author-Name: Lavoie, M. Year: 1983 Volume: 73 Issue: 5 Pages: 594-595 Abstract: We reviewed 86 third-trimester induced abortions reported to the Georgia Department of Human Resources in 1979 and 1980. Only three of the 78 with adequate data were classified correctly. Fetal deaths in utero accounted for 67.4 per cent of reported cases and first- or second-trimester abortions 18.6 per cent. The true rate of induced abortions performed in the third trimester was 4.3 per 100,000 legal abortions. Diagnosed anencephaly accounted for two out of the three valid third-trimester induced abortions performed. Handle: RePEc:aph:ajpbhl:1983:73:5:594-595_6 Template-Type: ReDIF-Article 1.0 Title: Mental health treatment and medical care utilization in a fee-for-service system: Outpatient mental health treatment following the onset of a chronic disease Journal: American Journal of Public Health Author-Name: Schlesinger, H.J. Author-Name: Mumford, E. Author-Name: Glass, G.V. Author-Name: Patrick, C. Author-Name: Sharfstein, S. Year: 1983 Volume: 73 Issue: 4 Pages: 422-429 Abstract: Charges for medical services of persons covered by the Blue Cross/Blue Shield Federal Employees Program from 1974 through 1978 who were first diagnosed as having one of four chronic diseases in 1975 and within one year began mental health treatment (MHT) were compared with persons who also were first diagnosed as having one of these diseases in 1975 but had no subsequent MHT. In the third year following the diagnosis, those having seven to 20 MHT visits had medical charges $309 lower and those having over 21 MHT visits had medical charges $284 lower than the comparison group. The savings in medical charges over three years of the group having seven to 20 MHT visits were a function of lower use of inpatient services and roughly equaled the cost of 20 MHT visits. Outpatient mental health treatment can be included in a fee-for-service medical care system to improve the quality and appropriateness of care and, if not extensive, may also serve to lower medical care costs. Handle: RePEc:aph:ajpbhl:1983:73:4:422-429_3 Template-Type: ReDIF-Article 1.0 Title: Podiatric health and jogging. Journal: American Journal of Public Health Author-Name: Stern, A. Year: 1983 Volume: 73 Issue: 6 Pages: 704 Handle: RePEc:aph:ajpbhl:1983:73:6:704_7 Template-Type: ReDIF-Article 1.0 Title: The valley of the shadow of birth. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1983 Volume: 73 Issue: 6 Pages: 635-638 Handle: RePEc:aph:ajpbhl:1983:73:6:635-638_8 Template-Type: ReDIF-Article 1.0 Title: Current sickle cell screening program for newborns in New York City, 1979-1980 Journal: American Journal of Public Health Author-Name: Grover, R. Author-Name: Shahidi, S. Author-Name: Fisher, B. Author-Name: Goldberg, D. Author-Name: Wethers, D. Year: 1983 Volume: 73 Issue: 3 Pages: 249-252 Abstract: The newborn screening program mandated by the New York State Public Health Law requires that every baby born in the state be tested for eight conditions including sickle cell anemia. Although sickle cell screening of newborns has been in operation since 1975, the follow-up program for case retrieval to obtain repeat blood samples for definitive diagnosis and referral of diagnosed patients for ongoing medical care was established only in 1979. Of the 106,565 blood samples tested in New York City Newborn Screening Laboratory, March 1, 1979 to February 29, 1980, 141 infants were identified on repeat blood testing as having various forms of sickle cell disease (SS, SC and Sβ-Thalassemia) and were referred for ongoing medical care. Data received on 131 patients from follow-up clinics revealed that the disease diagnosis made by the Newborn Screening Laboratory was confirmed in all patients. There were no deaths reported among the study patients (131 infants) followed for the period of 9-20 months despite the life-threatening complications among eight patients. Binomial distribution of the data on Black infants according to the Hardy-Weinberg equation showed reasonable agreement between the observed and computed incidence of various forms of sickle cell disease. Handle: RePEc:aph:ajpbhl:1983:73:3:249-252_7 Template-Type: ReDIF-Article 1.0 Title: Contamination of the food chain by polychlorinated biphenyls from a broken transformer Journal: American Journal of Public Health Author-Name: Drotman, D.P. Author-Name: Baxter, P.J. Author-Name: Liddle, J.A. Author-Name: Brokopp, C.D. Author-Name: Skinner, M.D. Year: 1983 Volume: 73 Issue: 3 Pages: 290-292 Abstract: In 1979, widespread distribution of chicken and egg food products and grease contaminated with polychlorinated biphenyl (PCBs) occurred across the United States and as far away as Canada and Japan. The contamination was traced to an accidental leakage of PCBs from a transformer stored in a hog slaughtering plant in Montana. Breast milk analyses showed the PCB absorption had occurred among egg consumers. The episode illustrates the need for heightened vigilance over the fate of PCBs still in use. Handle: RePEc:aph:ajpbhl:1983:73:3:290-292_9 Template-Type: ReDIF-Article 1.0 Title: Effect of polybrominated biphenyls (PBB) on developmental abilities in young children Journal: American Journal of Public Health Author-Name: Schwartz, E.M. Author-Name: Rae, W.A. Year: 1983 Volume: 73 Issue: 3 Pages: 277-281 Abstract: Eighteen children, ages 4 to 6 years, with known exposure to polybrominated biphenyls (PBB) in utero and/or through breast milk were administered developmental tests. These same children had exhibited low scores on a partial developmental assessment two years earlier. Current results were compared to normative test data. Findings showed: 1) PBB cohort children are within the normal range in all areas assessed; 2) An inverse relationship is noted between PBB fat level and scores on some developmental tasks. The importance of this finding for later development is unclear and, thus will bear future monitoring. Handle: RePEc:aph:ajpbhl:1983:73:3:277-281_2 Template-Type: ReDIF-Article 1.0 Title: Lake Michigan fish consumption as a source of polychlorinated biphenyls in human cord serum, maternal serum, and milk Journal: American Journal of Public Health Author-Name: Schwartz, P.M. Author-Name: Jacobson, S.W. Author-Name: Fein, G. Author-Name: Jacobson, J.L. Author-Name: Price, H.A. Year: 1983 Volume: 73 Issue: 3 Pages: 293-296 Abstract: Reported consumption of Lake Michigan sport fish was examined in relation to the levels of polychlorinated biphenyls (PCBs) in biological samples provided by a sample of maternity patients. Fish consumption was correlated with PCB levels in maternal serum and milk but not in cord serum. PCB levels in serum increased with age, but were unrelated to social class, parity, or weight. Women who breast fed consumed as much fish as women who did not and their maternal and cord sera PCB levels were similar. Handle: RePEc:aph:ajpbhl:1983:73:3:293-296_3 Template-Type: ReDIF-Article 1.0 Title: Developmental abilities of children exposed to polybrominated biphenyls (PBB) Journal: American Journal of Public Health Author-Name: Seagull, E.A.W. Year: 1983 Volume: 73 Issue: 3 Pages: 281-285 Abstract: To investigate whether ingestion of polybrominated biphenyls has an adverse effect on the neuropsychological development of young children exposed in utero and in infancy, five tests of the McCarthy Scales of Children's Abilities were administered to a group of 19 PBB-exposed Michigan children. When the data for the exposed group were analyzed according to body burden of PBB as determined by fat biopsy, correlations ranging from -.5228 to -.3004 were found between the natural logarithms of the children's fat PBB values and their standardized scores on the developmental scales. Four of the five correlations were significant at p < .05. Multivariate analysis of covariance confirmed the existence of a significant main effect for fat PBB level, with parental education held constant. Children with higher body burdens of PBB (> .100 ppm) scored significantly lower than exposed children with lower body burdens on the same four tests, and on a composite score representing overall performance. These results suggest the existence of an inverse relationship between body levels of PBB and some developmental abilities in young children. Handle: RePEc:aph:ajpbhl:1983:73:3:281-285_6 Template-Type: ReDIF-Article 1.0 Title: Identifying and tracing a population at risk: The DESAD project experience Journal: American Journal of Public Health Author-Name: Nash, S. Author-Name: Tilley, B.C. Author-Name: Kurland, L.T. Author-Name: Gundersen, J. Author-Name: Barnes, A.B. Author-Name: Labarthe, D. Author-Name: Donohew, P.S. Author-Name: Kovacs, L. Year: 1983 Volume: 73 Issue: 3 Pages: 253-259 Abstract: In recent years, medical record review has been used to alert patients who have received drugs or treatments that have newly discovered side-effects. The experience of the national cooperative Diethylstilbestrol-Adenosis (DESAD) Project in identifying and notifying women exposed in utero to diethylstilbestrol (DES) shows this to be a difficult task. In order to identify 4,830 exposed women, 221,245 charts were reviewed. Detailed tracing data for one of the centers participating in the DESAD Project indicated that only 85 per cent of the 690 DES-exposed women identified at that center could be notified of exposure. The DESAD Project experience has led to recommendations for standardized prenatal records and drug lists, long-term storage of medical records, new legal guidelines, and improved recording of follow-up information, taking into account issues of privacy. Handle: RePEc:aph:ajpbhl:1983:73:3:253-259_7 Template-Type: ReDIF-Article 1.0 Title: Possible effect of neonatal polybrominated biphenyl exposure on the developmental abilities of children Journal: American Journal of Public Health Author-Name: Nebert, D.W. Author-Name: Elashoff, J.D. Author-Name: Wilcox Jr., K.R. Year: 1983 Volume: 73 Issue: 3 Pages: 286-289 Handle: RePEc:aph:ajpbhl:1983:73:3:286-289_0 Template-Type: ReDIF-Article 1.0 Title: Breastfeeding among Hispanics. Journal: American Journal of Public Health Author-Name: Magnus, P.D. Year: 1983 Volume: 73 Issue: 5 Pages: 597-598 Handle: RePEc:aph:ajpbhl:1983:73:5:597-598_8 Template-Type: ReDIF-Article 1.0 Title: Prevalence of perimenstrual symptoms and response bias. Journal: American Journal of Public Health Author-Name: Strassburg, M.A. Year: 1983 Volume: 73 Issue: 5 Pages: 596-597 Handle: RePEc:aph:ajpbhl:1983:73:5:596-597_4 Template-Type: ReDIF-Article 1.0 Title: Investigations of health effects in populations living near nuclear installations. Journal: American Journal of Public Health Author-Name: Johnson, C.J. Year: 1983 Volume: 73 Issue: 5 Pages: 598-600 Handle: RePEc:aph:ajpbhl:1983:73:5:598-600_8 Template-Type: ReDIF-Article 1.0 Title: On comparison of age- and race-specific abortion ratios. Journal: American Journal of Public Health Author-Name: Hale, C.B. Author-Name: Pickett, G.E. Year: 1983 Volume: 73 Issue: 4 Pages: 453-454 Handle: RePEc:aph:ajpbhl:1983:73:4:453-454_6 Template-Type: ReDIF-Article 1.0 Title: On the usefulness and ethics of chemical testing of children. Journal: American Journal of Public Health Author-Name: Church, E. Year: 1983 Volume: 73 Issue: 4 Pages: 454-455 Handle: RePEc:aph:ajpbhl:1983:73:4:454-455_5 Template-Type: ReDIF-Article 1.0 Title: Environmental politics and science: the case of PBB contamination in Michigan. Journal: American Journal of Public Health Author-Name: Reich, M.R. Year: 1983 Volume: 73 Issue: 3 Pages: 302-313 Abstract: This article examines how politics and science interacted against a background of uncertainty to shape policy in the case of environmental contamination by polybrominated biphenyls (PBB) in Michigan. In 1973, between 500 and 1,000 pounds of the flame retardant PBB were accidentally shipped and used instead of the dairy feed additive magnesium oxide, resulting in the widespread contamination of animal feeds, animals, and human food products. The contamination was initially perceived as the private trouble of a single farmer. The problem next became a public issue as public and private institutions grappled with questions of illness, safety, and disposal. To gain influence over those institutions, dissatisfied individuals and groups then turned the PBB contamination into a political controversy. The final section of the present article analyzes how science and politics interacted in: the ways bureaucratic organizations defined the three problems of contamination; the role political controversy played in redefining problems and influencing policy; and the political roles of scientists in controversies over environmental contamination. Handle: RePEc:aph:ajpbhl:1983:73:3:302-313_8 Template-Type: ReDIF-Article 1.0 Title: Patient education, blood pressure control, and the long run. Journal: American Journal of Public Health Author-Name: Kirscht, J.P. Year: 1983 Volume: 73 Issue: 2 Pages: 134-135 Handle: RePEc:aph:ajpbhl:1983:73:2:134-135_3 Template-Type: ReDIF-Article 1.0 Title: Byssinosis: progress in prevention. Journal: American Journal of Public Health Author-Name: Merchant, J.A. Year: 1983 Volume: 73 Issue: 2 Pages: 137-139 Handle: RePEc:aph:ajpbhl:1983:73:2:137-139_3 Template-Type: ReDIF-Article 1.0 Title: Relationship of newborn screening tests for congenital hypothyroidism to subsequent SIDS. Journal: American Journal of Public Health Author-Name: Bader, M. Author-Name: Miyahara, R. Year: 1983 Volume: 73 Issue: 2 Pages: 215-216 Handle: RePEc:aph:ajpbhl:1983:73:2:215-216_6 Template-Type: ReDIF-Article 1.0 Title: In support of jogging. Journal: American Journal of Public Health Author-Name: Ibrahim, M.A. Year: 1983 Volume: 73 Issue: 2 Pages: 136-137 Handle: RePEc:aph:ajpbhl:1983:73:2:136-137_4 Template-Type: ReDIF-Article 1.0 Title: Evaluating the impact of physician peer review: Factors associated with successful PSROs Journal: American Journal of Public Health Author-Name: Adler, N.E. Author-Name: Milstein, A. Year: 1983 Volume: 73 Issue: 10 Pages: 1182-1185 Abstract: A five-component measurement method was developed and applied to the 1981 impact statements of 30 Professional Standards Review Organizations (PSROs) by four blind raters familiar with the PSRO program. High inter-rater reliability (.95) was achieved. Rater's scores for each PSRO were then averaged and regressed against five variables predicted to affect PSRO impact: geographical density of PSROs; PSRO affiliation with a medical society; surgical necessity review; use of data profiles; and pre-existing Medicare hospitalization rates. As a set, the variables accounted for 44% of the variance in PSRO performance (p < .05). When entered in stepwise regression, geographical density and use of surgical necessity review accounted for the largest share of the variance. The findings are believed to reflect the recency of PSRO motivation to demonstrate significant impact, and the value of surgical necessity review as an indicator of PSRO courage to risk unpleasant backlash from their medical communities. Handle: RePEc:aph:ajpbhl:1983:73:10:1182-1185_3 Template-Type: ReDIF-Article 1.0 Title: The organization and evaluation of a computer-assisted, centralized immunization registry Journal: American Journal of Public Health Author-Name: Loeser, H. Author-Name: Zvagulis, I. Author-Name: Hercz, L. Author-Name: Pless, I.B. Year: 1983 Volume: 73 Issue: 11 Pages: 1298-1301 Abstract: The rationale for, and establishment of, a computer-assisted, centralized immunization registry are described. This registry was created to improve the quality and quantity of information regarding immunization status for a defined population receiving primary care from a variety of providers, principally public clinics and private practitioners. An evaluation of the feasibility of the registry after one year's function shows that 93 per cent of eligible providers initially agreed to participate and 73 per cent continue to do so. Their reports have resulted in the creation of 17,500 individual patient files. Of a prospective cohort of newborns 23 per cent were identified as 'high-risk' for overdue immunizations. After one year, the immunization rates in audited groups improved significantly. The direct cost of this registry is less than 65 cents per currently registered child per year. Handle: RePEc:aph:ajpbhl:1983:73:11:1298-1301_7 Template-Type: ReDIF-Article 1.0 Title: Controlling the rise in cesarean section rates by the dissemination of information from vital records Journal: American Journal of Public Health Author-Name: Williams, R.L. Author-Name: Chen, P.M. Year: 1983 Volume: 73 Issue: 8 Pages: 863-867 Abstract: The recent rapid increase in cesarean childbirth is a source of growing public health concern. The authors suggest that one method of ameliorating the rise would be to disseminate hospital-specific cesarean section rates. To make such rates comparable between hospitals, it is necessary to adjust for variations in maternal and newborn factors associated with cesarean section. They therefore applied an indirect standardization technique to three years of California vital records data. The results show sizable variations in cesarean section rates among individual hoospitals and by hospital type, both before and after standardization. For such a method to be effective, complete and accurate information from birth certificates is an obvious prerequisite. Handle: RePEc:aph:ajpbhl:1983:73:8:863-867_5 Template-Type: ReDIF-Article 1.0 Title: Effects of WIC on cognitive development Journal: American Journal of Public Health Author-Name: Pollitt, E. Author-Name: Lorimor, R. Year: 1983 Volume: 73 Issue: 6 Pages: 698-700 Handle: RePEc:aph:ajpbhl:1983:73:6:698-700_2 Template-Type: ReDIF-Article 1.0 Title: Diabetes mortality in persons under 45 years of age Journal: American Journal of Public Health Author-Name: Connell, F.A. Author-Name: Louden, J.M. Year: 1983 Volume: 73 Issue: 10 Pages: 1174-1177 Abstract: A detailed review of death certificates in Washington State for the years 1968-1979 was undertaken to analyze diabetes mortality for persons under 45 years of age. Diabetics in this age group had a mortality rate from medical causes eight times higher than that of the comparable general population. Almost one-third of the deaths were due to acute complications for which there is definitive medical therapy. Over the 12-year period there was no consistent decline in mortality rates or in deaths from acute complications, nor was there evidence of increased survivorship as reflected in the average age at death. Although residence in areas of sparse medical resources was not associated with high mortality rates, a significant proportion of deaths in all geographical areas occurred at home or before arrival at a hospital. Mortality rates and the proportion of deaths from acute, potentially preventable causes were higher in this study than in other recently published series, suggesting that early diabetes mortality may be a more serious problem than has been previously recognized. Diabetes mortality in this age group can be considered a 'sentinel health event' and should call attention to potential problems in health care delivery. Handle: RePEc:aph:ajpbhl:1983:73:10:1174-1177_2 Template-Type: ReDIF-Article 1.0 Title: Is health care use equivalent across social groups? A diagnosis-based study Journal: American Journal of Public Health Author-Name: Yelin, E.H. Author-Name: Kramer, J.S. Author-Name: Epstein, W.V. Year: 1983 Volume: 73 Issue: 5 Pages: 562-571 Abstract: Previous studies of medical care utilization have controlled for medical need by signs or symptoms or broad disease classifications. The present study uses both symptoms and discrete diagnoses to control for medical need in order to determine if the use of ambulatory and hospital care differs by race, income, education, insurance coverage, or region. Using data from the 1976 National Health Interview Survey, we found that there were no consistent differences in the number of physician visits made in a year by these characteristics, medical need held constant. Lack of insurance coverage was associated with fewer hospitalizations in a year for five of nine chronic diseases under review. Race was associated with fewer hospitalizations for two conditions prevalent among minorities. These effects were not evident when medical need was controlled solely by signs or symptoms. Handle: RePEc:aph:ajpbhl:1983:73:5:562-571_8 Template-Type: ReDIF-Article 1.0 Title: A prescription is not a simple matter anymore Journal: American Journal of Public Health Author-Name: Wertheimer, A.I. Year: 1983 Volume: 73 Issue: 8 Pages: 844-845 Handle: RePEc:aph:ajpbhl:1983:73:8:844-845_5 Template-Type: ReDIF-Article 1.0 Title: Accurate occupational illness and injury data in the US: Can this enigmatic problem ever be solved? Journal: American Journal of Public Health Author-Name: Whorton, M.D. Year: 1983 Volume: 73 Issue: 9 Pages: 1031-1032 Handle: RePEc:aph:ajpbhl:1983:73:9:1031-1032_8 Template-Type: ReDIF-Article 1.0 Title: Breastfeeding and fertility control Journal: American Journal of Public Health Author-Name: Tyler Jr., C.W. Year: 1983 Volume: 73 Issue: 4 Pages: 364-365 Handle: RePEc:aph:ajpbhl:1983:73:4:364-365_5 Template-Type: ReDIF-Article 1.0 Title: Genetic screening: Implications for preventive medicine Journal: American Journal of Public Health Author-Name: Scriver, C.R. Year: 1983 Volume: 73 Issue: 3 Pages: 243-245 Abstract: Genetic screening is a search for persons in a population who possess certain genotypes: that are associated with existing disease or predispose to future disease: that may lead to disease in their descendants; or that produce other variations of interest but not known to be associated with disease. This concept is not quite encompassed in an earlier and well-respected document on screening for disease. It is obviously relevant to citizens living in industrialized societies who have benefited from traditional practices in public health. It has become a conventional public health exercise to screen bloods of newborns for the hyperphenylalaninemias, the tyrosinemias, the amino acidopathies in general, the galactosemias, and the aberrations of thyroid hormone biosynthesis; and to screen urines for disorders of amino acid or monosaccharide metabolism and transport. Screening of young adults to initiate genetic counseling for indications of Tay-Sachs, β thalassemia, and sickle cell heterozygosity has also become a common practice in the relevant high-risk ethnic communities. Screening to identify persons with variant phenotypes, such as α1-antitrypsin deficiency, has become a form of epidemiologic research to discover the natural history of the variant. Each of the screening modes presupposes that a risk to health can be identified and that something can be done to prevent disease or to understand better the predisposition to disease. The nature of disease from a biological viewpoint and the particular relevance of genetic screening in a modern world are discussed. Handle: RePEc:aph:ajpbhl:1983:73:3:243-245_8 Template-Type: ReDIF-Article 1.0 Title: Adult cancer prevention in primary care: Patterns of practice in Quebec Journal: American Journal of Public Health Author-Name: Battista, R.N. Year: 1983 Volume: 73 Issue: 9 Pages: 1036-1039 Abstract: We conducted a survey of a representative sample of all primary care physicians in the province of Quebec to ascertain their patterns of preventive practice with respect to cancer in four anatomical sites: breast, colon - rectum, cervix, and lung. A stratified random sample of 430 physicians in general practice was interviewed individually and weighted population estimates derived. Physicians report teaching breast self-examination to their patients (96 per cent), performing breast examination (99 per cent), taking pap tests routinely (91 per cent), and pursuing anti-smoking counselling (98 per cent). Very few of them report submitting their patients over 50 years of age to annual mammography (8 per cent) or checking for occult blood in stools in patients over 45 years of age (15 per cent). Many still use routine chest X-rays as an early detection measure of cancer of the lung (77 per cent); an estimated 41 per cent use sputum cytology for the same purpose. Preventive practices, when in-use, are carried out mainly in the context of major encounters with patients such as general check-ups. Less than 28 per cent of the population is estimated to be reached by this strategy for prevention. The unrealized potential for prevention through capitalizing on all encounters with primary care physicians is important, and should stimulate creative efforts to enhance preventive activities in medical practice. Handle: RePEc:aph:ajpbhl:1983:73:9:1036-1039_9 Template-Type: ReDIF-Article 1.0 Title: Four years' experience with home birth by licensed midwives in Arizona Journal: American Journal of Public Health Author-Name: Sullivan, D.A. Author-Name: Beeman, R. Year: 1983 Volume: 73 Issue: 6 Pages: 641-645 Abstract: In 1978, Arizona began licensing lay midwives under regulations designed to maintain adequate standards of care for women desiring a home birth. During four years of this program, 3 per cent of home birth clients were hospitalized for complications and another 15 per cent received postnatal outpatient care, primarily for second degree lacerations. Five per cent of the newborns required medical care after delivery; half of these were hospitalized. Complications declined over the period due to increased experience, close supervision, and continued education. Handle: RePEc:aph:ajpbhl:1983:73:6:641-645_1 Template-Type: ReDIF-Article 1.0 Title: Premature deaths avoided by the antismoking campaign Journal: American Journal of Public Health Author-Name: Warner, K.E. Author-Name: Murt, H.A. Year: 1983 Volume: 73 Issue: 6 Pages: 672-677 Abstract: The antismoking campaign has encouraged millions of people to quit smoking cigarettes and millions of others not to initiate the habit. Because quitting smoking, or deciding not to start, reduces one's mortality risks relative to the continuing smoker, we estimate that these consumption impacts resulted in the avoidance of more than 200,000 premature smoking-related deaths during 1964-1978. On average, each of these premature deaths averted translates into 23 additional years of life. Furthermore, campaign-related smoking cessation and non-initiation during the 1964-1978 period will result in the avoidance of many more premature deaths in the coming decades. Although these figures suggest that the antismoking campaign has been successful, tens of millions of Americans continue to smoke and the premature deaths avoided constitute only a small fraction of the 4 million deaths attributable to smoking that occurred during the same years. Handle: RePEc:aph:ajpbhl:1983:73:6:672-677_5 Template-Type: ReDIF-Article 1.0 Title: Comparison of an active and passive surveillance system of primary care providers for hepatitis, measles, rubella, and salmonellosis in Vermont Journal: American Journal of Public Health Author-Name: Vogt, R.L. Author-Name: LaRue, D. Author-Name: Klaucke, D.N. Author-Name: Jillson, D.A. Year: 1983 Volume: 73 Issue: 7 Pages: 795-797 Abstract: Between June 1, 1980 and May 31, 1981, The Vermont Health Department telephoned a randomly chosen half of the state's primary care offices for surveillance reports of hepatitis, measles, rubella, and salmonellosis. No reports were activity solicited from the other half of the primary-care practices in the state. Active-surveillance units made more reports and more complete reports of diseases and had twice the number of reports per patient seen by the practice than did passive-surveillance units. Handle: RePEc:aph:ajpbhl:1983:73:7:795-797_1 Template-Type: ReDIF-Article 1.0 Title: Spontaneous abortions after the Three Mile Island nuclear accident: A life table analysis Journal: American Journal of Public Health Author-Name: Goldhaber, M.K. Author-Name: Staub, S.L. Author-Name: Tokuhata, G.K. Year: 1983 Volume: 73 Issue: 7 Pages: 752-759 Abstract: A study was conducted to determine whether the incidence of spontaneous abortion was greater than expected near the Three Mile Island (TMI) nuclear power plant during the months following the March 28, 1979 accident. All persons living within five miles of TMI were registered shortly after the accident, and information on pregnancy at the time of the accident was collected. After one year, all pregnancy cases were followed up and outcomes ascertained. Using the life table method, it was found that, given pregnancies after four completed weeks of gestation counting from the first day of the last menstrual period, the estimated incidence of spontaneous abortion (miscarriage before completion of 16 weeks of gestation) was 15.1 per cent for women pregnant at the time of the TMI accident. Combining spontaneous abortions and stillbirths (delivery of a dead fetus after 16 weeks of gestation), the estimated incidence was 16.1 per cent for pregnancies after four completed weeks of gestation. Both incidences are comparable to baseline studies of fetal loss. Handle: RePEc:aph:ajpbhl:1983:73:7:752-759_5 Template-Type: ReDIF-Article 1.0 Title: Does smoking cessation lead to weight gain? The experience of asbestos-exposed shipyard workers Journal: American Journal of Public Health Author-Name: Coates, T.J. Author-Name: Li, V.C. Year: 1983 Volume: 73 Issue: 11 Pages: 1303-1304 Abstract: We examined the relationship between smoking cessation and weight change in a sample of 373 asbestos-exposed workers who had participated in a smoking cessation program. Those who quit smoking for one year and those who quit for shorter periods gained significantly more weight than those who continued to smoke. Those with initially poorer health and those who quit to avoid illness gained less weight. Handle: RePEc:aph:ajpbhl:1983:73:11:1303-1304_2 Template-Type: ReDIF-Article 1.0 Title: Differences in dental experiences, practices, and beliefs of inner-city and suburban adolescents Journal: American Journal of Public Health Author-Name: Cipes, M.H. Author-Name: Kegeles, S.S. Author-Name: Lund, A.K. Author-Name: Otradovec, C.L. Year: 1983 Volume: 73 Issue: 11 Pages: 1305-1307 Abstract: Inner-city and suburban students' dental experiences, current practices, beliefs, and compliance with two school-based preventive programs were examined. striking differences were found in the students' dental experiences, practices, and beliefs, but few in their compliance. These findings challenge the notion that inner-city students are poor compliers and suggest ways in which practitioners and public health officials might utilize the differing practices of these populations to plan preventive programs for adolescents. Handle: RePEc:aph:ajpbhl:1983:73:11:1305-1307_3 Template-Type: ReDIF-Article 1.0 Title: Health expectancy in Canada, late 1970s: Demographic, regional, and social dimensions Journal: American Journal of Public Health Author-Name: Wilkins, R. Author-Name: Adams, O.B. Year: 1983 Volume: 73 Issue: 9 Pages: 1073-1080 Abstract: Based on estimates of activity restriction from the Canada Health Survey, institutional data on long-term care, and survival data from vital statistics, we have calculated an index of health expectancy (life expectancy in each state of health), and a summary of these indices which we have called quality-adjusted life expectancy. At birth, expected years of long-term institutionalization were 0.8 for men and 1.5 for women. Expected years of activity restriction not involving long-term institutionalization were 10.8 for men and 14.0 for women; 3.0 of the expected years of activity restriction for men and 1.3 of these years for women were in the most severe category of restriction (unable to do major activity). For both sexes together, quality-adjusted life expectancy was 1.4 years greater in Ontario and the Prairies than in the Atlantic region, 3.2 years greater in Canada's three largest cities than in rural areas and small towns, and 7.7 years greater among persons from high-income families than among persons from low-income families. Handle: RePEc:aph:ajpbhl:1983:73:9:1073-1080_1 Template-Type: ReDIF-Article 1.0 Title: Characteristics of cancer patient referrals to home care: A regional perspective Journal: American Journal of Public Health Author-Name: Oleske, D. Author-Name: Hauck, W.W. Author-Name: Heide, E. Year: 1983 Volume: 73 Issue: 6 Pages: 678-682 Abstract: Records of 609 cancer patients referred in 1979 to home health agencies in rural and urban health service regions in Illinois were abstracted. There was no difference in the overall utilization of home care between the two regions, but significant differences in referral characteristics were found between the two regions with respect to patient's disability level, disease stage, presence of concurrent medical conditions, and living arrangement, and to the source of referral. Handle: RePEc:aph:ajpbhl:1983:73:6:678-682_6 Template-Type: ReDIF-Article 1.0 Title: Nuclear power: Psychology and statistics Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1983 Volume: 73 Issue: 11 Pages: 1327-1328 Handle: RePEc:aph:ajpbhl:1983:73:11:1327-1328_2 Template-Type: ReDIF-Article 1.0 Title: Delay, stage of disease, and survival among White and Black women with breast cancer Journal: American Journal of Public Health Author-Name: Gregorio, D.I. Author-Name: Cummings, K.M. Author-Name: Michalek, A. Year: 1983 Volume: 73 Issue: 5 Pages: 590-593 Abstract: Delay in obtaining treatment, stage of disease at diagnosis, and five-year survival were compared for 29 Black and 156 White females treated for breast cancer at Roswell Park Memorial Institute between 1957 and 1956. No statistically significant differences were found between Black and White patients in treatment delay although a tendency for longer delay among Blacks was noted. Race had little effect on survival when delay, stage of disease, and age were controlled. Handle: RePEc:aph:ajpbhl:1983:73:5:590-593_7 Template-Type: ReDIF-Article 1.0 Title: The prevalence and incidence of juvenile rheumatoid arthritis in an urban black population Journal: American Journal of Public Health Author-Name: Hochberg, M.C. Author-Name: Linet, M.S. Author-Name: Sills, E.M. Year: 1983 Volume: 73 Issue: 10 Pages: 1202-1203 Abstract: We determined the prevalence and incidence of juvenile rheumatoid arthritis (JRA) in an urban Black population in Baltimore, identifying three cases through review of computerized outpatient encounters and a fourth case by reviewing discharge records at area hospitals. The prevalence of JRA among Blacks, as of December 31, 1980, was estimated as 0.26 per 1,000 (95% confidence interval: 0.07, 0.66), the average annual incidence 6.6% per 100,000 per year (0.8, 23.8) for the years 1979 and 1980. These data suggest that Black race is not associated with significantly increased risk of development of JRA. Handle: RePEc:aph:ajpbhl:1983:73:10:1202-1203_2 Template-Type: ReDIF-Article 1.0 Title: The rural dental health program: The effect of a school-based, dental health education program on children's utilization of dental services Journal: American Journal of Public Health Author-Name: Bentley, J.M. Author-Name: Cormier, P. Author-Name: Oler, J. Year: 1983 Volume: 73 Issue: 5 Pages: 500-505 Abstract: Eighteen-hundred rural children ages five through thirteen were randomly assigned for dental treatment to a school-based practice, and to private practitioners in the community. Simultaneously, five of the nine public schools attended by the children offered an enriched program of dental education while the remaining schools taught the regular health education courses. All children participated in a school based fluoride program and their dental treatment was provided without charge. Data indicating how the children utilized dental services were collected over the three-year treatment phase of the study. Evidence from the third treatment year indicates that children assigned to the school based practice who also attended a school offering enriched dental health education used dental services on a more regular basis than children in the other three groups. Evidence obtained from log-linear modeling supports the hypothesis that dental health education had a positive effect on children's utilization of dental service. Handle: RePEc:aph:ajpbhl:1983:73:5:500-505_8 Template-Type: ReDIF-Article 1.0 Title: Uses of the 1980 census for Hispanic health services research Journal: American Journal of Public Health Author-Name: Giachello, A.L. Author-Name: Bell, R. Author-Name: Aday, L.A. Author-Name: Andersen, R.M. Year: 1983 Volume: 73 Issue: 3 Pages: 266-274 Abstract: The 1980 Census data provide a valuable resource for health services research on Hispanics. Hispanics are the fastest growing minority group in the United States and yet there is a paucity of large-scale empirical research on their health care and access needs. This paper describes how the census can assist in: 1) estimating the overall health care needs of this group, 2) identifying target groups within the Hispanic population who may have special health care problems (e.g., children, elderly, pregnant women, etc.); and 3) using other data sources to improve the quality of studies carried out on Hispanics. It also discusses problems in using the census for Hispanic health services research and some strategies for dealing with these problems. Handle: RePEc:aph:ajpbhl:1983:73:3:266-274_8 Template-Type: ReDIF-Article 1.0 Title: Paraquat and marijuana: Epidemiologic risk assessment Journal: American Journal of Public Health Author-Name: Landrigan, P.J. Author-Name: Powell, K.E. Author-Name: James, L.M. Author-Name: Taylor, P.R. Year: 1983 Volume: 73 Issue: 7 Pages: 784-788 Abstract: In March 1978, 13 (21 per cent) of 61 marijuana samples from the southwestern United States were found to be contaminated with the herbicide paraquat, a pulmonary toxin, in concentrations from 3 to 2,264 parts per million. The source of the contamination was an aerial spraying program in Mexico, supported indirectly by United States funds. To evaluate US exposure, a nationwide survey of the paraquat content of confiscated marijuana was conducted. The survey found 33 (3.6 per cent) of 910 marijuana specimens to contain detectable paraquat. In states adjacent to Mexico (Census Region VI), 23 (12.8 per cent) of 180 specimens were contaminated. Combustion testing indicated that approximately 0.2 per cent of paraquat on marijuana passses into smoke. From these data, we projected that 100-200 marijuana smokers in Census Region VI would be exposed by inhalation to 500 micrograms or more of paraquat per year, a dose judged to represent a health hazard; nationally, between 150 and 300 smokers were projected to have such exposure. another 6,000 persons in Region VI and 9,000 nationally were projected to be at risk of exposure to between 100 and 499 micrograms of paraquat annually. The risk of paraquat exposure was greatest among those smokers who make one large purchase of marijuana per year. No clinical cases of paraquat poisoning were recognized among marijuana smokers during these studies, but no systematic national search for such cases was undertaken. Handle: RePEc:aph:ajpbhl:1983:73:7:784-788_7 Template-Type: ReDIF-Article 1.0 Title: Cesarean section delivery rates: United States, 1981 Journal: American Journal of Public Health Author-Name: Placek, P.J. Author-Name: Taffel, S. Author-Name: Moien, M. Year: 1983 Volume: 73 Issue: 8 Pages: 861-862 Abstract: The rate of cesarean section delivery in the United States has risen from 4.5 per 100 deliveries in 1965 to 17.9 in 1981. The rate is highest in the Northeast, in hospitals of 500 beds or more, in proprietary hospitals, for Blue Cross as a source of payment, and for mothers aged 35 years and over. The rate is lowest in the North Central region, in hospitals with less than 100 beds, in government hospitals, for self-pay patients, and for mothers under 20 years of age. Handle: RePEc:aph:ajpbhl:1983:73:8:861-862_4 Template-Type: ReDIF-Article 1.0 Title: Health promotion programs sponsored by California employers Journal: American Journal of Public Health Author-Name: Fielding, J.E. Author-Name: Breslow, L. Year: 1983 Volume: 73 Issue: 5 Pages: 538-542 Abstract: A survey of California employers with more than 100 employees at one or more sites was undertaken to determine: 1) the nature and extent of health promotion activities; 2) plans for continuation and/or expansion of these activities; 3) plans for initiation of new activities; and 4) the relationship between reported health promotion activities and other characteristics of employers. Of 511 employers with whom interviews were attempted, 49 possible respondents could not be reached and 38 respondents refused to be interviewed, leaving 424 or 83 per cent. Among one-half of the sites where interviews were conducted had fewer than 200 employees. A total of 332 (78.2 per cent) of employers offered one or more health promotion activities. The most frequent activities provided were accident prevention (64.9 per cent) and CPR (52.8 per cent) with other frequent programs including alcohol/drug abuse (18.6 per cent), mental health counseling (18.4 per cent), stress management (13.0 per cent), fitness (11.6 per cent), hypertension screening (10.1 per cent), and smoking cessation (8.3 per cent). Employers with at least one activity averaged 2.8 activities. The likelihood of having health promotion activities increased with company size. Establishment of new programs appeared to accelerate rapidly in recent years. Handle: RePEc:aph:ajpbhl:1983:73:5:538-542_2 Template-Type: ReDIF-Article 1.0 Title: Patterns in hospitals' use of a regional poison information center Journal: American Journal of Public Health Author-Name: Chafee-Bahamon, C. Author-Name: Caplan, D.L. Author-Name: Lovejoy Jr., F.H. Year: 1983 Volume: 73 Issue: 4 Pages: 396-400 Abstract: A statewide poison center undertook a study to identify types of hospitals which used its information services. Initial trends in calls from hospitals to the center over the center's first two years and percentages of hospitals' patient caseloads for which the center consulted were analyzed for 104 acute care hospitals by hospitals' location, size, and emergency room staffing. After the center's establishment as a regional resource, emergency room staff in urban teaching hospitals showed the greatest increase in call within a year (88 per cent) and the highest consultation rates for poison patients seen (57 per cent). Private physician emergency room staff, and staff in distant and rural hospitals, showed lower or no increases in calls and lower consultation rates. Findings suggest that private physician emergency room staff and staff in distant and rural hospitals be considered for poison center outreach. Marketing of consultation services for non-pediatric overdoses is also indicated. Handle: RePEc:aph:ajpbhl:1983:73:4:396-400_6 Template-Type: ReDIF-Article 1.0 Title: Alcohol and brain damage: Cause or association? Journal: American Journal of Public Health Author-Name: Hill, S.Y. Year: 1983 Volume: 73 Issue: 5 Pages: 487-489 Abstract: It seems unwarranted to endorse a public health policy that warns of the long-term dangers of social drinking upon cognitive functioning. No one would deny that there are clear dangers from 'social drinking' as attested to by the number of fatal accidents committed by persons who were intoxicated although not necessarily alcoholic. However, without current data to establish the prevalence of cognitive deficits caused by alcohol, whether they are reversible, and whether they signify anything resembling impairment in functioning in the 'real' world, it would appear premature to condemn 'social' alcohol consumption. Handle: RePEc:aph:ajpbhl:1983:73:5:487-489_7 Template-Type: ReDIF-Article 1.0 Title: CPR skills: Achievement and retention under stringent and relaxed criteria Journal: American Journal of Public Health Author-Name: Martin, W.J. Author-Name: Loomis Jr., J.H. Author-Name: Lloyd, C.W. Year: 1983 Volume: 73 Issue: 11 Pages: 1310-1312 Abstract: The ability to deliver proper basic cardiac life support was evaluated in 33 health professional students immediately and three months post CPR training, the latter assessment unsuspected. Statistically significant declines were noted in psychomotor skills. Performance using American Heart Association (AHA) standards was compared to performance under 'relaxed' criteria. Results imply that current lengths of training sessions, duration of recertification, and application of established AHA standards may require re-evaluation. Handle: RePEc:aph:ajpbhl:1983:73:11:1310-1312_6 Template-Type: ReDIF-Article 1.0 Title: The influence of observing carbon monoxide level on cigarette smoking by public prenatal patients Journal: American Journal of Public Health Author-Name: Bauman, K.E. Author-Name: Bryan, E.S. Author-Name: Dent, C.W. Author-Name: Koch, G.G. Year: 1983 Volume: 73 Issue: 9 Pages: 1089-1091 Abstract: From theories that suggest behavior is influenced by direct observation of personal and immediate consequences of the behavior, we hypothesized that public prenatal patients whould reduce their smoking if they observed the level of carbon monoxide in their own alveolar air. An experimental design was used that involved 170 subjects, multiple measures of smoking, and data collection before the intervention and six weeks later. It was concluded that the intervention had either a small or no influence on cigarette smoking. Handle: RePEc:aph:ajpbhl:1983:73:9:1089-1091_0 Template-Type: ReDIF-Article 1.0 Title: Smoking cessation in a prospective study of healthy adult males: Effects of age, time period, and amount smoked Journal: American Journal of Public Health Author-Name: Garvey, A.J. Author-Name: Bosse, R. Author-Name: Glynn, R.J. Author-Name: Rosner, B. Year: 1983 Volume: 73 Issue: 4 Pages: 446-450 Abstract: The present study examined effects on smoking cessation of three variables - chronological age, time period, and amount smoked - in 637 healthy male smokers aged 22-69 at baseline. Subjects were followed from 1962-1975 using life table procedures. Age was not significantly related to quitting rates (p = .150). The amount smoked effect approached significance (p = .096) with rates of quitting progressively lower at higher consumption levels. Powerful time-period effects were found (p = .008). Incidence rates of quitting increased from 1962-1970, after which a marked decline occurred. Handle: RePEc:aph:ajpbhl:1983:73:4:446-450_8 Template-Type: ReDIF-Article 1.0 Title: Employment, sense of well-being, and use of professional services among women Journal: American Journal of Public Health Author-Name: Sheeler, A.P. Author-Name: Lee, E.S. Author-Name: Loe Jr., H.D. Year: 1983 Volume: 73 Issue: 8 Pages: 908-911 Abstract: Utilizing data from the National Health and Nutrition Examination Survey of 1971-1975 (NHANES I), comparisons wer made of general well-being scores and utilization of professional services between employed and non-employed women. Employed women tend to have a higher sense of well-being and utilize fewer professional services to cope with personal and mental health problems than their non-employed counterparts. This tendency is more pronounced among non-married and less-educated women, with an indication of a counter-tendency among college-educated non-White women. Handle: RePEc:aph:ajpbhl:1983:73:8:908-911_0 Template-Type: ReDIF-Article 1.0 Title: The variability of blood pressure measurements in children Journal: American Journal of Public Health Author-Name: Osborne, R. Author-Name: Mullin, C.S. Author-Name: Roberson, P.K. Year: 1983 Volume: 73 Issue: 10 Pages: 1207-1210 Abstract: This study examined the sources and amount of variation present in the blood pressures of 99 third grade children, using data collected from three repeated measurements made on three separate visits. The results highlight factors to consider when planning or evaluating studies designed to relate children's blood pressure levels to environmental conditions. Factors include variability both between and within children by visit and between observers; periodic restandardization of observers during the course of a study is desirable. Handle: RePEc:aph:ajpbhl:1983:73:10:1207-1210_7 Template-Type: ReDIF-Article 1.0 Title: Characteristics of physician visits for back symptoms: A national perspective Journal: American Journal of Public Health Author-Name: Cypress, B.K. Year: 1983 Volume: 73 Issue: 4 Pages: 389-395 Abstract: There are no national data on the extent of back problems in the population of the United States, but it is known that back symptoms is the second leading symptomatic reason expressed by patients for visiting physicians. To provide insight into the scope of this problem, data from the National Ambulatory Medical Care Surveys of 1977 and 1978 were examined using the sex of the patient and the physician's degree (MD or DO) as control variables, and typical encounter characteristics as dependent variables. Males 45-64 years of age had the highest visit rate, and visit rates for men 15-64 years of age were higher than those of women the same age. Common diagnoses were sprains and strains, arthritis and rheumatism, displacement of intervertebral disc, and diseases of urinary tract, with men more likely than women to have injuries. DOs were more likely to treat accidental injuries than were MDs. It is recommended that differential diagnosis be taken into account before studying sex differences in complaints. Handle: RePEc:aph:ajpbhl:1983:73:4:389-395_0 Template-Type: ReDIF-Article 1.0 Title: Prevalences of anemia and iron deficiency anemia in black and white women in the United States estimated by two methods Journal: American Journal of Public Health Author-Name: Meyers, L.D. Author-Name: Habicht, J.P. Author-Name: Johnson, C.L. Author-Name: Brownie, C. Year: 1983 Volume: 73 Issue: 9 Pages: 1042-1049 Abstract: Prevalences of anemia were estimated by two methods for 742 Black and 3,074 White nonpregnant women of childbearing age drawn from a large probability sample of the United States civilian noninstitutionalized population (NHANES I). One method defines the prevalence of anemia as the proportion of women with hemoglobin levels below a 12 g/dl 'cut-off'. The second method defines the prevalence of anemia as the proportion of women whose hemoglobin values are shifted downwards relative to a distribution of hemoglobin values of non-anemic women. Estimates produced by both methods suggest a higher prevalence of anemia in Black than in White women. Estimates produced by the 'cut-off' method, however, are higher than those from the 'distribution' method for both racial groups, probably because the 'cut-off' method results in large overestimates in populations where anemia prevalence is low. The 'distribution' method is further used to estimate the contribution of iron deficiency to anemia. Essentially all anemia in White women and a high proportion of anemia in Black women is associated with iron deficiency in the US civilian noninstitutionalized population. Iron supplementation trials are needed in order to define the magnitude of the problem accurately and plan appropriate public health programs. Handle: RePEc:aph:ajpbhl:1983:73:9:1042-1049_1 Template-Type: ReDIF-Article 1.0 Title: The effect of retirement on physical health Journal: American Journal of Public Health Author-Name: Ekerdt, D. Author-Name: Baden, L. Author-Name: Bosse, R. Author-Name: Dibbs, E. Year: 1983 Volume: 73 Issue: 7 Pages: 779-783 Abstract: This prospective study compared pre- to post-retirement changes in physical health among male retirees with changes among age peers who continued to work. The 229 retirees and 409 workers aged 55-73 at follow-up were all participants in the Veterans Administration Normative Aging Study. Physical health at baseline and follow-up (three to four years apart) was rated on a four-point scale according to the findings of medical examinations. Although physical health declined generally over time, regression analyses showed no significant difference between eventual retirees and continuing workers on health change, after controlling for age and excluding men who retired due to illness or disability. Among retirees alone, pre- to post-retirement health change was also not significantly associated with several circumstances which purportedly make the retirement transition more stressful, such as mandatory retirement or retirement to a reduced standard of living. The results of this study of physical health, which corroborate those of other studies based on self-reported health measures and mortality data, support the conclusion that the event of retirement does not influence the risk of health deterioration. Handle: RePEc:aph:ajpbhl:1983:73:7:779-783_8 Template-Type: ReDIF-Article 1.0 Title: The Pennsylvania Domiciliary Care experiment: I. Impact on quality of life Journal: American Journal of Public Health Author-Name: Sherwood, S. Author-Name: Morris, J.N. Year: 1983 Volume: 73 Issue: 6 Pages: 646-653 Abstract: This paper reports findings concerning the impact of quality of life of a case management focused program of small board and care facilities serving aging, mental health, and mental retardation adult target populations - the Pennsylvania Domiciliary Care Program. Program participants from the counties in which the Domiciliary Care Program was initiated were matched with persons residing in similar counties without the program who were comparable on a large array of characteristics prior to program initiation. Conducted separately by target group, 10-month follow-up assessments provided the basis for determining impact. In general, the effects were positive, particularly with respect to meeting program quality of life goals (providing needed services, improving living conditions, increasing community integration, and reducing institutional days); the effects were more positive for the aging and mental health than for the mentally retarded target populations. Handle: RePEc:aph:ajpbhl:1983:73:6:646-653_7 Template-Type: ReDIF-Article 1.0 Title: On obesity and weight control in children Journal: American Journal of Public Health Author-Name: Sachs, F.A. Author-Name: Sachs, M.L. Year: 1983 Volume: 73 Issue: 7 Pages: 813 Handle: RePEc:aph:ajpbhl:1983:73:7:813_8 Template-Type: ReDIF-Article 1.0 Title: An assessment of the environmental protection agency's asbestos hazard evaluation algorithm Journal: American Journal of Public Health Author-Name: Findley, M.E. Author-Name: Rose, V.E. Author-Name: Cutter, G.R. Author-Name: Windsor, R.A. Year: 1983 Volume: 73 Issue: 10 Pages: 1179-1181 Abstract: We performed an exploratory evaluation of the Environmental Protection Agency's algorithm for assessment of risk of exposure to asbestos in buildings. Observers scored five sites using the algorithm. One group (N = 23) conducted their assessments relying only on written instructions, while another (N = 20) was trained in the use of the algorithm. Five professional industrial hygienists, experienced in risk assessment, also used the algorithm on the same sites. A wide range of highly variable results, for both untrained and trained observers coupled with poor comparability with expert's scores raise concern as to the reliability of this assessment tool. The development of a valid and reliable 'lay' index of risk is still needed. Handle: RePEc:aph:ajpbhl:1983:73:10:1179-1181_7 Template-Type: ReDIF-Article 1.0 Title: How effective are daytime motorcycle headlight laws? A response to Zador's criticism Journal: American Journal of Public Health Author-Name: Muller, A. Year: 1983 Volume: 73 Issue: 7 Pages: 809-810 Handle: RePEc:aph:ajpbhl:1983:73:7:809-810_2 Template-Type: ReDIF-Article 1.0 Title: An evaluation of the Social Security Administration master beneficiary record file and the National Death Index in the ascertainment of vital status Journal: American Journal of Public Health Author-Name: Wentworth, D.H. Author-Name: Neaton, J.D. Author-Name: Rasmussen, W.L. Year: 1983 Volume: 73 Issue: 11 Pages: 1270-1274 Abstract: To evaluate the relative utility of the Social Security Administration and National Death Index as sources of mortality data, the vital status of 12,866 participants in the Multiple Risk Factor Intervention Trial was indentified from these sources and compared to the known mortality experience. The SSA correctly identified 87.8 per cent of the 409 deaths that occurred between 1974 and 1980. Underreporting of deaths by SSA occurred for participants with certain demographic characteristics, especially marital status. For the years 1979 and 1980, the period for which the SSA and NDI have comparable data, the SSA correctly identified 93.2 per cent and the NDI correctly identified 98.4 per cent of the 191 known deaths. The NDI matching process resulted in a large number of false positive matches. Handle: RePEc:aph:ajpbhl:1983:73:11:1270-1274_6 Template-Type: ReDIF-Article 1.0 Title: Public and private prevention Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1983 Volume: 73 Issue: 9 Pages: 1032-1034 Handle: RePEc:aph:ajpbhl:1983:73:9:1032-1034_4 Template-Type: ReDIF-Article 1.0 Title: Validation of self-reported smoking behavior: Biochemical analyses of cotinine and thiocyanate Journal: American Journal of Public Health Author-Name: Haley, N.J. Author-Name: Axelrad, C.M. Author-Name: Tilton, K.A. Year: 1983 Volume: 73 Issue: 10 Pages: 1204-1207 Abstract: Biochemical determinations of plasma and salivary cotinine and thiocyanate were used to differentiate smokers from non-smokers and to follow daily smoking patterns in smokers. Results indicate that cotinine is better suited than thiocyanate to determine smoking status in large scale epidemiologic studies and to follow alterations in smoking behavior over periods of time. Salivary cotinine is a reliable alternative to plasma for validation of smoking status and for following changes in daily smoking patterns. Handle: RePEc:aph:ajpbhl:1983:73:10:1204-1207_0 Template-Type: ReDIF-Article 1.0 Title: Coitus-related cervical cancer risk factors: Trends and differentials in racial and religious groups Journal: American Journal of Public Health Author-Name: Hendershot, G.E. Year: 1983 Volume: 73 Issue: 3 Pages: 299-301 Abstract: Data from nationally representative surveys conducted in 1965 and 1976 are presented which describe differences between women of different religious and racial groups with respect to the prevalence of primary marriage and use of barrier methods of contraception. These practices were significantly less likely among Black women and significantly more likely among Jewish women than among comparison groups, which is consistent with the hypothesis that cervical cancer risk is related to coital behaviors. Handle: RePEc:aph:ajpbhl:1983:73:3:299-301_0 Template-Type: ReDIF-Article 1.0 Title: Problem drinking and the dimension of involvement with drugs: A Guttman scalogram analysis of adolescent drug use Journal: American Journal of Public Health Author-Name: Donovan, J.E. Author-Name: Jessor, R. Year: 1983 Volume: 73 Issue: 5 Pages: 543-552 Abstract: Analyses of data from two nationwide surveys of high school students, one carried out in 1974 and the other in 1978, suggest that problem drinking may be seen as yet another step along an underlying dimension of involvement with both licit and illicit drugs. The dimension of involvement with drugs consists of the following levels: nonuse of alcohol or illicit drugs; nonproblem use of alcohol; marijuana use; problem drinking; use of pills (amphetamines, barbiturates, hallucinogenic drugs); and the use of 'hard drugs' such as cocaine or heroin. The dimension possesses excellent Guttman-scale properties in both national samples as well as in the subsamples differing in gender and ethnic backgrounds. The ordering of the levels of involvement was confirmed by the ordering of the alcohol-drug involvement groups based on their mean scores on measures of psychosocial proneness for involvement in problem behavior. The excessive use of a licit drug, i.e., problem drinking, appears to indicate greater involvement in drug use than does the use of an illicit drug, marijuana. This finding points to the importance of distinguishing between use and problem use of drugs in efforts to understand adolescent drug involvement. Handle: RePEc:aph:ajpbhl:1983:73:5:543-552_0 Template-Type: ReDIF-Article 1.0 Title: Tetanus and diphtheria immunity in an elderly population in Los Angeles county Journal: American Journal of Public Health Author-Name: Weiss, B.P. Author-Name: Strassburg, M.A. Author-Name: Feeley, J.C. Year: 1983 Volume: 73 Issue: 7 Pages: 802-804 Abstract: Fify-four per cent of 246 subjects attending senior citizen centers (mean age 69), and 29 per cent of 11 convalescent hospital subjects (mean age 82) had protective levels of tetanus antitoxin (≥ 0.01 units/ml). Age-specific immunity levels were lower for females than males, and generally decreased with age. Forty-eight and one-half per cent of the cenior citizen center subjects and 55.9 per cent of the convalescent hospital subjects had protective levels of diphtheria antitoxin (≥ 0.01 units/ml). Handle: RePEc:aph:ajpbhl:1983:73:7:802-804_9 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic characteristics of mortality from diabetes with acidosis or coma, United States, 1970-78 Journal: American Journal of Public Health Author-Name: Holman, R.C. Author-Name: Herron, C.A. Author-Name: Sinnock, P. Year: 1983 Volume: 73 Issue: 10 Pages: 1169-1173 Abstract: Deaths due to diabetes with acidosis or coma (DAC) in the United States from 1970 through 1978 were analyzed to determine epidemiologic characteristics associated with mortality likely to be due to diabetic ketoacidosis (DKA), a complication of diabetes mellitus considered largely preventable. Annual age-adjusted rates for DAC deaths decreased during the study period, and the secular trend was significant in all regional, race, and sex groups examined. General population-based mortality rates increased linearly with age, were higher in non-Whites than in Whites among persons aged > 14, were higher in females, and increased significantly with age in both races and both sexes. By region, rates were lowest in the West. DAC mortality rates specific to estimated diabetic populations decreased annually from 1970 to 1978 in all race and sex groups, and were highest at age ≥65, but did not show significant linear increases with age, except in non-Whites. These results indicate declining secular trends, as well as age, race, sex, and regional differences in the risk of such deaths. Further studies are warranted to determine factors contributing to these differences. Handle: RePEc:aph:ajpbhl:1983:73:10:1169-1173_0 Template-Type: ReDIF-Article 1.0 Title: An evaluation of subsidized rural primary care programs: II. The environmental contexts Journal: American Journal of Public Health Author-Name: Ricketts, T.C. Author-Name: Konrad, T.R. Author-Name: Wagner, E.H. Year: 1983 Volume: 73 Issue: 4 Pages: 406-413 Abstract: The placement of subsidized primary care programs in rural communities has been an important aspect of national health policy over the last decade. Using survey and secondary data from programs in over 700 counties in the United States, it was found that while about one-fourth of all counties with some rural populations have been affected by these programs, certain environmental factors are associated with more or less likelihood of placement. High levels of need and low levels of health care resources are positively associated with the presence of a program. States with health policy climates supportive of reimbursement and broader staffing of primary care programs also contained programs in a higher proportion of their rural counties. The effects of decreased federal funding, increased state responsibility, and the precarious market conditions for primary care programs are discussed with emphasis on the mechanisms for developing favorable climates for these programs. Handle: RePEc:aph:ajpbhl:1983:73:4:406-413_3 Template-Type: ReDIF-Article 1.0 Title: Passenger car size and driver seat belt use Journal: American Journal of Public Health Author-Name: O'Neill, B. Author-Name: Williams, A.F. Author-Name: Karpf, R.S. Year: 1983 Volume: 73 Issue: 5 Pages: 588-590 Abstract: The National Highway Traffic Safety Administration (NHTSA) claims, on the basis of survey results, that seat belt use in small cars is twice as high as in large cars. The agency interprets this as being due in part to perceptions of higher risk by small car occupants. In fact, little is known about the factors motivating belt use, including whether risk perception is important. A reanalysis of the NHTSA data indicates that most of the differences in belt use by car size can be explained by higher use in imported cars, and by geographical differences in belt use in domestic cars. Handle: RePEc:aph:ajpbhl:1983:73:5:588-590_9 Template-Type: ReDIF-Article 1.0 Title: Income differentials among primary care physicians: Organizational structure or deliberate choice? Journal: American Journal of Public Health Author-Name: Butter, I.H. Year: 1983 Volume: 73 Issue: 4 Pages: 362-363 Handle: RePEc:aph:ajpbhl:1983:73:4:362-363_0 Template-Type: ReDIF-Article 1.0 Title: Long-term follow-up is a problem Journal: American Journal of Public Health Author-Name: Beebe, G.W. Year: 1983 Volume: 73 Issue: 3 Pages: 245-246 Handle: RePEc:aph:ajpbhl:1983:73:3:245-246_2 Template-Type: ReDIF-Article 1.0 Title: The effect of the dental setting on blood pressure measurement Journal: American Journal of Public Health Author-Name: DiAngelis, N. Author-Name: Luepker, R.V. Year: 1983 Volume: 73 Issue: 10 Pages: 1210-1212 Abstract: Hypertension screening is a common activity in dental offices. However, this setting may elevate blood pressure, resulting in excessive patient concern and referrals. To experimentally test this question, blood pressure was measured in 60 subjects in a dental setting and a medical setting. Systolic and diastolic pressure differences were small but significantly higher (4.5 mmHg and 5.5 mmHg, respectively) in the dental setting. Handle: RePEc:aph:ajpbhl:1983:73:10:1210-1212_4 Template-Type: ReDIF-Article 1.0 Title: Alcohol use and cognitive loss among employed men and women Journal: American Journal of Public Health Author-Name: Parker, D.A. Author-Name: Parker, E.S. Author-Name: Brody, J.A. Author-Name: Schoenberg, R. Year: 1983 Volume: 73 Issue: 5 Pages: 521-526 Abstract: A representative sample of 1,367 employed men and women in Detroit responded to questions about their drinking practices and then completed a cognitive test which measures abstraction abilities. Abstraction, tested while respondents were sober, decreased significantly as reported quantity of alcohol usually consumed per drinking occasion increased. Handle: RePEc:aph:ajpbhl:1983:73:5:521-526_3 Template-Type: ReDIF-Article 1.0 Title: A hospital-based influenza immunization program, 1977-78 Journal: American Journal of Public Health Author-Name: Fedson, D.S. Author-Name: Kessler, H.A. Year: 1983 Volume: 73 Issue: 4 Pages: 442-445 Abstract: An influenza immunization program on General Medicine inpatient and outpatient units immunized a greater proportion of patients than did physicians on medical subspecialty units. Many patients hospitalized with influenza and other respiratory conditions had been discharged earlier in the year or seen in outpatient clinics. Previous hospital care may be a useful marker for identifying many high-risk patients who could receive influenza vaccine in organized programs for hospital-based immunization. Handle: RePEc:aph:ajpbhl:1983:73:4:442-445_7 Template-Type: ReDIF-Article 1.0 Title: Fatality rates and regulatory policies in bituminous coal mining, United States, 1959-1981 Journal: American Journal of Public Health Author-Name: Weeks, J.L. Author-Name: Fox, M. Year: 1983 Volume: 73 Issue: 11 Pages: 1278-1289 Abstract: In the eleven years prior to the passage of the Federal Coal Mine Health and Safety Act of 1969, rates changed little for underground miners and were increasing for surface miners, Following implementation of the 1969 Act, both rates decreased. Beginning in 1979, and continuing into the first six months of 1982, both rates increased. These associations suggest tht current relaxation of regulations and policies for coal safety are unwarranted. Handle: RePEc:aph:ajpbhl:1983:73:11:1278-1289_4 Template-Type: ReDIF-Article 1.0 Title: The physician visit patterns of chiropractic users: Health-seeking behavior of the elderly in Manitoba, Canada Journal: American Journal of Public Health Author-Name: Shapiro, E. Year: 1983 Volume: 73 Issue: 5 Pages: 553-557 Abstract: To assess the effect of chiropractic use on overall health care utilization patterns, the volume and pattern of ambulatory physician visits by elderly persons having contact with chiropractors are compared with those having contact with physicians only. This analysis is based on data representative of the Canadian Province of Manitoba's entire elderly population; they are drawn from interviews and from claims filed routinely as part of Manitoba's universally insured health care services. The results show that chiropractic services do not substitute for physician services among the elderly in a province which fully insures medical services and a limited number of chiropractic visits. The data suggest that, under these conditions, some elderly chiropractic users consume more physician services than other elderly of equal health status, in addition to visiting chiropractors. Handle: RePEc:aph:ajpbhl:1983:73:5:553-557_0 Template-Type: ReDIF-Article 1.0 Title: A review of the health effects of energy conserving materials Journal: American Journal of Public Health Author-Name: Levin, L. Author-Name: Purdom, P.W. Year: 1983 Volume: 73 Issue: 6 Pages: 683-690 Abstract: The energy conservation movement has promoted both greater use of insulating materials and the reduction of heat losses by sealing air leaks. The release of volatile or airborne materials from the installation of these building materials under these conditions has resulted in an exacerbated indoor air pollution with the potential for certain health and safety hazards. Consequently, a comparative review of the health and safety hazards, exposure standards, and regulatory action associated with the more commonly used insulating materials with particular respect to current energy conservation measures was undertaken. The materials reviewed included asbestos, urea-formaldehyde foam, polyvinyl chloride, cellulosic insulations, fibrous glass, mineral wool, and vermiculite. Although no longer used, the past installation of asbestos in a friable form is the greatest potential health hazard. The exposure to formaldehyde gas from its release from urea-formaldehyde foam has elicited subjective compliants of sensory irritation and unresolved controversy and regulatory action regarding its toxicity to humans. Lesser health problems have been associated with the more widely used fibrous glass and mineral or rock wools. Handle: RePEc:aph:ajpbhl:1983:73:6:683-690_2 Template-Type: ReDIF-Article 1.0 Title: Is the period of rapidly declining adult mortality in the United States coming to and end? Journal: American Journal of Public Health Author-Name: Cooper, R. Author-Name: Cohen, R. Author-Name: Amiry, A. Year: 1983 Volume: 73 Issue: 9 Pages: 1091-1093 Abstract: Age-standardized death rates from all causes for persons age 35-74 fell 23 per cent, 1968-1979. The monotonic decline was interrupted by only one period of excess influenza mortality. In the late 1970s, however, the decline in mortality decelerated and no further decrease was observed, 1979-1981. The recurrence of epidemic influenza contributed significantly to this trend although it would appear that the underlying mortality pattern has begun to change. Handle: RePEc:aph:ajpbhl:1983:73:9:1091-1093_8 Template-Type: ReDIF-Article 1.0 Title: Complications in cesarean and non-cesarean deliveries: United States, 1980 Journal: American Journal of Public Health Author-Name: Taffel, S.M. Author-Name: Placek, P.J. Year: 1983 Volume: 73 Issue: 8 Pages: 856-860 Abstract: Using 1980 National Hospital Discharge Survey data, complications reported for cesarean and non-cesarean deliveries coded by the Ninth Revision ICD-CM are compared. While over 16% of all deliveries in 1980 were by C-section, 94% of the deliveries where maternal-infant disproportion was noted were by C-section, and this complication was noted in one-fourth of all C-section deliveries. Similarly, where malposition or malpresentation of the fetus was evident, 59% of the mothers were delivered by C-section, and this complication was noted in one-sixth of all C-section deliveries. C-sections were also associated with placenta praevia, pre-eclampsia, infections of the genito-urinary tract, anemia, multiple births, and were almost universal for mothers who had had a previous C-section delivery. Competing explanations for the rise in C-sections from 5.5% of deliveries in 1970 to 16.5% in 1980 are discussed in the context of these findings. Handle: RePEc:aph:ajpbhl:1983:73:8:856-860_9 Template-Type: ReDIF-Article 1.0 Title: Interpretation of behavioral findings in studies of nutritional supplementation Journal: American Journal of Public Health Author-Name: Hicks, L.E. Author-Name: Langham, R.A. Author-Name: Takenaka, J. Year: 1983 Volume: 73 Issue: 6 Pages: 695-697 Handle: RePEc:aph:ajpbhl:1983:73:6:695-697_5 Template-Type: ReDIF-Article 1.0 Title: Nitroaromatic carcinogens in diesel soot: A review of laboratory findings Journal: American Journal of Public Health Author-Name: Wei, E.T. Author-Name: Shu, H.P. Year: 1983 Volume: 73 Issue: 9 Pages: 1085-1088 Abstract: The automobile industry plans to increase production of diesel-powered passenger cars because diesel engines provide better fuel economy than conventional gasoline engines. Diesel engines, however, produce more soot, and increased use of diesel cars will result in more discharge of diesel soot into the atmosphere. Recently, a new class of chemicals, called nitroaromatic compounds, have been identified in chemical extracts of diesel soot. Some of these nitroaromatic compounds produce mutations when tested in in vitro bacterial and mammalian cell assays, and cancer when tested in animals. Here, we review the relevance of these new laboratory findings to current deliberations over emission standards for particles from diesel cars. Handle: RePEc:aph:ajpbhl:1983:73:9:1085-1088_8 Template-Type: ReDIF-Article 1.0 Title: Public health and the law Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1983 Volume: 73 Issue: 7 Pages: 735 Handle: RePEc:aph:ajpbhl:1983:73:7:735_6 Template-Type: ReDIF-Article 1.0 Title: A reappraisal of time trends in ulcer disease: Factors related to changes in ulcer hospitalization and mortality rates Journal: American Journal of Public Health Author-Name: Kurata, J.H. Author-Name: Elashoff, J.D. Author-Name: Haile, B.M. Author-Name: Honda, G.D. Year: 1983 Volume: 73 Issue: 9 Pages: 1066-1072 Abstract: There has been a dramatic decline in reported hospitalization and mortality rates for peptic ulcer disease in the past two decades. Data from the National Center for Health Statistics and from the Commission on Professional and Hospital Activities were examined to determine the cause(s) for this decline. Gastric and duodenal ulcer motality rates decreased by 58 per cent and 68 per cent, respectively, from 1962 to 1978; changes in criteria for selecting the underlying cause of death might account for some of this apparent decrease. Hospitalization rates for duodenal ulcers decreased nearly 50 per cent from 1970 to 1978, but hospitalizations for gastric ulcers did not decrease. During this same time period, hospitalizations for peptic ulcers as one of the 'all listed' causes remained stable, and hospitalizations for a closely related diagnosis, gastritis/duodenitis, increased. Changes in coding practices, hospitalization criteria, and diagnostic procedures appear to have contributed to the decline in reported hospitalization and mortality rates for peptic ulcer disease. Handle: RePEc:aph:ajpbhl:1983:73:9:1066-1072_5 Template-Type: ReDIF-Article 1.0 Title: Adult cancer prevention in primary care: Contrasts among primary care practice settings in Quebec Journal: American Journal of Public Health Author-Name: Battista, R.N. Author-Name: Spitzer, W.O. Year: 1983 Volume: 73 Issue: 9 Pages: 1040-1041 Abstract: Four strata of Quebec primary care (general practitioner) physicians were delineated: fee-for-service physicians in urban and in rural settings, salaried physicians in Community Health Centers (CLSCs) and physicians reimbursed per session in Family Medicine Teaching Centers (FMCs). Physicians in CLSCs and FMCs did more mammographies in women aged 50 to 59, more testing for occult blood in stools of patients aged 45 and over, more Papanicolaou tests, and pursued preventive activities in a broader range of medical encounters than fee-for-service physicians. Handle: RePEc:aph:ajpbhl:1983:73:9:1040-1041_4 Template-Type: ReDIF-Article 1.0 Title: Caring for Southeast Asian refugee patients in the USA Journal: American Journal of Public Health Author-Name: Muecke, M.A. Year: 1983 Volume: 73 Issue: 4 Pages: 431-438 Abstract: This paper concerns care of refugees from Southeast Asia who speak little English and are relatively unfamiliar with the formal health care system in the United States. It aims to demystify the behaviors of refugee patients and to support health practitioners who are attempting to care for them. Western medicine is discussed in terms of the expectations that refugees tend to hold of it, and of the conflicts with Southeast Asian beliefs and practices which it presents. Despite language differences, health care agents can increase the effectiveness of their communication with persons from Southeast Asia, primarily by allowing for their viewpoints. Topics discussed: the first encounter with a refugee patient; use of interpreters; obtaining informed consent; 'the passive obedient' patient: the 'non-compliant' patient; body image; sources of social support for healing; use of medications; traditional self-care practices; and death and depression. Handle: RePEc:aph:ajpbhl:1983:73:4:431-438_6 Template-Type: ReDIF-Article 1.0 Title: The role of treponemal tests in therapeutic decision making Journal: American Journal of Public Health Author-Name: Hart, G. Year: 1983 Volume: 73 Issue: 7 Pages: 739-743 Abstract: As part of process evaluation of a syphilis control program, the predictability of serologic tests was assessed by reviewing the primary care case records (containing serology findings on 5,643 sera) of all individuals in six aboriginal communities. The direct relationship of predictability to positivity of treponemal test was influence by the Venereal Disease Research Laboratory (VDRL) titre and when results were stratified by this variable, an inverse association of predictive value with levels of positivity of treponemal test was demonstrated. The predictive values positive of the FTA-ABS-IgM test for untreated disease was 0.31 for VDRL titres of 1:4 and increased to 0.84 for VDRL titres exceeding 1:16. The predictive value of treponemal tests would be increased by more restrictive criteria for their performance, and optimum interpretation demands concurrent assessment of VDRL titre, and clinical and epidemiological background of the individual patient. This type of evaluation on individual control programs is encouraged because the quantitative findings will vary with disease prevalence, testing criteria, and the individual laboratory testing performance. Handle: RePEc:aph:ajpbhl:1983:73:7:739-743_8 Template-Type: ReDIF-Article 1.0 Title: Household size and the cost of nutritionally equivalent diets Journal: American Journal of Public Health Author-Name: Morgan, K.J. Author-Name: Johnson, S.R. Author-Name: Burt, J. Year: 1983 Volume: 73 Issue: 5 Pages: 530-537 Abstract: Economy of scale factors were developed in 1975 and have since been utilized as household size adjustment factors in estimating household costs of US Department of Agriculture (USFA) food plans. As such, these adjustment factors have a direct impact on the Food Stamp Program coupon allotments. In the present study, the stability of these factors over time was assessed, and the impact of diet quality measures in determining the adjustment factors was investigated. The reported household scale factors, estimated using regression analyses and the National Food Consumption Survey, Survey of Food Consumption in Low-Income Households, 1977-78, varied somewhat from former estimates and were found to be highly dependent on the diet quality measures incorporated in the analysis. Incorporation of several diet quality variables as well as partition specific means are recommended for determining household size adjustment factors to be used in estimating household costs of USDA food plans. Handle: RePEc:aph:ajpbhl:1983:73:5:530-537_6 Template-Type: ReDIF-Article 1.0 Title: Tick testing as a method of controlling Rocky Mountain spotted fever Journal: American Journal of Public Health Author-Name: Sacks, J.J. Author-Name: Pinner, T.A.F. Author-Name: Parker, R.L. Year: 1983 Volume: 73 Issue: 8 Pages: 903-906 Abstract: In South Carolina, 1974-1980, only two matches were found between 536 Rocky Mountain spotted fever (RMSF) cases and 965 individuals who submitted ticks that tested rickettsial antigen positive. In neither case did the positive test prevent RMSF. Tick rickettsial positivity rates varied inversely with human RMSF attack rates in different geographic areas. A physician survey established it as unlikely that RMSF ocurred in positive tick submitters (PTS), and that although not recommended, 34% of asymptomatic PTS received prophylactic treatment. Only 18% of positive ticks were engorged. Tick testing appears ineffective in preventing RMSF. Handle: RePEc:aph:ajpbhl:1983:73:8:903-906_4 Template-Type: ReDIF-Article 1.0 Title: Statistical validation of a severity of illness measure Journal: American Journal of Public Health Author-Name: Wagner, D.P. Author-Name: Knaus, W.A. Author-Name: Draper, E.A. Year: 1983 Volume: 73 Issue: 8 Pages: 878-884 Abstract: This paper provides statistical detail on the predictive power of a new severity of illness scale - APACHE (Acute Physiology and Chronic Health Evaluation) - on 833 consecutive medical admissions to an intensive care unit (ICU). In a multivariate logistic regression analysis of routine physiologic and other data obtained within 24 hours of ICU admission, severity of illness and age were significantly (p < .001) related to survival. Using the estimated equation to forecast death rates for independent data, APACHE allowed accurate estimates of death rates for groups of patients whose mortality at hospital discharge varied from 3 to 80%. The Acute Physiology Score of APACHE is also strongly and significantly associated with outcome within a number of specific cardiovascular, neurologic, respiratory, and gastrointestinal diagnoses. After multi-institutional validation studies, APACHE could prove useful in a wide range of studies involving acutely ill patients. Handle: RePEc:aph:ajpbhl:1983:73:8:878-884_7 Template-Type: ReDIF-Article 1.0 Title: Health-specific family coping index for noninstitutional care Journal: American Journal of Public Health Author-Name: Choi, T. Author-Name: Josten, L.V. Author-Name: Christensen, M.L. Year: 1983 Volume: 73 Issue: 11 Pages: 1275-1277 Abstract: We report on attempts to improve the Richmond/Hopkins Family Coping Index. Factor analysis showed that revised operational guidelines for using the index probably contributed to a significantly higher per cent of variance explained by the index (83 per cent versus 59 per cent). Correlation between this index and another coping index was also high (.94). Results support the continued use of the Family Coping Index - with new instructions - to assess patient/family coping. Handle: RePEc:aph:ajpbhl:1983:73:11:1275-1277_5 Template-Type: ReDIF-Article 1.0 Title: Prescribed medicines: Findings from the national medical care expenditure survey Journal: American Journal of Public Health Author-Name: Rossiter, L.F. Year: 1983 Volume: 73 Issue: 11 Pages: 1312-1315 Abstract: In 1977 the National Center for Health Services research, US Department of Health and Human Services, under took a survey of 40,000 individuals in the United States, soliciting information on expenditures and sources of payment for health services including prescribed medicines. Differences in the use of prescribed medicines by age, sex, ethnic/racial background, family income, and perceived health status were found across and within therapeutic categories. More than one-fifth of expenditures were for cardiovascular-renal agents. Sources of payment were similar in all but a few therapeutic categories. Handle: RePEc:aph:ajpbhl:1983:73:11:1312-1315_0 Template-Type: ReDIF-Article 1.0 Title: Medical data and injuries Journal: American Journal of Public Health Author-Name: Backer, S.P. Year: 1983 Volume: 73 Issue: 7 Pages: 733-734 Handle: RePEc:aph:ajpbhl:1983:73:7:733-734_6 Template-Type: ReDIF-Article 1.0 Title: Breast self-examination competency: an analysis of self-reported practice and associated characteristics Journal: American Journal of Public Health Author-Name: Celentano, D.D. Author-Name: Holtzman, D. Year: 1983 Volume: 73 Issue: 11 Pages: 1321-1323 Abstract: Of 308 Baltimore, Maryland women surveyed by telephone, 76.3 per cent reported having performed breast self-examination (BSE) during the last year, with only 35 per cent reporting monthly BSE ability scores showed that most women had little knowledge of the proper BSE technique. Utilization factors, socioeconomic status and knowledge/attitude about cancer were not related to BSE competency. Higher BSE competency having been taught the procedure by a health professional, and perceived confidence in BSE practice were also related to proper performance. Handle: RePEc:aph:ajpbhl:1983:73:11:1321-1323_9 Template-Type: ReDIF-Article 1.0 Title: Influenza vaccine: Delivering the goods Journal: American Journal of Public Health Author-Name: Schoenbaum, S. Year: 1983 Volume: 73 Issue: 4 Pages: 365-366 Handle: RePEc:aph:ajpbhl:1983:73:4:365-366_6 Template-Type: ReDIF-Article 1.0 Title: Dietary lead intake of preschool children Journal: American Journal of Public Health Author-Name: Bander, I.K. Author-Name: Morgan, K.J. Author-Name: Zabik, M.E. Year: 1983 Volume: 73 Issue: 7 Pages: 789-794 Abstract: A nationwide, seven-day consumption survey of 371 preschool children between the ages of birth and five years indicated that a direct linear relationship existed between age and increased dietary lead intake from foods consumed. Daily dietary lead intake averaged 62 μg and ranged from 15 μg to 234 μg. The various levels of lead intake were attributed to frequency of consumption of food items, quantity of food consumed, and the lead content of particular food items. To account for variation in the quantity of food consumed by the various children, average lead intake per 500 kilocalories consumed and per 500 g of food consumed was calculated. When these standardization procedures were followed, an equalization in the average daily dietary lead intake values was observed among the various aged children. Handle: RePEc:aph:ajpbhl:1983:73:7:789-794_2 Template-Type: ReDIF-Article 1.0 Title: Aging in America: The White House Conference of 1981 in retrospect Journal: American Journal of Public Health Author-Name: Hanham, R.A. Year: 1983 Volume: 73 Issue: 7 Pages: 799-801 Handle: RePEc:aph:ajpbhl:1983:73:7:799-801_4 Template-Type: ReDIF-Article 1.0 Title: Conditions for the chemical and physical inactivation of the K. Fu strain of the agent of Creutzfeldt-Jakob disease Journal: American Journal of Public Health Author-Name: Walker, A.S. Author-Name: Inderlied, C.B. Author-Name: Kingsbury, D.T. Year: 1983 Volume: 73 Issue: 6 Pages: 661-665 Abstract: The unusual resistance of the 'unconventional viruses' to inactivation by the commonly used disinfectants has led to a high degree of apprehension regarding patients with any form of dementia. The rapid adaptation of a newly acquired isolate of the agent of Creutzfeldt-Jakob Disease (CJD) to mice made possible this large scale study of its heat and chemical stability. The agent showed a decrease in titer of approximately two logs following incubation at 80°C for 30 minutes with no additional loss at 80°C for up to 500 minutes. There was greater than a three log decrease in titer at 100°C for 30 minutes and temperatures of 115° and 130°C completely inactivated the agent. Treatment with sodium hypochlorite at three concentrations (0.33 per cent, 0.66 per cent and 1.31 per cent) showed inactivation of greater than 99 per cent at each. Crude agent preparations were not inactivated by sodium dodecylsulfate at detergent to protein ratios up to 4:1. These results suggest that those hospital supplies which resist autoclaving may be adequately disinfected by autoclaving for at least 30 minutes. Treatment of surfaces with solutions of sodium hypochlorite (household bleach) at concentrations of 15 to 25 per cent is also effective. Detergent treatment of contaminated surfaces or materials is inadequate for proper decontamination. Handle: RePEc:aph:ajpbhl:1983:73:6:661-665_1 Template-Type: ReDIF-Article 1.0 Title: The relationship between hip fracture and water fluoridation: An analysis of national data Journal: American Journal of Public Health Author-Name: Madans, J. Author-Name: Kleinman, J.C. Author-Name: Cornoni Huntley, J. Year: 1983 Volume: 73 Issue: 3 Pages: 296-298 Abstract: Data from the 1973-1977 National Health Interview Surveys were used to determine whether water fluoridation prevents hip fractures related to osteoporosis. No protective effect was found for fluoride levels of 0.7 ppm, the level recommended for the prevention of dental caries. There are some indications that higher concentrations of fluoride might have a protective effect for groups with a high incidence of osteoporosis. However, no determination of the actual levels needed or the possible adverse effects of high water fluoride levels could be made. Handle: RePEc:aph:ajpbhl:1983:73:3:296-298_4 Template-Type: ReDIF-Article 1.0 Title: Nuclear power: Safety and economics Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1983 Volume: 73 Issue: 9 Pages: 1099-1100 Handle: RePEc:aph:ajpbhl:1983:73:9:1099-1100_1 Template-Type: ReDIF-Article 1.0 Title: Taking stock: Our chances of making a difference. 1982 Presidential address Journal: American Journal of Public Health Author-Name: Matek, S.J. Year: 1983 Volume: 73 Issue: 11 Pages: 1262-1264 Handle: RePEc:aph:ajpbhl:1983:73:11:1262-1264_4 Template-Type: ReDIF-Article 1.0 Title: Projection of Down's syndrome births in the United States 1979-2000, and the potential effects of prenatal diagnosis Journal: American Journal of Public Health Author-Name: Huether, C.A. Year: 1983 Volume: 73 Issue: 10 Pages: 1186-1189 Abstract: This study projects the annual number of Down's syndrome (DS) births during 1979-2000 by maternal age categories, and estimates the effects of prenatal chromosomal diagnosis utilization on reducing these baseline projections. Assuming no reduction in DS births through prenatal diagnosis, projected DS births increase from about 4,300 in 1979 to 5,300 in 1990, where the level would remain approximately stable throughout the 1990s. Applying Ohio's 1980-1981 prenatal chromosomal diagnosis utilization ratio of 17% to women ≥35 results in a maximum of 6% reduction in the annual baseline projections of DS births over the next two decades. However, if amniocentesis utilization by women age 30-34 increases to 37.5% and to 75% by women ≥35, a one-fourth to one-third annual reduction is achieved throughout the period studied. A substantial increase in prenatal diagnosis appears necessary to offset the projected increase in DS births resulting from a larger number of births to women ≥35. Handle: RePEc:aph:ajpbhl:1983:73:10:1186-1189_2 Template-Type: ReDIF-Article 1.0 Title: Indochinese refugee fertility rates and pregnancy risk factors, Oregon Journal: American Journal of Public Health Author-Name: Hopkins, D.D. Author-Name: Clarke, N.G. Year: 1983 Volume: 73 Issue: 11 Pages: 1307-1309 Abstract: Matching 471 Oregon birth certificates with official Indochinese arrival lists reveals a fertility rate of 126.7, 1.8 times the US rate of 68.5. Greater maternal and infant risk rates were noted, particularly for Hmong. Data indicate improvements in obtaining prenatal care and in reducing the number of low birth weight infants for refugees who have resided in the US three or more months; however, the improvement appear to be reversed after 12 months of US residency. Handle: RePEc:aph:ajpbhl:1983:73:11:1307-1309_3 Template-Type: ReDIF-Article 1.0 Title: To section or not to section Journal: American Journal of Public Health Author-Name: Pearse, W.H. Year: 1983 Volume: 73 Issue: 8 Pages: 843-844 Handle: RePEc:aph:ajpbhl:1983:73:8:843-844_4 Template-Type: ReDIF-Article 1.0 Title: Perinatal characteristics of newborns relinquished at birth Journal: American Journal of Public Health Author-Name: Yogman, M.W. Author-Name: Herrera, C. Author-Name: Bloom, K. Year: 1983 Volume: 73 Issue: 10 Pages: 1194-1196 Abstract: Demographic, perinatal, and newborn characteristics of single mothers relinquishing their newborns for adoption (N = 111) were compared with randomly selected and matched groups of mothers keeping their infants. Relinquishing mothers were younger, more apt to be Caucasian, Catholic, primiparous, and economically independent of government assistance, less likely to plan their pregnancies, and later starting prenatal care. In general, their pregnancies and infants were at no higher neonatal risk than those of other single mothers. Handle: RePEc:aph:ajpbhl:1983:73:10:1194-1196_5 Template-Type: ReDIF-Article 1.0 Title: Reassurance through prenatal diagnosis and willingness to bear children after age 35 Journal: American Journal of Public Health Author-Name: Roghmann, K.J. Author-Name: Doherty, R.A. Year: 1983 Volume: 73 Issue: 7 Pages: 760-762 Abstract: This study reports on a survey of 2,209 women age 25-45; most were married. Respondents were asked about their reproductive plans and whether prenatal reassurance might influence their reproductive intentions. For almost two-thirds of the age 35-45 respondents, either the woman or her husband had already chosen sterilization; of those able to bear children, but with uncertain plans, 25 per cent of 35-39 year olds and 12.8 per cent of 40-45 year olds indicated an increased willingness to have children if they were reassured that their baby had none of the birth defects detectable by ammniocentesis. Handle: RePEc:aph:ajpbhl:1983:73:7:760-762_6 Template-Type: ReDIF-Article 1.0 Title: Boxing: Atavistic spectacle or artistic sport? Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1983 Volume: 73 Issue: 7 Pages: 811-812 Handle: RePEc:aph:ajpbhl:1983:73:7:811-812_9 Template-Type: ReDIF-Article 1.0 Title: Patterns of vitamin C intake from food and supplements: Survey of an adult population in Alameda County, California Journal: American Journal of Public Health Author-Name: Shapiro, L.R. Author-Name: Samuels Breslow, S.L. Author-Name: Camacho, T. Year: 1983 Volume: 73 Issue: 7 Pages: 773-778 Abstract: Use of vitamin C in food and pills and its association with health habits and health status were investigated in a random sample of 3,119 adults in Alameda County, California. Vitamin C intakes of nearly 80 per cent of respondents met or exceeded Recommended Daily Dietary allowances. Fourteen per cent or fewer appeared to have inadequate vitamin C intake. Vitamin C supplement were taken daily by 29 per cent, occasionally by 21 per cent. Most respondents obtained 100 mg or less of vitamin C daily; 2 per cent had more than 2000 mg. Proportionately, more women than men took vitamin C pills daily. Men aged 16 to 44 were the most likely to have neither vitamin C foods nor pills. Persons 45 years and older tended to take vitamin C pills daily, younger persons to take them occasionally. Respondents who did not eat breakfast or who smoked cigarettes had lower vitamin C intakes. People in poor health took more vitamin C than those in good health. Health status may have influenced vitamin C intake rather than vitamin C intake influencing health status. Handle: RePEc:aph:ajpbhl:1983:73:7:773-778_8 Template-Type: ReDIF-Article 1.0 Title: The survival benefit of bystander cardiopulmonary resuscitation in a paramedic served metropolitan area Journal: American Journal of Public Health Author-Name: Guzy, P.M. Author-Name: Pearce, M.L. Author-Name: Greenfield, S. Year: 1983 Volume: 73 Issue: 7 Pages: 766-769 Abstract: We investigated the survival benefit of bystander cardiopulmonary resuscitation (CPR) for out-of-hospital emergencies in a paramedic served area of metropolitan Los Angeles. Clinical information for all events occurring between January 1 and December 31, 1978 was obtained from paramedic report forms and hospital medical records. Bystander CPR was performed for 93 cases and, of these, 20 (22 per cent) survived to hospital discharge, as compared to 7 (5 per cent) of the 150 patients not receiving bystander CPR (p < 0.001). Twelve (27 per cent) of the 45 patients in ventricular fibrillation (VF) who had bystander CPR survived, as compared to 4 (6 per cent) of 70 VF patients without bystander CPR (p < 0.01). We conclude that bystander CPR, initiated prior to arrival of paramedics, produced a fourfold improvement in survival. overall there was a 10 per cent survival rates at hospital discharge. Survival rates reported from Seattle may not necessarily be generalized to larger cities. Handle: RePEc:aph:ajpbhl:1983:73:7:766-769_0 Template-Type: ReDIF-Article 1.0 Title: On comparing studies of different Raza populations Journal: American Journal of Public Health Author-Name: Hayes Bautista, D.E. Year: 1983 Volume: 73 Issue: 3 Pages: 274-276 Handle: RePEc:aph:ajpbhl:1983:73:3:274-276_2 Template-Type: ReDIF-Article 1.0 Title: The organization of medical practice and primary care physician income Journal: American Journal of Public Health Author-Name: Wolinsky, F.D. Author-Name: Marder, W.D. Year: 1983 Volume: 73 Issue: 4 Pages: 379-383 Abstract: This study investigates the effect of the organization of medical practice, e.g., solo, fee-for-service group, or health maintenance organization (HMO) settings, on primary care physicians' net incomes. Using pooled data on 2,372 primary care physicians, multivariate regression analysis is used to adjust physicians' 1979 net incomes for differences in medical specialty, workload, sex, and experience before estimating the effects of the organization of medical practice. Among HMO physicians, only those in staff model HMOs were found to have significantly lower net incomes than their fee-for-service group practice counterparts. Accordingly, there is little evidence to support the popular belief that physicians practicing in HMOs consistently earn less than their fee-for-service counterparts. Handle: RePEc:aph:ajpbhl:1983:73:4:379-383_1 Template-Type: ReDIF-Article 1.0 Title: Cancer in North American Indians: Environment versus heredity Journal: American Journal of Public Health Author-Name: Sievers, M.L. Author-Name: Fisher, J.R. Year: 1983 Volume: 73 Issue: 5 Pages: 485-487 Abstract: The risk of cancer is significantly lower among the Indians of North America than in the general populations of the United States and Canada. In American Indians (Amerinds), the age-adjusted mortality rate of cancer is only one-half to two-thirds the national overall rate for non-Indians living in the United States. Indian males of British Columbia also reportedly have about half the age-standardized cancer mortality rate recorded for non-Indian populations of that southwestern Canadian Province. Among the Amerind, the relative deficit for malignant neoplasms has been largely confined to males. Native Americans, as compared with Whites, have significantly lower rates for cancer of the lung, breast, and colon, but higher rates for the gallbladder, kidney and cervix. For these six anatomic sites, the cancer mortalities of populations with only partial Indian ancestry, such as the tribes in Oklahoma and the Mexican-Americans (most of whom have some Indian admixture) are generally intermediate between the rates for the US general population and the rates for tribes having predominantly full Indian heritage, (e.g., the Indians in Arizona and New Mexico). Handle: RePEc:aph:ajpbhl:1983:73:5:485-487_8 Template-Type: ReDIF-Article 1.0 Title: Assessing the impact of copayment of family planning services: A preliminary analysis in California Journal: American Journal of Public Health Author-Name: Aved, B.M. Author-Name: Harp, V. Year: 1983 Volume: 73 Issue: 7 Pages: 763-765 Abstract: A legislatively mandated copayment system for California state-funded family planning services was evaluated after the first six months of experience. Most clients reportedly could make their payments, but three times as many providers suggested lowering the fees as suggested raising them, and one-third reported a decrease in client donations. While the majority of providers did not report a decrease in clients, 22 per cent did so. For these drop-outs, it is estimated that the State would pay approximately $3 million in costs associated with unintended pregnancies, or one and a half times the amount cut from the Family Planning budget. Handle: RePEc:aph:ajpbhl:1983:73:7:763-765_5 Template-Type: ReDIF-Article 1.0 Title: Apartheid and the causes of death: Disentangling ideology and laws from class and race Journal: American Journal of Public Health Author-Name: Susser, M. Year: 1983 Volume: 73 Issue: 5 Pages: 581-584 Handle: RePEc:aph:ajpbhl:1983:73:5:581-584_2 Template-Type: ReDIF-Article 1.0 Title: The practice and efficacy of breast self-examination: A critical review Journal: American Journal of Public Health Author-Name: Holtzman, D. Author-Name: Celentano, D.D. Year: 1983 Volume: 73 Issue: 11 Pages: 1324-1326 Abstract: Evaluation of the results of breast self-examination (BSE) is inconclusive. Studies which address the question of proper method of BSE find that most women do not know how to carry out the procedure correctly. Socio-demographic characteristics most consistently related to BSE practice are age and education. New research on BSE must not only take into account such correlates but also provide some verification of the procedure to determine the importance of BSE in the detection and control of breast cancer. Handle: RePEc:aph:ajpbhl:1983:73:11:1324-1326_6 Template-Type: ReDIF-Article 1.0 Title: Smoking habits in a hospitalized population: 1970-1980 Journal: American Journal of Public Health Author-Name: Covey, L.S. Author-Name: Mushinski, M.H. Author-Name: Wynder, E.L. Year: 1983 Volume: 73 Issue: 11 Pages: 1293-1297 Abstract: The smoking habits of 23,953 hospitalized men and women aged 20 to 80, interviewed in nine United States cities between 1970 and 1980, were examined. Comparisons were made of age-adjusted smoking rates in 1970-1975 vs 1976-1980, stratified by sex, race, and educational level. An overall decrease in smoking exposure between the time periods studied was observed: a decline in rates of current cigarette smokers and an increase in use of cigarettes containing ≤ 12 mg tar. Nevertheless, among current smokers, there was no reduction in the proportions of those who smoke 31+ cigarettes daily. An enhancing effect of higher education on rates of smoking cessation and use of cigarettes containing ≤12 mg tar was observed. In both time periods, proportionately more Black than White men were smokers, although the difference was smaller in college educated groups. These findings point up the limited effectiveness of public health education about smoking in lower socioeconomic groups, and suggest that the future, lung cancer and other diseases for which smoking is a major factor will be increasingly social class related diseases. Handle: RePEc:aph:ajpbhl:1983:73:11:1293-1297_7 Template-Type: ReDIF-Article 1.0 Title: Pennsylvania's Domiciliary Care experiment: II. Cost-benefit implications Journal: American Journal of Public Health Author-Name: Ruchlin, H.S. Author-Name: Morris, J.N. Year: 1983 Volume: 73 Issue: 6 Pages: 654-660 Abstract: A pilot program based on the substitution of domiciliary care for traditional instrumentational care was established by the Commonwealth of Pennsylvania to provide community-based care for individuals who could no longer live independently (aging, mentally retarded, mentally ill). To ascertain the cost saving potential of this program, 190 participants and a comparable pool of non-participants were followed for an average 10-month follow-up period. Within each subgroup, participants were disaggregated into two categories: those residing in a community setting at pretest, and those residing in an institutional setting. An analysis of medical care and social support service utilization profiles indicated that program savings exceeded program cost for five of the six study subsamples; the one exception was the mental retardation cohort residing in a community setting at pretest. Net savings were greatest for the three subsamples residing in an institutional setting at pretest. For all the subsamples, over 90 per cent of the program saving stemmed from a lower use of institutional placements. Handle: RePEc:aph:ajpbhl:1983:73:6:654-660_4 Template-Type: ReDIF-Article 1.0 Title: Severe local reactions to live measles virus vaccine following an immunization program Journal: American Journal of Public Health Author-Name: Stetler, H.C. Author-Name: Gens, R.D. Author-Name: Seastrom, G.R. Year: 1983 Volume: 73 Issue: 8 Pages: 899-900 Abstract: A cluster of nine severe local reactions occurred in a Pennsylvania school district following a mass measles immunization program in February 1981. A case-control study showed that the nine cases had a statistially significant increased history of having received killed measles vaccine previously (p < .001, Fisher's exact test) and a statistically significant higher geometric mean measles antibody titer (p < .01, Student's t test) than controls, suggesting that previous receipt of killed measles vaccine was the underlying cause of these reactions. Handle: RePEc:aph:ajpbhl:1983:73:8:899-900_7 Template-Type: ReDIF-Article 1.0 Title: Quantitative relationships of Candida albicans infections and dressing patterns in Nigerian women Journal: American Journal of Public Health Author-Name: Elegbe, I.A. Author-Name: Elegbe, I. Year: 1983 Volume: 73 Issue: 4 Pages: 450-452 Abstract: Candida albicans colon counts were far higher in patients with vaginitis wearing tight fitting clothing than in patients wearing loose fitting clothing. In Ile-Ife, Nigeria, tight fitting dresses, woollen and corduroy jeans, coupled with nylon underwear, appear to create an environment favorable to Candida albicans colonization. Handle: RePEc:aph:ajpbhl:1983:73:4:450-452_5 Template-Type: ReDIF-Article 1.0 Title: Prevalence and correlates of passive smoking Journal: American Journal of Public Health Author-Name: Friedman, G.D. Author-Name: Petitti, D.B. Author-Name: Bawol, R.D. Year: 1983 Volume: 73 Issue: 4 Pages: 401-405 Abstract: The duration per week of exposure to others' tobacco smoke in different locations was tabulated from the questionnaire responses of 37,881 non-smokers and ex-smokers who received multiphasic health checkups in 1979 and 1980. Altogether 63.3 per cent of subjects reported some exposure, 34.5 per cent were exposed at least 10 hours per week, and 15.9 per cent at least 40 hours per week. Duration of exposure per week was weakly correlated with serum thiocyanate level in a small test group. Exposure was strongly related to age with a peak of 78.2 per cent in the twenties decade and an accelerating decline thereafter to 13.9 per cent in those age 80 and over. Sex and race were related to passive smoking only to a relatively small degree. Persons reporting longer exposures were more apt to report greater use of alcohol and marijuana, exposure to occupational hazards, and being currently not married. Lack of college education was most frequent among those denying exposure but was directly related to exposure duration among those reporting some passive smoking. Studies of the health effects of passive smoking should take into account these associated factors. Although the reported passive smoking of married persons was strongly related to their spouses' habits, categorization by spouses' smoking resulted in considerable misclassification. Handle: RePEc:aph:ajpbhl:1983:73:4:401-405_6 Template-Type: ReDIF-Article 1.0 Title: Effectiveness of public health nurse home visits to primiparous mothers and their infants Journal: American Journal of Public Health Author-Name: Barkauskas, V.H. Year: 1983 Volume: 73 Issue: 5 Pages: 573-580 Abstract: The purpose of this study was to determine the effects of public health nurse postpartum home visits by comparing the health outcomes of 67 randomly selected mother-infant pairs who had received such services with 43 randomly selected mother-infant pairs who had not received them. Health outcome variables were mother's health and health services utilization, infant's health and health services utilization, and mother's parenting practices. Data were controlled from birth certificates, health service records, and by home interviews and observations at six months postpartum. No significant differences were noted between home-visited and not-home-visited mother-infant pairs for the majority of health outcome variables. Major, differential health assets and liabilities between groups of Black and White mother-infant pairs were observed. Handle: RePEc:aph:ajpbhl:1983:73:5:573-580_1 Template-Type: ReDIF-Article 1.0 Title: Reported cigarette smoke values: A closer look Journal: American Journal of Public Health Author-Name: Hoffmann, D. Author-Name: Adams, J.D. Author-Name: Haley, N.J. Year: 1983 Volume: 73 Issue: 9 Pages: 1050-1053 Abstract: Effects of mechanical compression of the filter tips and of blocking the air channels of a special filter design on the smoke yields of seven brands of commercial filter cigarettes were investigated. In addition, the influence of these variables on actual uptake of smoke constituents by smokers was studied with four subjects. Compression of filter tips produced major increases in smoke yields for the cigarette which features a filter tip with four longitudinal air channels at its periphery. Blocking of these air channels increased tar yields by 51 per cent, nicotine by 69 per cent, and carbon monoxide by 147 per cent. Subjects who smoked the cigarette with this special filter design tended to smoke fewer cigarettes per day than when they smoked cigarettes with perforated filter tips, yet their plasma cotinine levels were significantly higher. Blood pressure and pulse rate were markedly elevated after first exposure to smoke from the special filter cigarette, as were plasma nicotine levels. These results point out that individuals inhale different quantities of smoke constituents from cigarettes with reportedly similar smoke yields according to Federal Trade Commission methods. A redefinition of 'average' smoking parameters and readjustment of standard laboratory methodology are suggested. Handle: RePEc:aph:ajpbhl:1983:73:9:1050-1053_0 Template-Type: ReDIF-Article 1.0 Title: Alcohol consumption and diabetes mellitus mortality in different countries Journal: American Journal of Public Health Author-Name: Keilman, P.A. Year: 1983 Volume: 73 Issue: 11 Pages: 1316-1317 Abstract: Alcohol consumption on a per capita country basis is associated with diabetes mortality rates for men. The relation is also positive for women, but not statistically significant. Countries that consume primarily beer have higher diabetes mortality rates than countries that consume primarily spirits or wine. Handle: RePEc:aph:ajpbhl:1983:73:11:1316-1317_8 Template-Type: ReDIF-Article 1.0 Title: Beyond the statistics of adolescent smoking Journal: American Journal of Public Health Author-Name: Eckert, P. Year: 1983 Volume: 73 Issue: 4 Pages: 439-441 Abstract: Statistical studies can identify the demographic characteristics of the adolescent smoking population but cannot reveal how clusters of demographic categories combine in the culture of the community to form salient social categories, or how social processes link these categories to smoking and smoking-related behavior. Because smoking and smoking-related behavior function as a key social symbol, anti-smoking campaigns that are based on an inaccurate understanding of the social context in which smoking occurs can reinforce this behavior. Participant observation in a suburban high school suggests that adolescents begin smoking as part of a complex symbolic process growing out of the process of social differentiation between future members of the working class on the one hand and the middle class on the other. It points out inadequacies in two existing anti-smoking programs in the schools that result from ignoring the social dynamics of smoking. Handle: RePEc:aph:ajpbhl:1983:73:4:439-441_0 Template-Type: ReDIF-Article 1.0 Title: Effects of breastfeeding on IUD performance Journal: American Journal of Public Health Author-Name: Cole, L.P. Author-Name: McCann, M.F. Author-Name: Higgins, J.E. Author-Name: Waszak, C.S. Year: 1983 Volume: 73 Issue: 4 Pages: 384-388 Abstract: The effect that lactation might have on intrauterine device (IUD) performance was investigated by using data from a series of multicenter clinical trials. Life-table methods were applied to compare breastfeeding and non-breastfeeding women with respect to IUD expulsion, accidental pregnancy, IUD removal for various reasons, and overall continuation of IUD use. Results indicate that breastfeeding does not increase the risk of expulsion or other events, whether the device is inserted immediately (within ten minutes) or more than 42 days after delivery. Handle: RePEc:aph:ajpbhl:1983:73:4:384-388_5 Template-Type: ReDIF-Article 1.0 Title: How effective are daytime motorcycle headlight use laws? Journal: American Journal of Public Health Author-Name: Zador, P. Year: 1983 Volume: 73 Issue: 7 Pages: 808 Handle: RePEc:aph:ajpbhl:1983:73:7:808_9 Template-Type: ReDIF-Article 1.0 Title: Serologic investigation of an outbreak of hepatitis A in a rural day-care center Journal: American Journal of Public Health Author-Name: Gingrich, G.A. Author-Name: Hadler, S.C. Author-Name: Elder, H.A. Author-Name: Ash, K.O. Year: 1983 Volume: 73 Issue: 10 Pages: 1190-1193 Abstract: We studied an outbreak of hepatitis A in a day-care center in a rural community where less than 7% of the population possessed anti-HAV. Serotesting for IgM specific antibody to hepatitis A virus identified 78 cases in center attendees, staff, and families. Thirty-five per cent of the center children were seropositive. In children under age three anicteric infection was at least 17 times more frequent than icteric infection, but in older children and adults icterus was a predominant manifestation of the disease. Clinical suspicion should be high in any day-care child with nausea, emesis, diarrhea, or arthralgia. The low incidence of icterus in infected children suggested that outbreak reports reaching public health departments are likely to be incomplete and poorly indicative of outbreak magnitude. The high frequency of intrafamilial transmission and anicteric infection appeared to justify administration of immune serum globulin to household contacts of center children under age three when a day-care outbreak is detected. Handle: RePEc:aph:ajpbhl:1983:73:10:1190-1193_5 Template-Type: ReDIF-Article 1.0 Title: An outbreak of foodborne hepatitis A: The value of serologic testing and matched case-control analysis Journal: American Journal of Public Health Author-Name: Gustafson, T.L. Author-Name: Hutcheson Jr., R.H. Author-Name: Fricker, R.S. Author-Name: Schaffner, W. Year: 1983 Volume: 73 Issue: 10 Pages: 1199-1201 Abstract: In April 1981, an outbreak of hepatitis A occurred among state legislators in Tennessee. Although the number of cases was small, we traced the source to a food handler who served cold meats and cheese. This investigation demonstrates the value of rapid serologic testing using a radioimmunoassay technique and matched case-control analysis to identify small foodborne outbreaks of hepatitis A. Handle: RePEc:aph:ajpbhl:1983:73:10:1199-1201_5 Template-Type: ReDIF-Article 1.0 Title: Cancer surveillance in a remote Indian population in Northwestern Ontario Journal: American Journal of Public Health Author-Name: Young, T.K. Author-Name: Frank, J.W. Year: 1983 Volume: 73 Issue: 5 Pages: 515-520 Abstract: The incidence and mortality rates of malignant neoplasms in an isolated Indian population in northwestern Ontario, Canada during the period 1972-81 were determined and age-adjusted comparisons with the Canadian national population computed. Indian men were at half the risk of developing and dying from cancer compared to Canadian men, while among women the risks were similar. The most outstanding feature was the high mortality and incidence rates of kidney cancer in both sexes (relative risks for mortality and incidence 7 to 13 times that for Canadians). Gallbladder cancer was of importance in females, similar to observations in other Amerindian groups. Low-risk sites among Indians included: lung in men, breast in women, and skin in both sexes. Other sites such as colon and prostate were common in both populations. Establishing baseline incidence and mortality data and continuing surveillance over a period of time in a well-defined, geographically isolated Native population undergoing rapid social change is of interest both epidemiologically and from the health service perspective. Further studies may elucidate risk factors, of which diet appears most responsible for the peculiar pattern observed. Handle: RePEc:aph:ajpbhl:1983:73:5:515-520_8 Template-Type: ReDIF-Article 1.0 Title: Inadequate transfer of breast cancer self-detection technology Journal: American Journal of Public Health Author-Name: Sheley, J.F. Year: 1983 Volume: 73 Issue: 11 Pages: 1318-1320 Abstract: Results of a telephone interview of 290 New Orleans women indicate that, at best, only about 10 per cent of them efficaciously applied breast cancer self-detection technology. These findings suggest that research to date regarding breast self-examination efficacy in early tumor detection actually is problematic since few controls have been provided for the degree to which research subjects possess the knowledge to perform the examination correctly. Handle: RePEc:aph:ajpbhl:1983:73:11:1318-1320_2 Template-Type: ReDIF-Article 1.0 Title: Differential mortality among alcoholics by sample site Journal: American Journal of Public Health Author-Name: Combs Orme, T. Author-Name: Taylor, J.R. Author-Name: Robins, L.N. Author-Name: Holmes, S.J. Year: 1983 Volume: 73 Issue: 8 Pages: 900-903 Abstract: In a sample of 1,289 alcoholics from four clinical sites, the overall mortality rate after five to eight years of observation was 22.0%, 3.1 times the expected rate. Patients from the medical and surgical services of a general hospital suffered 4.0 times the rate of expected mortality and died most often of medical causes associated with alcoholism. Patients of the public alcoholism ward had a mortality rate 3.3 times the expected rate and died of causes often associated with low social class. Private psychiatric patients had a mortality rate 2.3 times the expected rate, and psychiatric outpatients had an excess mortality ratio of 2.1. Samples site must be considered as a variable in the study of mortality among alcoholics. Handle: RePEc:aph:ajpbhl:1983:73:8:900-903_8 Template-Type: ReDIF-Article 1.0 Title: Location decisions of National Health Service Corps physicians Journal: American Journal of Public Health Author-Name: Stamps, P.L. Author-Name: Kuriger, F.H. Year: 1983 Volume: 73 Issue: 8 Pages: 906-908 Abstract: Results of a survey of 100 National Health Service Corps (NHSC) physicians in 10 east coast states (94% response rate) indicate that 56 have plans to locate in a rural area after their service obligation is complete and 15 have not yet decided. Those who decide for a rural practice value personal and community factors to a higher degree than professional factors and are more likely to have a primary care practice. Handle: RePEc:aph:ajpbhl:1983:73:8:906-908_5 Template-Type: ReDIF-Article 1.0 Title: Community surveillance of stroke in persons under 70 years old: Contribution of uncontrolled hypertension Journal: American Journal of Public Health Author-Name: Barker, W.H. Author-Name: Feldt, K.S. Author-Name: Feibel, J.H. Year: 1983 Volume: 73 Issue: 3 Pages: 260-265 Abstract: In 1979, a community-wide hospital surveillance system was established in Monroe County, New York (population 702,000), to investigate the continuing contribution of uncontrolled high blood pressure (HBP) to the occurrence of stroke. This paper reports findings among 200 consecutive strokes in persons under 71 years of age. Average age was 58. There was a prestroke history of HBP in 129 (65 per cent) cases. Two-thirds of the 129 had other predisposing conditions (heart disease, diabetes, previous cerebrovascular accident) and 95 per cent had one or more other cardiovascular risk factors (smoking, elevated cholesterol, obesity). Over 90 per cent had visited a physician during the year prior to stroke (average of four visits). Elevated pressures (DBP ≥ 95 or SBP ≥ 160) were recorded at half or more of the visits for 45 per cent of the patients; these cases were classified as uncontrolled. Reduction of 'unnecessary' strokes in persons under age 71 should be achievable by giving increased attention to those already under medical care for hypertension who have co-existing stroke risk conditions and cardiovascular risk factors. Handle: RePEc:aph:ajpbhl:1983:73:3:260-265_2 Template-Type: ReDIF-Article 1.0 Title: Dental caries prevalence in children with a diet free of refined sugar Journal: American Journal of Public Health Author-Name: Silverstein, S.J. Author-Name: Knapp, J.F. Author-Name: Kircos, L. Author-Name: Edwards, H. Year: 1983 Volume: 73 Issue: 10 Pages: 1196-1199 Abstract: A study of the caries and dental hygiene status of 73 children living in the Synanon community revealed a mean DMF-S score at 0.53 for the 5-10 year old group and 3.33 for the 11-17 year old group. In spite of poor oral hygiene, 53% of the children were caries-free and none of the children was missing permanent teeth. The children had consumed a diet free of refined carbohydrates for five years and had received optimal fluoride supplementation since birth or joining Synanon. Handle: RePEc:aph:ajpbhl:1983:73:10:1196-1199_9 Template-Type: ReDIF-Article 1.0 Title: Will the growth of health and welfare services be resumed? Journal: American Journal of Public Health Author-Name: Morris, R. Year: 1983 Volume: 73 Issue: 7 Pages: 732-733 Handle: RePEc:aph:ajpbhl:1983:73:7:732-733_5 Template-Type: ReDIF-Article 1.0 Title: Measurement of the primary care roles of office-based physicians Journal: American Journal of Public Health Author-Name: Weiner, J.P. Author-Name: Starfield, B.H. Year: 1983 Volume: 73 Issue: 6 Pages: 666-671 Abstract: The Baltimore City Primary Care Study examined the role of the urban office-based physician in the delivery of primary care. During the course of the study, questionnaires were completed by over 90 per cent of licensed physicians in the city, and data were collected from a sample of 16,000 patients. The study developed and assessed three approaches for the measurement of primary care. An empirical method was based upon information regarding the following characteristics of each visit: first contact visit, referral visit, specialized care visit, or principal care visit. A normative method was based on an assessment of the degree to which the practice provided care that was comprehensive, longitudinal, acceptable, and family-centered. The third method used physicians' judgements as to the proportion of patients for whom they maintained ongoing responsibility for general medical care. All three methods produced the same categorization of different specialities as providing either primary, intermediate, or speciality care. As a group, primary care physicians included general and family physicians, pediatricians, and general internists. General surgeons and obstetrician/gynecologists have characteristics of both primary care and specialist care. All other physician groups have characteristics of specialists. Any of these methods or a combination of methods can be used to assess the extent to which the practice of a particular physician or group of physicians provide primary care. Handle: RePEc:aph:ajpbhl:1983:73:6:666-671_1 Template-Type: ReDIF-Article 1.0 Title: Age of walking and mental retardation Journal: American Journal of Public Health Author-Name: Kaminer, R.K. Author-Name: Jedrysek, E. Year: 1983 Volume: 73 Issue: 9 Pages: 1094-1096 Abstract: The age of independent walking was noted for 200 retarded children aged 30-60 months living in the community. The onset of walking tended to be later in more severely retarded children, but early walkers were found even among the most retarded. The majority of children with mild, moderate, and severe retardation walked by 17 months. Only in the group which was profoundly retarded did the majority begin to walk after 17 months. Onset of walking before 17 months is usual in retarded children and is compatible with all levels of mental retardation. Handle: RePEc:aph:ajpbhl:1983:73:9:1094-1096_7 Template-Type: ReDIF-Article 1.0 Title: Supply, workload and utilization: A population-based analysis of surgery in rural Manitoba Journal: American Journal of Public Health Author-Name: Roos Jr., L.L. Year: 1983 Volume: 73 Issue: 4 Pages: 414-421 Abstract: This paper explores the relationships among physician supply, workload (output per physician), and utilization (physician services per capita) in rural Manitoba. Surgery taking place within a patient's home area and that taking place outside this area are discussed. Longitudinal and cross-sectional analyses are compared. Although the average surgeon does more surgical procedures than does the average general practitioner, the number of procedures performed varies greatly within each specialty. Individual physician workloads remained fairly stable over time when a surgically active physician moved into an area, while population utilization increased 17 per cent. When such physicians left an area, the surgical workloads of the physicians increased significantly (18.7 per cent) while population utilization stayed essentially the same. Both physician workload and surgical utilization in control areas increased gradually (between 6 and 7 per cent) over the period studied. Several models of physician behavior were investigated using data on individual procedures as well as overall figures. A model emphasizing the importance of physician discretion appeared to provide the best fit with the data. Handle: RePEc:aph:ajpbhl:1983:73:4:414-421_0 Template-Type: ReDIF-Article 1.0 Title: The surgical role of family physicians. Journal: American Journal of Public Health Author-Name: Mainen, M.W. Year: 1982 Volume: 72 Issue: 12 Pages: 1359-1363 Abstract: A sample of Board-certified family physicians was surveyed regarding their role in providing operative surgical care. Twenty-one per cent reported operating and 40 per cent assisting at surgery. The percentage operating was 10 per cent in the East and 29 per cent in the West, while assisting was 22 per cent in the East and 57 per cent in the West. The frequency with which family doctors functioned as surgical operators was found to be inversely related to the perceived number of surgeons practicing in the local community, ranging from 16 per cent in communities where respondents perceived many surgeons to 56 per cent in communities with no surgeons. An interaction effect between geography and the relative number of surgeons in the local community appeared to influence whether the family physician functioned as operator or assistant. There was no independent relationship between community population size and operating by family physicians. The study suggests that the surgical role of the family physician develops in response to his local practice setting, and that the role cannot be defined from data averaged on a national scale. Handle: RePEc:aph:ajpbhl:1982:72:12:1359-1363_5 Template-Type: ReDIF-Article 1.0 Title: Mandatory PKU screening: the other side of the looking glass. Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1982 Volume: 72 Issue: 12 Pages: 1401-1403 Abstract: The challenge that PKU screening programs face is to be effective without sacrificing individual liberty. Most states have assumed that this is impossible, and have enacted mandatory PKU screening tests. It now appears that in fact voluntary screening for PKU can be effective. Accordingly, it seems appropriate to reexamine existing mandatory screening statutes to determine if we can replace government coercion with voluntary informed consent. Focus should be placed on the proper role of the government in screening, and on improving the consent process, and not on those few couples who withhold consent. Handle: RePEc:aph:ajpbhl:1982:72:12:1401-1403_7 Template-Type: ReDIF-Article 1.0 Title: A prospective study of long-term care institutionalization among the aged. Journal: American Journal of Public Health Author-Name: Branch, L.G. Author-Name: Jette, A.M. Year: 1982 Volume: 72 Issue: 12 Pages: 1373-1379 Abstract: A statewide probability sample of 1,625 elders living in Massachusetts are studied prospectively to identify key determinants of long-term care (LTC) institutionalization. One-hundred forty-seven elders, 9 per cent of the original cohort, entered a LTC institution during the six-year investigation. Using logistic multiple regression, we examine the predictive power of 19 independent variables grouped into six categories: demographic characteristics, attitude, social context, long-term care needs, physical disability, and mental/emotional disability. Five variables are significantly related to institutionalization: advancing age, using ambulatory aids, mental disorientation, living alone, and using assistance to perform "instrumental" ADL (activities of daily living). These results may be helpful to those trying to target non-institutional services to elders for use as substitutes for institutional long-term care. They may also help explain why recent experimental tests of substituting non-institutional care for institutional services have been less than successful. Handle: RePEc:aph:ajpbhl:1982:72:12:1373-1379_1 Template-Type: ReDIF-Article 1.0 Title: Prevention of mental retardation in offspring of hyperphenylalaninemic mothers. Journal: American Journal of Public Health Author-Name: Cartier, L. Author-Name: Clow, C.L. Author-Name: Lippman-Hand, A. Author-Name: Morissette, J. Author-Name: Scriver, C.R. Year: 1982 Volume: 72 Issue: 12 Pages: 1386-1390 Abstract: Maternal hyperphenylalaninemia constitutes a potential hazard to the fetus for whom the risks of postnatal mental retardation, microcephaly, and congenital malformations are elevated. Preconception and intragestational dietary treatment can apparently improve the outcome of such pregnancies. In the absence of predictive mechanisms for pregnancies at risk and preventive measures involving reproductive counseling and treatment, there could be a rebound in the population frequency of mental retardation related to disorders of phenylalanine metabolism in subsequent generations. We describe a program serving a population of six million that includes screening, diagnosis, treatment, and counseling of the hyperphenylalaninemias. The program has recently added a simple dedicated register for males and females with hyperphenylalaninemia to supplement traditional methods for continuous surveillance of probands. We registered 153 patients: 43 females and 56 males with phenylketonuria, 23 females and 31 males with benign hyperphenylalaninemia, of which 22, 7, 27 and 5, respectively, had reached their 12th birthday in an 1981. Regional centers in the program provided counseling about the consequences of maternal hyperphenylalaninemia and the options to prevent them. No family has rejected the principle or fact of the Register and its goals. Handle: RePEc:aph:ajpbhl:1982:72:12:1386-1390_6 Template-Type: ReDIF-Article 1.0 Title: Uses of ecologic analysis in epidemiologic research. Journal: American Journal of Public Health Author-Name: Morgenstern, H. Year: 1982 Volume: 72 Issue: 12 Pages: 1336-1344 Abstract: Despite the widespread use of ecologic analysis in epidemiologic research and health planning, little attention has been given by health scientists and practitioners to the methodological aspects of this approach. This paper reviews the major types of ecologic study designs, the analytic methods appropriate for each, the limitations of ecologic data for making causal inferences and what can be done to minimize these problems, and the relative advantages of ecologic analysis. Numerous examples are provided to illustrate the important principles and methods. A careful distinction is made between ecologic studies that generate or test etiologic hypotheses and those that evaluate the impact of intervention programs or policies (given adequate knowledge of disease etiology). Failure to recognize this difference in the conduct of ecologic studies can lead to results that are not very informative or that are misinterpreted by others. Handle: RePEc:aph:ajpbhl:1982:72:12:1336-1344_6 Template-Type: ReDIF-Article 1.0 Title: Child abuse in Georgia: a method to evaluate risk factors and reporting bias. Journal: American Journal of Public Health Author-Name: Jason, J. Author-Name: Andereck, N.D. Author-Name: Marks, J. Author-Name: Tyler Jr., C.W. Year: 1982 Volume: 72 Issue: 12 Pages: 1353-1358 Abstract: From July 1975 through December 1979, the Georgia Department of Protective Services Central Registry recorded population-based data on confirmed, non-confirmable, and ruled-out child abuse reports. We propose that reporting biases are reflected in the differential characteristics of confirmed and ruled-out reports of child abuse. Characteristics, households, or groups equally or more prevalent in the latter category cannot necessarily be considered associated with increased risk of child abuse, even if they are represented in the confirmed abuse population more than in the general public. Important examples of factors or categories for which an association was suggested in other studies but which are not supported by this analysis are: urban residence, teenage motherhood, infancy, and mothers and other female perpetrators. These are conditions or categories associated with greater surveillance; therefore, risk assessment is not possible using the data in this registry. Certain households do appear to be at increased risk for child abuse. These include large families, families without a biological mother or biological father, and families ever needing Aid to Families with Dependent Children (AFDC). This increased risk, however, is slight. Improved surveillance requires identification of reporting biases. A comparison of confirmed and ruled-out reports is an inexpensive and system-specific step toward achieving this aim. Handle: RePEc:aph:ajpbhl:1982:72:12:1353-1358_6 Template-Type: ReDIF-Article 1.0 Title: Health implications of organics in groundwater. Journal: American Journal of Public Health Author-Name: Metzler, D.F. Year: 1982 Volume: 72 Issue: 12 Pages: 1323-1324 Handle: RePEc:aph:ajpbhl:1982:72:12:1323-1324_5 Template-Type: ReDIF-Article 1.0 Title: Pesticides in groundwater: the aldicarb story in Suffolk County, NY. Journal: American Journal of Public Health Author-Name: Zaki, M.H. Author-Name: Moran, D. Author-Name: Harris, D. Year: 1982 Volume: 72 Issue: 12 Pages: 1391-1395 Abstract: Aldicarb, a carbamate pesticide, was detected for the first time in groundwater in Suffolk County, New York, in August 1979. Although all laboratory and field studies indicated that the pesticide could not reach groundwater, a combination of circumstances allowed its residues not only to reach groundwater but also to be ingested by humans. Inquiries in hospitals and poison control centers did not reveal any cases of carbamate poisoning. The extensive monitoring program, conducted by the County in cooperation with the federal and state agencies and the Union Carbide Corporation, showed that 1,121 (13.5 per cent) of the 8,404 wells examined exceeded the state recommended guidelines of 7 ppb. Of the contaminated wells 52 per cent contained adicarb between 8 and 30 ppb, 32 per cent between 31 and 75 ppb, and 16 per cent more that 75 ppb. Residents whose wells exceeded the guideline were advised not to use the water for drinking or cooking purposes and to obtain an alternate source of potable water. The Union Carbide Corporation provided those residents with activated carbon filtration units. The incident raises several serious issues, such as the testing of pesticides under field conditions prior to registration and during their use, the validity of the recommended actionable levels, and the paucity of long-term epidemiologic studies of the health effects resulting from consumption of pesticides in trace concentrations. Handle: RePEc:aph:ajpbhl:1982:72:12:1391-1395_1 Template-Type: ReDIF-Article 1.0 Title: Tonsillectomies performed in outpatient settings. Journal: American Journal of Public Health Author-Name: Buechner, J.S. Author-Name: Williams, D.C. Year: 1982 Volume: 72 Issue: 12 Pages: 1409-1410 Handle: RePEc:aph:ajpbhl:1982:72:12:1409-1410_9 Template-Type: ReDIF-Article 1.0 Title: Bats in the belfry: an outbreak of histoplasmosis. Journal: American Journal of Public Health Author-Name: Bartlett, P.C. Author-Name: Vonbehren, L.A. Author-Name: Tewari, R.P. Author-Name: Martin, R.J. Author-Name: Eagleton, L. Author-Name: Isaac, M.J. Author-Name: Kulkarni, P.S. Year: 1982 Volume: 72 Issue: 12 Pages: 1369-1372 Abstract: The belfry and attic of a 100-year-old school building located in central Illinois were infested with a colony of big brown bats (Eptesicus fuscus). During the week of April 14, 1980, four workers disturbed the piles of bat droppings in the attic, causing dust to become airborne. Seven to 10 days later, all four workers developed symptoms and chest x-ray findings compatible with acute pulmonary histoplasmosis. Their sera had complement fixation (CF) titers of greater than or equal to 1:32 with fungal antigens and showed M and/or H bands by immunodiffusion tests. An additional 73 persons who had visited the building were also studied, leading to the finding of 16 additional cases of acute pulmonary histoplasmosis, identified on the basis of positive serologies and compatible symptoms. H. capsulatum was isolated from the sputum of one patient and from the soil beneath the hole in the building's eaves where the bats had been entering the attic. Cases were associated with exposure to the attic and with total hours of building exposure when compared with controls. The epidemic curve suggests that sporadic exposures occurred during the spring of 1980, with an epidemic occurring after the bat droppings were disturbed by the four workers. Handle: RePEc:aph:ajpbhl:1982:72:12:1369-1372_8 Template-Type: ReDIF-Article 1.0 Title: Laboratory evaluation and assistance efforts: mailed, on-site and blind proficiency testing surveys conducted by the Centers for Disease Control. Journal: American Journal of Public Health Author-Name: Boone, D.J. Author-Name: Hansen, H.J. Author-Name: Hearn, T.L. Author-Name: Lewis, D.S. Author-Name: Dudley, D. Year: 1982 Volume: 72 Issue: 12 Pages: 1364-1368 Abstract: During the last three years, the Centers for Disease Control (CDC) has conducted: 1) on-site surveys in which trained personnel visited laboratories that had experienced performance problems in the quarterly mailed proficiency testing (PT) program, reviewing the laboratories' analytical procedures by using carefully referenced samples to determine sources of errors and providing assistance in correcting them; 2) special assistance surveys in which carefully referenced samples were mailed to laboratories that had performed unsatisfactorily in routine mailed PT surveys and then telephone consultations were conducted to correct the problems; and 3) blind surveys in which carefully referenced samples were sent through normal patient sample acquisition routes to assess the actual day-to-day performance capability of the laboratories. Results suggest that on-site surveys by trained laboratory surveyors and special mailed assistance surveys can be very effective in identifying the source of analytical errors in laboratories previously found, through mailed PT surveys, to have performance problems. Blind-survey results indicate that good performance in mailed PT does not necessarily imply good laboratory performance with routine patient specimens. Although difficult to conduct, blind surveys should be conducted whenever the logistics can be worked out by contractors for laboratory services, clinicians using laboratory services, and the laboratories themselves to assure the continuation of quality service. Handle: RePEc:aph:ajpbhl:1982:72:12:1364-1368_6 Template-Type: ReDIF-Article 1.0 Title: Norwalk virus: a major cause of epidemic gastroenteritis. Journal: American Journal of Public Health Author-Name: Blacklow, N.R. Author-Name: Cukor, G. Year: 1982 Volume: 72 Issue: 12 Pages: 1321-1303 Handle: RePEc:aph:ajpbhl:1982:72:12:1321-1303_2 Template-Type: ReDIF-Article 1.0 Title: Maternal PKU: control of an emerging problem. Journal: American Journal of Public Health Author-Name: Levy, H.L. Year: 1982 Volume: 72 Issue: 12 Pages: 1320-1321 Handle: RePEc:aph:ajpbhl:1982:72:12:1320-1321_7 Template-Type: ReDIF-Article 1.0 Title: Increased incidence of fatal right-sided ectopic pregnancy. Journal: American Journal of Public Health Author-Name: Muñoz, E. Year: 1982 Volume: 72 Issue: 12 Pages: 1410 Handle: RePEc:aph:ajpbhl:1982:72:12:1410_9 Template-Type: ReDIF-Article 1.0 Title: Rural health care delivery amidst federal retrenchment: lessons from the Robert Wood Johnson Foundation's Rural Practice Project. Journal: American Journal of Public Health Author-Name: Moscovice, I.S. Author-Name: Rosenblatt, R.A. Year: 1982 Volume: 72 Issue: 12 Pages: 1380-1385 Abstract: This paper examines the experience of the Robert Wood Johnson Foundation's Rural Practice Project (RPP), a major non-governmental effort in the last decade concentrating on the direct delivery of rural health services. The nine RPP sites started prior to 1977 showed a slow but steady increase in their utilization levels and improvement in their financial status during their initial operational years. The tempo of their development was remarkably similar to that of federally sponsored practices in underserved rural areas. After four years of operation, all of the practices had completed their period of grant support; the practices survived in all cases, with almost all of the practices still retaining community sponsorship, salaried physicians, and a commitment to comprehensive care. Practices in sparsely populated rural areas and in areas with fewer hospital beds grew more slowly than those set in rural areas with higher population density and more ancillary resources. We conclude that the use of time-limited initial subsidies is an effective strategy in starting new rural practices in underserved areas and that those practices have a good chance of surviving their start-up phase. Handle: RePEc:aph:ajpbhl:1982:72:12:1380-1385_1 Template-Type: ReDIF-Article 1.0 Title: A survey to evaluate parental consent as public policy for neonatal screening. Journal: American Journal of Public Health Author-Name: Faden, R. Author-Name: Chwalow, A.J. Author-Name: Holtzman, N.A. Author-Name: Horn, S.D. Year: 1982 Volume: 72 Issue: 12 Pages: 1347-1352 Abstract: Most states currently have laws which result in compulsory neonatal screening practices, despite a widespread consensus that participation in genetic services and programs should be voluntary. In 1976, Maryland adopted a regulation designed to respect parents' rights to refuse neonatal screening by imposing a parental consent requirement. The results of a study designed to evaluate the effects of this regulation are reviewed here. Many health care providers were unaware of the parental consent regulation. However, hospitals were generally in compliance with the technical stipulations of the regulations. There was little evidence that the regulation resulted in additional costs to the health care system, either in terms of hospital staff time or in terms of loss of efficiency in the number of infants screened. Mothers affected by the regulation were largely in favor of being informed about neonatal screening and learned a significant amount of new information from the disclosure process. They were almost evenly divided on whether they favored parental consent. Handle: RePEc:aph:ajpbhl:1982:72:12:1347-1352_5 Template-Type: ReDIF-Article 1.0 Title: Simplified method for Chlamydia trachomatis isolation using multi-well plate. Journal: American Journal of Public Health Author-Name: Hayashi, H. Author-Name: Sheth, P.K. Year: 1982 Volume: 72 Issue: 12 Pages: 1406-1407 Abstract: To simplify Chlamydia trachomatis isolation, we employed a 24-well tissue culture plate, thereby eliminating tedious steps and material in the conventional vial method. Parallel studies indicated that the vial and plate methods were equally sensitive for Chlamydia isolation. The time for culturing McCoy cells was reduced from 72 to four hours allowing us to inoculate specimens the same day. The potential hazard of handling coverslips which might contain infected cells was avoided. Handle: RePEc:aph:ajpbhl:1982:72:12:1406-1407_3 Template-Type: ReDIF-Article 1.0 Title: Eye sensitivity and vitamin C. Journal: American Journal of Public Health Author-Name: McIntosh, E.N. Year: 1982 Volume: 72 Issue: 12 Pages: 1412-1413 Handle: RePEc:aph:ajpbhl:1982:72:12:1412-1413_4 Template-Type: ReDIF-Article 1.0 Title: An attempt to eradicate silicotuberculosis in Ottawa County, Oklahoma. Journal: American Journal of Public Health Author-Name: Snider Jr., D.E. Author-Name: Dewberry, G. Author-Name: Gretz, H. Year: 1982 Volume: 72 Issue: 12 Pages: 1404-1405 Abstract: In 1974 and 1975, a selective tuberculosis screening program was conducted in a small mining community in Ottawa County, Oklahoma. Former miners, 50 years of age and over, who had abnormal chest radiographs consistent with silicosis or inactive tuberculosis and positive tuberculin skin tests, were offered isoniazid preventive therapy. Since the project ended, morbidity from silicotuberculosis has declined but silicotuberculosis has continued to occur. In this report, we examine the reasons for the failure to eradicate this disease from the community. Handle: RePEc:aph:ajpbhl:1982:72:12:1404-1405_0 Template-Type: ReDIF-Article 1.0 Title: The frequency of a Norwalk-like pattern of illness in outbreaks of acute gastroenteritis. Journal: American Journal of Public Health Author-Name: Kaplan, J.E. Author-Name: Feldman, R. Author-Name: Campbell, D.S. Author-Name: Lookabaugh, C. Author-Name: Gary, G.W. Year: 1982 Volume: 72 Issue: 12 Pages: 1329-1332 Abstract: Records of 642 outbreaks of acute gastroenteritis were reviewed to determine the proportion of outbreaks that were clinically and epidemiologically consistent with Norwalk-like virus infection. Using as our criteria stool cultures negative for bacterial pathogens, mean (or median) duration of illness 12-60 hours, vomiting in greater than or equal to 50 per cent of cases, and, if known, mean (or median) incubation period of 24-48 hours, we found that 23 per cent of waterborne outbreaks, 4 per cent of foodborne outbreaks, and 67 per cent, 60 per cent, and 28 per cent of outbreaks in nursing homes, in summer camps, and on cruise ships, respectively, satisfied the criteria for Norwalk-like pattern. Of 54 outbreaks that satisfied the criteria for Norwalk-like pattern, 14 were investigated for virus etiology. Ten of these (71 per cent) yielded serologic evidence of Norwalk-like virus infection. Norwalk-like viruses are probably an important cause of outbreaks of acute gastroenteritis. Investigation for Norwalk virus antibody in outbreaks that are clinically and epidemiologically consistent with Norwalk-like virus infection is likely to yield diagnostically useful results. Handle: RePEc:aph:ajpbhl:1982:72:12:1329-1332_2 Template-Type: ReDIF-Article 1.0 Title: Parental rights, child welfare, and public health: the case of PKU screening. Journal: American Journal of Public Health Author-Name: Faden, R.R. Author-Name: Holtzman, N.A. Author-Name: Chwalow, A.J. Year: 1982 Volume: 72 Issue: 12 Pages: 1396-1400 Abstract: The right of parents to refuse consent for phenylketonuria (PKU) screening is discussed in terms of moral justifications. The authors take the position that the primary function of a parental consent requirement is to protect children's welfare. In the case of PKU screening, the intervention poses minimal risk of harm while refusal of screening poses a significant risk to the child. Therefore, the principle of preventing harm overrides the parental right to refuse PKU screening. Handle: RePEc:aph:ajpbhl:1982:72:12:1396-1400_1 Template-Type: ReDIF-Article 1.0 Title: Irritants in cigarette smoke plumes. Journal: American Journal of Public Health Author-Name: Ayer, H.E. Author-Name: Yeager, D.W. Year: 1982 Volume: 72 Issue: 11 Pages: 1283-1285 Abstract: Concentrations of the irritants formaldehyde and acrolein in side stream cigarette smoke plumes are up to three orders of magnitude above occupational limits, readily accounting for eye and nasal irritation. "Low-tar" cigarettes appear at least as irritating as other cigarettes. More than half the irritant is associated with the particulate phase of the smoke, permitting deposition throughout the entire respiratory tract and raising the issue of whether formaldehyde in smoke is associated with bronchial cancer. Handle: RePEc:aph:ajpbhl:1982:72:11:1283-1285_3 Template-Type: ReDIF-Article 1.0 Title: Health services for mentally retarded people in community residences: problems and questions. Journal: American Journal of Public Health Author-Name: Garrard, S.D. Year: 1982 Volume: 72 Issue: 11 Pages: 1226-1228 Handle: RePEc:aph:ajpbhl:1982:72:11:1226-1228_1 Template-Type: ReDIF-Article 1.0 Title: Standards--a model for the nation. Journal: American Journal of Public Health Author-Name: Tilson, H.H. Year: 1982 Volume: 72 Issue: 11 Pages: 1223-1224 Handle: RePEc:aph:ajpbhl:1982:72:11:1223-1224_7 Template-Type: ReDIF-Article 1.0 Title: Surveillance of sylvatic plaque in Oregon by serotesting carnivores. Journal: American Journal of Public Health Author-Name: Hopkins, D.D. Author-Name: Gresbrink, R.A. Year: 1982 Volume: 72 Issue: 11 Pages: 1295-1297 Abstract: In Oregon, during 1974-1979, 10.3 per cent of 3.255 statewide blood samples from carnivores were positive for Yersinia pestis. The per cent positive rate and geometric mean positive titer increase monthly from January (6.5 per cent) to June (21.7 per cent), and decline thereafter. Data are presented on how geographic location, species, and time of year affect surveillance results. The correlation of carnivore plague surveillance with human cases in discussed. Handle: RePEc:aph:ajpbhl:1982:72:11:1295-1297_6 Template-Type: ReDIF-Article 1.0 Title: Perspectives on the past and future of psychiatric epidemiology. The 1981 Rema Lapouse Lecture. Journal: American Journal of Public Health Author-Name: Dohrenwend, B.P. Author-Name: Dohrenwend, B.S. Year: 1982 Volume: 72 Issue: 11 Pages: 1271-1279 Abstract: Two generations of epidemiological studies of the true prevalence of mental disorders have been conducted since the turn of the century. The first and smaller in number took place prior to World War II and was characterized by the use of records and key informants to define "cases." The second, utilizing the greatly expanded nomenclatures that followed World War II, were based for the most part on personal interviews with all subjects or samples there of in communities all over the world. In total, more than 80 different communities were studied by more than 60 different investigators or teams of investigators in these first and second generation studies. The legacy from these studies comes in two main parts: the first consists of methodological problems centering on the question of how to conceptualize and measure mental disorders independently of treatment status; the second is a set of consistent substantive findings about the amounts of various types of mental disorder, the proportions treated and untreated by members of the mental health professions, and the distribution of the disorders according to gender, rural vs urban location, and social class. Analyses of this legacy from first and second generation studies are presented with a view to developing informed speculations about what might be hoped for in the future, vastly different, third generation of studies in this field. Handle: RePEc:aph:ajpbhl:1982:72:11:1271-1279_3 Template-Type: ReDIF-Article 1.0 Title: Social and contextual factors in the analysis of mortality in end-stage renal disease patients: implications for health policy. Journal: American Journal of Public Health Author-Name: Plough, A.L. Author-Name: Salem, S. Year: 1982 Volume: 72 Issue: 11 Pages: 1293-1295 Abstract: A sample of medical records of decreased End-Stage Renal Disease (ESRD) patients was reviewed by a panel of experienced clinicians. The panel's determination of cause of death was compared to that reported for these patients in the Health Care Financing Administration Management Information System. There was concurrence in only 25 per cent of the cases. The difference is attributable to increased awareness of psychosocial and behavioral antecedent factors surrounding the occurrence of death. Handle: RePEc:aph:ajpbhl:1982:72:11:1293-1295_7 Template-Type: ReDIF-Article 1.0 Title: Blood lead levels among high-risk children, Detroit, Michigan. Journal: American Journal of Public Health Author-Name: Talbott, E.O. Author-Name: Burgess, R.A. Author-Name: Murphy, P.A. Author-Name: Kuller, L.H. Year: 1982 Volume: 72 Issue: 11 Pages: 1288-1290 Abstract: Since 1972, a federally funded lead screening program has been operational in Detroit, Michigan. Blood lead screening data (27,430 initial tests on Black children less than or equal to 6 years) were assigned by census tract of child's residence to one of the 15 socioeconomically similar areas in geographic proximity to one another. Higher blood lead levels were associated with lower education, lower income, and increased proportion of single parent families. This emphasizes the need to continue screening efforts in lower socioeconomic areas with older housing. Handle: RePEc:aph:ajpbhl:1982:72:11:1288-1290_0 Template-Type: ReDIF-Article 1.0 Title: The implementation of model standards in local health departments. Journal: American Journal of Public Health Author-Name: Weiler, P. Author-Name: Boggess, J. Author-Name: Eastman, E. Author-Name: Pomer, B. Year: 1982 Volume: 72 Issue: 11 Pages: 1230-1237 Abstract: Four local health departments in California tested a process of state/local negotiations for the purpose of implementing model standards in community preventive health services. The standards, which covered five program areas, had been developed by a collaborative work group of representatives from the United States Conference of City Health Officers, the National Association of County Health Officials, the Association of State and Territorial Health Officials, the American Public Health Association, and the US Department of Health, Education, and Welfare. Evaluation of the project indicates that the success of the negotiation transactions and results varied, both among local health departments and program areas. A number of factors have been identified as influencing the negotiations, including the availability of baseline data, the extent to which individual programs are currently affected by required standards of performance, and health department attitude toward the project. The future utility of this model is considered within the broader context of changes now occurring in the financing and organization of public health within the United States. Project findings suggest that the Model Standards negotiations could provide state and local levels of government with a valuable management tool for determining health care priorities and generating objective programmatic data for budget justification. Handle: RePEc:aph:ajpbhl:1982:72:11:1230-1237_5 Template-Type: ReDIF-Article 1.0 Title: A longitudinal study of blood pressure in a national survey of children. Journal: American Journal of Public Health Author-Name: Hait, H.I. Author-Name: Lemeshow, S. Author-Name: Rosenman, K.D. Year: 1982 Volume: 72 Issue: 11 Pages: 1285-1287 Abstract: Blood pressure changes over a three- to four-year period were studies in a cohort of 2,168 children examined during the US Heath Examination Survey. The sample used is a representative subset of a national probability sample. Significant positive correlations between initial and follow-up blood pressures were observed. In addition, relatively obese children tended to demonstrate higher blood pressures within age-race-sex specific subgroups. Handle: RePEc:aph:ajpbhl:1982:72:11:1285-1287_6 Template-Type: ReDIF-Article 1.0 Title: Medical care in China: equity vs modernization. Journal: American Journal of Public Health Author-Name: Sidel, V.W. Year: 1982 Volume: 72 Issue: 11 Pages: 1224-1226 Handle: RePEc:aph:ajpbhl:1982:72:11:1224-1226_3 Template-Type: ReDIF-Article 1.0 Title: Physicians: know thy ciguatera poisoning symptoms! Journal: American Journal of Public Health Author-Name: Dembert, M.L. Author-Name: Pearn, J.H. Year: 1982 Volume: 72 Issue: 11 Pages: 1298 Handle: RePEc:aph:ajpbhl:1982:72:11:1298_5 Template-Type: ReDIF-Article 1.0 Title: Recent trends in fatal poisoning by opiates in the United States. Journal: American Journal of Public Health Author-Name: Samkoff, J.S. Author-Name: Baker, S.P. Year: 1982 Volume: 72 Issue: 11 Pages: 1251-1256 Abstract: Deaths in the United States classified as unintentional poisoning by drugs and medicaments fell from 14.7 per million population in 1975 to 8.8 in 1978, a 40 per cent decrease. Seventy-three per cent of this drop attributable to a reduction in deaths coded to opiates and intravenous narcotism. These two categories accounted for 38 per cent of all unintentional drug deaths in 1975 but only 15 per cent in 1978. There was no simultaneous increase in other drug-related deaths, including suicides, to account for the reduction in deaths coded to opiates. The highest mortality rates and the greatest variation in mortality during 1970-78 occurred in 20-29 year old non-White males. Racial and sex differences in opiate poisoning mortality, notable early in the decade, were greatly reduced by 1978 due to a relatively larger decline in mortality of males and non-Whites. Time trends in mortality from opiate poisoning appear to coincide with variations in the amount of heroin smuggled into the country. Handle: RePEc:aph:ajpbhl:1982:72:11:1251-1256_5 Template-Type: ReDIF-Article 1.0 Title: Heatlh care in the People's Republic of China: a view from inside the system. Journal: American Journal of Public Health Author-Name: Henderson, G.E. Author-Name: Cohen, M.S. Year: 1982 Volume: 72 Issue: 11 Pages: 1238-1245 Abstract: During a three-month period, all admissions to an infectious disease ward at a tertiary care hospital in the People's Republic of China were studied. The hospital's catchment area covered a population of almost eight million, 10 per cent urban and 90 per cent rural. Seventy-two per cent of the patients admitted to this facility were city dwellers with illnesses which were significantly less serious in degree than the illnesses encountered among patients transferred from rural facilities. Ease of travel, nature of the disease process, availability of beds, ability to manipulate the referral ladder, and cost of health care may account for these results. Charges for health care in China proved very expensive relative to per capita income. This may be of major consequence to rural persons who are personally liable for some portion of this cost. These results suggest that although referral to tertiary care in China occurs more commonly among rural patients than is the case in other developing nations, access to this care and its cost are significant problems of the present system. During the drive for modernization, a multifactorial approach (including health policy, administrative controls, and patient and physician education) will be essential to avoid deterioration of the rural health system, and the increase financial burden to be expected with the introduction of advanced medical technology. Handle: RePEc:aph:ajpbhl:1982:72:11:1238-1245_1 Template-Type: ReDIF-Article 1.0 Title: A brief review of the current status of alternatives to chlorine disinfection of water. Journal: American Journal of Public Health Author-Name: Anderson, A.C. Author-Name: Reimers, R.S. Author-Name: deKernion, P. Year: 1982 Volume: 72 Issue: 11 Pages: 1290-1293 Handle: RePEc:aph:ajpbhl:1982:72:11:1290-1293_3 Template-Type: ReDIF-Article 1.0 Title: Prevalene of perimenstrual symptoms. Journal: American Journal of Public Health Author-Name: Woods, N.F. Author-Name: Most, A. Author-Name: Dery, G.K. Year: 1982 Volume: 72 Issue: 11 Pages: 1257-1264 Abstract: The purpose of this study was to determine the prevalence of perimenstrual symptoms (PMS) in a free-living population of US women and to determine if prevalence estimates varied with parity, contraceptive status, characteristics of the menstrual cycle, and selected demographic variables. We identified all households from a census listing for five southeastern city neighborhoods that offered variation in racial composition and socioeconomic status. We ascertained all households in which there was one nonpregnant woman between the ages of 18 and 35 years per household. Of the 241 eligible women, 179 (74 per cent) participated in the study. Trained interviewers administered the Moos Menstrual Distress Questionnaire (MDQ) and other demographic measures to women between March and July 1979. Symptoms with a prevalence greater than 30 per cent included weight gain, headache, skin disorders, cramps, anxiety, backache, fatigue, painful breasts, irritability, mood swings, depression, or tension. Only 2 to 8 per cent of women found most of these severe or disabling. The exceptions were severe cramps reported by 17 per cent of women and severe premenstrual and menstrual irritability by 12 per cent. Cramps, backaches, fatigue, and tension were most prevalent during the menstruum; weight gain, skin disorders, painful breasts, swelling, irritability, mood swings, and depression were more prevalent in the premenstruum. Parity, oral contraceptive use, age, employment, education, and income were negatively associated with selected PMS. Use of an IUD, having long menstrual cycles, long menstrual flow, or heavy menstrual flow, and being able to predict the next period were positively associated with selected PMS. Race had both positive and negative effects on PMS. Handle: RePEc:aph:ajpbhl:1982:72:11:1257-1264_7 Template-Type: ReDIF-Article 1.0 Title: The priceless value of human life. Journal: American Journal of Public Health Author-Name: Crum, G.E. Author-Name: Rice, D.P. Author-Name: Hodgson, T.A. Year: 1982 Volume: 72 Issue: 11 Pages: 1299-1300 Handle: RePEc:aph:ajpbhl:1982:72:11:1299-1300_4 Template-Type: ReDIF-Article 1.0 Title: Costs of providing dental services to adult mentally retarded: a preliminary report. Journal: American Journal of Public Health Author-Name: Gotowka, T.D. Author-Name: Johnson, E.S. Author-Name: Gotowka, C.J. Year: 1982 Volume: 72 Issue: 11 Pages: 1246-1250 Abstract: This study reports on the hourly costs of providing comprehensive dental services to mentally retarded adults in a hospital-based group dental practice. The analysis indicated average total hourly costs of $56.11 for dentist-provided services an $22.25 for dental hygienist-provided services. When compared to the revenues available for program maintenance, a net hourly deficit of $18.82 per dentist hour and $9.89 per dental hygienist hour resulted. The implications of this operating loss on the continued care of this patient population are discussed. Handle: RePEc:aph:ajpbhl:1982:72:11:1246-1250_4 Template-Type: ReDIF-Article 1.0 Title: New dimensions in cause of death statistics. Journal: American Journal of Public Health Author-Name: Chamblee, R.F. Author-Name: Evans, M.C. Year: 1982 Volume: 72 Issue: 11 Pages: 1265-1270 Abstract: This article discusses the limitations of traditional national cause of death statistics. These limitations derive from an attempt to conceptualize a multidimensional phenomenon and reduce down to a unidimensional framework. The article outlines the characteristics of a new multidimensional approach which involves the codification and tabulation of all causes (multiple causes) listed on death certificates. Preliminary data are presented which illustrate that multiple cause of death data do indeed represent a major new dimension to cause of death statistics. These data indicate that most major causes of death are contributory factors in many deaths in which they are not the underlying cause of death. For example, in 1976, diabetes mellitus was the underlying cause of approximately 35,000 deaths but was a contributing factor in another 100,000 deaths. This paper also demonstrates the contribution of multiple cause of death data to identifying patterns of association among diseases and the kinds of injuries resulting from various external causes. Finally, data are presented which depict the use of multiple cause data in evaluating the efficacy of the coding rules used to classify the underlying cause of death. Handle: RePEc:aph:ajpbhl:1982:72:11:1265-1270_9 Template-Type: ReDIF-Article 1.0 Title: Mortality during influenza epidemics in the United States, 1967-1978. Journal: American Journal of Public Health Author-Name: Choi, K. Author-Name: Thacker, S.B. Year: 1982 Volume: 72 Issue: 11 Pages: 1280-1283 Abstract: Excess deaths due to pneumonia and influenza and excess deaths for all causes were estimated using a time-series analysis for each of the eight influenza epidemics in the United States that occurred between 1967-1978. The effects of different analytic methods and different methods of structuring data are compared. Future directions for estimating the impact of influenza on mortality include a combination of regression techniques and multiple time-series analyses of surveillance data. Handle: RePEc:aph:ajpbhl:1982:72:11:1280-1283_5 Template-Type: ReDIF-Article 1.0 Title: The effects of family involvement and practitioner home visits on the control of hypertension. Journal: American Journal of Public Health Author-Name: Earp, J.A. Author-Name: Ory, M.G. Author-Name: Strogatz, D.S. Year: 1982 Volume: 72 Issue: 10 Pages: 1146-1154 Abstract: The effectiveness of two social support strategies designed to lower hypertensive patients' blood pressure were compared to each other and to a control group (N = 63) receiving routine care in a randomized clinical trial extending over a period of two years. Group 1 (N = 99) received visits and had family members actively participate in their care through home blood pressure monitoring; Group 2 (N = 56) received home visits from nurses and pharmacists. All groups were predominantly Black. After the first year of the trial, the proportion of patients with uncontrolled diastolic blood pressure (greater than or equal to 95mm Hg) had declined significantly for all three groups; no group showed a statistically significant advantage. However, during the last six months of the second year (after visiting had ended), both Groups 1 and 2 demonstrated clear superiority in DBP control over Group 3, achieving borderline statistical significance (p = .07) when multivariable analysis was performed to control for potential confounders. Supplementing routine care with periodic home visits produced an additional 21 per cent of patients with well-controlled DBP, while involving family members plus visits produced a 17 per cent improvement in the percentage of patients with DBP less than 95mm Hg. However, neither support strategy was clearly more effective than the other over time. The efficacy of the interventions is discussed with respect to cost and feasibility of implementation. Handle: RePEc:aph:ajpbhl:1982:72:10:1146-1154_9 Template-Type: ReDIF-Article 1.0 Title: Is WIC worthwhile? Journal: American Journal of Public Health Author-Name: Rush, D. Year: 1982 Volume: 72 Issue: 10 Pages: 1101-1103 Handle: RePEc:aph:ajpbhl:1982:72:10:1101-1103_1 Template-Type: ReDIF-Article 1.0 Title: Activities of an employer independent Occupational Medicine Clinic, Cook County Hospital, 1979-1981. Journal: American Journal of Public Health Author-Name: Orris, P. Author-Name: Kennedy, M.J. Author-Name: Guerriero, J. Author-Name: Hessl, S.M. Author-Name: Hryhorczuk, D.O. Author-Name: Hoffman, D. Year: 1982 Volume: 72 Issue: 10 Pages: 1165-1167 Abstract: In July 1976, Cook County Hospital, a 1,363-bed general public hospital in Chicago, Illinois, established a hospital-funded Occupational Medicine Clinic. A review was made of the clinic records of the 486 new patients evaluated at the clinic from July 1979 to June 1981. Information is presented concerning age, ethnic origin, sex, union representation, referral sources, reason for the referral, number and type of toxic exposure, diagnosis, occupational relationship of the disease, and disposition. Handle: RePEc:aph:ajpbhl:1982:72:10:1165-1167_7 Template-Type: ReDIF-Article 1.0 Title: Prescribing CPR: a survey of physicians. Journal: American Journal of Public Health Author-Name: Louis, P.S. Author-Name: Carter, W.B. Author-Name: Eisenberg, M.S. Year: 1982 Volume: 72 Issue: 10 Pages: 1158-1160 Abstract: We interviewed 55 cardiologists, internists, and family practitioners to determine attitudes and practices regarding cardiopulmonary resuscitation (CPR) counseling. There was unanimous support for citizen-CPR. However, only 40 per cent of the physicians interviewed recommended CPR training to spouses of patients with coronary heart disease and 42 per cent did not provide counseling about cardiac arrest. This suggests that the doctor's office can be better utilized in the promotion of CPR education. Handle: RePEc:aph:ajpbhl:1982:72:10:1158-1160_8 Template-Type: ReDIF-Article 1.0 Title: Oral rehydration and social change: the control of diarrheal diseases in the Third World. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1982 Volume: 72 Issue: 10 Pages: 1105-1106 Handle: RePEc:aph:ajpbhl:1982:72:10:1105-1106_1 Template-Type: ReDIF-Article 1.0 Title: Methodological rigor and citation frequency in patient compliance literature. Journal: American Journal of Public Health Author-Name: Bruer, J.T. Year: 1982 Volume: 72 Issue: 10 Pages: 1119-1123 Abstract: An exhaustive bibliography which assesses the methodological rigor of the patient compliance literature, and citation data from the Science Citation Index (SCI) are combined to determine if methodologically rigorous papers are used with greater frequency than substandard articles by compliance investigators. There are low, but statistically significant, correlations between methodological rigor and citation indicators for 138 patient compliance papers published in SCI source journals during 1975 and 1976. The correlation is not strong enough to warrant use of citation measures as indicators of rigor on a paper-by-paper basis. The data do suggest that citation measures might be developed as crude indicators of methodological rigor. There is no evidence that randomized trials are cited more frequently than studies that employ other experimental designs. Handle: RePEc:aph:ajpbhl:1982:72:10:1119-1123_0 Template-Type: ReDIF-Article 1.0 Title: Development trends of first cigarette smoking experience of children: the Bogalusa heart study. Journal: American Journal of Public Health Author-Name: Baugh, J.G. Author-Name: Hunter, S.M. Author-Name: Webber, L.S. Author-Name: Berenson, G.S. Year: 1982 Volume: 72 Issue: 10 Pages: 1161-1164 Abstract: During one school year a health habits survey investigated cigarette smoking behavior in a total biracial population of children, ages 8 to 17 years old. Information was collected concerning each child's first smoking experience. Over 60 per cent of the children reported they were given their first cigarettes. Half of those starting before age 12 smoked their first cigarettes with a family member or an older fried. The smoking habit appears to have become established by age 14, with a two-year gap between initiation and maintenance. Handle: RePEc:aph:ajpbhl:1982:72:10:1161-1164_2 Template-Type: ReDIF-Article 1.0 Title: An evaluation of the effectiveness of motor cycle daytime headlight laws. Journal: American Journal of Public Health Author-Name: Muller, A. Year: 1982 Volume: 72 Issue: 10 Pages: 1136-1141 Abstract: Currently, 17 states mandate the daytime use of motorcycle headlights. The purpose of these laws is to make the motorcyclists more conspicuous and reduce the number of daytime multi-vehicle collisions. The effectiveness of the laws is examined by comparing the proportion of daytime fatal, front, and side-angle collisions between states with and without such laws. The comparison is based on all motorcycle fatalities recorded by NHTSA for the years 1975-80. The analysis shows no statistically significant difference between states with and without such laws, suggesting that daytime headlight laws are ineffective. Several explanations of this negative finding are explored. Handle: RePEc:aph:ajpbhl:1982:72:10:1136-1141_0 Template-Type: ReDIF-Article 1.0 Title: Acute fluoride poisoning associated with an on-site fluoridator in a Vermont elementary school. Journal: American Journal of Public Health Author-Name: Vogt, R.L. Author-Name: Witherell, L. Author-Name: LaRue, D. Author-Name: Klaucke, D.N. Year: 1982 Volume: 72 Issue: 10 Pages: 1168-1169 Abstract: On August 30 1980, an outbreak of minor illnesses consisting of nausea and vomiting affected 22 individuals attending a farmers market at a school. Illness was associated with the consumption of beverages made from school water (Xc2 = 65.6, p less than .0001); analysis of the water showed high levels of fluoride (1,041 mg/l). The most likely source of the contamination was the school fluoridator, which had accidentally been left on continuous operation. Handle: RePEc:aph:ajpbhl:1982:72:10:1168-1169_2 Template-Type: ReDIF-Article 1.0 Title: A diarrhea clinic in rural Bangladesh: influence of distance, age, and sex on attendance and diarrheal mortality. Journal: American Journal of Public Health Author-Name: Rahaman, M.M. Author-Name: Aziz, K.M. Author-Name: Munshi, M.H. Author-Name: Patwari, Y. Author-Name: Rahman, M. Year: 1982 Volume: 72 Issue: 10 Pages: 1124-1128 Abstract: Attendance rates at a diarrhea clinic were monitored in a defined population in rural Bangladesh. Weekly home visits were also carried out to determine diarrheal attacks in communities within six miles of the clinic. Within the first one mile radius, 90 per cent of diarrheal cases came to the clinic for treatment. At two miles the attendance fell to 70 per cent for males and 40 per cent for females. On an average, the greater the distance to the clinic, the more severe was the degree of dehydration on presentation, requiring more frequent use of intravenous fluid. Mortality secondary to diarrhea was significantly reduced only within a two-mile radius of the clinic. Handle: RePEc:aph:ajpbhl:1982:72:10:1124-1128_8 Template-Type: ReDIF-Article 1.0 Title: Factors related to utilization of dental services by the elderly. Journal: American Journal of Public Health Author-Name: Evashwick, C. Author-Name: Conrad, D. Author-Name: Lee, F. Year: 1982 Volume: 72 Issue: 10 Pages: 1129-1135 Abstract: A household interview survey of 883 persons aged 62 and older residing in Seattle, Washington, asked about a broad range of health care and social service issues, including the need for and use of dental care. The Anderson model of health services utilization was used to identify predisposing, enabling, and need characteristics hypothesized to affect the use of dental services. A path analysis was conducted to distinguish the direct and indirect effects of the variables. The results showed that none of the predisposing variables, including age, was a significant factor in explaining the use of dental services. Education had both direct and indirect positive relationships to use. Having a regular sources of dental care was also an important factor affecting utilization. Neither income nor insurance variables were powerful factors. Need, measured by an index of dental problems and having dentures, was the stronger determinant of dental care use. In general, the model was better at predicting whether or not dental care would be sought by an older person at all (R2 = .27) than in predicting the amount of service used (R2 = .06). Handle: RePEc:aph:ajpbhl:1982:72:10:1129-1135_6 Template-Type: ReDIF-Article 1.0 Title: Cognitive and health measures following early nutritional supplementation: a sibling study. Journal: American Journal of Public Health Author-Name: Hicks, L.E. Author-Name: Langham, R.A. Author-Name: Takenaka, J. Year: 1982 Volume: 72 Issue: 10 Pages: 1110-1118 Abstract: A battery of cognitive measures, an adjustment measure, and multiple health indices were obtained for sibling pairs who differed in the timing of their participation in the Special Supplemental Food Program for Women, Infants, and Children (WIC) several years earlier, with participation during the perinatal period occurring for one sibling, but after one year of age for the other. Results indicated that the perinatally supplemented group showed significant enhancement of most intellectual and behavioral measures in the current home and school setting, including IQ, attention span, visual-motor synthesis, and school grade-point average when compared with the group supplemented later. Of the health assessments, most trends were in the expected direction, but only height for age values were significantly different for the two groups. Handle: RePEc:aph:ajpbhl:1982:72:10:1110-1118_9 Template-Type: ReDIF-Article 1.0 Title: Putting the lamentations of epidemiologists in perspective. Journal: American Journal of Public Health Author-Name: Hershey, N. Year: 1982 Volume: 72 Issue: 10 Pages: 1155-1157 Abstract: Epidemiologists have expressed concern about constraints upon the conduct of epidemiological research imposed by Institutional Review Boards (IRBs), attorneys, and both institutional and individual health services providers. The epidemiologists assert that these constraints, not necessarily required by law or sound policy, will deprive society of the benefits such research can yield. It is suggested that the complex of law and regulation, resulting from increased awareness of privacy and confidentiality interests, can often be dealt with if there is clearer understanding of the roles of attorneys, and flexibility shown by both epidemiologists and health services administrators and practitioners in the structuring and review of epidemiological research protocols. Handle: RePEc:aph:ajpbhl:1982:72:10:1155-1157_9 Template-Type: ReDIF-Article 1.0 Title: Prospects for eliminating racial differences in breast cancer survival rates. Journal: American Journal of Public Health Author-Name: Shapiro, S. Author-Name: Venet, W. Author-Name: Strax, P. Author-Name: Venet, L. Author-Name: Roeser, R. Year: 1982 Volume: 72 Issue: 10 Pages: 1142-1145 Abstract: Results from the randomized trial underway in the Health Insurance Plan of Greater New York to determine the efficacy of periodic screening with mammography and palpation of the breast have been examined to determine the effect of screening on racial differences in breast cancer survival rates. Consistent with experience in general populations, the control group showed a lower five-year survival rate among non-White women with breast cancer than among White women. In the study group, 65 per cent of whom participated in the screening program, there was no differential in the survival rates of the two racial groups. The elimination of the unfavorable status among non-Whites through screening does not appear to be explained by various artifacts explored. Secondary prevention measures may offer the possibility of reducing or closing the gap in breast cancer survival rates between White and non-White women. Handle: RePEc:aph:ajpbhl:1982:72:10:1142-1145_8 Template-Type: ReDIF-Article 1.0 Title: Impact of type A influenza on children: a retrospective study. Journal: American Journal of Public Health Author-Name: Mullooly, J.P. Author-Name: Barker, W.H. Year: 1982 Volume: 72 Issue: 9 Pages: 1008-1016 Abstract: Excess morbidity was studied during influenza A epidemics (1968-69, 1972-73) among children in a large prepaid group practice program. Excess rates of hospitalization for influenza-related conditions, primarily pneumonia and bronchitis, ranged from 5 per 10,000 (95 per cent confidence limits (CL): 1 to 9) for non-high-risk children to 29 per 10,000 (95 per cent CL: 5 to 53) for children with high-risk conditions. The relative increases in hospitalization rates were greatest for 5-14 year old boys: 278 per cent and 104 per cent increases for high-risk and non-high-risk boys, respectively. The absolute increase was greatest for 0-4 year olds. The excess rate of ambulatory medical care contacts, 2.6 per 100 (95 per cent CL: -1.6 to 6.8 per 100) was not statistically significant. Excess hospitalization rates among 0-14 year olds during epidemics were three to five times larger than those for persons between 15 and 64 years of age but only one-fifth the rate of persons over age 65. Handle: RePEc:aph:ajpbhl:1982:72:9:1008-1016_3 Template-Type: ReDIF-Article 1.0 Title: A dietary survey of Qi-bao middle school students. Journal: American Journal of Public Health Author-Name: Shao, Y.F. Author-Name: Yang, Z.G. Author-Name: Wang, Z.Z. Year: 1982 Volume: 72 Issue: S1 Pages: 43 Handle: RePEc:aph:ajpbhl:1982:72:S1:43_0 Template-Type: ReDIF-Article 1.0 Title: An anthropometric study of school children. Journal: American Journal of Public Health Author-Name: Yao, Y.L. Author-Name: Wang, B.J. Year: 1982 Volume: 72 Issue: S1 Pages: 41-42 Handle: RePEc:aph:ajpbhl:1982:72:S1:41-42_2 Template-Type: ReDIF-Article 1.0 Title: Home pregnancy testing kits: prevalence of use, false-negative rates, and compliance with instructions. Journal: American Journal of Public Health Author-Name: Valanis, B.G. Author-Name: Perlman, C.S. Year: 1982 Volume: 72 Issue: 9 Pages: 1034-1036 Abstract: This study investigated the prevalence of home pregnancy kit use, incidence of false-negative results, and compliance with testing procedures. Among 144 pregnant women, identified through three health care settings, prevalence of test-kit use was 28.5 per cent. The false-negative rate was 24.3 per cent. Total compliance with instructions was reported by only 32 per cent of users. Women testing less than nine days after menstrual period was due had false-negative rates of 33 per cent contrasted with 21 per cent for those testing after the nine days. Handle: RePEc:aph:ajpbhl:1982:72:9:1034-1036_1 Template-Type: ReDIF-Article 1.0 Title: Vital and heath statistics for the US hispanic population. Journal: American Journal of Public Health Author-Name: Trevino, F.M. Year: 1982 Volume: 72 Issue: 9 Pages: 979-982 Abstract: The lack of adequate vital and health statistics for the Hispanic population of the United States is discussed, and recommendations are made for improving the quality and quantity of these data. Handle: RePEc:aph:ajpbhl:1982:72:9:979-982_7 Template-Type: ReDIF-Article 1.0 Title: The sample household health interview survey. Journal: American Journal of Public Health Author-Name: Parker, R.L. Author-Name: Gong, Y.L. Author-Name: Shan, L.G. Author-Name: Huang, D.Y. Author-Name: Hinman, A.R. Year: 1982 Volume: 72 Issue: S1 Pages: 65-70 Handle: RePEc:aph:ajpbhl:1982:72:S1:65-70_7 Template-Type: ReDIF-Article 1.0 Title: Public health in China. Journal: American Journal of Public Health Author-Name: Wegman, M.E. Year: 1982 Volume: 72 Issue: 9 Pages: 978-979 Handle: RePEc:aph:ajpbhl:1982:72:9:978-979_3 Template-Type: ReDIF-Article 1.0 Title: Health services in Shanghai County: child health care. Journal: American Journal of Public Health Author-Name: Hu, X.J. Author-Name: Zhu, X.Y. Author-Name: Xu, S.E. Year: 1982 Volume: 72 Issue: S1 Pages: 36-38 Handle: RePEc:aph:ajpbhl:1982:72:S1:36-38_6 Template-Type: ReDIF-Article 1.0 Title: Rural drinking water supply. Journal: American Journal of Public Health Author-Name: Fang, X.Y. Author-Name: Zhu, H.G. Year: 1982 Volume: 72 Issue: S1 Pages: 52-53 Handle: RePEc:aph:ajpbhl:1982:72:S1:52-53_5 Template-Type: ReDIF-Article 1.0 Title: Outcomes of pregnancy in Hong-qiao and Qi-yi communes. Journal: American Journal of Public Health Author-Name: Li, B.Y. Author-Name: Dong, A.M. Author-Name: Zhuo, J.R. Year: 1982 Volume: 72 Issue: S1 Pages: 30-32 Handle: RePEc:aph:ajpbhl:1982:72:S1:30-32_4 Template-Type: ReDIF-Article 1.0 Title: Cost analysis of medical care. Journal: American Journal of Public Health Author-Name: Cheng, X.M. Author-Name: Ye, X.F. Year: 1982 Volume: 72 Issue: S1 Pages: 81-82 Handle: RePEc:aph:ajpbhl:1982:72:S1:81-82_5 Template-Type: ReDIF-Article 1.0 Title: A model for dental workload measurement. Journal: American Journal of Public Health Author-Name: Parker, W.A. Author-Name: Williams, D.L. Author-Name: Mayotte, R.V. Author-Name: James, J.J. Author-Name: Mangelsdorff, A.D. Year: 1982 Volume: 72 Issue: 9 Pages: 1022-1027 Abstract: The primary purpose of the study was to develop a model that would provide an efficient and standardized approach to workload reporting in a non-fee (HMO-like) dental care system. The model was also designed to predict the dental personnel resource requirements in the system as the overall dental needs of the population were already known. To accomplish this, a set of 246 task/procedures representing the broad scope of dental practice was developed. For each task/procedure, a Best Time-weighted Estimate (BTE) in terms of average expected man-minutes of work required for accomplishment was developed from over 35,000 actual time measurements on patient visits to 29 US Army dental clinics located throughout the United States. Because of the nature of the specific task/procedure data, it was necessary to use four different mathematical models to produce statistically optimal BTEs. It was concluded that, cumulatively the BTEs developed for each task/procedure evaluated could be used as a basis for both the development of a Dental Care Composite Unit workload measure and the determination of overall dental personnel resource requirements in a non-free dental care system. Handle: RePEc:aph:ajpbhl:1982:72:9:1022-1027_8 Template-Type: ReDIF-Article 1.0 Title: The community health teaching center in China. Journal: American Journal of Public Health Author-Name: Su, D.L. Author-Name: Taylor, C.E. Year: 1982 Volume: 72 Issue: S1 Pages: 89-91 Handle: RePEc:aph:ajpbhl:1982:72:S1:89-91_9 Template-Type: ReDIF-Article 1.0 Title: Tuberculosis control. Journal: American Journal of Public Health Author-Name: Han, J.J. Author-Name: Yang, S.J. Year: 1982 Volume: 72 Issue: S1 Pages: 48-49 Handle: RePEc:aph:ajpbhl:1982:72:S1:48-49_5 Template-Type: ReDIF-Article 1.0 Title: Financing the cooperative medical system. Journal: American Journal of Public Health Author-Name: Chao, L.M. Author-Name: Gong, Y.L. Author-Name: Gu, S.J. Year: 1982 Volume: 72 Issue: S1 Pages: 78-80 Handle: RePEc:aph:ajpbhl:1982:72:S1:78-80_5 Template-Type: ReDIF-Article 1.0 Title: Use of health services. Journal: American Journal of Public Health Author-Name: Parker, R.L. Author-Name: Hinman, A.R. Year: 1982 Volume: 72 Issue: S1 Pages: 71-77 Handle: RePEc:aph:ajpbhl:1982:72:S1:71-77_3 Template-Type: ReDIF-Article 1.0 Title: Survey of childbearing women in Qi-yi Commune. Journal: American Journal of Public Health Author-Name: Gao, E.S. Author-Name: Gu, X.Y. Author-Name: Zheng, X.Z. Author-Name: Ding, X.Y. Author-Name: Xu, G.D. Year: 1982 Volume: 72 Issue: S1 Pages: 27-29 Handle: RePEc:aph:ajpbhl:1982:72:S1:27-29_6 Template-Type: ReDIF-Article 1.0 Title: Understanding the transience or persistence of depression. Journal: American Journal of Public Health Author-Name: Westermeyer, J. Year: 1982 Volume: 72 Issue: 9 Pages: 982-983 Handle: RePEc:aph:ajpbhl:1982:72:9:982-983_0 Template-Type: ReDIF-Article 1.0 Title: Health services in Shanghai County; vital statistics. Journal: American Journal of Public Health Author-Name: Gu, X.Y. Author-Name: Chen, M.L. Year: 1982 Volume: 72 Issue: S1 Pages: 19-23 Handle: RePEc:aph:ajpbhl:1982:72:S1:19-23_6 Template-Type: ReDIF-Article 1.0 Title: A closer examination of neonatal mortality rates among the Texas Spanish surname population. Journal: American Journal of Public Health Author-Name: Powell-Griner, E. Author-Name: Streck, D. Year: 1982 Volume: 72 Issue: 9 Pages: 993-999 Abstract: Considering the poor socioeconomic status of the Spanish surnamed population in Texas, the Spanish surname neonatal mortality rate seems surprisingly low. During five of the last 10 years, the neonatal mortality rate for Texas Spanish surnamed population was actually lower than for Anglos. It is often suggested that the low Spanish surname neonatal mortality rate is due in part to reporting problems peculiar to the Spanish surname population in Texas. Linked birth and neonatal death records of Texas residents are examined for evidence of underreporting or misreporting of Spanish surnamed neonatal deaths. It is found that discrepancies in coding race on the birth and death records cause a minor deflation of Spanish surname neonatal and infant mortality rates. Indirect evidence indicates that there may be a substantial amount of underreporting of Spanish surname neonatal deaths. This underreporting appears to be associated with the presence of a large number of Mexican nationals misidentified as Texas residents, and the greater reliance upon lay midwives by the Spanish surname population in Texas. Reasons proposed to explain a reluctance to report neonatal deaths include fear of contact with authorities, and fear that a reported death would diminish the value of the birth certificate. Handle: RePEc:aph:ajpbhl:1982:72:9:993-999_1 Template-Type: ReDIF-Article 1.0 Title: Health services in Shanghai County: the future of US-PRC governmental collaboration in health services research. Journal: American Journal of Public Health Author-Name: Yang, M.D. Author-Name: Koplan, J.P. Author-Name: Bryant, J.H. Year: 1982 Volume: 72 Issue: S1 Pages: 92-93 Handle: RePEc:aph:ajpbhl:1982:72:S1:92-93_1 Template-Type: ReDIF-Article 1.0 Title: Telephone versus in-person surveys of community health status. Journal: American Journal of Public Health Author-Name: Aneshensel, C.S. Author-Name: Frerichs, R.R. Author-Name: Clark, V.A. Author-Name: Yokopenic, P.A. Year: 1982 Volume: 72 Issue: 9 Pages: 1017-1021 Abstract: Reports of physical morbidity are compared among a community sample of Los Angeles County adults (N = 546) randomly assigned to either in-person or telephone interviews. No statistically significant differences were found between the two interview methods for overall assessment of health status, illnesses reported for the previous four months, or reports of hospitalization. A significantly greater proportion of in-person respondents, however, reported the presence of restricted-activity days during the previous two weeks. This difference could not be directly attributed to sociodemographic characteristics or reported physical health status of the two samples. Handle: RePEc:aph:ajpbhl:1982:72:9:1017-1021_5 Template-Type: ReDIF-Article 1.0 Title: What good is legislation--or planning--if we can't make it work? The need for a comprehensive approach to health and welfare. Journal: American Journal of Public Health Author-Name: Snoke, A.W. Year: 1982 Volume: 72 Issue: 9 Pages: 1028-1033 Abstract: Health and welfare programs continue to be developed and implemented on a piecemeal basis in this country. There is difficulty in recognizing not only that health and social affairs are intimately related, but that the system must be dealt with as a whole of its interrelated problems are to be solved. Increasing costs for health and social programs are becoming of even greater concern, and cost containment (voluntary or regulatory) preoccupies both the payers and the recipients. Complicating the current situation is uncertainty of the role of financing and regulation on the part of the federal government and the states (the New Federalism), and the fragmentation and uncertainty of the private delivery sector and its third party reimbursement agencies. Questions are raised as to whether viable solutions can be obtained until all components (governmental and private) can work together in a partnership rather than an adversarial relationship in the development of an overall strategy with understandable objectives. Of basic importance is consideration of matters of organization, administration, and leadership at all levels so that whatever program may be developed or evolved can be successfully implemented. The subject is of such magnitude and is so complicated that it deserves a major coordinated effort of the federal government, the state governments, and the diverse private sector components to ensure a coordinated and systematic approach to any realistic solution. Handle: RePEc:aph:ajpbhl:1982:72:9:1028-1033_9 Template-Type: ReDIF-Article 1.0 Title: Background of US-PRC government cooperation in health: descriptive study and workshop on health services research in Shanghai County. Journal: American Journal of Public Health Author-Name: Yang, M.D. Author-Name: Bryant, J.H. Author-Name: Henry, P. Year: 1982 Volume: 72 Issue: S1 Pages: 9-11 Handle: RePEc:aph:ajpbhl:1982:72:S1:9-11_1 Template-Type: ReDIF-Article 1.0 Title: Characteristics of individuals with multiple behavioral risk factors for coronary heart disease: the Netherlands. Journal: American Journal of Public Health Author-Name: Kok, F.J. Author-Name: Matroos, A.W. Author-Name: van den Ban, A.W. Author-Name: Hautvast, J.G. Year: 1982 Volume: 72 Issue: 9 Pages: 986-991 Abstract: To test the hypothesis that risk factors are interrelated, the simultaneous occurrence of smoking, inadequate nutrition, obesity, and physical inactivity was studied in a random sample (n = 1,951) of the Dutch adult population. Although the results did not suggest systematic clustering, the assumption of independence of these risk factors could not be maintained. Sociodemographic and health-related characteristics of the group with three or four risk factors were assessed (n = 246). Comparison with a prudent life-style group (zero risk factors, n = 387) by means by discriminant analysis indicated that the target group included proportionally more men (odds ratio: OR = 3.3), of all ages, with low education and occupation (OR = 3.5 and 1.7). The two groups did not differ in awareness of cardiovascular risk factors, preventive orientation regarding cardiovascular risk, or disease in general, and the effectiveness of health education in modifying life-style. The target group exhibited a distorted perception of the healthfulness of its own life-style and unfavorable attitudes toward modifying existing smoking, eating habits, and physical activity. Handle: RePEc:aph:ajpbhl:1982:72:9:986-991_6 Template-Type: ReDIF-Article 1.0 Title: Occupational health in small plants. Journal: American Journal of Public Health Author-Name: Wu, J.H. Author-Name: He, J.L. Author-Name: Zhu, S.F. Author-Name: Gu, X.Q. Year: 1982 Volume: 72 Issue: S1 Pages: 56-58 Handle: RePEc:aph:ajpbhl:1982:72:S1:56-58_4 Template-Type: ReDIF-Article 1.0 Title: Eradication of schistosomiasis. Journal: American Journal of Public Health Author-Name: Chen, J.L. Author-Name: Huang, D.Y. Author-Name: Shen, G.Y. Year: 1982 Volume: 72 Issue: S1 Pages: 50-51 Handle: RePEc:aph:ajpbhl:1982:72:S1:50-51_0 Template-Type: ReDIF-Article 1.0 Title: Spermicides and Down's syndrome. Journal: American Journal of Public Health Author-Name: Van Peenen, P.F. Author-Name: Nelson, N.A. Year: 1982 Volume: 72 Issue: 9 Pages: 1047-1048 Handle: RePEc:aph:ajpbhl:1982:72:9:1047-1048_3 Template-Type: ReDIF-Article 1.0 Title: Health services in Shanghai County; women's health care. Journal: American Journal of Public Health Author-Name: Hu, X.J. Author-Name: Zhang, B.J. Year: 1982 Volume: 72 Issue: S1 Pages: 33-35 Handle: RePEc:aph:ajpbhl:1982:72:S1:33-35_8 Template-Type: ReDIF-Article 1.0 Title: Indicators of response to a mass media CPR recruitment campaign. Journal: American Journal of Public Health Author-Name: Selby, M.L. Author-Name: Kautz, J.A. Author-Name: Moore, T.J. Author-Name: Gombeski Jr., W.R. Author-Name: Ramirez, A.G. Author-Name: Farge, E.J. Author-Name: Forthofer, R.N. Year: 1982 Volume: 72 Issue: 9 Pages: 1039-1042 Abstract: Respondents to a mass media cardiopulmonary resuscitation (CPR) recruitment campaign in Harris County, Texas were more likely than non-respondents to be White, female, and under 45 years of age, to have had previous CPR training, experienced an incident in which knowledge of CPR might have been useful, or to have a friend or relative with a relevant medical history. The majority of the respondents were housewives, and professionals or technical workers, particularly in the health field. Findings can be used to identify audiences for future mass media CPR campaigns. Handle: RePEc:aph:ajpbhl:1982:72:9:1039-1042_8 Template-Type: ReDIF-Article 1.0 Title: Health services in Shanghai County: childhood immunization. Journal: American Journal of Public Health Author-Name: Li, B.X. Author-Name: He, C.H. Author-Name: Shen, F.M. Year: 1982 Volume: 72 Issue: S1 Pages: 39-40 Handle: RePEc:aph:ajpbhl:1982:72:S1:39-40_5 Template-Type: ReDIF-Article 1.0 Title: Analysis of illness records for members of two production brigades. Journal: American Journal of Public Health Author-Name: Cai, J.W. Author-Name: Li, Y.G. Year: 1982 Volume: 72 Issue: S1 Pages: 62-64 Handle: RePEc:aph:ajpbhl:1982:72:S1:62-64_1 Template-Type: ReDIF-Article 1.0 Title: The role of barefoot doctors. Journal: American Journal of Public Health Author-Name: Gong, Y.L. Author-Name: Chao, L.M. Year: 1982 Volume: 72 Issue: S1 Pages: 59-61 Handle: RePEc:aph:ajpbhl:1982:72:S1:59-61_9 Template-Type: ReDIF-Article 1.0 Title: Management of human excreta. Journal: American Journal of Public Health Author-Name: Lu, Z.X. Author-Name: Qiang, G.Y. Author-Name: Dai, X.D. Year: 1982 Volume: 72 Issue: S1 Pages: 54-55 Handle: RePEc:aph:ajpbhl:1982:72:S1:54-55_8 Template-Type: ReDIF-Article 1.0 Title: Health services in Shanghai County: introduction to Shanghai County. Journal: American Journal of Public Health Author-Name: Ye, X.F. Author-Name: Huang, D.Y. Author-Name: Hinman, A.R. Author-Name: Parker, R.L. Year: 1982 Volume: 72 Issue: S1 Pages: 13-18 Handle: RePEc:aph:ajpbhl:1982:72:S1:13-18_5 Template-Type: ReDIF-Article 1.0 Title: Costs of care. Journal: American Journal of Public Health Author-Name: Hinman, A.R. Author-Name: Parker, R.L. Year: 1982 Volume: 72 Issue: S1 Pages: 83-88 Handle: RePEc:aph:ajpbhl:1982:72:S1:83-88_0 Template-Type: ReDIF-Article 1.0 Title: The persistence of depressive symptomatology among prepaid group practice enrollees: an exploratory study. Journal: American Journal of Public Health Author-Name: Hankin, J.R. Author-Name: Locke, B.Z. Year: 1982 Volume: 72 Issue: 9 Pages: 1000-1007 Abstract: This exploratory study examines the persistence of depressive symptomatology as measured by the Center for Epidemiological Studies Depressive Scale (CES-D). Over as 12-month period, half of the group of 309 prepaid group practice enrollees reporting depressive symptoms at the beginning of the interval also had high scores on the CES-D at the end of the interval. Sociodemographic characteristics did not predict persistence of depression. Persistence of depression was positively associated with initially reporting cognitive and affective types of depressive symptoms, the presence of physical illness, the seeking of psychiatric treatment, and the receipt of psychotropic drug prescriptions. Handle: RePEc:aph:ajpbhl:1982:72:9:1000-1007_3 Template-Type: ReDIF-Article 1.0 Title: Infectious disease morbidity, 1956-1980. Journal: American Journal of Public Health Author-Name: Huang, D.Y. Author-Name: He, R.Z. Author-Name: Shau, Z.L. Year: 1982 Volume: 72 Issue: S1 Pages: 44-47 Handle: RePEc:aph:ajpbhl:1982:72:S1:44-47_5 Template-Type: ReDIF-Article 1.0 Title: Health services in Shanghai County; family planning. Journal: American Journal of Public Health Author-Name: Zheng, W.S. Author-Name: Gu, X.Y. Year: 1982 Volume: 72 Issue: S1 Pages: 24-25 Handle: RePEc:aph:ajpbhl:1982:72:S1:24-25_8 Template-Type: ReDIF-Article 1.0 Title: Hospitalizations for measles, 1970-78. Journal: American Journal of Public Health Author-Name: Nolan Jr., T.F. Author-Name: Goodman, R.A. Author-Name: Patriarca, P.A. Author-Name: Hinman, A.R. Year: 1982 Volume: 72 Issue: 9 Pages: 1037-1039 Abstract: The National Hospital Discharge Survey of the National Center for Health Statistics was analyzed for measles hospitalizations. From 1970-1978 there were an estimated 52,301 hospitalizations for measles, or approximately 5,800 per year. The median patient age was three years, and the median length of stay was four days. Forty-one per cent of the discharges listed respiratory complications, 10 per cent listed otitis media, and 3 per cent listed neurologic complications. Based on this analysis, hospitalizations for measles accounted for 314,063 hospital days during the period 1970-1978. Handle: RePEc:aph:ajpbhl:1982:72:9:1037-1039_8 Template-Type: ReDIF-Article 1.0 Title: A survey of personal habits, symptoms of illness, and histories of disease in men with and without vasectomies Journal: American Journal of Public Health Author-Name: Petitti, D.B. Author-Name: Klein, R. Author-Name: Kipp, H. Author-Name: Kahn, W. Author-Name: Siegelaub, A.B. Author-Name: Friedman, G.D. Year: 1982 Volume: 72 Issue: 5 Pages: 476-480 Abstract: Using questionnaire information provided by 4,385 vasectomized and 13,155 matched, non-vasectomized men, we found no significant differences between them for a large number of symptoms and diseases, including those of the cardiovascular system. After taking into account differences in their marital status, past smoking habits, and physical activity at work, significant statistical associations of vasectomy with joint pain or swelling, back trouble, and a history of kidney or bladder infection persisted. Our data are inconsistent with the occurrence of large increases in the risks of many important diseases in vasectomized humans. Handle: RePEc:aph:ajpbhl:1982:72:5:476-480_6 Template-Type: ReDIF-Article 1.0 Title: Impact on retention: comparison of two CPR training programs. Journal: American Journal of Public Health Author-Name: Gombeski Jr., W.R. Author-Name: Effron, D.M. Author-Name: Ramirez, A.G. Author-Name: Moore, T.J. Year: 1982 Volume: 72 Issue: 8 Pages: 849-852 Abstract: CPR trainees who completed 8-hour, 3 session and 4-hour single session courses were studied for skill and cognitive retention one year after certification. Knowledge and performance scores were significantly higher for trainees from the long course, but performance skills for both groups were below certification level when compared to American Heart Association standards. The findings suggest the need for further evaluation of course components which could improve retention levels for all trainees. Handle: RePEc:aph:ajpbhl:1982:72:8:849-852_5 Template-Type: ReDIF-Article 1.0 Title: Are bottled beverages safe for travelers? Journal: American Journal of Public Health Author-Name: Harris, J.R. Year: 1982 Volume: 72 Issue: 8 Pages: 787-788 Handle: RePEc:aph:ajpbhl:1982:72:8:787-788_8 Template-Type: ReDIF-Article 1.0 Title: Self-rated health: a predictor of mortality among the elderly. Journal: American Journal of Public Health Author-Name: Mossey, J.M. Author-Name: Shapiro, E. Year: 1982 Volume: 72 Issue: 8 Pages: 800-808 Abstract: Data from the Manitoba Longitudinal Study on Aging (MLSA) were used to test the hypothesis that self-rated health (SRH) is a predictor of mortality independent of "objective health status" (OHS). Subjects were a random sample of non-institutionalized residents of Manitoba aged 65+ in 1971 (n = 3,128). A single item measure of SRH was obtained during a survey conducted in 1971; a baseline measure of OHS was derived from physician and self-reported conditions and health service utilization data. Occurrence and date of death during the years 1971-1977 were known. Analyses of the data revealed that, controlling for OHS, age, sex, life satisfaction, income and urban/rural residence, the risk of early mortality (1971-1973) and late mortality (1974-1977) for persons whose SRH was poor was 2.92 and 2.77 times that of those whose SRH was excellent. This increased risk of death associated with poor self-rated health was greater than that associated with poor OHS, poor life satisfaction, low income and being male. These findings provide empirical support for the long held, but inadequately substantiated, belief that the way a person views his health is importantly related to subsequent health outcomes. Handle: RePEc:aph:ajpbhl:1982:72:8:800-808_7 Template-Type: ReDIF-Article 1.0 Title: Evaluation of a continuing education program in sex therapy. Journal: American Journal of Public Health Author-Name: Sarrel, P.M. Author-Name: Sarrel, L.J. Author-Name: Faraclas, W.G. Year: 1982 Volume: 72 Issue: 8 Pages: 839-843 Abstract: This paper describes a multi-dimensional, ongoing approach to evaluation in a sex therapy training program. The Yale Sex Therapy Training program agencies throughout Connecticut who would meet or surpass pre-determined standards for sex therapists. Because sex therapy is a new discipline, it was deemed essential that program evaluation be developed and carried out from the very beginnings of the program and throughout its course. Evaluative findings proved essential to monitoring the quality of teaching and supervisory efforts, in assessing change in knowledge and professional activity of trainees, and in measuring impact upon the communities served. Continuous feedback led to changes in program content and format through identification of needs and problems. The experience in the Yale program confirms the recommendations of others regarding the conduct of a continuing education program. These findings strongly imply that multi-dimensional, ongoing evaluation should be an integral component in any continuing education program. Handle: RePEc:aph:ajpbhl:1982:72:8:839-843_0 Template-Type: ReDIF-Article 1.0 Title: Bottled beverages and typhoid fever: the Mexican epidemic of 1972-73. Journal: American Journal of Public Health Author-Name: Gonzalez-Cortes, A. Author-Name: Gangarosa, E.J. Author-Name: Parrilla, C. Author-Name: Martin, W.T. Author-Name: Espinosa-Ayala, A.M. Author-Name: Ruiz, L. Author-Name: Bessudo, D. Author-Name: Hernandez-Arreortua, H. Year: 1982 Volume: 72 Issue: 8 Pages: 844-845 Abstract: A chloramphenicol resistant strain of S. typhi which caused a very large epidemic of typhoid fever in Mexico in 1972-73 survived in opened bottles of one carbonated drink with a pH of 4.6 for two weeks and in another such drink with a pH of 5.1 for six months. Bottled beverages are potential sources of large outbreaks of enteric disease, and deserve the same type of standards sand monitoring as comparable fluids such as milk. Handle: RePEc:aph:ajpbhl:1982:72:8:844-845_2 Template-Type: ReDIF-Article 1.0 Title: Rubella immunization of male health personnel. Journal: American Journal of Public Health Author-Name: Attico, N.B. Year: 1982 Volume: 72 Issue: 8 Pages: 855 Handle: RePEc:aph:ajpbhl:1982:72:8:855_4 Template-Type: ReDIF-Article 1.0 Title: Health status and survival needs of the elderly. Journal: American Journal of Public Health Author-Name: Muller, C. Year: 1982 Volume: 72 Issue: 8 Pages: 789-790 Handle: RePEc:aph:ajpbhl:1982:72:8:789-790_2 Template-Type: ReDIF-Article 1.0 Title: The impact on breastfeeding and pregnancy status of household contraceptive distribution in rural Haiti. Journal: American Journal of Public Health Author-Name: Bordes, A. Author-Name: Allman, J. Author-Name: Verly, A. Year: 1982 Volume: 72 Issue: 8 Pages: 835-838 Handle: RePEc:aph:ajpbhl:1982:72:8:835-838_8 Template-Type: ReDIF-Article 1.0 Title: What are the total costs of nuclear power disasters, and who shall pay? Journal: American Journal of Public Health Author-Name: Kenney, M.L. Year: 1982 Volume: 72 Issue: 8 Pages: 856-857 Handle: RePEc:aph:ajpbhl:1982:72:8:856-857_2 Template-Type: ReDIF-Article 1.0 Title: Race-specific patterns of abortion use by American teenagers. Journal: American Journal of Public Health Author-Name: Ezzard, N.V. Author-Name: Cates Jr., W. Author-Name: Kramer, D.G. Author-Name: Tietze, C. Year: 1982 Volume: 72 Issue: 8 Pages: 809-814 Abstract: Between 1972 and 1978, as legal abortion became more widely available nationally, abortion rates (abortions per 1,000 women) and ratios (abortions per 1,000 live births) increased for all American teenagers; from 1972 to 1975, the rates and ratios for teenagers for Black and other races increased faster than those for White teenagers. For all seven years, abortion rates were higher for teenagers of Black and other races than for white teenagers. This reflected both higher proportions of sexually active teenagers of Black and other races and a greater risk of pregnancy in these teenagers compared with White teenagers. Race-specific differences in legal abortion ratios narrowed during the seven-year interval, as did differences in alternative outcomes of teenage premarital pregnancies (term births, illegal abortions). Handle: RePEc:aph:ajpbhl:1982:72:8:809-814_8 Template-Type: ReDIF-Article 1.0 Title: Excess mortality from traffic accidents among elderly pedestrians living in the inner city. Journal: American Journal of Public Health Author-Name: Allard, R. Year: 1982 Volume: 72 Issue: 8 Pages: 853-854 Abstract: Age-specific death rates for pedestrian-car accidents among the populations living in four contiguous areas of a large city, one being the downtown area and the others gradually more removed from it, were compared. The rates are highest downtown and decrease progressively in the outlying areas, the absolute differences between areas being largest above age 65. These data suggest that pedestrian accident prevention efforts should take into account the specific needs of the elderly living in the inner city. Handle: RePEc:aph:ajpbhl:1982:72:8:853-854_0 Template-Type: ReDIF-Article 1.0 Title: Do quantity-frequency data underestimate drinking-related health risks? Journal: American Journal of Public Health Author-Name: Sobell, L.C. Author-Name: Cellucci, T. Author-Name: Nirenberg, T.D. Author-Name: Sobell, M.B. Year: 1982 Volume: 72 Issue: 8 Pages: 823-828 Abstract: Identifying health impairment related to ethanol consumption is one of the major objectives of public health research. The most frequently used method for assessing drinking behavior in public health surveys and related research has been estimation formulae, like the Quantity-Frequency (QF) method which derives an estimate of typical/average levels of daily consumption. In recent years, questions have arisen as to whether the QF method can accurately reflect actual drinking patterns. This study compares a QF method of assessing daily drinking behavior with a newer, more quantitative method (Time-Line, TL) of assessing daily drinking. The QF and TL methods yielded similar mean daily ethanol consumption levels; however, in contrast to the TL method, the QF method seriously masked subjects' actual drinking patterns by failing to identify certain types of ethanol consumption days, especially those thought to be associated with health risks. These findings, while provocative, were obtained with a small number of subjects (N = 40). Extrapolation to populations other than problem drinkers, while likely, awaits further empirical validation. Handle: RePEc:aph:ajpbhl:1982:72:8:823-828_9 Template-Type: ReDIF-Article 1.0 Title: Never-pregnant adolescents and family planning programs: contraception, continuation, and pregnancy risk. Journal: American Journal of Public Health Author-Name: Freeman, E.W. Author-Name: Rickels, K. Author-Name: Mudd, E.B. Author-Name: Huggins, G.R. Year: 1982 Volume: 72 Issue: 8 Pages: 815-822 Abstract: Four hundred urban Black teenagers enrolling in a family planning program before pregnancies occurred were followed for one year to assess factors influencing continuation of contraceptive use. Over half the follow-up respondents claimed to always use contraception. Program discontinuers were less likely to use contraception, but nearly half had no sex activity when contacted at follow-up. Sex frequency reported in the sample was low. Background factors of age, grade, and household were associated with contraceptive use and with pregnancy. Girls who had pregnancies were significantly more likely to live in a single-parent household, to have sex more frequently, and to have stated at enrollment that they wanted their first child before age 20. A majority of the sample, nearly all of whom obtained oral contraception, did not know at the one year follow-up how to use any alternative methods for preventing conception, hence many would again be at risk of pregnancy when sex activity resumed. Handle: RePEc:aph:ajpbhl:1982:72:8:815-822_0 Template-Type: ReDIF-Article 1.0 Title: A nutritional analysis of the Food Stamp Program. Journal: American Journal of Public Health Author-Name: Whitfield, R.A. Year: 1982 Volume: 72 Issue: 8 Pages: 793-799 Abstract: Conflicting claims made both for and against the Food Stamp program have never been based on empirical evidence of its effects on the adequacy and the quality of diets of poor people. In this study, individual diets are measured against dietary standards appropriate for individuals and models of nutritional adequacy are constructed which make possible a determination of the program's impact on many different components of human nutrition. Two types of multiple regression models of nutrient sufficiency--ratios of dietary intake to standard as well as nutrient densities--were developed with dietary recall data from 181 and 195 subjects, respectively. These subjects were selected in a random, probability sample of a low-income area of Tulsa. Oklahoma in 1978 and all had annual household incomes which placed them at or below the poverty level. Separate models were developed for each of six nutrients, calories, protein, calcium, iron, vitamin A and vitamin C, and a large number of covariates were included in these models to isolate the effects due to program participation. The results suggest that the effects of food stamps are not uniformly positive nor are they similar to the effects which could be expected under a less expensive system of direct cash payments. Handle: RePEc:aph:ajpbhl:1982:72:8:793-799_7 Template-Type: ReDIF-Article 1.0 Title: Characteristics of patients referred for treatment of end-stage renal disease in a defined population. Journal: American Journal of Public Health Author-Name: Hiatt, R.A. Author-Name: Friedman, G.D. Year: 1982 Volume: 72 Issue: 8 Pages: 829-833 Abstract: We studied the incidence of referral for treatment of end-stage renal disease (ESRD) in the Kaiser Foundation Health Plan (KFHP) in northern California from 1972 through 1977. In this population of over 1 million persons, we found an age-adjusted annual incidence of 44.9 per million after 1973, when the Federal ESRD Program went into effect. Age-specific incidence was highest in in men greater than 70 years of age and in women in the 50- to 59-year age group; the male/female ratio was 1.4:1. The most common diagnoses of patients referred with ESRD were glomerulonephritis (11.4 per million per year), diabetic nephropathy (5.0 per million per year), primary hypertensive disease (3.1 per million per year), and polycystic kidney disease (2.4 per million per year). Estimated rates of referral for ESRD were highest for Blacks, lowest for Whites, and intermediate for Asians. Incidence varied by geographic area within the health plan service area and was highest where the percentage of the Black population was highest. Handle: RePEc:aph:ajpbhl:1982:72:8:829-833_3 Template-Type: ReDIF-Article 1.0 Title: Trends and patterns in characteristics of local health administrators. Journal: American Journal of Public Health Author-Name: Rohrer, H.H. Author-Name: Dellaportas, G. Year: 1982 Volume: 72 Issue: 8 Pages: 846-849 Abstract: A survey of 1251 local health departments in 1980-81 (response rate 54 per cent) revealed that 74 per cent of those responding were healed by males, 96 per cent by Whites, 16 per cent by directors 60 or over. Forty per cent of the directors were physicians, a substantially lower percentage than that reported a decade ago. Physicians and males were most prevalent in large departments. Two-thirds of the smallest departments were headed by women, usually nurses. Handle: RePEc:aph:ajpbhl:1982:72:8:846-849_5 Template-Type: ReDIF-Article 1.0 Title: Mandatory rubella immunity program among New Mexico Health staff. Journal: American Journal of Public Health Author-Name: Mann, J.M. Author-Name: Montes, J. Year: 1982 Volume: 72 Issue: 8 Pages: 855-856 Handle: RePEc:aph:ajpbhl:1982:72:8:855-856_5 Template-Type: ReDIF-Article 1.0 Title: Competition in health care. Journal: American Journal of Public Health Author-Name: Weiss, R.J. Year: 1982 Volume: 72 Issue: 7 Pages: 655 Handle: RePEc:aph:ajpbhl:1982:72:7:655_5 Template-Type: ReDIF-Article 1.0 Title: Is smoker/nonsmoker segregation effective in reducing passive inhalation among nonsmokers? Journal: American Journal of Public Health Author-Name: Olshansky, S.J. Year: 1982 Volume: 72 Issue: 7 Pages: 737-739 Abstract: Using expired carbon monoxide (CO) and a test of coordination as measures of tobacco smoke exposure in a natural environmental setting where smokers and nonsmokers were segregated, results indicate that by comparison to a control group, subjects seated in adjacent smoking/ nonsmoking environments were not only exposed to similar ambient levels of CO, but also show similar physical and physiological reactions to their exposure in the form of coordination test scores, expired CO, and blood carboxyhemoglobin. While the results may not be generalized to other tobacco smoke constituents or other environmental settings, they raise questions about the health benefits of smoker segregation which future research must address. Handle: RePEc:aph:ajpbhl:1982:72:7:737-739_0 Template-Type: ReDIF-Article 1.0 Title: A study of carboxyhaemoglobin levels of cigarette and sheesha smokers in Saudi Arabia. Journal: American Journal of Public Health Author-Name: Zahran, F. Author-Name: Yousef, A.A. Author-Name: Baig, M.H. Year: 1982 Volume: 72 Issue: 7 Pages: 722-724 Abstract: A single carboxyhaemoglobin (COHb) estimation of late evening blood sample among non-smokers, cigarette smokers, and sheesha smokers was evaluated among Saudis. The COHb level in smokers of 15 to 40 cigarettes a day ranged between 0.7 and 10.3 with a mean value of 6.1 +/- 2.58 COHb. Values among sheesha smokers ranged between 6.5 and 13.9 with a mean value of 8.8 +/- 1.83, significantly higher than those of cigarette smokers (P less than 0.001) for a given degree of exposure to tobacco smoke. Handle: RePEc:aph:ajpbhl:1982:72:7:722-724_6 Template-Type: ReDIF-Article 1.0 Title: Dentistry at the crossroads: a study of professionalism. Journal: American Journal of Public Health Author-Name: Dunning, J.M. Year: 1982 Volume: 72 Issue: 7 Pages: 651-652 Handle: RePEc:aph:ajpbhl:1982:72:7:651-652_9 Template-Type: ReDIF-Article 1.0 Title: A comparison of height, weight, and triceps skinfold thickness of children ages 5-12 in Michigan (1978), Forsyth County North Carolina (1978), and HANES I (1971-1974). Journal: American Journal of Public Health Author-Name: Diseker, R.A. Author-Name: Michielutte, R. Author-Name: Ureda, J.R. Author-Name: Schey, H.M. Author-Name: Corbett, W. Year: 1982 Volume: 72 Issue: 7 Pages: 730-733 Handle: RePEc:aph:ajpbhl:1982:72:7:730-733_8 Template-Type: ReDIF-Article 1.0 Title: Rubella susceptibility in inner-city adolescents: the effect of a school immunization law. Journal: American Journal of Public Health Author-Name: Nelson, D.B. Author-Name: Layde, M.M. Author-Name: Chatton, T.B. Year: 1982 Volume: 72 Issue: 7 Pages: 710-713 Abstract: In order to improve the immune status of girls in our medical clinic, we conducted a prospective sero-survey to identify susceptibles and developed a system for vaccinating non-immune girls. Over an 18-month period, 481 inner-city adolescents were screened. Susceptibility rate defined by a titer less than 1:8 was 12 per cent and did not differ significantly with regard to age or race. Nine months into the study period, the State of Wisconsin enacted a "no immunization-no school" law. The susceptibility rate dropped from 22 per cent prior to the enactment of the law, to 5 per cent after. Of the 60 girls identified as susceptible, 54 (90 per cent) kept their follow up appointments for vaccinations. Enforced state immunization laws appear to be effective in lowering rubella susceptibility. Handle: RePEc:aph:ajpbhl:1982:72:7:710-713_7 Template-Type: ReDIF-Article 1.0 Title: Addict death rates during a four-year posttreatment follow-up. Journal: American Journal of Public Health Author-Name: Joe, G.W. Author-Name: Lehman, W. Author-Name: Simpson, D.D. Year: 1982 Volume: 72 Issue: 7 Pages: 703-709 Abstract: Mortality rates were examined among 3,324 Black and White daily opioid drug users for a four-year period following treatment in community-based agencies located across the United States. A total of 179 of these addicts died during this follow-up period, yielding a death rate of 15.2 per 1,000 person-years at risk. When adjusted for age, addict death rates were found to be three to 14 times higher than those in the general US population. Life table analysis was also used to examine these rates in relation to client demographic, background, and treatment variables obtained prospectively, both prior to and during treatment. Age, alcohol use, and criminal history were positively associated with higher death rates. With regard to causes of death, age proved to be the only significant predictor; older addicts (over 30) had the highest percentages of deaths due to "natural" causes, while over three-fourths of the deaths among younger addicts were drug related or involved violence. Handle: RePEc:aph:ajpbhl:1982:72:7:703-709_8 Template-Type: ReDIF-Article 1.0 Title: Pressures on the dental care system in the United States. Journal: American Journal of Public Health Author-Name: Wotman, S. Author-Name: Goldman, H. Year: 1982 Volume: 72 Issue: 7 Pages: 684-689 Abstract: A number of significant pressures are creating tensions in the dental profession and the dental care delivery system. These pressures may be categorized in five major areas: 1) regulation and deregulation pressures involve changes in the state dental practice acts, court decisions concerning antitrust and advertising, and the inclusion of consumers on State professional regulatory boards; 2) cost of services includes factors involving the out-of-pocket cost of dental care and the growth of dental insurance; 3) dentist-related factors include the increased number of dentists and the indebtedness of dental graduates; 4) the pressures of changes in the American populations include the decline in population growth and the increase in proportion of elderly people; 5) changes in the distribution of dental care are based on new epidemiologic data concerning dental caries and progress in the prevention of periodontal disease. Many of these pressures are inducing competition in the dental care system. It is clear that the dental care system is in the process of change as it responds to these complex pressures. Handle: RePEc:aph:ajpbhl:1982:72:7:684-689_7 Template-Type: ReDIF-Article 1.0 Title: Differences in trends of postneonatal mortality by birthweight in upstate New York, 1968-1979. Journal: American Journal of Public Health Author-Name: Zdeb, M.S. Year: 1982 Volume: 72 Issue: 7 Pages: 734-736 Abstract: Postneonatal mortality among neonatal survivors and the distribution of age at death among infant deaths were examined for births occurring in upstate New York, 1968-1979. Postneonatal mortality rates increased among infants weighing 501-1500 grams. Infants weighing 1501-2000 grams experienced an increase in postneonatal mortality during the mid-1970s, later returning to the level of 1968. Among infants 2001+ grams, postneonatal mortality declined throughout the study period. Among all levels of birthweight, the proportion of infant deaths occurring as postneonatal deaths increased. Handle: RePEc:aph:ajpbhl:1982:72:7:734-736_5 Template-Type: ReDIF-Article 1.0 Title: Dentistry at the crossroads: the future is uncertain: the challenges are many. Journal: American Journal of Public Health Author-Name: Allukian Jr., M. Year: 1982 Volume: 72 Issue: 7 Pages: 653-654 Handle: RePEc:aph:ajpbhl:1982:72:7:653-654_3 Template-Type: ReDIF-Article 1.0 Title: Traditional and emerging forms of dental practice. Cost, accessibility, and quality factors. Journal: American Journal of Public Health Author-Name: Rovin, S. Author-Name: Nash, J. Year: 1982 Volume: 72 Issue: 7 Pages: 656-662 Abstract: The traditional and predominant manner of delivering dental care is through a fee-for-service, private practice system. A number of alternative dental care delivery systems have emerged and are being tested, and others are just emerging. These systems include department store practices, hospital dental services, health maintenance organizations, the independent practice of dental hygiene, and denturism. Although it is too soon to draw final conclusions about the efficacy and effectiveness of these systems, we examine them for their potential to compete with and change the way dental care is currently delivered. Using the parameters of cost, accessibility, and quality, we compare these systems to traditional dental practice. Some of these emerging forms clearly have the potential to complete favorably with traditional practice. Other seem less likely to alter the existing system substantially. The system which can best control costs, increase accessibility, and enhance quality will gain the competitive edge. Handle: RePEc:aph:ajpbhl:1982:72:7:656-662_0 Template-Type: ReDIF-Article 1.0 Title: The effect of immediate access to a computerized medical record on physician test ordering: a controlled clinical trial in the emergency room. Journal: American Journal of Public Health Author-Name: Wilson, G.A. Author-Name: McDonald, C.J. Author-Name: McCabe Jr., G.P. Year: 1982 Volume: 72 Issue: 7 Pages: 698-702 Abstract: We performed a randomized clinical trial of the effect of immediately printed summaries of a computerized medical record on physician test ordering rates in an Emergency Room setting. The computerized medical record contained medication history, the results of most diagnostic studies, an outpatient problem list, and inpatient and emergency room diagnoses. Physicians were presented with a printed summary of the patient's computerized record for study but not for control encounters. All other patient information was equally available to both kinds of encounters. All results were provided for one period of the study, designated T1. Due to a program error, summaries were printed without recent data during a period of the study, designated T2. Two-thirds of the visits were cared for by internists, one-third by surgeons. During T1, internists ordered an average of 3.2 tests, costing $34.91 for control visits, and 2.7 tests, costing $29.94 for study control visits (p less than .026). Surgeons also ordered fewer tests during study visits as compared to controls (1.32 vs 1.54) but the differences were not statistically significant. There was no significant effect on either medical or surgical test ordering during time period T2. Handle: RePEc:aph:ajpbhl:1982:72:7:698-702_7 Template-Type: ReDIF-Article 1.0 Title: Attitudes and health promoting behavior of medical and law students. Journal: American Journal of Public Health Author-Name: Coe, R.M. Author-Name: Miller, D.K. Author-Name: Wolff, M. Author-Name: Prendergast, J.M. Author-Name: Pepper, M. Year: 1982 Volume: 72 Issue: 7 Pages: 725-727 Abstract: An entering class of medical students is compared with an entering class of law students on attitudes toward self-responsibility for health and reported health behaviors. Students' health behavior patterns are contrasted with those of practicing physicians and lawyers. Data were collected by self-administered questionnaires. Results indicated that medical students were stronger on self-responsibility and also reported more often engaging in health promoting behavior than law students. The same pattern of differences was reported for practicing physicians and lawyers. Handle: RePEc:aph:ajpbhl:1982:72:7:725-727_0 Template-Type: ReDIF-Article 1.0 Title: Chiropractic use: a test of several hypotheses. Journal: American Journal of Public Health Author-Name: Cleary, P.D. Year: 1982 Volume: 72 Issue: 7 Pages: 727-730 Handle: RePEc:aph:ajpbhl:1982:72:7:727-730_6 Template-Type: ReDIF-Article 1.0 Title: Community health planning from an interorganizational perspective. Journal: American Journal of Public Health Author-Name: Cohen, P.D. Year: 1982 Volume: 72 Issue: 7 Pages: 717-721 Abstract: Planning agencies do not have control over health care resources in the community. Resources are concentrated in a number of provider organizations, associations, and government agencies, which have common goals as well as a diversity of individual objectives, and therefore enter into networks of relationships to accomplish their overlapping service missions. Interorganizational research shows that it is important to enhance the interdependence and benefits of cooperation between organizations and at the same time maintain the identity and distinctive qualities of each organization. Thus, in addition to the important role to provide information for decisions, planners have a role to manage the interdependencies and identities among organizations in the health system. Research shows that in situations where only methods, data, and analysis were emphasized by health planners, they had less impact on community decisions than in situations where planners also emphasized the development of the interorganizational system of decision-making. In a neutral position with respect to competing forces, planners can more effectively use their leverage from their information processing role and from their regulatory powers to facilitate the balancing of interorganizational interests and to enhance cooperative benefits to the community. Handle: RePEc:aph:ajpbhl:1982:72:7:717-721_2 Template-Type: ReDIF-Article 1.0 Title: Toward a theory of the dental care market: a critique. Journal: American Journal of Public Health Author-Name: Littleton Jr., P.A. Year: 1982 Volume: 72 Issue: 7 Pages: 676-678 Handle: RePEc:aph:ajpbhl:1982:72:7:676-678_2 Template-Type: ReDIF-Article 1.0 Title: Cancer control in India: a multinational approach involving the USA and the USSR. Journal: American Journal of Public Health Author-Name: Sutnick, A.I. Author-Name: Saunders, J.F. Author-Name: Puchkov, Y.I. Year: 1982 Volume: 72 Issue: 7 Pages: 714-717 Abstract: Based on a long-standing cooperation in medicine and public health between the United States and the Soviet Union, and on the potential contributions to be made by scientists from both of these countries, the World Health Organization invited an American-Soviet collaborative team to recommend a cancer control program for the Government of India. The consultants defined the importance of cancer of the cervix uteri and of the oral cavity, which comprise one-half of India's cancer cases, as the basis for a cancer control program. They recommended incorporation of cancer control functions into the organizational structure of the Ministry of Health as well as specific recommendations in education, prevention, and early detection, diagnosis, treatment, and epidemiologic studies. The mission underscores the value of multinational cooperation on health care problems that are faced in common by the United States, the Soviet Union, and other countries of the world. In addition it serves as a basis for international friendship and understanding in the context of mutually productive activities which may provide a benefit for all nations. Handle: RePEc:aph:ajpbhl:1982:72:7:714-717_0 Template-Type: ReDIF-Article 1.0 Title: Pregnancy outcomes of Indochinese refugees, Santa Clara County, California. Journal: American Journal of Public Health Author-Name: Davis, J.M. Author-Name: Goldenring, J. Author-Name: McChesney, M. Author-Name: Medina, A. Year: 1982 Volume: 72 Issue: 7 Pages: 742-744 Abstract: Birth certificates and a sample of hospital obstetric records for Indochinese refugees in Santa Clara County, CA, 1979-1980, were reviewed. Among 542 live births, the overall median birthweight of 3175 gm and 5.7 per cent rate of low birthweight were favorable; it is our impression that the more recent arrivals, especially Cambodians and Laotians, present at greater risk, lacking prenatal care, and have more infants of low birth rate and more pregnancy complications. Handle: RePEc:aph:ajpbhl:1982:72:7:742-744_7 Template-Type: ReDIF-Article 1.0 Title: Institutional change in delivery of dental services: a marketing perspective. Journal: American Journal of Public Health Author-Name: Capon, N. Year: 1982 Volume: 72 Issue: 7 Pages: 679-683 Handle: RePEc:aph:ajpbhl:1982:72:7:679-683_1 Template-Type: ReDIF-Article 1.0 Title: Completeness of infant death registration for very low birthweight infants: Washington State 1978-79. Journal: American Journal of Public Health Author-Name: Frost, F. Author-Name: Jennings, T. Author-Name: Starzyk, P. Year: 1982 Volume: 72 Issue: 7 Pages: 740-741 Abstract: Washington State hospitals were queried about the fate of 507 infants born in 1978-79 for whom no linked death certificate existed. Only ten previously unregistered deaths were discovered, raising mortality for this group by 2.5 per cent. In addition, 13 previously unmatched death records were linked to birth records, providing more accurate calculation of birthweight-specific mortality rates. Washington State infant death registration is more complete that that found in either Georgia or North Carolina. Handle: RePEc:aph:ajpbhl:1982:72:7:740-741_9 Template-Type: ReDIF-Article 1.0 Title: Traditional and emerging forms of dental practice: another view. Journal: American Journal of Public Health Author-Name: Bailit, H.L. Year: 1982 Volume: 72 Issue: 7 Pages: 662-664 Handle: RePEc:aph:ajpbhl:1982:72:7:662-664_8 Template-Type: ReDIF-Article 1.0 Title: A political economic theory of the dental care market. Journal: American Journal of Public Health Author-Name: Lipscomb, J. Author-Name: Douglass, C.W. Year: 1982 Volume: 72 Issue: 7 Pages: 665-675 Abstract: A theory of the dental care market is introduced which proposes that the vertically integrated (local/state/national) structure of the profession services as an organizational vehicle both for intra-professional debate and for developing provider-oriented dental care policy. We suggest that a special relationship exists between professionalism and professional regulation. Such regulation has functioned simultaneously to limit competition and to foster a prized consumption commodity for providers: professionalism and professional esteem. The organized pursuit of this commodity inherently dampens competition. Professionalism itself plays a crucial role in: 1) securing for organized dentistry a form of state regulation in which the providers themselves are the principal decision-makers; and 2) influencing provider and consumer market behavior in several significant respects, the net result being the formation of maintenance of a type of "leadership cartel" in the local market. Thus, a political-economic theory of the dental care market formally acknowledges professionalism as valued by established dentists and recent graduates as a central determining influence. Traditional models of pure competition and monopoly emerge as special, extreme cases of the general theory. Hypotheses are offered regarding consumer and provider behavior, market dynamics, and health policy and regulation. Handle: RePEc:aph:ajpbhl:1982:72:7:665-675_6 Template-Type: ReDIF-Article 1.0 Title: Increasing efficiency in evaluation research: the use of sequential analysis. Journal: American Journal of Public Health Author-Name: Howe, H.L. Year: 1982 Volume: 72 Issue: 7 Pages: 690-697 Abstract: This paper describes Wald's sequential analysis and briefly reviews the history of its applied use. Two public health applications are presented as examples of how the method helped overcome two common problems associated with evaluation research. In one case, the sequential technique reduced dramatically the workload in an evaluation project where hospital records were being reviewed. In the second case, prompt feedback of data to a breast screening program was facilitated by the sequential method allowing program administrators to refocus their efforts on problem areas before the end of the funding period. On the average, Wald's sequential method results in a savings of 50 per cent in observations as compared to classical sampling procedures. The sample sizes will always terminate with a finite number and will rarely exceed three times the average sample size for any single sample. Handle: RePEc:aph:ajpbhl:1982:72:7:690-697_5 Template-Type: ReDIF-Article 1.0 Title: A color-matching technique for monitoring tar/nicotine yields to smokers. Journal: American Journal of Public Health Author-Name: Kozlowski, L.T. Author-Name: Rickert, W.S. Author-Name: Pope, M.A. Author-Name: Robinson, J.C. Year: 1982 Volume: 72 Issue: 6 Pages: 597-599 Handle: RePEc:aph:ajpbhl:1982:72:6:597-599_6 Template-Type: ReDIF-Article 1.0 Title: Memory aids in longitudinal health surveys: results from a field experiment. Journal: American Journal of Public Health Author-Name: Marcus, A.C. Year: 1982 Volume: 72 Issue: 6 Pages: 567-573 Abstract: The use of memory aids to improve respondent recall is becoming increasingly popular in health surveys. In a one-year field experiment involving over 1,200 respondents, people assigned memory aids reported over 50 per cent more symptom episodes than those not assigned memory aids. Differences in reporting levels were particularly striking during the first six to 12 weeks of the survey, for symptoms related to acute, transitory illness, and among minorities and the lower socioeconomic groups. Respondents assigned memory aids were also more likely to report a doctor contact--especially during the fall/winter months. Among respondent who used their memory aids at least once (N = 252), nearly 35 per cent said they were influenced by the information recorded in their memory aids, and most of those who were influenced said that they became more aware of their health. Ten of these people said that they became more worried or depressed because of the information recorded in their memory aids. This constitutes about a four per cent risk among those people who reported using their memory aids at least once. There was no evidence to suggest that the memory aids influenced perceptions of health status. Handle: RePEc:aph:ajpbhl:1982:72:6:567-573_8 Template-Type: ReDIF-Article 1.0 Title: Family planning and abortion: have they affected fertility in Tennessee? Journal: American Journal of Public Health Author-Name: Atrash, H.K. Author-Name: Rochat, R.W. Author-Name: Schulz, K.F. Author-Name: Allen, D.T. Year: 1982 Volume: 72 Issue: 6 Pages: 608-610 Abstract: In Tennessee between 1975 and 1978, birth rates among teenagers decreased while they increased among older age groups. This trend was unlike previous years and coincided temporally with the increased availability of legal abortion services in Tennessee and the special efforts to prevent unwanted pregnancies among teenagers. Increased use of family planning services was significantly associated with the drop in the fertility rate for Black teenagers; legal abortion use was significantly associated with the change in the fertility rate for Black females aged 20 years or older. Handle: RePEc:aph:ajpbhl:1982:72:6:608-610_8 Template-Type: ReDIF-Article 1.0 Title: Abortion alarums. Journal: American Journal of Public Health Author-Name: Tietze, C. Year: 1982 Volume: 72 Issue: 6 Pages: 534-535 Handle: RePEc:aph:ajpbhl:1982:72:6:534-535_6 Template-Type: ReDIF-Article 1.0 Title: Comparison of utilization of medical services by alcoholics and non-alcoholics. Journal: American Journal of Public Health Author-Name: Forsythe, A.B. Author-Name: Griffiths, B. Author-Name: Reiff, S. Year: 1982 Volume: 72 Issue: 6 Pages: 600-602 Handle: RePEc:aph:ajpbhl:1982:72:6:600-602_9 Template-Type: ReDIF-Article 1.0 Title: Parental smoking and the risk of childhood asthma. Journal: American Journal of Public Health Author-Name: Gortmaker, S.L. Author-Name: Walker, D.K. Author-Name: Jacobs, F.H. Author-Name: Ruch-Ross, H. Year: 1982 Volume: 72 Issue: 6 Pages: 574-579 Abstract: Data from two random population surveys are used to assess the relationship between parental smoking and the prevalence of asthma in children aged 0-17. Data from a 1977 Midwestern urbanized county indicate that, if mothers smoked, the prevalence of parent reported asthma increased from 5.0 per cent to 7.7 per cent (estimated relative risk of 1.5), and the prevalence of functionally impairing asthma increased from 1.1 per cent to 2.2 per cent (relative risk of 2.0). In a more rural Eastern county in 1980, a lower overall prevalence of asthma was noted. However, similar estimated relative risks of asthma (1.8) and functionally impairing asthma (2.4) were found to be associated with maternal smoking. Inconsistent relationships were found between the estimated prevalence of asthma and paternal smoking. When multivariate controls were introduced, the relationships between maternal smoking and asthma persisted. Estimated attributable risks indicate that between 18 per cent and 34 per cent of the asthma reported in these samples can be attributed to maternal smoking. Implications of these findings for primary care physicians are discussed. Handle: RePEc:aph:ajpbhl:1982:72:6:574-579_0 Template-Type: ReDIF-Article 1.0 Title: Ectopic pregnancy in New York City, 1975-1980. Journal: American Journal of Public Health Author-Name: Budnick, L.D. Author-Name: Pakter, J. Year: 1982 Volume: 72 Issue: 6 Pages: 580-584 Abstract: Seventy-three non-federal acute care New York City hospitals were asked to report the number of ectopic pregnancies. These reports were compared with legally required certificates of termination of pregnancy (fetal death certificates). The number of ectopic pregnancies reported via the questionnaire was six times the number reported on the certificates of termination of pregnancy. Based on the hospital survey, ectopic pregnancies increased from 1,457 in 1975 to 2,080 in 1980. The number of ectopic pregnancies per 1,000 conceptions per year increased 48.5 percent, from 6.48 in 1975 to 9.62 in 1980 (p less than .001). Of the 30 fatalities related to an ectopic pregnancy, 93.4 percent were Black or Hispanic and two-thirds were single. An unexplained finding was that 75 per cent of the fatal tubal pregnancies were right-sided (p less than .01). At least one-half of the deaths were attributable to physician error and one-fifth were attributable to patient neglect. Ectopic pregnancy continues to be overlooked and misdiagnosed. Increased physician suspicion of this complication in the susceptible population is needed to decrease fatalities. Handle: RePEc:aph:ajpbhl:1982:72:6:580-584_8 Template-Type: ReDIF-Article 1.0 Title: Cuban refugee health care: response of the American health care system to the unexpected arrival of 125,000 immigrants. Journal: American Journal of Public Health Author-Name: Bienia, R.A. Author-Name: VanDerDecker, J.D. Author-Name: Bienia, B.H. Year: 1982 Volume: 72 Issue: 6 Pages: 594-596 Abstract: During the spring of 1980, over 120,000 Cuban refugees emigrated to the United States. Their rapid, unexpected arrival overwhelmed existing health care facilities in south Florida. Government-operated screening centers capable of handling large patient loads were established. Health screening involved a brief history and physical examination and a search for active tuberculosis and venereal disease. Thousands of refugees were processed rapidly and released to waiting relatives and sponsors. Many others, who for social or psychological reasons could not be released. were transferred to holding centers in various parts of the country. US Public Health Service physicians were faced with difficulties whose basic cause could be traced to the boredom of camp life and stresses due to uncertainty regarding the future. Acting out and compliance problems with medical aftermaths were common. About 3,000 refugees remain in custody today. Handle: RePEc:aph:ajpbhl:1982:72:6:594-596_9 Template-Type: ReDIF-Article 1.0 Title: Cambodian disaster relief: refugee camp medical care. Journal: American Journal of Public Health Author-Name: Feldstein, B. Author-Name: Weiss, R. Year: 1982 Volume: 72 Issue: 6 Pages: 589-594 Abstract: The lack of available data impedes the efficient delivery of health care in disaster situations. We present organizational information and patient data based on review of 924 consecutive admissions seen during our three-month experience as refugee camp pediatricians at Khao-I-Dang Holding Center for Kampucheans in Thailand. Most patients had severe and multiple common diseases, with pneumonia, diarrhea, measles, and meningitis having the highest incidence. To optimize care, the gathering and distribution of epidemiologic data, the development of laboratory facilities and treatment protocols, standardization of supplies, and the initiation of programs for disease prevention must be stressed. Handle: RePEc:aph:ajpbhl:1982:72:6:589-594_8 Template-Type: ReDIF-Article 1.0 Title: Socioeconomic effects on child mortality in the United States. Journal: American Journal of Public Health Author-Name: Mare, R.D. Year: 1982 Volume: 72 Issue: 6 Pages: 539-547 Abstract: Despite considerable reason for scholarly and policy interest in socioeconomic mortality differentials, socioeconomic effects on child and teenage mortality in the United States have been a neglected research topic because of several data limitations. Exploiting data obtained for other purposes, this paper reports socioeconomic effects on the mortality of children and teenagers. Socioeconomic mortality differentials among children are large--at least as large as those among adults. The major source of socioeconomic mortality differences among children is apparently differential risk to accidental death. Within the child population, the strength of socioeconomic effects varies directly with the relative importance of accidents as a component of overall mortality. Handle: RePEc:aph:ajpbhl:1982:72:6:539-547_6 Template-Type: ReDIF-Article 1.0 Title: Identifying the health risks from very low-dose sparsely ionizing radiation. Journal: American Journal of Public Health Author-Name: Dreyer, N.A. Author-Name: Friedlander, E. Year: 1982 Volume: 72 Issue: 6 Pages: 585-588 Abstract: The health risks from low-dose sparsely ionizing (low-LET) radiation have been the subject of continued debate. At present, quantitative estimates of risk are extremely uncertain due to the controversy surrounding both the dosimetry for A-bomb survivor data and the choice of mathematical models for extrapolating risk from high to low doses. Nevertheless, much can be learned about the nature of the health risks by reviewing the epidemiologic literature. We present a summary of diseases which have been associated with low-LET radiation (less than 1000 rad) in at least two independent studies, according to the mean cumulative organ dose at which the disease was observed. At organ doses of less than or equal to 50 rad, the only diseases that have been reported consistently are thyroid cancer, salivary gland tumors, and leukemia. The first two diseases were observed in association with x-ray epilation of the scalp for tinea capitis, a therapy which is no longer employed. On the other hand, leukemia has been observed repeatedly to occur at cumulative doses of greater than or equal to 30 rad low-LET radiation. Handle: RePEc:aph:ajpbhl:1982:72:6:585-588_1 Template-Type: ReDIF-Article 1.0 Title: The economic value of life: linking theory to practice. Journal: American Journal of Public Health Author-Name: Landefeld, J.S. Author-Name: Seskin, E.P. Year: 1982 Volume: 72 Issue: 6 Pages: 555-566 Abstract: Human capital estimates of the economic value of life have been routinely used in the past to perform cost-benefit analyses of health programs. Recently, however, serious questions have been raised concerning the conceptual basis for valuing human life by applying these estimates. Most economists writing on these issues tend to agree that a more conceptually correct method to value risks to human life in cost-benefit analyses would be based on individuals.' "willingness to pay" for small changes in their probability of survival. Attempts to implement the willingness-to-pay approach using survey responses or revealed-preference estimates have produced a confusing array of values fraught with statistical problems and measurement difficulties. As a result, economists have searched for a link between willingness to pay and standard human capital estimates and have found that for most individuals a lower bound for valuing risks to life can be based on their willingness to pay to avoid the expected economic losses associated with death. However, while these studies provide support for using individual's private valuation of forgone income in valuing risks to life, it is also clear that standard human capital estimates cannot be used for this purpose without reformulation. After reviewing the major approaches to valuing risks to life, this paper concludes that estimates based on the human capital approach--reformulated using a willingness-to-pay criterion--produce the only clear, consistent, and objective values for use in cost-benefit analyses of policies affecting risks to life. The paper presents the first empirical estimates of such adjusted willingness-to-pay/human capital values. Handle: RePEc:aph:ajpbhl:1982:72:6:555-566_6 Template-Type: ReDIF-Article 1.0 Title: The value of human life revisited. Journal: American Journal of Public Health Author-Name: Rice, D.P. Author-Name: Hodgson, T.A. Year: 1982 Volume: 72 Issue: 6 Pages: 536-538 Handle: RePEc:aph:ajpbhl:1982:72:6:536-538_5 Template-Type: ReDIF-Article 1.0 Title: Incidence of Colles' fracture in a North American community. Journal: American Journal of Public Health Author-Name: Owen, R.A. Author-Name: Melton 3rd., L.J. Author-Name: Johnson, K.A. Author-Name: Ilstrup, D.M. Author-Name: Riggs, B.L. Year: 1982 Volume: 72 Issue: 6 Pages: 605-607 Abstract: In a 30-year period, 1,137 adult residents of Rochester, Minnesota experienced 1235 Colles' fractures. Fracture incidence among women increased over sixfold between ages 35-39 and 60-64 and then leveled off. Male rates were lower in every age group and did not rise as dramatically. Fractures associated with moderate trauma were responsible for the increased incidence with age and the excess among women. Overall, Rochester rates were 30 per cent or more greater than those reported from communities in other countries (Am J Public Health 1982; 72:605-607.). Handle: RePEc:aph:ajpbhl:1982:72:6:605-607_9 Template-Type: ReDIF-Article 1.0 Title: Child health and socioeconomic status. Journal: American Journal of Public Health Author-Name: Starfield, B.H. Year: 1982 Volume: 72 Issue: 6 Pages: 532-534 Handle: RePEc:aph:ajpbhl:1982:72:6:532-534_5 Template-Type: ReDIF-Article 1.0 Title: Induced abortion and spontaneous fetal loss in subsequent pregnancies. Journal: American Journal of Public Health Author-Name: Chung, C.S. Author-Name: Smith, R.G. Author-Name: Steinhoff, P.G. Author-Name: Mi, M.P. Year: 1982 Volume: 72 Issue: 6 Pages: 548-554 Abstract: The effect of induced abortion on spontaneous pregnancy loss in subsequent pregnancies was studied based on 3,416 pairs of matched data in a follow-up investigation. Pregnancy outcome was examined also in relation to abortion procedure, gestation length at time of abortion, and number of previous abortions. In general there was no significant association between prior induced abortion and risks of pregnancy loss with the relative risks of 1.10, 0.88, and 0.81 for the first to third trimester respectively. A slight increase of first-trimester spontaneous loss was noted with the D&C/Suction procedure and early induced abortion (less than 9 weeks). The D&C procedure was associated with non-significant increase of second-trimester loss with the relative risk of 1.59. Handle: RePEc:aph:ajpbhl:1982:72:6:548-554_9 Template-Type: ReDIF-Article 1.0 Title: Caffeine consumption and benign breast disease: a case-control comparison. Journal: American Journal of Public Health Author-Name: Marshall, J. Author-Name: Graham, S. Author-Name: Swanson, M. Year: 1982 Volume: 72 Issue: 6 Pages: 610-612 Abstract: In this case-control comparison of 323 women with benign breast disease and 1,458 controls, no differences were noted in the coffee and tea consumption patterns of the cases and controls. These findings do not support the recent suggestion of Minton, et al, that methylxanthine ingestion is causally related to benign breast disease or breast cancer. Handle: RePEc:aph:ajpbhl:1982:72:6:610-612_6 Template-Type: ReDIF-Article 1.0 Title: Long-term care criteria and standards agreement with professional placement determination. Journal: American Journal of Public Health Author-Name: Harris, J.F. Author-Name: Orr, M. Author-Name: Allaway, N.C. Year: 1982 Volume: 72 Issue: 6 Pages: 602-604 Abstract: The decisions made by physician-nurse teams and individual nurse-evaluators following examination of long-term care patients are compared with the results of placement assignment of the same patients obtained by using the New York State Patient Assessment Form (DMS-1), predictor scores, and numerical standard. The descriptors, when applied to long-term care patients and weighted according to intensity, were capable of matching the best judgment of these professionals with a 90 per cent concurrence. Handle: RePEc:aph:ajpbhl:1982:72:6:602-604_2 Template-Type: ReDIF-Article 1.0 Title: Soviet Health, Politics, and Economics. Journal: American Journal of Public Health Author-Name: Field, M.G. Year: 1982 Volume: 72 Issue: 5 Pages: 425-427 Handle: RePEc:aph:ajpbhl:1982:72:5:425-427_4 Template-Type: ReDIF-Article 1.0 Title: On 'subordination' of BSE. Journal: American Journal of Public Health Author-Name: Goldstein, M.K. Author-Name: Stein, G.H. Author-Name: Pennypacker, H.S. Year: 1982 Volume: 72 Issue: 5 Pages: 498-500 Handle: RePEc:aph:ajpbhl:1982:72:5:498-500_0 Template-Type: ReDIF-Article 1.0 Title: BSE versus dogmatism. Journal: American Journal of Public Health Author-Name: Kegeles, S.S. Author-Name: Grady, K.E. Year: 1982 Volume: 72 Issue: 4 Pages: 406 Handle: RePEc:aph:ajpbhl:1982:72:4:406_1 Template-Type: ReDIF-Article 1.0 Title: Another experience with breast cancer survey. Journal: American Journal of Public Health Author-Name: Morrison, B.J. Year: 1982 Volume: 72 Issue: 4 Pages: 405-406 Handle: RePEc:aph:ajpbhl:1982:72:4:405-406_8 Template-Type: ReDIF-Article 1.0 Title: Aspirin and myocardial infarction in young women. Journal: American Journal of Public Health Author-Name: Rosenberg, L. Author-Name: Slone, D. Author-Name: Shapiro, S. Author-Name: Kaufman, D.W. Author-Name: Miettinen, O.S. Author-Name: Stolley, P.D. Year: 1982 Volume: 72 Issue: 4 Pages: 389-391 Abstract: To assess whether aspirin reduces the risk of a first myocardial infarction (MI) in young women, we evaluated data from a case-control study among women less than 50 years of age without a prior MI: 48 of 551 cases of MI and 67 of 896 hospital controls had taken aspirin regularly for at least 12 weeks immediately before admission. The relative risk estimate was 0.8 upon allowance for confounding factors but it was not statistically significant (95 per cent confidence interval, 0.5-1.4). These data alone do not provide evidence of protection by aspirin against a first infarction in young women. Handle: RePEc:aph:ajpbhl:1982:72:4:389-391_6 Template-Type: ReDIF-Article 1.0 Title: Popullution, the 1981 APHA Presidential Address. Journal: American Journal of Public Health Author-Name: Gordon, L.J. Year: 1982 Volume: 72 Issue: 4 Pages: 341-346 Handle: RePEc:aph:ajpbhl:1982:72:4:341-346_2 Template-Type: ReDIF-Article 1.0 Title: Appraising the health of health risk appraisal. Journal: American Journal of Public Health Author-Name: Fielding, J.E. Year: 1982 Volume: 72 Issue: 4 Pages: 337-340 Handle: RePEc:aph:ajpbhl:1982:72:4:337-340_5 Template-Type: ReDIF-Article 1.0 Title: A comprehensive rabies control program in Alaska. Journal: American Journal of Public Health Author-Name: Middaugh, J. Author-Name: Ritter, D. Year: 1982 Volume: 72 Issue: 4 Pages: 384-386 Abstract: In 1975 the State of Alaska initiated a comprehensive Rabies Control Program. Lay vaccinators trained and certified by the state provided animal vaccination in rural areas. From 1975 through 1980, 182 persons received post-exposure rabies prophylaxis with Human Rabies Immune Globulin (HRIG) plus Duck Embryo Vaccine (DEV), or Human Diploid Cell Vaccine (HDCV), while 2,569 persons initially thought to have been exposed were not treated after consultation, at a cost saving of approximately $3,220,241. Handle: RePEc:aph:ajpbhl:1982:72:4:384-386_1 Template-Type: ReDIF-Article 1.0 Title: Pediatric counseling and subsequent use of smoke detectors. Journal: American Journal of Public Health Author-Name: Miller, R.E. Author-Name: Reisinger, K.S. Author-Name: Blatter, M.M. Author-Name: Wucher, F. Year: 1982 Volume: 72 Issue: 4 Pages: 392-393 Abstract: Effects of a brief educational and purchase program concerning home fires and smoke detectors by two pediatricians were compared to "routine" counseling without such a program using two groups each of 120 patients of well children. Inspection performed four to six weeks after the office visits showed that of 55 experimental group parents without detectors prior to the program, 26 purchased and 19 installed them correctly. No control group parents did so. Handle: RePEc:aph:ajpbhl:1982:72:4:392-393_1 Template-Type: ReDIF-Article 1.0 Title: OSHA criteria for laboratory proficiency in blood lead analysis. Journal: American Journal of Public Health Author-Name: Donadio, R.E. Year: 1982 Volume: 72 Issue: 4 Pages: 404-405 Handle: RePEc:aph:ajpbhl:1982:72:4:404-405_6 Template-Type: ReDIF-Article 1.0 Title: Defining legitimate births in Fulton County, Georgia, 1977. Journal: American Journal of Public Health Author-Name: Benussi, G. Author-Name: McCarthy, B.J. Author-Name: Friedman, J.S. Author-Name: Elsea, W. Author-Name: Morris, L. Year: 1982 Volume: 72 Issue: 4 Pages: 397-399 Abstract: In 1977, the parents of 1,043 births recorded for 15 to 19 year old women in Fulton County, Georgia, were classified as married. However, only 36 per cent of these births could be linked with marriage certificates. An analysis of the unlinked birth certificates showed that the overwhelming majority of teenage parents did not appear to be legally married. The absence of a specific statement regarding marital status on birth certificates results in inaccuracies in the reporting of births according to marital status of parents. Handle: RePEc:aph:ajpbhl:1982:72:4:397-399_1 Template-Type: ReDIF-Article 1.0 Title: The effects of the Freedom of Information Act on research. Journal: American Journal of Public Health Author-Name: Stallones, R.A. Year: 1982 Volume: 72 Issue: 4 Pages: 335-337 Abstract: Use of the Freedom of Information Act can be potentially harmful to the security of research in progress. There is no protection from disclosure of information in grant applications; collected research data can be obtained and disclosed prematurely; and data supporting published research may be acquired and re-analyzed in a faulty manner. Greater secretiveness and competition will result from a requirement to surrender research data on demand. Scientists are urged to refrain from invoking FOIA. Handle: RePEc:aph:ajpbhl:1982:72:4:335-337_9 Template-Type: ReDIF-Article 1.0 Title: An independent analysis of the National Cancer Institute study on non-nutritive sweeteners and bladder cancer. Journal: American Journal of Public Health Author-Name: Walker, A.M. Author-Name: Dreyer, N.A. Author-Name: Friedlander, E. Author-Name: Loughlin, J. Author-Name: Rothman, K.J. Author-Name: Kohn, H.I. Year: 1982 Volume: 72 Issue: 4 Pages: 376-381 Abstract: We evaluated the possible relation between use of non-nutritive sweeteners and bladder cancer using data obtained from the National Cancer Institute Bladder Cancer Study under the Freedom of Information Act. In the general study group, there was no evidence for an association between non-nutritive sweeteners and bladder cancer. Control for a variety of factors through multivariate techniques diminished the plausibility of earlier interpretations of these data, which had raised the possibility that certain subgroups of users or non-nutritive sweeteners might be at an increased risk for bladder cancer. We found that the putative effects of non-nutritive sweeteners were not consistent among subgroups with similar baseline risk, did not display consistent dose-response trends, and were subject to considerable sampling error. We concluded that the data provided little evidence that non-nutritive sweeteners increase risk for bladder cancer among subgroups of users, and that definitive evidence on this question is beyond the reach of conventional research. Handle: RePEc:aph:ajpbhl:1982:72:4:376-381_9 Template-Type: ReDIF-Article 1.0 Title: Cost-effectiveness of community-based long-term care: current findings of Georgia's alternative health services project. Journal: American Journal of Public Health Author-Name: Skellie, F.A. Author-Name: Mobley, G.M. Author-Name: Coan, R.E. Year: 1982 Volume: 72 Issue: 4 Pages: 353-358 Abstract: A study of the cost-effectiveness of community-based, long-term care was conducted with voluntary enrollees eligible for Medicaid reimbursed nursing home care. One year after enrollment, average longevity was greater for the 575 clients in the experiment group, but average Medicaid plus Medicare costs for this group were higher than for the 172 clients in the control group. Among those more at risk of entering a nursing home, costs for persons in the experimental group were somewhat lower than for those in the control group. The results suggest that community-based services targeted to those most at risk of institutionalization may be cost-effective. Handle: RePEc:aph:ajpbhl:1982:72:4:353-358_7 Template-Type: ReDIF-Article 1.0 Title: The environmental health matrix: information for use in planning. Journal: American Journal of Public Health Author-Name: Laessig, R.E. Author-Name: Urkowitz, A.G. Year: 1982 Volume: 72 Issue: 4 Pages: 373-375 Abstract: Environmental and Health planners and policy makers would benefit from a presentation of the casual relationships and the use of that information for plan development and priority setting. The concept of the Environmental-Health Matrix provides a simple structure for constructing data base of environmental-health research information. The Matrix is organized so that it can be used by either environmental or health planners. Entries in the cells of the Matrix assess the nature of the research evidence and direct the user to summaries of research findings. The initial application of the Matrix as both a guide for a literature review and a data base for planning is discussed. Handle: RePEc:aph:ajpbhl:1982:72:4:373-375_4 Template-Type: ReDIF-Article 1.0 Title: Giardia prevalence among 1-to-3-year-old children in two Washington State counties. Journal: American Journal of Public Health Author-Name: Harter, L. Author-Name: Frost, F. Author-Name: Jakubowski, W. Year: 1982 Volume: 72 Issue: 4 Pages: 386-388 Abstract: A survey of intestinal parasites was conducted in two Washington counties. Giardia prevalence among 518 children surveyed was 7.1 per cent and was unrelated to the source of domestic drinking water (surface or well), day care center attendance, or parental occupation. Identified risk factors for Giardia infection include a history of drinking untreated surface water and having two or more siblings between the ages of 3 and 10 years. Of 47 family members of Giardia positive children, 10 (21.3 per cent) were Giardia positive. Handle: RePEc:aph:ajpbhl:1982:72:4:386-388_3 Template-Type: ReDIF-Article 1.0 Title: Seasonal trends in reported poisonings. Journal: American Journal of Public Health Author-Name: Greenberg, R.S. Author-Name: Osterhout, S.K. Year: 1982 Volume: 72 Issue: 4 Pages: 394-396 Abstract: Review of 2,339 Duke Poison Control Center records for calendar year 1977 revealed that preschool children had an autumn peak for all poisonings; older victims a summer predominance. When the reports were stratified by poisoning agent, significant summer predominance was noted in preschool victims for plants, pesticides, paints, and cosmetics; winter predominance for external medicines. In older victims, spring predominance was found for pesticides and soaps, summer predominance for envenomations, plants, internal medicines, ethanol, soaps, and external medicines. Handle: RePEc:aph:ajpbhl:1982:72:4:394-396_5 Template-Type: ReDIF-Article 1.0 Title: The experimental evidence for weight-loss treatment of essential hypertension: a critical review. Journal: American Journal of Public Health Author-Name: Hovell, M.F. Year: 1982 Volume: 72 Issue: 4 Pages: 359-368 Abstract: The empirical evidence concerning the therapeutic effects of weight loss for hypertension treatment was reviewed. Interventions were critically reviewed for strength of measures and experimental design. Six of 21 intervention studies proved to be methodologically strong. However, only one study was considered a randomized clinical trial, testing the combined effects of weight reduction and pharmacological treatment of hypertension. Average blood pressure decrease obtained from the methodologically strongest studies was -21 mmHg and -13 mmHg, for systolic and diastolic measures, respectively. This magnitude change suggests that weight loss may be a clinically and statistically significant treatment. Confounding and bias variables, such as adherence to diet, medication, salt consumption, etc., were discussed and future areas of research were outlined. It was concluded that weight loss appears to be an effective and safe treatment of hypertension. Handle: RePEc:aph:ajpbhl:1982:72:4:359-368_1 Template-Type: ReDIF-Article 1.0 Title: Occupational risk for laryngeal cancer. Journal: American Journal of Public Health Author-Name: Flanders, W.D. Author-Name: Rothman, K.J. Year: 1982 Volume: 72 Issue: 4 Pages: 369-372 Abstract: In a case-control analysis, we studied the effects of type of employment on laryngeal cancer risk using the interview data from the Third National Cancer Survey. Effects were measured relative to the risk for those employed in a group of arbitrarily defined industries and occupations with low risk. We excluded females and controlled for age, tobacco use, alcohol use, and race in the analysis. We found ratio estimates above 3.0 for workers in the railroad industry and the lumber industry; and for sheetmetal workers, grinding wheel operators, and automobile mechanics. Handle: RePEc:aph:ajpbhl:1982:72:4:369-372_7 Template-Type: ReDIF-Article 1.0 Title: Minor error noted in study on child health in smokers' families. Journal: American Journal of Public Health Author-Name: Bonham, G.S. Author-Name: Wilson, R.W. Year: 1982 Volume: 72 Issue: 4 Pages: 403 Handle: RePEc:aph:ajpbhl:1982:72:4:403_5 Template-Type: ReDIF-Article 1.0 Title: Non-nutritive sweeteners and bladder cancer. Journal: American Journal of Public Health Author-Name: Hoover, R. Author-Name: Hartge, P. Year: 1982 Volume: 72 Issue: 4 Pages: 382-383 Handle: RePEc:aph:ajpbhl:1982:72:4:382-383_4 Template-Type: ReDIF-Article 1.0 Title: Spermicide use and Down's syndrome. Journal: American Journal of Public Health Author-Name: Rothman, K.J. Year: 1982 Volume: 72 Issue: 4 Pages: 399-401 Abstract: A connection has been suggested between use of vaginal spermicides and the occurrence of Down's syndrome among offspring born to women who used these contraceptive agents. This hypothesis was evaluated with data from a case-control study of congenital heart disease, which included among the subjects 16 infants with Down's syndrome. The estimated ratio of the proportion of Down's syndrome births among spermicide users to the proportion in non-users was 3.6, with a 90 per cent confidence interval of 1.2 to 9.0, thus providing a tentative confirmation of the hypothesis. Handle: RePEc:aph:ajpbhl:1982:72:4:399-401_4 Template-Type: ReDIF-Article 1.0 Title: An assessment of health hazard/health risk appraisal. Journal: American Journal of Public Health Author-Name: Wagner, E.H. Author-Name: Beery, W.L. Author-Name: Schoenbach, V.J. Author-Name: Graham, R.M. Year: 1982 Volume: 72 Issue: 4 Pages: 347-352 Abstract: A state-of-the-art review of a widely-used health promotion technique, the health hazard/health risk appraisal (HHA/HRA), was conducted. The review included preparing a 212-item annotated bibliography, compiling an inventory of 217 programs that have used HHA/HRA, holding discussions with HHA/HRA developers and users, conducting formal site visits to 15 HHA/HRA programs, and consultation with experts on epidemiology, biostatistics, and behavioral science as well as developers and users of HHA/HRA. Programs use HHA/HRA primarily as a promotional device, as a tool for structuring education about health-related behaviors, and as a motivational device for stimulating behavioral change. The scientific basis for HHA/HRA risk predictions is problematic, but their arithmetic imprecision is of less concern than insufficiency of the scientific evidence for certain behavioral recommendations, and inaccuracies in client-supplied data. Widely-held beliefs in HHA/HRA's efficacy for motivating behavioral change cannot be substantiated from available evidence, nor can the assumed absence of adverse effects. The importance of this particular health promotion technique appears to have been exaggerated. Handle: RePEc:aph:ajpbhl:1982:72:4:347-352_3 Template-Type: ReDIF-Article 1.0 Title: On alcohol availability and cirrhosis mortality. Journal: American Journal of Public Health Author-Name: Douglass, R.L. Year: 1982 Volume: 72 Issue: 4 Pages: 403-404 Handle: RePEc:aph:ajpbhl:1982:72:4:403-404_8 Template-Type: ReDIF-Article 1.0 Title: Project Burn Prevention: outcome and implications. Journal: American Journal of Public Health Author-Name: McLoughlin, E. Author-Name: Vince, C.J. Author-Name: Lee, A.M. Author-Name: Crawford, J.D. Year: 1982 Volume: 72 Issue: 3 Pages: 241-247 Abstract: Project Burn Prevention was designed and implemented to determine the ability of a public education program to increase awareness about burn hazards and reduce the incidence and severity of burn injuries. Media messages were transmitted to residents of a large metropolitan area; separate school and community interventions were implemented in two demographically similar communities within the Standard Metropolitan Statistical Area (SMSA). A second metropolitan area and two of its communities served as control sites. Messages for specific, high-risk age groups emphasized flame burns because of their severity and scalds because of their frequency. Knowledge gains were demonstrable only as a result of the school program. Neither the school program nor the media campaign reduced burn incidence or severity; the community intervention may have brought about a moderate, temporary reduction in injuries. Multiplicity of messages, brevity of the campaign, and separation of the interventions are among possible reasons for the program's failure to significantly reduce burn injuries. Education for personal responsibility is not sufficient. Product modification and environmental redesign must be instituted through education and legislation for successful control of burn injuries. Handle: RePEc:aph:ajpbhl:1982:72:3:241-247_0 Template-Type: ReDIF-Article 1.0 Title: Hospital organizational response to the nuclear accident at Three Mile Island: implications for future-oriented disaster planning. Journal: American Journal of Public Health Author-Name: Maxwell, C. Year: 1982 Volume: 72 Issue: 3 Pages: 275-279 Abstract: The 1979 nuclear accident at Three Mile Island (TMI) near Harrisburg, Pennsylvania, caused severe organizational problems for neighboring health care institutions. Dauphin County, just north of TMI, contained four hospitals ranging in distance from 9.5 to 13.5 miles from the stricken plant. Crash plans put into effect within 48 hours of the initial incident successfully reduced hospital census to below 50 per cent of capacity, but retained bedridden and critically ill patients within the risk-zone. No plans existed for area-wide evacuation of hospitalized patients. Future-oriented disaster planning should include resource files of host institution bed capacity and transportation capabilities for the crash evacuation of hospitalized patients during non-traditional disasters. Handle: RePEc:aph:ajpbhl:1982:72:3:275-279_5 Template-Type: ReDIF-Article 1.0 Title: Peer review again. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1982 Volume: 72 Issue: 3 Pages: 239-240 Handle: RePEc:aph:ajpbhl:1982:72:3:239-240_1 Template-Type: ReDIF-Article 1.0 Title: The interaction of cigarette smoking, oral contraceptive use, and cardiovascular risk factor variables in children: the Bogalusa Heart Study. Journal: American Journal of Public Health Author-Name: Webber, L.S. Author-Name: Hunter, S.M. Author-Name: Baugh, J.G. Author-Name: Srinivasan, S.R. Author-Name: Sklov, M.C. Author-Name: Berenson, G.S. Year: 1982 Volume: 72 Issue: 3 Pages: 266-274 Abstract: Two separate surveys were conducted in a total biracial population of children ages 8-17 years to determine the effects of cigarette smoking and oral contraceptive use on blood pressure and serum lipids and lipoproteins. Information regarding smoking habits and oral contraceptive use was obtained from detailed questionnaires. For White boys and White and Black girls, a small but statistically significant decrease in diastolic blood pressure levels for cigarette smokers when compared to non-smokers was noted. A significant increase among cigarette smokers in beta-lipoprotein cholesterol, pre-beta-lipoprotein cholesterol, and triglycerides as well as a decrease in alpha-lipoprotein cholesterol was noted, especially for White girls. This change in lipoprotein levels for cigarette smokers was noted in both surveys. Oral contraceptive users had higher total cholesterol and beta-lipoprotein cholesterol and lower alpha-lipoprotein cholesterol than nonusers. After adjusting for oral-contraceptive use, particularly among White girls, cigarette smokers still demonstrated high pre-beta-lipoprotein cholesterol and lower alpha-lipoprotein cholesterol levels than non-smokers. These results suggest that the lipid and lipoprotein response to cigarette smoking and oral contraceptive use is to increase cardiovascular risk. Handle: RePEc:aph:ajpbhl:1982:72:3:266-274_4 Template-Type: ReDIF-Article 1.0 Title: The incidence and severity of burn injuries following Project Burn Prevention. Journal: American Journal of Public Health Author-Name: MacKay, A.M. Author-Name: Rothman, K.J. Year: 1982 Volume: 72 Issue: 3 Pages: 248-252 Abstract: Project Burn Prevention, an educational program about burn safety, was implemented in the Greater Boston area from October 1977 through May 1978. The program consisted of three components: a media campaign, a school-initiated intervention, and a community-initiated intervention. Estimates of burn incidence and severity of injury because of scald, flame, electrical or contact burns, or smoke inhalation were made on all patients coming to target- or comparison-area hospitals for a four-year period before the program, the eight months during the program, and the 12 months after the program. Analysis of burn incidence during and after the interventions showed that the school-initiated intervention did not reduce the incidence or severity of burn injuries. The community-initiated intervention may have brought about a moderate, temporary reduction in the rate of burn injuries, although the increase in burn incidence observed for the media campaign of educational messages broadcast to the Greater Boston area suggests that the more plausible explanation for this effect is random variation in burn incidence. Handle: RePEc:aph:ajpbhl:1982:72:3:248-252_4 Template-Type: ReDIF-Article 1.0 Title: Winter weather and cardiovascular mortality in Minneapolis-St. Paul. Journal: American Journal of Public Health Author-Name: Baker-Blocker, A. Year: 1982 Volume: 72 Issue: 3 Pages: 261-265 Abstract: A study of vital statistics data from five Minneapolis-St. Paul winters indicates cardiovascular mortality is influenced by winter temperatures and snow. Although air temperature was not statistically implicated in triggering cardiovascular mortality in four of the five study winters, during the winter of 1976-77, about 15 per cent of the variance in daily cardiovascular mortality could be attributed to fluctuations in the daily minimum air temperature. Snow influenced mortality on the day of occurrence as well as the two days following a snowfall. There appear to be some differences in the ability of winter weather to influence mortality from acute myocardial infarction (ICD 410) and old myocardial infarction (ICD 412). The variance in daily ICD 410 mortality attributable to the influence of snow is somewhat less than that in daily ICD 412 mortality. The greatest variance in daily ICD 412 mortality that could be ascribed to snow occurred during the winter of 1974-75, and was 13 per cent. It is likely that rain intermixed with snow may also trigger increased mortality from cardiovascular disease. A combination of rain and snow can produce dramatic increased in mortality from ICD 410. Study of mortality data from five winters indicates that snow is somewhat more important in triggering deaths from heart disease than is air temperature. Handle: RePEc:aph:ajpbhl:1982:72:3:261-265_1 Template-Type: ReDIF-Article 1.0 Title: Ectopic pregnancy and prior induced abortion. Journal: American Journal of Public Health Author-Name: Levin, A.A. Author-Name: Schoenbaum, S.C. Author-Name: Stubblefield, P.G. Author-Name: Zimicki, S. Author-Name: Monson, R.R. Author-Name: Ryan, K.J. Year: 1982 Volume: 72 Issue: 3 Pages: 253-256 Abstract: We compared the prior pregnancy histories of 85 multigravid women with an ectopic pregnancy and 498 multigravid delivery comparison subjects. We found a relationship between the number of prior induced abortions and the risk of ectopic pregnancy: the crude relative risk of ectopic pregnancy was 1.6 for women with one prior induced abortion and 4.0 for women with two or more prior induced abortions; however, use of multivariate techniques to control confounding factors reduced the relative risks to 1.3 (95 per cent confidence interval, 0.6-2.7) and 2.6 (95 per cent confidence interval, 0.9-7.4), respectively. The analysis suggests that induced abortion may be one of several risk factors for ectopic pregnancy, particularly for women who have had abortions plus pelvic inflammatory disease or multiple abortions. Handle: RePEc:aph:ajpbhl:1982:72:3:253-256_7 Template-Type: ReDIF-Article 1.0 Title: Physician shortage in Kentucky, 1930-1980. Journal: American Journal of Public Health Author-Name: Johnson, T.P. Author-Name: Cooper, J.K. Year: 1982 Volume: 72 Issue: 3 Pages: 257-260 Abstract: Changes in the number and locations of Kentucky counties with a shortage of physicians (using current federal definitions of medical underservice) were examined for the decennial years 1930 to 1980. The number of counties with a physician shortage were found to have increased from four per cent in 1930 to 20 per cent in 1970 and 1980. The per cent of population in physician shortage counties was also found to have increased between 1930 and 1970, but to have declined slightly by 1980. Differences in the average population-to-physician ratios of Appalachian and non-Appalachian counties were significant for every year except 1980. Handle: RePEc:aph:ajpbhl:1982:72:3:257-260_1 Template-Type: ReDIF-Article 1.0 Title: Rubella screening and vaccination program for US Air Force trainees: an analysis of findings. Journal: American Journal of Public Health Author-Name: Blouse, L.E. Author-Name: Lathrop, G.D. Author-Name: Dupuy, H.J. Author-Name: Ball, R.J. Year: 1982 Volume: 72 Issue: 3 Pages: 280-283 Abstract: A preventive medicine program of rubella control for trainees at the Air Force Military Training Center, Lackland AFB, Texas, was begun in October 1977. Incoming trainees were screened for rubella susceptibility, and female trainees were additionally screened for pregnancy. During the period October 1977 to December 1978, an overall rubella susceptibility rate of 17.3 per cent was determined for 71,387 trainees entering basic training. Flights (50 persons each) to which these trainees are assigned varied widely in susceptibility from 0.0-47.7 per cent. Comparisons of susceptibility rates for trainees for for geographic areas and states indicated the highest overall percentage of susceptibles were from the Pacific geographic area with California showing the highest susceptibility (24.5 per cent). Race specific susceptibility rates were found to differ significantly between Whites and Blacks, 17.6 vs 14.8 per cent, respectively. The immunization program was effective as judged by a dampening of the incidence of clinical rubella at the basic training center and at other secondary training centers. Handle: RePEc:aph:ajpbhl:1982:72:3:280-283_6 Template-Type: ReDIF-Article 1.0 Title: Nutritional anemias in the English-speaking Caribbean: a review of the literature. Journal: American Journal of Public Health Author-Name: Johnson, A.A. Author-Name: Latham, M.C. Author-Name: Roe, D.A. Year: 1982 Volume: 72 Issue: 3 Pages: 285-289 Abstract: A review of the published literature on nutritional anemias in the English-speaking Caribbean was carried out. Published articles on the subject are few in number and are concentrated in the larger islands such as Jamaica and Trinidad. Nutritional anemias are most prevalent among women of childbearing age. Iron and folate deficiencies and, to a much lesser extent, protein deficiency resulting from insufficient dietary intakes of these nutrients are the major nutritional factors contributing to this anemia. Handle: RePEc:aph:ajpbhl:1982:72:3:285-289_0 Template-Type: ReDIF-Article 1.0 Title: Minor women obtaining abortions: a study of parental notification in a metropolitan area. Journal: American Journal of Public Health Author-Name: Clary, F. Year: 1982 Volume: 72 Issue: 3 Pages: 283-285 Abstract: Data were collected from 141 women under age 18 attending an abortion clinic that did not require parental notification. Most of them informed their girl friend but not their parents of the plans for abortion. Younger minors and those who perceive their parents to hold positive attitudes toward abortion were more apt to inform parents. Reasons for not informing parents included fears of physical retaliation. Implications for parental notification legislation are discussed. Handle: RePEc:aph:ajpbhl:1982:72:3:283-285_5 Template-Type: ReDIF-Article 1.0 Title: A role for public health in the nuclear age. Journal: American Journal of Public Health Author-Name: MacLeod, G.K. Year: 1982 Volume: 72 Issue: 3 Pages: 237-239 Handle: RePEc:aph:ajpbhl:1982:72:3:237-239_6 Template-Type: ReDIF-Article 1.0 Title: Hospitalization for medical-legal and other abortions in the United States 1970-1977 Journal: American Journal of Public Health Author-Name: Bracken, M.B. Author-Name: Freeman Jr., D.H. Author-Name: Hellenbrand, K. Year: 1982 Volume: 72 Issue: 1 Pages: 30-36 Abstract: The National Hospital Discharge Survey records for medical-legal, spontaneous, and 'other' abortions (ICDA-8 640-641, 643, and 644 respectively) for 1970-77 were analyzed to investigate the impact of liberalized access to abortion on abortion-related morbidity in the United States. The analysis suggests that in census regions where an increase in medical-legal abortions performed in hospitals occurred over the study period there was an associated decreased likelihood of a 'spontaneous' or 'other' abortion. The spontaneous and 'other' abortion codes appear to have been used synonymously and a small number of each used to classify complications of both illegal and legal abortions performed outside hospitals. There was a significant reduction in length of stay for spontaneous and other abortions between 1970 and 1977. This is suggestive of decreasingly severe presenting symptomatology for complicated abortion. The study further suggests that: during 1970-77 illegal abortions were largely replaced by legal procedures; increases in legal abortion beyond those replacing illegal have not resulted in increased rates of hospitalization for complicated abortion; and, the case morbidity rate for legal abortion appears to have declined. Handle: RePEc:aph:ajpbhl:1982:72:1:30-36_9 Template-Type: ReDIF-Article 1.0 Title: Analysis of survey data challenged. Journal: American Journal of Public Health Author-Name: Calhoun, W.F. Author-Name: Thornton, J.C. Author-Name: Smith Jr., H. Author-Name: Lepkowski, J.M. Author-Name: Brock, B.M. Year: 1982 Volume: 72 Issue: 2 Pages: 213-214 Handle: RePEc:aph:ajpbhl:1982:72:2:213-214_9 Template-Type: ReDIF-Article 1.0 Title: Ischemic heart disease mortality declining since 1940. Journal: American Journal of Public Health Author-Name: Gillum, R.F. Year: 1982 Volume: 72 Issue: 2 Pages: 213 Handle: RePEc:aph:ajpbhl:1982:72:2:213_0 Template-Type: ReDIF-Article 1.0 Title: Comments on the Gay Report on STD. Journal: American Journal of Public Health Author-Name: Ruben, S.M. Author-Name: McKenna, M.K. Author-Name: Lednar, W.M. Year: 1982 Volume: 72 Issue: 2 Pages: 214-215 Handle: RePEc:aph:ajpbhl:1982:72:2:214-215_9 Template-Type: ReDIF-Article 1.0 Title: Physicians and nurse practitioners: Do they provide equivalent health care? Journal: American Journal of Public Health Author-Name: Ramsay, J.A. Author-Name: McKenzie, J.K. Author-Name: Fish, D.G. Year: 1982 Volume: 72 Issue: 1 Pages: 55-57 DOI: 10.2105/AJPH.72.1.55 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.55 Abstract: Data from 40 patients attending a hypertension clinic staffed by physicians were compared to data from 40 patients attending a hypertension clinic staffed by nurses over a period of 15 months. Nurses appeared to have more success in handling obesity and to achieve somewhat better control of hypertension. Attrition rate was 50 per cent, but particularly high in patients not receiving medication in the physician clinic. There were no differences in appointment keeping. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.55_1 Template-Type: ReDIF-Article 1.0 Title: Life expectancy increases, but the life span is fixed. Journal: American Journal of Public Health Author-Name: Fries, J.F. Year: 1982 Volume: 72 Issue: 1 Pages: 91-92 Handle: RePEc:aph:ajpbhl:1982:72:1:91-92_1 Template-Type: ReDIF-Article 1.0 Title: Access to generic drugs in the 1950s: The politics of a social problem Journal: American Journal of Public Health Author-Name: Facchinetti, N.J. Author-Name: Dickson, W.M. Year: 1982 Volume: 72 Issue: 5 Pages: 468-475 DOI: 10.2105/AJPH.72.5.468 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.468 Abstract: From the published literature of the 1950s, the social history of anti-substitution law is analyzed in terms of sociological theory on the construction of social problems. The analysis reveals how the substitution of generic drugs for prescribed brands came to be recognized as a social problem in need of remedial legislation. The most influential party in the process was the brand-drug industry which centered the debate on matters of public health and professionalism instead of industrial profitability. The industry was able to form a coalition of interests and establish the saliency and legitimacy of the problem, even though there was no objective evidence to establish brand substitution as a hazard to health. The case fits well into the theory of social problem construction. Other issues in health care, particularly drug issues, can be studied from this same perspective. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.468_6 Template-Type: ReDIF-Article 1.0 Title: Nurse practitioner and physician adherence to standing orders criteria for consultation or referral Journal: American Journal of Public Health Author-Name: Watkins, L.O. Author-Name: Wagner, E.H. Year: 1982 Volume: 72 Issue: 1 Pages: 22-29 DOI: 10.2105/AJPH.72.1.22 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.22 Abstract: The degree to which nurse-practitioners (NPs) and physicians (MDs) follow the mutually agreed-upon rules for their practice and the effects of any deviations are unknown. This study assessed whether NPs adhered to consultation/referral (C/R) criteria in NP standing orders for hypertension, whether MDs adhered to the task-delegation intent expressed in standing orders, and the relationship between adherence and blood-pressure (BP) control. A sample of 161 patients from a practice of five MDs and four NPs in a rural primary care clinic was studied over 16 months. Patient characteristics associated with provider non-adherence were identified by discriminant analysis. NPs failed to obtain consultation or referral for 22 of 66 patients (33 per cent) with conditions requiring C/R. MDs retained 17 of the 43 patients (40 per cent) without C/R conditions. NP nonadherence was associated with care by a single NP, presence of few non-hypertension problems, and need for dietary alteration (p<.05). MD non-adherence was associated with males and presence of severe nonhypertensive disease (p<.005). Diastolic BP control (≤90 mm Hg) was similar in NP patient groups without C/R conditions, retained by NPs despite C/R conditions and shared with MDs by C/R. Control in the shared group was better than in the MD-treated group with C/R conditions (p<.025). Although in this setting NPs frequently did not adhere to C/R criteria for hypertension, this did not affect acceptable BP control. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.22_5 Template-Type: ReDIF-Article 1.0 Title: Recent trends in coronary risk factors in the USSR Journal: American Journal of Public Health Author-Name: Cooper, R. Author-Name: Schatzkin, A. Year: 1982 Volume: 72 Issue: 5 Pages: 431-440 DOI: 10.2105/AJPH.72.5.431 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.431 Abstract: The Soviet Union has experienced an increase in the incidence of coronary heart disease over the last 15 years sufficient to result in an overall deterioration in the health of adults. The distribution of coronary risk factors, and the secular trends in diet and cigarette consumption provide a potential explanation for the upsurge in death rates. The animal fat content of the Soviet diet has been steadily enriched since the 1950s and cigarette production increased 72 per cent from 1959 to 1980. The post-Stalin orientation of the Soviet economy toward a policy of motivating the work force primarily through the provision of consumer goods, in a pattern comparable to western capitalist countries, appears to have laid the basis for these developments. Given the central control of Soviet society, the negative impact of current economic policy on the public health could be viewed as paradoxical. Our analysis suggests that the paradox is only apparent, however, and that the basis for the widespread occurrence of coronary heart disease is similar in the Soviet Union and western societies. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.431_3 Template-Type: ReDIF-Article 1.0 Title: Public health implications of rubella antibody levels in California Journal: American Journal of Public Health Author-Name: Dales, L.G. Author-Name: Chin, J. Year: 1982 Volume: 72 Issue: 2 Pages: 167-172 DOI: 10.2105/AJPH.72.2.167 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.167 Abstract: Rubella hemaggluttination inhibition (HI) antibody determination were performed in 1977 on a sample of California school children and in 1977-1979 on young women who were about to be married or who were pregnant. Among the pupils, 66 per cent reported prior rubella immunization; immunization history was more common in younger pupils. Seventy-seven per cent had detectable antibody, with little trend of greater seropositivity at older ages. Over 86 per cent of those with a written record of immunization had detectable antibody. There was no consistent indication of loss of seropositivity with increasing time since immunization. Children immunized at 12-14 months of age tended to have a lower seropositivity rate than those immunized at older ages. Among young women, the prevalence of detectable antibody was 80-83 per cent. Comparison with data obtained in 1968-1969 indicates that rubella immunization has had a marked impact on levels in teenagers and adults. The pool of rubella-susceptibles entering secondary schools will probably not decrease soon, so that rubella outbreaks may continue in high school and college-age populations. Ultimately, school entry immunization requirements should drastically curtail disease activity. In the interim, programs to immunize teenagers and young adult females must be strengthened. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.167_1 Template-Type: ReDIF-Article 1.0 Title: Emerging patterns of tampon use in the adolescent female: The impact of toxic shock syndrome Journal: American Journal of Public Health Author-Name: Irwin Jr., C.E. Author-Name: Millstein, S.G. Year: 1982 Volume: 72 Issue: 5 Pages: 464-467 DOI: 10.2105/AJPH.72.5.464 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.464 Abstract: From November 1980 through January 1981, we queried 714 post menarchal adolescents (ages 12 to 19) about menstrual product use at menarche (T1), during summer 1980 (T2), at last menstrual period (T3), and about intended product for next menstrual period (T4). The percentage of adolescents reporting use of tampons at each point in time were: T1, 3.1 per cent; T2, 24.1 per cent; T3 (following the media coverage of toxic shock syndrome [TSS]), 19.3 per cent; and T4, 19.5 per cent. Prior to TSS coverage there was a shift toward tampon use in 141 of the 672 subjects who used napkins (21 per cent) and no increase in napkin use. Following media coverage, shifts toward tampon use among napkin users decreased to 2.3 per cent while 32.9 per cent of the 168 summer tampon users (T2) shifted to the use of napkins; reasons for the shift were significantly associated with TSS (p<.001). Ethnicity (White) was highly associated with reported tampon use. Following TSS coverage, adolescents in all ethnic groups decreased their tampon use at the same rate. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.464_1 Template-Type: ReDIF-Article 1.0 Title: Research on nurse practitioners: Process behind the outcome? Journal: American Journal of Public Health Author-Name: Sullivan, J.A. Year: 1982 Volume: 72 Issue: 1 Pages: 8-9 DOI: 10.2105/AJPH.72.1.8 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.8 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.8_4 Template-Type: ReDIF-Article 1.0 Title: Severity of illness and the relationship between intensive care and survival Journal: American Journal of Public Health Author-Name: Scheffler, R.M. Author-Name: Knaus, W.A. Author-Name: Wagner, D.P. Author-Name: Zimmerman, J.E. Year: 1982 Volume: 72 Issue: 5 Pages: 449-454 DOI: 10.2105/AJPH.72.5.449 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.449 Abstract: Currently about 15 per cent of hospital costs are attributed to intensive care. Research using statistical models has not adequately demonstrated that therapy in intensive care units (ICUs) is associated with reductions in the probability of death. In a study of 613 consecutive admissions to a multidisciplinary ICU, we reevaluate the relationship between ICU care and survival using a new acute physiology scoring system to control for the severity of illness of the patient population. When our severity of illness index was employed, we found a statistically significant and nonlinear relationship between the use of intensive medical care and the probability of survival. This statistical relationship produced a U-shaped curve with three distinct segments. The first segment exhibited an overall decrease in the probability of death with increasing therapy (275 admissions); the second segment, a fairly stable survival rate (281 admissions). Only in the third segment, where there were 57 admissions, did we find an overall increase in the probability of death as utilization of therapy increased. These findings suggest that quantitative measurement of severity of illness, when used in clinical studies, could produce improved insights into the relationship between therapy and health outcomes. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.449_0 Template-Type: ReDIF-Article 1.0 Title: A comparative study of hospice services in the United States Journal: American Journal of Public Health Author-Name: Buckingham, R.W. Author-Name: Lupu, D. Year: 1982 Volume: 72 Issue: 5 Pages: 455-463 DOI: 10.2105/AJPH.72.5.455 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.455 Abstract: In order to document the implementation of the hospice concept in the United States, 24 hospices, in operation at least one year and serving at least 100 patients, were selected from the National Hospice Organization roster to participate in a survey of organization, staffing, funding, services and population served. All of the hospices offered both home care and bereavement programs but only 41.7 per cent provided an inpatient program. Ten of the hospices were institutionally based, usually in a hospital. Inpatient services were associated with institutional affiliations. The average profile of patients admitted to hospice was a 60-year-old White (89 per cent), female (54.3 per cent) cancer patient (94.5 per cent) whose spouse was primary caregiver (63.8 per cent). Hospices provided a wide variety of both medical and social services provided by volunteers as well as paid staff. It appears that two divergent types of hospices are developing: 1) independent, heavily volunteer hospices with a variety of professional staff delivering a wide array of social/psychological services with unstable funding; and 2) institutionally based hospices providing both inpatient and home care, greater variety of medical/nursing services, less variety of social/psychological services, using fewer types of volunteers and paid staff, and not experiencing funding problems. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.455_8 Template-Type: ReDIF-Article 1.0 Title: Assessment of dietary compliance Journal: American Journal of Public Health Author-Name: Remmell, P.S. Year: 1982 Volume: 72 Issue: 2 Pages: 128-129 DOI: 10.2105/AJPH.72.2.128 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.128 Abstract: Full advantage has not been taken of self-evaluation for achieving and maintaining dietary compliance. Self-monitoring of food choices is an educational and motivational device for effective personal intervention. Systems which rely exclusively on compliance assessments by the counselor have a major weakness. They fail to transfer the responsibility for change to the person trying to alter his or her eating habits. The need for better methods of improving compliance is obvious. Adherence is a key issue in programs to assist dietary modification, where nutritional programs can help only if they are applied over the long-term. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.128_5 Template-Type: ReDIF-Article 1.0 Title: Phased trial of a proven algorithm at a new primary care clinic Journal: American Journal of Public Health Author-Name: Christensen-Szalanski, J.J.J. Author-Name: Diehr, P.H. Author-Name: Wood, R.W. Author-Name: Tompkins, R.K. Year: 1982 Volume: 72 Issue: 1 Pages: 16-21 DOI: 10.2105/AJPH.72.1.16 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.16 Abstract: A previous study showed that a clinical algorithm for respiratory illnesses, consisting of a checklist, a set of instructions (logic), and computer audit/feedback, could reduce costs significantly while maintaining a high quality of care. The results of this study show that the algorithm system, developed and validated at one primary care clinic, can be successfully imported to another primary care clinic. In the present study, the algorithm system significantly improved the completeness of the medical records, reduced the use of medical tests by 20 per cent-75 per cent, and reduced non-provider costs by 36 per cent per patient visit. This study also shows that all three components of the algorithm system appear to be necessary to achieve these improvements and maintain a high quality of medical care. These results suggest that a wider use of the algorithm system for minor acute medical problems is both feasible and useful in providing high-quality cost-effective care that is auditable. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.16_0 Template-Type: ReDIF-Article 1.0 Title: Algorithms and the 'art' of medicine Journal: American Journal of Public Health Author-Name: Komaroff, A.L. Year: 1982 Volume: 72 Issue: 1 Pages: 10-12 DOI: 10.2105/AJPH.72.1.10 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.10 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.10_1 Template-Type: ReDIF-Article 1.0 Title: Stress and smoking in hospital nurses Journal: American Journal of Public Health Author-Name: Tagliacozzo, R. Author-Name: Vaughn, S. Year: 1982 Volume: 72 Issue: 5 Pages: 441-448 DOI: 10.2105/AJPH.72.5.441 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.441 Abstract: The smoking behavior of hospital nurses and the association between work-related stress and smoking were studied by means of a questionnaire mailed to the entire direct patient care nursing staff at the University of Michigan Hospital. Prevalence of smoking was considerably lower than in the US nurse population surveyed in 1975 and in the general female population of the same age range surveyed in 1978. Significantly higher scores were obtained for smokers than for non-smokers on scales concerning the physical and emotional stress of the job and the dissatisfaction with its rewards. The results supported more weakly the asociation of smoking with the perception of stress induced by role ambiguity, by nurse-doctor conflict, and by conflict between nurses. Some personal and situational variables were found to interact with perception of stress and smoking. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.441_6 Template-Type: ReDIF-Article 1.0 Title: Changes in age and sex specific tonsillectomy rates: United States, 1970-1977 Journal: American Journal of Public Health Author-Name: Freeman, J.L. Author-Name: Jekel, J.F. Author-Name: Freeman Jr., D.H. Year: 1982 Volume: 72 Issue: 5 Pages: 488-491 DOI: 10.2105/AJPH.72.5.488 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.488 Abstract: National estimates of tonsillectomy rates were generated from the Hospital Discharge Survey for the years 1970 and 1977. A comparison of the rates over the seven-year period revealed significant declines in T&A for all age and sex categories and in tonsillectomy alone for males aged 20 through 29. It was also observed that sex differences found in 1970 persisted in 1977. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.488_8 Template-Type: ReDIF-Article 1.0 Title: Trends in the incidence of breastfeeding for hispanics of Mexican origin and anglos on the US-Mexico border Journal: American Journal of Public Health Author-Name: Smith, J.C. Author-Name: Mhango, C.G. Author-Name: Warren, C.W. Author-Name: Rochat, R.W. Author-Name: Huffman, S.L. Year: 1982 Volume: 72 Issue: 1 Pages: 59-61 DOI: 10.2105/AJPH.72.1.59 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.59 Abstract: In 1979 the Centers for Disease Control conducted a household probability survey of reproductive aged women living in 51 selected US counties on the US-Mexico border. Information on the incidence of breastfeeding for the period 1971-1979 was analyzed on 345 Anglo women and 689 Hispanic women of Mexican origin. Results indicated that the Anglos are following the national trend of increased breastfeeding, but Hispanics show no indication of an increase in the practice of breastfeeding. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.59_4 Template-Type: ReDIF-Article 1.0 Title: Waterborne gastroenteritis due to the Norwalk agent: Clinical and epidemiologic investigation Journal: American Journal of Public Health Author-Name: Wilson, R. Author-Name: Anderson, L.J. Author-Name: Holman, R.C. Author-Name: Gary, G.W. Author-Name: Greenberg, H.B. Year: 1982 Volume: 72 Issue: 1 Pages: 72-74 DOI: 10.2105/AJPH.72.1.72 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.72 Abstract: An outbreak of gastroenteritis occurred at a Pennsylvania summer camp in July 1978. Symptoms included abdominal pain (81 per cent), nausea (72 per cent), and vomiting (53 per cent); upper respiratory infections symptoms occurred in 35 per cent of the campers. Illness was associated with consumption of five or more glasses of water or water-containing beverages. Stool cultures from affected persons were negative for bacterial pathogens; however, a fourfold or greater rise to the Norwalk agent was demonstrated in serum samples of three of three ill persons tested and in none of eight controls (p<.02). Campers ill during the first session who were also present during the second session did not become ill during the second session (p<.001). Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.72_9 Template-Type: ReDIF-Article 1.0 Title: A study of intestinal protozoa including non-pathogenic Entamoeba histolytica from patients in a group of mental hospitals Journal: American Journal of Public Health Author-Name: Sargeaunt, P.G. Author-Name: Williams, J.E. Year: 1982 Volume: 72 Issue: 2 Pages: 178-180 DOI: 10.2105/AJPH.72.2.178 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.178 Abstract: Twenty-five per cent of 174 patients residing in three mental hospitals were found to be infected with protozoa. Seven per cent of the patients were infected with Entameba histolytica. Isoenzyme characterization of the E. histolytica grown in culture showed that there were no pathogenic zymodemes of this organism in any of the specimens tested. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.178_9 Template-Type: ReDIF-Article 1.0 Title: Progress in primary prevention: The smoking-health issue Journal: American Journal of Public Health Author-Name: Milio, N. Year: 1982 Volume: 72 Issue: 5 Pages: 428-430 DOI: 10.2105/AJPH.72.5.428 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.428 Abstract: The elimination of cigarette smoking is in the health interests of the public, i.e., it is a public health issue. But like other issues so broadly defined, it tends to become no one's issue. One of the most oft-repeated statements by health professionals for many years - 'balanced' for the public in the broadcast media by a contrary view from the Tobacco Institute - is that the single most health promoting action among Americans would be the elimination of cigarette smoking. Yet, in spite of a general decline in the prevalence of smoking, the cigarette industry is more profitable than ever, is spending more money on promotion than ever, and is more effective politically than ever. Projections from the US Department of Agriculture show that, even with continued extensions of restricted smoking laws and regulations, Americans will still be smoking about 3,100 cigarettes per person in 1990 compared with about 3,600 in the early 1970s. This is about what Australians - in many ways similar to Americans - consume now; and the figure is considered by Australians to be unacceptably high. The greater share of the health burden from this slow pace of change will fall on women. Their death rates from lung cancer are rising faster than men's and are projected to continue rising. The full range of other health-damaging reverberations in acute and chronic disease, prenatal and infant problems, and drug-smoking interactions are arrayed in the 1980 Surgeon General's report on Health Consequences of Smoking for Women. That teenage girls now match or surpass their male peers in taking up smoking does not augur a future of better health for women. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.428_0 Template-Type: ReDIF-Article 1.0 Title: Concurrent evaluation of epidemic St. Louis encephalitis: Are you on the upward or downward side of the curve? Journal: American Journal of Public Health Author-Name: Powell, K.E. Author-Name: Blakey, D.L. Year: 1982 Volume: 72 Issue: 1 Pages: 62-64 DOI: 10.2105/AJPH.72.1.62 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.62 Abstract: Laboratory confirmation of reported cases of St. Louis encephalitis (SLE) lags 2-4 weeks behind onset of illness. A review of our experience in Mississippi in 1975 and 1976 suggests that plotting the number of reported suspects ≥ 50 years of age by date of onset and adjusting for reporting delays can help determine when the peak of the epidemic has passed. This method circumvents the obligatory delay of serologic tests, minimizes the bias of publicity and intensive surveillance, and may avoid promoting control procedures which are expensive, dangerous, and of uncertain efficacy. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.62_9 Template-Type: ReDIF-Article 1.0 Title: Assessing methods for measuring compliance with a fat-controlled diet Journal: American Journal of Public Health Author-Name: Hyman, M.D. Author-Name: Insull Jr., W. Author-Name: Palmer, R.H. Author-Name: O'Brien, J. Author-Name: Gordon, L. Author-Name: Levine, B. Year: 1982 Volume: 72 Issue: 2 Pages: 152-160 DOI: 10.2105/AJPH.72.2.152 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.152 Abstract: This study assessed the relative validity of the following non-laboratory measures of compliance with a fat-controlled diet by hypercholesterolemic males: quantitative and qualitative measures of compliance derived from three-day food records and structured interviews, and summary ratings by nutritionists and interviewers. The quantitative measures of consumption referred to: saturated fat, linoleic acid, polyunsaturated fat, P/S ratio and cholesterol. The non-laboratory measures were assessed using the following two laboratory measures as criteria of validity: serum cholesterol concentration and the proportion of linoleic acid among the fatty acids of the serum cholesteryl esters. The results showed that, with respect to quantitative measures, the food record and interview manifested approximately equal validity, with the former marginally more valid. However, under certain conditions qualitative measures, such as patients' self-ratings, were about as valid as the more rigorous and expensive quantitative measures. Characteristics of the patient influenced the validity of the various methods. Validity was enhanced by the simultaneous use of certain combinations of measures. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.152_2 Template-Type: ReDIF-Article 1.0 Title: Ectopic pregnancies: Rising incidence rates in Northern California Journal: American Journal of Public Health Author-Name: Shiono, P.H. Author-Name: Harlap, S. Author-Name: Pellegrin, F. Year: 1982 Volume: 72 Issue: 2 Pages: 173-175 DOI: 10.2105/AJPH.72.2.173 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.173 Abstract: In a population of about 300,000 Northern California women aged 15-44, the age-adjusted incidence of ectopic pregnancy rose from 55.5 to 84.2/100,000 women, 1972-1978. The ratio of ectopics to 1,000 deliveries-plus-spontaneous abortions rose from 9.4 to 14.8. The change occurred mainly in women under age 30, and was observed in seven of the eight hospitals in the area. There was no alteration in the frequency of hospitalized pelvic inflammatory disease (PID); salpingitis decreased over the years studied; and tubal sterilization events remained constant at around 0.9 per cent per year of women aged 15-44. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.173_3 Template-Type: ReDIF-Article 1.0 Title: Sex differences in declining cohort death rates from heart disease Journal: American Journal of Public Health Author-Name: Patrick, C.H. Author-Name: Palesch, Y.Y. Author-Name: Feinleib, M. Author-Name: Brody, J.A. Year: 1982 Volume: 72 Issue: 2 Pages: 161-166 DOI: 10.2105/AJPH.72.2.161 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.161 Abstract: We examined cohort mortality from heart disease (HD) at ages 40 and over for white men and women in the United States between 1945 and 1975. For each successive birth cohort from 1886 to 1890 and 1906 to 1910, female HD mortality rates exhibit a continuous decline with parallel slopes which shows no sign of abating in recent years. Among men, cohort HD mortality rates were increasing prior to 1965; since 1965, there has been a reversal of prior trends, i.e., each successive cohort has shown a decrease in HD mortality rates. None of the various hypotheses put forward to explain the recent decline in HD mortality provides a cogent explanation for the differential effects in men and women. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.161_9 Template-Type: ReDIF-Article 1.0 Title: Brand preference and advertising recall in adolescent smokers: Some implications for health promotion Journal: American Journal of Public Health Author-Name: Chapman, S. Author-Name: Fitzgerald, B. Year: 1982 Volume: 72 Issue: 5 Pages: 491-494 DOI: 10.2105/AJPH.72.5.491 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.491 Abstract: A survey on brand preference and cigarette advertising recall in 1,195 school children was conducted in Sydney, Australia. Four of the 130 available brands accounted for the cigarettes smoked by 78.7% of smokers. Smokers were nearly twice as likely to correctly identify edited cigarette advertisements and slogans than were non-smokers. Brand preference is considered an important descriptor of smoking profiles. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.491_0 Template-Type: ReDIF-Article 1.0 Title: Intestinal parasitosis among Southeast Asian immigrants in New Mexico Journal: American Journal of Public Health Author-Name: Skeels, M.R. Author-Name: Nims, L.J. Author-Name: Mann, J.M. Year: 1982 Volume: 72 Issue: 1 Pages: 57-59 DOI: 10.2105/AJPH.72.1.57 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.57 Abstract: Results of an intestinal parasite survey of 776 Southeast Asian immigrants in New Mexico are presented. Parasites were found in 71.8 per cent of the patients; 44.3 per cent were multiply infected. Twenty different parasites were identified, some of which are not common in the United States. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.57_6 Template-Type: ReDIF-Article 1.0 Title: Lung cancer mortality and smoking habits: Mexican-American women. Journal: American Journal of Public Health Author-Name: Holck, S.E. Author-Name: Warren, C.W. Author-Name: Rochat, R.W. Author-Name: Smith, J.C. Year: 1982 Volume: 72 Issue: 1 Pages: 38-42 Abstract: Lung cancer mortality was reported to be higher among Mexican-American women as compared with Anglo women from 1950 until 1970; however, smoking habits of Mexican-American women have not been adequately described. This study updates lung cancer mortality data in Texas, describes smoking patterns of 1,255 Mexican-American women from a household survey in the four states bordering Mexico, and compares these findings to a reference group of Anglo women residing in the same area. In 1970, lung cancer mortality rates were similar for Mexican-American and Anglo women in Texas; however, by 1974-1976 Mexican-American women in Texas had a 40 per cent lower rate than Anglo women and by 1979, a 49 per cent lower rate. In our 1979 survey results, Mexican-American women reported lower levels of smoking, both in prevalence and amount smoked, as compared with Anglo women. The lower prevalence was reported for all social and demographic categories examined. The relatively low lung cancer mortality rate is most likely due to relatively low levels of cigarette smoking among Mexican-American women. Based on the trend in lung cancer deaths and our survey findings, we would anticipate a continuing low level of lung cancer mortality among Mexican-American women. Handle: RePEc:aph:ajpbhl:1982:72:1:38-42_6 Template-Type: ReDIF-Article 1.0 Title: A preliminary study on dressing patterns and incidence of candidiasis Journal: American Journal of Public Health Author-Name: Elegbe, I.A. Author-Name: Botu, M. Year: 1982 Volume: 72 Issue: 2 Pages: 176-177 DOI: 10.2105/AJPH.72.2.176 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.176 Abstract: The incidence of candidiasis in two groups of voluntary participants wearing tight and loose fitted dresses was investigated by both microscopic and cultural techniques for a period of two months. Two-thirds of the positives by stain and culture were recovered from those wearing tight clothing (P < 0.05). The findings suggest that tight clothing can predispose the wearer to candidiasis, an organism that can cause vaginitis. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.176_7 Template-Type: ReDIF-Article 1.0 Title: The North Karelia project: What it tells us about the prevention of cardiovascular disease Journal: American Journal of Public Health Author-Name: Wagner, E.H. Year: 1982 Volume: 72 Issue: 1 Pages: 51-53 DOI: 10.2105/AJPH.72.1.51 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.51 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.51_2 Template-Type: ReDIF-Article 1.0 Title: Illness-absences of hospital employees. Journal: American Journal of Public Health Author-Name: Baird, R. Year: 1982 Volume: 72 Issue: 1 Pages: 89-90 Handle: RePEc:aph:ajpbhl:1982:72:1:89-90_0 Template-Type: ReDIF-Article 1.0 Title: Advice on administering vaccines. Journal: American Journal of Public Health Author-Name: Murray, D.L. Year: 1982 Volume: 72 Issue: 1 Pages: 92-93 Handle: RePEc:aph:ajpbhl:1982:72:1:92-93_8 Template-Type: ReDIF-Article 1.0 Title: On the distribution of underlying causes of death Journal: American Journal of Public Health Author-Name: Gittelsohn, A.M. Year: 1982 Volume: 72 Issue: 2 Pages: 133-140 DOI: 10.2105/AJPH.72.2.133 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.133 Abstract: The feasibility of applying surveillance techniques to large health data is being explored through study of a national mortality data base encompassing 21 million United States death records for the period 1968-1978. Through the development of efficient file structures and information recovery techniques, it is possible to pose a series of questions and follow-up questions of the entire data set within budgetary constraints. Initial screening of the mortality data base reveals that major changes have occurred over the 11 years with marked declines for diseases of cardiovascular, respiratory, digestive and renal systems and maternal and perinatal mortality. There is a tendency for increased usage of non-specific terminology. The occurrence of unlikely and unusual causes in the data set is documented and reasons for their inclusion discussed in terms of underlying cause of death logic. Problems in the study of geographic distribution of cause specific mortality are outlined with illustrations of the dispersion of standardized mortality ratios for major causes of death over areas of the country. Clusters of high mortality areas require interpretation in terms of underlying dispersion and possible reporting artifacts arising out of geographic differentials in diagnostic labeling practice. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.133_5 Template-Type: ReDIF-Article 1.0 Title: The decreasing incidence of endometrial cancer: Public health implications Journal: American Journal of Public Health Author-Name: Austin, D.F. Author-Name: Roe, K.M. Year: 1982 Volume: 72 Issue: 1 Pages: 65-68 DOI: 10.2105/AJPH.72.1.65 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.65 Abstract: The incidence of endometrial cancer in the San Francisco area between 1969 and 1979 is compared to trends in estrogen sales and prescriptions. Both estrogen use and endometrial cancer incidence increased steadily until 1975 and then decreased significantly. The data support the previously documented association between endometrial cancer and estrogen use, but suggest that short-term usage may carry only slightly increased risk which can be eliminated entirely upon termination of therapy. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.65_0 Template-Type: ReDIF-Article 1.0 Title: Refugees, immigrants, and the public health Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1982 Volume: 72 Issue: 1 Pages: 12-14 DOI: 10.2105/AJPH.72.1.12 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.12 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.12_6 Template-Type: ReDIF-Article 1.0 Title: Education and counseling in hospital care Journal: American Journal of Public Health Author-Name: Westermayer, J. Year: 1982 Volume: 72 Issue: 2 Pages: 127-128 Handle: RePEc:aph:ajpbhl:1982:72:2:127-128_1 Template-Type: ReDIF-Article 1.0 Title: The recent trend in milk feeding among WIC infants Journal: American Journal of Public Health Author-Name: Martinez, G.A. Author-Name: Stahle, D.A. Year: 1982 Volume: 72 Issue: 1 Pages: 68-71 DOI: 10.2105/AJPH.72.1.68 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.68 Abstract: The type of milk fed infants from birth to six months of age was ascertained by quarterly surveys of a national sample of births. WIC (Women, Infants and Children Program) participants were identified from this sample, and trend data indicate that an increased percentage of WIC mothers are choosing to breastfeed their infants. Infant formula use has declined in the early months of life, but increased at the expense of cow's milk toward the middle of the first year. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.68_4 Template-Type: ReDIF-Article 1.0 Title: Improving the precision of clinical trials Journal: American Journal of Public Health Author-Name: Mosteller, F. Year: 1982 Volume: 72 Issue: 5 Pages: 430 Handle: RePEc:aph:ajpbhl:1982:72:5:430_9 Template-Type: ReDIF-Article 1.0 Title: The effects of psychological intervention on recovery from surgery and heart attacks: An analysis of the literature Journal: American Journal of Public Health Author-Name: Mumford, E. Author-Name: Schlesinger, H.J. Author-Name: Glass, G.V. Year: 1982 Volume: 72 Issue: 2 Pages: 141-151 Abstract: A quantitative review of 34 controlled studies demonstrates that, on the average, surgical or coronary patients who are provided information or emotional support to help them master the medical crisis do better than patients who receive only ordinary care. A review of 13 studies that used hospital days post-surgery or post-heart attack as outcome indicators showed that on the average psychological intervention reduced hospitalization approximately two days below the control group's average of 9.92 days. Most of the interventions were modest and, in most studies, were not matched in any way to the needs of particular patients or their coping styles. Beyond the intrinsic value of offering humane and considerate care, the evidence is that psychological care can be cost-effective. Handle: RePEc:aph:ajpbhl:1982:72:2:141-151_2 Template-Type: ReDIF-Article 1.0 Title: Theory and action for health promotion: Illustrations from the North Karelia project Journal: American Journal of Public Health Author-Name: McAlister, A. Author-Name: Puska, P. Author-Name: Salonen, J.T. Author-Name: Tuomilehto, J. Author-Name: Koskela, K. Year: 1982 Volume: 72 Issue: 1 Pages: 43-50 DOI: 10.2105/AJPH.72.1.43 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.43 Abstract: The North Karelia Project in Finland illustrates the fundamental goals of health promotion. Specific activities of the project serve as examples of how concepts from the social and behavioral sciences can be applied to achieve estimated reductions in predicted risk of disease. The results in North Karelia are not conclusive, but they are encouraging, and the investigation conducted there is an essential reference for future research in health promotion and disease prevention. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.43_9 Template-Type: ReDIF-Article 1.0 Title: Demographic trends in tubal sterilization: United States, 1970-1978 Journal: American Journal of Public Health Author-Name: DeStefano, F. Author-Name: Greenspan, J.R. Author-Name: Ory, H.W. Author-Name: Peterson, H.B. Author-Name: Maze, J.M. Author-Name: Smith, J.C. Year: 1982 Volume: 72 Issue: 5 Pages: 480-484 DOI: 10.2105/AJPH.72.5.480 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.480 Abstract: In the period 1970-1978, an estimated 4,236,000 women 15-44 years of age had tubal sterilization operations in United States hospitals. Both the number and the rate of tubal sterilizations increased each year from 1970-1977, but in 1978 both declined. Tubal sterilization rates for Black women were higher than for White women. Black women also tended to be younger at the time of tubal sterilization. For the nation as a whole, the mean age at the time of tubal sterilization remained constant at about 30 with the youngest age group having the highest proportion of never-married women. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.480_3 Template-Type: ReDIF-Article 1.0 Title: Some lessons from the North Karelia project Journal: American Journal of Public Health Author-Name: Klos, D.M. Author-Name: Rosenstock, I.M. Year: 1982 Volume: 72 Issue: 1 Pages: 53-54 DOI: 10.2105/AJPH.72.1.53 File-URL: http://hdl.handle.net/10.2105/AJPH.72.1.53 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.1.53_4 Template-Type: ReDIF-Article 1.0 Title: A national study on professional preparation in patient education Journal: American Journal of Public Health Author-Name: Pigg Jr., R.M. Year: 1982 Volume: 72 Issue: 2 (180-182 Pages: DOI: 10.2105/AJPH.72.2.180 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.180 Abstract: During the 1980-1981 academic year, 249 academic institutions were surveyed concerning professional preparation in patient education. Various degress of involvement were reported by 39 institutions. Findings indicate that such programs are relatively new, and enrollment in degree programs and courses is limited. Placement of program graduates was termed excellent; especially in public hospitals, private hospitals, and clinics. Part-time teaching faculty are utilized extensively, while some faculty lack either formal preparation or clinical experience in patient education. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.180_6 Template-Type: ReDIF-Article 1.0 Title: Transformation in defeat: The changing objectives of National Health Insurance, 1915-1980 Journal: American Journal of Public Health Author-Name: Starr, P. Year: 1982 Volume: 72 Issue: 1 Pages: 78-88 Handle: RePEc:aph:ajpbhl:1982:72:1:78-88_5 Template-Type: ReDIF-Article 1.0 Title: The continued vitality of vital statistics Journal: American Journal of Public Health Author-Name: Kleinman, J.C. Year: 1982 Volume: 72 Issue: 2 Pages: 125-127 DOI: 10.2105/AJPH.72.2.125 File-URL: http://hdl.handle.net/10.2105/AJPH.72.2.125 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.2.125_3 Template-Type: ReDIF-Article 1.0 Title: Gastrointestinal illness on passenger cruise ships, 1975-1978 Journal: American Journal of Public Health Author-Name: Dannenberg, A.L. Author-Name: Yashuk, J.C. Author-Name: Feldman, R.A. Year: 1982 Volume: 72 Issue: 5 Pages: 484-488 DOI: 10.2105/AJPH.72.5.484 File-URL: http://hdl.handle.net/10.2105/AJPH.72.5.484 Abstract: Following investigations in 1972-1973 of outbreaks of enteric disease on cruise ships using American ports, a surveillance system was established which required that 24 hours before arrival in port, each ship report the number of persons with diarrheal illness seen by the ship's physician during the cruise. The reported data were found to be reliable; they established a baseline incidence for diarrhea on cruise ships. A significantly high portion of enteric disease outbreaks occurred on vessels that did not pass routine annula or semiannual sanitation inspections. The cruise ship sanitation program, developed with the cooperation of the cruise ship industry and the Centers for Disease Control, appears to have been successful in reducing the overall rate of cruise ship associated outbreaks of enteric illness. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.72.5.484_6 Template-Type: ReDIF-Article 1.0 Title: Tap water burns. Journal: American Journal of Public Health Author-Name: Stanwick, R.S. Year: 1981 Volume: 71 Issue: 12 Pages: 1408 Handle: RePEc:aph:ajpbhl:1981:71:12:1408_0 Template-Type: ReDIF-Article 1.0 Title: Monitoring referrals in VD cases. Journal: American Journal of Public Health Author-Name: Wiesner, P.J. Year: 1981 Volume: 71 Issue: 12 Pages: 1410-1411 Handle: RePEc:aph:ajpbhl:1981:71:12:1410-1411_5 Template-Type: ReDIF-Article 1.0 Title: Microbial sampling variables and recreational water quality standards ( Lake Erie). Journal: American Journal of Public Health Author-Name: Brenniman, G.R. Author-Name: Rosenberg, S.H. Author-Name: Northrop, R.L. Year: 1981 Volume: 71 Issue: Pages: 283-289 Abstract: Examined 2 beaches on Lake Erie to evaluate the water sampling design for the collection of several microbiological indicator organisms in relation to day, time, and location of collection. -from US Govt Reports Announcements, 18, 1981 Handle: RePEc:aph:ajpbhl:1981:71::283-289_1 Template-Type: ReDIF-Article 1.0 Title: Asbestos workers and lung cancer Journal: American Journal of Public Health Author-Name: Kristein, M.M. Year: 1981 Volume: 71 Issue: 12 Pages: 1409 Handle: RePEc:aph:ajpbhl:1981:71:12:1409_4 Template-Type: ReDIF-Article 1.0 Title: Issues surrounding genetic screening programs. Journal: American Journal of Public Health Author-Name: Wyatt, P.R. Year: 1981 Volume: 71 Issue: 12 Pages: 1411 Handle: RePEc:aph:ajpbhl:1981:71:12:1411_4 Template-Type: ReDIF-Article 1.0 Title: Incidence of congenital anomalies among Black and White live births with long-term follow-up Journal: American Journal of Public Health Author-Name: Christianson, R.E. Author-Name: Van Den Berg, B.J. Author-Name: Milkovich, L. Author-Name: Oechsli, F.W. Year: 1981 Volume: 71 Issue: 12 Pages: 1333-1341 Abstract: The incidence of congenital anomalies at birth and accumulated to age five years is presented for live-born children in a large prospective study. Congenital anomalies are not all diagnosable at birth; our data demonstrate that the incidence rate increases approximately three-and-one-halffold for Blacks and fivefold for Whites between six days of age and five years of age. The incidence of congenital anomalies at birth was higher among Black children than White children, but there were no notable differences between the groups in incidence accumulated to age five years. At five years, the incidence rate of severe and moderate (but not trivial) congenital anomalies amounted to 15%; for severe congenital anomalies, 4%. Severe congenital anomalies diagnosed through age five years were observed to have a much higher incidence among children who weighed 2,500 gm or less at birth than among those who were heavier. Handle: RePEc:aph:ajpbhl:1981:71:12:1333-1341_9 Template-Type: ReDIF-Article 1.0 Title: Mass screening for skin cancer. Journal: American Journal of Public Health Author-Name: Tennant Jr., F.S. Year: 1981 Volume: 71 Issue: 10 Pages: 1172-1173 Handle: RePEc:aph:ajpbhl:1981:71:10:1172-1173_1 Template-Type: ReDIF-Article 1.0 Title: Assessing the value of negative associations. Journal: American Journal of Public Health Author-Name: Massey, R.M. Year: 1981 Volume: 71 Issue: 8 Pages: 860 Handle: RePEc:aph:ajpbhl:1981:71:8:860_9 Template-Type: ReDIF-Article 1.0 Title: Modifying snow shoveling behaviors in an urban area. Journal: American Journal of Public Health Author-Name: Jason, L.A. Year: 1981 Volume: 71 Issue: 8 Pages: 861 Handle: RePEc:aph:ajpbhl:1981:71:8:861_6 Template-Type: ReDIF-Article 1.0 Title: Should we educate for motorcycle safety helmet use? Journal: American Journal of Public Health Author-Name: Allegrante, J.P. Year: 1981 Volume: 71 Issue: 8 Pages: 859 Handle: RePEc:aph:ajpbhl:1981:71:8:859_9 Template-Type: ReDIF-Article 1.0 Title: Smokers eat more, weigh less than nonsmokers. Journal: American Journal of Public Health Author-Name: Jacobs Jr., D.R. Year: 1981 Volume: 71 Issue: 8 Pages: 859-860 Handle: RePEc:aph:ajpbhl:1981:71:8:859-860_5 Template-Type: ReDIF-Article 1.0 Title: The influence of patient-practitioner agreement on outcome of care Journal: American Journal of Public Health Author-Name: Starfield, B. Author-Name: Wray, C. Author-Name: Hess, K. Author-Name: Gross, R. Author-Name: Birk, P.S. Author-Name: D'Lugoff, B.C. Year: 1981 Volume: 71 Issue: 2 Pages: 127-132 Abstract: A previous study suggested that patient-practitioner agreement and follow-up in ambulatory care facilities problem resolution as judged by patients. In this study in another medical practice, practitioner-patient agreement on what problems required follow-up was associated with greater problem resolution as judged by the practitioners regardless of the severity of the problems. In this study, patients did not judge problems mentioned only by themselves to be less improved than problems mentioned by both them and their practitioners. However, in this study more of the problems mentioned only by patients were mentioned in the note of the visit contained in the medical record. Patients expected less and reported less improvement of problems that were neither mentioned by the practitioner nor written in the medical record than was the case for problems listed both by patients and practitioners. The findings of this study confirm those of the previous study in suggesting that practitioner-patient agreement about problems is associated with greater expectations for improvement and with better outcome as perceived by patients. In addition, they indicate that practitioners also report better outcome under the same circumstances. Handle: RePEc:aph:ajpbhl:1981:71:2:127-132_0 Template-Type: ReDIF-Article 1.0 Title: Estrogen benefits outweight risks. Journal: American Journal of Public Health Author-Name: Gordan, G.S. Author-Name: Vaughan, C. Year: 1981 Volume: 71 Issue: 3 Pages: 320-321 Handle: RePEc:aph:ajpbhl:1981:71:3:320-321_0 Template-Type: ReDIF-Article 1.0 Title: HSAs: a partnership in long-term care. Journal: American Journal of Public Health Author-Name: Katz, A. Year: 1981 Volume: 71 Issue: 3 Pages: 315-316 Handle: RePEc:aph:ajpbhl:1981:71:3:315-316_0 Template-Type: ReDIF-Article 1.0 Title: SIDS: increased risk to second born twins. Journal: American Journal of Public Health Author-Name: Getts, A. Year: 1981 Volume: 71 Issue: 3 Pages: 317-318 Handle: RePEc:aph:ajpbhl:1981:71:3:317-318_7 Template-Type: ReDIF-Article 1.0 Title: The challenge of change. The 1980 presidential address. Journal: American Journal of Public Health Author-Name: Christmas, J.J. Year: 1981 Volume: 71 Issue: 3 Pages: 235-241 Handle: RePEc:aph:ajpbhl:1981:71:3:235-241_9 Template-Type: ReDIF-Article 1.0 Title: Variance and Reliability in estimates of OC use. Journal: American Journal of Public Health Author-Name: Hendershot, G.E. Author-Name: Mosher, W.D. Year: 1981 Volume: 71 Issue: 3 Pages: 316-317 Handle: RePEc:aph:ajpbhl:1981:71:3:316-317_5 Template-Type: ReDIF-Article 1.0 Title: Does the doctor understand what I am asking? Journal: American Journal of Public Health Author-Name: Catlin, R.J. Year: 1981 Volume: 71 Issue: 2 Pages: 122-123 Handle: RePEc:aph:ajpbhl:1981:71:2:122-123_4 Template-Type: ReDIF-Article 1.0 Title: A state view of local health departments. Journal: American Journal of Public Health Author-Name: Pickett, G.E. Year: 1981 Volume: 71 Issue: S1 Pages: 84-85 Handle: RePEc:aph:ajpbhl:1981:71:S1:84-85_6 Template-Type: ReDIF-Article 1.0 Title: Isolation of N. meningitidis from patients in a gonorrhea screening program: A four-year survey in New York City Journal: American Journal of Public Health Author-Name: Faur, Y.C. Author-Name: Wilson, M.E. Author-Name: May, P.S. Year: 1981 Volume: 71 Issue: 1 Pages: 53-58 Abstract: In the course of the screening program for gonorrhea in New York City, a total of 964 N. meningitidis strains were recovered from the genitourinary tract and/or anal canal over a four-year period (April 1975-April 1979), the rate of such recoveries having tripled during this time. The majority of strains were isolated from anal canal cultures of male patients most of whom were seen in a clinic treating homosexuals. N. meningitidis and N. gonorrhoeae were cultured together from 41 patients: in 24 cases from different sites and in 17 instances from the same specimen. Evidence of clinically significant N. meningitidis involvement of genitourinary sites was obtained in a number of cases of urethritis and proctitis as well as in three instances of epidemiologically linked cases. The rising frequency of N. meningitidis isolations from these sites, with its potential clinical implications, should alert microbiologists, clinicians, and epidemiologists to the need for careful distinction of meningococcal from gonorrheal infection, particularly among homosexual men. Handle: RePEc:aph:ajpbhl:1981:71:1:53-58_4 Template-Type: ReDIF-Article 1.0 Title: Closed-claims data for malpractice actions in the United States Journal: American Journal of Public Health Author-Name: Curran, W.J. Year: 1981 Volume: 71 Issue: 9 Pages: 1066-1067 DOI: 10.2105/AJPH.71.9.1066 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1066 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1066_1 Template-Type: ReDIF-Article 1.0 Title: High and low surgical rates: Risk factors for area residents Journal: American Journal of Public Health Author-Name: Roos, N.P. Author-Name: Roos, L.L. Year: 1981 Volume: 71 Issue: 6 Pages: 591-600 DOI: 10.2105/AJPH.71.6.591 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.591 Abstract: Patterns of surgical practice, the type of operations performed, and risk characteristics of elderly patients brought to surgery are examined in areas with differing surgical rates. This population-based analysis covering Manitoba's 56 rural hospital areas uses discharge claims filed routinely with the provincial Health Services Commission. One and a half times as much surgery was performed in high rate areas (115.2 procedures per 1,000 elderly) as in low rate areas (74.7 procedures/1,000). Since surgical case mix varied little between high and low rate areas, the rate variation means that place of residence strongly influences exposure to major surgical procedures. In similar fashion, the proportion of surgical cases classified as high-risk does not vary with the surgical rate. High risk patients resident in high surgical rate areas are more likely to come to surgery than are their counterparts in low rate areas. Further analyses of nonsurgical hospitalization, of three common elective procedures, and of area characteristics were carried out. The surgical selection process, not characteristics of the population residing in the area, appears to determine the rate at which high and low risk patients come to surgery. Our research clearly suggests that high surgical rates carry with them the risk of excess surgical deaths. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.591_4 Template-Type: ReDIF-Article 1.0 Title: Fluoridation: Strategies for success Journal: American Journal of Public Health Author-Name: Isman, R. Year: 1981 Volume: 71 Issue: 7 Pages: 717-721 DOI: 10.2105/AJPH.71.7.717 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.717 Abstract: Of 19 referenda on community water fluoridation held in the first 6 months of 1980, 17 were defeated. Among the postulated reasons are a growing distrust of government and the health establishment. The public remains largely ignorant of the purpose and benefits of fluoridation. The emotionalism surrounding the issue has made it difficult to generate public support outside of the health profession. Opponents have also learned to fight fluoridation with increasingly sophisticated techniques. Some of the strategies used in recent successful campaigns in Oakland, California, and Portland, Oregon are described; recommendations that can be applied to communities considering fluoridation include careful wording of ballot measures so they are unquivocally clear and simple; timing ballot measures with elections likely to draw the largest voter turnout; broadening the base of political and financial support; using a figurehead if possible; and making maximum use of the media. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.717_9 Template-Type: ReDIF-Article 1.0 Title: National health insurance - Always just around the corner? Journal: American Journal of Public Health Author-Name: Schroeder, S.A. Year: 1981 Volume: 71 Issue: 10 Pages: 1101-1103 DOI: 10.2105/AJPH.71.10.1101 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1101 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1101_6 Template-Type: ReDIF-Article 1.0 Title: Repeal of mandated premarital tests for syphilis: A survey of state health officers Journal: American Journal of Public Health Author-Name: Felman, Y.M. Year: 1981 Volume: 71 Issue: 2 Pages: 155-159 DOI: 10.2105/AJPH.71.2.155 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.155 Abstract: Statistics on the mandated premarital tests for syphilis (PMSTs) in the United States for the year 1978 were analyzed to determine whether this program is epidemiologically and economically effective. Overall close to four million PMSTs contributed 1.27 per cent of the tests found positive for infectious syphilis in the 44 states where PMSTs are mandated. Of all mandated PMSTs, only one in 8,461 was positive for infectious syphilis. In a companion study, venereal disease control officers were canvassed for their opinions regarding the retention or abolition of the mandatory tests. Out of 44 states which mandated tests, only 13 respondents favored retention while 31 found the program unsatisfactory, preferred abolition or changes, or were undecided. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.155_1 Template-Type: ReDIF-Article 1.0 Title: Effects of restricted public funding for legal abortions: A second look Journal: American Journal of Public Health Author-Name: Selik, R.M. Author-Name: Cates Jr., W. Author-Name: Tyler Jr., C.W. Year: 1981 Volume: 71 Issue: 1 Pages: 77-81 DOI: 10.2105/AJPH.71.1.77 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.77 Abstract: At hospitals in three cities where public funding for legal abortions had been restricted, the authors interviewed the records of women with complications of all types of abortions. They compared the number of complications in the year before funding restriction with the number in the following year, during restriction. For complications of illegal and spontaneous abortions, they found no significant change in either the number and proportion of publicly funded hospitalizations. For complications of legal abortions, they found a decrease in both the number and proportion of publicly funded hospitalizations. For poor women, it appears that restriction of public funding for legal abortions has not markedly increased the number of illegal abortions, but has reduced the number of legal abortions, especially those at later gestational ages, which would have cost more and been at greater risk of complications. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.77_4 Template-Type: ReDIF-Article 1.0 Title: Increasing utilization of a rural cervical cancer detection program Journal: American Journal of Public Health Author-Name: Windsor, R.A. Author-Name: Kronenfeld, J.J. Author-Name: Cain, M.G. Author-Name: Cutter, G.R. Author-Name: Goodson, L.A. Author-Name: Edwards, E. Year: 1981 Volume: 71 Issue: 6 Pages: 641-643 DOI: 10.2105/AJPH.71.6.641 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.641 Abstract: The Alabama Department of Public Health established, in 1973, a Cancer Screening Program (CSP). Although 66,000 women have been screened, many rural females had never used the program. After a community health organization education effort was introduced into a target rural county, an examination of CSP new user data for two intervention quarters revealed 345 and 150 per cent increases, respectively, in the pattern of use. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.641_7 Template-Type: ReDIF-Article 1.0 Title: The advent of human diploid cell rabies vaccine: Impact on vaccine utilization in New Mexico Journal: American Journal of Public Health Author-Name: Mann, J.M. Author-Name: Hoffman, R.E. Author-Name: Rollag, O.J. Author-Name: Bartol, L. Author-Name: Burkhart, M.J. Year: 1981 Volume: 71 Issue: 4 Pages: 423-424 DOI: 10.2105/AJPH.71.4.423 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.423 Abstract: Three months' experience with the newly licensed human diploid cell rabies vaccine in the New Mexico comprehensive consultation-biologics system was reviewed. Comparison with the same period in 1978 and 1979 showed no increase in vaccine utilization despite the advent of this simpler-to-use, safer rabies vaccine. Anti-rabies treatments appear to be minimally influenced by new vaccine technology when a comprehensive consultation system is available to support and guide the private physician. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.423_6 Template-Type: ReDIF-Article 1.0 Title: The quality and utility of death certificate data Journal: American Journal of Public Health Author-Name: Glasser, J.H. Year: 1981 Volume: 71 Issue: 3 Pages: 231-233 DOI: 10.2105/AJPH.71.3.231 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.231 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.231_0 Template-Type: ReDIF-Article 1.0 Title: Planning and budgeting in the Crippled Children's sector through goal programming Journal: American Journal of Public Health Author-Name: Joiner, C. Author-Name: Drake, A.E. Year: 1981 Volume: 71 Issue: 9 Pages: 1012-1015 DOI: 10.2105/AJPH.71.9.1012 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1012 Abstract: This article describes how the goal programming methodology was applied to a state level Crippled Children's Program. The various organizational goals are incorporated into the programming model to indicate the trade-offs associated with the resource allocation process. Alternative allocations are presented in terms of a 'what if' approach to programming. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1012_7 Template-Type: ReDIF-Article 1.0 Title: Diffusion of new medical information Journal: American Journal of Public Health Author-Name: Kessner, D.M. Year: 1981 Volume: 71 Issue: 4 Pages: 367-368 DOI: 10.2105/AJPH.71.4.367 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.367 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.367_8 Template-Type: ReDIF-Article 1.0 Title: Freedom and protection: A balancing of interests Journal: American Journal of Public Health Author-Name: Baker, S.P. Author-Name: Teret, S.P. Year: 1981 Volume: 71 Issue: 3 Pages: 295-297 DOI: 10.2105/AJPH.71.3.295 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.295 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.295_8 Template-Type: ReDIF-Article 1.0 Title: Occurrence of enteroviruses in community swimming pools Journal: American Journal of Public Health Author-Name: Keswick, B.H. Author-Name: Gerba, C.P. Author-Name: Goyal, S.M. Year: 1981 Volume: 71 Issue: 9 Pages: 1026-1030 DOI: 10.2105/AJPH.71.9.1026 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1026 Abstract: Municipal swimming pools and wading pools were examined for the presence of human enteric viruses using a portable virus concentrator at the site to concentrate viruses from 100-gallon to 500-gallon samples. Ten of 14 samples contained viruses; three of these were positive for virus in the presence of residual free chlorine. Enteroviruses were isolated from two pools which exceeded the 0.4 ppm free residual chlorine standard. This study appears to be supportive of recent evidence that indicates a higher incidence of enterovirus infection among bathers. All seven wading pool samples contained virus. Coxsackieviruses B3 and B4, poliovirus 1, and echovirus 7 were isolated. Total coliform bacteria were not adequate indicators of the presence of virus, as six of the samples were positive for virus but negative for coliforms. Total plate counts appeared to provide a better indication of the sanitary quality of the pool water, but viruses could still be detected in samples that met currently recommended bacterial levels. It is possible that swimming and wading pools may serve as a means of transmission of enteroviral disease, especially in children, during summer months. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1026_9 Template-Type: ReDIF-Article 1.0 Title: Modifying dog litter in urban communities Journal: American Journal of Public Health Author-Name: Jason, L.A. Author-Name: Zolik, E.S. Year: 1981 Volume: 71 Issue: 7 Pages: 746-747 DOI: 10.2105/AJPH.71.7.746 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.746 Abstract: Dog litter not only damages the esthetic quality of a community but also poses a serious health problem. The present paper summarizes a series of projects which were designed to ameliorate this litter problem. Two studies indicated that surrounding specific target areas with posts connected by string effectively eliminated dog droppings. Two other studies, which focused on prompting dog owners to pick up their dogs' droppings, also brought about considerable reductions in dog litter. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.746_4 Template-Type: ReDIF-Article 1.0 Title: The role of the skill-trained volunteer in international public health: Peace Corps' health programming and health policy in developing countries Journal: American Journal of Public Health Author-Name: King, M.E. Year: 1981 Volume: 71 Issue: 4 Pages: 408-409 DOI: 10.2105/AJPH.71.4.408 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.408 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.408_8 Template-Type: ReDIF-Article 1.0 Title: Why do high surgery rates raise case fatality rates? Journal: American Journal of Public Health Author-Name: Peterson, O.L. Year: 1981 Volume: 71 Issue: 6 Pages: 574-576 DOI: 10.2105/AJPH.71.6.574 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.574 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.574_4 Template-Type: ReDIF-Article 1.0 Title: Mental health primary prevention: The role of parent mutual support groups Journal: American Journal of Public Health Author-Name: Kagey, J.R. Author-Name: Vivace, J. Author-Name: Lutz, W. Year: 1981 Volume: 71 Issue: 2 Pages: 166-167 DOI: 10.2105/AJPH.71.2.166 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.166 Abstract: A primary prevention program was developed to provide supportive services for parents of newborns. Ninety-eight parents responded to a survey intended to evaluate what the groups provided and to describe characteristics of parents who attended the groups. Parents evaluated the groups as effective in providing social contact, supporting the parenting role, feeling less alone, understanding children's development, and increasing child-caring skills. The parents did not evaluate the groups as helping to improve a relationship with their spouse. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.166_3 Template-Type: ReDIF-Article 1.0 Title: The role of city government in personal health services. Journal: American Journal of Public Health Author-Name: Millman, M. Year: 1981 Volume: 71 Issue: S1 Pages: 47-57 Handle: RePEc:aph:ajpbhl:1981:71:S1:47-57_5 Template-Type: ReDIF-Article 1.0 Title: A federal view of local health departments. Journal: American Journal of Public Health Author-Name: McGinnis, J.M. Year: 1981 Volume: 71 Issue: S1 Pages: 83-84 Handle: RePEc:aph:ajpbhl:1981:71:S1:83-84_0 Template-Type: ReDIF-Article 1.0 Title: Comparison of body proportions of one-year-old Mexican-American and Anglo children Journal: American Journal of Public Health Author-Name: Kautz, L. Author-Name: Harrison, G.G. Year: 1981 Volume: 71 Issue: 3 Pages: 280-282 DOI: 10.2105/AJPH.71.3.280 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.280 Abstract: The body proportions of 95 Anglo and Mexican-American children aged 48-56 weeks in the Women, Infants, and Children (WIC) Special Supplemental Food Program were determined by use of multiple anthropometric measurements. Ethnic differences were several and collectively define the Mexican-American child as being greater in weight-for-length than the Anglo child with greater chest and thigh circumferences, subscapular skinfolds, and estimated body fat. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.280_3 Template-Type: ReDIF-Article 1.0 Title: Foreign-born persons with tuberculosis in the United States Journal: American Journal of Public Health Author-Name: Powell, K.E. Author-Name: Meador, M.P. Author-Name: Farer, L.S. Year: 1981 Volume: 71 Issue: 11 Pages: 1223-1227 DOI: 10.2105/AJPH.71.11.1223 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1223 Abstract: Two recent surveys of selected states and cities suggest that foreign-born persons account for approximately 15 per cent of the new cases of tuberculosis reported annually in the areas surveyed. In both surveys the largest number of foreign-born persons came from the Western Hemisphere, the next largest from Asia. The largest number of foreign-born persons with tuberculosis are in the 15-29 year age group, presumably because most entering aliens are in this age group. Among persons with tuberculosis, a larger per cent of foreign-born patients have extrapulmonary disease than do native-born patients. About 50 per cent of the foreign-born persons with tuberculosis entered the United States within the five years prior to onset of disease. Within the United States, significant inter-area variation exists in the proportion of persons with tuberculosis who are foreign-born and in the countries of origin of these persons. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1223_4 Template-Type: ReDIF-Article 1.0 Title: Physician-delivered births in Washington State, 1978: Geographic patterns Journal: American Journal of Public Health Author-Name: Starzyk, P.M. Year: 1981 Volume: 71 Issue: 9 Pages: 1063-1065 DOI: 10.2105/AJPH.71.9.1063 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1063 Abstract: Linkage of birth certificate and physician survey data was used to analyze characteristics of physicians attending deliveries in Washington State in 1978. This analysis revealed substantial differences in attendant characteristics between rural and urban areas. The more urban areas were characterized by a higher proportion of births delivered by obstetrical specialists and a higher average number of births/physician. These results are briefly discussed in terms of supply and accessibility of physicians in several different rural-urban classifications. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1063_7 Template-Type: ReDIF-Article 1.0 Title: Second consultant opinion for elective orthopedic surgery Journal: American Journal of Public Health Author-Name: McCarthy, E.G. Author-Name: Finkel, M.L. Year: 1981 Volume: 71 Issue: 11 Pages: 1233-1236 DOI: 10.2105/AJPH.71.11.1233 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1233 Abstract: We abstracted records of 369 patients whose recommendations for elective orthopedic surgery were not confirmed by a second opinion consultant. Six months or more after the initial recommendation for surgery, 82 per cent had not had the operation performed, irrespective of the diagnosis and the characteristics of the physician recommending surgery. Reasons for consultant non-confirmation included: use of a cast, brace, or corrective footwear preferable (26.3 per cent), symptoms not severe enough (18.4 per cent), and physical therapy/exercises preferable (17.8 per cent). Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1233_9 Template-Type: ReDIF-Article 1.0 Title: Hypertension in health care providers: Effectiveness of worksite treatment programs in a state mental health agency Journal: American Journal of Public Health Author-Name: Baer, L. Author-Name: Parchment, Y. Author-Name: Kneeshaw, M. Year: 1981 Volume: 71 Issue: 11 Pages: 1261-1263 DOI: 10.2105/AJPH.71.11.1261 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1261 Abstract: Twenty-seven per cent of 6,785 employees of the Office of Mental Health, New York State, had blood pressure ≥ 140/90; 66 per cent were previously known hypertensives. Treatment of hypertension was initiated at three worksites by a nurse-physician team using a stepped-care drug protocol. Of 232 patients under treatment, 67 per cent (156) have diastolic blood pressure controlled to less than 95 mmHg. Mean length of follow-up at the first established worksite was 3.7 ± 0.4 years and at all three worksites 13.5 months. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1261_3 Template-Type: ReDIF-Article 1.0 Title: Alcohol availability and cirrhosis mortality rates by gender and race Journal: American Journal of Public Health Author-Name: Colon, I. Year: 1981 Volume: 71 Issue: 12 Pages: 1325-1328 DOI: 10.2105/AJPH.71.12.1325 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1325 Abstract: This study tests whether the availability of alcoholic beverages is a simple integrated dimension as implied by certain policy models and in its treatment by researchers. Factor analysis reveals two independent availability factors: on-premise and retail availability. A correlation analysis found that on-premise availability was related to cirrhosis mortality rates for the total population, White males, non-White males, and White females. It was not related to non-White female cirrhosis mortality. In contrast, retail availability was not related to any of cirrhosis mortality rates. Examination of the states with extremes of high and low on-premise availability indicates that this type of availability is not a manipulable control variable but an index of extant norms toward drinking. It is recommended that differential prevention strategies be adopted rather than a uniform policy prevention model. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1325_1 Template-Type: ReDIF-Article 1.0 Title: The Framingham Disability Study: I. Social disability among the aging Journal: American Journal of Public Health Author-Name: Branch, L.G. Author-Name: Jette, A.M. Year: 1981 Volume: 71 Issue: 11 Pages: 1202-1210 DOI: 10.2105/AJPH.71.11.1202 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1202 Abstract: The Framingham Disability Study (FDS), a recent component of the Heart Disease Epidemiological Study in Framingham, Massachusetts, was designed to investigate the nature and magnitude of disability among non-institutionalized aging adults. From September 1976, through November 1978, 2,654 individuals aged 55 to 84 years from the original cohort were interviewed in person or by telephone (94 per cent of the potential participant pool). This paper reports results on the prevalence of social disability in five areas: housekeeping, transportation, social interaction, food preparation, and grocery shopping. Only 6 per cent of the sample have existing unmet needs in one or more of these five areas. The magnitude of social disability increases with advancing age. Women, in general, report a higher degree of unmet social needs than men. These findings are compared with other epidemiological investigations of social disability among the elderly. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1202_6 Template-Type: ReDIF-Article 1.0 Title: Enhancement of high risk children's utilization of dental services Journal: American Journal of Public Health Author-Name: Olson, D.G. Author-Name: Levy, R.L. Author-Name: Evans Jr., C.A. Author-Name: Olson, S.K. Year: 1981 Volume: 71 Issue: 6 Pages: 631-634 DOI: 10.2105/AJPH.71.6.631 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.631 Abstract: One hundred twenty-four children identified as needing care in two elementary schools by a routine department of public health screening were randomly assigned to either a standard treatment group (notification to parents by a form letter) or an experimental group that added personal contact to the standard treatment. Overall, 53 per cent of the subjects in the experimental condition who needed treatment at the initial screening had received this treatment at follow-up, while only 12 per cent of the subjects in the control group had received needed treatment. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.631_1 Template-Type: ReDIF-Article 1.0 Title: Tuberculosis and the health worker Journal: American Journal of Public Health Author-Name: Farer, L.S. Author-Name: Atkinson, M.L. Year: 1981 Volume: 71 Issue: 11 Pages: 1200-1201 DOI: 10.2105/AJPH.71.11.1200 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1200 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1200_7 Template-Type: ReDIF-Article 1.0 Title: The impact of the accident at the Three Mile Island on the behavior and well-being of nuclear workers. Part II: Job tension, psychophysiological symptoms, and indices of distress Journal: American Journal of Public Health Author-Name: Kasl, S.V. Author-Name: Chisholm, R.F. Author-Name: Eskenazi, B. Year: 1981 Volume: 71 Issue: 5 Pages: 484-495 DOI: 10.2105/AJPH.71.5.484 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.484 Abstract: TMI workers experienced much greater job tension and lower occupational self-esteem (supervisors only). At the time of the accident, TMI workers reported experiencing more periods of anger, extreme worry and extreme upset, and more psychophysiological symptoms. Six months after the accident, some persistence of these feelings and symptoms was evident. Demoralization was greater primarily among TMI non-supervisory workers. The impact of the accident was not greater among TMI workers living closer to the plant. Presence of a preschool child at home enhanced the impact of the accident, but primarily among TMI supervisors. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.484_3 Template-Type: ReDIF-Article 1.0 Title: Rh hemolytic disease of the newborn: Using incidence observations to evaluate the use of Rh immune globulin Journal: American Journal of Public Health Author-Name: Adams, M.M. Author-Name: Marks, J.S. Author-Name: Gustafson, J. Author-Name: Oakley Jr., G.P. Year: 1981 Volume: 71 Issue: 9 Pages: 1031-1035 DOI: 10.2105/AJPH.71.9.1031 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1031 Abstract: During the 1970s, the crude incidence of Rh hemolytic disease of the newborn (RhHDN) in the United States dropped 65 per cent - from 40.5/10,000 total births in 1970 to 14.3/10,000 total births in 1979. Since the risk of RhHDN is directly associated with birth order, changes both in birth order-specific RhHDN incidence rates and in the birth order distribution would be expected to influence crude RhHDN incidence. Review of birth order-specific incidences ascertained in Connecticut, 1972-1977, shows that incidence was stable for first and second births, whereas it dropped significantly for third and fourth births. Due to the nearly complete use of Rh immune globulin (RhIG) in Connecticut during these years, the drop in these specific rates is best attributed to this prevention strategy. Nationwide, during the 1970s, the annual percentages of fourth and higher order births decreased from 18 per cent to 10 per cent. We estimate that some 30 per cent to 40 per cent of the 1970-1979 drop in the crude rate is attributed to changes in the birth order distribution, whereas 60 per cent to 70 per cent of the drop is attributed to RhIG. However, comparison of pooled incidences for 1972-1974 and 1975-1977 observed in Connecticut for first births and births to 15-19 year olds showed significant increases for both groups in 1975-1977. Further study of specific trends from other areas is needed to confirm these observations. Also needed is investigation of likely causes of sensitization among these teenaged, primiparous women. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1031_1 Template-Type: ReDIF-Article 1.0 Title: The impact of the accident at the Three Mile Island on the behavior and well-being of nuclear workers. Part I: Perceptions and evaluations, behavioral responses, and work-related attitudes and feelings Journal: American Journal of Public Health Author-Name: Kasl, S.V. Author-Name: Chisholm, R.F. Author-Name: Eskenazi, B. Year: 1981 Volume: 71 Issue: 5 Pages: 472-483 DOI: 10.2105/AJPH.71.5.472 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.472 Abstract: In order to assess the impact of the accident at the Three Mile Island (TMI), telephone interviews were conducted six months later with 324 nuclear workers assigned to TMI and 298 workers assigned to a comparison plant at Peach Bottom (PB). Examination of PB-TMI differences, stratified by supervisory status, revealed the following: Part I: TMI workers reported greater exposure to radiation at the time of the accident and felt that their health had been thereby endangered. TMI workers experienced more uncertainty and conflict at the time of the accident. Coping responses such as seeing a doctor, taking drugs, and increasing alchol consumption were quite infrequent. Leaving the area was more common; however, over 40 per cent of TMI workers wished to leave but did not do so because of work obligations. TMI workers reported much lower job satisfaction and much greater uncertainty about their job future. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.472_9 Template-Type: ReDIF-Article 1.0 Title: Choosing measures of health status for individuals in general populations Journal: American Journal of Public Health Author-Name: Ware Jr., J.E. Author-Name: Brook, R.H. Author-Name: Davies, A.R. Author-Name: Lohr, K.N. Year: 1981 Volume: 71 Issue: 6 Pages: 620-625 DOI: 10.2105/AJPH.71.6.620 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.620 Abstract: This paper offers suggestions to aid the selection of appropriate instruments and data gathering methods for studies that require measures of personal health status applicable in general populations. Before selecting measures, the reason for studying health status must be identified. Next, definitional issues arise when attempting to specify the components of health that are to be studied. Evidence supports restriction of the definition of personal health status to its physical and mental components, rather than including social circumstances as well. In evaluating the suitability of available measures, three features must be considered: 1) practicality in terms of administration, respondent burden, and analysis; 2) reliability in terms of the study design and group or individual comparisons; 3) validity, in terms of providing information about the particular health components of interest to the study. Evaluating validity will be difficult for most available measures; careful attention to item content will be helpful in choosing appropriate measures. Despite problems in development and interpretation, overall health status indicators will prove useful to many studies and should be considered, as should both subjective and objective measures of health status. Given that the reasons to measure health have been identified, the aspects of health to be measured specified, and attention paid to their suitability, appropriate measures may often be found among those now available. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.620_4 Template-Type: ReDIF-Article 1.0 Title: Black attrition in physician assistant training programs Journal: American Journal of Public Health Author-Name: Weiner, T. Author-Name: Schneller, E.S. Year: 1981 Volume: 71 Issue: 4 Pages: 425-427 DOI: 10.2105/AJPH.71.4.425 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.425 Abstract: We report on correlates of attrition for Blacks and Whites in physician's assistant training programs. The data reveal an unusually high rate of attrition for Blacks (65 per cent) and, in particular, for Black males (59 per cent). This latter group, regardless of educational background and other potential predictors of educational success, encounters significant difficulty in the educational process. An understanding of this attrition phenomenon is useful for designing admissions policies which identify a larger percentage of low risk recruits to health professions education. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.425_1 Template-Type: ReDIF-Article 1.0 Title: The paperwork crunch in state public health laboratories Journal: American Journal of Public Health Author-Name: Adcock, D.E. Author-Name: Lawton, H.L. Year: 1981 Volume: 71 Issue: 7 Pages: 748-750 DOI: 10.2105/AJPH.71.7.748 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.748 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.748_2 Template-Type: ReDIF-Article 1.0 Title: How successful is screening for congenital disease of the hip? Journal: American Journal of Public Health Author-Name: Parkin, D.M. Year: 1981 Volume: 71 Issue: 12 Pages: 1378-1383 DOI: 10.2105/AJPH.71.12.1378 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1378 Abstract: The efficacy of neonatal screening for congenital disease of the hip is reviewed in relation to currently accepted criteria. There is poor validity of the tests used, imperfect understanding of the natural history of the condition, and absence of information on the outcome of treatment following screening compared to that following conventional diagnosis. The benefits of screening, although probably real, are therefore difficult to quantify. Strategies for increasing the efficiency of screening (maximizing the benefit:cost ratio) by mass screening after the neonatal period or by instituting routine retesting of all infants are discussed. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1378_0 Template-Type: ReDIF-Article 1.0 Title: Impact of a regional infant dispatch center on neonatal mortality Journal: American Journal of Public Health Author-Name: Vogt, J.F. Author-Name: Chan, L.S. Author-Name: Wu, P.Y.K. Author-Name: Hawes, W.E. Year: 1981 Volume: 71 Issue: 6 Pages: 577-582 DOI: 10.2105/AJPH.71.6.577 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.577 Abstract: In 1976, a regional Infant Medical Dispatch Center (IMDC) was implemented in Southern California to improve the lives and well-being of the critically ill newborn infants by expediting location of beds in neonatal intensive care units. Comparison of birth weight-specific neonatal mortality rates among 701-2000 grams neonates before and after the program showed a six-fold improvement in hospitals served by the Center over hospitals not served by the Center during the two-year period. From 1975 to 1977, a 43.7 per cent improvement in neonatal mortality among the 701-2000 grams neonates with hyaline membrane disease was observed in the transported infants served by the Infant Medical Dispatch Center as compared to a 22.9 per cent improvement in the group of transported infants not served by an IMDC. Both indicators had consistently shown a marked improvement associated with the IMDC program beyond the improvement of medical sciences over the two years. The data suggest that the improved outcome of the neonates referred by IMDC might be related to the improved efficiency of locating available neonatal intensive care beds. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.577_8 Template-Type: ReDIF-Article 1.0 Title: High blood pressure diagnosis and treatment: Consensus recommendations vs actual practice Journal: American Journal of Public Health Author-Name: Thomson, G.E. Author-Name: Alderman, M.H. Author-Name: Wassertheil-Smoller, S. Author-Name: Rafter, J.G. Author-Name: Samet, R. Year: 1981 Volume: 71 Issue: 4 Pages: 413-416 DOI: 10.2105/AJPH.71.4.413 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.413 Abstract: Diagnostic and treatment practices of institutional facilities treating high blood pressure in New York City were surveyed by mail in 1978. Respondents were adhering to the treatment recommendations of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. Ninety-two per cent of respondents reported 90-104 mm Hg as the diastolic blood pressure level at which drug therapy was initiated, indicating a more aggressive approach than was warranted by the information available at the time of the survey. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.413_6 Template-Type: ReDIF-Article 1.0 Title: Role of state and local governments in relation to personal health services. The New York State story. Journal: American Journal of Public Health Author-Name: Berman, R.A. Year: 1981 Volume: 71 Issue: S1 Pages: 86 Handle: RePEc:aph:ajpbhl:1981:71:S1:86_3 Template-Type: ReDIF-Article 1.0 Title: Assessing environmental risks of energy Journal: American Journal of Public Health Author-Name: Gleick, P.H. Author-Name: Holdren, J.P. Year: 1981 Volume: 71 Issue: 9 Pages: 1046-1050 DOI: 10.2105/AJPH.71.9.1046 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1046 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1046_3 Template-Type: ReDIF-Article 1.0 Title: Trends in contraceptive method of use by California family planning clinic clients aged 10-55, 1976-1979 Journal: American Journal of Public Health Author-Name: Aved, B.M. Year: 1981 Volume: 71 Issue: 10 Pages: 1162-1164 DOI: 10.2105/AJPH.71.10.1162 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1162 Abstract: The types of primary contraceptive method chosen by women seeking services in California family planning clinics are reviewed for the years 1976-1979. Of most significance was the decline in the use of oral contraceptives (OC) and the concurrent rise in nonprescription methods at all ages. A striking difference in OC use between the earlier and latter time periods was noted for women age 40 and older. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1162_5 Template-Type: ReDIF-Article 1.0 Title: Measuring effectiveness of service aides in infant immunization surveillance program in North Central Texas Journal: American Journal of Public Health Author-Name: Moore, B.J. Author-Name: Morris, D.W. Author-Name: Burton, B. Author-Name: Kilcrease, D.T. Year: 1981 Volume: 71 Issue: 6 Pages: 634-636 DOI: 10.2105/AJPH.71.6.634 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.634 Abstract: The Immunization Division of Texas Public Health Region 5 sought to measure the per cent of referrals taking immunization action as a result of service aide contact. From data collected on newborn-nonresponders during a 12-month period, results show that aides may be credited with influencing 44 per cent of the referrals reporting subsequent immunization. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.634_7 Template-Type: ReDIF-Article 1.0 Title: Estimating costs of illness and injuries: A response Journal: American Journal of Public Health Author-Name: Smart, C.N. Author-Name: Thompson, M.S. Author-Name: Hartunian, N.S. Year: 1981 Volume: 71 Issue: 12 Pages: 1394-1395 DOI: 10.2105/AJPH.71.12.1394 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1394 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1394_2 Template-Type: ReDIF-Article 1.0 Title: Relative mortality of unbelted infant passengers and belted non-infant passengers in air accidents with survivors Journal: American Journal of Public Health Author-Name: Fife, D. Author-Name: Rosner, B. Author-Name: McKibben, W. Year: 1981 Volume: 71 Issue: 11 Pages: 1242-1246 DOI: 10.2105/AJPH.71.11.1242 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1242 Abstract: Aircraft accidents with survivors were examined to determine the relative risk of mortality for unrestrained infant passengers vs seat-belted adult passengers. The crude relative risk was estimated to be 7.1, based on US data, and 7.4, based on worldwide data. More refined estimates allow for possible effects of seat location and for differences in lethality between crashes. Using such estimates, unbelted infant passengers have relative risk of 5.9 based on US data and 9.6 based on worldwide data. The injury experience of restrained vs unrestrained automobile passengers suggests that the observed excess risk to infant air passengers may be related to the absence of a mechanical restraint system. Recommendations for a mechanical restraint system are made and the cost and benefits of implementing these recommendations in the US are discussed. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1242_3 Template-Type: ReDIF-Article 1.0 Title: Helmet use, helmet use laws, and motorcyclist fatalities Journal: American Journal of Public Health Author-Name: Watson, G.S. Author-Name: Zador, P.L. Author-Name: Wilks, A. Year: 1981 Volume: 71 Issue: 3 Pages: 297-300 DOI: 10.2105/AJPH.71.3.297 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.297 Abstract: In contrast to the unproven effects of education, the effectiveness of helmets in preventing fatal head injuries, and of helmet use laws in producing near universal compliance among motorcyclists, is supported by a vast quantity of painstakingly documented research. Helmet use laws reduce motorcyclist fatalities by about 30% and their repeal increases fatal injuries by about 40%. If such laws were repealed by all states, over 1,100 additional motorcyclists would die each year. If helmet use laws were reinstated in all states, there would be 600 fewer fatalities annually. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.297_3 Template-Type: ReDIF-Article 1.0 Title: Does the doctor understand what I am asking? Journal: American Journal of Public Health Author-Name: Catlin, R.J.O. Year: 1981 Volume: 71 Issue: 2 Pages: 123-124 DOI: 10.2105/AJPH.71.2.123 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.123 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.123_8 Template-Type: ReDIF-Article 1.0 Title: Deregulation and the right to life Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1981 Volume: 71 Issue: 8 Pages: 797-798 DOI: 10.2105/AJPH.71.8.797 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.797 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.797_6 Template-Type: ReDIF-Article 1.0 Title: The Tennessee child restraint law in its third year Journal: American Journal of Public Health Author-Name: Williams, A.F. Author-Name: Wells, J.K. Year: 1981 Volume: 71 Issue: 2 Pages: 163-165 DOI: 10.2105/AJPH.71.2.163 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.163 Abstract: Observations of child travel were made in Knoxville and Nashville, Tennessee, and Lexington and Louisville, Kentucky about two and one-half years after the Tennessee child restraint law went into force. Use of child restraints anchored by seat belts increased in Tennessee from 8 per cent prior to the law to 29 per cent, compared to a change from 11 to 14 per cent in Kentucky, which does not have a child restraint law. Travel in arms, a hazardous practice permitted by the law, was at the same level in Tennessee and Kentucky as prior to passage of the law. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.163_8 Template-Type: ReDIF-Article 1.0 Title: Tuberculosis risk for hospital employees: Analysis of a five-year tuberculin skin testing program Journal: American Journal of Public Health Author-Name: Berman, J. Author-Name: Levin, M.L. Author-Name: Orr, S.T. Author-Name: Desi, L. Year: 1981 Volume: 71 Issue: 11 Pages: 1217-1222 DOI: 10.2105/AJPH.71.11.1217 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1217 Abstract: This study of hospital employee tuberculin conversion rates was undertaken in a 516-bed urban general hospital to determine if employment in such a hospital placed employees at risk of infection with tuberculosis. Data collected on the tuberculin status of employees from 1971 through 1976 indicated that the five-year conversion rate for all employees in a hospital-wide testing program was 7.1 per cent. Employees at greatest risk for conversion were non-White, age 46 through 64, in the lowest socioeconomic quintile, and employed in the Laundry, Housekeeping, and Engineering and Maintenance Departments. It was concluded that the higher than expected employee conversion rate was not attributable to exposure to infectious patients, but to a combination of the booster effect in serial tuberculin testing, use of a multiple puncture device for skin tests, and exposure to tuberculosis in the community. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1217_4 Template-Type: ReDIF-Article 1.0 Title: Social factors associated with breast self-examination among high risk women Journal: American Journal of Public Health Author-Name: Howe, H.L. Year: 1981 Volume: 71 Issue: 3 Pages: 251-255 DOI: 10.2105/AJPH.71.3.251 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.251 Abstract: A sample of 708 women, who by sociodemographic characteristics are high risk to breast cancer, were interviewed by telephone about their knowledge, attitude, and practice of breast self-examination (BSE). Reported frequency of BSE, knowledge of BSE and breast cancer, and BSE attitude in this sample are comparable to data reported by others. This report analyzes the associations between the frequency of a breast self-examination practice and the variables, age, education, detection confidence, social influence, modesty, preventive health behaviors, and memory. These relationships are discussed and several new hypotheses are proposed. Since the data were collected retrospectively, they are not able to describe causal relationships. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.251_3 Template-Type: ReDIF-Article 1.0 Title: A financial analysis of Hodgkin lymphoma staging Journal: American Journal of Public Health Author-Name: Corder, M.P. Author-Name: Lachenbruch, P.A. Author-Name: Lindle, S.G. Author-Name: Sisson, J.H. Author-Name: Johson, P.S. Author-Name: Kosier, J.T. Year: 1981 Volume: 71 Issue: 4 Pages: 376-380 DOI: 10.2105/AJPH.71.4.376 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.376 Abstract: A clinical algorithm was developed for staging of Hodgkin disease. This represented the treatment logic employed in a specified time period and was used to categorize charges incurred in the staging of 50 consecutive patients who underwent this process at a university hospital. Charges were categorized as: necessary (in concordance with the algorithm), justifiable (a result of care for a separate medical disorder or for consideration of distance), and perceived excess (neither necessary nor justifiable). Thirty per cent of the total charges were identified as perceived excess. Hospitalization accounted for 68 per cent and laboratory charges 22 per cent of the perceived excess charges. Fifty-eight per cent of the patients had a percentage of perceived excess bed charges exceeding 30 per cent of the total. Perceived excess medical hospitalization correlated positively with time from diagnosis to treatment decision. It is recommended that attempts to reduce the expense of Hodgkin lymphoma staging be directed at decreasing hospitalization. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.376_4 Template-Type: ReDIF-Article 1.0 Title: Asbestos in Vermont schools: Findings of a statewide on-site investigation Journal: American Journal of Public Health Author-Name: Novick, L.F. Author-Name: Rice, C. Author-Name: Freedman, M.A. Author-Name: Jillson, D. Year: 1981 Volume: 71 Issue: 7 Pages: 744-746 DOI: 10.2105/AJPH.71.7.744 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.744 Abstract: Materials containing asbestos were found in 75% of 336 Vermont Schools constructed or renovated between 1946 and 1974, with two-fifths of the materials in student exposure areas. Findings from visits to all schools contrasted with an earlier investigation relying on self-reporting. Of 105 schools with student exposure disclosed by the current survey, only 8 had been identified in the earlier effort. Ceiling tiles, previously not believed to contain substantial asbestos material, constituted a source of student exposure in 36 schools. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.744_6 Template-Type: ReDIF-Article 1.0 Title: Alcoholic beverages and myocardial infarction in young women Journal: American Journal of Public Health Author-Name: Rosenberg, L. Author-Name: Slone, D. Author-Name: Shapiro, S. Author-Name: Kaufman, D.W. Author-Name: Miettinen, O.S. Author-Name: Stolley, P.D. Year: 1981 Volume: 71 Issue: 1 Pages: 82-85 DOI: 10.2105/AJPH.71.1.82 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.82 Abstract: Moderate alcohol consumption has been associated with a reduction in the risk of myocardial infarction (MI) in men. To evaluate this relation in young women, the authors studied 513 patients with first infarctions and 918 hospital controls, all of whom were less than 50 years of age. The estimated relative risk of MI for current drinkers, after allowance for potential confounding factors, was 0.7 (95% confidence interval. 0.5-1.0), and the apparent reduction in risk was strongest for women who drank wine. There was no evidence of an effect among ex-drinkers. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.82_2 Template-Type: ReDIF-Article 1.0 Title: Factors associated with mortality after widowhood Journal: American Journal of Public Health Author-Name: Helsing, K.J. Author-Name: Szklo, M. Author-Name: Comstock, G.W. Year: 1981 Volume: 71 Issue: 8 Pages: 802-809 DOI: 10.2105/AJPH.71.8.802 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.802 Abstract: A non-concurrent prospective study in Washington County, Maryland identified 4,032 (1,204 male, 2,828 female) White persons aged 18 and over who were enumerated in a 1963 non-official census and who became widowed between 1963 and 1974, and an equal number of married persons, each matched to a widowed as to race, sex, year of birth and geography of residence. All were followed to 1975, the date of a second census. Mortality rates based on person-years at risk were about the same for widowed as for married females, but significantly higher for male widowed than male married, even after adjustment for a number of demographic, socioeconomic, and behavioral variables. Mortality rates among widowed males who remarried were very much lower than among those who did not remarry, but no significant difference was observable among widowed females who did or did not remarry. Multiple regression analysis also showed that, for both sexes and independently of other factors, moving into a nursing home or other chronic care facility was associated with higher mortality than any other residential change or no change, and living alone was associated with higher mortality than living with someone else in the household. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.802_0 Template-Type: ReDIF-Article 1.0 Title: Widowhood: A situational life stress or a stressful life event? Journal: American Journal of Public Health Author-Name: Susser, M. Year: 1981 Volume: 71 Issue: 8 Pages: 793-795 DOI: 10.2105/AJPH.71.8.793 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.793 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.793_1 Template-Type: ReDIF-Article 1.0 Title: Making school health education effective Journal: American Journal of Public Health Author-Name: Rogers, K.D. Year: 1981 Volume: 71 Issue: 1 Pages: 5-6 DOI: 10.2105/AJPH.71.1.5 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.5 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.5_0 Template-Type: ReDIF-Article 1.0 Title: Disability trends in the United States population 1966-76: Analysis of reported causes Journal: American Journal of Public Health Author-Name: Colvez, A. Author-Name: Blanchet, M. Year: 1981 Volume: 71 Issue: 5 Pages: 464-471 DOI: 10.2105/AJPH.71.5.464 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.464 Abstract: According to data published by the United States National Center for Health Statistics, disability reported among the US population has increased substantially during the years 1966 to 1976. Among younger age groups, the increase in activity limitation involves visual and hearing impairments as well as asthma. In the middle age group (45-64), four causes increased in both sexes (diabetes, musculoskeletal disorders, hypertension, and diseases of the circulatory system other than hypertension and heart conditions); one cause affected men only (heart conditions) and one women only (malignant neoplasms). In the 65 and over age group, diabetes and circulatory diseases (excluding heart conditions and hypertension) increased significantly. Although the US population increased by 10 per cent, the number of persons permanently limited in their activities because of health conditions increased by 37 per cent with a much larger proportion of those disabled claiming to be unable to carry on their main activity. Changes in health survey procedures and changes in standards used by respondents to rate their health status are not believed to account for these findings. Factors which could have contributed to this trend include environmental deterioration and improved social benefits easing retirement and providing better access to the health care system. Planning agencies need to recognize the relationships of the health care system to disability as well as to mortality. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.464_8 Template-Type: ReDIF-Article 1.0 Title: Anemia of pregnancy: Evaluation of the effectiveness of routine dietary supplementation program in an Israeli community Journal: American Journal of Public Health Author-Name: Palgi, A. Author-Name: Levi, S. Author-Name: Reshef, A. Year: 1981 Volume: 71 Issue: 7 Pages: 736-739 DOI: 10.2105/AJPH.71.7.736 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.736 Abstract: Of 514 Israeli women 4-5 months pregnant, 200 who were non-anemic (Hb 11 gm/100 ml or higher) took a daily supplement of ferrous sulfate (100 mg elemental iron). The 160 who remained on this regimen showed, as a group, significantly less reduction in hemoglobin levels than 180 non-anemic women who did not wish to take the supplement. Forty of the 200 women either dropped out or were shifted to other treatment regimens because they developed anemia after the 5th month. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.736_4 Template-Type: ReDIF-Article 1.0 Title: Community awareness of emergency phone numbers Journal: American Journal of Public Health Author-Name: Eisenberg, M. Author-Name: Hallstrom, A. Author-Name: Becker, L. Year: 1981 Volume: 71 Issue: 9 Pages: 1058-1060 DOI: 10.2105/AJPH.71.9.1058 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1058 Abstract: Knowledge of numbers to call for medical emergencies was compared among communities with three different call numbers: 1) 911; 2) regional seven-digit numbers; and, 3) local seven-digit numbers. Correct responses were 85 per cent in the 911 communities; 47 per cent in areas with regional systems, and 36 per cent in areas with local systems. Persons living adjacent to a 911 area were more likely to believe 911 was the emergency number (28 per cent) than persons not adjacent to 911 areas (12 per cent). Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1058_6 Template-Type: ReDIF-Article 1.0 Title: Environmental contamination of human breast milk Journal: American Journal of Public Health Author-Name: Barr Jr., M. Year: 1981 Volume: 71 Issue: 2 Pages: 124-126 DOI: 10.2105/AJPH.71.2.124 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.124 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.124_4 Template-Type: ReDIF-Article 1.0 Title: Quality and care assessment: Its role in the 1980s Journal: American Journal of Public Health Author-Name: Brook, R.H. Author-Name: Lohr, K.N. Year: 1981 Volume: 71 Issue: 7 Pages: 681-682 DOI: 10.2105/AJPH.71.7.681 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.681 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.681_0 Template-Type: ReDIF-Article 1.0 Title: Health beliefs and smoking behavior Journal: American Journal of Public Health Author-Name: Weinberger, M. Author-Name: Greene, J.Y. Author-Name: Mamlin, J.J. Author-Name: Jerin, M.J. Year: 1981 Volume: 71 Issue: 11 Pages: 1253-1255 DOI: 10.2105/AJPH.71.11.1253 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1253 Abstract: Smoking histories and beliefs about smoking were obtained on 120 ex- and current smokers. Ex-smokers view smoking as a serious health problem, did not report having a physician recommend they stop, and feel personally susceptible to its adverse effects. Moderate smokers (0-10/day) also view smoking as serious, but do not see themselves as vulnerable to its adverse effects. The data suggest that certain attitudes can discriminate between groups of current smokers, as well as smokers from ex-smokers. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1253_4 Template-Type: ReDIF-Article 1.0 Title: Breast self-examination: An adjuvant to early cancer detection Journal: American Journal of Public Health Author-Name: Cole, P. Author-Name: Austin, H. Year: 1981 Volume: 71 Issue: 6 Pages: 572-574 DOI: 10.2105/AJPH.71.6.572 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.572 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.572_2 Template-Type: ReDIF-Article 1.0 Title: The epidemiology of adolescent drug use in France and Israel Journal: American Journal of Public Health Author-Name: Kandel, D.B. Author-Name: Adler, I. Author-Name: Sudit, M. Year: 1981 Volume: 71 Issue: 3 Pages: 256-265 DOI: 10.2105/AJPH.71.3.256 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.256 Abstract: Based on samples of adolescents residing in urban areas in France and in Israel, cross-cultural comparisons of adolescent use of alcoholic beverages, cigarettes, and illicit drugs are reported. Lifetime and current prevalences of use of all substances are higher in France than in Israel. The relative ranking of the prevalence of use of the various drugs is identical in the two countries, and is similar to that found in American samples. In both countries, drug use is more prevalent among males than females, and among older than younger adolescents. There are no differences among different socioeconomic groups. Religiosity affects the rates of use of all drugs in France, and the rates of non-alcoholic substances and the amounts of alcoholic beverages consumed in Israel. Differences in the prevalence of substance use across cultures and within a culture decrease as overall prevalence of use increases. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.256_1 Template-Type: ReDIF-Article 1.0 Title: Massive obesity in a migrant Samoan population Journal: American Journal of Public Health Author-Name: Pawson, I.G. Author-Name: Janes, C. Year: 1981 Volume: 71 Issue: 5 Pages: 508-513 DOI: 10.2105/AJPH.71.5.508 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.508 Abstract: Peoples of the Pacific Islands tend to become overweight when they migrate or are exposed to modernization in situ. Recent evidence suggests that Samoans are particularly susceptible, exhibiting a high prevalence of obesity and hypertension following migration to Hawaii. We report the preliminary results of a survey of height, weight, blood pressure, and fasting plasma glucose (FPG) among an urbanized Samoan community in the San Francisco Bay Area. Although the participants' average height fell between the 25th and 50th percentile of the US population, about one-half our sample exceeded the 95th percentile for weight. The extreme overweight was accompanied by elevated blood pressure and, in females, by elevated FPG. The massive adult weight of migrants from the Pacific Islands carries serious public health implications for areas that support large migrant communities. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.508_8 Template-Type: ReDIF-Article 1.0 Title: Single-site localization of rabies virus: Impact on laboratory reporting policy Journal: American Journal of Public Health Author-Name: Maserang, D.L. Author-Name: Leffingwell, L. Year: 1981 Volume: 71 Issue: 4 Pages: 428-429 DOI: 10.2105/AJPH.71.4.428 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.428 Abstract: Information accumulated by our rabies laboratory during 1977-1979 was retrospectively analyzed for patterns of rabies localization in brain. Of the 1,730 specimens reported positive during that period, 37 were positive at a single site, 27 involving only the cerebellum. Therefore, we recommend that those laboratories which offer the fluorescent rabies antibody test (FRA) examine both cerebellum and hippocampus. Definitive reports based on the FRA should be offered only when both sites have been shown negative for viral particles, or when a positive result is unquestionable. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.428_8 Template-Type: ReDIF-Article 1.0 Title: Smoking and weight: The Minnesota Lipid Research Clinic Journal: American Journal of Public Health Author-Name: Jacobs Jr., D.R. Author-Name: Gottenborg, S. Year: 1981 Volume: 71 Issue: 4 Pages: 391-396 DOI: 10.2105/AJPH.71.4.391 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.391 Abstract: The relationship between smoking and weight was examined in data of the Lipid Research Clinic (LRC) Prevalence Study in Richfield, Minnesota. Weight was analyzed according to smoking status, age, and sex, holding constant self-perceived physical activity relative to others of the same age and sex. Our findings confirm that weight differences between smokers of 15-29 cigarettes a day (cig/day) and those who never smoked are noticeable in 20-39 year olds and quite marked in the 40-59 year age group. Ex-smokers are somewhat heavier than those who never smoked while, among smokers, a U-shaped curve exists with those smoking 15-29 cig/day being the lightest class. Height varied little between smoking classes. Daily caloric intake was estimated based on 24-hour dietary recalls and analyzed according to smoking status, sex, and age. The results showed that smokers of 15-29 cig/day generally are consuming at least as many or more calories as those who never smoked yet have lower weight. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.391_5 Template-Type: ReDIF-Article 1.0 Title: A method for the geographical evaluation of emergency medical service performance Journal: American Journal of Public Health Author-Name: Mayer, J.D. Year: 1981 Volume: 71 Issue: 8 Pages: 841-844 DOI: 10.2105/AJPH.71.8.841 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.841 Abstract: Emergency Medical Service (EMS) evaluation is usually conducted on an aggregated, system-wide basis, despite the fact that there is substantial geographical variation in EMS performance. This paper suggests a method for the identification and analysis of geographically disaggregated EMS performance, using Seattle's Medic I program as an example. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.841_0 Template-Type: ReDIF-Article 1.0 Title: Do prescriptions adversely affect doctor-patient interactions? Journal: American Journal of Public Health Author-Name: Wartman, S.A. Author-Name: Morlock, L.L. Author-Name: Malitz, F.E. Author-Name: Palm, E. Year: 1981 Volume: 71 Issue: 12 Pages: 1358-1361 DOI: 10.2105/AJPH.71.12.1358 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1358 Abstract: The purpose of this study was to assess the impact of the prescription on the doctor-patient interaction. Data were collected during ongoing quality assessment studies at a prepaid group practice of about 19,000 enrollees. Adult patients and their providers completed forms on all visits to the Department of Medicine and Urgent Care Center during a two-week period. A 50% random sample of patients was interviewed by telephone one week after the index visit. Patients who did not receive precriptions reported more satisfaction with the communicative aspects of their visits to physicians than patients who did receive prescriptions. We suggest that prescriptions may hinder patient satisfaction with the doctor-patient interaction by substituting for other, more 'meaningful' communication between patient and provider. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1358_1 Template-Type: ReDIF-Article 1.0 Title: GMENAC: Its manpower forecasting framework Journal: American Journal of Public Health Author-Name: McNutt, D.R. Year: 1981 Volume: 71 Issue: 10 Pages: 1116-1124 DOI: 10.2105/AJPH.71.10.1116 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1116 Abstract: The Graduate Medical Education National Advisory Committee (GMENAC) was an advisory group to the Secretary, US Department of Health and Human Services. Its charter ended September 30, 1980. It submitted 107 recommendations to achieve a better balance between future physician requirements and future physician supply, by specialty and geography. Among its contributions were the development of a manpower forecasting framework and series of models which are described here, together with the results of these models. These models may have significant utility in future resource planning at both national and local levels. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1116_5 Template-Type: ReDIF-Article 1.0 Title: The GMENAC forecast: An alternative view Journal: American Journal of Public Health Author-Name: Reinhardt, U.E. Year: 1981 Volume: 71 Issue: 10 Pages: 1149-1157 DOI: 10.2105/AJPH.71.10.1149 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1149 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1149_1 Template-Type: ReDIF-Article 1.0 Title: Role of state and local government in relation to personal health services. A view of rural health services. Journal: American Journal of Public Health Author-Name: Madison, D.L. Year: 1981 Volume: 71 Issue: S1 Pages: 89-90 Handle: RePEc:aph:ajpbhl:1981:71:S1:89-90_7 Template-Type: ReDIF-Article 1.0 Title: Primary health care for urban children and youth: the role of local health departments. Journal: American Journal of Public Health Author-Name: Chang, A. Year: 1981 Volume: 71 Issue: S1 Pages: 31-33 Handle: RePEc:aph:ajpbhl:1981:71:S1:31-33_2 Template-Type: ReDIF-Article 1.0 Title: Role of state and local governments in relation to personal health services: introduction and summary. Journal: American Journal of Public Health Author-Name: Jain, S.C. Year: 1981 Volume: 71 Issue: S1 Pages: 5-8 Handle: RePEc:aph:ajpbhl:1981:71:S1:5-8_9 Template-Type: ReDIF-Article 1.0 Title: Measuring functional disability in the older population Journal: American Journal of Public Health Author-Name: German, P.S. Year: 1981 Volume: 71 Issue: 11 Pages: 1197-1199 DOI: 10.2105/AJPH.71.11.1197 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1197 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1197_7 Template-Type: ReDIF-Article 1.0 Title: Inconsistency in level of care assignment decisions in skilled nursing facilities Journal: American Journal of Public Health Author-Name: Greene, V.L. Author-Name: Monahan Deb., J. Year: 1981 Volume: 71 Issue: 9 Pages: 1036-1039 DOI: 10.2105/AJPH.71.9.1036 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1036 Abstract: In Arizona, a no-Medicaid state, we investigated the extent to which unregulated level of care assignments in Skilled Nursing Facilities consistently reflect level and nature of patient impairment. Using Multiple Discriminant Analysis (MDA) to develop optimal prediction functions, approximately 70 per cent of patients could be correctly classified. Factors identified by MDA as discriminating among patients at different levels of care are an Activities of Daily Living (ADL) impairment factor, and a factor defined by confusion, transitory contact with the social environment, and propensity to wander. Results are compared with those of studies using MDA to replicate Multidisciplinary Review Team (MRT) or other expert level of care assignments intended to develop patient classification functions for clinical use. MRT assignments appear to reflect patient impairment characteristics only slightly better than do unregulated institutional assignments, suggesting that such utilization review efforts may result in minimal net gains in appropriateness of placement. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1036_2 Template-Type: ReDIF-Article 1.0 Title: Food, sanitation, and the socioeconomic determinants of child growth in Colombia Journal: American Journal of Public Health Author-Name: Koopman, J.S. Author-Name: Fajardo, L. Author-Name: Bertrand, W. Year: 1981 Volume: 71 Issue: 1 Pages: 31-37 DOI: 10.2105/AJPH.71.1.31 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.31 Abstract: To describe the causes of growth failure in a developing country, the authors studied family food availability, anthropometric measurements of preschool children, and family and neighborhood socioeconomic conditions in a stratified random sample of Cali, Colombia families. The influences on preschool child growth of food availability, neighborhood socioeconomic conditions, and family socioeconomic conditions were separated statistically. Neither food avilability nor other family factors were related directly to growth, but neighborhood factors did have a strong relationship to growth. Children decreased progressively from 97.5% of expected weight in the top one-sixth of neighborhoods the authors studied to 89% in the bottom one-sixth. Food availability, although not related to growth, was strongly related to family factors. The top one-sixth of families had 115% of FAO (Food and Agricultural Organization) protein allowances, while the bottom one-sixth had only 75%. These findings are inconsistent with food availability or family factors being the principal causes of growth retardation. They are consistent with neighborhood determined factors, possibly enteric infections, being the principal cause of growth retardation in preschool children in Cali. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.31_2 Template-Type: ReDIF-Article 1.0 Title: Accuracy of cancer death certificates and its effect on cancer mortality statistics Journal: American Journal of Public Health Author-Name: Percy, C. Author-Name: Stanek III, E. Author-Name: Gloeckler, L. Year: 1981 Volume: 71 Issue: 3 Pages: 242-250 DOI: 10.2105/AJPH.71.3.242 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.242 Abstract: A study to determine the accuracy of cancer mortality data was done using cancer deaths occurring during 1970 and 1971 in 8 of the 9 areas included in the Third National Cancer Survey (TNCS). Death certificates with an underlying cause of death of cancer were compared to the hospital diagnosis for 48,826 resident cases of single primary cancers. The underlying cause of death as coded on the death certificate was found to be accurate for about 65% of the cancer deaths in this study. Misclassification problems occurred for colorectal cancer, the second leading cause of death from cancer. Colon cancer was overreported and rectal cancer was underreported on death certificates. Other misclassification problems were found for cancers of the uterus, brain, and buccal cavity including most of its sub-sites. Physicians tended to report a non-specific site of cancer on the death certificate rather than the specific site identified by the hospital diagnosis. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.242_7 Template-Type: ReDIF-Article 1.0 Title: Criteria, norms and standards of quality: What do they mean? Journal: American Journal of Public Health Author-Name: Donabedian, A. Year: 1981 Volume: 71 Issue: 4 Pages: 409-412 DOI: 10.2105/AJPH.71.4.409 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.409 Abstract: Quality assessment requires specification of: 1) a set of phenomena that are usually attributes of either process or outcome; 2) a general rule of what constitutes goodness; and 3) a precise numerical statement of what constitutes acceptable or optimal goodness with respect to each of these phenomena. The terms 'criteria', 'norms', and 'standards', as currently employed, do not correspond well with these three components, but they could be used effectively if the basic distinctions were understood. Alternatively, one could use, as corresponding terms, 'elements', 'parameters', and 'standards'. The terms 'criteria', and 'norms' would then be redefined and be available to be used more uniformly, while 'standards' could be further differentiated according to method of measurement, configuration, level, and flexibility. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.409_0 Template-Type: ReDIF-Article 1.0 Title: Racial differences in blood pressure levels of adolescents Journal: American Journal of Public Health Author-Name: Reed, W.L. Year: 1981 Volume: 71 Issue: 10 Pages: 1165-1167 DOI: 10.2105/AJPH.71.10.1165 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1165 Abstract: Although essential hypertension is more prevalent among Black adults than White adults, results of an extensive high school blood pressure screening program reveal that this relationship does not obtain among adolescents. In fact, the blood pressure levels of White youths equal or exceed that of Black youths. This race effect still exists when age, sex, weight, and socioeconomic status are controlled. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1165_1 Template-Type: ReDIF-Article 1.0 Title: The Framingham Disability Study: II. Physical disability among the aging Journal: American Journal of Public Health Author-Name: Jette, A.M. Author-Name: Branch, L.G. Year: 1981 Volume: 71 Issue: 11 Pages: 1211-1216 DOI: 10.2105/AJPH.71.11.1211 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1211 Abstract: The Framingham Disability Study (FDS), a recent component of the Heart Disease Epidemiological Study in Framingham, Massachusetts, was designed to investigate the nature and magnitude of disability among non-institutionalized elderly. From September 1976 through November 1978, 2,654 individuals aged 55 to 84 years from the original Framingham cohort were interviewed in person or by telephone (94 per cent of the potential participant pool). The findings support the well known relationship between physical disability and age. The magnitude of disability, however, is not as great as conventional wisdom might suggest. This paper presents the physical disability prevalence findings and compares these results to earlier epidemiological investigations of disability in the elderly. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1211_3 Template-Type: ReDIF-Article 1.0 Title: An assessment of Tel-Med utilization by physicians and dentists Journal: American Journal of Public Health Author-Name: Diseker, R.A. Author-Name: Michielutte, R. Author-Name: Morrison, V. Year: 1981 Volume: 71 Issue: 10 Pages: 1168-1170 DOI: 10.2105/AJPH.71.10.1168 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1168 Abstract: A mail survey of physicians and dentists assessed their knowledge of Tel-Med; their use of it in the practice setting; and their opinion of its potential value in practice. Data suggest that both physicians and dentists regard Tel-Med's potential as high and small percentages of both groups have actually used Tel-Med in their practices. However, both groups are concerned over the potential for unsound self-diagnosis. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1168_6 Template-Type: ReDIF-Article 1.0 Title: Public awareness and knowledge about the risks of drinking during pregnancy in Multnomah County, Oregon Journal: American Journal of Public Health Author-Name: Little, R.E. Author-Name: Grathwohl, H.L. Author-Name: Pytkowicz Streissguth, A. Author-Name: McIntyre, C. Year: 1981 Volume: 71 Issue: 3 Pages: 312-314 DOI: 10.2105/AJPH.71.3.312 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.312 Abstract: Public awareness of the risks of drinking during pregnancy was assessed in a Northwestern metropolitan county. 90% of respondents stated spontaneously that drinking might be harmful, and one-fourth of this group felt pregnant women should customarily abstain from alcohol. The balance of those who considered drinking harmful felt an average of more than 3 drinks was safe for daily use. Thus awareness of risk does not necessarily result in recommendation of low-risk behavior. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.312_0 Template-Type: ReDIF-Article 1.0 Title: Effect of coverage on use of an HMO alcoholism treatment program, outcome, and medical care utilization Journal: American Journal of Public Health Author-Name: Hayami, D.E. Author-Name: Freeborn, D.K. Year: 1981 Volume: 71 Issue: 10 Pages: 1133-1143 DOI: 10.2105/AJPH.71.10.1133 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1133 Abstract: Two-hundred-fifty alcoholics were randomly assigned to a full benefit or 50 per cent copayment group before entering an HMO (health maintenance organization) alcoholism treatment program. Data on use of treatment services, use of medical care services, and drinking behavior were collected for one year after intake. The medical care utilization and drinking behavior data were compared to data for the year before intake. The two coverage groups were comparable on sociodemographic characteristics and baseline drinking behavior, but the full benefit group tended to have higher utilization rates for the year prior to intake and significantly more treatment contacts than those having the 50 percent copayment requirement. Changes in use of medical care services were similar in both groups. Both payment groups improved, but the full benefit group tended to be somewhat more improved. Regression analysis supported the relative unimportance of extent of alcoholism coverage in affecting outcome and subsequent medical care utilization. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1133_6 Template-Type: ReDIF-Article 1.0 Title: Sexually transmitted diseases in homosexual men Journal: American Journal of Public Health Author-Name: Handsfield, H.H. Year: 1981 Volume: 71 Issue: 9 Pages: 989-990 DOI: 10.2105/AJPH.71.9.989 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.989 Abstract: Recent studies have suggested that homosexual behavior in men is associated with significant personal and public health problems due to several sexually transmitted diseases (STD). Gay men appear to be at greater risk than heterosexual men or women for gonorrhea, syphilis, anorectal venereal warts, and perhaps for genital and anorectal herpes simplex virus infections, as well as for several STDs outside the traditional sphere of venereology, including hepatitis A, hepatitis B, amebiasis, giardiasis, shigellosis, enteritis due to Campylobacter fetus, genital and anorectal meningococcal infection, and cytomegalovirus infection. Most studies to date, however, have been conducted in STD clinics or at sites where persons congregate for anonymous sexual activity, such as steambaths, and the applicability of their findings to the homosexual male population at large is unknown. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.989_6 Template-Type: ReDIF-Article 1.0 Title: Occupational health values in the Supreme Court: Cost-benefit analysis Journal: American Journal of Public Health Author-Name: Curran, W.J. Author-Name: Boden, L.I. Year: 1981 Volume: 71 Issue: 11 Pages: 1264-1265 DOI: 10.2105/AJPH.71.11.1264 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1264 Abstract: In American Textile Manufacturers Institute v. Donovan, the Supreme Court refuted an industry challenge, supported by the Reagan administration, to the cotton dust standard established under the Occupational Safety and Health Act. Petitioners argued that the Act required cost-benefit analysis, but the Court ruled in favor of workers' health where toxic materials were concerned. An earlier Supreme Court decision, Industrial Union Dept. v. American Petroleum Institute, invalidated OSHA's standard on occupational exposure to benzene as too stringent for the determined risk. These two decisions provide boundaries within which standards may be promulgated balancing industrial growth and development against worker safety and health. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1264_8 Template-Type: ReDIF-Article 1.0 Title: Description and evaluation of the smoking cessation component of a multiple risk factor intervention program Journal: American Journal of Public Health Author-Name: Malotte, C.K. Author-Name: Fielding, J.E. Author-Name: Danaher, B.G. Year: 1981 Volume: 71 Issue: 8 Pages: 844-847 DOI: 10.2105/AJPH.71.8.844 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.844 Abstract: The smoking cessation component of a residential program which attempts to concurrently intervene on several risk factors related to chronic disease is described. Seventy-two per cent of the 43 smokers in the first 13 cohorts were abstinent at discharge. Fifty-five per cent were abstinent at two months. Six-month data for the first nine cohorts show 53 per cent abstinence. Possible advantages and disadvantages of a multiple behavior change program in a residential setting are discussed. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.844_0 Template-Type: ReDIF-Article 1.0 Title: Mistreatment of the elderly in the domestic setting: An exploratory study Journal: American Journal of Public Health Author-Name: Hickey, T. Author-Name: Douglass, R.L. Year: 1981 Volume: 71 Issue: 5 Pages: 500-507 DOI: 10.2105/AJPH.71.5.500 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.500 Abstract: Professionals and practitioners (N = 228) involved in providing services to the elderly were interviewed regarding their experiences with the mistreatment of older people by their families. Semi-structured questions dealt with: case identification and follow-up procedures; perceptions of etiological factors; and descriptive typologies from illustrative case histories. Findings indicated that domestic mistreatment of the elderly was familiar to most professionals interviewed, to the extent that 60 per cent of the respondents dealt with such cases on a weekly basis. Among the 10 professional groups interviewed, there was little variation in their experiences with neglect; police officers, lawyers, community mental health and aging services workers had greater exposure to cases of physical abuse. Intentional mistreatment was typically viewed as a consequence of inadequacies in the caretaker, while unintentional cases were related to the victims' isolation. Most respondents indicated that there were no established procedures for dealing with, or following-up mistreatment cases, and over one-half reported that nothing was done. Differences in perception of the etiology of domestic mistreatment of the elderly were closely related to the occupational perspectives of the various respondent groups. Although incidence rates could not be established, 89 illustrative cases of domestic mistreatment of the elderly were indicative of the severity of the occurrences and the absence of appropriate interventions. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.500_4 Template-Type: ReDIF-Article 1.0 Title: Potentials of local health surveys: A state-of-the-art summary Journal: American Journal of Public Health Author-Name: Aday, L.A. Author-Name: Sellers, C. Author-Name: Andersen, R.M. Year: 1981 Volume: 71 Issue: 8 Pages: 835-840 DOI: 10.2105/AJPH.71.8.835 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.835 Abstract: This paper provides a state-of-the-art summary of the potentials and limitations of local surveys for assessing health problems in local areas. The information they provide may be helpful for a variety of purposes such as measuring the need for services, planning programs to address these needs, and evaluating their impact. Particular advantages of surveys are that they: provide information on the needs of people who have not sought care; permit special studies of particular target groups; provide data on variables which are only available from 'asking' people; enable information to be collected on a range of correlates and indicators of health care behavior; provide an opportunity for examining relationships among variables; and permit well-timed community estimates of the impact of experimental programs. Limitations include the validity and reliability of survey data, and the costs and other problems of survey implementation. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.835_1 Template-Type: ReDIF-Article 1.0 Title: The role of the states in the delivery of health services. Journal: American Journal of Public Health Author-Name: Clarke, G.J. Year: 1981 Volume: 71 Issue: S1 Pages: 59-69 Handle: RePEc:aph:ajpbhl:1981:71:S1:59-69_5 Template-Type: ReDIF-Article 1.0 Title: The biological advantages and social disadvantages of teenage pregnancy Journal: American Journal of Public Health Author-Name: Morris, N.M. Year: 1981 Volume: 71 Issue: 8 Pages: 796 Handle: RePEc:aph:ajpbhl:1981:71:8:796_0 Template-Type: ReDIF-Article 1.0 Title: Margaret Sanger labeled 'racist'. Journal: American Journal of Public Health Author-Name: Aul, D.J. Year: 1981 Volume: 71 Issue: 1 Pages: 91 Handle: RePEc:aph:ajpbhl:1981:71:1:91_3 Template-Type: ReDIF-Article 1.0 Title: Verbal judgements of Taiwanese family planning field workers about induced abortion Journal: American Journal of Public Health Author-Name: Cernada, G.P. Author-Name: Chen Cernada, C.C. Year: 1981 Volume: 71 Issue: 4 Pages: 420-422 Abstract: Four hundred female governmental family planning field workers in Taiwan were asked by questionnaire whether women should or should not have an induced abortion under certain circumstances. Major findings were that although most workers were favorable to induced abortion under most circumstances, many were unfavorable when marital status, parity, and contraceptive usage of the woman were considered. Furthermore, cumulative judgement scales were shown to exist which have important implications for program approaches elsewhere. Handle: RePEc:aph:ajpbhl:1981:71:4:420-422_6 Template-Type: ReDIF-Article 1.0 Title: Role of state and local governments in relation to personal health services. The Cambridge story. Journal: American Journal of Public Health Author-Name: Porter, P.J. Year: 1981 Volume: 71 Issue: S1 Pages: 86-88 Handle: RePEc:aph:ajpbhl:1981:71:S1:86-88_6 Template-Type: ReDIF-Article 1.0 Title: Validity of synthetic estimates of problem-drinker prevalence Journal: American Journal of Public Health Author-Name: Furst, C.J. Author-Name: Beckman, L.J. Author-Name: Nakamura, C.Y. Year: 1981 Volume: 71 Issue: 9 Pages: 1016-1020 DOI: 10.2105/AJPH.71.9.1016 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1016 Abstract: For the purpose of evaluating their validity, survey-based synthetic estimates of problem-drinker prevalence in California's counties were correlated with social indicators of alcohol abuse. Prevalence estimates were predictive of automobile accidents and drunk-driving arrests but not of other problems. Data on drinking practices from a statewide survey provide more valid estimates than national survey data. Taking into account empirical and other factors impinging upon the validity of this prevalence formula, it is concluded that synthetic estimates provide a defensible but limited basis for estimating needs for alcoholism services in small areas. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1016_6 Template-Type: ReDIF-Article 1.0 Title: Community structural characteristics and the adoption of fluoridation Journal: American Journal of Public Health Author-Name: Smith, R.A. Year: 1981 Volume: 71 Issue: 1 Pages: 24-30 DOI: 10.2105/AJPH.71.1.24 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.24 Abstract: A study of community structural characteristics associated with fluoridation outcomes was conducted in 47 communities. A three-part outcome distinction was utilized: communities never having publicly considered the fluoridation issue, those rejecting it, and those accepting it. The independent variables reflect the complexity of the community social and economic structure, social integration, and the centralization of authority. Results of mean comparisons show statistically significant differences between the three outcome types on the independent variables. A series of discriminant analyses provides further evidence of how the independent variables are associated with each outcome type. Non-considering communities are shown to be low in complexity, and high in social integration and the centralization of governmental authority. Rejecters are shown to be high in complexity, but low in social integration and centralized authority. Adopters are relatively high on all three sets of variables. Theoretical reasoning is provided to support the hypotheses and why these results are expected. The utility of these results and structural explanations in general are discussed, especially for public/environmental health planning and political activities. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.24_2 Template-Type: ReDIF-Article 1.0 Title: Seasonal patterns of skin melanoma incidence in Hawaii Journal: American Journal of Public Health Author-Name: Hinds, M.W. Author-Name: Lee, J. Author-Name: Kolonel, L.N. Year: 1981 Volume: 71 Issue: 5 Pages: 496-499 DOI: 10.2105/AJPH.71.5.496 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.496 Abstract: We analyzed the seasonal pattern of diagnosis of malignant melanoma of the skin among Caucasians in Hawaii during 1960-1978. For all cases combined, a significant since-wave pattern with a summertime peak was found. This pattern was most pronounced for melanoma of head and neck and lower extremities and for persons age 50 and over. These findings support the hypothesis that solar ultraviolet radiation may be a short-term promoter of some malignant melanomas of the skin. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.496_0 Template-Type: ReDIF-Article 1.0 Title: Inter-governmental relationships: More different, or more the same? Journal: American Journal of Public Health Author-Name: Tilson, H.H. Year: 1981 Volume: 71 Issue: 10 Pages: 1103-1104 DOI: 10.2105/AJPH.71.10.1103 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1103 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1103_1 Template-Type: ReDIF-Article 1.0 Title: Heart healthy eating and exercise: Introducing and maintaining changes in health behaviors Journal: American Journal of Public Health Author-Name: Coates, T.J. Author-Name: Jeffery, R.W. Author-Name: Slinkard, L.A. Year: 1981 Volume: 71 Issue: 1 Pages: 15-23 DOI: 10.2105/AJPH.71.1.15 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.15 Abstract: The Heart Healthy Program in a health education project developed for elementary school students. It was designed to (1) increase their consumption of complex carbohydrates, and decrease their consumption of saturated fat, cholesterol, sodium, and sugar; (2) increase their level of habitual physical activity; and (3) generalize these changes to other family members. The overall program and 12 class lessons were designed using informative instruction, participatory classroom activities, personal goal setting, parent handouts, feedback, and reinforcement. The program was evaluated using a time-series experimental design with all students in three 4th grade classes at School 1 and three 5th grade classes at School 2. Evaluation was conducted using direct observation of eating and activity, as well as paper-and-pencil assessments of knowledge and attitude. Results indicated substantial changes in eating behavior at school, knowledge about heart health, food preferences, and family eating patterns as reported by parents. Observed changes in exercise were minimal during treatment, and were related to seasonal sports activities at follow-up. Eating habit changes persisted over a four-month follow-up which spanned summer vacation. These outcomes suggest that school programs developed using specific techniques can be effective in facilitating important behavior changes at school and at home. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.15_2 Template-Type: ReDIF-Article 1.0 Title: Life-style and death patterns of the Missouri RLDS church members Journal: American Journal of Public Health Author-Name: McEvoy, L. Author-Name: Land, G. Year: 1981 Volume: 71 Issue: 12 Pages: 1350-1357 DOI: 10.2105/AJPH.71.12.1350 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1350 Abstract: Members of the Reorganized Church of Jesus Christ of Latter-Day Saints (RLDS) are dissuaded from the use of tobacco, alcohol, and hot drinks. A well-balanced diet is also stressed. This study compares the 1972-78 mortality experience of the Missouri RLDS with three other population groups. The findings show Missouri RLDS experiencing age-adjusted death rates which are 22.6% lower than rates for Missouri non-RLDS Whites; 19.6% lower than the non-RLDS of Independence, Missouri; and 14.4% lower than Utah residents. The RLDS display lower death rates than the two Missouri comparison groups for each of seven selected causes - particularly lung cancer, pneumonia/influenza, and violent deaths. Comparisons between the Missouri RLDS and Utah residents show an inconsistent pattern, with Utah residents having non-signficantly lower death rates for lung cancer and ischemic heart disease, but with the Missouri RLDS having significantly lower rates for pneumonia/influenza and violent deaths. These inconsistencies are of interest because 72% of Utah's population belong to the Mormon Church which advocates life-styles similar to the RLDS. If these disparate mortality patterns persist under a more direct comparison between the Missouri RLDS and Utah Mormons, they could provide the opportunity to assess the impact of similar life-styles in separate settings. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1350_6 Template-Type: ReDIF-Article 1.0 Title: Role of state and local government in relation to personal health services. The Denver story. Journal: American Journal of Public Health Author-Name: Kauver, A.J. Year: 1981 Volume: 71 Issue: S1 Pages: 88-89 Handle: RePEc:aph:ajpbhl:1981:71:S1:88-89_0 Template-Type: ReDIF-Article 1.0 Title: Alcohol-related deaths in Wisconsin: The impact of alcohol on mortality Journal: American Journal of Public Health Author-Name: Nashold, R.D. Author-Name: Naor, E.M. Year: 1981 Volume: 71 Issue: 11 Pages: 1237-1241 DOI: 10.2105/AJPH.71.11.1237 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1237 Abstract: Analysis of the impact of alcohol as an underlying and non-underlying cause of death in Wisconsin showed a marked increase between 1963 and 1977 in the frequency of deaths reported with mention of alcohol. The rate of deaths for which alcohol was a non-underlying cause rose more sharply during this period (2.4 per 100,000 to 9.3) than that of alcohol-related causes (4.6/100,000 to 9.0). Nearly 90 per cent of alcohol-related deaths at ages 15-24 reported alcohol as a non-underlying cause, compared to 40.7 per cent at ages 45-54 and 57 per cent at ages 75+. This proportion was higher (50.8 per cent) among males than among females (32.8 per cent). Deaths related to alcohol are attributed to a number of underlying causes in addition to alcohol. In 1975-77, nearly half of the reported alcohol-related deaths were attributed to other causes, including accidents (14.8 per cent), heart disease (14.3 per cent), respiratory diseases (4.9 per cent), suicide (3.7 per cent), and cancer (31 per cent). These percentages may reflect substantial underreporting. Comparison of motor vehicle driver death certificates with blood alcohol test reports for these drivers shows 90 per cent underreporting of alcohol on death certificates. This fact, along with other information on underreporting, shows that the approximately 650 deaths now being reported with mention of alcohol annually in Wisconsin, represent only a portion of such deaths. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1237_6 Template-Type: ReDIF-Article 1.0 Title: Neonatal mortality by the day of the week in the 1974-75 Arkansas live birth cohort Journal: American Journal of Public Health Author-Name: Mangold, W.D. Year: 1981 Volume: 71 Issue: 6 Pages: 601-605 DOI: 10.2105/AJPH.71.6.601 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.601 Abstract: this study is an analysis of daily variations in neonatal mortality among 66,049 live births in the 1974-75 Arkansas live birth cohort. Weekends and holidays in general, and Sundays in particular, were found to have the fewest number of deliveries. Variations in deliveries by the day of the week were attributed to obstetric practices. Births weighing less than 2500 gms. were over-represented among weekend deliveries as were infants experiencing a birth-related injury. Neonatal mortality was found to be higher among weekend deliveries with a Sunday rate that was 27 per cent above the weekly average. Separate analysis by race and birth weight revealed the weekend peak to be more pronounced among non-whites. Analysis of daily variations by cause of death showed that Sundays exceeded the overall average for seven of the eight cause of death categories examined. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.601_0 Template-Type: ReDIF-Article 1.0 Title: Famine relief and imperial policy in early modern Morocco: The political functions of public health Journal: American Journal of Public Health Author-Name: Meyers, A.R. Year: 1981 Volume: 71 Issue: 11 Pages: 1266-1273 DOI: 10.2105/AJPH.71.11.1266 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1266 Abstract: There has been no systematic ethnology nor comparative history of public health. In fact, there has been a broad concensus that prior to the arrival of missionaries and colonial health authorities there was no indigenous public health. These assumptions apply to only some settings and do not reflect the general history of public health. The present study concerns public health in the first century of Alawi rule in Morocco, ca. 1670-1790. The early Alawi sultans undertook public health programs, most of which concerned the prevention and relief of mass starvation. Goals of the programs were consistent with other features of their public policies. Effectiveness of the programs was limited partly by technical and scientific factors, but more by political constraints, especially the sultans' higher priorities for political stability than public welfare and publich health. These data provide important insights not only into Moroccan social and political history, but also into the more general problem of the political nature of public health. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1266_4 Template-Type: ReDIF-Article 1.0 Title: Postpartum sterilization in cesarean section and non-cesarean section deliveries: United States, 1970-75 Journal: American Journal of Public Health Author-Name: Placek, P.J. Author-Name: Taffel, S.M. Author-Name: Smith, J.C. Author-Name: Maze, J.M. Year: 1981 Volume: 71 Issue: 11 Pages: 1258-1261 DOI: 10.2105/AJPH.71.11.1258 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1258 Abstract: National Hospital Discharge Survey data indicate that the overall postpartum sterilization rate per 100 deliveries increased by 75 per cent from 4.0 in 1970 to 7.0 in 1975; by type of delivery, rates rose from 18.0 per 100 cesarean section deliveries and 3.2 for all other deliveries in 1970 to 19.0 and 5.6 respectively in 1975. The South had the highest postpartum sterilization rates overall. Deliveries to older mothers and cesarean section deliveries in hospitals with less than 100 beds were more often characterized by higher sterilization rates. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1258_6 Template-Type: ReDIF-Article 1.0 Title: St. Louis encephalitis: A comparison of two epidemics in Harris County, Texas Journal: American Journal of Public Health Author-Name: Bell, R.L. Author-Name: Christensen, B. Author-Name: Holguin, A. Author-Name: Smith, O. Year: 1981 Volume: 71 Issue: 2 Pages: 168-170 DOI: 10.2105/AJPH.71.2.168 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.168 Abstract: The frequency and distribution of cases in two epidemics of St. Louis encephalitis in Houston, Texas are compared by age, sex, race, season, duration, geographic area and resources available. The second epidemic was far less severe than the first. The influence of community intervention on the observed differences between the two epidemics is discussed. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.168_1 Template-Type: ReDIF-Article 1.0 Title: Sedating drugs and automobile accidents leading to hospitalization Journal: American Journal of Public Health Author-Name: Jick, H. Author-Name: Hunter, J.R. Author-Name: Dinan, B.J. Author-Name: Madsen, S. Author-Name: Stergachis, A. Year: 1981 Volume: 71 Issue: 12 Pages: 1399-1400 DOI: 10.2105/AJPH.71.12.1399 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1399 Abstract: The use of central nervous system depressant drugs among 244 people hospitalized for injuries suffered in an automobile accident was similar for drivers presumed at fault for the accident compared with other drivers and passengers. It was only slightly higher in the three groups than it was in the population at large. The absence of an important association in this population might be related to the warnings given to people filling prescriptions for these drugs. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1399_3 Template-Type: ReDIF-Article 1.0 Title: A prospective study of response error in food history questionnaires: Implications for foodborne outbreak investigation Journal: American Journal of Public Health Author-Name: Mann, J.M. Year: 1981 Volume: 71 Issue: 12 Pages: 1362-1366 DOI: 10.2105/AJPH.71.12.1362 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1362 Abstract: To explore the problem of response error in food history data, a prospective study examined the validity of food questionnaire data obtained five days after the study meal. Unobtrusive observation of 64 persons selecting two different foods at a buffet-style luncheon were compared with subsequent histories of food consumption. The predictive value of a positive response was 0.73 for one food and 0.82 for the second food. The response error measures obtained were then applied to data from a published foodborne outbreak to illustrate the impact of predictive value positive and predictive value negative levels on the significance of a food-illness association. Public health workers engaged in food questionnaire administration and analysis must consider response error and should explore methods of reducing this problem through attention to both interviewer-respondent interaction and questionnaire design. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1362_9 Template-Type: ReDIF-Article 1.0 Title: The triage experiment in coordinated care for the elderly Journal: American Journal of Public Health Author-Name: Hicks, B. Author-Name: Raisz, H. Author-Name: Segal, J. Author-Name: Doherty, N. Year: 1981 Volume: 71 Issue: 9 Pages: 991-1003 DOI: 10.2105/AJPH.71.9.991 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.991 Abstract: Triage is a model project designed to overcome the organizational and financial barriers inhibiting the provision of appropriate care to the elderly. Teams made up of a nurse clinician and a social worker performed assessment, service coordination, and monitoring functions. Services arranged by the teams were financed through a series of waivers on the use of the Medicare Trust Fund. Three hundred and seven Triage clients were followed and compared to a group of 195 elderly in a two-year quasi-experimental study of functioning status outcomes, use of services, and health care costs. Triage clients had slightly better mental functioning outcomes than comparison clients; results of physical and social functioning outcomes were inconclusive. Both service utilization and costs were somewhat higher for Triage clients; the proportional difference in utilization was greater than the proportional difference in costs. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.991_6 Template-Type: ReDIF-Article 1.0 Title: How much, for what, and for whom? Journal: American Journal of Public Health Author-Name: Callahan Jr., J.J. Year: 1981 Volume: 71 Issue: 9 Pages: 987-988 DOI: 10.2105/AJPH.71.9.987 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.987 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.987_6 Template-Type: ReDIF-Article 1.0 Title: Choosing populations to study the health effects of low-dose ionizing radiation Journal: American Journal of Public Health Author-Name: Dreyer, N.A. Author-Name: Loughlin, J.E. Author-Name: Friedlander, E.R. Author-Name: Clapp, R.W. Author-Name: Fahey, F.H. Year: 1981 Volume: 71 Issue: 11 Pages: 1247-1252 DOI: 10.2105/AJPH.71.11.1247 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1247 Abstract: In January 1978, the United States Congress requested information about the utility of additional epidemiologic studies for quantifying the health effects of low-dose ionizing radiation. In our judgement, no single population can be recommended for study on purely scientific grounds, since the largest group offers only a small chance to obtain a definitive result. On the other hand, if social pressures and regulatory agencies mandate that such studies be attempted, we would recommend prospective cohort studies of occupational populations. We propose that a national worker registry be developed using ionizing radiation as the prototype for studying other occupational exposures. The problems related to studying low-level radiation are not unique, but apply equally to investigations dealing with a great variety of toxic agents. A national plan for collecting information on workers' exposure and health could provide a cost-efficient means to answer public health questions posed by the Congress, scientists and the public. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1247_4 Template-Type: ReDIF-Article 1.0 Title: Down's syndrome: Percentage reporting on birth certificates and single year maternal age risk rates for Ohio 1970-79: Comparison with upstate New York data Journal: American Journal of Public Health Author-Name: Huether, C.A. Author-Name: Gummere, G.R. Author-Name: Hook, E.B. Author-Name: Dignan, P.S. Author-Name: Volodkevich, H. Author-Name: Barg, M. Author-Name: Ludwig, D.A. Author-Name: Lamson, S.H. Year: 1981 Volume: 71 Issue: 12 Pages: 1367-1372 DOI: 10.2105/AJPH.71.12.1367 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1367 Abstract: Estimates of single maternal age risk rates for Down's Syndrome births to White residents of Ohio over the period 1970-79 are reported. The rates were estimated from birth certificate data, which first necessitated estimating the percentage of reporting of Down's Syndrome on Ohio birth certificates. Using data from cytogenetic laboratories within the state, percentages of Down's Syndrome cases reported were found to be 36.5 (319/875) for White and 33.9 (342/1,010) overall. Final single year maternal age risk rates reported here are corrected for underreporting using these figures. They should be useful for genetic counselors and obstetricians. Comparisons of observed, uncorrected single year maternal incidence rates were made within Ohio 1970-74 vs 1975-79, and between Ohio and upstate New York for various time periods using both a hierarchial log-linear model for multiway cross-tabulations and a weighted least squares solution. All comparisons showed excellent agreement, indicating no evidence for temporal or geographic differences and implying that environmental factors are unimportant in determining single year maternal age incidence rates in Down's Syndrome for the time periods and populations studied. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1367_3 Template-Type: ReDIF-Article 1.0 Title: Evaluation of rural primary health care services in Iran: Report on vital statistics in West Azarbaijan Journal: American Journal of Public Health Author-Name: Barzegar, M.A. Author-Name: Djazayery, A. Year: 1981 Volume: 71 Issue: 7 Pages: 739-742 DOI: 10.2105/AJPH.71.7.739 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.739 Abstract: Iranian indigenous front-line health workers (FLHW) were locally trained to deliver environmental and primary health care services to mothers and children. After 2 years, there was a significant decline in crude birth and death rates and in infant and 1-5 year mortality rates in the test area as compared to a control area. One out of 4 encounters was referred to a health center physician, the remainder being handled by the FLHWs themselves. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.739_6 Template-Type: ReDIF-Article 1.0 Title: The cost-effectiveness of telephone vs clinic counseling for hypertensive patients: A pilot study Journal: American Journal of Public Health Author-Name: Bertera, E.M. Author-Name: Bertera, R.L. Year: 1981 Volume: 71 Issue: 6 Pages: 626-629 DOI: 10.2105/AJPH.71.6.626 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.626 Abstract: The cost-effectiveness of counselling by telephone and by clinic visit contacts were compared in 40 hypertensive patients each of whom received counseling and reinforcement every three weeks for six months regarding diet, exercise, smoking, and coping with stress. Blood pressure declined significantly in both counseling groups (N: 10 each) but not in a control group (N:20). The cost per patient under control was $82 for the clinic counseling and $39 for the telephone counseling strategy, suggesting that telephone counseling was a cost-effective technique. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.626_1 Template-Type: ReDIF-Article 1.0 Title: The regionalization of perinatal care Journal: American Journal of Public Health Author-Name: McCormick, M.C. Year: 1981 Volume: 71 Issue: 6 Pages: 571-572 DOI: 10.2105/AJPH.71.6.571 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.571 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.571_0 Template-Type: ReDIF-Article 1.0 Title: Community leadership competencies in the Northeast US: Implications for training public health educators Journal: American Journal of Public Health Author-Name: Strand, G.A. Year: 1981 Volume: 71 Issue: 4 Pages: 397-402 DOI: 10.2105/AJPH.71.4.397 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.397 Abstract: A survey was conducted to determine leadership competencies as perceived by 679 community residents (urban/rural) in six states of the Northeast United States. Respondents were asked to rate the extent to which it is important for a community leader to use each competency listed in the instrument. A factor analysis reduced the list of 39 competency items examined into nine distinct factors. Alpha internal consistency estimates revealed the strength of correlation among items in each factor. A series of one-way analyses of variance failed to show a significant difference between urban/rural community respondents' scores for each factor. The findings suggest specific leadership competencies which should be emphasized in training experiences. Conceptual competencies were identified as most important (problem delineation, organization, management of change, etc.), followed by human competencies (demeanor, empathy, attitudes) and technical competencies (budgeting, supervision, needs assessment) respectively. Items within each factor have implications for development of specific content areas in a leadership training curriculum for public health educators. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.397_8 Template-Type: ReDIF-Article 1.0 Title: Manning the battlements of research epidemiology Journal: American Journal of Public Health Author-Name: Brody, J.A. Year: 1981 Volume: 71 Issue: 1 Pages: 70-72 DOI: 10.2105/AJPH.71.1.70 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.70 Abstract: International trends and recently proposed changes risk confining the duties of epidemiologists to support of health services delivery or to serving as functionaries within exclusively clinical departments pose a threat to the future role and training of epidemiologists. It is argued that these attempts would weaken the academic focus for epidemiologists and compromise the system of recognition and rewards available through the hierarchy of the discipline. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.70_6 Template-Type: ReDIF-Article 1.0 Title: Newborn diagnosis of abnormal hemoglobins from a large municipal hospital in Los Angeles Journal: American Journal of Public Health Author-Name: Ewing, N. Author-Name: Powars, D. Author-Name: Hilburn, J. Author-Name: Schroeder, W.A. Year: 1981 Volume: 71 Issue: 6 Pages: 629-631 DOI: 10.2105/AJPH.71.6.629 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.629 Abstract: Cord blood samples from 29,611 infants born in Los Angeles over a 7 1/2 year period were examined for hemoglobinopathies. Among 4,134 Black newborns, the frequency of sickle cell anemia (SS) was 0.3 per cent, of sickle cell trait (AS) 8 per cent, and of Hb-C trait (AC) 2 per cent. Of 17,781 Spanish surnamed (Mexican) newborns, 0.5 per cent had sickle cell trait, and 0.1 per cent had Hb-C trait. Of the 5,541 Caucasian infants, 0.7 per cent had sickle cell trait, and 0.15 per cent had Hb-C trait. Twenty-three Black children with major hemoglobinopathies included 16 with sickle cell anemia, two with hemoglobin C disease (CC), and five with SC disease. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.629_7 Template-Type: ReDIF-Article 1.0 Title: Occupational information on death certificates: a survey of state practices Journal: American Journal of Public Health Author-Name: Kaminski, R. Author-Name: Brockert, J. Author-Name: Sestito, J. Author-Name: Frazier, T. Year: 1981 Volume: 71 Issue: 5 Pages: 525-526 DOI: 10.2105/AJPH.71.5.525 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.525 Abstract: A national survey was conducted in 1979 to determine the extent to which state and local vital registration offices coded and stored occupational information reported on death certificates. This survey found that 11 states routinely code occupation, seven routinely code industry, and six have coded occupation and/or industry on a limited basis. State and federal cooperation is needed to facilitate increased use of mortality data for environmental and occupational health research. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.525_9 Template-Type: ReDIF-Article 1.0 Title: Chemical wastes - Illegal hazards and legal remedies Journal: American Journal of Public Health Author-Name: Landrigan, P.J. Author-Name: Gross, L. Year: 1981 Volume: 71 Issue: 9 Pages: 985-987 DOI: 10.2105/AJPH.71.9.985 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.985 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.985_3 Template-Type: ReDIF-Article 1.0 Title: Drinking water sodium and blood pressure in children: A second look Journal: American Journal of Public Health Author-Name: Tuthill, R.W. Author-Name: Calabrese, E.J. Year: 1981 Volume: 71 Issue: 7 Pages: 722-729 DOI: 10.2105/AJPH.71.7.722 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.722 Abstract: A previous study by the current authors demonstrated a statistically significant and clinically important elevation of 3-5 mmHg in mean systolic and diastolic blood pressure in high school sophomores in a community with 108 mg/L of sodium in the water supply when compared to their peers in an appropriately matched community with 8 mg/L of sodium. The current investigation, employing identical techniques but studying third graders in the same two communities, showed similar results. This second look considered dietary intake and urinary excretion of sodium. Since the difference in 24-hour dietary sodium consumption was 300 milligrams between the communities, an intake of one liter of high sodium tap water represented approximately 25% of the difference in total sodium intake between the two communities. These studies suggest that sodium consumption in both drinking water and diet may be contributing to the difference in blood pressure distributions among the normotensive children in the two communities. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.722_6 Template-Type: ReDIF-Article 1.0 Title: Iodine-131 levels in sludge and treated municipal wastewaters near a large medical complex Journal: American Journal of Public Health Author-Name: Prichard, H.M. Author-Name: Gesell, T.F. Author-Name: Davis, E. Year: 1981 Volume: 71 Issue: 1 Pages: 47-52 DOI: 10.2105/AJPH.71.1.47 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.47 Abstract: Iodine-131 was found to dominate the gamma spectra of dried sludge and concentrated liquid effluent samples from a sewage treatment plant serving the area containing the Texas Medical Center in 1975. The concentration of Iodine-131 varied considerably on a time scale of weeks but was fairly stable in the course of a single day. The partition of Iodine-131 between the dried sludge and the liquid effluent was found to be reasonably constant during the sampling period. Knowledge of the concentration in these phases and the daily output of sludge and effluent led to the estimate of an annual discharge of over one Curie of Iodine-131. Circumstantial evidence linking this discharge to the practice of nuclear medicine in the area is considered strong, but an attempt to correlate variation in the effluent activity with actual nuclide use was inconclusive due, among other reasons, to an insufficient clinical data base. An analysis of possible exposure pathways indicated that negligible human exposure resulted from the Iodine-131 released primarily because the receiving body of water is a saline industrial waterway. A more extensive analysis would be in order for a similar plant discharging treated wastewaters into an inland water system. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.47_8 Template-Type: ReDIF-Article 1.0 Title: Chloroquine poisoning: Double barrier prevention Journal: American Journal of Public Health Author-Name: Alexander, W.J. Author-Name: Palmisano, P.A. Year: 1981 Volume: 71 Issue: 3 Pages: 317 Handle: RePEc:aph:ajpbhl:1981:71:3:317_6 Template-Type: ReDIF-Article 1.0 Title: Health departments and long-term care. Journal: American Journal of Public Health Author-Name: Lee, P.R. Year: 1981 Volume: 71 Issue: S1 Pages: 90-92 Handle: RePEc:aph:ajpbhl:1981:71:S1:90-92_8 Template-Type: ReDIF-Article 1.0 Title: A method for determining costs associated with laboratory error Journal: American Journal of Public Health Author-Name: Cavenaugh, E.L. Year: 1981 Volume: 71 Issue: 8 Pages: 831-834 DOI: 10.2105/AJPH.71.8.831 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.831 Abstract: A study directed toward developing a method for determining .Costs associated with laboratory error was developed, relying on panels of physicians to rank frequency of performance and impact of error of various laboratory tests. Cost estimates of error impact were then developed, using cost of error to patient as the basis. Findings indicate that economic costs of laboratory error differ with the test. Probable costs per error can be used to identify tests with the highest costs to patients. These cost-per-error-data, when combined with test volume data and error rates by test, will help pinpoint the tests that should receive priority effort in a laboratory improvement program. The method developed could serve as one basis for developing an effective laboratory improvement program; it could also be used for budget justification and ultimately for program evaluation. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.831_1 Template-Type: ReDIF-Article 1.0 Title: Height, weight, and triceps skinfold thickness of Michigan children, 1978 Journal: American Journal of Public Health Author-Name: Sady, S.P. Author-Name: Moffatt, R.J. Author-Name: Owen, G.M. Year: 1981 Volume: 71 Issue: 8 Pages: 855-858 DOI: 10.2105/AJPH.71.8.855 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.855 Abstract: Height, weight, and triceps skinfold measurements were made on 258 Michigan males and 225 females, age 2 to 18 years, comprising a representative sample of Michigan children in 1978. Boys of most age groups and younger girls were slightly taller, heavier, and fatter than their US counterparts, studied between 1963 and 1974. Older Michigan girls were slightly shorter but heavier and fatter than their earlier US counterparts. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.855_7 Template-Type: ReDIF-Article 1.0 Title: Decision-making under uncertainty: Foster care for abused or neglected children? Journal: American Journal of Public Health Author-Name: Fanshel, D. Year: 1981 Volume: 71 Issue: 7 Pages: 685-686 DOI: 10.2105/AJPH.71.7.685 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.685 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.685_4 Template-Type: ReDIF-Article 1.0 Title: Coronary heart disease risk factors in men with light and dark skin in Puerto Rico Journal: American Journal of Public Health Author-Name: Costas Jr., R. Author-Name: Garcia-Palmieri, M.R. Author-Name: Sorlie, P. Author-Name: Hertzmark, E. Year: 1981 Volume: 71 Issue: 6 Pages: 614-619 DOI: 10.2105/AJPH.71.6.614 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.614 Abstract: The association of skin color with coronary heart disease risk factors was studied in 4,000 urban Puerto Rican men. Skin color on the inner upper arm was classified according to the von Luschan color tiles. Using this grading, men were separated into two groups of light or dark skin color. The dark group had a lower socioeconomic status (SES) based on income, education, and occupation. Dark men had slightly higher mean systolic blood pressures (SBP) and lower mean serum cholesterol levels than the light, but the relative weights and cigarette smoking habits of both groups were similar. After controlling for the differences in SES, skin color showed a small but statistically significant association with SBP. Whether this association with skin color represents genetic or environmental influences on SBP could not be determined from this study. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.614_6 Template-Type: ReDIF-Article 1.0 Title: The relationship between age of mother and child health and development Journal: American Journal of Public Health Author-Name: Rothenberg, P.B. Author-Name: Varga, P.E. Year: 1981 Volume: 71 Issue: 8 Pages: 810-817 DOI: 10.2105/AJPH.71.8.810 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.810 Abstract: This study investigates the relationship between age of mother and children's health and development at birth and at approximately three years of age. The sample is composed of Black and Hispanic women and their firstborn children who were delivered on the wards of a large New York City hospital in 1975. There were no differences between children of teenage and older mothers in terms of prematurity or birthweight, but the children of younger mothers had higher Apgar scores than those of older mothers. Age of mother was not significantly related to hospitalizations, the need to see a physician regularly, or abnormal weight. Although the number of injurious conditions and the incidence of burns were higher among the children of adolescent mothers, the effect of age of mother was not independent of other factors. The children of teenage mothers scored better than those of older mothers on the total Denver Developmental Screening Test, as well as on the Fine Motor sector. These findings thus suggest that when relevant background characteristics are controlled, children of teenage mothers are as healthy and develop as well as children of older mothers. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.810_2 Template-Type: ReDIF-Article 1.0 Title: Perspective on the public good Journal: American Journal of Public Health Author-Name: Perkins, R.J. Year: 1981 Volume: 71 Issue: 3 Pages: 294-295 DOI: 10.2105/AJPH.71.3.294 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.294 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.294_3 Template-Type: ReDIF-Article 1.0 Title: The prospects for state and local governments playing a broader role in health care in the 1980s. Journal: American Journal of Public Health Author-Name: Blendon, R.J. Year: 1981 Volume: 71 Issue: S1 Pages: 9-14 Handle: RePEc:aph:ajpbhl:1981:71:S1:9-14_0 Template-Type: ReDIF-Article 1.0 Title: Automobile safety regulations and death reductions in the United States Journal: American Journal of Public Health Author-Name: Robertson, L.S. Year: 1981 Volume: 71 Issue: 8 Pages: 818-822 DOI: 10.2105/AJPH.71.8.818 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.818 Abstract: The effectiveness of federal automobile safety standards was examined using detailed data on 236,000 vehicles in fatal crashes in the United States during 1975-1978. Controlling statistically for type of regulation, types of vehicles, and ages of vehicles, the federal motor vehicle safety standards were associated with substantial reductions in car occupant deaths per 100 million vehicle miles travelled, and some reductions in fatal collisions of the federally regulated vehicles with pedestrians, motorcyclists, and bicyclists. Some 37,000 fewer deaths occurred in 1975-1978 than would have been expected without the federal standards. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.818_5 Template-Type: ReDIF-Article 1.0 Title: The ups and downs of prevention Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1981 Volume: 71 Issue: 1 Pages: 6-9 DOI: 10.2105/AJPH.71.1.6 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.6 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.6_1 Template-Type: ReDIF-Article 1.0 Title: Hypertension labeling and sense of well-being Journal: American Journal of Public Health Author-Name: Bloom, J.R. Author-Name: Monterossa, S. Year: 1981 Volume: 71 Issue: 11 Pages: 1228-1232 DOI: 10.2105/AJPH.71.11.1228 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1228 Abstract: Seventy-one individuals were mislabeled on the basis of a prevalence survey (N=1,031) conducted in low-income community. They were told by a physician that they were hypertensive but were later judged normotensive on the basis of three blood pressure measures. None of these persons was taking antihypertensive medication or under medical care. Compared to the total normotensive sample, the mislabeled group reported more depressive symptoms (P=.005), lower present health (p=.001), and a worsening of their health over the past five years (p=.035). Compared to a control group matched on gender, age, ethnicity, education, and marital status, the mislabeled group reported even more depressive symptoms (P=.005), and lower present health (p=.034). They did not, however, have a worsening of health over the past five years (p=.074). These findings could not be explained by greater utilization of medical care or comorbidity. It is suggested that these findings are a result of people being falsely labeled as hypertensive. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1228_9 Template-Type: ReDIF-Article 1.0 Title: Cancer in the Third World: Bangladesh 1980 Journal: American Journal of Public Health Author-Name: Lynch, H.T. Author-Name: Rahim, M.A. Year: 1981 Volume: 71 Issue: 10 Pages: 1158-1161 DOI: 10.2105/AJPH.71.10.1158 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1158 Abstract: Bangladesh exemplifies all of the problems of Third World countries: poverty, hunger, reduced longevity, and an illiteracy rate hovering at more than 80 per cent. The current status of oncology in Bangladesh was surveyed. Staff physicians, deans, medical students, nurses and patients at six of the eight medical college hospitals, seven village hospitals, and a large private hospital provided background and clinical material. There are no medical or surgical oncologists in Bangladesh. The eight qualified therapists are able to provide only meager diagnostic potential or radiation therapy with their antiquated equipment. Pathology service was severely handicapped by understaffing and outmoded equipment. With a relatively modest investment, epidemiological studies could be undertaken and an effective cancer control program established since oral and cervical cancers are common. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1158_7 Template-Type: ReDIF-Article 1.0 Title: The program implications of administrative relationships between local health departments and state and local government Journal: American Journal of Public Health Author-Name: DeFriese, G.H. Author-Name: Hetherington, J.S. Author-Name: Brooks, E.F. Author-Name: Miller, C.A. Author-Name: Jain, S.C. Author-Name: Kavaler, F. Author-Name: Stein, J.S. Year: 1981 Volume: 71 Issue: 10 Pages: 1109-1115 DOI: 10.2105/AJPH.71.10.1109 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1109 Abstract: A typology of organizational arrangements between state and local public health agencies was used as a framework within which the organizational environment of the local health department was studied for its effects on progam development and implementation by local public health departments. Data collected in a national sample of local health officers were used in measuring the effect of four different patterns of administrative relationships on the selected characteristics of local health department programs. Important differences were observed among the four organizational types with regard to constraints on programs and program priorities, and health officers' perceptions of the primary functions of local health departments and sources of local health department funding. These findings were then used as a baseline from which to consider the possible impact of recent federal health budgetary proposals (specifically, block grants) both on existing patterns of intergovernmental relations and on the funding and operation of local health department programs. It was determined that the most likely general development arising from these proposed changes in federal budgetary policy is that the administrative control of state health agencies over those at local level is likely to be enhanced. Other likely developments include changes in the programs and priorities of local health departments related to reductions in overall funding levels for human services and forced competition for fewer dollars by an enlarged constituency. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1109_3 Template-Type: ReDIF-Article 1.0 Title: A multiple cause of death analysis of hypertension-related mortality in North Carolina, 1968-1977 Journal: American Journal of Public Health Author-Name: Wing, S. Author-Name: Manton, K.G. Year: 1981 Volume: 71 Issue: 8 Pages: 823-830 DOI: 10.2105/AJPH.71.8.823 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.823 Abstract: In this paper, records of all medical conditions on death certificates are used to evaluate hypertension-related mortality in North Carolina over the decade 1968-1977. Use of both an inclusive hypertension recode category and multiple cause data resulted in gains in information of over 750 per cent in all four race/sex groups compared to the commonly used underlying cause, hypertensive disease category. Race, sex and age specific 10-year trends in death rates for all mentions of hypertension are analyzed, with comparisons to underlying cause mortality from ischemic heart disease and stroke. Age-adjusted declines of 19 to 24 per cent between 1968 and 1977 were observed for all race/sex groups, although non-White declines occurred mainly at younger ages while White declines (especially White males) occurred mainly at older ages. The non-White excess of hypertension mentions (compared to Whites) increased for males and decreased for females. The decline in hypertension mentions, in spite of the increased awareness of hypertension as a public health problem which would make it more likely to be mentioned on death certificates, suggests that there was a real reduction in the contribution of hypertension to total mortality over the period. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.823_7 Template-Type: ReDIF-Article 1.0 Title: Job decision latitude, job demands, and cardiovascular disease: A prospective study of Swedish men Journal: American Journal of Public Health Author-Name: Karasek, R. Author-Name: Baker, D. Author-Name: Marxer, F. Author-Name: Ahlbom, A. Author-Name: Theorell, T. Year: 1981 Volume: 71 Issue: 7 Pages: 694-705 DOI: 10.2105/AJPH.71.7.694 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.694 Abstract: The association between specific job characteristics and subsequent cardiovascular disease was tested using a large random sample of the male working Swedish population. The prospective development of coronary heart disease (CHD) symptoms and signs was analyzed using a multivariate logistic regression technique. Additionally, a case-controlled study was used to analyze all cardiovascular-cerebrovascular (CHD-CVD) deaths during a 6-year follow-up. The indicator of CHD symptoms and signs was validated in a 6-year prospective study of CHD deaths (standardized mortality ratio 5.0; p ≤ .001). A hectic and psychologically demanding job increases the risk of developing CHD symptoms and signs (standardized odds ratio 1.29, p < .025) and premature CHD-CVD death (relative risk 4.0, p < .01). Low decision latitude - expressed as low intellectual discretion and low personal schedule freedom - is also associated with increased risk of cardiovascular disease. Low intellectual discretion predicts the development of CHD symptoms and signs (SOR 1.44, p < .01), while low personal schedule freedom among the majority of workers with the minimum statutory education increases the risk of CHD-CVD death (RR 6.6, p < .0002). The associations exist after controlling for age, education, smoking, and overweight. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.694_8 Template-Type: ReDIF-Article 1.0 Title: Hospitalization of medicaid children: Analysis of small area variations in admission rates Journal: American Journal of Public Health Author-Name: Connell, F.A. Author-Name: Day, R.W. Author-Name: LoGerfo, J.P. Year: 1981 Volume: 71 Issue: 6 Pages: 606-613 DOI: 10.2105/AJPH.71.6.606 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.606 Abstract: Population-based hospitalization rates were computed and analyzed for AFDC children among 14 small area subdivisions of the State of Washington. Medical-surgical admission rates ranged from 65.3 to 161.7 per 1,000 person-years among the 14 areas. Surgical admission rates were significantly higher in urban areas; medical admission rates were significantly higher in rural areas. The majority of variance in overall rates was accounted for by admissions for four diagnostic categories: gastroenteritis (18-fold differences), lower respiratory infections (15-fold differences), upper respiratory infections (8-fold differences), and ear, nose, and throat (ENT) surgery (6-fold differences). Secondary analysis indicates that these differences in admission rates wre not associated with: medical need or demographic factors, epidemic patterns of disease, physician supply, hospital bed supply or occupancy rates, or severity of disease or delay in seeking medical care as reflected by average length of stay. It is possible that the observed variations may reflect either differences in the propensity of local physicians to hospitalize or differences in the use or adequacy of community, ambulatory, and preventive care. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.606_6 Template-Type: ReDIF-Article 1.0 Title: Determinants of foster care placement for the maltreated child Journal: American Journal of Public Health Author-Name: Runyan, D.K. Author-Name: Gould, C.L. Author-Name: Trost, D.C. Author-Name: Loda, F.A. Year: 1981 Volume: 71 Issue: 7 Pages: 706-711 DOI: 10.2105/AJPH.71.7.706 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.706 Abstract: This study examined the records of the North Carolina Central Registry of Child Abuse and Neglect to determine which social, family, and child characteristics were most influential in the decision to place a child in foster care. These records contained all theoretically relevant factors as well as demographic data. Analysis included the computation of odds ratios for foster care for each of 250 variables. A maximum likelihood logistic regression model was constructed to obtain the independent and cumulative contribution of each factor. Some expected variables such as parental stress factors (substance abuse) and types of abuse (burns and scalds) placed a child at a significant risk for placement in foster care (p < 0.01). However, less obvious factors such as referral source (law enforcement agencies) or geographic area also placed children at risk. Overall, the model explained little of the variance of these decisions (R2 = 0.168) and poorly predicted placement (sensitivity 66.3%, specificity 74.6%). Using existing data, we were unable to adequately describe the decision process in selecting foster care. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.706_3 Template-Type: ReDIF-Article 1.0 Title: Frequency of hospitalization among hospital employees and their families Journal: American Journal of Public Health Author-Name: Greene, S.B. Year: 1981 Volume: 71 Issue: 9 Pages: 1021-1025 DOI: 10.2105/AJPH.71.9.1021 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1021 Abstract: Using claims data from 443 employee groups in North Carolina, this study examines the acute care hospital utilization rates of hospital employees and their dependents and compares them to employee groups in non-hospital settings. Results show that hospital employee groups account for 28 per cent more hospital days than non-hospital employee groups. The significantly higher rates are due primarily to employee utilization, although hospital employee dependents also showed higher rates of use than would be expected. We hypothesize that the high utilization rates of the hospital employee groups is due to the unusual availability and accessibility of hospital services and an atypical doctor-patient relationship. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1021_3 Template-Type: ReDIF-Article 1.0 Title: New reductions in infant mortality: The challenge of low birthweight Journal: American Journal of Public Health Author-Name: Shapiro, S. Year: 1981 Volume: 71 Issue: 4 Pages: 365-366 DOI: 10.2105/AJPH.71.4.365 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.365 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.365_6 Template-Type: ReDIF-Article 1.0 Title: Smoking and epidemic influenza-like illness in female military recruits: a brief survey Journal: American Journal of Public Health Author-Name: Kark, J.D. Author-Name: Lebiush, M. Year: 1981 Volume: 71 Issue: 5 Pages: 530-532 DOI: 10.2105/AJPH.71.5.530 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.530 Abstract: An outbreak of influenza-like disease caused illness among 48 per cent of 173 female military recruits, 35 per cent of whom smoked cigarettes. The risk of influenza-like illness was greater in smokers (60.0 per cent) than in nonsmokers (41.6 per cent), with a risk ratio of 1.44 (95 per cent CL 1.03-2.01). Among those ill, a significantly greater proportion of smokers visited the clinic than nonsmokers. This could have been due to more severe illness among smokers, or to a greater tendency to visit the physician. The proportion of influenza-like disease attributable to smoking in this population was 13 per cent. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.530_9 Template-Type: ReDIF-Article 1.0 Title: To hell with economics? Journal: American Journal of Public Health Author-Name: Littenberg, B. Author-Name: Neuhauser, D. Year: 1981 Volume: 71 Issue: 4 Pages: 363-365 DOI: 10.2105/AJPH.71.4.363 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.363 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.363_5 Template-Type: ReDIF-Article 1.0 Title: Biosocial effects of urban migration on the development of families and children in Guatemala Journal: American Journal of Public Health Author-Name: Bogin, B. Author-Name: MacVean, R.B. Year: 1981 Volume: 71 Issue: 12 Pages: 1373-1377 DOI: 10.2105/AJPH.71.12.1373 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1373 Abstract: The relationship between rural to urban migration and child growth and family structure is reported in a sample of 302 children from families of low socioeconomic status, living in Guatemala City. The sample was divided into three groups: 1) children of parents born outside the city, 2) children of parents born in the city, and 3) children with one migrant and one city-born parent. Children of migrants to the city were the smallest and significantly shorter than children of migrant city-born parents. Migrant parents also had the largest families; family size correlated negatively with growth in height. Growth in weight followed a pattern similar to height, but no significant differences associated with migration status were found between groups. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1373_0 Template-Type: ReDIF-Article 1.0 Title: Low-cost health delivery systems: lessons from Nicaragua Journal: American Journal of Public Health Author-Name: Heiby, J.R. Year: 1981 Volume: 71 Issue: 5 Pages: 514-519 DOI: 10.2105/AJPH.71.5.514 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.514 Abstract: In 1976 the Ministry of Health of Nicaragua began a low cost program to deliver simple health services in rural areas through trained traditional birth attendants or 'parteras'. After two years the program had prepared 768 parteras in a five-day training course. Parteras were equipped with a kit that included oral rehydration salts, an antihelminthic, multivitamins with iron, aspirin, contraceptives, and obstetrical equipment. The difficulties encountered in implementing this limited set of simple health services illustrate a number of potential ostacles to the achievement of universal, comprehensive primary health care in less developed countries. The most prominent difficulties involved elements of the health service delivery system itself: supervision, the collection and use of management information, training, partera selection, and logistics. The experience also provided examples of issues in the design of delivery systems that require specific applied research. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.514_6 Template-Type: ReDIF-Article 1.0 Title: The quality of medical care delivered by lay practitioners in a feminist clinic Journal: American Journal of Public Health Author-Name: Elhai, L.S. Year: 1981 Volume: 71 Issue: 8 Pages: 853-855 DOI: 10.2105/AJPH.71.8.853 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.853 Abstract: The completion of essential components of patient encounters by lay paramedics in a feminist clinic was compared to that of nurse practitioners in a student health gynecology clinic using explicit criteria for the gynecological annual examination and the examination for vulvo-vaginitis. According to evidence charted in medical records, the lay paramedics conducted patient encounters as well as the nurse practitioners, with the exception that the lay paramedics consulted more frequently. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.853_2 Template-Type: ReDIF-Article 1.0 Title: Pap smears, prevention, primary care, and the guarantee of good health Journal: American Journal of Public Health Author-Name: Curran, W.J. Year: 1981 Volume: 71 Issue: 6 Pages: 646-647 DOI: 10.2105/AJPH.71.6.646 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.646 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.646_1 Template-Type: ReDIF-Article 1.0 Title: The risk of hip fracture in postmenopausal females with and without estrogen drug exposure Journal: American Journal of Public Health Author-Name: Johnson, R.E. Author-Name: Specht, E.E. Year: 1981 Volume: 71 Issue: 2 Pages: 138-144 DOI: 10.2105/AJPH.71.2.138 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.138 Abstract: This study estimated the risk of hip fracture among postmenopausal females with and without estrogen drug exposure. The Kaiser-Permanente Medical Care Program in Portland, Oregan served as the setting and medical records the source of data. A retrospective case-control method that matched each female member hospitalized with a hip fracture (N = 168) between 1965-1975 with two control female members hospitalized for reasons other than a hip fracture was used. The estrogen exposure rate of cases was 29.2 per cent and of controls 36.0 per cent. The risk of hip fracture was reduced with postmenopausal and prefracture estrogen exposure (R(ML) = 0.72, 95 per cent CL: 0.48-1.09). However, the number of cases was sufficient only to detect a reduction in risk of about 50 percent or greater. A possible protective effect from estrogens was also suggested with oral estrogen exposure and with longer lengths of estrogen exposure. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.138_3 Template-Type: ReDIF-Article 1.0 Title: Role of local health departments in the delivery of ambulatory care. Journal: American Journal of Public Health Author-Name: Miller, C.A. Author-Name: Moos, M.K. Author-Name: Kotch, J.B. Author-Name: Brown, M.L. Author-Name: Brainard, M.P. Year: 1981 Volume: 71 Issue: S1 Pages: 15-29 Abstract: Many people (40 per cent) receive each year some personal health service provided by local health departments. A substantial number of poor children (50 per cent) look to public agencies including health departments for all or part of their medical care. A number of departments including those represented in this study come close to serving as the guarantor of basic medical care for entire constituent populations, reaching those people who are not reached by other provider systems. Health departments over the past decade have increased their involvement as providers of medical care, in part assisted by such federal initiatives as WIC, and Medicaid. Health departments have institutionalized many of the innovations generated by federal demonstration projects of the 1960s, and continue a tradition as centers of important innovation in styles and continuity of health care. The health departments studied are notable in many respects, not the least of which is their constructive relationship with private providers. Some health departments appear to function at high levels of effectiveness in a dual fashion alongside private provider systems. Other departments interact or accommodate with private providers in ways that appear beneficial to the populations they serve. It would appear that both public and private provider systems are essential, and that they need not compete; they can provide mutual reinforcement for achieving universal and equitable health services in the public interest. Handle: RePEc:aph:ajpbhl:1981:71:S1:15-29_4 Template-Type: ReDIF-Article 1.0 Title: Breast self-examination and medical examination related to breast cancer stage Journal: American Journal of Public Health Author-Name: Senie, R.T. Author-Name: Rosen, P.P. Author-Name: Lesser, M.L. Author-Name: Kinne, D.W. Year: 1981 Volume: 71 Issue: 6 Pages: 583-590 DOI: 10.2105/AJPH.71.6.583 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.583 Abstract: The frequency and type of breast examinations reported by 1,216 primary breast cancer patients was studied in relation to local stage of disease. No significant relationship was found between the reported frequency of breast self-examination (BSE) and stage of disease; however, annual medical examination was significantly associated with small tumor size (P < .01) and absence of axillary lymph node metastases (P < .001). Regardless of the frequency of any method of examination, the majority (80 per cent) of tumors were first detected by the patients. Among those who detected their lesion, a greater frequency of medical examination was associated with an earlier pathological stage of disease (P < .001). Patients who were examined more frequently by a physician appeared to be more sensitive to clinically significant breast abnormalities. These findings underscore the importance of examiner skill in the successful use of palpation to detect breast cancer. Instruction in BSE by a health professional during periodic examinations may provide the optimal opportunity for improved proficiency in self-examination. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.583_7 Template-Type: ReDIF-Article 1.0 Title: Evaluation of the Rhode Island child restraint law Journal: American Journal of Public Health Author-Name: Williams, A.F. Author-Name: Wells, J.A.K. Year: 1981 Volume: 71 Issue: 7 Pages: 742-743 DOI: 10.2105/AJPH.71.7.742 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.742 Abstract: In Rhode island, a law went into force July 1, 1980, requiring drivers to transport children who are in the front seats of vehicles in properly used child restraints. In the 4th month of the law, restraint use and travel in rear seats had increased moderately; the net result was an increase in proper restraint use in rear seats (11 to 23%) and a decrease in unrestrained, front seat travel (41 to 26%). Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.742_9 Template-Type: ReDIF-Article 1.0 Title: Adolescents' use of mental health services in a comprehensive treatment facility: Age, sex and mode of entry Journal: American Journal of Public Health Author-Name: Mitchell, J.R. Author-Name: Smith, M.S. Year: 1981 Volume: 71 Issue: 12 Pages: 1329-1332 DOI: 10.2105/AJPH.71.12.1329 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1329 Abstract: Data are presented from the clinical records of 185 adolescents who were admitted to the mental health service of a youth health center serving a community of military dependents. Eight and one-half per cent of the population made a first visit to the center during an eight month period. Midadolescence (age 15-16) was the age period when patients began to refer themselves to mental health services in significant numbers. The importance of parents as referral sources decreased with age, while medical and school sources were important in all ages. The psychological morbidity in the target population was greater in midadolescence than in early and late adolescence and higher in females than in males. Females presented with more somatic and family problems, males more often with aggressive behavior and problems. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1329_1 Template-Type: ReDIF-Article 1.0 Title: Drinking water sodium and blood pressure: A cautious view of the 'second look' Journal: American Journal of Public Health Author-Name: Willett, W.C. Year: 1981 Volume: 71 Issue: 7 Pages: 729-732 DOI: 10.2105/AJPH.71.7.729 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.729 Abstract: Overall knowledge strongly suggests that large changes in sodium intake (e.g., several grams per day) do have an effect on blood pressure in at least some individuals, and it is therefore probable that even the relatively small increments in sodium intake attributable to certain water supplies have some effect on blood pressure. However, the studies of Tuthill and Calabrese provide little evidence relating to the magnitude of such an effect. Differences in blood pressure attributable to drinking water sodium are likely to be substantially less than the observed differences between the two communities they have studied, and may be undetectable by epidemiologic methods. However, their report serves an important function by focusing attention on our ignorance regarding the dose-response relation of sodium intake to blood pressures of children and normotensive adults. This clearly deserves further study because of the large amounts of sodium added to our food, both by individuals and commercial food processors. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.729_9 Template-Type: ReDIF-Article 1.0 Title: Prenatal care and pregnancy outcome in an HMO and general population: A multivariate cohort analysis Journal: American Journal of Public Health Author-Name: Quick, J.D. Author-Name: Greenlick, M.R. Author-Name: Roghmann, K.J. Year: 1981 Volume: 71 Issue: 4 Pages: 381-390 DOI: 10.2105/AJPH.71.4.381 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.381 Abstract: We studied the use of prenatal care and pregnancy outcome in 4,148 deliveries among members of a well-established health maintenance organization (HMO) and 19,116 births among the 1973-1974 White birth cohort in the Portland, Oregon area. Mothers in the HMO were almost one year older on the average, slight better educated, and less frequently unmarried, but had virtually identical past pregnancy histories when compared with the general population cohort. HMO members began prenatal care one month later and had three fewer visits than the general population (p<.01); 78 per cent of the general population and only 64 per cent of HMO members began prenatal care in the first trimester (p<.01). With maternal risk held constant, low birthweight, neonatal mortality, and infant mortality were 1.5 to 5 times greater with late, less frequent prenatal care than with early, frequent care. Multivariate analysis demonstrated a positive relationship between prenatal care and birthweight. Although this relationship was independent of risk factors recorded on birth certificates, it is not necessarily a causal relationship. Unadjusted prematurity, neonatal and infant mortality rates did not differ between the HMO and general populations. Multivariate analyses indicated that, independent of all maternal risk factors, HMO membership was associated with an increase of 30 grams in the predicted birthweight (p<.01), but had no effect on mortality. The data suggest that, in Portland, Oregon, pregnancy outcome for HMO members is comparable to that of the general population. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.381_7 Template-Type: ReDIF-Article 1.0 Title: Smoking, drinking, and drug use among American high school students: Correlates and trends, 1975-1979 Journal: American Journal of Public Health Author-Name: Bachman, J.G. Author-Name: Johnston, L.D. Author-Name: O'Malley, P.M. Year: 1981 Volume: 71 Issue: 1 Pages: 59-69 DOI: 10.2105/AJPH.71.1.59 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.59 Abstract: This paper uses findings from five nationally representative surveys of high school seniors from 1975 through 1979 to examine the correlates of licit and illicit drug use, and to consider whether recent changes in youthful drug use are linked to any changes in the correlates. Males still exceed females in use of alcohol and marijuana, but no longer in cigarette smoking. Black seniors now report less drug use than Whites. Other dimensions of family background, region, and urbanicity show only modest associations with drug use. Above average drug use occurs among those less successful in adapting to the educational environment, as indicated by truancy and low grades; those who spend many evenings out for recreation; and those with heavy time commitments to a job and/or relatively high incomes. Drug use is below average among seniors with strong religious commitments and conservative political views. From 1975 through 1979, among seniors cigarette use peaked and subsequently declined, marijuana use rose and the leveled off, and the (still infrequent) use of cocaine rose rapidly. However, these shifts in drug use were not accompanied by substantial shifts in the above correlates of use. The findings thus suggest that the kinds of young people most at risk remain much the same, while the types and amounts of substances they use shift somewhat from year to year. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.59_8 Template-Type: ReDIF-Article 1.0 Title: Obtaining hospital and physician participation in a case-control study of colon cancer Journal: American Journal of Public Health Author-Name: Herrmann, N. Author-Name: Amsel, J. Author-Name: Lynch, E. Year: 1981 Volume: 71 Issue: 12 Pages: 1314-1319 DOI: 10.2105/AJPH.71.12.1314 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1314 Abstract: This paper describes efforts to solicit hospital and physician participation for a case-control study of the etiology of colon cancer in the five Pennsylvania counties of the Philadelphia metropolitan area. Forty-seven of the 70 hospitals in this region were eligible for inclusion in the study. Thirty-seven (79%) agreed to participate, 27 of them within six months of initial contact. The median time to approval of participation was three months and the median number of separate contacts was nine. At least five participating hospitals submitted the protocol to their lawyers and nine required that special procedures be developed for release of patient information. Two hundred fourteen of 256 listed attending physicians were eligible for participation; 161 (75%) permitted all patients to be contacted; 23 (11%) permitted some patients to be contacted; 30 (14%) refused all patient contact. A significant association between type of specialty and type of permission was found (p~.005). Concerns about confidentiality and lack of personal advantage were frequently cited by non-participants. The validity of case-control studies relying on hospital or physician ascertainment of cases is seriously challenged by such lengthy delays and lack of participation which can result in a biased pool of potential cases. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1314_5 Template-Type: ReDIF-Article 1.0 Title: The child-adolescent blood pressure study: I. Distribution of blood pressure levels in Seventh-Day Adventist (SDA) and non-SDA children Journal: American Journal of Public Health Author-Name: Harris, R.D. Author-Name: Phillips, R.L. Author-Name: Williams, P.M. Author-Name: Kuzma, J.W. Author-Name: Fraser, G.E. Year: 1981 Volume: 71 Issue: 12 Pages: 1342-1349 DOI: 10.2105/AJPH.71.12.1342 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1342 Abstract: Distribution of systolic and diastolic blood pressures (measured with an automated blood pressure recorder) of two large groups of children - 3,159 from Seventh-Day Adventist (SDA) schools and 4,681 from non-SDA schools - are reported. The boys and girls were from four different ethnic groups and attended grades one through 10 in 29 Southern California schools. The analysis of the data failed to show significant differences in mean blood pressure levels between the two groups of children at all ages, despite marked differences in life-style between the two groups, and despite the fact that adults from the two population groups have marked differences in mortality from diseases associated with elevated blood pressure. A comparison between boys and girls showed significantly higher trends in mean systolic blood pressure for boys after age 12. Inter-ethnic comparisons of blood pressure revealed that Black children of both sexes had slightly higher mean blood pressure levels at all ages. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1342_2 Template-Type: ReDIF-Article 1.0 Title: Low measles incidence: Association with enforcement of school immunization laws Journal: American Journal of Public Health Author-Name: Robbins, K.B. Author-Name: Brandling-Bennett, A.D. Author-Name: Hinman, A.R. Year: 1981 Volume: 71 Issue: 3 Pages: 270-274 DOI: 10.2105/AJPH.71.3.270 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.270 Abstract: Of 54 federal immunization project areas in the United States, 13 areas with low measles incidence rates in 1977 and 1978 and 10 with high measles incidence rates were compared for differences in surveillance systems, demography, vaccine utilization, school immunization laws, and immunity levels. There was no significant difference between the low incidence and high incidence group for any examined parameter of demographic characteristics, vaccine utilization, or surveillance systems. However, in the low incidence group, school immunization laws were found to be more comprehensive and more strictly enforced with a statewide policy of exclusion from school of noncompliant students. Furthermore, immunization levels were similar for 2-year-olds in both groups but were significantly higher for school entrants in the low incidence group. In all public health efforts to control or eliminate measles, priority should be given to establishing and strictly enforcing comprehensive school immunization laws. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.270_3 Template-Type: ReDIF-Article 1.0 Title: Family Life Theatre and Youth Health Services Journal: American Journal of Public Health Author-Name: Boria, M.C. Author-Name: Welch, E.J. Author-Name: Vargas, A.M. Year: 1981 Volume: 71 Issue: 2 Pages: 150-154 DOI: 10.2105/AJPH.71.2.150 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.150 Abstract: The Family Life Theatre, integrated into the Youth Health Services of a medical institution in a large urban community, has achieved rather unusual success. After seven years of experience marked by a constant quest for improvements, what was started in 1973 as a very modest health education program, through the medium of improvisational theatre, has now become a pilot project, duplicated by many groups and institutions throughout the country. The experiences of the Family Life Theatre, and its multiple ramifications leading to a comprehensive approach to the adolescent health problems, are presented and analyzed in a public health perspective. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.150_4 Template-Type: ReDIF-Article 1.0 Title: Patterns of alcohol use among veterans and nonveterans: A confirmation of previous findings Journal: American Journal of Public Health Author-Name: Boscarino, J. Year: 1981 Volume: 71 Issue: 1 Pages: 85-88 Abstract: Analysis of alcohol consumption among veterans (N = 684) included in a 1977 national household survey of 3,322 adults confirmed previous findings based on 1975 national survey data. As previously found, higher levels of alcohol consumption were significantly related to being a veteran of U.S. military service. However, when demographic differences were adjusted between veterans and nonveterans, this was no longer the case. It was suggested that this confirmation of earlier findings strengthens the validity of these findings. Handle: RePEc:aph:ajpbhl:1981:71:1:85-88_4 Template-Type: ReDIF-Article 1.0 Title: Colorado court involvement in chemical spill clean-up activities Journal: American Journal of Public Health Author-Name: Rice, D. Year: 1981 Volume: 71 Issue: 9 Pages: 1044-1045 DOI: 10.2105/AJPH.71.9.1044 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1044 Abstract: Judicial involvement was utilized to force the owners of a pesticide formulation plant to decontaminate property that had been covered with toxic pesticides having the potential to contaminate both surface and groundwater supplies in the East Denver metropolitan area. This case represented the first use of the Colorado state court system in dealing with a hazardous waste 'spill.' In this case, judicial intervention was unsatisfactory because of the delays involved. Other courses of action will be considered in future cases of a similar nature. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1044_5 Template-Type: ReDIF-Article 1.0 Title: A thirty-month clinical experience in natural family planning Journal: American Journal of Public Health Author-Name: Kambic, R. Author-Name: Kambic, M. Author-Name: Brixius, A.M. Author-Name: Miller, S. Year: 1981 Volume: 71 Issue: 11 Pages: 1255-1258 DOI: 10.2105/AJPH.71.11.1255 File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1255 Abstract: A Natural Family Planning service was evaluated at the end of a 30-month developmental phase. There were 444 women taught and 322 method acceptors of which 248 intended to avoid pregnancy. NFP clients were older (mean age 26.9 vs 22.4 and 23.7 for comparison groups), had more children (1.4 vs 1.2 for the comparison group), and a larger percentage were married (83.1 per cent vs 23.0 per cent for the comparison group). After one year of use, the unplanned pregnancy rate was 14.4 per cent and the total dropout rate was 37.6 per cent by life table analysis. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1255_2 Template-Type: ReDIF-Article 1.0 Title: Parasitic disease control in a residential facility for the mentally retarded: Failure of selected isolation procedures Journal: American Journal of Public Health Author-Name: Thacker, S.B. Author-Name: Kimball, A.M. Author-Name: Wolfe, M. Author-Name: Choi, K. Author-Name: Gilmore, L. Year: 1981 Volume: 71 Issue: 3 Pages: 303-305 DOI: 10.2105/AJPH.71.3.303 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.303 Abstract: Asymptomatic infection with either Entamoeba histolytica or Giardia lamblia was found in 60% of the residents in an institution for the mentally retarded one year after eradication of these parasites. The residents were then segregated into infected and noninfected groups and drug therapy was again successfully undertaken. The two groups remained separated except during periods of play. A one-year follow-up showed that both study and control groups were equally infected. The failure of segregation was confounded by patient age and infection with nonpathogenic parasites. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.303_5 Template-Type: ReDIF-Article 1.0 Title: Job satisfaction in the practice of clinical pharmacy Journal: American Journal of Public Health Author-Name: Rauch, T.M. Year: 1981 Volume: 71 Issue: 5 Pages: 527-529 DOI: 10.2105/AJPH.71.5.527 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.527 Abstract: Two groups of pharmacists (n = 69) assigned to 35 US Army Medical Treatment Facilities were surveyed to assess job satisfaction. Pharmacists providing patient care were significantly more satisfied on intrinsic job satisfaction measures than pharmacists not providing patient care. On the other hand, no significant difference in satisfaction was found between pharmacy groups on extrinsic job satisfaction measures. The results are discussed relative to intrinsic and extrinsic sources of job satisfaction and patient care. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.527_4 Template-Type: ReDIF-Article 1.0 Title: Underestimation of the role of pneumonia and influenza in causing excess mortality Journal: American Journal of Public Health Author-Name: Barker, W.H. Author-Name: Mullooly, J.P. Year: 1981 Volume: 71 Issue: 6 Pages: 643-645 DOI: 10.2105/AJPH.71.6.643 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.643 Abstract: Underestimation of pneumonia and influenza (P&I) mortality during influenza epidemics was explored in 38 P&I associated deaths among a population of adults during two influenza A (H3N2) epidemics. Pneumonia or influenza was mentioned on 32 (84 per cent) of the death certificates. However, based on rules for assigning cause of death, only nine (24 per cent, SE = 7) and 23 (61 per cent, SE = 8) of the cases would have been included in P&I mortality statistics compiled by the National Center for Health Statistics and the Center for Disease Control, respectively. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.643_7 Template-Type: ReDIF-Article 1.0 Title: Skin color and education effects on blood pressure Journal: American Journal of Public Health Author-Name: Keil, J.E. Author-Name: Sandifer, S.H. Author-Name: Loadholt, C.B. Author-Name: Boyle Jr., E. Year: 1981 Volume: 71 Issue: 5 Pages: 532-534 DOI: 10.2105/AJPH.71.5.532 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.532 Abstract: This study reports that education effects but not skin color effects were associated with blood pressure and the incidence of hypertension in a cohort of Black females in Charleston, South Carolina, observed over the period 1960-1975. The authors suggest that skin color may be a secondary (non-causal) associate of blood pressure in Blacks. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.532_4 Template-Type: ReDIF-Article 1.0 Title: To screen or not to screen: Congenital dislocation of the hip Journal: American Journal of Public Health Author-Name: Frankenburg, W.K. Year: 1981 Volume: 71 Issue: 12 Pages: 1311-1313 DOI: 10.2105/AJPH.71.12.1311 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1311 Abstract: A list of criteria, some disease-related and some screening test-related, is presented for use in assessing the value of screening for a particular disease or disorder. Based on these criteria, and on the principle that an unrequested screening test is not justified unless its advantages clearly outweigh its disadvantages, mass screening programs to identify children with dislocated hips are judged to be unethical at this time. Physicians can, however, incorporate a hip assessment into their physical examination. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1311_4 Template-Type: ReDIF-Article 1.0 Title: Estimating costs of illness and injuries: A criticism Journal: American Journal of Public Health Author-Name: Sondik, E.J. Author-Name: Kristein, M.M. Year: 1981 Volume: 71 Issue: 12 Pages: 1392-1393 DOI: 10.2105/AJPH.71.12.1392 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1392 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1392_4 Template-Type: ReDIF-Article 1.0 Title: Children's ability to evaluate television commercial messages for sugared products Journal: American Journal of Public Health Author-Name: Lambo, A.M. Year: 1981 Volume: 71 Issue: 9 Pages: 1060-1062 DOI: 10.2105/AJPH.71.9.1060 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1060 Abstract: A study of the ability of 120 children to evaluate the cariogenic potential of products presented in commercial television messages was undertaken. Each child was shown commercials for sugar-containing products. The results indicated: 1) grade-related differences exist in a child's ability to evaluate products; 2) no differences between socioeconomic status groups were found in a child's ability to evaluate products; 3) a weak relationship between the level of dental health knowledge and ability to evaluate the products. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1060_6 Template-Type: ReDIF-Article 1.0 Title: Teaching poison prevention to preschool children, their parents, and professional educators through child care centers Journal: American Journal of Public Health Author-Name: Krenzelok, E.P. Author-Name: Garber, R.J. Year: 1981 Volume: 71 Issue: 7 Pages: 750-752 DOI: 10.2105/AJPH.71.7.750 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.750 Abstract: A program to teach poison prevention to preschool children in day care centers was designed to teach three basic concepts: where poison is, what poison is, and how to avoid poison. A series of 10 slide-cassette presentations and numerous teaching aids were developed for use by the day care center instructor to the children. Over 3,000 children were enrolled in the program. Evaluation shows that poison prevention education can be demonstrated in children less than 5 years of age. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.750_5 Template-Type: ReDIF-Article 1.0 Title: Fatal falls and jumps from motor vehicles Journal: American Journal of Public Health Author-Name: Williams, A.F. Author-Name: Goins, S.E. Year: 1981 Volume: 71 Issue: 3 Pages: 275-279 DOI: 10.2105/AJPH.71.3.275 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.275 Abstract: In 1978, 345 persons were killed in the United States in jumps and falls from non-crashing motor vehicles: 64% fell; 15% jumped; and it was not known whether the other 21% jumped or fell. 201 people had been traveling on the exterior of vehicles, especially truck beds, and almost all of these people fell from their vehicles. The other 144 fatalities involved people in passenger compartments. Many of the falls from compartments occurred when occupants opened doors, or when vehicles changed direction. 77% of those who fell from passenger compartments were males and 44% were less than 5 years old. Among those who jumped from vehicle compartments, 62% were women and all were older than 14 years. Fatal falls and jumps from vehicles could be reduced in a variety of ways. These include legislation to prohibit travel on vehicle exteriors, designing vehicles so that doors cannot be opened when in motion, improving door designs, installing signals that provide warning if doors are not closed completely, and using occupant restraints. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.275_3 Template-Type: ReDIF-Article 1.0 Title: The risk of childbearing re-evaluated Journal: American Journal of Public Health Author-Name: Rubin, G. Author-Name: McCarthy, B. Author-Name: Shelton, J. Author-Name: Rochat, R.W. Author-Name: Terry, J. Year: 1981 Volume: 71 Issue: 7 Pages: 712-716 DOI: 10.2105/AJPH.71.7.712 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.712 Abstract: To determine the completeness of reporting of maternal deaths after live born deliveries in Georgia for 1975 and 1976, we matched death certificates with corresponding birth certificates for women of reproductive age. For these two years, more intensive searching led to our finding a minimum of a 27% higher number of maternal deaths than that found by routine death certificate surveillance. When the delivery-death interval was not restricted to 42 days, use of the record linkage method led to a 50% increase in reporting of maternal deaths. We recommend that special efforts be made to obtain more complete reporting of all pregnancy-related deaths and that completeness of reporting be periodically evaluated for all states. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.712_3 Template-Type: ReDIF-Article 1.0 Title: Nutritional status of Southeast Asian refugee children Journal: American Journal of Public Health Author-Name: Peck, R.E. Author-Name: Chuang, M. Author-Name: Robbins, G.E. Author-Name: Nichaman, M.Z. Year: 1981 Volume: 71 Issue: 10 Pages: 1144-1148 DOI: 10.2105/AJPH.71.10.1144 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1144 Abstract: Since 1975 nearly 300,000 Indochinese refugees have been relocated in the United States. The Nutrition Division, Centers for Disease Control, Atlanta, surveyed the medical records of four west coast clinics to obtain nutrition-related data on 821 Southeast Asian refugee children under six years of age, arriving between July 1979 and June 1980. Hemoglobin, hematocrit, and anthropometric data were compared to those of a comparison group of Southeast Asian children screened prior to 1979 and to a National Health Examination Survey reference population. The newly-arrived refugee group was found to be highly anemic and stunted relative to the comparison group. Although stunted, the study group did not appear greatly wasted. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1144_0 Template-Type: ReDIF-Article 1.0 Title: Rural areas and personal health services: current strategies. Journal: American Journal of Public Health Author-Name: Sheps, C.G. Author-Name: Bachar, M. Year: 1981 Volume: 71 Issue: S1 Pages: 71-82 Handle: RePEc:aph:ajpbhl:1981:71:S1:71-82_3 Template-Type: ReDIF-Article 1.0 Title: A comparison of medical record with billing diagnostic information associated with ambulatory medical care Journal: American Journal of Public Health Author-Name: Studney, D.R. Author-Name: Hakstian, A.R. Year: 1981 Volume: 71 Issue: 2 Pages: 145-149 DOI: 10.2105/AJPH.71.2.145 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.145 Abstract: The degree of similarity between diagnostic information furnished with claims and that simultaneously entered into the medical record was estimated for 1,215 private office visits in British Columbia, Canada. For each visit, claim card and chart diagnoses were compared by having three independent internists (blinded to source and type of the data) make judgments about each diagnostic pair. The judges were highly consistent internally and their judgments were stable over time. In 40 per cent of cases chart and claims data were judged dissimilar, and in 38 per cent of cases claims data were judged more valuable as a reflection of the primary problem treated. The degree of judged similarity of chart and claims data correlated significantly and negatively with physician workload, income, and judges' preference for the billing card diagnosis. We conclude that in using claims data to determine the content of ambulatory visits, independent validation of such data may be important. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.145_9 Template-Type: ReDIF-Article 1.0 Title: Public support for national health insurance Journal: American Journal of Public Health Author-Name: Goodman, L.J. Author-Name: Steiber, S.R. Year: 1981 Volume: 71 Issue: 10 Pages: 1105-1108 DOI: 10.2105/AJPH.71.10.1105 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1105 Abstract: In 1978 a majority of the American public felt there was a need for National Health Insurance (NHI). This study develops models of public support for NHI both with and without a tax subsidy. Support for NHI is highest among the young, lower socioeconomic groups, non-Whites, and urbanites. The older, more educated, White and rural populations are less supportive. In addition, substantial differences exist across political party orientation and health insurance status. Although support for NHI declines by considering a tax subsidy, logit estimates remain relatively stable. Only age and socioeconomic status lose statistical significance when the tax issue is considered. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1105_3 Template-Type: ReDIF-Article 1.0 Title: Analysis of interrupted time series mortality trends: An example to evaluate regionalized perinatal care Journal: American Journal of Public Health Author-Name: Gillings, D. Author-Name: Makuc, D. Author-Name: Siegel, E. Year: 1981 Volume: 71 Issue: 1 Pages: 38-46 DOI: 10.2105/AJPH.71.1.38 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.38 Abstract: Interrupted time series designs are frequently employed to evaluate program impact. Analysis strategies to determine if shifts have occurred are not well known. The case where statistical fluctuations (errors) may be assumed independent is considered, and a segmented regression methodology presented. The method discussed is applied to the assessment of changes in local and state perinatal postneonatal mortality to identify historical trends and will be used to evaluate the impact of the North Carolina Regionalized Perinatal Care Program when seven years of postprogram mortality data become avilable. The perinatal program region is contrasted with a control region to provide a basis for interpretation of differences noted. Relevant segmented regression models provided good fits to the data and highlighted mortality trends over the last 30 years. Considerable racial differences in these trends were identified, particularly for postneonatal mortality. Segmented regression is considered relevant fon the analysis of interrupted time series designs in other applications when errors can be taken to be independent. Thus, the methodology may be regarded as a general statistical tool for evaluation purposes. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.38_6 Template-Type: ReDIF-Article 1.0 Title: Stability and change: Another view Journal: American Journal of Public Health Author-Name: Starfield, B. Year: 1981 Volume: 71 Issue: 3 Pages: 301-302 DOI: 10.2105/AJPH.71.3.301 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.301 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.301_1 Template-Type: ReDIF-Article 1.0 Title: Save that child: Children and automobile restraints Journal: American Journal of Public Health Author-Name: Meyer, R.J. Year: 1981 Volume: 71 Issue: 2 Pages: 122-123 DOI: 10.2105/AJPH.71.2.122 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.122 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.122_3 Template-Type: ReDIF-Article 1.0 Title: Help-seeking behavior among select populations of Black unmarried adolescent fathers: Implications for human service agencies Journal: American Journal of Public Health Author-Name: Hendricks, L.E. Author-Name: Howard, C.S. Author-Name: Caesar, P.P. Year: 1981 Volume: 71 Issue: 7 Pages: 733-735 DOI: 10.2105/AJPH.71.7.733 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.733 Abstract: This study was undertaken to provide additional information on what are appropriate roles for agencies in relation to unmarried adolescent fathers. The findings indicate that such appropriate roles for agencies would include the provision of psychosocial counseling, vocational guidance, and parenting education. It was concluded that agency personnel would have to reach out assertively to unmarried adolescent fathers in order to serve them more effectively. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.733_1 Template-Type: ReDIF-Article 1.0 Title: Ethnic differences in hemoglobin distribution of Asian and European Jewish women in Israel, both pregnant and nonpregnant Journal: American Journal of Public Health Author-Name: Palgi, A. Year: 1981 Volume: 71 Issue: 8 Pages: 847-851 DOI: 10.2105/AJPH.71.8.847 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.847 Abstract: Hemoglobin levels of Asian Jewish women both while pregnant and nonpregnant were lower than in their European counterparts by about 0.23 g/100 ml to 0.3 g/100 ml. The groups had similar parity numbers but the Asian women's socioeconomic status was lower. In both the pregnant and nonpregnant, Israeli-born Asian women had higher mean hemoglobin levels than Asian immigrants but lower than Israeli-born Europeans. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.847_6 Template-Type: ReDIF-Article 1.0 Title: The epidemiologist's lament Journal: American Journal of Public Health Author-Name: Rothman, K.J. Year: 1981 Volume: 71 Issue: 12 Pages: 1309-1311 DOI: 10.2105/AJPH.71.12.1309 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1309 Abstract: Despite increasing public demand and support for epidemiological research, Rothman and other investigators find it increasingly difficult to obtain permission to conduct their studies in hospitals. Considered outsiders in most institutions but dependent on patient interviews for much of their data, epidemiologists must meet stringent, often unrealistic informed consent requirements set by unsympathetic institutional review boards (IRBs). Since it appears unlikely that the boards will relinquish their review prerogatives, the author recommends the appointment of epidemiologists to hospital IRBs to advise members on how to evaluate epidemiologic projects. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1309_4 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of alcohol abuse in military and civilian populations Journal: American Journal of Public Health Author-Name: Polich, J.M. Year: 1981 Volume: 71 Issue: 10 Pages: 1125-1132 DOI: 10.2105/AJPH.71.10.1125 File-URL: http://hdl.handle.net/10.2105/AJPH.71.10.1125 Abstract: Results from a random sample survey of US Air Force personnel show that 4.6 per cent exhibit alcohol dependence, indicated by symptoms of withdrawal and impaired control over drinking. An additional 9.3 per cent can be identified as nondependent alcohol abusers, indicated by serious adverse effects of drinking (such as arrest, accident, hospitalization, or significant work impairment) or by heavy alcohol consumption (over 150 ml of ethanol daily). Compared with data from supervisors and offical records, survey results did not understate alcohol-related problems. Survey reports of alcohol consumption did underestimate alcoholic beverage sales by about 20 per cent, but adjustments for this discrepancy increased the prevalence rate by less than one percentage point. Rates of serious alcohol abuse among representative samples of males in the US Army, Navy, Air Force, and civilian populations were also compared. Although the rates were higher in the military than among civilians, most of the difference were associated with the higher-risk demographic characteristics of military personnel, who are more likely than civilians to be young unmarried males. Results indicate that the rate of alcohol abuse in the military is about the same as in civilian groups with comparable demographic characteristics. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.10.1125_0 Template-Type: ReDIF-Article 1.0 Title: Primary health care and the local health department: the North Carolina experience. Journal: American Journal of Public Health Author-Name: Tilson, H.H. Author-Name: Jellinek, P. Year: 1981 Volume: 71 Issue: S1 Pages: 35-45 Handle: RePEc:aph:ajpbhl:1981:71:S1:35-45_0 Template-Type: ReDIF-Article 1.0 Title: Surgical fertility regulation among women on the Navajo Indian Reservation, 1972-1978 Journal: American Journal of Public Health Author-Name: Temkin-Greener, H. Author-Name: Kunitz, S.J. Author-Name: Broudy, D. Author-Name: Haffner, M. Year: 1981 Volume: 71 Issue: 4 Pages: 403-407 DOI: 10.2105/AJPH.71.4.403 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.403 Abstract: Changes in the rates of induced abortions, bilateral tubal ligations, and hysterectomies on the Navajo Indian Reservation have been examined for the years 1972-1978. While the incidence of abortions and tubal sterilizations is still considerably lower among Navajo women than among the total United States population of women, it has risen, especially among those in the prime of the reproductive cycle, i.e., ages 20-34. The rate of hysterectomy has not changed substantially. Regression analyses performed on the data indicate that the utilization of surgery for fertility regulation in women on the Navajo Reservation, unlike other surgical procedures, is not affected by access to hospitals which provide surgery. Rather measures of involvement in the wage work economy are of primary importance. Those areas of the Reservation having the highest levels of such involvement exhibit the highest rates of such surgery. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.403_2 Template-Type: ReDIF-Article 1.0 Title: Quality assessment by process and outcome methods: Evaluation of emergency room care of asthmatic adults Journal: American Journal of Public Health Author-Name: Mates, S. Author-Name: Sidel, V.W. Year: 1981 Volume: 71 Issue: 7 Pages: 687-693 DOI: 10.2105/AJPH.71.7.687 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.687 Abstract: Weighted process criteria based on chart review and weighted outcome criteria based on telephone interview were used to assess the quality of care for adult patients with asthma in the emergency rooms of a municipal and a voluntary hospital which share medical personnel. Process scores were highly correlated with 24-hour outcome scores at both hospitals but not with 7-day outcome scores. Our findings suggest that appropriate weighted process and outcome criteria are valid and useful methods for quality assessment, and underline the importance of choice of an appropriate 'time window' for assessment of outcome. In addition, these assessment methods provide important 'feedback' information for those providing care in the emergency room. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.687_2 Template-Type: ReDIF-Article 1.0 Title: The effect of a thirty per cent reduction in physician fees on Medicaid surgery rates in Massachusetts Journal: American Journal of Public Health Author-Name: Shwartz, M. Author-Name: Martin, S.G. Author-Name: Cooper, D.D. Author-Name: Ljung, G.M. Author-Name: Whalen, B.J. Author-Name: Blackburn, J. Year: 1981 Volume: 71 Issue: 4 Pages: 370-375 DOI: 10.2105/AJPH.71.4.370 File-URL: http://hdl.handle.net/10.2105/AJPH.71.4.370 Abstract: In this paper, we use an interrupted time series analysis to assess the effect of a 30 per cent reduction in the Medicaid reimbursement fee for physician services on the rate at which eight elective surgical procedures were performed in the Massachusetts Medicaid population. Tonsillectomy/adenoidectomy is the only procedure in which there was a statistically significant decline in the rate of surgery in most areas of the state following the fee cut. There is some evidence of an increase in the rate of disc surgeries/spinal fusions. The rate of other procedures increased in some areas of the state and decreased in other areas in the period after the fee cut. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.4.370_8 Template-Type: ReDIF-Article 1.0 Title: Past asbestos exposure among cable splicers Journal: American Journal of Public Health Author-Name: Fischbein, A. Author-Name: Rohl, A.N. Author-Name: Langer, A.M. Author-Name: Selikoff, I.J. Year: 1981 Volume: 71 Issue: 11 Pages: 1277-1278 DOI: 10.2105/AJPH.71.11.1277-a File-URL: http://hdl.handle.net/10.2105/AJPH.71.11.1277-a Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.11.1277-a_5 Template-Type: ReDIF-Article 1.0 Title: The contribution of school health education to community health promotion: What can we reasonably expect? Journal: American Journal of Public Health Author-Name: Bartlett, E.E. Year: 1981 Volume: 71 Issue: 12 Pages: 1384-1391 DOI: 10.2105/AJPH.71.12.1384 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1384 Abstract: Evaluative studies of outcomes of traditional school health education programs have shown that they are very effective in increasing knowledge, somewhat effective in improving attitudes, and, with a few notable exceptions, generally ineffective in changing health practices. This paper discusses the previous reviews of the literature of outcomes of school health education programs, and discusses the constraints inherent in school-based activities: an emphasis on cognitive learning, lecture-oriented teaching methods, inadequate pupil assessment procedures, a captive audience, competing subject areas, competing behavioral influences, behavior change attempts directed at ingrained health habits, inadequate coordination with community resources, and lack of consensus regarding educational goals. The paper then examines several recent successful school health education programs emphasizing non-traditional approaches in self-initiated care, pregnancy prevention, smoking prevention, and nutrition. It is concluded that school-based health education programs have three important roles in community health promotion: 1) the provision of a fundamental understanding of health and disease concepts to large segments of the population; 2) the reinforcement of positive health attitudes; and 3) the alteration of concurrent health behaviors for significant health problems. Although school health education may be helpful in enhancing decision-making and social interaction skills, little empirical evidence exists at this time to support this conclusion. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1384_5 Template-Type: ReDIF-Article 1.0 Title: Saliva thiocyanate: A chemical indicator of cigarette smoking in adolescents Journal: American Journal of Public Health Author-Name: Luepker, R.V. Author-Name: Pechacek, T.F. Author-Name: Murray, D.M. Author-Name: Johnson, C.A. Author-Name: Hund, F. Author-Name: Jacobs, D.R. Year: 1981 Volume: 71 Issue: 12 Pages: 1320-1324 DOI: 10.2105/AJPH.71.12.1320 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1320 Abstract: Denial and minimization in self-reports of cigarette smoking are probably common among youth and other groups where smoking is discouraged. Chemical measures may obtain more accurate measurement of smoking habits in those groups. One such measure, saliva thiocyanate (SCN), was evaluated in 1,419 eighth grade students. In that group, 54.9% of students admitted to regular smoking of > one pack/week had thiocyanates ≥ 100 μg/ml compared to 2.3% nonsmokers at those levels. Of students who smoked ≥ 10 cigarettes in the prior 24 hours, 66.7% were at or above 100 μg/ml. Elevated SCN in nonsmokers was uncommon. Saliva SCN is a safe, inexpensive, and acceptable prevalence measurement for cigarette smoking. It can be used in place of self-reports to document smoking of greater than one pack/week in populations of youth. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1320_7 Template-Type: ReDIF-Article 1.0 Title: Prospectives on the risks of alternative fuel cycles Journal: American Journal of Public Health Author-Name: Johnson, D.H. Author-Name: Kastenberg, W.E. Author-Name: Griesmeyer, J.M. Year: 1981 Volume: 71 Issue: 9 Pages: 1050-1057 DOI: 10.2105/AJPH.71.9.1050 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1050 Abstract: A commentary is provided on the uncertainties in the data and in qualifying the phenomena relating to the risks imposed by the various steps involved in the use of coal, oil, natural gas, hydropower, and nuclear fuels for the generation of electricity. Uncertainties appear to be extremely large for hydropower which exhibits both large scale ecological impacts and the potential for high consequence, moderate frequency events at specific sites. Major risk-related uncertainties with the use of nuclear fuels include those surrounding nuclear weapons proliferation and reactor accident frequencies and consequences. Uncertainties for coal and oil include specification of the damage function of air transported sulfates and the effects of atmospheric CO2 buildup, acid rain, and groundwater contamination from mine water runoff. Compoundig these problems is the potential impact of the growing global competition for a diminishing supply of oil. In the studies reviewed herein, the assessed risks of the nuclear fuel cycle are no greater than those of the primary alternatives. Prudence suggests that we do not totally reject any particular option at this time on the basis of health effects alone; similarly, no option is an undisputed choice. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1050_7 Template-Type: ReDIF-Article 1.0 Title: Screening for cervical cancer, 1973-1976 Journal: American Journal of Public Health Author-Name: Hendershot, G.E. Year: 1981 Volume: 71 Issue: 8 Pages: 851-852 DOI: 10.2105/AJPH.71.8.851 File-URL: http://hdl.handle.net/10.2105/AJPH.71.8.851 Abstract: Using data from the National Survey of Family Growth, Cycle II, the per cent of women without a Pap test in 1973-1976 is shown according to race, residence, and income, updating an earlier report based on 1973 data. Poor women and nonmetropolitan women continued to be significantly less likely than other women to have had a Pap test. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.8.851_9 Template-Type: ReDIF-Article 1.0 Title: Occupational health in Cuba Journal: American Journal of Public Health Author-Name: Gomez, M.R. Year: 1981 Volume: 71 Issue: 5 Pages: 520-524 DOI: 10.2105/AJPH.71.5.520 File-URL: http://hdl.handle.net/10.2105/AJPH.71.5.520 Abstract: Health and safety regulation, training, and research were practically non-existent in Cuba before the Revolution in 1959. Since that time important advances have been made. Specialized inspectors, occupational physicians, and other such personnel are now trained in Cuba. An Occupational Health Institute, founded in 1976, provides training and specialized technical services, and conducts research. In 1978, a far reaching 'Work Safety and Health Law' was enacted which defines the rights and responsibilities of government agencies, workplace administrators, unions, and workers. Comprehensive control of toxic substances in workplaces, still at an early stage, is likely to increase in light of the new law, the growing availability of qualified personnel, and the mounting concern of public health authorities with the increasingly 'developed' health profile of the pupulation. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.5.520_1 Template-Type: ReDIF-Article 1.0 Title: Who is being screened for cervical cancer? Journal: American Journal of Public Health Author-Name: Kleinman, J.C. Author-Name: Kopstein, A. Year: 1981 Volume: 71 Issue: 1 Pages: 73-76 DOI: 10.2105/AJPH.71.1.73 File-URL: http://hdl.handle.net/10.2105/AJPH.71.1.73 Abstract: Data from the 1973 National Health Interview Survey, a probability sample of the United States population, are used to examine the relationship between Pap testing and four socioeconomic variables. It was found that women at highest risk of cervical cancer are least likely to have had Pap tests. The proportion of women who report never having had a Pap test is greater among Blacks, the poor, the elderly and nonmetropolitan residents. In particular, poor Black women in nonmetropolitan areas have extremely high proportions reporting no Pap test. However, high risk women are only slightly less likely to have visited a doctor in the two years preceding interview. These results suggest that improvement in Pap test coverage among high risk women could be attained by encouraging the use of the Pap test in regular ambulatory medical care. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.1.73_7 Template-Type: ReDIF-Article 1.0 Title: Accuracy of information on smoking habits provided on self-administered research questionnaires Journal: American Journal of Public Health Author-Name: Petitti, D.B. Author-Name: Friedman, G.D. Author-Name: Kahn, W. Year: 1981 Volume: 71 Issue: 3 Pages: 308-311 DOI: 10.2105/AJPH.71.3.308 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.308 Abstract: In the setting of a prepaid medical care plan, self-administered questionnaires were an accurate source of information on smoking habits and the standard against which the physiologic measures of smoking, serum thiocyanate, and expired carbon monoxide, must be judged. Questionnaire responses were internally consistent and highly reproducible. In contrast, the physiologic measures had low overall sensitivity as tests of current tobacco exposure (0.72). Their sensitivity was improved by utilizing the self-reported information. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.308_6 Template-Type: ReDIF-Article 1.0 Title: Does visiting the school health room teach appropriate or inappropriate use of health services? Children's use of school health rooms Journal: American Journal of Public Health Author-Name: Nader, P.R. Author-Name: Brink, S.G. Year: 1981 Volume: 71 Issue: 4 Pages: 416-419 Abstract: This study examines the school health room visiting behavior, over two school years, of a random sample (N=671) of urban children, grades K-5. Excluding eight students who visited regularly for medication (and who alone accounted for 25 per cent of all visits), 94 per cent of the students made at least one visit. Girls visited more frequently than boys (5.1 visits/year vs 4.1 visits/year). Girls were more likely to be in the frequent visitor group (P=0.01); to have presented five or more different complaints (P=0.02); and to have visited for stomachache (P≤0.001). These sex differences were observed as early as first grade. Almost 58 per cent of the variance in visiting in the second year was predicted by frequency of visiting in the first year. These data raise questions about the influence of the school in either reinforcing or modifying the health services utilization behavior of individuals. Handle: RePEc:aph:ajpbhl:1981:71:4:416-419_1 Template-Type: ReDIF-Article 1.0 Title: Smoking and depression: A community survey Journal: American Journal of Public Health Author-Name: Frerichs, R.R. Author-Name: Aneshensel, C.S. Author-Name: Clark, V.A. Author-Name: Yokopenic, P. Year: 1981 Volume: 71 Issue: 6 Pages: 637-640 DOI: 10.2105/AJPH.71.6.637 File-URL: http://hdl.handle.net/10.2105/AJPH.71.6.637 Abstract: Smoking status and symptoms of mental depression were determined as part of a community survey of adults in Los Angeles County. Nearly 42 per cent of the males and 31 per cent of the females were current smokers. Smokers compared to nonsmokers reported significantly higher levels of depression as measured by the Center for Epidemiologic Studies - Depression (CES-D) index (10.02 vs 78.76, p < .05). The differences were not significant however, when analyzed by sex. Furthermore, there were no significant differences in the CES-D score when comparing those who had never smoked, ex-smokers, current smokers who wanted to quit, and current smokers who did not want to quit. After controlling in a linear regression analysis for the effects of income, age, employment status, and sex, none of the smoking status variables contributed significantly to explaining the variance of the CES-D score. While both mental depression and smoking are individually major public health problems, the results of this investigation suggest that there is little relationship between the two in the general community. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.6.637_7 Template-Type: ReDIF-Article 1.0 Title: Children's health in families with cigarette smokers Journal: American Journal of Public Health Author-Name: Bonham, G.S. Author-Name: Wilson, R.W. Year: 1981 Volume: 71 Issue: 3 Pages: 290-293 DOI: 10.2105/AJPH.71.3.290 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.290 Abstract: Recent studies have indicated higher rates of certain respiratory conditions among children who live in households with adults who smoke cigarettes. This paper analyzes data from the 1970 National Health Interview Survey. Children in families with no smokers had an average of 1.1 fewer restricted-activity days and 0.8 fewer bed-disability days per year than did children in families with two smokers. Children in families with one smoker were in between. Acute respiratory illness accountd for the difference in disability days among children in families with different smoking characteristics. Family smoking was also measured by the combined number of cigarettes smoked by adults; children in families which smoked 45 or more cigarettes a day had 1.9 more restricted activity days and 0.9 more bed-disability days due to acute respiratory conditions than did children in families who did not smoke cigarettes. The age of the child, the number of adults in the family, the education of the family head, and the family income were all controlled and did not eliminate the relationship between children's health and family smoking. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.290_0 Template-Type: ReDIF-Article 1.0 Title: Patient attitudes following participation in a health outcome survey Journal: American Journal of Public Health Author-Name: Funch, D.P. Author-Name: Marshall, J.R. Year: 1981 Volume: 71 Issue: 12 Pages: 1396-1398 DOI: 10.2105/AJPH.71.12.1396 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1396 Abstract: A study was conducted to assess attitudes of women with breast cancer following their participation in a health outcome interview survey. The majority of the sample indicated that the interview was easier than expected and no one reported being inconvenienced by the interview; 94% indicated they were glad to have participated and 58% felt they had recieved some personal benefit. There was no evidence of distress resulting from participation. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1396_6 Template-Type: ReDIF-Article 1.0 Title: Change in smoking status among school-aged youth: Impact of a smoking-awareness curriculum, attitudes, knowledge and environmental factors Journal: American Journal of Public Health Author-Name: Pederson, L.L. Author-Name: Baskerville, J.C. Author-Name: Lefcoe, N.M. Year: 1981 Volume: 71 Issue: 12 Pages: 1401-1404 DOI: 10.2105/AJPH.71.12.1401 File-URL: http://hdl.handle.net/10.2105/AJPH.71.12.1401 Abstract: The present study examined the relationships between exposure to a smoking awareness curriculum, attitudes toward and knowledge about smoking, sociodemographic and smoking exposure characteristics, and change in smoking status over three years. During this period, 4.5% of the students decreased their involvement with cigarettes, 56.6% reported no change, and 38.9% reported an increase. Exposure to the curriculum did not bear a significant relationship to change in smoking; however, changes in peer smoking, knowledge, and parental smoking were significant predictors. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.12.1401_6 Template-Type: ReDIF-Article 1.0 Title: The gay report on sexually transmitted diseases Journal: American Journal of Public Health Author-Name: Darrow, W.W. Author-Name: Barrett, D. Author-Name: Jay, K. Author-Name: Young, A. Year: 1981 Volume: 71 Issue: 9 Pages: 1004-1011 DOI: 10.2105/AJPH.71.9.1004 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1004 Abstract: Most studies of sexually transmitted diseases in homosexual men have examined prevalence in clinic populations; for comparative purposes, we analyzed data from a survey of 4,329 gay men conducted in 1977. Among 4,212 respondents to the self-administered questionnaire, 66.8 per cent reported previous infection with pediculosis; 38.4 per cent, gonorrhea; 24.1 per cent, nonspecific urethritis; 18.1 per cent, venereal warts; 13.5 per cent, syphilis; 9.7 per cent, hepatitis; and 9.4 per cent, herpes. Number of different lifetime sexual partners best predicted histories of syphilis (r = .249), gonorrhea (r = .402), and the other diseases; frequency of checkups, years as a practicing homosexual, and furtive sexual activities were among the many other significant correlates of venereal infections. Respondents most often sought examinations from private physicians (39.4 per cent); those who visited gay clinics were examined most often and felt most positive about their medical care. Gay men who participated in the survey reported frequent infections with many of the same sexually transmitted diseases often seen in private medical practices, public VD clinics, and gay health centers. Since high rates of disease are related to large numbers of different partners, frequent exposures with anonymous contacts, and anal intercourse, we recommend frequent examinations for those whose life-styles include these characteristics. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1004_7 Template-Type: ReDIF-Article 1.0 Title: Cutaneous inflammation caused by inadvertent intradermal administration of DTP instead of PPD Journal: American Journal of Public Health Author-Name: Graham, D.R. Author-Name: Dan, B.B. Author-Name: Bertagnoll, P. Author-Name: Dixon, R.E. Year: 1981 Volume: 71 Issue: 9 Pages: 1040-1043 DOI: 10.2105/AJPH.71.9.1040 File-URL: http://hdl.handle.net/10.2105/AJPH.71.9.1040 Abstract: In 1979, 101 adults were skin-tested by a health department to evaluate tuberculin reactivity; of the 96 persons followed, 87 (91 per cent) experienced inflammation marked by swelling, erythema, arm pain, and fever. Five months later, a 5 mm to 10 mm purple macule persisted in 76 persons. The vials of PPD reportedly used for testing had been discarded, but PPD had been stored in the refrigerator with DT and DTP. The mean tetanus antitoxin titer in skin-tested persons was 0.14 units per ml (u/ml) vs 0.08 u/ml in untested control persons (p < 0.03). The mean diphtheria antitoxin titer in skin-tested people was 0.90 u/ml vs 0.16 for controls (p = 10-5). The mean pertussis antibody in skin-tested persons was 1:169 vs 1:12 for controls (p = 10-5). Intradermal DTP in immune rabbits produced histologically typical Arthus reactions similar to those experienced by the humans. Seven months later, 90 persons received PPD injections. Ten had induration; none experienced persistent reactions. We concluded that the humans initially received DTP instead of PPD. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.9.1040_5 Template-Type: ReDIF-Article 1.0 Title: The challenge of studying the disease effects of stressful work conditions Journal: American Journal of Public Health Author-Name: Kasl, S.V. Year: 1981 Volume: 71 Issue: 7 Pages: 682-684 DOI: 10.2105/AJPH.71.7.682 File-URL: http://hdl.handle.net/10.2105/AJPH.71.7.682 Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.7.682_4 Template-Type: ReDIF-Article 1.0 Title: Polychlorinated biphenyl contamination of nursing mothers' milk in Michigan Journal: American Journal of Public Health Author-Name: Wickizer, T.M. Author-Name: Brilliant, L.B. Author-Name: Copeland, R. Author-Name: Tilden, R. Year: 1981 Volume: 71 Issue: 2 Pages: 132-137 DOI: 10.2105/AJPH.71.2.132 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.132 Abstract: The problem of environmental contamination by toxic substances and human exposure to these substances has attracted increased attention in recent years. Particular concern has centered on polychlorinated biphenyls (PCBs), which have become widespread environmental pollutants as well as contaminants of the human population. This paper reports data from a study of PCB contamination of nursing mothers' breast milk in Michigan. During 1977 and 1978, breast milk samples of 1,057 nursing mothers residing in Michigan were tested for PCB residues. All of the 1,057 samples collected from 68 of the state's 83 counties contained PCB residues ranging from trace amounts to 5.100 parts per million (fat weight basis). The mean level was 1,496 parts per million (ppm), with 49.5 per cent of the samples having PCB levels of 1.2 ppm, 17.4 per cent had 2-3 ppm, and 6.14 per cent had more than 3 ppm. There was no consistent trend in the level of PCB contamination over the 24 months of monitoring. The mean PCB level for the eighth quarter of monitoring was slightly higher than for the first quarter. The public health significance of PCB contamination in human populations and its effects on breast-fed infants are unclear. However, an infant breast-fed for eight months by a woman with the average PCB level in this sample would have an estimated body burden of approximately 0.89 ppm of PCBs. The implications of PCB contamination of human milk with regard to current breast-feeding practices are discussed and several precautionary measures are recommended. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.132_2 Template-Type: ReDIF-Article 1.0 Title: Patient recovery from type A botulism: Morbidity assessment following a large outbreak Journal: American Journal of Public Health Author-Name: Mann, J.M. Author-Name: Martin, S. Author-Name: Hoffman, R. Author-Name: Marrazzo, S. Year: 1981 Volume: 71 Issue: 3 Pages: 266-269 DOI: 10.2105/AJPH.71.3.266 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.266 Abstract: A large outbreak of foodborne botulism provided an opportunity to study the recovery from type A botulism in a group of 27 patients. Patients were interviewed either 9 or 13 months after the outbreak, and a written questionnaire was mailed at 24 months, to obtain information on each patient's symptom complex and on subsequent symptom resolution. Recovery from symptoms of botulism was slow. Patients reported that resolution of 50% of their original symptoms occurred by an average of 5 months. Thirteen of 14 patients contacted 13 months after onset of botulism reported some persistent symptoms. This study, although limited to interview data, strengthens the concept of a prolonged recovery phase in botulism, as previously suggested in individual case reports. Physicians and other health workers caring for patients with botulism should anticipate physical and psychological problems resulting from a lengthy and difficult convalescent period. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.266_2 Template-Type: ReDIF-Article 1.0 Title: Premarital syphilis screening: Weighing the benefits Journal: American Journal of Public Health Author-Name: Kingon, R.J. Author-Name: Wiesner, P.J. Year: 1981 Volume: 71 Issue: 2 Pages: 160-162 DOI: 10.2105/AJPH.71.2.160 File-URL: http://hdl.handle.net/10.2105/AJPH.71.2.160 Abstract: The overall value of the routine use of serologic tests in the control of syphilis and reduction of complications has been clearly documented during the past four decades. This value in outpatient settings has recently been underscored by Chapel in an analysis of patients with secondary syphilis who were seen by physicians in community practice. His analysis found that one-third of these patients were diagnosed only on the basis of a routine serologic test. The specific contribution of premarital testing to the overall value of routine serologic testing is less certain and must be decided in each state. Decisions regarding premarital serologic tests must be made by responsible officials in light of epidemiologic factors in the community being served. Felman portrays the dilemma which state health officials must face in deciding the appropriatenes of mandated premarital syphilis serologic testing. Our hope is that the full range of benefits which may be derived from premarital examinations will be rigorously investigated by policymakers within each affected jurisdiction. We do not oppose a state's decision to repeal its premarital laws. We do oppose an over-simplified cost-effectiveness analysis leading to that decision. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.2.160_0 Template-Type: ReDIF-Article 1.0 Title: Female laundry and dry cleaning workers in Wisconsin: A mortality analysis Journal: American Journal of Public Health Author-Name: Katz, R.M. Author-Name: Jowett, D. Year: 1981 Volume: 71 Issue: 3 Pages: 305-307 DOI: 10.2105/AJPH.71.3.305 File-URL: http://hdl.handle.net/10.2105/AJPH.71.3.305 Abstract: The mortality patterns of 671 female laundry and dry cleaning workers for the period 1963-1977 were analyzed, using Wisconsin death certificate data. Results fail to show an overall increase in malignant neoplasms, but elevated risk was found for cancers of the kidney and genitals (unspecified), along with a smaller excess of bladder and skin cancer and lymphosarcoma. Handle: RePEc:aph:ajpbhl:10.2105/AJPH.71.3.305_1