Template-Type: ReDIF-Article 1.0 Title: Dental office practices for tobacco users: Independent practice and HMO clinics Journal: American Journal of Public Health Author-Name: Severson, H.H. Author-Name: Eakin, E.G. Author-Name: Stevens, V.J. Author-Name: Lichtenstein, E. Year: 1990 Volume: 80 Issue: 12 Pages: 1503-1505 Abstract: Surveys of independent dental practitioners and health maintenance organization (HMO) dentists and their adult male patients in Oregon found that cessation information and advice was being given to tobacco-using patients, especially smokeless tobacco users, and that the tobacco users surveyed expressed interest in obtaining help to quit. Oral health providers expressed an interest in further training in how to help their tobacco-using patients to quit. Handle: RePEc:aph:ajpbhl:1990:80:12:1503-1505_3 Template-Type: ReDIF-Article 1.0 Title: Garlic-in-oil associated botulism: Episode leads to product modification Journal: American Journal of Public Health Author-Name: Morse, D.L. Author-Name: Pickard, L.K. Author-Name: Guzewich, J.J. Author-Name: Devine, B.D. Author-Name: Shayegani, M. Year: 1990 Volume: 80 Issue: 11 Pages: 1372-1373 Abstract: In February 1989, three cases of botulism occurred in persons who consumed garlic bread made from a garlic-in-oil product. Testing of leftover garlic-in-oil showed it to have a pH of 5.7 and to contain high concentrations of Clostridium botulinum organisms and toxin. This was the second episode of botulism associated with a low acid garlic-in-oil product which needs constant refrigeration. In response, the Food and Drug Administration has taken steps to prevent a recurrence by requiring that microbial inhibitors or acidifying agents be added to such products. Handle: RePEc:aph:ajpbhl:1990:80:11:1372-1373_2 Template-Type: ReDIF-Article 1.0 Title: The 'Free Dental Day' - a voluntary public health initiative Journal: American Journal of Public Health Author-Name: Kaldenberg, D.O. Author-Name: Becker, B.W. Author-Name: Hallan, J.B. Year: 1990 Volume: 80 Issue: 11 Pages: 1392-1393 Handle: RePEc:aph:ajpbhl:1990:80:11:1392-1393_9 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of reported cases of AIDS in lesbians, United States 1980-89 Journal: American Journal of Public Health Author-Name: Chu, S.Y. Author-Name: Buehler, J.W. Author-Name: Fleming, P.L. Author-Name: Berkelman, R.L. Year: 1990 Volume: 80 Issue: 11 Pages: 1380-1381 Abstract: National surveillance data for reported cases of acquired immunodeficiency syndrome (AIDS) were used to assess demographic characteristics and behavioral risk factors in lesbians. From June 1, 1980 through September 30, 1989, 79 women with AIDS reported sex relations only with a female partner; most of these women (95 percent) were intravenous drug users. Prevention of human immunodeficiency virus (HIV) infection in the lesbian community will require efforts to prevent and reduce intravenous drug use. Handle: RePEc:aph:ajpbhl:1990:80:11:1380-1381_5 Template-Type: ReDIF-Article 1.0 Title: Hospital policy, practice re HIV testing for pregnant women and newborns Journal: American Journal of Public Health Author-Name: Schwartz, R.M. Author-Name: Dresser, M. Author-Name: Maynard, E.C. Year: 1990 Volume: 80 Issue: 10 Pages: 1276 Handle: RePEc:aph:ajpbhl:1990:80:10:1276_1 Template-Type: ReDIF-Article 1.0 Title: Can genetic constitution affect the 'objective' diagnosis of nicotine dependence? Journal: American Journal of Public Health Author-Name: Henningfield, J.E. Year: 1990 Volume: 80 Issue: 9 Pages: 1040-1041 Handle: RePEc:aph:ajpbhl:1990:80:9:1040-1041_5 Template-Type: ReDIF-Article 1.0 Title: Hepatitis transmission among the Sioux Indians of South Dakota. Journal: American Journal of Public Health Author-Name: Shaw Jr., F.E. Author-Name: Shapiro, C.N. Author-Name: Welty, T.K. Author-Name: Dill, W. Author-Name: Reddington, J. Author-Name: Hadler, S.C. Year: 1990 Volume: 80 Issue: 9 Pages: 1091-1094 Abstract: Hepatitis A continues to occur in cyclical community-wide epidemics on the Indian reservations of South Dakota. In June 1985 a population-based serosurvey for viral hepatitis involving 120 households was conducted at the Pine Ridge and Rosebud Sioux Indian reservations in South Dakota. The serosurvey was performed shortly after a large hepatitis A epidemic on the Pine Ridge reservation in 1983-84, and immediately before a large hepatitis A epidemic on the Rosebud reservation in 1985-86. The overall seroprevalence for antibodies to hepatitis A virus (anti-HAV) was 76.2 percent (Pine Ridge reservation 80.5 percent, Rosebud reservation 72.0 percent, relative risk = 1.12, 95 percent confidence interval = 1.01, 1.24). For age groups 0 to 4 years, 54.2 percent and 36.1 percent of children were seropositive at Pine Ridge and Rosebud, respectively. Seropositivity rose rapidly with age; by age 40, more than 90 percent of persons at both Pine Ridge and Rosebud were anti-HAV positive. Only 1.1 percent of persons tested were positive for hepatitis B markers. Anti-HAV seroprevalence rates in both communities are similar to rates observed in developing countries. The surprisingly high anti-HAV seroprevalence among young children at Rosebud, where clinical hepatitis A had been virtually absent in the previous seven years, indicates that high-grade silent transmission was taking place during the interepidemic period. Handle: RePEc:aph:ajpbhl:1990:80:9:1091-1094_0 Template-Type: ReDIF-Article 1.0 Title: Erratum: Feldman, Gerber abstract. Journal: American Journal of Public Health Author-Name: Coles, G.V. Year: 1990 Volume: 80 Issue: 9 Pages: 1137 Handle: RePEc:aph:ajpbhl:1990:80:9:1137_1 Template-Type: ReDIF-Article 1.0 Title: Access to obstetric care in rural areas: Effect on brith outcomes Journal: American Journal of Public Health Author-Name: Nesbitt, T.S. Author-Name: Connell, F.A. Author-Name: Hart, L.G. Author-Name: Rosenblatt, R.A. Year: 1990 Volume: 80 Issue: 7 Pages: 814-818 Abstract: Hospital discharge data from 33 rural hospital service areas in Washington State were categorized by the extent to which patients left their local communities for obstetrical services. Women from communities with relatively few obstetrical providers in proportion to number of briths were less likely to deliver in their local community hospital than women in rural communities with greater numbers of physicians practicing obstetrics in proportion to number of briths. Women from these high-outflow communities had a greater proportion of complicated deliveries, higher rates of prematurity, and higher costs of neonatal care than women from communities where most patients delivered in the local hospital. Handle: RePEc:aph:ajpbhl:1990:80:7:814-818_5 Template-Type: ReDIF-Article 1.0 Title: A critique of the Harvard Resource-Based Relative Value Scale. Journal: American Journal of Public Health Author-Name: McMahon Jr., L.F. Year: 1990 Volume: 80 Issue: 7 Pages: 793-798 Abstract: Physician payment reform has assumed a prominent place in the national health policy debate. A key component in this debate is the Harvard Resource-Based Relative Value Scale (RBRVS). The Harvard research effort relied upon several necessary methodologic assumptions and compromises that must be understood to appreciate the RBRVS's strengths and weaknesses. For example, the Harvard group surveyed too few cases to cover the range of clinical practice in a specialty, had too little input in the selection of cases that were judged to be the same or equivalent between specialties, and used an unproven extrapolation methodology to assign final values for total work to non-surveyed physician services. This methodology led to a number of anomalies in the final RBRVS, such as values for comprehensive services for some specialties that were lower for new than for established patients, and total work values for many new patient office services that were lower for Internal Medicine than for Family Practice, a finding inconsistent with empiric evidence. The Harvard RBRVS represents a significant contribution that increases our understanding of physician practice. The system should not be viewed as a finished product. Further investigation and explanation of the assumptions and anomalies are needed to construct a system that reflects adequately the complexity in physician work. Handle: RePEc:aph:ajpbhl:1990:80:7:793-798_9 Template-Type: ReDIF-Article 1.0 Title: The dramatic increase in the rate of low birthweight in New York City: An aggregate time-series analysis Journal: American Journal of Public Health Author-Name: Joyce, T. Year: 1990 Volume: 80 Issue: 6 Pages: 682-684 Abstract: This paper uses monthly time-series data from 1968 through 1988 to test whether the observed increase in the incidence of low birthweight in New York City represents a reversal of the downward trend that existed prior to 1984. We find that the trend has shifted for both Whites and Blacks. We estimate that between July 1984 and December 1988 there were, 3,110 additional low-birthweight births to Blacks and 1,385 additional low-birthweight births to Whites above what would have been expected had the rate of low birthweight not shifted upwards. The incremental costs of treating these infants in their first year of life is estimated at over $22,000,000 in 1986 dollars. Handle: RePEc:aph:ajpbhl:1990:80:6:682-684_4 Template-Type: ReDIF-Article 1.0 Title: The opium wars revisited as US forces tobacco exports in Asia Journal: American Journal of Public Health Author-Name: Chen, T.T.L. Author-Name: Winder, A.E. Year: 1990 Volume: 80 Issue: 6 Pages: 659-662 Abstract: The tobacco industry has lobbied successfully to obtain the support of the United States government for opening Asian markets to American tobacco products. This paper comments on two issues arising from these efforts: the development of an atmosphere of invasion and resistance to invasion in Asia; and the change in the image of the United States in Asian nations from that of a leader in health to that of an exporter of death. The threat of sanctions and the effects of the open market and United States tobacco company advertising in Japan, Taiwan, and South Korea are noted. Parallels are drawn between the opium wars a century and a half ago in China and the current threat of trade sanctions. Reacting to American policy, an Asia-Pacific Association for Control of Tobacco has been formed and linked with the US Coalition Against Smoking. Handle: RePEc:aph:ajpbhl:1990:80:6:659-662_1 Template-Type: ReDIF-Article 1.0 Title: Is it cost-beneficial to screen adolescent males for Chlamydia? Journal: American Journal of Public Health Author-Name: Alexander, E.R. Year: 1990 Volume: 80 Issue: 5 Pages: 531-532 Abstract: In conclusion, when it can be demonstrated that the need is great, an action produces the desired benefits, the risks are not too high, the intervention is economically feasible, and there are no viable, more scientifically certain alternatives, then policy-makers should proceed even in the face of less than complete evidence. It should be remembered that scientific uncertainty may be exploited by special interest groups as a shield for opposition to the measure. Public policy decisions may be said to be made or not made on the basis of scientific uncertainty, but they may in actuality be driven by political or economic considerations. With respect to balancing individual rights and the public interest, it is clear that, in many instances, these two interests will be congruent. If they conflict, however, then weight should be given to the public interest in line with the principle that public health is social justice. Handle: RePEc:aph:ajpbhl:1990:80:5:531-532_1 Template-Type: ReDIF-Article 1.0 Title: Tobacco excise and declining tobacco consumption: The case of Papua New Guinea Journal: American Journal of Public Health Author-Name: Chapman, S. Author-Name: Richardson, J. Year: 1990 Volume: 80 Issue: 5 Pages: 537-540 Abstract: Excise elasticities of demand for non-cigarette tobacco and cigarettes were calculated for Papua New Guinea for the 14 years 1973-86. Respectively, these were -0.50 and -0.71. This means that 10 percent increases in cigarette and non-cigarette tobacco excise are associated with an estimated 7.1 percent fall in demand for cigarettes and a 5 percent decrease in the demand for tobacco. As tax (excise) elasticities would normally be significantly smaller than price elasticities, these results imply that the consumption of cigarettes and tobacco in Papua New Guinea are more responsive to prices than in the United States and other Western countries. The level of excise is therefore an important and practical instrument for the control of consumption. These elasticities appear to be the first reported for a developing country. It is suggested that if they are indicative of consumer behavior in lower income countries then increasing tobacco and cigarette excise should be considered as an important strategy for the control of smoking in these countries which, because of their large populations, are huge markets for tobacco products and thus major targets for tobacco control measures. Handle: RePEc:aph:ajpbhl:1990:80:5:537-540_9 Template-Type: ReDIF-Article 1.0 Title: Tobacco taxation as health policy in the Third World Journal: American Journal of Public Health Author-Name: Warner, K.E. Year: 1990 Volume: 80 Issue: 5 Pages: 529-531 Handle: RePEc:aph:ajpbhl:1990:80:5:529-531_2 Template-Type: ReDIF-Article 1.0 Title: Smoking before, during, and after pregnancy Journal: American Journal of Public Health Author-Name: Fingerhut, L.A. Author-Name: Kleinman, J.C. Author-Name: Kendrick, J.S. Year: 1990 Volume: 80 Issue: 5 Pages: 541-544 Abstract: We report the first national data on smoking before, during, and after pregnancy. Estimates are based on the 1986 Linked Telephone Survey that reinterviewed 1,550 White women 20-44 years of age who were respondents to the 1985 National Health Interview Survey. An estimated 39 percent of White women who had smoked before pregnancy quit smoking while pregnant (27 percent when they found out they were pregnant and 12 percent later during pregnancy). Women with less than 12 years of education were five times as likely to smoke and one-fourth as likely to quit as those with 16 or more years of education. Women who smoked more than one pack of cigarettes per day before pregnancy were one-fifth as likely to quit as those smoking less. Of the women who quit, 70 percent resumed smoking within one year of delivery. Of those who relapsed, 67 percent resumed smoking within three months of delivery and 93 percent within six months. There is little evidence of educational differentials in relapse rates. The fact that relapse remains high suggests that while health of the fetus is a strong influence on women's smoking habits, women may be less aware of the effect of passive smoke on the infant. Handle: RePEc:aph:ajpbhl:1990:80:5:541-544_0 Template-Type: ReDIF-Article 1.0 Title: Screening for Chlamydia trachomatis in adolescent males: A cost-based decision analysis Journal: American Journal of Public Health Author-Name: Randolph, A.G. Author-Name: Washington, A.E. Year: 1990 Volume: 80 Issue: 5 Pages: 545-550 Abstract: To evaluate the cost and benefits of screening tests for Chlamydia trachomatis in adolescent males, we developed a decision analysis model and compared the leukocyte esterase urine dipstick test with culture, with direct-smear fluorescent antibody (DFA), and with the option of no screening (no treatment). The leukocyte esterase test has the lowest average cost-per-cure ($51) compared with direct-smear fluorescent antibody ($192) and culture ($414). Compared with the DFA, we estimate that the leukocyte esterase test saves over $9,727 per cohort of 1,000 sexually active adolescent males screened. Sensitivity analyses show the leukocyte esterase test results in a lower cost-per-cure and lower overall costs (per cohort) than culture and direct-smear fluorescent antibody at any prevalence of C. trachomatis infection, and lower overall costs (per cohort) than no screening at prevalences above 21 percent. Handle: RePEc:aph:ajpbhl:1990:80:5:545-550_4 Template-Type: ReDIF-Article 1.0 Title: Past pregnancy outcomes among women living in the vicinity of a lead smelter in Kosovo, Yugoslavia Journal: American Journal of Public Health Author-Name: Murphy, M.J. Author-Name: Graziano, J.H. Author-Name: Popovac, D. Author-Name: Kline, J.K. Author-Name: Mehmeti, A. Author-Name: Factor-Litvak, P. Author-Name: Ahmedi, G. Author-Name: Shrout, P. Author-Name: Rajovic, B. Author-Name: Nenezic, D.U. Author-Name: Stein, Z.A. Year: 1990 Volume: 80 Issue: 1 Pages: 33-35 Abstract: This analysis compares the rates of spontaneous abortion among women living in the vicinity of a lead smelter with those of women living in a town where blood lead levels were low. Data derive from the obstetric histories of both groups of women obtained while seeking prenatal care for a later pregnancy. A total of 639 women (304 exposed, 335 unexposed) had at least one previous pregnancy and lived at the same address since their first pregnancy. The geometric mean blood lead concentrations in the sample at the time of the interviews were 0.77 μmol/L in the exposed town and 0.25 μmol/L in the unexposed town. The rates of spontaneous abortions in first pregnancies were similar, with 16.4 percent of women in the exposed town and 14.0 percent in the unexposed town reporting loss. The adjusted odds ratio relating town of residence to spontaneous abortion was 1.1 (95% CI = 0.9, 1.4). This analysis represents the first systematic attempt to seek an association between environmental lead exposure and spontaneous abortion. As such, the failure to find a positive association strongly suggests that at the levels of exposure represented in our sample, such an association does not exist. Handle: RePEc:aph:ajpbhl:1990:80:1:33-35_7 Template-Type: ReDIF-Article 1.0 Title: Comments from NCHS/Rosenberg Journal: American Journal of Public Health Author-Name: Rosenberg, H.M. Year: 1990 Volume: 80 Issue: 6 Pages: 752 Handle: RePEc:aph:ajpbhl:1990:80:6:752_3 Template-Type: ReDIF-Article 1.0 Title: The association between Type A behavior and change in coronary risk factors among young adults Journal: American Journal of Public Health Author-Name: Garrity, T.F. Author-Name: Kotchen, J.M. Author-Name: McKean, H.E. Author-Name: Gurley, D. Author-Name: McFadden, M. Year: 1990 Volume: 80 Issue: 11 Pages: 1354-1357 Abstract: The association of Type A/B behavior pattern and changes in blood pressure, total serum cholesterol, serum triglyceride, body mass, and smoking was estimated in a cohort of 375 young Black and White men and women from a rural county in Central Kentucky between 1978-79 and 1985-88. Type A participants experienced significant increases in systolic (2.90 ± 1.29 mmHg) and diastolic (3.80 ± 1.17 mmHg) blood pressure and in cigarette smoking (3.26 ± 0.89 cigarettes per day) over the eight-year follow-up period, but Type B participants experienced no change. Type A and B individuals showed similar changes in total serum cholesterol, serum triglyceride, or body mass. Differences between behavioral types in blood pressure were present for women but not men, and for Blacks but not for Whites. These findings suggest a possible significance of the Type A pattern for the development of cardiovascular risk of young adults. Handle: RePEc:aph:ajpbhl:1990:80:11:1354-1357_9 Template-Type: ReDIF-Article 1.0 Title: '...tribute to whom tribute is due...' - Romans 13:7 Journal: American Journal of Public Health Author-Name: Ibrahim, M.A. Year: 1990 Volume: 80 Issue: 7 Pages: 789 Handle: RePEc:aph:ajpbhl:1990:80:7:789_2 Template-Type: ReDIF-Article 1.0 Title: Caffeine-containing beverages, total fluid consumption, and premenstrual syndrome Journal: American Journal of Public Health Author-Name: Mackay Rossignol, A. Author-Name: Bonnlander, H. Year: 1990 Volume: 80 Issue: 9 Pages: 1106-1110 Abstract: The main objective of this study was to evaluate whether daily consumption of caffeine-containing beverages is related to the prevalence and severity of premenstrual syndrome apart from any effects of daily total fluid consumption. A secondary objective was to determine whether daily total fluid consumption itself is related to premenstrual syndrome. The study is based on 841 responses to a questionnaire probing menstrual and premenstrual health, and daily fluid consumption, which was mailed to female university students in Oregon. Analysis of the data revealed that consumption of caffeine-containing beverages was strongly related to the prevalence of premenstrual syndrome. Among women with more severe symptoms, the relation between consumption of caffeine-containing beverages and premenstrual syndrome was dose-dependent, with prevalence odds ratios equal to 1.3 for consumers of one cup of a caffeine-containing beverage per day and increasing steadily to 7.0 for consumers of eight to 10 cups per day. The effects were apparent among both caffeine-containing tea/coffee consumers and caffeine-containing soda consumers. The observed effects were only slightly reduced when daily total fluid consumption was controlled. Daily total fluid consumption also was related to the prevalence of premenstrual symptoms although the effects were large only for consumers of 13-19 cups of fluid per day (the largest amount studied). Handle: RePEc:aph:ajpbhl:1990:80:9:1106-1110_3 Template-Type: ReDIF-Article 1.0 Title: Blaming the victim: The negative consequence of preventive medicine Journal: American Journal of Public Health Author-Name: Marantz, P.R. Year: 1990 Volume: 80 Issue: 10 Pages: 1186-1187 Handle: RePEc:aph:ajpbhl:1990:80:10:1186-1187_1 Template-Type: ReDIF-Article 1.0 Title: Letter on epidemiologic research methods (Reply) Journal: American Journal of Public Health Author-Name: Feinstein, A.R. Author-Name: Chan, C.K. Author-Name: Esdaile, J.M. Author-Name: McFarlane, M.J. Author-Name: Wells, C.K. Year: 1990 Volume: 80 Issue: 5 Pages: 623-624 Handle: RePEc:aph:ajpbhl:1990:80:5:623-624_2 Template-Type: ReDIF-Article 1.0 Title: Racial differences in exposure to on-the-job hazards Journal: American Journal of Public Health Author-Name: French, M.T. Author-Name: Zarkin, G.A. Year: 1990 Volume: 80 Issue: 1 Pages: 89 Handle: RePEc:aph:ajpbhl:1990:80:1:89_4 Template-Type: ReDIF-Article 1.0 Title: A small area simulation approach to determining excess variation in dental procedure rates Journal: American Journal of Public Health Author-Name: Diehr, P. Author-Name: Grembowski, D. Year: 1990 Volume: 80 Issue: 11 Pages: 1343-1348 Abstract: All small area analyses need to compare the observed variability in rates to that expected by chance alone, but the expected variability is usually not known. This paper uses patient-level data for five dental procedures to simulate the distributions of the summary statistics that are usually generated in such studies. These statistics are found to vary greatly even under the ''null hypothesis'' that all dentists are using procedures at the same rates. The simulated dentist rates are compared to observed rates obtained in a different study. These findings illustrate problems that can occur in small area analysis studies, and emphasize the importance of using statistical techniques that are appropriate for the data that are to be analyzed. Investigators should make every effort to obtain patient-level data, or at least to understand the underlying distribution of the number of procedures per patient, to avoid mistaking significant deviations from an incorrect model as evidence for significant variation among small areas. Handle: RePEc:aph:ajpbhl:1990:80:11:1343-1348_8 Template-Type: ReDIF-Article 1.0 Title: Recovery of hepatitis A virus from a water supply responsible for a common source outbreak of hepatitis A Journal: American Journal of Public Health Author-Name: Bloch, A.B. Author-Name: Stramer, S.L. Author-Name: Smith, J.D. Author-Name: Margolis, H.S. Author-Name: Fields, H.A. Author-Name: McKinley, T.W. Author-Name: Gerba, C.P. Author-Name: Maynard, J.E. Author-Name: Sikes, R.K. Year: 1990 Volume: 80 Issue: 4 Pages: 428-430 Abstract: An outbreak of hepatitis A occurred in a north Georgia trailer park served by a private well. Of 18 residents who were serosusceptible to hepatitis A virus (HAV), 16 (89%) developed hepatitis A. Well water samples were collected 3 months after illness onset in the index case and 28 days after illness onset in the last trailer park resident. Hepatitis A virus antigen (HAVAg) was detected in the samples by enzyme immunoassay from three of the five cell lines following two 30-day passages and from a fourth cell line following a third passage of 21 days. Handle: RePEc:aph:ajpbhl:1990:80:4:428-430_1 Template-Type: ReDIF-Article 1.0 Title: How valid are mammography self-reports? Journal: American Journal of Public Health Author-Name: King, E.S. Author-Name: Rimer, B.K. Author-Name: Trock, B. Author-Name: Balshem, A. Author-Name: Engstrom, P. Year: 1990 Volume: 80 Issue: 11 Pages: 1386-1388 Abstract: We compared mammography reports in medical records to self-reports obtained during a 1989 telephone interview survey for a sample of 100 women members of a health maintenance organization (HMO) who indicated they had mammograms within the past year and 100 who said they had not had mammograms within the past year. Of the women reporting they had not had mammograms within the past year, none had mammogram reports in the HMO data center. Of the 100 women reporting they had mammograms within the past year, 94 had confirmatory radiology records. Handle: RePEc:aph:ajpbhl:1990:80:11:1386-1388_0 Template-Type: ReDIF-Article 1.0 Title: Lead-induced anemia: Dose-response relationships and evidence for a threshold Journal: American Journal of Public Health Author-Name: Schwartz, J. Author-Name: Landrigan, P.J. Author-Name: Baker Jr., E.L. Author-Name: Orenstein, W.A. Author-Name: Von Lindern, I.H. Year: 1990 Volume: 80 Issue: 2 Pages: 165-168 Abstract: We conducted a cross-sectional epidemiologic study to assess the association between blood lead level and hematocrit in 579 one to five year-old children living near a primary lead smelter in 1974. Blood lead levels ranged from 0.53 to 7.91 μmol/L (11 to 164 μg/dl). To predict hematocrit as a function of blood lead level and age, we derived non-linear regession models and fit percentile curves. We used logistic regression to predict the probability of hematocrit values less than 35 percent. We found a strong non-linear, dose-response relationship between blood lead level and hematocrit. This relationship was influenced by age, but (in this age group) not by sex; the effect was strongest in youngest children. In one year-olds, the age group most severely affected, the risk of an hematocrit value below 35 percent was 2 percent above background at blood lead levels between 0.97 and 1.88 μmol/L (20 and 39 μg/dl), 18 percent above background at lead levels of 1.93 to 2.85 μmol/L (40 to 59 μg/dl), and 40 percent above background at lead levels 2.9 μmol/L (60 μg/dl) and greater; background was defined as a blood lead level below 1.88 μmol/L (20 μg/dl). This effect appeared independent of iron deficiency. These findings suggest that blood lead levels close to the currently recommended limit value of 1.21 μmol/L (25 μg/dl) are associated with dose-related depression of hematocrit in young children. Handle: RePEc:aph:ajpbhl:1990:80:2:165-168_9 Template-Type: ReDIF-Article 1.0 Title: The Los Angeles connection: A follow-up report Journal: American Journal of Public Health Author-Name: Alkon, E. Author-Name: Evans, C. Author-Name: Afifi, A. Author-Name: Scrimshaw, S. Year: 1990 Volume: 80 Issue: 10 Pages: 1273 Handle: RePEc:aph:ajpbhl:1990:80:10:1273_2 Template-Type: ReDIF-Article 1.0 Title: Coding external causes of injury (E-codes) in Maryland hospital discharges 1979-88: A statewide study to explore the uncoded population Journal: American Journal of Public Health Author-Name: Marganitt, B. Author-Name: MacKenzie, E.J. Author-Name: Smith, G.S. Author-Name: Damiano, A.M. Year: 1990 Volume: 80 Issue: 12 Pages: 1463-1466 Abstract: We examined the trends in hospital discharge E-coding in Maryland over a 10-year period. The overall proportion of E-coded discharges has increased from 40 percent in 1979 to 55 percent in 1988. E-coding was lower in the severely injured, the elderly, and patients with long hospital stays. Our findings demonstrate that E-code reporting varies because of the limited number of data fields available for coding of discharge diagnoses. Universal, systematic reporting of E-codes in hospital discharge data is essential if these data are to provide critically needed information about nonfatal injuries. Hospital discharge data formats should contain separate fields for E-codes and the use of these codes, we believe, should be mandated. Handle: RePEc:aph:ajpbhl:1990:80:12:1463-1466_0 Template-Type: ReDIF-Article 1.0 Title: Evaluating community-based nutrition programs: Assessing the reliability of a survey of grocery store product displays Journal: American Journal of Public Health Author-Name: Cheadle, A. Author-Name: Psaty, B. Author-Name: Wagner, E. Author-Name: Diehr, P. Author-Name: Koepsell, T. Author-Name: Curry, S. Author-Name: Von Korff, M. Year: 1990 Volume: 80 Issue: 6 Pages: 709-711 Abstract: A pilot test of a survey of grocery store product displays was conducted to measure the amount of health-education information provided and the proportion of the display devoted to 'healthier' products. Inter-rater reliability ranged between 0.73 and 0.78 for the healthiness indices and between 0.30 and 0.67 for the health education measures. Test-retest reliability ranged from 0.44 to 1.0. Handle: RePEc:aph:ajpbhl:1990:80:6:709-711_4 Template-Type: ReDIF-Article 1.0 Title: Seat belt use on interstate highways Journal: American Journal of Public Health Author-Name: Wells, J.K. Author-Name: Williams, A.F. Author-Name: Lund, A.K. Year: 1990 Volume: 80 Issue: 6 Pages: 741-742 Abstract: More than 5,000 miles of limited-access highways in the eastern United States and Canada were traveled to observe seat belt use. Overall belt use was 58 percent in the United States and 79 percent in Canada. The data indicate that belt use in the United States follows a different pattern on interstate highways than on other streets and roads, with relatively high belt use rates (over 50 percent) appearing to be somewhat independent of belt use law provisions. Handle: RePEc:aph:ajpbhl:1990:80:6:741-742_3 Template-Type: ReDIF-Article 1.0 Title: Variables influencing condom use among intravenous drug users Journal: American Journal of Public Health Author-Name: Magura, S. Author-Name: Shapiro, J.L. Author-Name: Siddiqi, Q. Author-Name: Lipton, D.S. Year: 1990 Volume: 80 Issue: 1 Pages: 82-84 Abstract: Correlates of condom use were identified using cross-sectional data from a convenience sample of 211 sexually active intravenous drug users enrolled in methadone maintenance in New York City. Sixty-eight percent did not use condoms at all in the previous month and only 11 percent used condoms every time. Nineteen percent were planning on conception, only 20 percent of whom had been tested for human immunodeficiency virus (HIV) antibody (all seronegative). Multiple logistic regression analysis indicated that condom use was independently associated with greater personal acceptance of condoms, greater partner receptivity to sexual protection, and recent entry to methadone treatment. Handle: RePEc:aph:ajpbhl:1990:80:1:82-84_6 Template-Type: ReDIF-Article 1.0 Title: Technology at birth Journal: American Journal of Public Health Author-Name: Paneth, N. Year: 1990 Volume: 80 Issue: 7 Pages: 791-792 Handle: RePEc:aph:ajpbhl:1990:80:7:791-792_3 Template-Type: ReDIF-Article 1.0 Title: Evaluation of active versus passive AIDS surveillance in Oregon Journal: American Journal of Public Health Author-Name: Modesitt, S.K. Author-Name: Hulman, S. Author-Name: Fleming, D. Year: 1990 Volume: 80 Issue: 4 Pages: 463-464 Abstract: We searched for unreported AIDS cases in Oregon through death certificate and medical record review, and enhanced infection control practitioner and physician surveillance. Fifty-six AIDS cases diagnosed between February 1, 1986 and January 31, 1987 were reported passively. Twenty-nine additional cases diagnosed during this time were retrospectively identified by active methods. Ninety percent of those 29 cases were diagnosed by physicians and cared for in hospitals that had previously reported cases. Completeness of reporting under the passive study system was 64 percent. Handle: RePEc:aph:ajpbhl:1990:80:4:463-464_2 Template-Type: ReDIF-Article 1.0 Title: Effects of individually motivating smoking cessation in male blue collar workers Journal: American Journal of Public Health Author-Name: Kilburn, K.H. Author-Name: Warshaw, R.H. Year: 1990 Volume: 80 Issue: 11 Pages: 1334-1337 Abstract: Adverse demonstrable health effects linked to the individual's smoking were shown to 2,689 American workers to motivate cessation during routine examinations to detect asbestosis. This intervention was evaluated six to 25 months later by a mailed questionnaire and by telephone to non-responders. Results were compared to yearly quit rates of 2.5 percent to 5 percent for 736 workers who were ex-smokers at the initial examination. Of the 504 men who responded by mail, 29.8 percent had quit smoking, 35.9 percent had cut down from a mean of 28 to 13 cigarettes per day, and 34.3 percent were smoking as before. Subsequent follow-up at one year showed that 25.6 percent remained quit, and that 23 percent of those who cut down had quit, for an overall quit rate of 34 percent. Of 101 non-responders contacted by telephone, 17 percent had quit and 53 percent had reduced smoking. In both samples, those who quit were more likely to have had lower alveolar carbon monoxide (CO(a)) levels, to be older, and to have had asbestosis. Responders by mail were the same age as non-responders but had smoked longer, had higher prevalences of asbestosis, emphysema, chronic bronchitis and higher CO(a). Demonstration of the adverse personal effects of smoking appear to have contributed to the quit rates or reduced smoking rates in 65 percent of the responding workers. Handle: RePEc:aph:ajpbhl:1990:80:11:1334-1337_4 Template-Type: ReDIF-Article 1.0 Title: Ten-year changes in birthweight distributions of Black and White infants, South Carolina Journal: American Journal of Public Health Author-Name: Mayberry, R.M. Author-Name: Lewis, R.F. Year: 1990 Volume: 80 Issue: 6 Pages: 724-726 Abstract: The birthweight distributions of Black and White infants in South Carolina were compared for the paired-year periods 1975-76 and 1985-86. No discernible changes in birthweight distributions between the two time periods were observed especially among Black infants. The distributions among White infants reflected an overall improvement in birthweight most noticeably above 2500 g. Handle: RePEc:aph:ajpbhl:1990:80:6:724-726_1 Template-Type: ReDIF-Article 1.0 Title: The onset of decline in ischemic heart disease in Italy Journal: American Journal of Public Health Author-Name: La Vecchia, C. Author-Name: Negri, E. Author-Name: Decarli, A. Year: 1990 Volume: 80 Issue: 4 Pages: 502 Handle: RePEc:aph:ajpbhl:1990:80:4:502_2 Template-Type: ReDIF-Article 1.0 Title: Validation of mothers' reports of dietary intake by four to seven year-old children Journal: American Journal of Public Health Author-Name: Basch, C.E. Author-Name: Shea, S. Author-Name: Arliss, R. Author-Name: Contento, I.R. Author-Name: Rips, J. Author-Name: Gutin, B. Author-Name: Irigoyen, M. Author-Name: Zybert, P. Year: 1990 Volume: 80 Issue: 11 Pages: 1314-1317 Abstract: The validity of mothers' recall of four to seven year-old children's diet was assessed among 46 first generation Latino immigrant families from the Dominican Republic by comparing intake recalled by the mother to unobtrusive home observations of children. Correlations were moderate to high for calories and for most nutrients. There were no differences in mean intake of total calories or in intake of most macronutrients and micronutrients assessed. At least two-thirds of the children in the lowest (or highest) quintile based on home observation were correctly classified into the lowest or second lowest (or highest) quintiles based on mother's reports for calories and most nutrients. For all food items that were both observed and reported, 51 percent of reported portion sizes were equivalent to observed portion sizes, 15.5 percent were smaller, and 33.5 percent were larger. There was fair to good agreement on the number of food items eaten, with the exception of vegetables. Mothers' recall appears to be useful for classifying children by intake of calories, macronutrients and micronutrients, but provides a somewhat less accurate measure of actual foods eaten, portion sizes, and nutrient levels consumed. Handle: RePEc:aph:ajpbhl:1990:80:11:1314-1317_2 Template-Type: ReDIF-Article 1.0 Title: Editor's report: Scientific misconduct and the responsibility of journal editors Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1990 Volume: 80 Issue: 4 Pages: 399-400 Handle: RePEc:aph:ajpbhl:1990:80:4:399-400_0 Template-Type: ReDIF-Article 1.0 Title: On looking risk in the eye Journal: American Journal of Public Health Author-Name: Stoeckle, J.D. Year: 1990 Volume: 80 Issue: 10 Pages: 1170-1171 Handle: RePEc:aph:ajpbhl:1990:80:10:1170-1171_8 Template-Type: ReDIF-Article 1.0 Title: The impact of DRGs on community-based service providers: Implications for the elderly Journal: American Journal of Public Health Author-Name: Wood, J.B. Author-Name: Estes, C.L. Year: 1990 Volume: 80 Issue: 7 Pages: 840-843 Abstract: We investigated changes in community-based agencies following the implementation of the Medicare prospective payment system for hospitals utilizing DRGs (diagnosis-related groups). Data were collected in 1986 and 1987 from 771 community service providers. There were five major findings: 1) hospital discharge planners, nursing homes, and home health agencies experienced DRG effects before other types of community providers studies; 2) the 'reach' of DRG impact is widespread; 3) providers report a change in clientele toward a heavier-care client; 4) the impact of DRGs affects the types of services agencies provide; and 5) community providers have experienced a decrease in their ability to refer their clients both to hospitals and to each other. Handle: RePEc:aph:ajpbhl:1990:80:7:840-843_2 Template-Type: ReDIF-Article 1.0 Title: The quality of ambulatory care in Medicare health maintenance organizations Journal: American Journal of Public Health Author-Name: Retchin, S.M. Author-Name: Brown, B. Year: 1990 Volume: 80 Issue: 4 Pages: 411-415 Abstract: The quality of ambulatory care received by Medicare recipients who enrolled in health maintenance organizations (HMOs) was compared to the care received by fee-for-service (FFS) Medicare recipients, in a quasi-experimental, non-randomized design. Both samples were drawn from the four major geographic areas in the country, and included two types of HMO practices: staff/group models, and independent practice associations (IPAs). A panel of expert physicians developed criteria for evaluating ambulatory care, and medical record abstractions using these criteria were performed on 1,590 outpatient records: 777 FFS and 813 HMO (441 staff/group, 372 IPA). While individual items of medical histories and physical examinations were performed most often for staff/group HMO patients and least often in FFS patients, odds ratios (OR) for performance in staff/group HMO patients were particularly large for health maintenance items: tonometry (OR = 8.4), mammography (OR = 2.7), pelvic examination (OR = 5.3), rectal examination (OR = 2.9), fecal occult blood test (OR = 3.3). The results suggest that recommended elements of routine and preventive care are more likely to be performed for Medicare enrollees in staff/group HMOs than in FFS settings. Handle: RePEc:aph:ajpbhl:1990:80:4:411-415_6 Template-Type: ReDIF-Article 1.0 Title: Changes in ambulatory surgery utilization 1983-88: A community-based analysis Journal: American Journal of Public Health Author-Name: Lagoe, R.J. Author-Name: Milliren, J.H. Year: 1990 Volume: 80 Issue: 7 Pages: 869-871 Abstract: Changes in ambulatory surgery utilization in the metropolitan area of Syracuse, New York 1983-88 were identified. Total ambulatory surgery utilization rose from 12,479 to 24,643 procedures. Approximately 69 percent of the increase was generated by freestanding surgery centers. Operations responsible for the largest additional volumes included lens procedures, certain cervical procedures, hernias, and excision of skin and breast lesions. Handle: RePEc:aph:ajpbhl:1990:80:7:869-871_6 Template-Type: ReDIF-Article 1.0 Title: Cigarette smoking as a risk factor for sudden infant death syndrome: A population-based study Journal: American Journal of Public Health Author-Name: Haglund, B. Author-Name: Cnattingius, S. Year: 1990 Volume: 80 Issue: 1 Pages: 29-32 Abstract: Risk factors for sudden infant death syndrome (SIDS) wer examined in a prospective study based on Swedish births between 1983 and 1985. All infants surviving the first week of life were included (279,938). The overall rate of SIDS was 0.7 per 1,000 first week survivors. Elevated relative risks were associated with low maternal age, multiparity, maternal smoking, and male infants. Smoking doubled the risk and a clear dose-response relation by amount smkoked was observed. Maternal smoking also seemed to influence the time of death, as infants of smokers died at an earlier age. In countries like Sweden, smoking may be the single most important preventable risk factor for sudden infant death syndrome. Handle: RePEc:aph:ajpbhl:1990:80:1:29-32_4 Template-Type: ReDIF-Article 1.0 Title: Consistent pattern of elevated symptoms in air-conditioned office buildings: A reanalysis of epidemiologic studies Journal: American Journal of Public Health Author-Name: Mendell, M.J. Author-Name: Smith, A.H. Year: 1990 Volume: 80 Issue: 10 Pages: 1193-1199 Abstract: Published studies of the relation between type of building ventilation system and work-related symptom prevalence in office workers have been contradictory. A reanalysis was performed of six studies meeting specific eligibility criteria, combining published data with unpublished information obtained from study authors. Five eligible studies were from the United Kingdom, and one was from Denmark. Standardized categories of building ventilation type were created to allow comparison of effects across studies. Within each study, prevalence odds ratios (PORs) were calculated for symptoms in each ventilation category relative to a baseline category of naturally ventilated buildings. Air-conditioned buildings were consistently associated with increased prevalence of work-related headache (POR = 1.3-3.1), lethargy (POR = 1.4-5.1), and upper respiratory/mucus membrane symptoms (POR = 1.3-4.8). Humidification was not a necessary factor for the higher symptom prevalence associated with air-conditioning. Mechanical ventilation without air-conditioning was not associated with higher symptom prevalence. The consistent associations found between type of building ventilation and reported symptom prevalence have potentially important public health and economic implications. Handle: RePEc:aph:ajpbhl:1990:80:10:1193-1199_2 Template-Type: ReDIF-Article 1.0 Title: Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents Journal: American Journal of Public Health Author-Name: Hingson, R.W. Author-Name: Strunin, L. Author-Name: Berlin, B.M. Author-Name: Heeren, T. Year: 1990 Volume: 80 Issue: 3 Pages: 295-299 Abstract: In August 1988, 1,773 Massachusetts 16-19-year-olds were surveyed by telephone using anonymous random digit dialing; response rate 82 percent. Logistic regression tested whether alcohol and drug use, perceived susceptibility to human immunodeficiency virus (HIV), severity of HIV if infected, effectiveness of condoms in preventing infection, barriers to condom use, and behavioral cues such as exposure to media or personal communication about acquired immunodeficiency syndrome (AIDS) were independently related to condom use. Among sexually active respondents, (61 percent of those interviewed) 31 percent reported always using condoms. Respondents who believed condoms are effective in preventing HIV transmission and worried they can get AIDS were 3.1 and 1.8 times, respectively, more likely to use condoms all the time. Respondents who carried condoms and who had discussed AIDS with a physician were 2.7 and 1.7 times, respectively, more likely to use them. Those who believed condoms do not reduce sexual pleasure and would not be embarrassed if asked to use them were 3.1 and 2.4 times, respectively, more likely to use condoms. Teens who averaged five or more drinks daily or used marijuana in the previous month were 2.8 and 1.9 times, respectively, less likely to use condoms. Among respondents who drink and use drugs, 16 percent used condoms less often after drinking and 25 percent after drug use. Those counseling adolescents about HIV should assess and discuss beliefs outlined in the Health Belief Model, as well as their alcohol and drug use. Handle: RePEc:aph:ajpbhl:1990:80:3:295-299_0 Template-Type: ReDIF-Article 1.0 Title: Physician breach of patient confidentiality among individuals with human immunodeficiency virus (HIV) infection: Patterns of decision Journal: American Journal of Public Health Author-Name: Schwartzbaum, J.A. Author-Name: Wheat, J.R. Author-Name: Norton, R.W. Year: 1990 Volume: 80 Issue: 7 Pages: 829-834 Abstract: To determine whether the sex, race, or sexual preference of a patient infected with immunodeficiency virus (HIV) influences a physician's decision to breach patient confidentiality, Tennessee primary care physicians were mailed a questionnaire containing a case study in which an HIV-infected patient presented a risk to a third party. Eight different descriptions of the sex, race, and sexual preference of the hypothetical patient were discributed randomly among the physicians, one description to each physician. The physicians were asked to decide whether to maintain confidentiality, notify the health department, or inform the patient's partner. Responses of 199 White male physicians were analyzed using an unconditional saturated logistic regression model. The odds ratios for these physicians saying they would send the patient's antibody status to the health department extend from 18.4 (95 percent confidence interval: 1.3, 260.1) for Black homosexual males to .5 (95 percent CI: 0, 11.5) for White homosexual females. The odds ratios for White male physicians saying they would inform the patient's partner range from 7.5 (95 percent CI: .8, 69.2) for Black heterosexual males to 1.0 (reference category) for Black homosexual females. The results suggest that when physicians decide to protect a third party by breaching an HIV-infected patient's confidentiality, their decision may be influenced in some cases by the race, sex, and sexual preference of the patient. Handle: RePEc:aph:ajpbhl:1990:80:7:829-834_7 Template-Type: ReDIF-Article 1.0 Title: Comparative evaluation of American Cancer Society and American Lung Association smoking cessation clinics Journal: American Journal of Public Health Author-Name: Lando, H.A. Author-Name: McGovern, P.G. Author-Name: Barrios, F.X. Author-Name: Etringer, B.D. Year: 1990 Volume: 80 Issue: 5 Pages: 554-559 Abstract: We compared the effectiveness of American Cancer Society, FreshStart, American Lung Association, Freedom from Smoking, and laboratory clinic methods in subjects (N = 1041) from three communities. Three-month follow-up results favored the laboratory method over the two public service approaches on both a prevalence and a sustained abstinence measure. At one-year follow-up, treatment effects for smoking prevalence were no longer significant. However, sustained abstinence results at one-year remained highly significant and favored the more intensive laboratory and Freedom from Smoking clinics over the FreshStart method. FreshStart fared less well than the other interventions both in producing initial quit attempts and in sustaining abstinence among initial quitters. It should be noted, however, that FreshStart requires considerably less facilitator contact than do the other approaches. Unexpected outcome effects occurred for treatment location. Future clinic programs should include a specific target date for quitting and should place more emphasis upon recycling participants who fail to sustain abstinence. Handle: RePEc:aph:ajpbhl:1990:80:5:554-559_6 Template-Type: ReDIF-Article 1.0 Title: Age and human immunodeficiency virus infection in persons with hemophilia in California Journal: American Journal of Public Health Author-Name: Holman, R.C. Author-Name: Gomperts, E.D. Author-Name: Jason, J.M. Author-Name: Abildgaard, C.F. Author-Name: Zelasky, M.T. Author-Name: Evatt, B.L. Year: 1990 Volume: 80 Issue: 8 Pages: 967-969 Abstract: Thirteen hemophilia centers provide comprehensive care to approximately 90 percent of persons with hemophilia in California. For 1987, these centers reported patient human immunodeficiency virus (HIV) antibody status, age group, level of clotting factor deficiency, and hemophilia type on 1,438 persons with hemophilia A and B; HIV serologic status was known for 860 persons (59.8 percent) of whom 537 (62.4 percent) were HIV-antibody-positive. The HIV positivity rate increased with age after taking into account hemophilia type, clotting factor level and treatment center type. The three-year cumulative incidence of reported AIDS (acquired immunodeficiency syndrome) cases based on the number of HIV positive patients, was 11.6 percent. The cumulative incidence rate was 14.6 percent (54 of 370) for those patients over 20 years of age and 4.8 percent (8 of 167) for those under 21 years of age. Although a comparable distribution of the date of diagnoses of AIDS was seen by age group, there appeared to be a bimodal distribution in the rate of AIDS among the age groups, with the 6-12-year-olds and the 21 and older age groups showing higher incidence rates. Handle: RePEc:aph:ajpbhl:1990:80:8:967-969_7 Template-Type: ReDIF-Article 1.0 Title: Effect of changing patterns of care and duration of survival on the cost of treating the acquired immunodeficiency syndrome (AIDS) Journal: American Journal of Public Health Author-Name: Seage III, G.R. Author-Name: Landers, S. Author-Name: Lamb, G.A. Author-Name: Epstein, A.M. Year: 1990 Volume: 80 Issue: 7 Pages: 835-839 Abstract: We performed a two-year cost of illness study of 240 AIDS patients (55 percent of all Massachusetts cases) diagnosed and treated at five hospitals from March 1984 through February 1986. Sociodemographic and clinical data as well as information on medical utilization were obtained from review of inpatient and outpatient hospital records. The yearly inpatient cost per patient decreased by 28 percent from $38,369 in year one to $27,714 in year two. These changes were related to shorter lengths of stay (from 20.6 days to 16.8 days per hospitalization, mean difference of 3.8 days, 95% CI of the difference -.2, 7.8), and less costly hospitalizations (from $12,463 to $9,957, mean difference of $2,506, 95% CI of the difference $135, $4,877). The probability of hospitalization, however, was similar in both years. These patterns of care were still evident after controlling for transmission category, race, site, mortality, insurance, age, gender, number and type of opportunistic diseases and time since diagnosis. Although the cost per patient per year decreased between years one and two, median survival increased by 70 percent (from 10 to 17 months). Hence overall estimated lifetime costs increased by 24 percent. Handle: RePEc:aph:ajpbhl:1990:80:7:835-839_1 Template-Type: ReDIF-Article 1.0 Title: Pharmacy education about HIV and condoms Journal: American Journal of Public Health Author-Name: Cleary, P.D. Author-Name: Brandt, A.M. Author-Name: Gostin, L.O. Author-Name: Mayer, K. Year: 1990 Volume: 80 Issue: 11 Pages: 1395 Handle: RePEc:aph:ajpbhl:1990:80:11:1395_7 Template-Type: ReDIF-Article 1.0 Title: The sick building syndrome: Where is the epidemiologic basis? Journal: American Journal of Public Health Author-Name: Kreiss, K. Year: 1990 Volume: 80 Issue: 10 Pages: 1172-1173 Handle: RePEc:aph:ajpbhl:1990:80:10:1172-1173_7 Template-Type: ReDIF-Article 1.0 Title: Vermont International Travel Clinic. Group or individual appointments Journal: American Journal of Public Health Author-Name: Stevenson, J.S. Author-Name: Fisher, S. Author-Name: Kerschner, S. Author-Name: Russell, A. Year: 1990 Volume: 80 Issue: 5 Pages: 616-617 Handle: RePEc:aph:ajpbhl:1990:80:5:616-617_7 Template-Type: ReDIF-Article 1.0 Title: Evaluation of the efficacy and cost effectiveness of health education methods to increase medication adherence among adults with asthma Journal: American Journal of Public Health Author-Name: Windsor, R.A. Author-Name: Bailey, W.C. Author-Name: Richards Jr., J.M. Author-Name: Manzella, B. Author-Name: Soong, S.-J. Author-Name: Brooks, M. Year: 1990 Volume: 80 Issue: 12 Pages: 1519-1521 Abstract: We randomized 135 adult asthma patients to a control group, and 132 patients to an experimental group which received a special health education intervention. Four adherence measures were documented at baseline and 12-month follow-up: correct inhaler use, inhaler adherence, medication adherence, and total adherence rating. Costs to routinely deliver the intervention were $32.03/patient. Experimental group patients exhibited a significantly higher level of improvement in adherence (44 percent) than control group patients (2 percent). Handle: RePEc:aph:ajpbhl:1990:80:12:1519-1521_3 Template-Type: ReDIF-Article 1.0 Title: Personality traits and addictive disease (I) Journal: American Journal of Public Health Author-Name: Ernst, T. Year: 1990 Volume: 80 Issue: 4 Pages: 498-499 Handle: RePEc:aph:ajpbhl:1990:80:4:498-499_6 Template-Type: ReDIF-Article 1.0 Title: Cancer mortality in native Americans in North Carolina Journal: American Journal of Public Health Author-Name: Horner, R.D. Year: 1990 Volume: 80 Issue: 8 Pages: 940-944 Abstract: This paper describes age-adjusted mortality from malignant neoplasms for Native Americans in North Carolina for 1968-72 and 1978-82. Sex-specific standardized mortality ratios were calculated from death certificate data, using the cancer mortality experience of White North Carolinians to obtain the number of expected deaths. For most categories and specific sites of cancer, mortality was at or below the expected level, but higher than expected mortality was found for genitourinary cancers in males (SMR = 1.62, 95% CI = 1.15, 2.21) for the 1978-82 period; within this category, there was a higher than expected level of mortality from prostate cancer (SMR = 2.00; 95% CI = 1.36, 2.83) and cancer of the penis and other male genital organs (SMR = 9.09; 95% CI = 1.10, 32.84). Female Native Americans had an elevated mortality from cervical cancer (SMR = 2.27, 95% CI = 1.09, 4.17) for the 1968-72 period only. Handle: RePEc:aph:ajpbhl:1990:80:8:940-944_8 Template-Type: ReDIF-Article 1.0 Title: XI. The prevalence of total tooth loss, dental caries, and periodontal disease among Mexican Americans, Cuban Americans, and Puerto Ricans: Findings from HHANES 1982-1984 Journal: American Journal of Public Health Author-Name: Ismail, A.I. Author-Name: Szpunar, S.M. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 66-70 Abstract: This paper describes the prevalence of total tooth loss, dental caries, and periodontal disease in 2,226 Puerto Ricans, 1,192 Cuban Americans, and 5,983 Mexican Americans, ages five to 74 years, who were examined during the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). The prevalence of total tooth loss was 2.60, 6.10, and 2.80 percent among Mexican Americans, Cuban Americans, and Puerto Ricans, respectively. After adjusting for the confounding effects of age, sex, income, and education status, no statistically significant differences were found in the mean number of decayed teeth among the three groups of Hispanics. Puerto Rican children had an average of 2.09 filled teeth compared with an average of 1.39 and 1.43 filled teeth for Mexican Americans and Cuban Americans, respectively. In adults, Puerto Ricans and Cuban Americans had at least 40 percent higher mean number of filled teeth than Mexican Americans. Cuban American and Puerto Rican adults had about twice as many missing teeth as Mexican Americans. The pit-and-fissure tooth surfaces in children accounted for the majority of sites affected by caries. All Hispanics had a higher prevalence of gingivitis than American adults as estimated during the 1985-86 National Institute of Dental Research (NIDR) survey of American adults. Puerto Ricans had the highest level of periodontal disease and the highest Debris Index scores among the Hispanic groups. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:66-70_6 Template-Type: ReDIF-Article 1.0 Title: Racial differences in serum cotinine levels among smokers in the Coronary Artery Risk Development in (Young) Adults Study Journal: American Journal of Public Health Author-Name: Wagenknecht, L.E. Author-Name: Cutter, G.R. Author-Name: Haley, N.J. Author-Name: Sidney, S. Author-Name: Manolio, T.A. Author-Name: Hughes, G.H. Author-Name: Jacobs, D.R. Year: 1990 Volume: 80 Issue: 9 Pages: 1053-1056 Abstract: Cotinine was measured in the serum of nearly all 5,115 18-30 years old, Black and White, men and women participating in the Coronary Artery Risk Development in (Young) Adults Study, 30 percent of whom reported current cigarette smoking. Ninety-five percent of the reported smokers had serum cotinine levels indicative of smoking (> 13 ng/ml). The median cotinine level was higher in Black than White smokers (221 ng/ml versus 170 ng/ml; 95 percent CI for difference: 34,65) in spite of the fact that estimated daily nicotine exposure and serum thiocyanate were higher in Whites. The difference persisted after controlling for number of cigarettes, nicotine content, frequency of inhalation, weekly sidestream smoke exposure, age, gender, and education. A reporting bias and nicotine intake were ruled out as explanations for the racial difference suggesting that the metabolism of nicotine or the excretion of cotinine may differ by race. Racial differences in cotinine levels may provide clues to the reasons for the observed lower cessation rates and higher rates of some smoking-related cancers in Blacks. Handle: RePEc:aph:ajpbhl:1990:80:9:1053-1056_8 Template-Type: ReDIF-Article 1.0 Title: The relation of obstetrical volume and nursery level to perinatal mortality Journal: American Journal of Public Health Author-Name: Mayfield, J.A. Author-Name: Rosenblatt, R.A. Author-Name: Baldwin, L.-M. Author-Name: Chu, J. Author-Name: Logerfo, J.P. Year: 1990 Volume: 80 Issue: 7 Pages: 819-823 Abstract: We investigated the relation of hospital delivery volume and nursery technology level to perinatal outcome in 226,164 White singleton births in Washington State, 1980-83. Level III facilities (neonatal intensive care unit) were defined by the state licensing commission. We defined the Level II (intermediate) and Level I (normal newborn) facilities using published criteria. Infants under 2000 gm born in Level III facilities had half the risk of perinatal death compared to those born in a Level I or II facility. No significant improvement was noted among level or volume groupings for normal birthweight infants. A loglinear regression model of hospital perinatal death rates showed that when birthweight and maternal risk were controlled, obstetrical volume added minimal explanatory power to level of nursery care. Handle: RePEc:aph:ajpbhl:1990:80:7:819-823_7 Template-Type: ReDIF-Article 1.0 Title: A randomized evaluation of smoking cessation interventions for pregnant women at a WIC clinic Journal: American Journal of Public Health Author-Name: Mayer, J.P. Author-Name: Hawkins, B. Author-Name: Todd, R. Year: 1990 Volume: 80 Issue: 1 Pages: 76-78 Abstract: Pregnant smokers attending a local health department WIC clinic were randomly assigned to one of two self-help smoking cessation programs or usual care. The multiple component program resulted in larger quit rates than usual care during the last month of pregnancy (11 percent vs 3 percent) and postpartum (7 percent vs 0 percent). Achieving quit rates in WIC similar to those in studies conducted at prenatal care settings, suggests that smoking cessation programs for low-income pregnant WIC clients are feasible. Handle: RePEc:aph:ajpbhl:1990:80:1:76-78_3 Template-Type: ReDIF-Article 1.0 Title: Commitment to quality care Journal: American Journal of Public Health Author-Name: Salive, M.E. Author-Name: Benjamin, K. Author-Name: Raskin, I.E. Year: 1990 Volume: 80 Issue: 10 Pages: 1276-1277 Handle: RePEc:aph:ajpbhl:1990:80:10:1276-1277_2 Template-Type: ReDIF-Article 1.0 Title: Evidence for gonococcal transmission within a correctional system Journal: American Journal of Public Health Author-Name: Van Hoeven, K.H. Author-Name: Rooney Jr., W.C. Author-Name: Joseph, S.C. Year: 1990 Volume: 80 Issue: 12 Pages: 1505-1506 Abstract: In a study to examine sexually transmissable disease occurring within a large correctional system where sexual activity is prohibited, 27 male inmates acquired culture-proven gonorrhea from in-jail sexual activity during a three-month period. These results provide evidence to encourage inmate education about the acquired immunodeficiency syndrome (AIDS) and to support condom distribution programs in correctional facilities. Handle: RePEc:aph:ajpbhl:1990:80:12:1505-1506_3 Template-Type: ReDIF-Article 1.0 Title: Recent time trends in uterine cancer Journal: American Journal of Public Health Author-Name: Persky, V. Author-Name: Davis, F. Author-Name: Barrett, R. Author-Name: Ruby, E. Author-Name: Sailer, C. Author-Name: Levy, P. Year: 1990 Volume: 80 Issue: 8 Pages: 935-939 Abstract: Recent trends in corpus uterine cancer incidence rates were explored using 1979-86 data from the Surveillance and End Results Program (SEER); recent trends in hospitalizations for corpus uterine cancer were explored using 1979-86 data from National Hospital Discharge Surveys (NHDS); and recent trends in exogenous hormone use were delineated using data from the 1980, 1981, and 1985 National Ambulatory Medical Care Surveys (NAMCS). Uterine cancer incidence rates using SEER data have continued to decline since 1979. An acceleration in the decline since 1983-84 is suggested in all women and in women with intact uteri ages 45-64. Hospitalizations for uterine cancer have also declined since 1979, with a marked acceleration in the decline since 1983-84 for all women and for women ages 40-79 has increased 22 percent and use of unopposed exogenous estrogens in women of similar age has increased 7 percent, while use of exogenous progesterones have shown much more substantial increases of approximately 700 percent. Possible relationships between trends in exogenous hormone use and incidence rates of corpus uterine cancer are discussed. Handle: RePEc:aph:ajpbhl:1990:80:8:935-939_4 Template-Type: ReDIF-Article 1.0 Title: Mortality from infectious diseases among New Mexico's American Indians, Hispanic Whites, and other Whites, 1958-1987 Journal: American Journal of Public Health Author-Name: Becker, T.M. Author-Name: Wiggins, C. Author-Name: Peek, C. Author-Name: Key, C.R. Author-Name: Samet, J.M. Year: 1990 Volume: 80 Issue: 3 Pages: 320-323 Abstract: To examine ethnic differences in infectious disease-related mortality in New Mexico's American Indian, Hispanic White and other White populations, we analyzed vital records data from 1958 to 1987. We found that for most infectious causes, American Indians had the highest mortality rates, followed by Hispanics. The state's minority populations remain at increased risk for infectious disease mortality. Handle: RePEc:aph:ajpbhl:1990:80:3:320-323_5 Template-Type: ReDIF-Article 1.0 Title: Community impact of a localized smoking cessation contest Journal: American Journal of Public Health Author-Name: Lando, H.A. Author-Name: Loken, B. Author-Name: Howard-Pitney, B. Author-Name: Pechacek, T. Year: 1990 Volume: 80 Issue: 5 Pages: 601-603 Abstract: The present study assessed the effectiveness of a localized community contest timed to coincide with a statewide smoking cessation contest. Follow-up interviews were conducted with 218 local contest participants and 198 participants from the statewide contest. Overall cessation impact (participation rate x abstinence) was 0.39 percent for the local contest and 0.09 percent for the statewide contest. Localized community contest offered in conjunction with statewide or national campaigns may represent cost-effective methods of reaching large numbers of smokers. Handle: RePEc:aph:ajpbhl:1990:80:5:601-603_2 Template-Type: ReDIF-Article 1.0 Title: Risk communication and public confidence in health departments Journal: American Journal of Public Health Author-Name: Dandoy, S. Year: 1990 Volume: 80 Issue: 11 Pages: 1299-1300 Handle: RePEc:aph:ajpbhl:1990:80:11:1299-1300_8 Template-Type: ReDIF-Article 1.0 Title: The female condom Journal: American Journal of Public Health Author-Name: Sakondhavat, C. Year: 1990 Volume: 80 Issue: 4 Pages: 498 Handle: RePEc:aph:ajpbhl:1990:80:4:498_4 Template-Type: ReDIF-Article 1.0 Title: Medical care in the community for adults with mental retardation Journal: American Journal of Public Health Author-Name: Crocker, A.C. Year: 1990 Volume: 80 Issue: 9 Pages: 1037-1038 Handle: RePEc:aph:ajpbhl:1990:80:9:1037-1038_6 Template-Type: ReDIF-Article 1.0 Title: Comment on occupational heavy metals absorption (I) Journal: American Journal of Public Health Author-Name: Stein, E. Year: 1990 Volume: 80 Issue: 8 Pages: 1003 Handle: RePEc:aph:ajpbhl:1990:80:8:1003_8 Template-Type: ReDIF-Article 1.0 Title: Maternal stress and depressive symptoms Journal: American Journal of Public Health Author-Name: Pascoe, J.M. Year: 1990 Volume: 80 Issue: 11 Pages: 1397 Handle: RePEc:aph:ajpbhl:1990:80:11:1397_2 Template-Type: ReDIF-Article 1.0 Title: Designing fee schedules by formulae, politics, and negotiations Journal: American Journal of Public Health Author-Name: Glaser, W.A. Year: 1990 Volume: 80 Issue: 7 Pages: 804-809 Abstract: Fee-for-service cannot be used successfully by organized health insurance without a fee schedule. America first tried to pay doctors under Medicare by an involved formula system without a fee schedule, but the effort has failed. The United States has now commissioned a research project to design a unique fee schedule that will precisely reflect physicians' effort and practice costs and that will represent the prices produced by a perfectly competitively market. The primary goal is the same as that pursued recently by reformers in all countries: viz., narrow the spread in fees and income between surgical and cognitive fields. There are serious technical limitations on this effort, despite the talent of the research team. An additional difficulty lies in the nature of the subject: paying the doctor involves conflicts of interest between payers and all doctors as well as among the medical specialties, and the conflicts cannot be resolved by any formulae calculated by any single research team. Methodological and political compromises will be necessary, in order to adopt a reform. The new method may be just as politically driven, complicated, and disputes as the old one, despite America's pretenses that it prefers free markets and opposes excessive government. Handle: RePEc:aph:ajpbhl:1990:80:7:804-809_0 Template-Type: ReDIF-Article 1.0 Title: Using nature to understand nurture Journal: American Journal of Public Health Author-Name: VanItallie, T.B. Author-Name: Stunkard, A.J. Year: 1990 Volume: 80 Issue: 6 Pages: 657-658 Handle: RePEc:aph:ajpbhl:1990:80:6:657-658_0 Template-Type: ReDIF-Article 1.0 Title: Abstinence from smoking and expired-air carbon monoxide levels: Lactose intolerance as a possible source of error Journal: American Journal of Public Health Author-Name: McNeill, A.D. Author-Name: Owen, L.A. Author-Name: Belcher, M. Author-Name: Sutherland, G. Author-Name: Fleming, S. Year: 1990 Volume: 80 Issue: 9 Pages: 1114-1115 Abstract: We investigated a possible source of contamination of expired-air carbon monoxide (CO) readings on CO monitors from raised expired-air hydrogen (H2) levels, namely lactose intolerance, the norm in certain ethnic groups. A significant correlation between expired-air CO and H2 readings was observed in four non-smoking lactose maldigesters. Handle: RePEc:aph:ajpbhl:1990:80:9:1114-1115_3 Template-Type: ReDIF-Article 1.0 Title: Maintenance of nonsmoking postpartum by women who stopped smoking during pregnancy Journal: American Journal of Public Health Author-Name: Mullen, P.D. Author-Name: Quinn, V.P. Author-Name: Ershoff, D.H. Year: 1990 Volume: 80 Issue: 8 Pages: 992-994 Abstract: This paper describes self-reported maintenance of nonsmoking at six months postpartum by women whose abstinence was verified beginning before the 20th week of pregnancy and continuing through delivery (n = 134). The overall maintenance rate of 37 percent was not related to sociodemographic characteristics, smoking and obstetric history, the time when quitting occurred, or a prenatal smoking cessation program. Although this rate is encouraging, more attention should be directed to sustaining prenatal abstinence from smoking beyond delivery. Handle: RePEc:aph:ajpbhl:1990:80:8:992-994_9 Template-Type: ReDIF-Article 1.0 Title: Poison control center follow-up of occupational disease Journal: American Journal of Public Health Author-Name: Bresnitz, E.A. Year: 1990 Volume: 80 Issue: 6 Pages: 711-712 Abstract: We followed up 73 of 372 calls to a Regional Poison Control Center (RPCC) that involved workplace disease/exposure(s); most other calls were not made by the workers. An average of 12 additional people per workplace were potentially exposed. Six of the 73 contacted a government agency for investigation of the hazard/illness. Twenty-five percent of callers were still exposed an average of seven months after the original call. The results indicate that poison control centers should develop a public health component to calls about possible workplace poisonings. Handle: RePEc:aph:ajpbhl:1990:80:6:711-712_9 Template-Type: ReDIF-Article 1.0 Title: Public health implications of the microbial pesticide Bacillus thuringiensis: An epidemiology study, Oregon, 1985-86 Journal: American Journal of Public Health Author-Name: Green, M. Author-Name: Heumann, M. Author-Name: Sokolow, R. Author-Name: Foster, L.R. Author-Name: Bryant, R. Author-Name: Skeels, M. Year: 1990 Volume: 80 Issue: 7 Pages: 848-852 Abstract: Bacillus thuringiensis var. kurstaki (B.t.-k) is a microbial pesticide which has been widely used for over 30 years. Its safety for a human population living a sprayed areas has never been tested. Surveillance for human infections caused by B.t.-k among Lane County, Oregon residents was conducted during two seasons of aerial B.t.-k spraying for gypsy moth control. Bacillus isolates from cultures obtained for routine clinical purposes were tested for presence of Bacillus thuringiensis (B.t.). Detailed clinical information was obtained for all B.t.-positive patients. About 80,000 people lived in the first year's spray area, and 40,000 in the second year's area. A total of 55 B.t.-positive cultures were identified. The cultures had been taken from 18 different body sites or fluids. Fifty-two (95 percent) of the B.t. isolates weere assessed to be probable contaminants and not the cause of clinical illness. For three patients, B.t. could neither be ruled in nor out as a pathogen. Each of these three B.t.-positive patients had preexisting medical problems. The level of risk for B.t.-k and other existing or future microbial pesticides in immunocompromised hosts deserves further study. Handle: RePEc:aph:ajpbhl:1990:80:7:848-852_2 Template-Type: ReDIF-Article 1.0 Title: HIV seroconversion in two homosexual men after receptive oral intercourse with ejaculation: Implications for counseling concerning safe sexual practices Journal: American Journal of Public Health Author-Name: Lifson, A.R. Author-Name: O'Malley, P.M. Author-Name: Hessol, N.A. Author-Name: Buchbinder, S.P. Author-Name: Cannon, L. Author-Name: Rutherford, G.W. Year: 1990 Volume: 80 Issue: 12 Pages: 1509-1511 Abstract: Seroconversion for HIV antibody occurred in two homosexual men who reported no anal intercourse for ≥ 5 years and multiple episodes of receptive oral intercourse with ejaculation. Neither man reported intravenous drug use or receipt of blood products. The last antibody-negative specimen was also negative by the polymerase chain reaction and p24 antigen assays. All sexually active persons should be clearly counselled that receptive oral intercourse with ejaculation carries a potential risk of HIV transmission. Handle: RePEc:aph:ajpbhl:1990:80:12:1509-1511_5 Template-Type: ReDIF-Article 1.0 Title: Assessment of AIDS knowledge, attitudes, behaviors, and risk level of Northwestern American Indians Journal: American Journal of Public Health Author-Name: Hall, R.L. Author-Name: Wilder, D. Author-Name: Bodenroeder, P. Author-Name: Hess, M. Year: 1990 Volume: 80 Issue: 7 Pages: 875-877 Abstract: A survey was made of 710 American Indians of Oregon, Washington, and Idaho to assess the population's knowledge, attitudes, and behaviors in respect to acquired immunodeficiency syndrome (AIDS), to estimate the population's risk, and to plan strategies to reduce it. In contrast to 3 percent of the general population, this study found 10.6 percent of male and 6.4 percent of female Pacific Northwestern American Indians in groups considered at high risk for AIDS. Handle: RePEc:aph:ajpbhl:1990:80:7:875-877_4 Template-Type: ReDIF-Article 1.0 Title: Age, sex, and road-use patterns of motor vehicular trauma in Rhode Island: A population-based hospital emergency department study Journal: American Journal of Public Health Author-Name: Rockett, I.R.H. Author-Name: Lieberman, E.S. Author-Name: Hollinshead, W.H. Author-Name: Putnam, S.L. Author-Name: Thode, H.C. Year: 1990 Volume: 80 Issue: 12 Pages: 1516-1518 Abstract: Population-based hospital emergency department data on motor vehicle traffic trauma in Rhode Island, 1984-85, are analyzed by age, sex, and road-use status. Annualized rates of overall and severe trauma were 1,195 cases (95% confidence interval [CI] = 1,164, 1,225) and 102 cases (95% CI = 94, 111) per 100,000 population, respectively. Overall and severe rates peaked at ages 15-24 years. Male rate excesses were most pronounced for motorcycle and pedal cycle trauma. Handle: RePEc:aph:ajpbhl:1990:80:12:1516-1518_6 Template-Type: ReDIF-Article 1.0 Title: Perforating eye injury in Allegheny County, Pennsylvania Journal: American Journal of Public Health Author-Name: Landen, D. Author-Name: Baker, D. Author-Name: LaPorte, R. Author-Name: Thoft, R.A. Year: 1990 Volume: 80 Issue: 9 Pages: 1120-1122 Abstract: From 1980 through 1986, acute perforating eye injury (ICD codes 871.0-871.9) was diagnosed in 345 residents of Allegheny County, Pennsylvania. The mean incidence rate was 3.49 per 100,000 person years. There was no significant change in incidence over the seven-year period. The largest number of injuries occurred among individuals working with tools, of which 47 percent were occupational. Males had a 6.5-fold risk of injury relative to females. Blacks had a risk of 2.2 times that of Whites, mainly due to an excess of assaultive injuries. Individuals who had had recent ocular surgery accounted for 4.6 percent of cases overall, and for 31.6 percent of cases in those over age 60. Handle: RePEc:aph:ajpbhl:1990:80:9:1120-1122_0 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic features of treated end-stage renal disease in a large prepaid health plan Journal: American Journal of Public Health Author-Name: Ordonez, J.D. Author-Name: Hiatt, R.A. Author-Name: Quesenberry, C.P. Year: 1990 Volume: 80 Issue: 1 Pages: 47-49 Abstract: We examined the incidence of treated end-stage renal disease (ESRD) among the two million members of the Kaiser Permanente Medical Care Program of Northern California from 1973 through 1985. The age-adjusted incidence rates rose from 33.9 to 81.7 per million person-years and showed no signs of stabilization. Rates were higher in men than in women and rose with age. Marked upward trends (p < .001) in the rates of treated ESRD associated with diabetic nephropathy and hypertension were noted. Handle: RePEc:aph:ajpbhl:1990:80:1:47-49_0 Template-Type: ReDIF-Article 1.0 Title: Predictors of the initiation of psychotherapeutic medicine use Journal: American Journal of Public Health Author-Name: Trinkoff, A.M. Author-Name: Anthony, J.C. Author-Name: Munoz, A. Year: 1990 Volume: 80 Issue: 1 Pages: 61-65 Abstract: This study examined the hypothesized predictive association between illicit drug use and the onset of prescribed psychotherapeutic medicine use. The effect of psychiatric symptoms on this relationship was also explored. Data were gathered retrospectively, through standardized household interviews conducted in 1981 for the Baltimore site of the National Institute of Mental Health Epidemiologic Catchment Area Program. For this analysis, the sample was restricted to 1,716 respondents ages 18-44 at the time of interview, drawn by probability sampling area household residents of all adult ages. Using Cox proportional hazards models, the onset of psychotherapeutic medicine use was modeled as a function of illicit drug use and psychiatric symptoms, both defined as time-dependent covariates. Newly observed in this analysis was an indepedent association of illicit drug use with psychotherapeutic medicine use, which was unexplained by psychiatric symptoms (relative hazard = 2.61, 95% confidence interval (CI) = 2.15, 3.18). Adjustment for age of onset of alcohol intoxication did not alter the impression that illicit drug users were more likely to initiate use of prescribed psychotherapeutic medicines (relative hazard = 2.52, 95% CI = 2.02, 3.11). Handle: RePEc:aph:ajpbhl:1990:80:1:61-65_2 Template-Type: ReDIF-Article 1.0 Title: Passive smoking and 20-year cardiovascular disease mortality among nonsmoking wives, Evans County, Georgia Journal: American Journal of Public Health Author-Name: Humble, C. Author-Name: Croft, J. Author-Name: Gerber, A. Author-Name: Casper, M. Author-Name: Hames, C.G. Author-Name: Tyroler, H.A. Year: 1990 Volume: 80 Issue: 5 Pages: 599-601 Abstract: The association of passive smoking and cardiovascular disease (CVD) mortality was assessed in a cohort of 513 rural, married Black and White women who were disease-free and self-described as never-smokers at baseline in 1960. Over a 20-year period, 76 of 147 total deaths were attributed to CVD. Relative risk estimates adjusted for age, cholesterol, blood pressure, and body mass from proportional hazards models were 1.59 for CVD (95% CI = 0.99, 2.57) and 1.39 (CI = 0.99, 1.94) for all cause mortality among women with husbands who smoked cigarettes. Handle: RePEc:aph:ajpbhl:1990:80:5:599-601_5 Template-Type: ReDIF-Article 1.0 Title: Nongenetic influences of obesity on other cardiovascular disease risk factors: An analysis of identical twins Journal: American Journal of Public Health Author-Name: Newman, B. Author-Name: Selby, J.V. Author-Name: Quesenberry Jr., C.P. Author-Name: King, M.-C. Author-Name: Friedman, G.D. Author-Name: Fabsitz, R.R. Year: 1990 Volume: 80 Issue: 6 Pages: 675-678 Abstract: The importance of genetic influences on obesity has been emphasized recently. We conducted matched co-twin analyses of 250 pairs of White, male, monozygotic twins from the National Heart, Lung, and Blood Institute (NHLBI) Twin Study. Entirely in the absence of genetic influences, obesity was significantly associated with systolic and diastolic blood pressures; one-hour, post-load glucose; total LDL-, and HDL-cholesterol; and triglycerides among these 42-55 year old men. Similar results were obtained in longitudinal analyses of weight change during adulthood (from mean age of 20 to mean age of 48 years) and risk factor status at middle-age. These results indicate that behaviors and environmental exposures that occur later in life are responsible, at least in part, for the associations between adult obesity and cardiovascular disease risk, supporting the appropriateness of weight reduction efforts during adulthood. Handle: RePEc:aph:ajpbhl:1990:80:6:675-678_1 Template-Type: ReDIF-Article 1.0 Title: Death resulting from motor vehicle immersions: The nature of the injuries, personal and environmental contributing factors, and potential interventions Journal: American Journal of Public Health Author-Name: Wintemute, G.J. Author-Name: Kraus, J.F. Author-Name: Teret, S.P. Author-Name: Wright, M.A. Year: 1990 Volume: 80 Issue: 9 Pages: 1068-1070 Abstract: We present an epidemiologic characterization of deaths from motor vehicle immersions, based on 77 deaths in 63 motor vehicle immersions in Sacramento County, CA, during 1974-85. All persons were autopsied; all but one of the deaths were due to drowning. Average annual mortality rates per million persons year were 12 for males, four for females, 30 for Hispanics, six for White non-Hispanics, Blacks and Asians. Seventy-one percent of drivers and 60 percent of passengers had a blood alcohol concentration ≥ 22 mmol/L. Most cases (57 percent) had an Injury Severity Score of 1 (minor injury) or 0 (no injury). Alcohol use was associated with higher Injury Severity Scores. Road curvature of 20° or greater was far more common at crash sites than at matched control sites one mile away (OR = 6.57, 95% CI = 2.93, 14.71). Guard rail placement along highly curved sections of roadway may be an effective preventive measure. Handle: RePEc:aph:ajpbhl:1990:80:9:1068-1070_8 Template-Type: ReDIF-Article 1.0 Title: Food and nutrient intake differences between smokers and non-smokers in the US Journal: American Journal of Public Health Author-Name: Subar, A.F. Author-Name: Harlan, L.C. Author-Name: Mattson, M.E. Year: 1990 Volume: 80 Issue: 11 Pages: 1323-1329 Abstract: Data from the Second National Health and Nutrition Examination Survey were analyzed to determine food and nutrient intake differences between current smokers (also categorized as light, moderate, and heavy smokers) and non-smokers. Smokers in several age-race-sex categories have lower intakes of vitamin C, folate, fiber, and vitamin A than non-smokers, and intake tended to decrease as cigarette consumption increased, particularly for vitamin C, fiber, and folate. Smokers were less likely to have consumed vegetables, fruits (particularly fruits and vegetables high in vitamins C and A), high fiber grains, low fat milk, and vitamin and mineral supplements than non-smokers. A negative linear trend was found between smoking intensity and intake of several categories of fruits and vegetables. These data suggest that the high cancer risk associated with smoking is compounded by somewhat lower intake of nutrients and foods which are thought to be cancer protective. Handle: RePEc:aph:ajpbhl:1990:80:11:1323-1329_9 Template-Type: ReDIF-Article 1.0 Title: Incidence of bicycle-related injuries in a defined population Journal: American Journal of Public Health Author-Name: Thompson, D.C. Author-Name: Thompson, R.S. Author-Name: Rivara, F.P. Year: 1990 Volume: 80 Issue: 11 Pages: 1388-1389 Abstract: Population-based incidence rates for head injuries and total injuries resulting from bicycle crashes were calculated in a Seattle, Washington health maintenance organization population. Overall rates were 163 per 100,00 for all injuries and 42/100,000 for head injuries. Individuals between 5 and 14 years of age are at highest risk for bicycle-related injuries. The data are presented for their potential utility in program planning. Handle: RePEc:aph:ajpbhl:1990:80:11:1388-1389_0 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic and clinical characteristics of persons with serologic evidence of E. canis infection Journal: American Journal of Public Health Author-Name: Rohrbach, B.W. Author-Name: Harkess, J.R. Author-Name: Ewing, S.A. Author-Name: Kudlac, J. Author-Name: McKee, G.L. Author-Name: Istre, G.R. Year: 1990 Volume: 80 Issue: 4 Pages: 442-445 Abstract: The results of a serosurvey of Oklahomans for the presence of antibody to Ehrlichia canis is reported. Paired serum specimens, from patients lacking the serologic criteria for diagnosis of Rocky Mountain spotted fever (RMSF), were tested. A four-fold increase in E. Canis-IFA antibody was found in 16/144 (11 percent) of these paired serum samples. Patients with serologic evidence of E. canis infection had a mean age of 34 years, 69 percent were male, and 63 percent lived in a town <10,000 population. Signs and symptoms included: fever 94 percent, headach 94 percent, fatigue 94 percent, anorexia 81 percent, nausea 60 percent, and rash 44 percent. When compared to control patients, whose sera were submitted for RMSF testing but did not meet serologic criteria for RMSF or E. canis, case-patients were more likely to have had leukopenia (OR = 4.9, 95 percent Cl = 1.2, 19.0) and tick exposure (OR = 9.5, 95 percent Cl = 1.4, 62.7). The results suggest E. canis, or a closely related agent, is a cause of human illness. Ticks are a probable vector (Am J Public Health 1990; 80:442-445). Handle: RePEc:aph:ajpbhl:1990:80:4:442-445_9 Template-Type: ReDIF-Article 1.0 Title: The differential effect of traditional risk factors on infant birthweight among Blacks and Whites in Chicago Journal: American Journal of Public Health Author-Name: Collins Jr., J.W. Author-Name: David, R.J. Year: 1990 Volume: 80 Issue: 6 Pages: 679-681 Abstract: We analyzed 103,072 White and Black births in Chicago from the 1982 and 1983 Illinois vital records, using 1980 median family income of mother's census tract as an ecologic variable. Thirty-one percent of Blacks and 4 percent of Whites resided in census tracts with median family incomes ≤ $10,000/year. Only 2 percent of Black mothers, compared to 16 percent of White mothers, lived in areas where the median family income was greater than $25,000/year. Among Blacks with incomes ≤ $10,000/year, maternal age, education, and marital status had minimal predictive power on the incidence of low birthweight (LBW) infants. Among high-risk mothers in the poorest areas the proportion of LBW infants in Blacks and Whites was less divergent than in higher income areas. Independent of residential area, low-risk Whites had half the occurrence of LBW infants as Blacks. We conclude that the extremes of residential environments show dramatic racial disparity in prevalence, yet the few low-risk Blacks still do less well than low-risk Whites. Traditional risk factors do not completely explain racial differences in neonatal outcome. Handle: RePEc:aph:ajpbhl:1990:80:6:679-681_7 Template-Type: ReDIF-Article 1.0 Title: Premarital screening for antibodies to human immunodeficiency virus type 1 in the United States Journal: American Journal of Public Health Author-Name: Petersen, L.R. Author-Name: White, C.R. Author-Name: Benjamin, R.A. Author-Name: Checko, P.J. Author-Name: Farrales, F.B. Author-Name: Harkess, J.R. Author-Name: Kudlac, J. Author-Name: Hull, H.F. Author-Name: Kao, Y.S. Author-Name: Kelly, C. Author-Name: Leonard, G.L. Author-Name: Moody, R.C. Author-Name: Sikes, K. Author-Name: Strahan, N.D. Author-Name: Smith, D.E. Author-Name: Wallace, H.G. Author-Name: Wallace, M.E. Year: 1990 Volume: 80 Issue: 9 Pages: 1087-1090 Abstract: To evaluate premarital human immunodeficiency virus (HIV) screening as an approach to AIDS prevention in the United States, we determined the HIV antibody seroprevalence in marriage license applicants in eight areas by blinded testing of blood specimens routinely collected for syphilis serology. The seroprevalences were 0.0-0.4 percent in women and 0.0-1.1 percent in men. We also examined the impact of mandatory premarital HIV screening on marriage rates in Louisiana and Illinois. In 1988, after screening began, 9 percent and 16 percent fewer marriage licenses than in the previous two years were issued in Louisiana and Illinois, respectively. We estimated that mandatory premarital screening, if adopted nationally, would cost $167,230,000. We conclude that compared with other HIV prevention programs mandatory premarital screening would be expensive and would probably have a minor impact on the HIV epidemic. Handle: RePEc:aph:ajpbhl:1990:80:9:1087-1090_0 Template-Type: ReDIF-Article 1.0 Title: Retirement and primary cardiac arrest in males Journal: American Journal of Public Health Author-Name: Siscovick, D.S. Author-Name: Strogatz, D.S. Author-Name: Weiss, N.S. Author-Name: Rennert, G. Year: 1990 Volume: 80 Issue: 2 Pages: 207-208 Abstract: We investigated the association between retirement and primary cardiac arrest (PCA) in 126 male cases and controls, 25-75 years of age, without prior heart disease or comorbidity. After adjustment for age alone, retirement was not associated with an increased risk of PCA, (OR = 1.1; 95% confidence intervals = 0.5, 2.4). This lack of association was not uniform across age strata, however. In 10 of 19 discordant pairs 60 gr more years of age, the control subject had been retired; in all seven discordant pairs under 60, the case had been retired (lower 95% CI of the relative risk = 1.9). Handle: RePEc:aph:ajpbhl:1990:80:2:207-208_2 Template-Type: ReDIF-Article 1.0 Title: The prevalence of severe mental disorder among male urban jail detainees: Comparison with the epidemiologic catchment area program Journal: American Journal of Public Health Author-Name: Teplin, L.A. Year: 1990 Volume: 80 Issue: 6 Pages: 663-669 Abstract: This paper presents the prevalence rates of schizophrenia and major affective disorders by age and race among a random sample of male jail detainees. Subjects were administered the National Institute of Mental Health Diagnostic Interview Schedule (NIMH-DIS). The jail prevalence rates when then compared with general population data from the five-city Epidemiologic Catchment Area program using difference of proportion tests and loglinear analysis. After controlling for demographic differences between the jail and five-city samples, the jail prevalence rates were still two to three times higher than those in the general population. These findings suggest several public policy modifications concerning the psychiatric management of our burgeoning jail population. Handle: RePEc:aph:ajpbhl:1990:80:6:663-669_1 Template-Type: ReDIF-Article 1.0 Title: Drownings in Minnesota, 1980-85: A population-based study Journal: American Journal of Public Health Author-Name: Hedberg, K. Author-Name: Gunderson, P.D. Author-Name: Vargas, C. Author-Name: Osterholm, M.T. Author-Name: MacDonald, K.L. Year: 1990 Volume: 80 Issue: 9 Pages: 1071-1074 Abstract: We conducted a population-based study of drownings in Minnesota from 1980 through 1985. Five hundred and forty-one drownings (2.1 per 100,000 person-years) were identified from death certificates and from incident reports filed with the Minnesota Department of Natural Resources. Most drownings (334,62 percent) occurred during summer months (May-August) and involved boating (42 percent) and swimming (35 percent) events. However, 62 drownings (11 percent) occurred during winter months (December-February) and primarily involved snowmobiles and motor vehicles (71 percent) breaking through ice on lakes and waterways. The risk of drowning, estimated by the ratio of drownings to number of water-related activities, was highest during March and April, when the ice on lakes and waterway surfaces is melting, and during October and November, when lake and waterway surfaces are starting to freeze. Drowning rates were highest for males (3.7 per 100,000 person-years), persons 15 to 25 years of age (3.3 per 100,000 person-years), and children less than 5 years of age (2.5 per 100,000 person-years). These data can be used to target prevention strategies, particularly in northern climates. Handle: RePEc:aph:ajpbhl:1990:80:9:1071-1074_0 Template-Type: ReDIF-Article 1.0 Title: Workplace health hazards: Analysis of hotline calls over a six-year period Journal: American Journal of Public Health Author-Name: Quint, J. Author-Name: Handley, M. Author-Name: Cummings, K. Year: 1990 Volume: 80 Issue: 2 Pages: 202-204 Abstract: Between 1981-1986 a state-based occupational health telephone hotline received more than 8,000 inquiries on over 3,000 hazardous agents. Major caller groups were employees (37%), employers (20%), health care providers, primarily physicians (19%), government agencies (12%), and labor unions (6%). Employees were the fastest growing caller group. Callers inquired about general health hazards of chemicals (65%), the relation of symptoms to work (22%), and risks to pregnancy (13%). Handle: RePEc:aph:ajpbhl:1990:80:2:202-204_7 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic differences between chlamydia and gonorrhea Journal: American Journal of Public Health Author-Name: Zimmerman, H.L. Author-Name: Potterat, J.J. Author-Name: Dukes, R.L. Author-Name: Muth, J.B. Author-Name: Zimmerman, H.P. Author-Name: Fogle, J.S. Author-Name: Pratts, C.I. Year: 1990 Volume: 80 Issue: 11 Pages: 1338-1342 Abstract: To assess the prevalence, demographics, and transmission patterns of genital chlamydia infection, we screened 3,078 patients, and compared identified cases (N = 511) to gonorrhea cases (N = 291) diagnosed in the same setting. Chlamydia cases were younger and more likely to be White than their gonorrhea counterparts. Chlamydia cases were distributed diffusely; geographic overlap between the two diseases was only about 40 percent. Gonoccocal coinfection was noted in <10 percent of patients with chlamydia. Nearly half of men with chlamydia and four-fifths of women were asymptomatic and most cases were identified through screening or contact tracing. Populations at high risk for chlamydia are seemingly different from those for gonorrhea. Differences may be due to control interventions (active for gonorrhea, passive for chlamydia). Chlamydia case reporting and control initiatives are recommended. Handle: RePEc:aph:ajpbhl:1990:80:11:1338-1342_1 Template-Type: ReDIF-Article 1.0 Title: AIDS and state developmental disability agencies: A national survey Journal: American Journal of Public Health Author-Name: Marchetti, A.G. Author-Name: Nathanson, R.S. Author-Name: Kastner, T.A. Author-Name: Owens, R. Year: 1990 Volume: 80 Issue: 1 Pages: 54-56 Abstract: A survey of state developmental disability agencies was undertaken in October 1987 regarding AIDS policy development, education, and training and service provision. Of 44 states responding to the 27-item questionnaire, only 21 had formal AIDS policies. Policies varied considerably from state to state. Twenty-five of the responding states include information on AIDS in their staff training curriculum, with such training more likely to be provided to institutional staff than to community-based staff. Only 10 states reported AIDS prevention to be part of their client training programs, with training more likely to be found in institutional settings. Eleven states reported HIV positive cases, with such cases found more often in institutions than in community settings. Several states reported some type of segregation of HIV positive individuals. Policies, educational programming, and services to meet the special needs of persons with developmental disabilities are called for. Handle: RePEc:aph:ajpbhl:1990:80:1:54-56_0 Template-Type: ReDIF-Article 1.0 Title: Effect of disinfectants on pseudomonads colonized on the interior surface of the PVC pipes Journal: American Journal of Public Health Author-Name: Anderson, R.L. Author-Name: Holland, B.W. Author-Name: Carr, J.K. Author-Name: Bond, W.W. Author-Name: Favero, M.S. Year: 1990 Volume: 80 Issue: 1 Pages: 17-21 Abstract: We investigated the effect of disinfectants on microbial contamination present on the interior surface of polyvinyl chloride (PVC) pipes filled with 600 ml of water contaminated with Pseudomonas pickettii and P. aeruginosa. After eight weeks, water was removed, and the test pipes exposed to various types of aqueous disinfectants. Disinfectant samples were removed, neutralized, and examined for recovery of microorganisms by membrane filtration. After seven-days exposure, disinfectant solutions were removed and pipes filled with sterile distilled water. Water was examined by membrane filtration at seven-day intervals to determine whether the organisms had survived in the pipes. Colonization of PVC surfaces were examined during each study phase by scanning electron-microscopy (SEM). P. aeruginosa was isolated directly from iodophor disinfectant, phenolic germicide, and iodophor antiseptic solutions. After addition of sterile water, P. aeruginosa was recovered from PVC pipes previously exposed to chlorine, phenolic, quaternary-ammonium, and iodophor disinfectants; P. pickettii was recovered from water in pipes treated with iodophor disinfectant, chlorine, and ethanol. The existence of glycocalyx-like cellular masses on the interior wall of PVC pipes most likely protected embedded organisms from the microbicidal action of some of the disinfectants tested and served as the reservoir for continuous contamination. Handle: RePEc:aph:ajpbhl:1990:80:1:17-21_7 Template-Type: ReDIF-Article 1.0 Title: Serious poisonings among older adults: A study of hospitalization and mortality rates in Massachusettes 1983-85 Journal: American Journal of Public Health Author-Name: Woolf, A. Author-Name: Fish, S. Author-Name: Azzara, C. Author-Name: Dean, D. Year: 1990 Volume: 80 Issue: 7 Pages: 867-869 Abstract: We analyzed poisoning-related hospitalization and mortality rates among older adults living in Massachusetts during 1983-85. While poisoning-related hospitalization rates of individuals ≥ 60 years were near the state average, death rates for men ≥ 70 years and for women over 60 were higher than those of younger individuals. Medications and carbon monoxide were commonly implicated agents in these poisoning deaths. Older adults are more vulnerable to death from a poisoning than are younger age groups. Handle: RePEc:aph:ajpbhl:1990:80:7:867-869_3 Template-Type: ReDIF-Article 1.0 Title: Challenges for public health nutrition in the 1990s Journal: American Journal of Public Health Author-Name: Willett, W. Year: 1990 Volume: 80 Issue: 11 Pages: 1295-1298 Handle: RePEc:aph:ajpbhl:1990:80:11:1295-1298_6 Template-Type: ReDIF-Article 1.0 Title: The prime time diet: A content analysis of eating behavior and food messages in television program content and commercials Journal: American Journal of Public Health Author-Name: Story, M. Author-Name: Faulkner, P. Year: 1990 Volume: 80 Issue: 6 Pages: 738-740 Abstract: The purpose of this study was to identify and analyze messages related to food and eating behavior as presented on prime time television (8:00-11:00 pm) both in programming and commercials. Food references occurred an average of 4.8 times per 30 minutes of programming time. Over half (60 percent) of all food references in programs were for low nutrient beverages and sweets. The prime time diet is inconsistent with dietary guidelines for healthy Americans. Handle: RePEc:aph:ajpbhl:1990:80:6:738-740_8 Template-Type: ReDIF-Article 1.0 Title: Cervix and breast cancer incidence in immigrant Caribbean women Journal: American Journal of Public Health Author-Name: Fruchter, R.G. Author-Name: Nayeri, K. Author-Name: Remy, J.C. Author-Name: Wright, C. Author-Name: Feldman, J.G. Author-Name: Boyce, J.G. Author-Name: Burnett, W.S. Year: 1990 Volume: 80 Issue: 6 Pages: 722-724 Abstract: Cervix and breast cancer incidence in 1978-82 was computed for immigrant and United States-born Black women in Brooklyn, New York. Compared to the national SEER (Surveillance, Epidemiology and End Results) rates, US-born and Haitian women had high rates of invasive cervical cancer, while English-speaking Caribbean immigrants had an average rate. However, while US-born women had an average rate of carcinoma in situ of the cervix, both immigrant groups had low rates. Both immigrant groups had low rates of breast cancer, whereas US-born Black women had an average rate. Handle: RePEc:aph:ajpbhl:1990:80:6:722-724_9 Template-Type: ReDIF-Article 1.0 Title: Human behavior and the communicable diseases of childhood Journal: American Journal of Public Health Author-Name: Dunn, F.L. Year: 1990 Volume: 80 Issue: 2 Pages: 141-142 Handle: RePEc:aph:ajpbhl:1990:80:2:141-142_1 Template-Type: ReDIF-Article 1.0 Title: Trends in hospital utilization, 1965-86 Journal: American Journal of Public Health Author-Name: Pokras, R. Author-Name: Kozak, L.J. Author-Name: McCarthy, E. Author-Name: Graves, E.J. Year: 1990 Volume: 80 Issue: 4 Pages: 488-490 Handle: RePEc:aph:ajpbhl:1990:80:4:488-490_5 Template-Type: ReDIF-Article 1.0 Title: The infrastructure of religious communities: A neglected resource for care of people with AIDS Journal: American Journal of Public Health Author-Name: Shelp, E.E. Author-Name: DuBose, E.R. Author-Name: Sunderland, R.H. Year: 1990 Volume: 80 Issue: 8 Pages: 970-972 Abstract: The AIDS Interfaith Council of Houston, sponsored by the Foundation for Interfaith Research and Ministry, recruits, trains, and coordinates volunteers for home-based care for adults and children with AIDS (acquired immunodeficiency syndrome). The program provides compassionate, non-judgmental care for the sick and respite support for the primary care provider. Care is provided by highly motivated, trained volunteers. The respite care team model also represents a support system to complement medical management and other health care services for people with AIDS. With the expanding number of cases and the growing preference for clients to remain at home, such a model will become increasingly important as people continue to live longer with AIDS. Handle: RePEc:aph:ajpbhl:1990:80:8:970-972_3 Template-Type: ReDIF-Article 1.0 Title: The federal environmental health workforce in the United States Journal: American Journal of Public Health Author-Name: Sexton, K. Author-Name: Perlin, S.A. Year: 1990 Volume: 80 Issue: 8 Pages: 913-920 Abstract: This paper summarizes existing data on the size and composition of the federal environmental health workforce, delineates the major categories of activities carried out by its members, identifies current and emerging issues that are likely to affect workforce activities, and makes qualitative inferences about future trends and directions. Findings suggest that there is a current and future need for more and better qualified professionals in the federal environmental health workforce. Handle: RePEc:aph:ajpbhl:1990:80:8:913-920_4 Template-Type: ReDIF-Article 1.0 Title: 65 mph speed limit on rural interstates Journal: American Journal of Public Health Author-Name: Baxter, J.J. Year: 1990 Volume: 80 Issue: 4 Pages: 501 Handle: RePEc:aph:ajpbhl:1990:80:4:501_4 Template-Type: ReDIF-Article 1.0 Title: Survey of occupational exposure of waste industry workers to infectious waste in Washington state Journal: American Journal of Public Health Author-Name: Turnberg, W.L. Author-Name: Frost, F. Year: 1990 Volume: 80 Issue: 10 Pages: 1262-1264 Abstract: We surveyed 940 Washington state waste industry workers to evaluate occupational exposure to potentially infectious materials (response rate 47 percent). Only 26 percent were trained specifically to deal with safety hazards associated with medical waste. For the year preceding the survey, 50 percent of respondents reported having received cuts and scratches on the job, 22 percent reported direct contact with waste blood on their clothing or shoes, 8 percent had blood exposure on their skin, 3 percent blood exposure on their face or eyes, and 6 percent occupational hypodermic needlestick injuries (10 percent among waste collectors). Handle: RePEc:aph:ajpbhl:1990:80:10:1262-1264_8 Template-Type: ReDIF-Article 1.0 Title: Erratum: Breastfeeding trends in the Philippines, 1973 and 1983 (Am J Public Health 1989; 79(1):32-35) Journal: American Journal of Public Health Author-Name: Popkin, B.M. Author-Name: Akin, J.S. Author-Name: Flieger, W. Author-Name: Wong, E.L. Year: 1990 Volume: 80 Issue: 3 Pages: 285 Handle: RePEc:aph:ajpbhl:1990:80:3:285_5 Template-Type: ReDIF-Article 1.0 Title: The prevalence of high-risk sexual behavior in male intravenous drug users with steady female partners Journal: American Journal of Public Health Author-Name: Lewis, D.K. Author-Name: Watters, J.K. Author-Name: Case, P. Year: 1990 Volume: 80 Issue: 4 Pages: 465-466 Abstract: A sample of 149 (70 White, 79 Black) male intravenous drug users with steady female sexual partners were interviewed in 1987, in treatment and street settings, about sexual practices during the previous five years. Eighty-three percent had multiple partners, 15 percent reported male sexual contact, 38 percent reported heterosexual anal intercourse, and 73 percent never used condoms. Thirty-seven White and 30 Black subjects reported bisexuality or heterosexual anal intercourse or both. Handle: RePEc:aph:ajpbhl:1990:80:4:465-466_2 Template-Type: ReDIF-Article 1.0 Title: Stalking the HIV epidemic: Which tracks to follow and how far? Journal: American Journal of Public Health Author-Name: Peterman, T.A. Author-Name: Petersen, L.R. Year: 1990 Volume: 80 Issue: 4 Pages: 401-402 Handle: RePEc:aph:ajpbhl:1990:80:4:401-402_8 Template-Type: ReDIF-Article 1.0 Title: Eight-year follow-up results of an adolescent smoking prevention program: The North Karelia Youth Project Journal: American Journal of Public Health Author-Name: Vartiainen, E. Author-Name: Fallonen, U. Author-Name: McAlister, A.L. Author-Name: Puska, P. Year: 1990 Volume: 80 Issue: 1 Pages: 78-79 Abstract: In the North Karelia Youth Program five to 10 classroom sessions over two years taught skills to resist pressures to start smoking to 13 to 15 year old students. Compared to students from comparison schools, the treatment groups reported less smoking immediately after the intervention and in a four-year follow-up survey. At the eight-year follow-up, there was consistent evidence of possible preventive effects only among those who had been non-smokers when the progam began. Handle: RePEc:aph:ajpbhl:1990:80:1:78-79_7 Template-Type: ReDIF-Article 1.0 Title: Human immunodeficiency virus seropositive among members of the active duty US Army 1985-89 Journal: American Journal of Public Health Author-Name: Kelley, P.W. Author-Name: Miller, R.N. Author-Name: Pomerantz, R. Author-Name: Wann, F. Author-Name: Brundage, J.F. Author-Name: Burke, D.S. Year: 1990 Volume: 80 Issue: 4 Pages: 405-410 Abstract: Between October 1985 and June 1989, most active duty US Army soldiers were screened for human immunodeficiency virus (HIV) antibody. Of 648,032 screened soldiers in this analysis, 1,588 were HIV-antibody positive. In a multivariate analysis, correlates of positivity included: age [Adjusted Odds Ratios (ref <20 years) = 20-24 years, 3.7; 25-29, 9.3; 30-34, 15.7 ≥35, 15.9]; being male, [4.2]; being Black or Hispanic (vs white) [3.7 and 3.0, respectively]; being single (vs married) [3.8]; assignment to an HIV endemic location [1.7], and having a medical occupation [2.7, 2.7, and 2.6 for negligible, low, and high blood exposure professions, respectively]. Seropositivity rate ratios for medical vs non-medical personnel were 0.7 [95% CI = 0.4, 1.4] for females and 2.9 [95% CI = 2.5, 3.3] for males. For male medical personnel, being single (vs married) correlated strongly with antibody positivity [prevalence ratio = 3.4, 95% CI = 2.6, 4.6]. Excess HIV risk among medical personnel appeared largely attributable to factors other than occupational exposures. Handle: RePEc:aph:ajpbhl:1990:80:4:405-410_3 Template-Type: ReDIF-Article 1.0 Title: Dependency on soup kitchens in urban areas of New York state Journal: American Journal of Public Health Author-Name: Rauschenbach, B.S. Author-Name: Frongillo Jr., E.A. Author-Name: Thompson, F.E. Author-Name: Andersen, E.J.Y. Author-Name: Spicer, D.A. Year: 1990 Volume: 80 Issue: 1 Pages: 57-60 Abstract: We studied the dependency of persons on soup kitchens in Albany, Buffalo, Rochester, Syracuse, and Westchester County, New York. Seventeen percent of the meal recipients were homeless, 62 percent lived in apartments or houses, 20 percent were working, 40 percent were women, and 17 percent had a child in their household. Fifty-nine percent started eating at the soup kitchen more than a year ago, and 51 percent ate five or more meals at soup kitchens in the last week. Most reported they came to the soup kitchen because of economic problems or lack of food; 93 percent had incomes below the poverty threshold. Most used some government food program; 48 percent recieved food stamps. Utilization of soup kitchens and other programs differed between men and women and between households with and without children. Handle: RePEc:aph:ajpbhl:1990:80:1:57-60_3 Template-Type: ReDIF-Article 1.0 Title: Letter on epidemiologic research methods (II) Journal: American Journal of Public Health Author-Name: Maclure, M. Year: 1990 Volume: 80 Issue: 5 Pages: 623 Handle: RePEc:aph:ajpbhl:1990:80:5:623_1 Template-Type: ReDIF-Article 1.0 Title: Lead exposure in indoor firing ranges (I: Reply) Journal: American Journal of Public Health Author-Name: Martyny, J. Author-Name: Valway, S. Author-Name: Mangione, E. Year: 1990 Volume: 80 Issue: 3 Pages: 354 Handle: RePEc:aph:ajpbhl:1990:80:3:354_4 Template-Type: ReDIF-Article 1.0 Title: Cabarrus County employees 'Leap into Life' Program Journal: American Journal of Public Health Author-Name: Goff, G.M. Year: 1990 Volume: 80 Issue: 8 Pages: 998-999 Handle: RePEc:aph:ajpbhl:1990:80:8:998-999_5 Template-Type: ReDIF-Article 1.0 Title: The utility of multiple strategies for understanding complex behaviors Journal: American Journal of Public Health Author-Name: Adler, N.E. Author-Name: Kegeles, S.M. Author-Name: Irwin Jr., C.E. Year: 1990 Volume: 80 Issue: 10 Pages: 1180-1182 Abstract: Nickerson's critique of our brief report on changes in knowledge, attitudes and use of condoms among adolescents over a year's time mistakenly interprets the paper as examining an attitude/behavior discrepancy. A number of her criticisms follow from this mistaken interpretation. We agree with some of her general points but identify several errors in her analysis and note areas of disagreement about strategies for studying complex behaviors. Handle: RePEc:aph:ajpbhl:1990:80:10:1180-1182_1 Template-Type: ReDIF-Article 1.0 Title: V. Utilization of curanderos by Mexican Americans: Prevalence and predictors findings from HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Higginbotham, J.C. Author-Name: Trevino, F.M. Author-Name: Ray, L.A. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 32-35 Abstract: Data from the Southwest sample of the Hispanic Health and Nutrition Examination Survey (HHANES) were analyzed to examine whether the use of a curandero or other folk medicine practitioner hindered, enhanced, or did not affect the utilization of western health care services by Mexican Americans. Findings revealed that only 4.2 percent of the HHANES sample persons between the ages of 18-74 years reported consulting a curandero, herbalista, or other folk medicine practitioner within the 12 months prior to the survey. Income, self-perceived health status, the language of the interview, and dissatisfaction with modern medical care recently received independently predicted curandero utilization (adjusted OR 2.01 and 1.66, respectively). Low income and self-perceived health status were less strongly related to curandero utilization. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:32-35_7 Template-Type: ReDIF-Article 1.0 Title: Overcoming potential pitfalls in the use of Medicare data for epidemiologic research Journal: American Journal of Public Health Author-Name: Fisher, E.S. Author-Name: Baron, J.A. Author-Name: Malenka, D.J. Author-Name: Barrett, J. Author-Name: Bubolz, T.A. Year: 1990 Volume: 80 Issue: 12 Pages: 1487-1490 Abstract: We used Medicare data bases and US Census data to address two questions critical to the use of Medicare files for epidemiologic research. First, we examined the degree to which the population enrolled in the Medicare program is similar to the elderly resident population of the United States, as estimated by the US Census. We found small differences in the total population estimates but substantial differences by age and race. Second, we found that among Medicare enrollees, physician claims identify a small proportion of hip fracture cases which are not documented in the hospital discharge files. This proportion varies by age, region, and state within the United States. Calculation of rates based on Medicare hospital discharge data, and probably other hospital discharge data sets as well, must take these limitations into account. Use of all available Medicare data files can overcome these limitations. Handle: RePEc:aph:ajpbhl:1990:80:12:1487-1490_5 Template-Type: ReDIF-Article 1.0 Title: Use of fat-modified food products to change dietary fat intake of young people Journal: American Journal of Public Health Author-Name: Curtis Ellison, R. Author-Name: Goldberg, R.J. Author-Name: Witschi, J.C. Author-Name: Capper, A.L. Author-Name: Puleo, E.M. Author-Name: Stare, F.J. Year: 1990 Volume: 80 Issue: 11 Pages: 1374-1376 Abstract: Food purchasing and preparation practices were modified in two boarding high schools to increase the polyunsaturated-to-saturated fat ratio (P/S) of the diet of students by changing food products rather than attempting to change eating behaviors. During years when fat-modified products were served, the P/S of males increased by 75 percent, versus a decrease of 6 percent during control years. For females, P/S increased by 53 percent during intervention years, versus an increase of 6 percent during control years. Handle: RePEc:aph:ajpbhl:1990:80:11:1374-1376_5 Template-Type: ReDIF-Article 1.0 Title: Prevalence of chronic bronchitis among US Hispanics from the Hispanic Health and Nutrition Examination Survey, 1982-84 Journal: American Journal of Public Health Author-Name: Bang, K.M. Author-Name: Gergen, P.J. Author-Name: Carroll, M. Year: 1990 Volume: 80 Issue: 12 Pages: 1495-1497 Abstract: In the Hispanic Health and Nutrition Examination Survey (HHANES), Puerto Ricans had a higher age-adjusted prevalence of self-reported chronic bronchitis (2.9 percent, 95% CI = 2.2, 3.6) than Mexican Americans (1.7 percent, 95% CI = 1.3, 2.1) or Cubans (1.7 percent, 95% CI = 0.9, 2.5). The prevalence of chronic bronchitis was at least 2 times higher in smokers as compared to nonsmokers among Puerto Ricans and Cubans, but not for Mexican Americans. Handle: RePEc:aph:ajpbhl:1990:80:12:1495-1497_1 Template-Type: ReDIF-Article 1.0 Title: Information on tar and nicotine yields on cigarette packages Journal: American Journal of Public Health Author-Name: Davis, R.M. Author-Name: Healy, P. Author-Name: Hawk, S.A. Year: 1990 Volume: 80 Issue: 5 Pages: 551-553 Abstract: We examined information on tar and nicotine yields on the packages of 160 cigarette brands, 58 percent of the 275 brands for which tar and nicotine yields were listed in a recent Federal Trade Commission report. The tar yield was indicated on 14 percent, the nicotine yield was indicated on 11 percent. As tar yield increased among brands, the yield was progressively less likely to be shown on the package and was not disclosed on the package of any cigarette yielding 11 mg or more of tar. Handle: RePEc:aph:ajpbhl:1990:80:5:551-553_1 Template-Type: ReDIF-Article 1.0 Title: Kettering labortory: A pioneer in lead research (I) Journal: American Journal of Public Health Author-Name: Suskind, R.R. Year: 1990 Volume: 80 Issue: 8 Pages: 1001-1002 Handle: RePEc:aph:ajpbhl:1990:80:8:1001-1002_4 Template-Type: ReDIF-Article 1.0 Title: The buddy volunteer commitment in AIDS care Journal: American Journal of Public Health Author-Name: Velentgas, P. Author-Name: Bynum, C. Author-Name: Zierler, S. Year: 1990 Volume: 80 Issue: 11 Pages: 1378-1380 Abstract: Buddy volunteers provide crucial assistance to people with HIV-related illnesses. Based on volunteers' self-administered questionnaires, our study describes the nature of buddy work. Volunteers indicated their satisfaction with both personal performance and buddy program administration. Several factors were associated with volunteer satisfaction. This report is a first attempt to describe this special relationship created in response to the human immunodeficiency virus (HIV) epidemic. Handle: RePEc:aph:ajpbhl:1990:80:11:1378-1380_2 Template-Type: ReDIF-Article 1.0 Title: The attitude/behavior discrepancy as a methodological artifact: Comment on 'sexually active adolescents and condoms' Journal: American Journal of Public Health Author-Name: Nickerson, C.A.E. Year: 1990 Volume: 80 Issue: 10 Pages: 1174-1179 Abstract: A recent questionnaire-based study published in the American Journal of Public Health found that although sexually active adolescents both believe that the use of condoms offers protection against sexually transmitted diseases and value such protection, they do not intend to use (or have their partners use) condoms. This attitude/behavior discrepancy is more apparent than real. Six methodological problems in the study are discussed in detail in order to demonstrate how the overly simplified treatment of a complex behavior can lead to invalid conclusions. Handle: RePEc:aph:ajpbhl:1990:80:10:1174-1179_9 Template-Type: ReDIF-Article 1.0 Title: Use of contraception and family planning services in the United States, 1988 Journal: American Journal of Public Health Author-Name: Mosher, W.D. Author-Name: Pratt, W.F. Year: 1990 Volume: 80 Issue: 9 Pages: 1132-1133 Handle: RePEc:aph:ajpbhl:1990:80:9:1132-1133_8 Template-Type: ReDIF-Article 1.0 Title: Clustering of atherogenic behaviors in coffee drinkers Journal: American Journal of Public Health Author-Name: Puccio, E.M. Author-Name: McPhillips, J.B. Author-Name: Barrett-Connor, E. Author-Name: Ganiats, T.G. Year: 1990 Volume: 80 Issue: 11 Pages: 1310-1313 Abstract: We studied the clustering of coffee consumption and selected atherogenic behaviors in older adults living in a southern California community. Men were somewhat more likely to drink caffeinated coffee while women were more likely to drink decaffeinated coffee. In men, but not women, caffeinated coffee drinking decreased with age and decaffeinated coffee drinking increased. Caffeinated coffee drinkers drank more alcohol, consumed more dietary saturated fats and cholesterol, were more likely to be current smokers and less likely to be current exercisers than were non-coffee drinkers. Smoking and exercise also showed a dose-response relationship to the amount of caffeinated coffee consumed. Risk factor levels among drinkers of decaffeinated coffee were more like those of caffeinated coffee than non-drinkers. These data illustrate the clustering of atherogenic behaviors with coffee drinking and highlight their potential importance in interpreting the growing body of literature about coffee and health. Handle: RePEc:aph:ajpbhl:1990:80:11:1310-1313_3 Template-Type: ReDIF-Article 1.0 Title: A twin study of the effects of the Vietnam conflict on alcohol drinking patterns Journal: American Journal of Public Health Author-Name: Goldberg, J. Author-Name: Eisen, S.A. Author-Name: True, W.R. Author-Name: Henderson, W.G. Year: 1990 Volume: 80 Issue: 5 Pages: 570-574 Abstract: This study examines the association between military service in Southeast Asia and alcohol drinking patterns in 2,169 male-male monozygotic twin pairs who both served on active military duty during the Vietnam era (1965-75). Data on alcohol drinking were collected in 1987 by mail and telephone interview. The alcohol drinking measures include three indicators of abstention (lifetime abstainer, lifetime non-regular drinker, and current abstainer) and two indicators of consumption (average daily ethanol consumption and high consumption). In adjusted and co-twin adjusted analyses, neither service in Southeast Asia nor combat exposure was significantly associated with any measure of abstention. In the co-twin adjusted analysis, there was no association of Southeast Asia service and combat exposure with average daily ethanol consumption. After adjustment for co-twin effects, 4.0 percent of non-Southeast Asia veterans were high consumers compared to 6.7 percent of Southeast Asia veterans who served in high combat. We conclude that prior military service in a war zone has a relatively modest long-term effect on the alcohol drinking patterns of male veterans. Handle: RePEc:aph:ajpbhl:1990:80:5:570-574_6 Template-Type: ReDIF-Article 1.0 Title: Playground hazards in Atlanta child care centers Journal: American Journal of Public Health Author-Name: Sacks, J.J. Author-Name: Holt, K.W. Author-Name: Holmgreen, P. Author-Name: Colwell Jr., L.S. Author-Name: Brown Jr., J.M. Year: 1990 Volume: 80 Issue: 8 Pages: 986-988 Abstract: We identified 684 playground hazards in 66 child care centres despite regulations mandating that the grounds be hazard-free. Of 21 centers with ≤5 hazards, 42.9 percent reported a playground-related injury in the previous year; of 25 centers with 6-11 haards, 52.0 percent reported a playground-related injury; and of 20 centers with ≥12 hazards, 60.0 percent reported a playground-related injury. Climbing equipment ≥6 feet tall generally had inadequate impact-absorbing undersurfacing and had over twice the rate of fall injuries as climbing equipment <6 feet. Handle: RePEc:aph:ajpbhl:1990:80:8:986-988_8 Template-Type: ReDIF-Article 1.0 Title: Cesarean section use and source of payment: An analysis of California hospital discharge abstracts Journal: American Journal of Public Health Author-Name: Stafford, R.S. Year: 1990 Volume: 80 Issue: 3 Pages: 313-315 Abstract: This study assessed the relation between payment source and cesarean section use by analyzing California data on hospital deliveries. Of 461,066 deliveries in 1986, cesarean sections were performed in 24.4 percent. Women with private insurance had the highest cesarean section rates (29.1 percent). Successively lower rates were observed for women covered by non-Kaiser health maintenance organizations (26.8 percent), Medi-Cal (22.9 percent), Kaiser (19.7 percent), self-pay (19.3 percent), and Indigent Services (15.6 percent). Vaginal birth after cesarean (VBAC) occurred more than twice as frequently in women covered by Kaiser (19.9 percent) and Indigent Services (24.8 percent), compared to those with private insurance (8.1 percent). Sizable, although less pronounced, associations between payment source and cesarean section use were noted for the indications of breech presentation, dystocia, and fetal distress. Accounting for maternal age and race/ethnicity did not alter these findings. Variations in the use of cesarean section have a substantial financial impact on health care payors. Handle: RePEc:aph:ajpbhl:1990:80:3:313-315_1 Template-Type: ReDIF-Article 1.0 Title: Longitudinal predictors of reductions in unprotected anal intercourse among gay men in San Francisco: The AIDS behavioral research project Journal: American Journal of Public Health Author-Name: McKusick, L. Author-Name: Coates, T.J. Author-Name: Morin, S.F. Author-Name: Pollack, L. Author-Name: Hoff, C. Year: 1990 Volume: 80 Issue: 8 Pages: 978-983 Abstract: Predictors of unprotected anal intercourse were examined among 508 gay men in San Francisco. The cohort was recruited in 1983-84 at which time 49.8 percent of non-monogamous men (N = 435) and 71.2 percent of monogamous men (N = 73) reported practicing unprotected anal intercourse. Only 12 percent of non-monogamous and 27.4 percent of monogamous men reported these practices in 1988. The non-monogamous men who practiced unprotected anal intercourse in 1984 were more likely to be younger, to report that unprotected anal intercourse was their favorite sexual activity, to be low in perceived efficacy to change sexual behavior, to report that friends were more likely to engage in high-risk behaviors, to have less knowledge of health guidelines, and to be less depressed at that time. Non-monogamous individuals who in 1984 reported that unprotected anal intercourse was theri favorite sexual activity were more likely to practice that behavior in 1988. Those who knew their serostatus as positive were less likely to report unprotected anal intercourse in 1988. These data infer that in order to modify AIDS-related high-risk behaviors, community risk-reduction programs be differentially aimed at young persons so as to increase personal efficacy about risk reduction, challenge peer norms, promote antibody testing, and eroticize safer sexual activities. Handle: RePEc:aph:ajpbhl:1990:80:8:978-983_2 Template-Type: ReDIF-Article 1.0 Title: The art and science of interpreting survey data Journal: American Journal of Public Health Author-Name: Johnson, C.L. Author-Name: Woteki, C.E. Year: 1990 Volume: 80 Issue: 12 Pages: 1427-1429 Handle: RePEc:aph:ajpbhl:1990:80:12:1427-1429_6 Template-Type: ReDIF-Article 1.0 Title: Sociodemographic correlates of neutralizing poliovirus and hepatitis A virus antibodies as markers of different modes of acquiring immunity Journal: American Journal of Public Health Author-Name: Green, M.S. Author-Name: Cohen, D. Author-Name: Slepon, R. Author-Name: Handsher, R. Author-Name: Zaaide, Y. Author-Name: Rannon, L. Author-Name: Danon, Y. Year: 1990 Volume: 80 Issue: 10 Pages: 1270-1271 Abstract: The prevalence and sociodemographic correlates of antibodies against poliovirus and hepatitis A virus (HAV) were compared in a random sample of 457 military recruits in Israel inducted during 1987. Lower socioeconomic status (SES) was associated with a higher prevalence of anti-HAV antibodies (67.3 vs 32.5 percent), whereas the reverse was true for type 1 poliovirus (78.4 vs 89.5 percent). While the high prevalence of anti-HAV antibodies observed in the lower SES groups reflects considerable natural exposure to enteroviruses, immunity against poliovirus appears to be determined primarily by compliance with vaccination. Handle: RePEc:aph:ajpbhl:1990:80:10:1270-1271_1 Template-Type: ReDIF-Article 1.0 Title: Infant formula promotion and the health sector in the Philippines Journal: American Journal of Public Health Author-Name: Popkin, B.M. Author-Name: Fernandez, M.E. Author-Name: Avila, J.L. Year: 1990 Volume: 80 Issue: 1 Pages: 74-75 Abstract: We use data collected in 1984, 1986, and 1988 from public and private health facilities in the Metropolitan Cebu area of the Philippines to assess effects of World Health Organization and Government of the Philippines Codes of Marketing of Breast Milk Substitutes on distribution of formula supplies. Distribution of free and low-cost infant formula declined drastically between 1986 and 1988. Industry compliance was almost complete. Handle: RePEc:aph:ajpbhl:1990:80:1:74-75_8 Template-Type: ReDIF-Article 1.0 Title: A note on the measurement of hypertension in HHANES Journal: American Journal of Public Health Author-Name: Geronimus, A.T. Author-Name: Neidert, L.J. Author-Name: Bound, J. Year: 1990 Volume: 80 Issue: 12 Pages: 1437-1442 Abstract: Using data from the HHANES, we found the rates of elevated blood pressure readings on clinical examination to be extremely low for a sample of Mexican American and Puerto Rican women. The prevalence rates were one-fourth to one-fifth the rates found for a comparable sample of White women from NHANESII. These findings are discrepant with the little that is known about hypertension prevalence among Hispanics and with estimates of hypertension prevalence for Mexican Americans and Puerto Ricans drawn from NHANESII. While our HHANES samples women had much lower rates of clinical high blood pressure than Whites, they reported hypertension histories in excess of Whites. Rates of medicine usage among Hispanics were insufficiently large for effective treatment to explain the disparity. The prevalence estimates increased, but the relative discrepancies remained when we altered our sample specifications and clinical high blood pressure measure. A possible explanation for these discrepancies is that few physicians performed the majority of blood pressure readings in our HHANES sample. This may have been statistically inefficient. The discrepancies noted suggest that HHANES may not be a reliable source of information on hypertension among Hispanic women. Handle: RePEc:aph:ajpbhl:1990:80:12:1437-1442_9 Template-Type: ReDIF-Article 1.0 Title: Benzodiazepine tranquilizers and the risk of accidental injury Journal: American Journal of Public Health Author-Name: Oster, G. Author-Name: Huse, D.M. Author-Name: Adams, S.F. Author-Name: Imbimbo, J. Author-Name: Russell, M.W. Year: 1990 Volume: 80 Issue: 12 Pages: 1467-1470 Abstract: To determine whether benzodiazepine tranquilizers increase the risk of accidental injury requiring medical attention, we used pharmacy claims submitted to a large third-party payer to identify 4,554 persons who had been prescribed these agents and a matched control group of 13,662 persons who had been prescribed drugs other than benzodiazepines. We then used diagnoses recorded on claims submitted by medical care providers to identify all accident-related care received by these persons during three months before their first-observed prescription for a benzodiazepine or nonbenzodiazepine agent, respectively, and six months subsequently. We found accident-related care was more likely among persons who had been prescribed benzodiazepines; among these persons, the probability of an accident-related medical encounter was higher during months in which a prescription for a benzodiazepine had recently been filled compared to other months; and persons who had filled three or more prescriptions for these agents in the six months following initiation of therapy had a significantly higher risk of an accident-related medical event than those who had filled only one such prescription. Approximately two-fold risks of accident-related care were found, after controlling for age, sex, and prior utilization. Handle: RePEc:aph:ajpbhl:1990:80:12:1467-1470_9 Template-Type: ReDIF-Article 1.0 Title: VI. Alcohol consumption patterns among Mexican American mothers and among children from single- and dual-headed households: Findings from HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Stroup-Benham, C.A. Author-Name: Trevino, F.M. Author-Name: Trevino, D.B. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 36-41 Abstract: Data from the southwestern United States sample of the Hispanic Health and Nutrition Examination Survey were employed to compare the patterns of alcohol use among Mexican American mothers and children in female-headed households with use patterns among mothers and children in couple-headed households. Single female heads of household drank more alcoholic beverages on more days than females from dual-headed households. As a whole, the children of single heads of household still living at home did not demonstrate significantly different drinking patterns from their dual-headed household counterparts. While male children of single-headed households drank more days and total drinks than their dual-headed household counterparts, female children of dual-headed households drank more days and total drinks than female children from single-headed households. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:36-41_6 Template-Type: ReDIF-Article 1.0 Title: Tuberculin skin testing in US Navy and Marine Corps personnel and recruits, 1980-86 Journal: American Journal of Public Health Author-Name: Cross, E.R. Author-Name: Hyams, K.C. Year: 1990 Volume: 80 Issue: 4 Pages: 435-438 Abstract: An extensive skin testing program is part of the United States Navy Medical Command's infectious disease control effort. From 1980 to 1986, 2,306,533 skin tests, using five TU PPD, were performed on active-duty Navy and Marine Corps personnel, 0.97 percent of which were positive. A downward trend in positive tests was found with a high of 1.43 percent in 1980 and a low of 0.80 percent in 1983. Since 1984, the percentage of positive tests has remained the same or increased. Shore-based medical facilities around the world reported 1,491,646 skin tests with 1.07 percent positive; Navy ships reported 814,887 skin tests with 0.78 percent positive. PPD-positivity for the ships in the Pacific area was higher (0.98 percent) than for ships in the Atlantic (0.62 percent). During this same period, the percentage of positive tests in Navy and Marine Corps recruits ranged from a high of 1.82 percent in 1981 to a low of 1.23 percent in 1986. Since 1984, the percentage of positive tests has remained relatively stable in recruits. The frequency of positive PPD tests found in this study is lower than the percentage positive (1.59 percent) found in active-duty Naval personnel in 1969 and the percentage positive (5.2 percent) found in a study of Navy and Marine Corps recruits between 1958 and 1969. Handle: RePEc:aph:ajpbhl:1990:80:4:435-438_5 Template-Type: ReDIF-Article 1.0 Title: Placing patients in the queue for coronary revascularization: Evidence for practice variations from an expert panel process Journal: American Journal of Public Health Author-Name: Naylor, C.D. Author-Name: Basinski, A. Author-Name: Baigrie, R.S. Author-Name: Goldman, B.S. Author-Name: Lomas, J. Year: 1990 Volume: 80 Issue: 10 Pages: 1246-1252 Abstract: A panel of 16 cardiologists and cardiac surgeons rated 438 case scenarios for the maximum acceptable delay prior to revascularization, using a scale with seven interventional time frames and two nodes for designating dubious or inappropriate cases. If consensus was defined as agreement by 12 or more panelists, only 1.4 percent of the case scenarios showed consensus on a single rating. Dividing the scale into three broad clinical categories (revascularize promptly, place on a waiting list, or no intervention), 11.4 percent of scenarios showed all 16 panelists agreeing on a single category, rising to 59.4 percent of scenarios if agreement by 12 panelists was accepted as a consensus. The mean difference between the panelists' highest and lowest urgency ratings yielded waiting time differences of two weeks for scenarios of very unstable angina, and more than three months for those with stable angina. However, in a regression model, individual panelist factors on average had less effect than clinical features such as severity and stability of angina, or stenosis of major coronary arteries. These findings strongly support the need for consensus criteria to ensure that triage practices are consistent and fair, and also suggest that widespread adoption of a standardized approach to revascularization priorities may be feasible. Handle: RePEc:aph:ajpbhl:1990:80:10:1246-1252_2 Template-Type: ReDIF-Article 1.0 Title: Methods ommited to calculate confidence intervals. Dr. Murray's response (I: Reply) Journal: American Journal of Public Health Author-Name: Murray, D.L. Year: 1990 Volume: 80 Issue: 6 Pages: 753 Handle: RePEc:aph:ajpbhl:1990:80:6:753_7 Template-Type: ReDIF-Article 1.0 Title: Passive smoking results: New risk for active smokers Journal: American Journal of Public Health Author-Name: Nemetz, P.N. Year: 1990 Volume: 80 Issue: 10 Pages: 1274 Handle: RePEc:aph:ajpbhl:1990:80:10:1274_3 Template-Type: ReDIF-Article 1.0 Title: Educational infant care and the public health Journal: American Journal of Public Health Author-Name: Leviton, M. Author-Name: Leviton, J. Author-Name: Leviton, A. Year: 1990 Volume: 80 Issue: 7 Pages: 790-791 Handle: RePEc:aph:ajpbhl:1990:80:7:790-791_5 Template-Type: ReDIF-Article 1.0 Title: Lyme disease in New Jersey outdoor workers: A statewide survey of seroprevalence and tick exposure Journal: American Journal of Public Health Author-Name: Goldstein, M.D. Author-Name: Schwartz, B.S. Author-Name: Friedmann, C. Author-Name: Maccarillo, B. Author-Name: Borbi, M. Author-Name: Tuccillo, R. Year: 1990 Volume: 80 Issue: 10 Pages: 1225-1229 Abstract: To evaluate the spread of Lyme disease in New Jersey, we conducted a statewide cross-sectional study of Lyme disease seroprevalence in a high-risk occupational group of outdoor employees. Of the 689 employees who participated in the study, 39 (5.7 percent) were positive for antibody to B. burgdorferi, the causative agent of Lyme disease. Seroprevalence varied markedly by county; unexpectedly high seroprevalence rates were found in several northern counties (Sussex, Hudson, and Hunterdon). Furthermore, some southern counties (Atlantic, Cape May, and Ocean) with large tick populations (as measured by self-reported exposure to ticks) had low seroprevalence rates which were inversely correlated with self-reported preventive practices. These data suggest that lyme disease, as measured by seroprevalence of antibody to B. burgdorferi, may be spreading beyond the southern portion of the state where it had been previously well documented and that preventive behaviors may play an important role in minimizing the risk of the disease. Handle: RePEc:aph:ajpbhl:1990:80:10:1225-1229_4 Template-Type: ReDIF-Article 1.0 Title: Young children who drown in hot tubs, spas, and whirlpools in California: A 26-year survey Journal: American Journal of Public Health Author-Name: Shinaberger, C.S. Author-Name: Anderson, C.L. Author-Name: Kraus, J.F. Year: 1990 Volume: 80 Issue: 5 Pages: 613-614 Abstract: A survey of drownings in hot tubs, spas, and whirlpools in California 1960-85 suggest a person- and site-specific profile. The identified 74 deaths occurred mostly in White children, under two years of age, in Southern California, during the late afternoons, from May through August. From 1967 to 1985, the drowning rate increased tenfold. The deaths were associated with access to the water, lack of supervision, neuromotor handicaps, and entrapment by suction. Educational and environmental control efforts are required to reduce the incidence. Handle: RePEc:aph:ajpbhl:1990:80:5:613-614_2 Template-Type: ReDIF-Article 1.0 Title: Defining arthritis and measuring functional status in elders: Methodological issues in the study of disease and physical disability Journal: American Journal of Public Health Author-Name: Guccione, A.A. Author-Name: Felson, D.T. Author-Name: Anderson, J.J. Year: 1990 Volume: 80 Issue: 8 Pages: 945-949 Abstract: This study explores the degree to which the association of knee osteoarthritis with physical disability changes with different definitions of osteoarthritis in 1,416 Framingham Study elders. When all categories of radiographic osteoarthritis were aggregated into a single 'arthritis' variable and dependence upon human assistance in one or more functional activities combined into a single variable, elders with osteoarthritis had only moderately increased odds for dependence after controlling for age or sex (OR = 1.25). A definition of osteoarthritis based only upon symptoms produced larger odds for dependency (OR = 1.85). Elders with mild osteoarthritis and infrequent knee pain had no significantly elevated risk for dependence in any of the seven functional activities. Elders with infrequently symptomatic, moderate to marked radiographic osteoarthritis were at increased risk for dependence in stair climbing, walking a mile, housekeeping, and carrying bundles. Elders with radiographic osteoarthritis accompanied by frequent pain had an increased odds of dependence in stair climbing, walking a mile, and housekeeping. Using a generic definition of 'arthritis' and aggregating functinal activities may underestimate the impact of osteoarthritis on physical disability in the elderly and obscure the task-specific nature of that relationship. Handle: RePEc:aph:ajpbhl:1990:80:8:945-949_1 Template-Type: ReDIF-Article 1.0 Title: Letter on epidemiologic research methods (I) Journal: American Journal of Public Health Author-Name: Poole, C. Author-Name: Lanes, S.F. Author-Name: Davis, F. Author-Name: Pearce, N. Author-Name: Cohen, A.J. Author-Name: Shalat, S.L. Author-Name: Savitz, D.A. Author-Name: Morgenstern, H. Author-Name: Greenland, S. Year: 1990 Volume: 80 Issue: 5 Pages: 622 Handle: RePEc:aph:ajpbhl:1990:80:5:622_6 Template-Type: ReDIF-Article 1.0 Title: Quality of death certificates: Studying or burying? (I) Journal: American Journal of Public Health Author-Name: Salmi, L.R. Author-Name: Dabis, F. Author-Name: McKinley, T. Year: 1990 Volume: 80 Issue: 6 Pages: 751 Handle: RePEc:aph:ajpbhl:1990:80:6:751_8 Template-Type: ReDIF-Article 1.0 Title: Prior condom use and the risk of tubal pregnancy Journal: American Journal of Public Health Author-Name: Li, D.-K. Author-Name: Daling, J.R. Author-Name: Stergachis, A.S. Author-Name: Chu, J. Author-Name: Weiss, N.S. Year: 1990 Volume: 80 Issue: 8 Pages: 964-966 Abstract: The relationship between prior condom use and tubal pregnancy was assessed in a population-based case-control study at Group Health Cooperative of Puget Sound during 1981-86. We interviewed 227 women with a tubal pregnancy who had no clinical indication of infertility and no history of sterilization and 674 similarly defined controls who were matched to the cases on age and county of residence. A history of condom use for more than one year was associated with a decreased risk of subsequent tubal pregnancy (RR = 0.74, 95% CI = 0.44, 1.26) adjusted for the effects of age, current use of contraceptive methods, educational level, and age at first intercourse. The effect was more pronounced when condoms had been used during five-year periods with more than one partner (RR = 0.38, 95% CI = 0.15, 1.0) than during five-year periods with one partner (RR = 0.89, 95% CI = 0.45, 1.76). Condom use for less than one year was unrelated to risk of ectopic pregnancy. Since the use of condoms offers protection against sexually transmitted diseases, one or more of which are likely to be causally related to tubal pregnancy, the observed negative association plausibly represents a protective influence of long-term condom use on the occurrence of tubal pregnancy. Handle: RePEc:aph:ajpbhl:1990:80:8:964-966_5 Template-Type: ReDIF-Article 1.0 Title: Are women using postmenopausal estrogens? A community survey Journal: American Journal of Public Health Author-Name: Harris, R.B. Author-Name: Laws, A. Author-Name: Reddy, V.M. Author-Name: King, A. Author-Name: Haskell, W.L. Year: 1990 Volume: 80 Issue: 10 Pages: 1266-1268 Abstract: Self-reported estrogen and progestin use in a California community was determined in 1986-87 from a telephone survey of postmenopausal women (n = 954) ages 50-65 years. Current use of hormones was reported by 32 percent; 26 percent took estrogens alone while 6 percent used estrogen + progestin. Comparisons pointed to significant social network and medical care utilization differences. Women who used estrogen therapy were younger, thinner, lived in smaller household units, and were less likely to be widowed. Handle: RePEc:aph:ajpbhl:1990:80:10:1266-1268_6 Template-Type: ReDIF-Article 1.0 Title: Behavioral covariates of waist-to-hip ratio in Rancho Bernardo Journal: American Journal of Public Health Author-Name: Laws, A. Author-Name: Terry, R.B. Author-Name: Barrett-Connor, E. Year: 1990 Volume: 80 Issue: 11 Pages: 1358-1362 Abstract: We examined lifestyle and dietary habits in 685 men and 943 women (mean age 67 years) who completed an interview, examination, and food frequency questionnaire in 1984-87. Waist-to-hip ratio increased with age and body mass index in both men and women. In multiple regression, waist-to-hip ratio was independently associated with smoking, alcohol consumption, and exercise in men, and with smoking and alcohol consumption in women. The data suggest that waist-to-hip ratio is affected, at least in part, by behavioral, and potentially modifiable, factors. Handle: RePEc:aph:ajpbhl:1990:80:11:1358-1362_1 Template-Type: ReDIF-Article 1.0 Title: When is the quality of care good enough? Journal: American Journal of Public Health Author-Name: Schoenbaum, S.C. Year: 1990 Volume: 80 Issue: 4 Pages: 403-404 Handle: RePEc:aph:ajpbhl:1990:80:4:403-404_5 Template-Type: ReDIF-Article 1.0 Title: Estimating the full cost of workplace injuries Journal: American Journal of Public Health Author-Name: French, M.T. Year: 1990 Volume: 80 Issue: 9 Pages: 1118-1119 Abstract: While many studies estimate medical costs and lost wages from workplace injuries, few have estimated pain and suffering costs. This study develops a wage-risk model for railroad workers and estimates the total cost of on-the-job injuries. On average, the total cost of an on-the-job injury to a railroad worker in 1980 was between $19,500 and $22,500. These estimates are substantially higher than the sum of medical costs plus lost wages. Handle: RePEc:aph:ajpbhl:1990:80:9:1118-1119_1 Template-Type: ReDIF-Article 1.0 Title: Injury and disability in matched men's and women's intercollegiate sports Journal: American Journal of Public Health Author-Name: Lanese, R.R. Author-Name: Strauss, R.H. Author-Name: Leizman, D.J. Author-Name: Rotondi, A.M. Year: 1990 Volume: 80 Issue: 12 Pages: 1459-1462 Abstract: Eight matched men's and women's intercollegiate varsity teams were studied prospectively for one academic year to determine the incidence of athletic injury and resulting disability. Sports in which both men and women participated in a comparable manner were chosen: basketball, fencing, gymnastics, swimming, tennis, indoor track, outdoor track, and volleyball. Men (232) and women (150) were injured at comparable rates, 42 percent versus 39 percent. When adjusted for exposure time, seven of the eight sports continued to show similar injury rates. Women gymnasts, however, experienced .82 injuries per 100 person-hours of exposure as compared to .21 injuries for the men (p = .0001). Disability was greater in women gymnasts, 7.44 days per 100 person-hours versus 1.15 days for men (p = .0004). Percent of season lost to injury was also greater for women gymnasts. Types and sites of injury were similar for men and women, with sprains and strains accounting for over half of all injuries. We found no evidence for gender differences in matched sports except for gymnastics, in which technically diverse events may have accounted for the differences observed. Handle: RePEc:aph:ajpbhl:1990:80:12:1459-1462_8 Template-Type: ReDIF-Article 1.0 Title: III. Health risk behaviors of Hispanics in the United States: Findings from HHANES, 1982-84 Journal: American Journal of Public Health Author-Name: Marks, G. Author-Name: Garcia, M. Author-Name: Solis, J.M. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 20-26 Abstract: With data from the Hispanic Health and Nutrition Examination Survey (HHANES), we examined several health risk behaviors (cigarette smoking, alcohol use, dietary practices, and recency of health screening) of Mexican American, Cuban American, and Puerto Rican adults (ages 20-74). For each sample, a greater percentage of men than women smoked cigarettes and used alcohol. Heavy smoking (20+ cigarettes per day) was most prevalent for Cuban American males, and heavy drinking (1.00+ oz ethanol per day) was most prevalent for Mexican American and Puerto Rican men. Acculturation correlated positively with alcohol use (particularly for females) and negatively with dietary balance (for Mexican American men and women). The Puerto Ricans' diet was less balanced than that of the other two groups. For each sample, more men than women had not had a routine physical or dental examination within the past five years; the recency of screening was lowest for Mexican American men. Screening (including Pap smear for the women) was lower for those who smoked cigarettes and for those with poor dietary practices, indicating that many Hispanics at special risk of disease underutilize preventive health services, increasing the likelihood of diagnosis at a later stage of illness. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:20-26_5 Template-Type: ReDIF-Article 1.0 Title: Environmental tobacco smoke exposure during infancy Journal: American Journal of Public Health Author-Name: Chilmonczyk, B.A. Author-Name: Knight, G.J. Author-Name: Palomaki, G.E. Author-Name: Pulkkinen, A.J. Author-Name: Williams, J. Author-Name: Haddow, J.E. Year: 1990 Volume: 80 Issue: 10 Pages: 1205-1208 Abstract: We collected information about household smoking habits from 518 mothers when they made their first well child visit with a 6 to 8-week old infant. A urine sample was also collected from the infant, the cotinine concentration measured, and the measurement correlated with data provided by the mother. Eight percent of the infant urine cotinine values fell at or above 10 μg/L in the 305 households where no smoking was reported. Corresponding rates were 44 percent in the 96 households where a member other than the mother smoked, 91 percent in the 43 households where only the mother smoked, and 96 percent in the 74 households where both the mother and another household member smoked. In households where the mother smoked, infant urine cotinine levels were lower in the summer, and higher when the infant was breast-fed. A screening question about family smoking habits in conjunction with well child care could effectively define a group of infants exposed to environmental tobacco smoke and thus be at greater risk for respiratory diseases. Handle: RePEc:aph:ajpbhl:1990:80:10:1205-1208_5 Template-Type: ReDIF-Article 1.0 Title: Comparison of antineoplastic drug handling policies of hospitals with OSHA guidelines: A pilot study Journal: American Journal of Public Health Author-Name: Valanis, B. Author-Name: Driscoll, K. Author-Name: McNeil, V. Year: 1990 Volume: 80 Issue: 4 Pages: 480-481 Abstract: Hospital antineoplastic drug handling policies of 24 hospitals in eight Southwestern Ohio countries were compared with recommendations of the 1986 Occupational Safety and Health Administration (OSHA) guidelines. Although most study facilities where antineoplastics are handled have policies, content varies and is generally less complete than OSHA guidelines, particularly regarding storing, transporting, and disposing of drugs; managing equipment; informing personnel of risk; and surveillance. Recommendations for personal protection concur more closely with OSHA guidelines than do other content areas. Handle: RePEc:aph:ajpbhl:1990:80:4:480-481_4 Template-Type: ReDIF-Article 1.0 Title: X. Generational differences in perinatal health among the Mexican American population: Findings from HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Guendelman, S. Author-Name: Gould, J.B. Author-Name: Hudes, M. Author-Name: Eskenazi, B. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 61-65 Abstract: Data from the Hispanic Health and Nutrition Examination Survey (HHANES) were used to examine a profile of social, medical, and behavioral characteristics associated with low birth-weight (LBW) and miscarriages in first and second generation Hispanics of Mexican descent. The percentage of LBW was 5.3 and of miscarriages was 12.7. LBW rates were higher for second generation primipara and multipara compared with first generation women. Using multivariate logistic regression techniques and adjusting for complex design effects, generation was found to be a significant predictor of LBW but not of miscarriages. The findings support existing evidence that a Mexican cultural orientation protects first generation, Mexico-born women against a risk for LBW. However, the findings do not show significant effects of generation on miscarriages, suggesting that cultural effects are not consistent for all pregnancy outcomes. Furthermore, we suggest that the higher rates of LBW in second generation women are not due to a higher rate of miscarriages as has been hypothesized. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:61-65_9 Template-Type: ReDIF-Article 1.0 Title: The effects of workplace health promotion on absenteeism and employment costs in a large industrial population Journal: American Journal of Public Health Author-Name: Bertera, R.L. Year: 1990 Volume: 80 Issue: 9 Pages: 1101-1105 Abstract: We evaluated the impact of a comprehensive workplace health promotion program on absences among full-time employees in a large, multi-location, diversified industrial company. A pretest-posttest control group design was used to study 41 intervention sites and 19 control sites with 29,315 and 14,573 hourly employees, respectively. Blue-collar employees at intervention sites experienced an 14.0 percent decline in disability days over two years versus a 5.8 percent decline at control sites. This resulted in a net difference of 11,726 fewer disability days over two years at program sites compared with non-program sites. Savings due to lower disability costs at intervention sites offset program costs in the first year, and provided a return of $2.05 for every dollar invested in the program by the end of the second year. These results suggest that comprehensive workplace health promotion programs can reduce disability days among blue collar employees and provide a good return on investiment. Handle: RePEc:aph:ajpbhl:1990:80:9:1101-1105_7 Template-Type: ReDIF-Article 1.0 Title: Hip fracture incidence among the old and very old: A population-based study of 745,435 cases Journal: American Journal of Public Health Author-Name: Jacobsen, S.J. Author-Name: Goldberg, J. Author-Name: Miles, T.P. Author-Name: Brody, J.A. Author-Name: Stiers, W. Author-Name: Rimm, A.A. Year: 1990 Volume: 80 Issue: 7 Pages: 871-873 Abstract: Data were obtained from the Health Care Financing Administration and the Department of Veterans Affairs (formerly called Veterans Administration) on all hospital discharges among the elderly population from 1984 through 1987 and combined with census estimates to calculate incidence rates of hip fracture for the elderly population of the United States. Rates for White women were the highest, reaching 35.4 per 1,000 per year among 95 year-olds. Comparably, White men, Black women, and Black men experienced similar age-related increases in risk, although of less magnitude and relatively less rate of change, respectively. Handle: RePEc:aph:ajpbhl:1990:80:7:871-873_7 Template-Type: ReDIF-Article 1.0 Title: Walking and serum cholesterol in adults Journal: American Journal of Public Health Author-Name: Tucker, L.A. Author-Name: Friedman, G.M. Year: 1990 Volume: 80 Issue: 9 Pages: 1111-1113 Abstract: We measured the association between walking for exercise and the ratio of total cholesterol/HDL cholesterol in 3,621 adults. After controlling for age, gender, income, body fat, alcohol use, exercise other than walking, and cigarette smoking, adults in the high, moderate, and low duration walking categories were compared to those in the no walking-no exercise category. The relative risk for total/HDL ratios of 5.0 or more were .46 (95% CI = .27, .80), .48 (95% CI = .30, .76), and 1.11 (95% CI = .81, 1.52) respectively. Handle: RePEc:aph:ajpbhl:1990:80:9:1111-1113_1 Template-Type: ReDIF-Article 1.0 Title: Environmental and biological monitoring for lead exposure in California workplaces Journal: American Journal of Public Health Author-Name: Rudolph, L. Author-Name: Sharp, D.S. Author-Name: Samuels, S. Author-Name: Perkins, C. Author-Name: Rosenberg, J. Year: 1990 Volume: 80 Issue: 8 Pages: 921-925 Abstract: Patterns of environmental and biological monitoring for lead exposure were surveyed in lead-using industries in California. Employer self-reporting indicates a large proportion of potentially lead-exposed workers have never participated in a monitoring program. Only 2.6 percent of facilities have done environmental monitoring for lead, and only 1.4 percent have routine biological monitoring programs. Monitoring practices vary by size of facility, with higher proportions in industries in which larger facilities predominate. Almost 80 percent of battery manufacturing employees work in job classifications which have been monitored, versus only 1 percent of radiator-repair workers. These findings suggest that laboratory-based surveillance for occupational lead poisoning may seriously underestimate the true number of lead poisoned workers and raise serious questions regarding compliance with key elements of the OSHA Lead Standard. Handle: RePEc:aph:ajpbhl:1990:80:8:921-925_8 Template-Type: ReDIF-Article 1.0 Title: Sexual histories of heterosexual couples with one HIV-infected partner Journal: American Journal of Public Health Author-Name: Padian, N.S. Year: 1990 Volume: 80 Issue: 8 Pages: 990-991 Abstract: Ninety-eight heterosexual couples enrolled in a HIV transmission study, at least one of whom was HIV-infected, were interviewed about sexual behavior. Although males and females were interviewed separately, there was agreement between them on the number of sexual contacts, the practice of anal intercourse, and condom use. These findings of strong reliability are encouraging, but do not necessarily imply that the data are valid. Handle: RePEc:aph:ajpbhl:1990:80:8:990-991_9 Template-Type: ReDIF-Article 1.0 Title: A survey of state regulation of testing for drugs of abuse outside of licensed (accredited) clinical laboratories Journal: American Journal of Public Health Author-Name: Baer, D.M. Author-Name: Belsey, R.E. Author-Name: Skeels, M.R. Year: 1990 Volume: 80 Issue: 6 Pages: 713-715 Abstract: We surveyed all 50 states to find out if testing for drugs of abuse outside of clinical laboratories was regulated. In 14 states such regulations existed or were contemplated. Eight additional states indicated that regulatory language does not restrict their oversight of such testing. Content of the regulations is described for each of these 22 states. Handle: RePEc:aph:ajpbhl:1990:80:6:713-715_3 Template-Type: ReDIF-Article 1.0 Title: Computerization of annual immunization surveys Journal: American Journal of Public Health Author-Name: MacLean, L.M. Year: 1990 Volume: 80 Issue: 12 Pages: 1523-1524 Handle: RePEc:aph:ajpbhl:1990:80:12:1523-1524_4 Template-Type: ReDIF-Article 1.0 Title: IV. Health care utilization barriers among Mexican Americans: Evidence from HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Estrada, A.L. Author-Name: Trevino, F.M. Author-Name: Ray, L.A. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 27-31 Abstract: Data from the Hispanic Health and Nutrition Examination Survey (HHANES) conducted by the National Center for Health Statistics in 1982-1984 were analyzed to document the type of barriers encountered which prevented Mexican Americans from obtaining health care, the sociodemographic subgroups most vulnerable to such barriers, and to examine the combined effects of predisposing, enabling, and need characteristics on these barriers. The findings suggest, in general, that low income groups, younger age groups, the less acculturated, those who lack health insurance coverage, those with functional limitations, and those in poorer perceived health status encounter more barriers than others, and are prevented by these barriers from obtaining health care for themselves. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:27-31_7 Template-Type: ReDIF-Article 1.0 Title: Lifetime risk of a hip fracture (I) Journal: American Journal of Public Health Author-Name: Melton III, L.J. Year: 1990 Volume: 80 Issue: 4 Pages: 500 Handle: RePEc:aph:ajpbhl:1990:80:4:500_7 Template-Type: ReDIF-Article 1.0 Title: Fear of AIDS and attrition among medical technologists Journal: American Journal of Public Health Author-Name: Gauch, R.R. Author-Name: Feeney, K.B. Author-Name: Brown, J.W. Year: 1990 Volume: 80 Issue: 10 Pages: 1264-1265 Abstract: Attitudes toward AIDS were measured by a survey of 212 attendees at the annual meeting of the New Jersey Society for Medical Technology. Twenty five percent of the respondents were considering leaving the profession because of a fear of AIDS. In addition, almost half would not have chosen the field knowing they would be handling HIV-positive samples. This high degree of concern may be an important factor contributing to the shortage of medical technologists. Handle: RePEc:aph:ajpbhl:1990:80:10:1264-1265_3 Template-Type: ReDIF-Article 1.0 Title: AIDS prevention for IV drug users and their sexual partners in Philadelphia Journal: American Journal of Public Health Author-Name: Liebman, J. Author-Name: McIlvaine, D.S. Author-Name: Kotranski, L. Author-Name: Lewis, R. Year: 1990 Volume: 80 Issue: 5 Pages: 615-616 Handle: RePEc:aph:ajpbhl:1990:80:5:615-616_2 Template-Type: ReDIF-Article 1.0 Title: What infant mortality tells us Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1990 Volume: 80 Issue: 6 Pages: 653-654 Handle: RePEc:aph:ajpbhl:1990:80:6:653-654_3 Template-Type: ReDIF-Article 1.0 Title: Cocaine and the risk of low birth weight Journal: American Journal of Public Health Author-Name: Petitti, D.B. Author-Name: Coleman, C. Year: 1990 Volume: 80 Issue: 1 Pages: 25-28 Abstract: In a population-based case-control study, we assessed the relation between cocaine use and the risk of low birth weight in Alameda County, California, excluding women who used heroin and/or methadone during pregnancy. After adjustment for confounders, the relative risk of low birth weight in users of cocaine throughout pregnancy was 4.0 (95% CI = 1.8, 8.9), Cocaine use was estimated to account for 10 percent of cases of low birth weight in Black women in Alameda County. Handle: RePEc:aph:ajpbhl:1990:80:1:25-28_0 Template-Type: ReDIF-Article 1.0 Title: Promoting the art of the possible in long-term care Journal: American Journal of Public Health Author-Name: Kane, R.L. Year: 1990 Volume: 80 Issue: 1 Pages: 15-16 Handle: RePEc:aph:ajpbhl:1990:80:1:15-16_9 Template-Type: ReDIF-Article 1.0 Title: Food-borne outbreak of Giardia lamblia Journal: American Journal of Public Health Author-Name: Porter, J.D.H. Author-Name: Gaffney, C. Author-Name: Heymann, D. Author-Name: Parkin, W. Year: 1990 Volume: 80 Issue: 10 Pages: 1259-1260 Abstract: An outbreak of giardiasis occurred following a family party for 25 persons. Nine who had eaten fruit salad became ill, compared with one who had not eaten the salad (Relative Risk = 7.4, 95% CI = 1.4, 169.3). The fruit salad preparer had a diapered child and a pet rabbit at home who were both positive for Giardia lamblia. This outbreak emphasizes the importance of good hygienic practices in food preparation and the possibility of domestic-animal-to-person transmission in Giardia outbreaks. Handle: RePEc:aph:ajpbhl:1990:80:10:1259-1260_1 Template-Type: ReDIF-Article 1.0 Title: Refinement and expansion of the Harvard resource-based relative value scale: The second phase Journal: American Journal of Public Health Author-Name: Becker, E.R. Author-Name: Dunn, D. Author-Name: Braun, P. Author-Name: Hsiao, W.C. Year: 1990 Volume: 80 Issue: 7 Pages: 799-803 Abstract: The Harvard resource-based relative value scale (RBRVS) for physician services has assumed a critical role in physician payment reform. We have demonstrated that the relative resource costs of providing physician services can be defined and measured in a rational and systematic way and that the results are reliable and valid. Consequently, the RBRVS is a viable basis for national payment policy and could be used for establishing a national fee schedule for physician services or to identify 'mispriced' physician procedures. Since the release of the final report of the first phase of the Harvard RBRVS study in September of 1988, there has been extensive review, discussion, and criticism of the RBRVS. Dr. Laurence F. McMahon, Jr., in the accompanying article, provides a further critique of our research. In this paper, we review the RBRVS study and results and respond to the major criticisms that have been raised by Dr. McMahon and others. We then describe the tasks we are currently undertaking to expand and validate our research and address the important criticisms and limitations. Handle: RePEc:aph:ajpbhl:1990:80:7:799-803_4 Template-Type: ReDIF-Article 1.0 Title: The effects of case definition in maternal screening and reporting criteria on rates of congenital syphilis Journal: American Journal of Public Health Author-Name: Cohen, D.A. Author-Name: Boyd, D. Author-Name: Prabhudas, I. Author-Name: Mascola, L. Year: 1990 Volume: 80 Issue: 3 Pages: 316-317 Abstract: Reports of congenital syphilis in 1987 were reviewed to determine how new national guidelines for defining congenital syphilis would influence reported rates in Los Angeles County. After reviewing all reported reactive serologic tests for syphilis, we found 166 additional cases, resulting in a 426 percent increase in the 1987 reported rate of congenital syphilis. Rates of congenital syphilis are dependent upon surveillance practices, screening policies, and case definition. Handle: RePEc:aph:ajpbhl:1990:80:3:316-317_8 Template-Type: ReDIF-Article 1.0 Title: Effects of workplace smoking bans on cigarette consumption Journal: American Journal of Public Health Author-Name: Borland, R. Author-Name: Chapman, S. Author-Name: Owen, N. Author-Name: Hill, D. Year: 1990 Volume: 80 Issue: 2 Pages: 178-180 Abstract: A sample of staff working in the Australian Public Service (n = 2113) were surveyed two to four weeks before a mandated total ban on workplace smoking was introduced, and again five to six months later. Among the 391 smokers on whom complete data were available, the workplace smoking bans were associated with reduced rates of smoking, particularly among heavier smokers where the reduction in consumption was over 25 percent. Handle: RePEc:aph:ajpbhl:1990:80:2:178-180_0 Template-Type: ReDIF-Article 1.0 Title: Apparent underreporting of cigarette consumption among Mexican American smokers Journal: American Journal of Public Health Author-Name: Perez-Stable, E.J. Author-Name: Vanoss Marin, B. Author-Name: Marin, G. Author-Name: Brody, D.J. Author-Name: Benowitz, N.L. Year: 1990 Volume: 80 Issue: 9 Pages: 1057-1061 Abstract: To determine the accuracy of self-report of cigarette consumption among Mexican American smokers, we compared self-reported cigarette use and serum cotinine concentrations in a sample of 547 participants in the Hispanic Health and Nutrition Examination Survey (HHANES). We defined underreporting of cigarette use as a cotinine to cigarette-per-day ratio of > 0.142 μM/l which represented a substantial discrepancy between self-reported consumption and serum cotinine. Of the 98 men and 97 women who reported smoking one to nine cigarettes/day, 20.4 percent and 24.7 percent, respectively, underreported their cigarette consumption. Underreporting was less common among men and women smoking 10 to 19 cigarettes/day (8.3 percent and 10.8 percent, respectively) and 20 or more cigarettes/day (2.2 percent and 2.9 percent, respectively). Comparison of underreporters to other smokers by demographic characteristics within sex and cigarettes/day categories showed no differences. Differences in cotinine metabolism and extremely efficient smoking are alternative explanations that can not be ruled out with these data. We believe, however, that a proportion of Mexican American light smokers may underreport the quantity of cigarettes smoked per day, and may truly be moderate or heavy smokers. Handle: RePEc:aph:ajpbhl:1990:80:9:1057-1061_9 Template-Type: ReDIF-Article 1.0 Title: City directories as sources for survey work in low- and middle-income Black communities Journal: American Journal of Public Health Author-Name: Stanek III, E.J. Author-Name: Pastides, H. Author-Name: Darity, W.A. Author-Name: Elkins, M. Year: 1990 Volume: 80 Issue: 9 Pages: 1125-1126 Abstract: Commercial directories and governmental lists of dwelling units in low income urban Black communities in four eastern cities were evaluated for completeness. With rare exceptions, less than 90 percent of dwelling units were included in any one list and no list adequately identified multiple dwelling unit structures. Since household income is likely to be lower among households in such structures, all lists tend to miss the very poor, i.e., those who may be at highest health risk. Handle: RePEc:aph:ajpbhl:1990:80:9:1125-1126_8 Template-Type: ReDIF-Article 1.0 Title: Teenage pregnancies and the recriminalization of abortions Journal: American Journal of Public Health Author-Name: Wattleton, F. Year: 1990 Volume: 80 Issue: 3 Pages: 269-270 Handle: RePEc:aph:ajpbhl:1990:80:3:269-270_3 Template-Type: ReDIF-Article 1.0 Title: A statewide case registry for surveillance of occupational heavy metals absorption Journal: American Journal of Public Health Author-Name: Baser, M.E. Author-Name: Marion, D. Year: 1990 Volume: 80 Issue: 2 Pages: 162-164 Abstract: The New York State Heavy Metals Registry is a legislatively mandated program through which clinical laboratories, physicians, and health facilities report state residents 18 years of age and older with elevated levels of lead, mercury, arsenic, or cadmium in blood or urine. From 1982-86, the current employer was determined for 95.9 percent of 3,309 cases. Occupational exposures in 328 companies accounted for 82.8 percent of cases. The majority of companies were reported for lead (247 companies, 75.3 percent of total) or mercury (47 companies, 14.3 percent of total). Of the 247 companies reported to the Registry for lead, the Occupational Safety and Health Administration (OSHA) inspected 18 of 98 companies (18.4 percent) in the manufacturing sector, but only one of the 149 companies (0.6 percent) outside the manufacturing sector. We conclude that the Registry effectively detects companies with heavy metals exposures, and is an especially useful adjunct to OSHA inspections outside the manufacturing sector. Handle: RePEc:aph:ajpbhl:1990:80:2:162-164_1 Template-Type: ReDIF-Article 1.0 Title: Asbestos and other toxins Journal: American Journal of Public Health Author-Name: Lowinger, P. Year: 1990 Volume: 80 Issue: 10 Pages: 1274 Handle: RePEc:aph:ajpbhl:1990:80:10:1274_4 Template-Type: ReDIF-Article 1.0 Title: Unlicensed midwifery practice in Washington State Journal: American Journal of Public Health Author-Name: Myers, S.J. Author-Name: St. Clair, P.A. Author-Name: Gloyd, S.S. Author-Name: Salzberg, P. Author-Name: Myers-Ciecko, J. Year: 1990 Volume: 80 Issue: 6 Pages: 726-728 Abstract: We examined the role of unlicensed midwives in Washington State by questioning mothers of infants born out-of-hospital with an unlicensed person in attendance. Only a small proportion of the state's births (0.11 percent) were attended by unlicensed midwives. Unlicensed midwives attended 7 percent of home births, licensed midwives and certified nurse-midwives attended 69 percent. Mothers chose unlicensed midwives because they had religious beliefs in common, or because they were the only providers available who would attend a home birth. Handle: RePEc:aph:ajpbhl:1990:80:6:726-728_5 Template-Type: ReDIF-Article 1.0 Title: Kettering laboratory: A pioneer in lead research (I: Reply) Journal: American Journal of Public Health Author-Name: Rabin, R. Year: 1990 Volume: 80 Issue: 8 Pages: 1002 Handle: RePEc:aph:ajpbhl:1990:80:8:1002_3 Template-Type: ReDIF-Article 1.0 Title: Fatal and severe injury: Scooter and moped crashes in California, 1985 Journal: American Journal of Public Health Author-Name: Salatka, M. Author-Name: Arzemanian, S. Author-Name: Kraus, J.F. Author-Name: Anderson, C.L. Year: 1990 Volume: 80 Issue: 9 Pages: 1122-1124 Abstract: Fatal and severe injury crashes for scooters and mopeds in California for 1985 were compared with those for motocycles during the same year. Scooters had more than twice the injury crash rate of mopeds but one-half the rate of motorcycles. Age of injured drivers and crash patterns for scooters, mopeds, and motorcycles varied significantly. Handle: RePEc:aph:ajpbhl:1990:80:9:1122-1124_4 Template-Type: ReDIF-Article 1.0 Title: Breastfeeding patterns in Puerto Rico Journal: American Journal of Public Health Author-Name: Becerra, J.E. Author-Name: Smith, J.C. Year: 1990 Volume: 80 Issue: 6 Pages: 694-697 Abstract: In the 1950s, Puerto Rico began an active industrialization program. We used data from the 1982 Puerto Rico Fertility and Family Planning Assessment to describe the trend in the incidence of breastfeeding in Puerto Rico over time and to ascertain some of its determinants. From 1946 through 1982, 5,884 infants were born among this statistically representative sample or reproductive-aged women. The proportion of infants who had ever been breastfed was 59 percent for births before 1960 (mean duration = 7.8 months), dropped to 25 percent for infants born from 1970 to 1974 (mean duration = 4.9), and rose to 38 percent for births delivered from 1980 to 1982 (mean duration = 3.4). Prior breastfeeding experience was an important determinant of breastfeeding a newborn. Infants of mothers who had breastfed a previous baby were 7.3 times more likely to be breastfed (95% confidence interval = 6.6, 8.0) compared with infants of mothers who had not previously breastfed. The 38 percent of infants who were breastfed in Puerto Rico in the early 1980s is below the 74 percent of 97 percent reported in Latin America and below the 54 percent reported in the United States for the same period. This study provides baseline data for any future intervention strategies. Handle: RePEc:aph:ajpbhl:1990:80:6:694-697_8 Template-Type: ReDIF-Article 1.0 Title: Violence during pregnancy and substance use Journal: American Journal of Public Health Author-Name: Amaro, H. Author-Name: Fried, L.E. Author-Name: Cabral, H. Author-Name: Zuckerman, B. Year: 1990 Volume: 80 Issue: 5 Pages: 575-579 Abstract: Violent incidents were assessed as part of a prospective study of 1,243 pregnant women. Participants were predominantly poor, urban, minority group women. Seven percent (n = 92) of women reported physical or sexual violence during pregnancy. Most of the women (94 percent) knew their assailant. Victims of violence were at greater risk of having a history of depression and attempted suicide, having more current depressive symptoms, reporting less happiness about being pregnant, and receiving less emotional support from others for the current pregnancy. Comparisons of victims and non-victims showed that victims were more likely to be users of alcohol and drugs. In addition, partners of victims were more likely to use marijuana and cocaine. When possible confounders were controlled using multivariable analyses, a woman's alcohol use during pregnancy and her partner's drug use were independently associated with an increased risk of being a victim of violence during pregnancy. Results of this study highlight the importance of assessing exposure to violence during prenatal care, especially among women who are heavy users of alcohol or drugs or whose partners use these substances. Handle: RePEc:aph:ajpbhl:1990:80:5:575-579_5 Template-Type: ReDIF-Article 1.0 Title: HIV-1 counseling and testing sites, Minnesota: Analysis of trends in client characteristics Journal: American Journal of Public Health Author-Name: Danila, R.N. Author-Name: Schultz, J.M. Author-Name: Osterholm, M.T. Author-Name: Henry, K. Author-Name: Simpson, M.L. Author-Name: MacDonald, K.L. Year: 1990 Volume: 80 Issue: 4 Pages: 419-422 Abstract: We report here a summary of the data obtained from two HIV-1 antibody counseling and testing sites in Minneapolis-St. Paul for the first 48 months of operation (24,911 persons tested). The HIV-1 antibody seroprevalence rate for all persons tested was 5 percent. The highest seroprevalence rates were in male homosexual/bisexual intravenous drug users (23 percent) and homosexual/bisexual men (13 percent). There was a significant decrease in the HIV-1 antibody seroprevalence rate among clients during the 48-month period from 14 percent in the first six months to 3 percent in the last six months. This decrease coincided with an increase in the number of low-risk female clients and low-risk heterosexual male clients, and a decrease in the number of homosexual/bisexual males participating in the programs. These findings suggest that the need for development and implementation of other strategies to identify and reach persons at highest risk for HIV-1 infection. Handle: RePEc:aph:ajpbhl:1990:80:4:419-422_5 Template-Type: ReDIF-Article 1.0 Title: Increasing rubella seronegativity despite a compulsory school law Journal: American Journal of Public Health Author-Name: Schum, T.R. Author-Name: Nelson, D.B. Author-Name: Duma, M.A. Author-Name: Sedmak, G.V. Year: 1990 Volume: 80 Issue: 1 Pages: 66-69 Abstract: To determine if lower rubella susceptibility persisted five to seven years after immunization legislation, we retrospectively reviewed the serologic status of 341 outpatients from 1985 to 1987 in an inner-city school age population. Seronegative rates increased significantly during the two-year study period from 4.2 to 24.5 percent (17 percent overall). (β = 6.8%, 95% CI = 3.3, 10.3). Charts were reviewed for 57 of 58 seronegative and 114 seropositive controls. Estimates were then made to the population of 341 subjects. Those with documented rubella immunization had a seronegative rate of 13 percent compared to 19 percent if the immunization status was unknown. For patients who received care in our clinic for < two years, 32 percent were seronegative compared to 10 percent for those treated ≥ 2 years (odds ratio = 0.31, 95% CI = 0.16, 0.60). Among patients immunized in 1977 or 1978, 33 percent were seronegative compared to 7 percent immunized at other times (OR = 0.21, 95% CI = 0.07, 0.63). Factors associated with increased rubella seronegativity include immunization in 1977 or 1978 and lack of continuity of care in our clinic. Much of the increase remains unexplained. Handle: RePEc:aph:ajpbhl:1990:80:1:66-69_0 Template-Type: ReDIF-Article 1.0 Title: Fruit and vegetables in the American diet: Data from the NHANES II survey Journal: American Journal of Public Health Author-Name: Patterson, B.H. Author-Name: Block, G. Author-Name: Rosenberger, W.F. Author-Name: Pee, D. Author-Name: Kahle, L.L. Year: 1990 Volume: 80 Issue: 12 Pages: 1443-1449 Abstract: Twenty-four hour dietary recall data from the Second National Health and Nutrition Examination Survey (1976-80) were used to estimate the numbers of servings of fruit and vegetables consumed by Black and White adults, to examine the types of servings (e.g., potatoes, garden vegetables, fruit, and juice), and to estimate the mean intake of calories, fat, dietary fiber, and vitamins A and C by number of servings. An estimated 45 percent of the population had no servings of fruit or juice and 22 percent had no servings of a vegetable on the recall day. Only 27 percent consumed the three or more servings of vegetables and 29 percent had the two or more servings of fruit recommended by the US Departments of Agriculture and of Health and Human Services; 9 percent had both. Consumption was lower among Blacks than Whites. The choice of vegetables lacked variety. Diets including at least three servings of vegetables and two servings of fruit contained about 17 grams of dietary fiber. Although caloric and fat intake increased with increasing servings of fruit and vegetables, the percent of calories from fat remained relatively constant. Although these data are 10 years old, more recent surveys have shown similar results. The discrepancy between dietary guidelines and the actual diet suggests a need for extensive public education. Handle: RePEc:aph:ajpbhl:1990:80:12:1443-1449_4 Template-Type: ReDIF-Article 1.0 Title: Death in prison: Changing mortality patterns among male prisoners in Maryland, 1979-87 Journal: American Journal of Public Health Author-Name: Salive, M.E. Author-Name: Smith, G.S. Author-Name: Brewer, T.F. Year: 1990 Volume: 80 Issue: 12 Pages: 1479-1480 Abstract: The leading causes of death (rate per 100,000 prisoner-years) in Maryland state prisons for the period 1979-87 were circulatory system disease (59), suicide (40), and homicide and legal intervention (30). Acquired immunodeficiency syndrome (AIDS) became the leading cause of death in 1987. Homicides declined after 1980; drug overdose deaths peaked in 1981 and later disappeared. Male inmates have 39 percent lower all-cause death rates than the general population of Maryland after adjustment for age and race. Handle: RePEc:aph:ajpbhl:1990:80:12:1479-1480_0 Template-Type: ReDIF-Article 1.0 Title: Illegal abortion in Mexico: Client perceptions Journal: American Journal of Public Health Author-Name: Pick De Weiss, S. Author-Name: David, H.P. Year: 1990 Volume: 80 Issue: 6 Pages: 715-716 Abstract: An exploratory study of the perceptions of 156 abortion clients in Mexico suggests that perceived quality of service was the main reason for choosing physicians while cost and anonymity were the major reasons for choosing nonphysicians. 'Too young' was the most often cited reason for pregnancy termination, followed by economic situation and having too many children already. Cost was, on average, equivalent to three to four weeks minimum wage; physicians' charges were about three times higher than those of nonphysicians. Handle: RePEc:aph:ajpbhl:1990:80:6:715-716_9 Template-Type: ReDIF-Article 1.0 Title: Predictors of vaccination behavior among persons ages 65 years and older Journal: American Journal of Public Health Author-Name: Stehr-Green, P.A. Author-Name: Sprauer, M.A. Author-Name: Williams, W.W. Author-Name: Sullivan, K.M. Year: 1990 Volume: 80 Issue: 9 Pages: 1127-1129 Abstract: We estimated influenza vaccination coverage of 32 percent among persons 65 years of age and older from the 1987 Behavioral Risk Factor Surveillance System survey. Race other than White, obesity, lack of seatbelt use, and current smoking were associated with decreased likelihood of having been vaccinated. Controlling for these factors, the best predictor of having received influenza vaccination was having had a medical checkup within the last year (Odds Ratio = 2.40, 95% confidence interval = 1.84, 3.14). Handle: RePEc:aph:ajpbhl:1990:80:9:1127-1129_9 Template-Type: ReDIF-Article 1.0 Title: A rural outbreak of Legionnaire's disease linked to visiting a retail store Journal: American Journal of Public Health Author-Name: Redd, S.C. Author-Name: Lin, F.Y.C. Author-Name: Fields, B.S. Author-Name: Biscoe, J. Author-Name: Plikaytis, B.B. Author-Name: Powers, P. Author-Name: Patel, J. Author-Name: Lim, B.L. Author-Name: Joseph, J.M. Author-Name: Devadason, C. Author-Name: Israel, E. Author-Name: Cohen, M.L. Year: 1990 Volume: 80 Issue: 4 Pages: 431-434 Abstract: Between May 7 and June 7, 1986, 27 residents of a rural county in Maryland developed legionellosis, and two died. Legionella pneumophila serogroup 1 was cultured from the sputum of two patients and identified in lung tissue of a third patient by direct fluorescent antibody staining. An additional 11 patients had four-fold rises in antibody titer to L. pneumophila, and 13 had single titers ≥1:256. To determine risk factors for disease, we performed a case-control study. Twelve of 16 case-patients reported visiting store A in the two weeks before onset of illness compared with four of 28 control-patients. A serologic survey of employees showed that employees of store A were 3.63 times more likely than control employees to have titers of antibody to L. pneumophila ≥1:256 (95% confidence intervals 0.8, 16.7). Cultures of soil specimens, samples of water from the hot water system of store A and from stagnant ponds near store A collected five weeks after the end of the outbreak were negative for Legionella species. Store A was adjacent to a site of excavation and construction during May 1986, when the community was experiencing an extended drought. This investigation suggests that exposure to excavation and construction activity may be a risk factor for legionellosis. Handle: RePEc:aph:ajpbhl:1990:80:4:431-434_4 Template-Type: ReDIF-Article 1.0 Title: Health effects of a thorium waste disposal site Journal: American Journal of Public Health Author-Name: Reza Najem, G. Author-Name: Voyce, L.K. Year: 1990 Volume: 80 Issue: 4 Pages: 478-480 Abstract: A case-control study of 112 households residing in the vicinity of a thorium waste disposal site found a higher prevalence of birth defects (RR 2.1) and liver disease (RR 2.3) among exposed than the unexposed group. The numbers were quite small and the confidence intervals wide, however, so that no definite conclusions can be drawn from these data. Handle: RePEc:aph:ajpbhl:1990:80:4:478-480_1 Template-Type: ReDIF-Article 1.0 Title: Modeling the impact of breast-feeding by HIV-infected women on child survival Journal: American Journal of Public Health Author-Name: Heymann, S.J. Year: 1990 Volume: 80 Issue: 11 Pages: 1305-1309 Abstract: This study models the survival outcomes of children born to HIV-infected (human immunodeficiency virus) women who are breast-fed, bottle-fed, and wet-nursed. It is estimated that, given the relative risk of alternatives to maternal milk in developing countries, the probability of HIV transmission via breast milk would need to be at least .12 in a community with an under five child mortality rate from non-HIV causes of 100/1000 live births and at least .27 in a community with a rate of 200/1000 before alternative feeding practices should be recommended even to the known HIV-infected mother who has an available feeding alternative with a relative risk of 2:1. While such a low relative risk may be achievable with wet nursing, most studies report a relative risk of at least 3:1 for bottle feeding. A sensitivity analysis is conducted around the relative risk of child mortality from non-HIV causes associated with different feeding practices. While the critical transmission rate does not vary significantly with a rate of false positives as high as 20 percent on the HIV screening test, the critical transmission rate is very sensitive to the availability of HIV screening. In communities where the HIV prevalence rate among mothers reaches 40 percent, breast-feeding should still be recommended in the absence of HIV screening unless HIV transmission via breast milk surpasses 30 percent. Handle: RePEc:aph:ajpbhl:1990:80:11:1305-1309_5 Template-Type: ReDIF-Article 1.0 Title: The mortality profile of Black Seventh-day Adventists residing in Metropolitan Atlanta: A pilot study Journal: American Journal of Public Health Author-Name: Murphy, F.G. Author-Name: Blumenthal, D.S. Author-Name: Dickson-Smith, J. Author-Name: Peay, R.P. Year: 1990 Volume: 80 Issue: 8 Pages: 984-985 Abstract: Mortality information was gathered for 110 Black Seventh-day Adventist members of seven churches in Metropolitan Atlanta, Georgia during the period 1980-87. Seventy-seven percent of the deaths were due to cardiovascular diseases; 8 percent due to cancer, the second leading cause of deth. The cancer rate is extremely low in comparison to the proportion of deaths due to cardiovascular diseases. Subsequent research on this population will take into consideraton lifestyle factors which could contribute to this finding. Handle: RePEc:aph:ajpbhl:1990:80:8:984-985_3 Template-Type: ReDIF-Article 1.0 Title: Field comparison of several commercially available radon detectors Journal: American Journal of Public Health Author-Name: Field, R.W. Author-Name: Kross, B.C. Year: 1990 Volume: 80 Issue: 8 Pages: 926-930 Abstract: To determine the accuracy and precision of commercialy available radon detectors in a field setting, 15 detectors from six companies were exposed to radon and compared to a reference radon level. The detectors from companies that had already passed National Radon Measurement Proficiency Program testing had better precision and accuracy than those detectors awaiting proficiency testing. Charcoal adsorption detectors and diffusion barrier charcoal adsorption detectors performed very well, and the latter detectors displayed excellent time averaging ability. Alternatively, charcoal liquid scintillation detectors exhibited acceptable accuracy but poor precision, and bare alpha registration detectors showed both poor accuracy and precision. The mean radon level reported by the bare alpha registration detectors was 68 percent lower than the radon reference level. Handle: RePEc:aph:ajpbhl:1990:80:8:926-930_3 Template-Type: ReDIF-Article 1.0 Title: The association of corneal arcus with coronary heart disease and cardiovascular disease mortality in the Lipid Research Clinics Mortality Follow-up Study Journal: American Journal of Public Health Author-Name: Chambless, L.E. Author-Name: Fuchs, F.D. Author-Name: Linn, S. Author-Name: Kritchevsky, S.B. Author-Name: Larosa, J.C. Author-Name: Segal, P. Author-Name: Rifkind, B.M. Year: 1990 Volume: 80 Issue: 10 Pages: 1200-1204 Abstract: The relationship between corneal arcus (arcus senilis) and mortality from coronary heart disease (CHD) and cardiovascular disease (CVD) is examined in a prospective study of White men (n = 3,930) and women non-hormone users (n = 2,139), ages 30-69, followed for an average of 8.4 years as part of the Lipid Research Clinics Mortality Follow-up Study. After excluding those with clinically manifest CHD at baseline, corneal arcus was strongly associated with CHD and CVD mortality only in hyperlipidemic men ages 30-49 years, for whom the relative risk for CHD and CVD death was 3.7 and 4.0, respectively, after adjusting for age, total cholesterol, HDL cholesterol, and smoking status using a Cox proportional hazards model. Among 30-49 year old males, corneal arcus appears to be a prognostic factor for CHD, independent of its association with hyperlipidemia in this age-group, of about the same magnitude as other common risk factors, underscoring the usefulness of corneal arcus as a prognostic factor to the practicing clinician. Handle: RePEc:aph:ajpbhl:1990:80:10:1200-1204_9 Template-Type: ReDIF-Article 1.0 Title: Screening for chlamydial cervicitis in a sexually active university population Journal: American Journal of Public Health Author-Name: Malotte, C.K. Author-Name: Wiesmeier, E. Author-Name: Gelineau, K.J. Year: 1990 Volume: 80 Issue: 4 Pages: 469-471 Abstract: Enzyme-linked immunoabsorbent assays to detect chlamydial cervicitis were performed on samples from 1,320 sexually active university women. Seventy-five (prevalence 5.7 percent) had positive tests. Demographic, history, symptom, and physical examination variables were insufficient to predict infection accurately. We conclude that screening during routine visits with this population is cost-effective. Handle: RePEc:aph:ajpbhl:1990:80:4:469-471_9 Template-Type: ReDIF-Article 1.0 Title: Personality traits and addictive disease (I: Reply) Journal: American Journal of Public Health Author-Name: Yates, W.R. Year: 1990 Volume: 80 Issue: 4 Pages: 499 Handle: RePEc:aph:ajpbhl:1990:80:4:499_7 Template-Type: ReDIF-Article 1.0 Title: Homeless and housed families in Los Angeles: A study comparing demographic, economic, and family function characteristics Journal: American Journal of Public Health Author-Name: Wood, D. Author-Name: Haldez, B. Author-Name: Hayashi, T. Author-Name: Shen, A. Year: 1990 Volume: 80 Issue: 9 Pages: 1049-1052 Abstract: We studied 196 homeless and 194 housed poor families in Los Angeles, California to gain an understanding of events that precipitate family homelessness. Both homeless and housed poor mothers averaged 29 years old and were accompanied by two or three children. Three-fourths of both the homeless and housed families had income below the poverty level, and both groups expended almost two-thirds of their income on housing. Mothers in homeless families more commonly reported spousal abuse (35 vs 16 percent), child abuse (28 vs 10 percent), drug use (43 vs 30 percent), or mental health problems (14 vs 6 percent) and weaker support networks. Homeless mothers more commonly came from homes where their parents abused drugs or alcohol (49 vs 34 percent) or more commonly lived outside the home or in foster care (35 vs 25 percent). Homelessness was reported as due primarily to economic pressures of housing costs, but personal and family problems frequently played a contributing role, especially for single parent families. Burdens of increasing housing costs and family dysfunction among housed poor families place many at risk for homelessness. Handle: RePEc:aph:ajpbhl:1990:80:9:1049-1052_3 Template-Type: ReDIF-Article 1.0 Title: Teaching status and resource use for patients with acute myocardial infarction: A new look at the indirect costs of graduate medical education Journal: American Journal of Public Health Author-Name: Udvarhelyi, I.S. Author-Name: Rosborough, T. Author-Name: Lofgren, R.P. Author-Name: Lurie, N. Author-Name: Epstein, A.M. Year: 1990 Volume: 80 Issue: 9 Pages: 1095-1100 Abstract: To investigate whether the process of graduate medical education increases costs in teaching hospitals by causing longer lengths of stay and greater resource use, we compared lengths of stay, hospital charges, and the use of cardiovascular procedures for patients with acute myocardial infarction admitted to the teaching and nonteaching services of a university-affiliated community hospital. After adjusting for severity of illness and demographic characteristics, patients on the teaching services had a mean length of stay that was shorter by 0.6 days (p = 0.04) and mean charges that were $2,060 lower (p = 0.15) than for patients on the nonteaching service. Patients on the teaching service also had 15 percent (95% CI: -26, -4) fewer cardiac catheterizations and 9 percent (-18, 0) fewer procedures for myocardial revascularization (angioplasty or cardiac bypass surgery). These findings suggest that graduate medical education per se may not directly increase the use of health care resources and that the cost differences between teaching and nonteaching hospitals may be largely a consequence of other factors. These factors may include epiphenomena of teaching such as a specialized organizational structure, specialized patient care services, and continuing medical education for the nursing and medical staffs. The may also include factors not related to teaching such as differences in patients' severity of illness and sociodemographic characteristics. Handle: RePEc:aph:ajpbhl:1990:80:9:1095-1100_1 Template-Type: ReDIF-Article 1.0 Title: Are patients talking to their physicians about AIDS? Journal: American Journal of Public Health Author-Name: Gerbert, B. Author-Name: Maguire, B.T. Author-Name: Coates, T.J. Year: 1990 Volume: 80 Issue: 4 Pages: 467-468 Abstract: We conducted a nationwide telephone survey of a random sample of United States adults in summer 1988 (n = 2000, response rate = 75 percent) to find out if physicians were providing education and counseling to the public about AIDS and AIDS prevention. Within the previous five years, 94 percent had seen a physician but only 15 percent had discussed AIDS even though most said they would not object to discussing the topic. AIDS-related conversations are not commonplace in physician's offices and in most cases (72 percent) patients are the initiatiors of such conversations. Handle: RePEc:aph:ajpbhl:1990:80:4:467-468_7 Template-Type: ReDIF-Article 1.0 Title: Weekly food servings and participation in social programs among low income families Journal: American Journal of Public Health Author-Name: Taren, D.L. Author-Name: Clark, W. Author-Name: Chernesky, M. Author-Name: Quirk, E. Year: 1990 Volume: 80 Issue: 11 Pages: 1376-1378 Abstract: Low income families were interviewed to determine factors related to the number of family food servings per week. A multiple regression model indicated that participation in WIC (supplemental food program for women, infants and children), household size, and number of different income sources were associated with more family food servings per week. Number of food servings per week decreased the last week of the month most often in families with younger members. Handle: RePEc:aph:ajpbhl:1990:80:11:1376-1378_0 Template-Type: ReDIF-Article 1.0 Title: The increasing frequency of heterosexually acquired AIDS in the United States, 1983-88 Journal: American Journal of Public Health Author-Name: Holmes, K.K. Author-Name: Karon, J.M. Author-Name: Kreiss, J. Year: 1990 Volume: 80 Issue: 7 Pages: 858-863 Abstract: Of 88,510 cases of acquired immunodeficiency syndrome (AIDS) reported in adults in the United States from 1983 through 1988, the percentage attributed to reported heterosexual contact with persons known to be infected or at increased risk of infection with human immunodeficiency virus (HIV) has increased steadily from 0.9 percent in the first quarter of 1983 to 4.0 percent in the fourth quarter of 1988, from 0.1 (in 1983) to 1.4 percent (1988) among men, and from 13 (in 1983) to 28 percent (in 1988) among women. Among women, the cumulative incidence of AIDS attributable to heterosexual contact per million population is over 11 times greater for Blacks and Hispanics than for Whites. Among men, this incidence is over 10 times greater for Blacks and four times greater for Hispanics than for Whites. The pattern of distribution of heterosexually acquired AIDS parallels the distribution of other heterosexually transmitted diseases, which are also more frequent in Black and Hispanic inner-city populations. Drug use, exchange of sex for drugs or money, and early onset of sexual activity in adolescents are increasingly associated with heterosexually transmitted infections and are likely to be very important in heterosexual transmission of HIV in inner-city US populations. Handle: RePEc:aph:ajpbhl:1990:80:7:858-863_1 Template-Type: ReDIF-Article 1.0 Title: Self-rated health and mortality in the NHANES-I epidemiologic follow-up study Journal: American Journal of Public Health Author-Name: Idler, E.L. Author-Name: Angel, R.J. Year: 1990 Volume: 80 Issue: 4 Pages: 446-452 Abstract: The ability of self-rated health status to predict mortality was tested with data from the National Health and Nutrition Examination Survey (NHANES-I) Epidemiologic Follow-Up-Study (NHEFS), conducted from 1971-84. The sample consists of adult NHANES-I respondents ages 25-74 years (N = 6,440) for whom data from a comprehensive physical examination at the initial interview and survival status at follow-up are available. Self-rated health consists of the response to the single item, 'Would you say your health in general is excellent, very good, good, fair, or poor'? Proportional hazards analyses indicated that, net of its association with medical diagnoses given in the physical examination, demographic factors, and health related behaviors, self-rated health at Time 1 is associated with mortality over the 12-year follow-up period among middle-aged males, but not among elderly males or females of any age. Handle: RePEc:aph:ajpbhl:1990:80:4:446-452_8 Template-Type: ReDIF-Article 1.0 Title: Occupational physical activity and other risk factors for preterm birth among US army primigravidas Journal: American Journal of Public Health Author-Name: Ramirez, G. Author-Name: Grimes, R.M. Author-Name: Annegers, J.F. Author-Name: Davis, B.R. Author-Name: Slater, C.H. Year: 1990 Volume: 80 Issue: 6 Pages: 728-730 Abstract: We examined the relation of occupational physical activity to the risk of preterm birth among US Army active-duty primigravidas between 1981 and 1984 using 604 cases (preterm deliveries; ≤ 37 weeks gestation) and 6,070 controls (term and post-term deliveries). Women employed in the highest physical activity levels had increased odds of preterm delivery ranging from 1.69 to 1.75. The relation was not changed by adjustment for the effects of age, marital status, socioeconomic status, or education. Missing data suggest cautious interpretation. Handle: RePEc:aph:ajpbhl:1990:80:6:728-730_0 Template-Type: ReDIF-Article 1.0 Title: The impact of legalized abortion on adolescent childbearing in New York City Journal: American Journal of Public Health Author-Name: Joyce, T.J. Author-Name: Mocan, N.H. Year: 1990 Volume: 80 Issue: 3 Pages: 273-278 Abstract: In this paper we estimate the impact on adolescent childbearing of the liberalization of the New York State abortion law in 1970. Using Box-Jenkins time series techniques to analyze monthly data on the number of births to White and Black adolescents from January 1963 to December 1987, we found that the level of births to Black adolescents living in New York City fell 18.7 percent, approximately 142 fewer births per month, after the law became effective; the level of White births fell 14.1 percent, approximately 111 fewer births per month. Projections based on the fitted model suggest that a ban on legalized abortion today would have a major impact on adolescent childbearing in New York City as well as other parts of the country, although the magnitude of the change would vary according to local conditions. Handle: RePEc:aph:ajpbhl:1990:80:3:273-278_5 Template-Type: ReDIF-Article 1.0 Title: Sex-specific and race-specific hip fracture rates Journal: American Journal of Public Health Author-Name: Kellie, S.E. Author-Name: Brody, J.A. Year: 1990 Volume: 80 Issue: 3 Pages: 326-328 Abstract: Sex-, race- and age-specific hip fracture rates were determined using Health Care Financing Administration data for Medicare-reimbursed hip fracture hospitalizations from 1980 to 1982. Rates were highest in White women, lowest in Black men, and intermediate in White men and Black women. Proportions of hip fracture patients dying during hospitalization and those discharged to nursing homes, respectively, were: White men (10.5%; 49%); Black men (9.3%; 32%); White women (5.0%; 54%); and Black women (8.2%; 30%). Handle: RePEc:aph:ajpbhl:1990:80:3:326-328_7 Template-Type: ReDIF-Article 1.0 Title: Post-hospital support program for the frail elderly and their caregivers: A quasi-experimental evaluation Journal: American Journal of Public Health Author-Name: Oktay, J.S. Author-Name: Volland, P.J. Year: 1990 Volume: 80 Issue: 1 Pages: 39-46 Abstract: This paper evaluates the Post-Hospital Support Program for the frail elderly and their caregivers using a quasi-experimental design. The program goals were to reduce stress in the caregivers, improve functioning and reduce mortality in patients, and reduce health service utilization in patients. Subjects were patients at the Johns Hopkins Hospital in Baltimore, Maryland, age 65 or over, who were returning home to the care of a non-paid caregiver and who had extensive post-hospital care needs which were expected to continue for at least one year. The 93 comparison group patient/caregiver pairs were discharged between May 15, 1983 and May 14, 1984. The 98 treatment group pairs were discharged between May 15, 1984 and May 14, 1985. Interviews were conducted with patients and caregivers at 1, 3, 6, 9, and 12 months after discharge. Results showed a slight reduction in caregiver stress and a substantial reduction in hospital days used by the treatment group. When confounding and history effects are taken into consideration, an average difference of 6.5 days per patient remains. The data also suggest that the treatment program may have postponed some deaths and nursing home placements. The results suggest that support services for the frail elderly and their caregivers can be cost efficient by reducing hospital length-of-stay. Savings were estimated at $4,585 per patient per year in this study. However, further work is needed to design programs which more effectively reduce caregiver stress. Handle: RePEc:aph:ajpbhl:1990:80:1:39-46_9 Template-Type: ReDIF-Article 1.0 Title: Leukemia incidence and radioactivity in drinking water in 59 Iowa towns Journal: American Journal of Public Health Author-Name: Fuortes, L. Author-Name: McNutt, L.A. Author-Name: Lynch, C. Year: 1990 Volume: 80 Issue: 10 Pages: 1261-1262 Abstract: Fifty-nine towns in Iowa with single source drinking water supplies were stratified on the basis of radium content in finished non-softened water to test the hypothesis of an association with total or acute myeloid leukemia. Fourteen towns had radium concentrations in drinking water exceeding the EPA safety limit of 5 picocuries per liter (pCi/L). A small increasing trend existed for total leukemia with increased radium content in drinking water that is in accordance with either the hypothesis of no effect or of a small effect. Handle: RePEc:aph:ajpbhl:1990:80:10:1261-1262_3 Template-Type: ReDIF-Article 1.0 Title: At last - A view of hispanic health and nutritional status Journal: American Journal of Public Health Author-Name: Murphy, R.S. Year: 1990 Volume: 80 Issue: 12 Pages: 1429-1430 Handle: RePEc:aph:ajpbhl:1990:80:12:1429-1430_6 Template-Type: ReDIF-Article 1.0 Title: Risk factors for depressive symptomatology in a drug using population Journal: American Journal of Public Health Author-Name: Buckner, J.C. Author-Name: Mandell, W. Year: 1990 Volume: 80 Issue: 5 Pages: 580-585 Abstract: This study employs a prospective design to examine possible personality, drug use, stressful life event, and social support-related variabilities with the onset of a depressive episode in a cohort of psychoactive drug using young adults. Two waves of data, collected one year apart, were available on 942 individuals. Cases (n = 62) were free of depressive symptoms at time 1 but reported significant symptomatology at time 2 as measured by the depression subscale of the Brief Symptom Inventory. Controls (n = 490) were those free of depressive symptoms at both time points. In multivariate analyses, users of the central nervous system depressant methaqualone had a nearly four-fold elevated risk for depressed mood as compared to nonusers. Additional risk factors significant after multivariate adjustment included lower self-esteem at time 1 and negative life events. These results highlight the multifactorial nature of depressive symptomatology. Handle: RePEc:aph:ajpbhl:1990:80:5:580-585_3 Template-Type: ReDIF-Article 1.0 Title: Erratum: Coverage gaps in seat belt use laws (Am J Public Health 1989; 79:332-333) Journal: American Journal of Public Health Author-Name: Wells, J.K. Author-Name: Williams, A.F. Author-Name: Fields, M. Year: 1990 Volume: 80 Issue: 3 Pages: 285 Handle: RePEc:aph:ajpbhl:1990:80:3:285_0 Template-Type: ReDIF-Article 1.0 Title: Infant care permits: A practical method for raising the quality of infant care within a community Journal: American Journal of Public Health Author-Name: Jerardi, R.J. Year: 1990 Volume: 80 Issue: 12 Pages: 1522-1523 Handle: RePEc:aph:ajpbhl:1990:80:12:1522-1523_5 Template-Type: ReDIF-Article 1.0 Title: Comparison of two methodologies to measure agricultural occupational fatalities Journal: American Journal of Public Health Author-Name: Murphy, D.J. Author-Name: Seltzer, B.L. Author-Name: Yesalis, C.E. Year: 1990 Volume: 80 Issue: 2 Pages: 198-200 Abstract: Agricultural occupational fatalities in Pennsylvania for the years 1985-87 were followed up. Supplemental data concerning the occupation of the deceased and circumstances of the fatal accident were obtained from a family member. The number of fatalities designated as agriculturally and occupationally related by the National Traumatic Occupational Fatality (NTOF) system was compared with the number of fatalities identified by using alternative criteria for classification of agriculturally and occupationally related fatalities. There may be nearly a 30 percent error in the NTOF method resulting in a 20 percent undercount. Handle: RePEc:aph:ajpbhl:1990:80:2:198-200_1 Template-Type: ReDIF-Article 1.0 Title: Global health, national development, and the role of government Journal: American Journal of Public Health Author-Name: Roemer, M.I. Author-Name: Roemer, R. Year: 1990 Volume: 80 Issue: 10 Pages: 1188-1192 Abstract: In spite of extreme differences in health status between the more developed and less developed countries, trends of infant mortality and life expectancy show substantial improvements in both types of country between 1950 and 1980. These improvements may be attributed to three types of change: 1) socio-economic development with decolonization, increased industrialization, growth of gross domestic product, urbanization, the gains of women, and enhanced education; 2) cross-national influences due to greater international trade, the spread of technology, and widespread affirmation of human rights; and 3) national health system development through expanded governmental health programs. Further improvements will depend on greater strength in public sector health services rather than private sector services which aggravate inequities. Handle: RePEc:aph:ajpbhl:1990:80:10:1188-1192_3 Template-Type: ReDIF-Article 1.0 Title: TEEN TALK: Peer groups addressing teen pregnancy Journal: American Journal of Public Health Author-Name: Minter, P.W. Year: 1990 Volume: 80 Issue: 3 Pages: 349-350 Handle: RePEc:aph:ajpbhl:1990:80:3:349-350_6 Template-Type: ReDIF-Article 1.0 Title: The new class of abortifacients Journal: American Journal of Public Health Author-Name: Goldenring, J.M. Year: 1990 Volume: 80 Issue: 11 Pages: 1394 Handle: RePEc:aph:ajpbhl:1990:80:11:1394_5 Template-Type: ReDIF-Article 1.0 Title: Depressive symptoms and cigarette smoking among Latinos in San Francisco Journal: American Journal of Public Health Author-Name: Perez-Stable, E.J. Author-Name: Marin, G. Author-Name: Marin, B.V. Author-Name: Katz, M.H. Year: 1990 Volume: 80 Issue: 12 Pages: 1500-1502 Abstract: We administered the Center for Epidemiological Studies Depression (CES-D) Scale to 547 San Francisco Latinos as part of a random digit dialing telephone survey to evaluate smoking behavior. Both men and women current smokers had the highest mean CES-D levels (9.7 and 14.3, respectively). Logistic regression analysis adjusting for gender, acculturation, education, age, and employment showed that current smokers had an odds ratio of 1.7 (95% CI = 1.3, 2.2) for significant depressive symptoms compared to former smokers (OR = 1.1; 95% CI = .8, 1.6) and never smokers (OR = 1). Handle: RePEc:aph:ajpbhl:1990:80:12:1500-1502_7 Template-Type: ReDIF-Article 1.0 Title: Cardiovascular deaths among Alaskan Natives, 1980-86 Journal: American Journal of Public Health Author-Name: Middaugh, J.P. Year: 1990 Volume: 80 Issue: 3 Pages: 282-285 Abstract: Average annual, age-adjusted death rates from cardiovascular diseases and atherosclerosis from 1980-86 among Alaskan Natives were lower than rates among other Alaskans (162.0 vs 242.1; RR = 0.67), while death rates from other causes were higher (954.4 vs 618.6; RR = 1.54). These suggest that Alaskan Natives have less cardiovascular disease than other populations. Additional research on the role of marine omega-3 fatty acids is needed. Handle: RePEc:aph:ajpbhl:1990:80:3:282-285_5 Template-Type: ReDIF-Article 1.0 Title: Secular change in birthweight among Southeast Asian immigrants to the United States Journal: American Journal of Public Health Author-Name: Li, D.-K. Author-Name: Ni, H. Author-Name: Schwartz, S.M. Author-Name: Daling, J.R. Year: 1990 Volume: 80 Issue: 6 Pages: 685-688 Abstract: We analyzed the Washington State births in 1980-1986 to Southeast Asian parents whose birth place was coded as being outside of the US. The mean birthweight increased from 3188 grams in 1980-81 to 3283 grams in 1986, an annual increment of about 18 grams (95% CI = 11, 25 grams). The prevalence of low birthweight (< 2500 grams) decreased from 7.2 percent in 1980-81 to 5.4 percent in 1986, an annual reduction of 6.4 percent (95% CI = 1.3, 11.2 percent) In an analysis of information ascertained from the birth certificate, the change of paternal occupational status (from student to employed) was associated with 27 percent of the reduction in the prevalence of low birthweight, independent of maternal age, infant sex, and prior gravidity. A similar temporal change of birthweight during the same period of time was not observed among infants of US-born Asian mothers. Among the women who had two consecutive births from 1984 to 1986, the improvement of birthweight for the second birth compared to the first birth was much greater in infants born to the Southeast Asian mothers than that to White mothers. Our study suggests that living in the United States after immigration from their native countries has had a positive impact on the birthweight of infants born to Southeast Asian immigrants. Handle: RePEc:aph:ajpbhl:1990:80:6:685-688_1 Template-Type: ReDIF-Article 1.0 Title: Risk factors and non-differential misclassification (I) Journal: American Journal of Public Health Author-Name: Hatfield, T.H. Year: 1990 Volume: 80 Issue: 8 Pages: 1000-1001 Handle: RePEc:aph:ajpbhl:1990:80:8:1000-1001_3 Template-Type: ReDIF-Article 1.0 Title: The effects of detoxification of domestic gas on suicide in the United States Journal: American Journal of Public Health Author-Name: Lester, D. Year: 1990 Volume: 80 Issue: 1 Pages: 80-81 Abstract: As domestic gas was detoxified in the United States, the rate of suicide by domestic gas decreased. During this time period (1950-60), there was a parallel increase in the per capita ownership of cars and an accompanying increase in the rate of suicide by motor vehicle exhaust. However, displacement of suicide method from domestic gas to car exhaust occurred only for males and not for females. Handle: RePEc:aph:ajpbhl:1990:80:1:80-81_1 Template-Type: ReDIF-Article 1.0 Title: Long-term impact of smoking cessation on the incidence of coronary heart disease Journal: American Journal of Public Health Author-Name: Tosteson, A.N.A. Author-Name: Weinstein, M.C. Author-Name: Williams, L.W. Author-Name: Goldman, L. Year: 1990 Volume: 80 Issue: 12 Pages: 1481-1486 Abstract: Using a simulation model of the US male population, we estimated the long-term impact that future smoking cessation programs would have on the distribution and occurrence of coronary heart disease in males ages 35-84. For interventions that reduce the number of smokers by 25 percent in 1990, the number of men free of coronary heart disease is projected to increase by 416,787 (0.7 percent) in 2015, and the age-standardized absolute incidence to decline by 2.3 percent. Incidence rates and absolute incidences are projected to fall in men under age 65, but absolute incidence would rise in men over age 65, in large part because of the increased number of men who were at risk for coronary heart disease because of a reduction in non-coronary smoking-related mortality. These trends were more marked for greater smoking reductions and were generally unaffected in a variety of analyses using alternative assumptions, which considered smoking as a risk factor in the elderly, a lag-time before benefits from smoking cessation were realized and secular declines in smoking prevalence. Subject to the assumptions of our model, we conclude that smoking reductions will markedly reduce coronary heart disease, especially in younger age groups, and that this benefit will be slightly offset by a small increase in absolute incidence in elderly men. Handle: RePEc:aph:ajpbhl:1990:80:12:1481-1486_0 Template-Type: ReDIF-Article 1.0 Title: Paternal military service in Vietnam and the risk of late adverse pregnancy outcomes Journal: American Journal of Public Health Author-Name: Aschengrau, A. Author-Name: Monson, R.R. Year: 1990 Volume: 80 Issue: 10 Pages: 1218-1224 Abstract: To investigate the relationship between paternal military service in Vietnam and the risk of late adverse pregnancy outcomes, we conducted a case-control study of women who delivered infants from August 1977 until March 1980 at Boston Hospital for Women. Paternal military service history among 857 congenital anomaly cases, 61 stillbirth cases, and 48 neonatal death cases were compared with that of 998 normal controls. Military service veterans were identified by crossmatching identifying information from obstetric records with state and national military records. After controlling for confounding variables, we found that the Vietnam veterans' relative risk of fathering an infant with one or more major malformations was 1.7 (95% CI = 0.8, 3.5) compared to non-Vietnam veterans. The increased risk was present in several organ systems and did not seem to be related to a particular type of defect. No associations or highly unstable associations were found between paternal military service in Vietnam and the occurrence of congenital anomalies overall, minor malformations, normal variants, stillbirths, and neonatal deaths. These findings should be viewed with caution since maternal and delivery characteristics appear to have contributed to the etiology of several of the major malformations among the Vietnam veterans' children. Handle: RePEc:aph:ajpbhl:1990:80:10:1218-1224_3 Template-Type: ReDIF-Article 1.0 Title: Prospective payment and the utilization of physical therapy service in the hospitalized elderly Journal: American Journal of Public Health Author-Name: Holt, P. Author-Name: Winograd, C.H. Year: 1990 Volume: 80 Issue: 12 Pages: 1491-1494 Abstract: We studied the effect, in a university teaching hospital, of the prospective payment system (PPS) on utilization of physical therapy (PT), a non-reimbursable service; subjects were hospitalized patients aged 75 or older with non-PT-related diagnoses (myocardial infarction, pneumonia, congestive heart failure, and colectomy) and PT-related diagnoses (cerebrovascular accident and hip fracture). The proportion of patients referred for PT increased from 68 percent pre-PPS to 85 percent post-PPS for those with PT-related diagnoses and from 13 percent pre-PPS to 19 percent post-PPS for those with non-PT-related diagnoses. The mean number of sessions of PT decreased slightly for both groups: from 8.5 to 7.6 sessions for those with PT-related diagnoses and from 5.2 to 4.5 for those with non-PT-related diagnoses. In patients with PT-related diagnoses whose ambulatory status worsened during hospitalization, referrals for PT increased from 76 percent pre-PPS to 98 percent post-PPS. Referrals of comparable patients with non-PT-related diagnoses did not increase. Changes in provider education and efforts to reduce length of stay may account for these findings. Handle: RePEc:aph:ajpbhl:1990:80:12:1491-1494_0 Template-Type: ReDIF-Article 1.0 Title: The growing proportion of female physicians: Implications for US physician supply Journal: American Journal of Public Health Author-Name: Kletke, P.R. Author-Name: Marder, W.D. Author-Name: Silberger, A.B. Year: 1990 Volume: 80 Issue: 3 Pages: 300-304 Abstract: This study analyzes how the growing proportion of women in the United States physician population will affect the amount and type of physician services available to the US population. Female physicians work fewer hours per week, are slightly less likely to be in patient care, and tend to enter different specialties than male physicians. Female physicians also have higher retirement rates than male physicians, but due to their lower mortality rates, have work lives nearly as long as male physicians. We examined how the changing composition of the physician population will affect the availability of physician services by comparing historical and projected trends for the number of active post-residency physicians with comparable trends for a full-time-equivalent measure of physician supply. The full-time-equivalent measure takes into account the different labor supply behavior of key subpopulations (e.g., women and graduates of US versus foreign medical schools). The results suggest that the changing composition of the physician population will reduce the growth of effective physician supply between 1986 and 2010 but only by four percentage points. Handle: RePEc:aph:ajpbhl:1990:80:3:300-304_8 Template-Type: ReDIF-Article 1.0 Title: Meeting the needs for health services of persons with mental retardation living in the community Journal: American Journal of Public Health Author-Name: Minihan, P.M. Author-Name: Dean, D.H. Year: 1990 Volume: 80 Issue: 9 Pages: 1043-1048 Abstract: Adequate health services are critical to the success of efforts to maintain persons with mental retardation in the community, yet information concerning the health status of this population is in short supply. This paper presents the results of a survey of 333 mentally retarded persons randomly selected from a population of 1,333 such individuals living in community settings. Almost two-thirds had chronic conditions requiring medical intervention. The top five conditions in terms of prevalence were neurologic, ophthalmologic, dermatologic, psychiatric-emotional, and orthopedic. The majority of conditions were being managed appropriately in the community health system. A substantial proportion can be managed by primary care physicians with limited specialty involvement. For almost 60 percent of clients with conditions requiring home treatments on an ongoing basis, however, service gaps were identified. Other problems included the reluctance of some providers to accept Medicaid, and the inability of some clients to cooperate with medical examinations. Handle: RePEc:aph:ajpbhl:1990:80:9:1043-1048_8 Template-Type: ReDIF-Article 1.0 Title: Obstetrical pulmonary embolism mortality, United States, 1970-85 Journal: American Journal of Public Health Author-Name: Franks, A.L. Author-Name: Atrash, H.K. Author-Name: Lawson, H.W. Author-Name: Colberg, K.S. Year: 1990 Volume: 80 Issue: 6 Pages: 720-721 Abstract: To investigate pulmonary embolism as a cause of obstetrical death, vital records data from 1970 through 1985 were analyzed. Results showed that the number of obstetrical pulmonary embolism deaths per 100,000 live births declined by 50 percent for both Whites and Blacks. However, Black women maintained more than a 2.5-fold higher risk, and women over age 40 had a ten-fold higher risk of embolism mortality. Thus, although the risk of obstetrical pulmonary embolism death has declined, some subgroups of women remain at higher risk. Handle: RePEc:aph:ajpbhl:1990:80:6:720-721_4 Template-Type: ReDIF-Article 1.0 Title: Loss of maternally acquired measles antibodies in well-nourished infants and response to measles vaccination, Peru Journal: American Journal of Public Health Author-Name: Vaisberg, A. Author-Name: Alvarez, J.O. Author-Name: Hernandez, H. Author-Name: Guillen, D. Author-Name: Chu, P. Author-Name: Colarossi, A. Year: 1990 Volume: 80 Issue: 6 Pages: 736-738 Abstract: Clinical, anthropometric, and serological evaluations were conducted at birth and at 3, 6, 9, and 10 months (post measles vaccination) in 34 well-nourished Peruvian infants. Seroconversion rate after measles vaccination was 94 percent. The rate of antibody loss was a direct function of birth titer; at age 9 months, all children had identical mean titres regardless of their titer at birth. Differences in maternally acquired measles antibodies at birth were important only during the first six months of life. Handle: RePEc:aph:ajpbhl:1990:80:6:736-738_7 Template-Type: ReDIF-Article 1.0 Title: Lead in the modern workplace Journal: American Journal of Public Health Author-Name: Landrigan, P.J. Year: 1990 Volume: 80 Issue: 8 Pages: 907-908 Handle: RePEc:aph:ajpbhl:1990:80:8:907-908_2 Template-Type: ReDIF-Article 1.0 Title: Depressive mood, the single-parent home, and adolescent cigarette smoking Journal: American Journal of Public Health Author-Name: Covey, L.S. Author-Name: Tam, D. Year: 1990 Volume: 80 Issue: 11 Pages: 1330-1333 Abstract: The association between depressive mood and cigarette smoking among adolescents was examined within a multivariate model. Subjects were 205 eleventh graders (123 boys and 82 girls) enrolled in a Northeast metropolitan public high school for science-oriented students. Logistic regression analysis showed an independent relation of depressive mood, friends' smoking behavior, and living in a single-parent home with cigarette smoking. Depression scores correlated with the number of cigarettes smoked. These associations suggest that depressive mood and stress may contribute to the onset of smoking. Handle: RePEc:aph:ajpbhl:1990:80:11:1330-1333_6 Template-Type: ReDIF-Article 1.0 Title: Persistence of anti-HBs among health care personnel immunized with hepatitis B vaccine Journal: American Journal of Public Health Author-Name: Pasko, M.T. Author-Name: Beam Jr., T.R. Year: 1990 Volume: 80 Issue: 5 Pages: 590-593 Abstract: Health care personnel who received the hepatitis B vaccine (Heptavax-B(R), MSD) were followed for persistence of hepatitis B surface antibody (anti-HBs). Response occurred in 135/146 (92.5 percent) vaccinees. Loss of anti-HBs (<72 RIA units; 10 S/N) occurred in 35.9 percent during the 36-month surveillance. Stepwise discriminant analysis found age and magnitude of initial antibody level, but not weight-height index, to be predictive of antibody loss over the 36 months. Twenty-four of 27 employees (88.9 percent) who lost anti-HBs responded to a fourth vaccine dose. In contrast, three of eight initial non-responders (37.5 percent) developed antibody after a fourth vaccine dose. Handle: RePEc:aph:ajpbhl:1990:80:5:590-593_4 Template-Type: ReDIF-Article 1.0 Title: Potential exposure and health risks of infants following indoor residential pesticide applications Journal: American Journal of Public Health Author-Name: Fenske, R.A. Author-Name: Black, K.G. Author-Name: Elkner, K.P. Author-Name: Lee, C.-L. Author-Name: Methner, M.M. Author-Name: Soto, R. Year: 1990 Volume: 80 Issue: 6 Pages: 689-693 Abstract: Air and surface chlorpyrifos residues were measured for 24 hours following a 0.5 percent Dursban® broadcast application for fleas inside a residence. Two of the three treated rooms were ventilated following application. Maximum air concentrations were measured 3-7 hours post-application. Peak concentrations in the infant breathing zone were 94 μg/m3 in the nonventilated room and 61 μg/m3 in the ventilated room, and were substantially higher than concentrations in the sitting adult breathing zone. Concentrations of approximately 30 μg/m3 were detected in the infant breathing zone 24 hours post-application. Surface residues available through wipe sampling were 0.7-1.6 μg/cm2 of carpet on the day of application and 0.3-0.5 μg/cm2 24 hours post-application. Estimated total absorbed doses for infants were 0.08-0.16 mg/kg on the day of application and 0.04-0.06 mg/kg the day following application, with dermal absorption representing approximately 68 percent of the totals. These doses are 1.2-5.2 times the human No Observable Effect Level (NOEL). Exposures to cholinesterase inhibiting compounds following properly conducted broadcast applications could result in doses at or above the threshold of toxicological response in infants, and should be minimized through appropriate regulatory policy and public education. Handle: RePEc:aph:ajpbhl:1990:80:6:689-693_9 Template-Type: ReDIF-Article 1.0 Title: A population-based descriptive study of housefire deaths in North Carolina Journal: American Journal of Public Health Author-Name: Patetta, M.J. Author-Name: Cole, T.B. Year: 1990 Volume: 80 Issue: 9 Pages: 1116-1117 Abstract: We report a population-based study of housefire deaths in North Carolina in 1985 using data obtained from fire investigators and the North Carolina medical examiner system. The crude death rate was 3.2 per 100,000 population; age-specific death rates were highest for ages 75-84 years. Death rates for Whites were one-third as high as death rates for other races. Of those decedents tested for alcohol, 56 percent had blood alcohol levels ≥ 22 mmol/L. Most fatal fires were caused by heating units or cigarettes. Handle: RePEc:aph:ajpbhl:1990:80:9:1116-1117_3 Template-Type: ReDIF-Article 1.0 Title: A multifocal outbreak of hepatitis A traced to commercially distributed lettuce Journal: American Journal of Public Health Author-Name: Rosenblum, L.S. Author-Name: Mirkin, I.R. Author-Name: Allen, D.T. Author-Name: Safford, S. Author-Name: Hadler, S.C. Year: 1990 Volume: 80 Issue: 9 Pages: 1075-1079 Abstract: From February 1 through March 20, 1988, 202 cases of hepatitis A were reported in and around Jefferson County, Kentucky. The epidemic curve indicated a common-source exposure. However, there was no apparent single source of exposure from a restaurant, or community gathering; nor was there a geographic clustering by residence. Cases were mainly adults 20-59 years old (89 percent); 51 percent were female. A case-control study using neighborhood controls found that factors associated with hepatitis A were: having eaten downtown (odds ratios [OR] = 4.0) and having dined at any one of three restaurants (OR = 21.0). Case-control studies of patrons of two of these restaurants found that eating green salad was strongly associated with acquiring hepatitis A: OR = 11.6 and OR = 4.4. The three implicated restaurants accounted for 71 percent of the cases. All three restaurants were supplied by the same fresh produce distributor; however, investigation suggested that contamination most likely occurred prior to local distribution. This outbreak of hepatitis A is the first in the United States apparently associated with fresh produce contaminated before distribution to restaurants, and raises important public health issues regarding the regulation of fresh produce. Handle: RePEc:aph:ajpbhl:1990:80:9:1075-1079_1 Template-Type: ReDIF-Article 1.0 Title: Seroconversion to human immunodeficiency virus in prison inmates Journal: American Journal of Public Health Author-Name: Horsburgh Jr., C.R. Author-Name: Jarvis, J.Q. Author-Name: McArthur, T. Author-Name: Ignacio, T. Author-Name: Stock, P. Year: 1990 Volume: 80 Issue: 2 Pages: 209-210 Abstract: We evaluated the prevalence and incidence of human immunodeficiency virus (HIV) infection in 3,837 inmates of a state prison system. Ninety-two (2.4 percent) were HIV-seropositive. The highest proportion of HIV-seropositive inmates was found among Blacks (5.4 percent), females, and those 30 years of age or older. HIV-seropositivity of entering inmates was also 2.4 percent and was unchanged over the three years of the study. Seroconversion occurred in two inmates while in prison, a rate of one conversion per 604 person-years, but HIV infection could have occurred before entry. Seroconversion to HIV was rare in inmates in this correctional facility. Handle: RePEc:aph:ajpbhl:1990:80:2:209-210_8 Template-Type: ReDIF-Article 1.0 Title: Epidemiologic assessment of screening tests for antibody to human T lymphotropic virus type I (HTLV-I) Journal: American Journal of Public Health Author-Name: Khabbaz, R.F. Author-Name: Hartley, T.M. Author-Name: Lairmore, M.D. Author-Name: Kaplan, J.E. Year: 1990 Volume: 80 Issue: 2 Pages: 190-192 Abstract: We tested 196 sera from a human T lymphotropic virus type I (HTLV-I) risk group (prostitute women) with two commercial 'research' enzyme-linked immunoabsorbent assays (EIA) for HTLV-I antibodies. All tested sera were characterized by HTLV-I Wester immunoblots and by HTLV-I radioimmunoprecipitation assays. The estimated sensitivities of the EIA tests were 93.8 percent and 100 percent, and the specificities were 98.8 percent and 95.8 percent, respectively, using recommended criteria for seropositivity (requiring reactivity to both gag p24 and env gp46 or gp61/68). Calculated negative predictive values remained excellent (>99.9 percent and 100 percent, respectively) at lower seroprevalence rates but the positive predictive values were only 7.3 percent and 2.3 percent when calculated for a seroprevalence rate of 0.1 percent. These results emphasize the importance and need for additional HTLV-I supplementary serologic testing when screening populations with low HTLV-I seroprevalence rates. Handle: RePEc:aph:ajpbhl:1990:80:2:190-192_6 Template-Type: ReDIF-Article 1.0 Title: Comment on occupational heavy metals absorption (I: Reply) Journal: American Journal of Public Health Author-Name: Baser, E.M. Year: 1990 Volume: 80 Issue: 8 Pages: 1003 Handle: RePEc:aph:ajpbhl:1990:80:8:1003_9 Template-Type: ReDIF-Article 1.0 Title: On quality of ambulatory care (I) Journal: American Journal of Public Health Author-Name: Ashley, J.T. Year: 1990 Volume: 80 Issue: 9 Pages: 1136 Handle: RePEc:aph:ajpbhl:1990:80:9:1136_0 Template-Type: ReDIF-Article 1.0 Title: The South Florida perinatal network Journal: American Journal of Public Health Author-Name: Lesser, M. Author-Name: McGovern, P. Year: 1990 Volume: 80 Issue: 6 Pages: 744-745 Handle: RePEc:aph:ajpbhl:1990:80:6:744-745_1 Template-Type: ReDIF-Article 1.0 Title: Decline in NHSC physicians threatens patient care Journal: American Journal of Public Health Author-Name: Brown, J. Author-Name: Stone, V. Author-Name: Sidel, V.W. Year: 1990 Volume: 80 Issue: 11 Pages: 1395-1396 Handle: RePEc:aph:ajpbhl:1990:80:11:1395-1396_5 Template-Type: ReDIF-Article 1.0 Title: Hypertension prevalence and the status of awareness, treatment, and control in the hispanic health and nutrition examination survey (HHANES), 1982-84 Journal: American Journal of Public Health Author-Name: Pappas, G. Author-Name: Gergen, P.J. Author-Name: Carroll, M. Year: 1990 Volume: 80 Issue: 12 Pages: 1431-1436 Abstract: The prevalence rates of hypertension among adult (ages 18-74) Mexican Americans, Cuban Americans, and Puerto Ricans were estimated using data from the 1982-84 Hispanic Health and Nutrition Examination Survey (HHANES). Hypertension is defined as diastolic greater than or equal to 90 mm Hg, or systolic greater than or equal to 140 mm Hg, or currently taking antihypertensive medication. Among Mexican Americans in the Southwestern United States, 16.8 percent of the males and 14.1 percent of the females were found to be hypertensive. Among Cuban Americans in Dade County, Florida 22.8 percent of the males and 15.5 percent of the females were hypertensive. Among Puerto Ricans in the New York City area 15.6 percent of the males and 11.5 percent of the females were hypertensive. The age-adjusted rates are significantly lower than comparable rates for Whites and Blacks as measured in the second National Health and Nutrition Examination Survey (NHANES II), 1976-80. Control of hypertension in the HHANES populations fall short of the 1990 Objectives for the Nation established by the US Public Health Service 60 percent (34 percent controlled Mexican American hypertensives, 27.8 percent controlled Cuban American hypertensives, and 29 percent controlled Puerto Rican hypertensives). Handle: RePEc:aph:ajpbhl:1990:80:12:1431-1436_8 Template-Type: ReDIF-Article 1.0 Title: HIV seroprevalence among male IVDUs in Houston, Texas Journal: American Journal of Public Health Author-Name: Williams, M.L. Year: 1990 Volume: 80 Issue: 12 Pages: 1507-1509 Abstract: HIV seroprevalence was 8.4 percent in a sample of 921 heterosexual male intravenous drug users in Houston, Texas who were not in drug treatment at the time of the study. Males who were Black, injected drugs daily, or had a history of syphilis had greater odds of being HIV positive than participants without those characteristics. Handle: RePEc:aph:ajpbhl:1990:80:12:1507-1509_8 Template-Type: ReDIF-Article 1.0 Title: A comparison of alcohol sales data with survey data on self-reported alcohol use in 21 states Journal: American Journal of Public Health Author-Name: Smith, P.F. Author-Name: Remington, P.L. Author-Name: Williamson, D.F. Author-Name: Anda, R.F. Year: 1990 Volume: 80 Issue: 3 Pages: 309-312 Abstract: We used data from 21 states that participated in the 1985 Behavioral Risk Factor Surveillance System to compare state-specific per capita self-reported alcohol consumption and the prevalence of three drinking behaviors with state-specific per capita sales. The correlation coefficient for per capita sales and per capita self-reported consumption for the 21 states was 0.81. Per capita sales were also significantly correlated with the prevalence of self-reported heavier drinking, binge drinking, and drinking and driving; the corresponding correlation coefficients were 0.74, 0.59, and 0.51. These findings suggest that states with higher per capita sales of alcohol also have higher rates of self-reported consumption and drinking patterns suggestive of high-risk behavior. Handle: RePEc:aph:ajpbhl:1990:80:3:309-312_9 Template-Type: ReDIF-Article 1.0 Title: Prior cesarean delivery in women with secondary tubal infertility Journal: American Journal of Public Health Author-Name: Wolf, M.E. Author-Name: Daling, J.R. Author-Name: Voigt, L.F. Year: 1990 Volume: 80 Issue: 11 Pages: 1382-1383 Abstract: The history of cesarean delivery was evaluated in a population-based case-control study of secondary infertility in King County, Washington. Sixty-one married women diagnosed with secondary infertility due to tubal problems who had a previous viable pregnancy were compared to 343 married women who had a previous viable pregnancy and then had a live birth that was conceived at the same time the infertile women began trying to conceive. The risk of tubal infertility was not substantially elevated in women who had a previous cesarean delivery in the most recent viable prenancy compared to women with vaginal delivery (odds ratio = 1.2; 95% confidence interval = 0.4, 3.7). Handle: RePEc:aph:ajpbhl:1990:80:11:1382-1383_1 Template-Type: ReDIF-Article 1.0 Title: Trends in hospitalized discharge rates for head injury in Maryland, 1979-86 Journal: American Journal of Public Health Author-Name: MacKenzie, E.J. Author-Name: Edelstein, S.L. Author-Name: Flynn, J.P. Year: 1990 Volume: 80 Issue: 2 Pages: 217-219 Abstract: Hospital discharge data from all acute care hospitals in Maryland were used to examine trends in hospitalized head injury incidence and outcome by severity. From 1979 to 1986, discharge rates increased by 3.4/100,000 per year; the largest percent increase was for more severe injuries. Discharge rates increased the most for adults ages 15-24 and ages 75+ but declined for children ages 0-4. Coinciding with the increase in head injury discharges was a decrease in the hospital case-fatality rate across all severity groups. Handle: RePEc:aph:ajpbhl:1990:80:2:217-219_2 Template-Type: ReDIF-Article 1.0 Title: Use of OSHA inspections data for fatal occupational injury surveillance in New Jersey Journal: American Journal of Public Health Author-Name: Stanbury, M. Author-Name: Goldoft, M. Year: 1990 Volume: 80 Issue: 2 Pages: 200-202 Abstract: Occupational Safety and Health Administration (OSHA) computerized inspections data, death certificates, and medical examiner records identified 204 fatal occupational injuries in New Jersey, 1984-85. OSHA computerized data uniquely identified seven cases. They did not identify 35 fatalities under OSHA's jurisdiction, of which 24 were investigated by OSHA but not recorded, four were not considered work-related, and seven were not known to OSHA. Eighty-seven were outside OSHA's jurisdiction; 28 were among the self-employed who are not under the health and safety protection of any governmental agency. Handle: RePEc:aph:ajpbhl:1990:80:2:200-202_6 Template-Type: ReDIF-Article 1.0 Title: Risk behavior change in gay men (I) Journal: American Journal of Public Health Author-Name: Kelly, J.A. Author-Name: St. Lawrence, J.S. Year: 1990 Volume: 80 Issue: 3 Pages: 351 Handle: RePEc:aph:ajpbhl:1990:80:3:351_3 Template-Type: ReDIF-Article 1.0 Title: An analysis of occupational risks for brain cancer Journal: American Journal of Public Health Author-Name: Brownson, R.C. Author-Name: Reif, J.S. Author-Name: Chang, J.C. Author-Name: Davis, J.R. Year: 1990 Volume: 80 Issue: 2 Pages: 169-172 Abstract: We evaluated the risks of brain cancer in relation to employment history in a case-control study of 312 cases and 1,248 cancer controls. Subjects were identified through the Missouri Cancer Registry for the period 1984 through 1988. Job classification was based on data routinely abstracted from hospital records. Elevated risks were identified for certain white collar occupations: for men employed in engineering, the odds ratio (OR) = 2.1; 95% confidence interval (CI) = 0.4, 10.3; for social science professionals, the OR = 6.1; 95% CI = 1.5, 26.1. Among occupations with potential exposure to occupational carcinogens, increased risks were observed for men employed in agricultural crop production (OR = 1.5; 95% CI = 1.0, 2.4), printing and publishing (OR = 2.8; 95% CI = 1.0, 8.3), and brickmasons and tilesetters (OR = 2.5; 95% CI = 0.5, 11.5). Most of elevated brain cancer risks were due to astrocytic cancers, but the excess among agricultural workers occurred in other cell types. No increase in risk was noted for current cigarette smokers (OR = 0.9; 95% CI = 0.7, 1.5) or ex-smokers (OR = 1.0; 95% CI = 0.7, 1.5). This exploratory study indicates a need for further studies of occupational risks of brain cancer. Handle: RePEc:aph:ajpbhl:1990:80:2:169-172_9 Template-Type: ReDIF-Article 1.0 Title: Depression, worry, and the incidence of cancer Journal: American Journal of Public Health Author-Name: Friedman, G.D. Year: 1990 Volume: 80 Issue: 11 Pages: 1396-1397 Handle: RePEc:aph:ajpbhl:1990:80:11:1396-1397_4 Template-Type: ReDIF-Article 1.0 Title: The new claass of abortifacients (Reply) Journal: American Journal of Public Health Author-Name: Wattleton, F. Year: 1990 Volume: 80 Issue: 11 Pages: 1394 Handle: RePEc:aph:ajpbhl:1990:80:11:1394_4 Template-Type: ReDIF-Article 1.0 Title: Tailored safety training for miners in small Pennsylvania surface coal mines Journal: American Journal of Public Health Author-Name: Passmore, D. Author-Name: Bennett, J. Author-Name: Radomsky, M. Author-Name: Saperstein, L. Year: 1990 Volume: 80 Issue: 9 Pages: 1134-1135 Handle: RePEc:aph:ajpbhl:1990:80:9:1134-1135_4 Template-Type: ReDIF-Article 1.0 Title: Precision and accuracy of a portable blood analyzer system during cholesterol screening Journal: American Journal of Public Health Author-Name: Greenland, P. Author-Name: Bowley, N.L. Author-Name: French, C.A. Author-Name: Meiklejohn, B. Author-Name: Gagliano, S. Author-Name: Sparks, C.E. Year: 1990 Volume: 80 Issue: 2 Pages: 181-184 Abstract: The precision and accuracy of two Kodak Ektachem DT-60 portable blood analyzers were assessed in a model (research) cholesterol screening program in Rochester, New York. Between June and October 1987, a total of 8,573 people underwent a cholesterol screening held in a movable trailer. A wide variety of temperature, humidity, and other potentially adverse conditions were encountered during the screening period. Between-run coefficients of variation ranged from 1.9 percent to 4.8 percent per month; average bias compared to a Reference Laboratory method ranged between +0.2 percent and +2.0 percent. Both precision and accuracy met currently recommended standards for cholesterol testing in the United States. Handle: RePEc:aph:ajpbhl:1990:80:2:181-184_3 Template-Type: ReDIF-Article 1.0 Title: I. Hispanic health and nutrition examination survey: Methodological considerations Journal: American Journal of Public Health Author-Name: Delgado, J.L. Author-Name: Johnson, C.L. Author-Name: Roy, I. Author-Name: Trevino, F.M. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 6-10 Abstract: The Hispanic Health and Nutrition Examination Survey (HHANES) was the first special population survey undertaken by the National Center for Health Statistics. The HHANES was designed to assess the health and nutritional status and needs of Mexican Americans, mainland Puerto Ricans and Cuban Americans. Data were collected using five data collection techniques: direct physical examinations, diagnostic testing, anthropometry, laboratory analyses, and interviews. Unlike other surveys conducted by the National Center for Health Statistics, the HHANES was not designed as a national survey. The HHANES was a survey of three Hispanic subgroups of the population in selected areas of the United States with a survey universe that included approximately 76 percent of the 1980 Hispanic-origin population in the United States. This article discusses statistical issues that should be addressed by researchers when analyzing HHANES data. Specifically, analysts need to account for the complex sample design, nonresponse bias, potential non-coverage bias, and the regional nature of the HHANES sample. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:6-10_7 Template-Type: ReDIF-Article 1.0 Title: Health and environmental outcomes of traditional and modified practices for abatement of residential lead-based paint Journal: American Journal of Public Health Author-Name: Farfel, M.R. Author-Name: Chisolm Jr., J.J. Year: 1990 Volume: 80 Issue: 10 Pages: 1240-1245 Abstract: We evaluated traditional and modified practices for abating lead-based paint in homes of children with blood-lead concentrations (PbB) > 1.4 μmol/L (> 29 μg/dl). Traditional abatement resulted in acute increases in: 1) lead contaminated house dust (generally 3 to 6-fold over pre-abatement levels, but at abated sites typically 10 to 100-fold); and 2) the PbBs of nearly half of the occupant children. Modified practices represented modest short-term improvement compared to traditional practices but were also inadequate. By six months, it was clear that neither form of abatement resulted in long-term reductions of PbB or house dust lead levels, leaving children at continued risk of excessive exposure to lead and permanent adverse neurobehavioral effects. Windows were found to be high sources of lead contaminated house dust. Recommendations are made for improved abatement practices including more complete abatement of window units and more effective clean-up to remove lead-bearing dust. Thirteen million US children live in lead-painted dwellings. Research is needed to identify abatement strategies that will be practical and well suited to the current understanding of low-level lead toxicity. Handle: RePEc:aph:ajpbhl:1990:80:10:1240-1245_9 Template-Type: ReDIF-Article 1.0 Title: A survey of state medicaid policies for coverage of abortion and prenatal diagnostic procedures Journal: American Journal of Public Health Author-Name: Weiner, J. Author-Name: Bernhardt, B.A. Year: 1990 Volume: 80 Issue: 6 Pages: 717-720 Abstract: In the summer of 1988, we surveyed all states to evaluate access to Medicaid funding for abortion after the diagnosis of an anomalous fetus. All state Medicaid programs covered amniocentesis, and most had expanded coverage to include newer prenatal diagnostic procedures for eligible women. In 29 states, however, abortion coverage was limited to instances when continuation of abortion threatens the life of the mother. Only 13 states paid for a woman on Medicaid to obtain an abortion after diagnosis of an anomalous fetus. Handle: RePEc:aph:ajpbhl:1990:80:6:717-720_2 Template-Type: ReDIF-Article 1.0 Title: The economic impact of injuries: A major source of medical costs Journal: American Journal of Public Health Author-Name: Harlan, L.C. Author-Name: Harlan, W.R. Author-Name: Parsons, P.E. Year: 1990 Volume: 80 Issue: 4 Pages: 453-459 Abstract: Data from the 1980 National Medical Care Utilization and Expenditure Survey were analyzed to place the costs for injuries in the context of all medical costs and to describe the distribution by demographic and diagnostic groups. For the non-institutionalized population, injuries, which include intentional and unintentional, were the second leading cause of direct medical costs, accounting for $16,745 million in medical care expenditures and a major contributor to work loss and disability in the US. For the working-age population (17-64 years) injuries were the leading cost category ($11,341 million) and the third most costly category for persons 65 years of age and over ($3,479 million). The preponderance of costs were attributable to hospital-based care. Direct medical costs were disproportionately greater for males, White and other persons and for those with household incomes less than $5,000. Injury morbidity also accounts for major indirect costs. Fractures accounted for the highest direct medical costs, greatest per capita charges (based on those with charges), and largest number of restricted activity days. These national estimates document the economic importance of injuries and direct public attention to policy imperatives related to research and prevention. Handle: RePEc:aph:ajpbhl:1990:80:4:453-459_1 Template-Type: ReDIF-Article 1.0 Title: Spanish version of the Nottingham Health Profile: Translation and preliminary validity Journal: American Journal of Public Health Author-Name: Alonso, J. Author-Name: Anto, J.M. Author-Name: Moreno, C. Year: 1990 Volume: 80 Issue: 6 Pages: 704-708 Abstract: We report the transfer into Spanish of a multidimensional measure of perceived health originally developed in Great Britain, the Nottingham Health Profile (NHP), and an assessment of the preliminary validity of the version is presented. Translation of the questionnaire was obtained from experts and from a Spanish monolingual lay group. Construct validity of the version was assessed in two studies: testing relationship of NHP scores to other self-reported measures of health in a general population survey; and comparing NHP scores for a group of frequent users and for a group of non-users of primary health services. Mean scores of NHP dimensions were higher for people with poorer self-reported health and higher for the frequent health services users than for the non-users. Findings suggest that the Spanish version of the NHP is culturally equivalent to the original questionnaire, and has a similar level of construct validity. Nevertheless, further research on reliability and on the weighting system is required to establish the equivalence of the Spanish version definitively. Handle: RePEc:aph:ajpbhl:1990:80:6:704-708_4 Template-Type: ReDIF-Article 1.0 Title: Quality assurance and computer-based patient records Journal: American Journal of Public Health Author-Name: Barnett, G.O. Author-Name: Winickoff, R.N. Year: 1990 Volume: 80 Issue: 5 Pages: 527-528 Handle: RePEc:aph:ajpbhl:1990:80:5:527-528_9 Template-Type: ReDIF-Article 1.0 Title: Increasing hospital staff compliance with influenza immunization recommendations Journal: American Journal of Public Health Author-Name: Girasek, D.C. Year: 1990 Volume: 80 Issue: 10 Pages: 1272-1273 Handle: RePEc:aph:ajpbhl:1990:80:10:1272-1273_6 Template-Type: ReDIF-Article 1.0 Title: IX. Acculturation and marijuana and cocaine use: Findings from HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Amaro, H. Author-Name: Whitaker, R. Author-Name: Coffman, G. Author-Name: Heeren, T. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 54-60 Abstract: We examined the relation between acculturation and illicit drug use among Hispanics in the United States employing data from the 1982-84 Hispanic Health and Nutrition Evaluation Survey (HHANES). Across all Hispanic groups, acculturation into US society, as reflected in English language use, was associated with higher rates of illicit drug use even after sociodemographic variables such as gender, age, income, and education were considered. Significant interactions between language and education indicated that the predominant use of English was more strongly associated with marijuana and cocaine use among Mexican Americans and Puerto Ricans of lower educational attainment than among those of higher educational attainment. Significant interactions between language use and other factors such as sex, marital status, and place of birth were also associated with marijuana and cocaine use. These results suggest that the experience of acculturation, especially as it relates to drug use, is closely tied to the social and economic context in which an individual lives. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:54-60_2 Template-Type: ReDIF-Article 1.0 Title: Patient, provider and hospital characteristics associated with inappropriate hospitalization Journal: American Journal of Public Health Author-Name: Siu, A.L. Author-Name: Manning, W.G. Author-Name: Benjamin, B. Year: 1990 Volume: 80 Issue: 10 Pages: 1253-1256 Abstract: To determine the relation between patient and provider characteristics and inappropriate hospital use, we examined adult nonpregnancy hospitalizations from a randomized trial of health insurance conducted in six sites in the United States. Appropriateness of inpatient treatment was based on medical record review; patient characteristics on sociodemographic, economic, and health status; and provider characteristics on descriptors of physician practice and hospital facilities. Twenty-seven percent of admissions attended by physicians licensed for more than 15 years were judged inappropriate, compared to 20 percent for younger physicians. Admissions were more likely to be inappropriate if the patient was female (27 percent compared with 18 percent). Controlling for patient and provider characteristics reduces but does not eliminate the differences in the appropriateness of inpatient care across the study's six sites. Differences in available provider and patient characteristics do not account for geographic differences in inappropriate hospitalization in this study. Handle: RePEc:aph:ajpbhl:1990:80:10:1253-1256_1 Template-Type: ReDIF-Article 1.0 Title: Ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus in New York Health Care Facilities, 1988 Journal: American Journal of Public Health Author-Name: Budnick, L.D. Author-Name: Schaefler, S. Year: 1990 Volume: 80 Issue: 7 Pages: 810-813 Abstract: The emergence in 1988 of ciprofloxacin-resistant methicillin-resistant Staphylococcus aureus (MRSA) in New York City was studied in nine hospitals and eight nursing homes. Of the 43 hospitalized patients studied, 21 were admitted from home, while nine of the 12 nursing home patients were transferred form a hospital. Twenty-four of the 55 patients had been treated previously with ciprofloxacin, and 26 had an identifiable risk factor for a nosocomial infection. MRSA was a contributing factor in at least five of the 21 deaths. MRSA resistance to ciprofloxacin was detected within three months of the drug's commercial availability, apparently emerged independently at a number of the health care facilities, and has become widespread. If such resistance is found in a health care facility, ciprofloxacin may not be useful as a first line antibiotic. Handle: RePEc:aph:ajpbhl:1990:80:7:810-813_4 Template-Type: ReDIF-Article 1.0 Title: End state renal disease among Native Americans, 1983-1986 Journal: American Journal of Public Health Author-Name: Newman, J.M. Author-Name: Marfin, A.A. Author-Name: Eggers, P.W. Author-Name: Helgerson, S.D. Year: 1990 Volume: 80 Issue: 3 Pages: 318-319 Abstract: We used data reported to Medicare from 1983 through 1986 to determine the incidence of end-stage renal disease (ESRD) among Native Americans and Whites in the United States. The 1,075 Native American cases represented an annual incidence, age-adjusted to the White population, of 269 per million, 2.8 times the rate for Whites. Fifty-six percent of Native American cases and 27 percent of the White cases were attributed to diabetes, indicating that ESRD is a major problem. Diabetes control provides the greatest opportunity for prevention. Handle: RePEc:aph:ajpbhl:1990:80:3:318-319_8 Template-Type: ReDIF-Article 1.0 Title: Does 4 equal 2? Decisions based on radon measurements Journal: American Journal of Public Health Author-Name: Harley, N.H. Year: 1990 Volume: 80 Issue: 8 Pages: 905-906 Handle: RePEc:aph:ajpbhl:1990:80:8:905-906_4 Template-Type: ReDIF-Article 1.0 Title: Use of medical care for chest pain: Differences between Blacks and Whites Journal: American Journal of Public Health Author-Name: Strogatz, D.S. Year: 1990 Volume: 80 Issue: 3 Pages: 290-294 Abstract: Data from a 1980, community-based survey of adult residents of Edgecombe County, North Carolina were analyzed to examine differences between Blacks and Whites in the reported use of medical care after experiencing chest pain. Of all adults (N=302) with chest pain in the year prior to interview, 49 percent of Blacks and 27 percent of Whites did not see a physician following the chest pain (difference = 22%, 95% CI = 12, 33). A multivariable analysis found that although the association between race and utilization was reduced at poverty levels of income, it was not explained by differences in demographic characteristics, health status or other dimensions of access to care. Handle: RePEc:aph:ajpbhl:1990:80:3:290-294_8 Template-Type: ReDIF-Article 1.0 Title: Jails and prisons: The new asylums? Journal: American Journal of Public Health Author-Name: Shenson, D. Author-Name: Dubler, N. Author-Name: Michaels, D. Year: 1990 Volume: 80 Issue: 6 Pages: 655-656 Handle: RePEc:aph:ajpbhl:1990:80:6:655-656_4 Template-Type: ReDIF-Article 1.0 Title: AIDS as a cause of death in children, adolescents, and young adults Journal: American Journal of Public Health Author-Name: Kilbourne, B.W. Author-Name: Buehler, J.W. Author-Name: Rogers, M.F. Year: 1990 Volume: 80 Issue: 4 Pages: 499-500 Handle: RePEc:aph:ajpbhl:1990:80:4:499-500_5 Template-Type: ReDIF-Article 1.0 Title: Foreword Journal: American Journal of Public Health Author-Name: Delgado, J.L. Author-Name: Murphy, R.S. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 4 Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:4_5 Template-Type: ReDIF-Article 1.0 Title: A personal monitoring study to assess workplace exposure to environmental tobacco smoke Journal: American Journal of Public Health Author-Name: Coultas, D.B. Author-Name: Samet, J.M. Author-Name: McCarthy, J.F. Author-Name: Spengler, J.D. Year: 1990 Volume: 80 Issue: 8 Pages: 988-990 Abstract: We enrolled 15 nonsmoking volunteers to evaluate the feasibility of measuring personal exposure to environmental tobacco smoke (ETS) at work and to characterize workplace exposures. During one workshift, we obtained questionnaires on exposure, saliva and urine for cotinine, and personal air samples for respirable particles and nicotine. The levels of cotinine, respirable particles, and nicotine varied widely with self-reports of exposure to ETS, but on average increased with increasing exposure. Handle: RePEc:aph:ajpbhl:1990:80:8:988-990_2 Template-Type: ReDIF-Article 1.0 Title: Association of hepatitis B surface antigen and core antibody with acquisition and manifestations of human immunodeficiency virus type 1 (HIV-1) infection Journal: American Journal of Public Health Author-Name: Solomon, R.E. Author-Name: VanRaden, M. Author-Name: Kaslow, R.A. Author-Name: Lyter, D. Author-Name: Visscher, B. Author-Name: Farzadegan, H. Author-Name: Phair, J. Year: 1990 Volume: 80 Issue: 12 Pages: 1475-1478 Abstract: We examined the associations between seropositivity for hepatitis B virus (HBV) with the presence or development of antibodies to human immunodeficiency virus (HIV-1) and with HIV-1 induced T-helper lymphocyte deficiency or acquired immunodeficiency syndrome (AIDS). Serologic data on HBV and HIV-1, cytometric enumeration of CD4+ lymphocytes, clinical events (AIDS by Centers for Disease Control criteria) and hepatitis B vaccination histories were available on 4,498 homosexual participants in the Multicenter AIDS Cohort Study. Men were classified as to previous infection with HBV and prevalent or incident infection with HIV-1. Although there was an association between seropositivity for HBV infection and HIV-1 infection at enrollment (odds ratios anti-HB(c) 2.6; HB(s)Ag 4.2), the relation between HBV seropositivity and subsequent seroconversion to HIV-1 was weaker (odds ratios 1.3 and 1.6). HIV-1 seroconversion was also associated with a history of certain other sexually transmitted diseases, but predisposing sexual practices did not account for the association between HBV and HIV-1 infection. Seropositivity for HBV infection at entry was not related to initially low or more rapid subsequent decline in T-helper lymphocyte counts and was not associated with an increased incidence of AIDS during 2.5 years of follow-up. History of vaccination against HBV did not appear to decrease susceptibility to HIV-1 infection or to subsequent progression of immunodeficiency. We conclude that prior HBV infection is unlikely to be specifically associated with acquisition of HIV-1 infection and is unrelated to more rapid progression of HIV-1-induced immunodeficiency. Handle: RePEc:aph:ajpbhl:1990:80:12:1475-1478_7 Template-Type: ReDIF-Article 1.0 Title: HIV prevention: The need for methods women can use Journal: American Journal of Public Health Author-Name: Stein, Z.A. Year: 1990 Volume: 80 Issue: 4 Pages: 460-462 Abstract: Efforts to prevent heterosexual transmission of HIV (human immunodeficiency virus) infection have thus far focused on modifying sexual behaviors and the use of condoms. While the experience of family planners, particularly in those countries most threatened by heterosexual HIV transmission, has shown that the most effective measures of pregnancy prevention have relied on women, little attention has been given to barriers to HIV transmission that depend on the woman and are under her control. Tactics which interrupt transmission of the virus should be considered in their own right and separated from those that interrupt pregnancy, for insurance, the diaphragm. Greater emphasis is urged for research on preventive methods women could use, including the possibility of a topical virucide that might block transmission through the vaginal route. Handle: RePEc:aph:ajpbhl:1990:80:4:460-462_4 Template-Type: ReDIF-Article 1.0 Title: Potential for laboratory exposures to biohazardous agents found in blood Journal: American Journal of Public Health Author-Name: Evans, M.R. Author-Name: Henderson, D.K. Author-Name: Bennett, J.E. Year: 1990 Volume: 80 Issue: 4 Pages: 423-427 Abstract: The magnitude of risk for occupational exposures to biohazardous agents found in blood was assessed by 800 environmental samples taken from a total of 10 clinical and research laboratories at the National Institutes of Health (NIH). Thirty-one samples from 11 work stations in three laboratories contained hepatitis B virus surface antigen (HBsAg). Observations of workers indicated that environmental contamination arose from several sources. Among the 11 work stations with HBsAg environmental samples, eight had high work loads, seven had inappropriate behaviors, and nine had flawed laboratory techniques. This information suggests that a multifactorial approach is needed to minimize the risk of laboratory-associated infections. Handle: RePEc:aph:ajpbhl:1990:80:4:423-427_9 Template-Type: ReDIF-Article 1.0 Title: Foreign-born and US-born Black women: Differences in health behaviors and birth outcomes Journal: American Journal of Public Health Author-Name: Cabral, H. Author-Name: Fried, L.E. Author-Name: Levenson, S. Author-Name: Amaro, H. Author-Name: Zuckerman, B. Year: 1990 Volume: 80 Issue: 1 Pages: 70-72 Abstract: We studied health behaviors and birth outcome among 201 foreign-born and 616 US-born Black women receiving prenatal care at Boston City Hospital. Foreign-born women had better pre-pregnancy nutritional status and prenatal health behaviors, and their infants had greater intrauterine growth. Black women are not a homogeneous group; culture and ethnicity, in addition to other variables, must be considered in the study of their birth outcomes. Handle: RePEc:aph:ajpbhl:1990:80:1:70-72_1 Template-Type: ReDIF-Article 1.0 Title: Improving influenza vaccination performance in an HMO setting: The use of computer-generated reminders and peer comparison feedback Journal: American Journal of Public Health Author-Name: Barton, M.B. Author-Name: Schoenbaum, S.C. Year: 1990 Volume: 80 Issue: 5 Pages: 534-536 Abstract: We evaluated a program for improving influenza immunization performance in a health maintenance organization (HMO). The HMO implemented several interventions successively from 1984-87: a postcard reminder to members at high risk for complications of influenza, a computer-generated reminder to the physician at the time of any primary care visit by high-risk patients, performance feedback to chiefs of service, and, finally, retrospective feedback to each physician comparing his/her performance with that of the other physicians. We examined immunization rates for a group of members older than age 65, a high-risk group under age 65, and a group of diabetic members who had not been subject to the reminders (vs a group who had been covered by the program). Vaccination rates were increased in those diabetic members who received reminders. Nevertheless, among members younger and older than age 65 whose experience was observed over three flu seasons, a significant increase in vaccination rates was not achieved until physician feedback was added to the program. We conclude that each element of the reminder and feedback program has contributed to the overall increase in vaccination rates at the HMO and that effective ongoing influenza immunization programs can be implemented in practice settings with appropriate systems support. Handle: RePEc:aph:ajpbhl:1990:80:5:534-536_2 Template-Type: ReDIF-Article 1.0 Title: Drinking water contamination and the incidence of leukemia: An ecologic study Journal: American Journal of Public Health Author-Name: Fagliano, J. Author-Name: Berry, M. Author-Name: Bove, F. Author-Name: Burke, T. Year: 1990 Volume: 80 Issue: 10 Pages: 1209-1212 Abstract: An ecologic study was performed to examine the relation between the incidence of leukemias and the occurrence of volatile organic chemical (VOC) contamination of drinking water supplies within a study area comprised of subpopulations differentially exposed to drinking water VOCs (trichloroethylene and related solvents). Populations served by community water supplies were classified into exposure categories according to VOC contamination status based on 1984-85 sampling data. Leukemia incidence data (1979-84) were collected from a population-based cancer registry. For females, the standardized incidence ratio was elevated only in towns in the highest of three exposure categories. No association was observed in males in any of the exposure categories. A Poisson regression analysis of the data, using finer exposure strata, indicated an increase in risk among females with increasing level of contamination which appeared to be distributed evenly across all age strata. The rate ratio for females at the highest exposure stratum for total non-THM VOCs compared to the least exposed stratum was 1.68. The observed association appears to suggest that drinking water contaminated with VOCs may increase the incidence of leukemia among exposed females, but caution is advised in the interpretation of these results because of the uncertainties inherent in ecologic studies. Handle: RePEc:aph:ajpbhl:1990:80:10:1209-1212_5 Template-Type: ReDIF-Article 1.0 Title: Paul Anthony Lembcke, MD, MPH: A pioneer in medical care evaluation Journal: American Journal of Public Health Author-Name: Silver, G.A. Year: 1990 Volume: 80 Issue: 3 Pages: 342-348 Handle: RePEc:aph:ajpbhl:1990:80:3:342-348_7 Template-Type: ReDIF-Article 1.0 Title: Suicide clusters: An examination of age-specific effects Journal: American Journal of Public Health Author-Name: Gould, M.S. Author-Name: Wallenstein, S. Author-Name: Kleinman, M.H. Author-Name: O'Carroll, P. Author-Name: Mercy, J. Year: 1990 Volume: 80 Issue: 2 Pages: 211-212 Abstract: The age specificity of time-space clusters of suicide was examined using National Center for Health Statistics data for 1978-84. Significant clustering of suicide occurred primarily among teenagers and young adults, with minimal effect beyond 24 years of age. Clustering was two to four times more common among adolescents and young adults than among other age groups. Handle: RePEc:aph:ajpbhl:1990:80:2:211-212_4 Template-Type: ReDIF-Article 1.0 Title: Males' use of public health department family planning services Journal: American Journal of Public Health Author-Name: Glasser, M. Year: 1990 Volume: 80 Issue: 5 Pages: 611-612 Abstract: Information was obtained from over 200 males visiting a family planning service either to obtain free-of-charge condoms or incidental to accompanying their female partner. The former group was younger and more likely to reside near the health department; over 40 percent of this group used the health department as sole condom source. Both groups indicated willingness to share in costs for male services. Future programs need to more effectively plan public health family planning for these males. Handle: RePEc:aph:ajpbhl:1990:80:5:611-612_3 Template-Type: ReDIF-Article 1.0 Title: Public health's promise for the future: 1989 Presidential address Journal: American Journal of Public Health Author-Name: Shannon, I.S. Year: 1990 Volume: 80 Issue: 8 Pages: 909-912 Abstract: Public health's promise for the future is inextricably related to efforts which maximize human potential and which realize the world's interdependence. Public health challenges are not only constant and complex but frequently surrounded by political activities. In this environment, the public health enterprise has been enhanced by the Institute of Medicine, National Academy of Sciences' report on The Future of Public Health and the assessment framework it provides. Risk reduction through preventive and health promotion activities is the primary focus of public health, but facilitation is often dependent upon society's understanding and willingness-to-pay for such services. The effectiveness of public health is related to an ability to coordinate public and private efforts at national, state, and local levels. Also in this environment, public health is empowered through its multidisciplinary approach. However, epidemiology provides a unifying framework for the collective public health effort. Based on the use of epidemiology, public health is empowered to make the argument for a national health program and to support the concept of health as a determinant of life options. Public health's promise for the future can be fulfilled by continuing to increase its scientific base for decision-making, by self-examination and correction, by advocating and promoting social justice and by promoting firm partnerships with the public. Handle: RePEc:aph:ajpbhl:1990:80:8:909-912_1 Template-Type: ReDIF-Article 1.0 Title: Who will manage the environment? Journal: American Journal of Public Health Author-Name: Gordon, L.J. Year: 1990 Volume: 80 Issue: 8 Pages: 904-905 Handle: RePEc:aph:ajpbhl:1990:80:8:904-905_8 Template-Type: ReDIF-Article 1.0 Title: Risk factors for syphilis: Cocaine use and prostitution Journal: American Journal of Public Health Author-Name: Rolfs, R.T. Author-Name: Goldberg, M. Author-Name: Sharrar, R.G. Year: 1990 Volume: 80 Issue: 7 Pages: 853-857 Abstract: In Philadelphia, a large increase in syphilis among minority group heterosexuals began in 1986 and preceded similar increases elsewhere in the United States. To determine reasons for this increase, we conducted a case-control study in the metropolitan sexually transmitted diseases clinic during 1987 and 1988. Cocaine use (odds ratio [OR] 3.1; 95% confidence interval [95% CI] = 1.5, 6.5 among men; OR 5.8; 95% CI = 1.5, 33 among women) and exchange of drugs for sex (OR 3.5; 95% CI = 1.4, 8.7 among men) were risk factors for syphilis. Although cocaine users reported more sexual partners and more frequently reported sex with prostitutes, cocaine use remained a risk factor after adjustment for these behaviors. These data suggest that sexual behavior or another factor, such as availability or utilization of health care, among cocaine users leads to increased risk of syphilis in this population. Increases in cocaine use may be partly responsible for recent increases in syphilis incidence in the United States. Handle: RePEc:aph:ajpbhl:1990:80:7:853-857_0 Template-Type: ReDIF-Article 1.0 Title: Crop duster aviation mechanics: High risk for pesticide poisoning Journal: American Journal of Public Health Author-Name: McConnell, R. Author-Name: Anton, A.F.P. Author-Name: Magnotti, R. Year: 1990 Volume: 80 Issue: 10 Pages: 1236-1239 Abstract: A cross-sectional medical survey was conducted among 63 Nicaraguan aviation mechanics exposed to organophosphate and other toxic pesticides. Thirty-one (49 percent) reported having been acutely poisoned on the job. Also, seven of 14 novice mechanics, with less than one year on the job, reported that they had been poisoned. Thirty-eight (61 percent) had cholinesterase levels below the lower limit of normal, including three workers with levels less than 20 percent of the lower limit of normal. Risk factors for low cholinesterase included recent hire and recent poisoning. Workers did not use protective equipment, nor were there facilities for bathing on site. As a result of this survey, the government has prohibited the mixing and loading of pesticides at this airport and requires the washing of planes prior to maintenance work; coveralls and thin, pesticide impermeable gloves are to be issued to mechanics handling pesticide-contaminated parts. Closed system mixing and loading systems have been installed at satellite airstrips. Handle: RePEc:aph:ajpbhl:1990:80:10:1236-1239_3 Template-Type: ReDIF-Article 1.0 Title: Soviet health care and perestroika Journal: American Journal of Public Health Author-Name: Schultz, D.S. Author-Name: Rafferty, M.P. Year: 1990 Volume: 80 Issue: 2 Pages: 193-197 Abstract: Health and health care in the Soviet Union are drawing special attention during these first years of perestroika, Mikhail Gorbachev's reform of Soviet political and economic life. This report briefly describes the current state of Soviet health and medical care, Gorbachev's plans for reform, and the prospects for success. In recent years the Soviet Union has experienced a rising infant mortality rate and declining life expectancy. The health care system has been increasingly criticized for its uncaring providers, low quality of care, and unequal access. The proposed measures will increase by 50 percent the state's contribution to health care financing, encourage private medicine on a small scale, and begin experimentation with capitation financing. It seems unlikely that the government will be able to finance its share of planned health improvements, or that private medicine, constrained by the government's tight control, will contribute much in the near term. Recovery of the Soviet economy is general as well as the ability of health care institutions to gain access to Western materials will largely determine the success of reform of the Soviet health care system. Handle: RePEc:aph:ajpbhl:1990:80:2:193-197_4 Template-Type: ReDIF-Article 1.0 Title: Elevated blood lead in California adults, 1987: Results of a statewide surveillance program based on laboratory reports Journal: American Journal of Public Health Author-Name: Maizlish, N. Author-Name: Rudolph, L. Author-Name: Sutton, P. Author-Name: Jones, J.R. Author-Name: Kizer, K.W. Year: 1990 Volume: 80 Issue: 8 Pages: 931-934 Abstract: California medical laboratories that test for blood lead are required to report results exceeding 1.21 μmol/L (25 μg/dl). Between April and December 1987, the California Department of Health Services received 3,077 blood lead reports from 34 laboratories for 1,293 civilian, non-institutionalized adults. Approximately 1 percent of all reports exceeded 3.87 μmol/L (80 μg/dl), 7 percent exceeded 2.42 μmol/L (50 μg/dl), and 21 percent exceeded 1.93 μmol/L (40 μg/dl). Individuals tested were overwhelmingly male (94 percent), disproportionately Hispanic surnamed (44 percent), and most often residents of Los Angeles County (81 percent). Workers in lead smelting, battery manufacturing, and brass foundries accounted for nearly 80 percent of reports. Construction, radiator repair, pottery and ceramics manufacturing, and gun firing ranges accounted for the remainder. All adults with reports of ≥2.90 μmol/L who were contacted reported an occupational exposure. Approximately half were not in routien medical monitoring programs. Despire OSHA standards, elevated blood lead with the potential for serious acute and chronic lead poisoning in California adults remains a significant public health and major occupational health concern. Handle: RePEc:aph:ajpbhl:1990:80:8:931-934_8 Template-Type: ReDIF-Article 1.0 Title: Medical and psychosocial factors predictive of psychotropic drug use in elderly patients Journal: American Journal of Public Health Author-Name: Ried, L.D. Author-Name: Christensen, D.B. Author-Name: Stergachis, A. Year: 1990 Volume: 80 Issue: 11 Pages: 1349-1353 Abstract: The purpose of this study was to investigate medical and psychosocial factors that may be used to identify patients at risk of psychotropic drug use. Population-based surveys were completed by 278 elderly health maintenance organization (HMO) patients in August 1984. Physical and mental health status and social support were measured in the survey. Automated prescription records from the year prior to and the year after the survey were linked to data from the survey. Patients received 737 prescriptions for psychotropic drugs during the two-year period under study. Doxepin (20.2 percent), flurazepam (15.2 percent), and diazepam (14.8 percent) were dispensed most frequently. Nearly 30 percent of the patients received a prescription for at least one psychotropic drug during the two-year period, and 14 percent received at least one prescription during both years. Three significant predictors of subsequent psychotropic drug use were: prior use (odds ratio = 17.2, 95% CI = 6.25, 47.33), the number of physical impairments (OR = 1.73, 95% CI = 1.05, 2.84), and the respondent's rating on the Alameda Health Scale (OR = 1.65, 95% CI = 0.99, 2.75). Patient's self-reported mental health status and sociodemographic characteristics were not significant predictors of subsequent use. Handle: RePEc:aph:ajpbhl:1990:80:11:1349-1353_2 Template-Type: ReDIF-Article 1.0 Title: Evaluating the impact of municipal water fluoridation on the aquatic environment Journal: American Journal of Public Health Author-Name: Osterman, J.W. Year: 1990 Volume: 80 Issue: 10 Pages: 1230-1235 Abstract: Although highly beneficial for dental health, low concentrations of fluoride in environmental waters may be toxic to several organisms. In an era of heightened public awareness about the environment, this may lead city officials to withhold implementing water fluoridation for environmental reasons. This paper presents a mass balance approach to evaluate this perceived risk. Generally speaking, fluoridated water loss during use, dilution of sewage by rain and ground water infiltrate, fluoride removal during secondary sewage treatment, and diffusion dynamics at effluent outfall combine to eliminate fluoridation-related environmental effects. In Montreal, water fluoridation would raise average aquatic fluoride levels in the waste water plume immediately below effluent outfall by only 0.05-0.09 mg/l. Downstream, these changes would be only 0.02-0.05 mg/l at 1 km, and 0.01-0.03 mg/l at 2 km below outfall. Overall river fluoride concentrations theoretically would be raised by 0.001-0.002 mg/l, a value not measurable by current analytical techniques. All resulting concentrations would be well below those recommended for environmental safety and would not exceed natural levels found elsewhere in Quebec. A literature review did not reveal any examples of municipal water fluoridation causing recommended environmental concentrations to be exceeded, although excesses occurred in several cases of severe industrial water pollution. Handle: RePEc:aph:ajpbhl:1990:80:10:1230-1235_3 Template-Type: ReDIF-Article 1.0 Title: First nursing home admissions: Time spent at home and in institutions after discharge Journal: American Journal of Public Health Author-Name: Lewis, M.A. Author-Name: Leake, B. Author-Name: Leal-Sotelo, M. Author-Name: Clark, V. Year: 1990 Volume: 80 Issue: 1 Pages: 22-24 Abstract: We tracked 96 percent of a sample of 1,942 nursing home patients admitted to a nursing home for the first time in 1982-83. Patients discharged alive from the nursing home were followed for two years or until death. The relative time spent at home, in hospitals, and in skilled nursing facilities is reported. Of the 705 patients discharged from their initial nursing home admission to homes in the community, about 50 percent made only one transfer and only 15 percent made four or more transfers. Of the 509 discharged to a hospital, 26 percent died there and 37 percent of the 374 survivors made four or more moves in the next two years. In all, 1,332 patients were discharged alive and they spent almost two-thirds of the subsequent two years, or their remaining lifetimes, in the community. Of those who transferred only once, over two-thirds of their follow-up time was spent in their own homes. Policies concerned with long-term care should use some type of actuarial data base to successfully plan and implement long-term care insurance. Handle: RePEc:aph:ajpbhl:1990:80:1:22-24_4 Template-Type: ReDIF-Article 1.0 Title: Surveillance of occupational lung disease: Comparison of hospital discharge data to physician reporting Journal: American Journal of Public Health Author-Name: Rosenman, K.D. Author-Name: Trimbath, L. Author-Name: Stanbury, M. Year: 1990 Volume: 80 Issue: 10 Pages: 1257-1258 Abstract: A survey of 762 New Jersey physicians showed that 35% reported seeing patients with either asbestosis, coal worker's pneumoconiosis, occupational asthma or silicosis. Three to four times as many patients with these diagnoses were seen as outpatients as were hospitalized. The implications of these results in using hospital discharge data for occupational disease surveillance are discussed. Handle: RePEc:aph:ajpbhl:1990:80:10:1257-1258_4 Template-Type: ReDIF-Article 1.0 Title: On quality of ambulatory care (I: Reply) Journal: American Journal of Public Health Author-Name: Retchin, S.M. Author-Name: Brown, B. Year: 1990 Volume: 80 Issue: 9 Pages: 1136 Handle: RePEc:aph:ajpbhl:1990:80:9:1136_3 Template-Type: ReDIF-Article 1.0 Title: Rabies vaccine adsorbed: Neutralizing antibody titers after three-dose pre-exposure vaccination Journal: American Journal of Public Health Author-Name: Berlin, B.S. Year: 1990 Volume: 80 Issue: 4 Pages: 476-478 Abstract: Field trials at several schools of veterinary medicine showed that three-dose pre-exposure rabies vaccination with Rabies Vaccine Adsorbed developed by the Michigan Department of Health elicited neutralization antibody in practically all recipients two to three weeks after immunization. Titers declined during the first six months after vaccination. However, by 18 to 24 months, 98 percent of recipients still had titers equal or greater than a 1:5 dilution of serum. Handle: RePEc:aph:ajpbhl:1990:80:4:476-478_4 Template-Type: ReDIF-Article 1.0 Title: Pawtucket Heart Health Program point-of-purchase nutrition education program in supermarkets Journal: American Journal of Public Health Author-Name: Hunt, M.K. Author-Name: Lefebvre, R.G. Author-Name: Hixson, M.L. Author-Name: Banspach, S.W. Author-Name: Assaf, A.R. Author-Name: Carleton, R.A. Year: 1990 Volume: 80 Issue: 6 Pages: 730-732 Abstract: Point-of-purchase nutrition education in supermarkets is one intervention strategy of the Pawtucket Heart Health Program, a community cardiovascular disease prevention program in Pawtucket, Rhode Island. Using consumer intercept interviews, awareness of shelf labels and their effect on purchase behavior have been continuously evaluated. Between 1984 and 1988, the percent of shoppers who could identify correct labels increased from 11 percent to 24 percent (95% confidence intervals of difference: 7,17). The percent who reported they were encouraged to purchase the identified foods increased from 36 percent to 54 percent (95% CI of difference: 5,41). Handle: RePEc:aph:ajpbhl:1990:80:6:730-732_7 Template-Type: ReDIF-Article 1.0 Title: Recurring urinary tract infection: Incidence and risk factors Journal: American Journal of Public Health Author-Name: Foxman, B. Year: 1990 Volume: 80 Issue: 3 Pages: 331-333 Abstract: Urinary tract infection (UTI) is a common infection among young women, with a high recurrence rate. This study documents the six-month incidence of second UTI among a cohort of women with one initial UTI and the factors associated with recurrence. Among the cohort of 113 women, 30 (26.6 percent) experienced at least one culture-confirmed recurrence within the six months following initial infection. The presence of hematuria and urgency as symptoms of initial infection were the strongest predictors of second infection. Behavioral factors associated with initial infection (frequency of sexual intercourse, diaphragm use, and voiding after sexual intercourse) did not distinguish between women who would and would not experience a second UTI during the six-month follow-up period. Handle: RePEc:aph:ajpbhl:1990:80:3:331-333_5 Template-Type: ReDIF-Article 1.0 Title: Evidence against increasing rubella seronegativity among adolescent girls Journal: American Journal of Public Health Author-Name: Stehr-Green, P.A. Author-Name: Cochi, S.L. Author-Name: Preblud, S.R. Author-Name: Orenstein, W.A. Year: 1990 Volume: 80 Issue: 1 Pages: 88 Handle: RePEc:aph:ajpbhl:1990:80:1:88_2 Template-Type: ReDIF-Article 1.0 Title: Patient 'dumping' post-COBRA Journal: American Journal of Public Health Author-Name: Kellermann, A.L. Author-Name: Hackman, B.B. Year: 1990 Volume: 80 Issue: 7 Pages: 864-867 Abstract: To gauge the impact of the new federal patient transfer provisions following the federal Combined Budget Reconciliation Act of 1985 (COBRA), we monitored all emergency interhospital transfers to a public hospital emergency department in the Memphis, Tennessee area during three identical time periods: June 1 to August 31 of 1986, 1987, and 1988. A high number of transfers in the summer of 1986 diminished only slightly in summer 1987 (following implementation of COBRA). Far greater reductions occurred in summer 1988, when overcrowding forced our hospital to refuse most transfers. In contrast to changes in hospital policy, COBRA alone had little effect in this area. Handle: RePEc:aph:ajpbhl:1990:80:7:864-867_1 Template-Type: ReDIF-Article 1.0 Title: Seat belt use in cars with air bags Journal: American Journal of Public Health Author-Name: Williams, A.F. Author-Name: Wells, J.K. Author-Name: Lund, A.K. Year: 1990 Volume: 80 Issue: 12 Pages: 1514-1516 Abstract: Seat belt use was observed in 1,628 cars with air bags and manual belts and 34,223 cars with manual seat belts only. Sixty-six percent of drivers in cars with air bags wore seat belts compared to 63 percent of drivers in cars with manual belts only. The study found no evidence for the speculation that drivers with air bags will reduce their seat belt use because they believe an air bag alone provides sufficient protection. Handle: RePEc:aph:ajpbhl:1990:80:12:1514-1516_0 Template-Type: ReDIF-Article 1.0 Title: Car design and risk of pedestrian deaths Journal: American Journal of Public Health Author-Name: Robertson, L.S. Year: 1990 Volume: 80 Issue: 5 Pages: 609-610 Abstract: Fatal pedestrian injury rates by cars with relatively sharp front-corner designs were compared to such rates by cars of similar-size with relatively smooth front-corner designs. The relative risk of death by front-corner impact was 26 percent greater among the sharp-cornered cars. Pedestrian death rates from impact with other points on the cars and insurance claim frequencies among the studied cars were similar between the two sets of cars. Handle: RePEc:aph:ajpbhl:1990:80:5:609-610_2 Template-Type: ReDIF-Article 1.0 Title: HIV seroprevalence and the acceptance of voluntary HIV testing among newly incarcerated male prison inmates in Wisconsin Journal: American Journal of Public Health Author-Name: Hoxie, N.J. Author-Name: Vergeront, J.M. Author-Name: Firsby, H.R. Author-Name: Pfister, J.R. Author-Name: Golubjatnikov, R. Author-Name: Davis, J.P. Year: 1990 Volume: 80 Issue: 9 Pages: 1129-1131 Abstract: In 1986-88, voluntary and blinded HIV testing was conducted among Wisconsin male prison entrants. The HIV seroprevalence was 0.30 percent in 1986, 0.53 percent in 1987, and 0.56 percent in 1988. The seroprevalence rates among entrants tested voluntarily did not differ from those tested blindly. Voluntary HIV testing was accepted by 71 percent of male prison entrants in 1988; among entrants reporting intravenous drug use 83 percent consented to voluntary HIV testing. Voluntary HIV testing of entrants appears to be an effective screening strategy in Wisconsin prisons. Handle: RePEc:aph:ajpbhl:1990:80:9:1129-1131_9 Template-Type: ReDIF-Article 1.0 Title: Wanted: Plastics with antimicrobial properties Journal: American Journal of Public Health Author-Name: Litsky, W. Year: 1990 Volume: 80 Issue: 1 Pages: 13-15 Handle: RePEc:aph:ajpbhl:1990:80:1:13-15_6 Template-Type: ReDIF-Article 1.0 Title: Day care characteristics associated with Haemophilus influenzae disease Journal: American Journal of Public Health Author-Name: Wenger, J.D. Author-Name: Harrison, L.H. Author-Name: Hightower, A. Author-Name: Broome, C.V. Year: 1990 Volume: 80 Issue: 12 Pages: 1455-1458 Abstract: To identify characteristics of day care facilities associated with H. influenzae disease, we compared 92 licensed facilities in which a case of H. influenzae disease had occurred with randomly selected facilities at which no cases occurred. Matched univariate analysis showed that personnel at facilities where H. influenzae disease occurred were more likely than those at control facilities to use towels or handkerchiefs to wipe children's noses, admit children who were not toilet trained or had diarrhea (''liberal fecal policy''), had a narrower age range, were more likely than control facilities to be for-profit and less likely to use volunteers. In a multivariate model that adjusted for age range, profit status and liberal fecal policy, towel or handkerchief use (OR 5.5, 95% CI: 1.1, 30) was the only variable independently associated with case facilities. This is the first association of a specific day care practice with H. influenzae disease. Handle: RePEc:aph:ajpbhl:1990:80:12:1455-1458_5 Template-Type: ReDIF-Article 1.0 Title: Drs. Steenland and Thun respond Journal: American Journal of Public Health Author-Name: Steenland, N.K. Author-Name: Thun, M.J. Year: 1990 Volume: 80 Issue: 10 Pages: 1275-1276 Handle: RePEc:aph:ajpbhl:1990:80:10:1275-1276_7 Template-Type: ReDIF-Article 1.0 Title: Response from Drs. Retchin and Brown Journal: American Journal of Public Health Author-Name: Retchin, S.M. Author-Name: Brown, B. Year: 1990 Volume: 80 Issue: 10 Pages: 1277 Handle: RePEc:aph:ajpbhl:1990:80:10:1277_6 Template-Type: ReDIF-Article 1.0 Title: Longevity and left-handedness (I) Journal: American Journal of Public Health Author-Name: Ellis, S.J. Year: 1990 Volume: 80 Issue: 3 Pages: 353 Handle: RePEc:aph:ajpbhl:1990:80:3:353_5 Template-Type: ReDIF-Article 1.0 Title: Erratum: Feasibility of a telephone survey to study a minority community: Hispanics in San Francisco (Am J Public Health 1990;80:323-326) Journal: American Journal of Public Health Author-Name: Marin, G. Author-Name: Vanoss Marin, B. Author-Name: Perez-Stable, E.J. Year: 1990 Volume: 80 Issue: 5 Pages: 536 Handle: RePEc:aph:ajpbhl:1990:80:5:536_2 Template-Type: ReDIF-Article 1.0 Title: Changes in needle sharing behavior among intravenous drug users: San Francisco, 1986-88 Journal: American Journal of Public Health Author-Name: Guydish, J.R. Author-Name: Abramowitz, A. Author-Name: Woods, W. Author-Name: Black, D.M. Author-Name: Sorensen, J.L. Year: 1990 Volume: 80 Issue: 8 Pages: 995-997 Abstract: We analyzed data for San Francisco intravenous drug users entering treatment, April 1986-September 1988 (N = 7,660). The proportion of cases reporting any needle sharing in the month preceding treatment decreased from 50 percent in 1986 to 28 percent in 1988. Similar decreases were reported by two longitudinal cohorts (needle sharing by the same individuals) admitted in 1986 and 1987 (n = 303), and in 1986 and 1988 (n = 205). In a multiple logistic regression model four variables predicted needle sharing: earlier time of admission, cocaine use, younger age, and being White rather than Black. Handle: RePEc:aph:ajpbhl:1990:80:8:995-997_3 Template-Type: ReDIF-Article 1.0 Title: The epidemiology of vulvovaginal candidiasis: Risk factors Journal: American Journal of Public Health Author-Name: Foxman, B. Year: 1990 Volume: 80 Issue: 3 Pages: 329-331 Abstract: The effects of personal hygiene, sexual history, diet, and stress on the risk of vulvovaginal candidiasis were estimated from a case-control study of students attending a public university during 1986-87. Data from medical records and self-administered questionnaires were used to compare 85 cases to 1,245 other students using the Health Service, and to 113 subjects chosen from the total student population. Frequent sexual intercourse was the strongest risk factor (seven or more times a week versus none): OR = 4.3; 95% CI: 1.4, 12.9 (for cases versus Health Service controls). Handle: RePEc:aph:ajpbhl:1990:80:3:329-331_0 Template-Type: ReDIF-Article 1.0 Title: Pertussis immunization in eight-month-old children in North Carolina Journal: American Journal of Public Health Author-Name: Clements, D.A. Author-Name: Wilfert, C.M. Author-Name: Newton MacCormack, J. Author-Name: Weigle, K.A. Author-Name: Denny, F.W. Year: 1990 Volume: 80 Issue: 6 Pages: 734-736 Abstract: Between 1984 and 1987 reported pertussis cases in North Carolina increased threefold. Pertussis immunization rates were examined for those years in three one-year cohorts drawn from a random selection of North Carolina birth records. The percentage of children immunized with three DTPs at eight months of age was 58.1, 58.6, and 56.7 for the three cohorts. Only 20.5 percent of 117 reported pertussis cases in children 9-36 months of age during the last 10 years were adequately immunized. The low pertussis immunization rate may have contributed to the recent increase in pertussis cases in North Carolina. Handle: RePEc:aph:ajpbhl:1990:80:6:734-736_9 Template-Type: ReDIF-Article 1.0 Title: Executive women and health: Perceptions and practices Journal: American Journal of Public Health Author-Name: LaRosa, J.H. Year: 1990 Volume: 80 Issue: 12 Pages: 1450-1454 Abstract: The purpose of this study was to obtain a socioeconomic/health profile of a select group of executive women, to understand more about their personal and professional lives, and to examine how these factors relate to their overall health. The data were obtained from a self-administered 73-item questionnaire that was mailed during spring 1987 to the 1,000 members of a professional executive women's organization with 15 chapters across the United States. Findings suggest that the women in executive positions do not necessarily compromise their health. In comparison with a group of age/gender/education matched working women, the overall wellness and risk assessment scores were remarkably similar. The study group, however, reported greater life satisfaction, stronger social support, and excellent health status; the overwhelming majority was satisfied with their personal and professional lives and believed that they were in control of both. This perception, coupled with the relatively high wellness scores, suggests that on average this group of executives may be in better health than had been predicted as women rose to executive positions within organizations. Handle: RePEc:aph:ajpbhl:1990:80:12:1450-1454_4 Template-Type: ReDIF-Article 1.0 Title: An evaluation of external cause-of-injury codes using hospital records from the Indian Health Service, 1985 Journal: American Journal of Public Health Author-Name: Smith, S.M. Author-Name: Colwell Jr., L.S. Author-Name: Sniezek, J.E. Year: 1990 Volume: 80 Issue: 3 Pages: 279-281 Abstract: To evaluate the usefulness of International Classification of Diseases external cause-of-injury and poisoning codes (E codes) for public health surveillance of nonfatal injuries, we analyzed E codes from Indian Health Service (IHS) hospital records. E codes for unknown or unspecified causes were used for 25 percent of records. At two hospitals, 63 percent of E codes assigned by independent coders agreed; another 18 percent matched on general cause-of-injury groups. With uniform guidelines and increased training, E coding could provide a valuable, cost-effective method of quantifying and characterizing severe, nonfatal injuries. Handle: RePEc:aph:ajpbhl:1990:80:3:279-281_9 Template-Type: ReDIF-Article 1.0 Title: Occupational and other exposures associated with male end-stage renal disease: A case/control study Journal: American Journal of Public Health Author-Name: Steenland, N.K. Author-Name: Thun, M.J. Author-Name: Ferguson, C.W. Author-Name: Port, F.K. Year: 1990 Volume: 80 Issue: 2 Pages: 153-157 Abstract: We conducted a case-control study of 325 men ages 30-69 who were diagnosed with end-stage renal disease (ESRD) between 1976 and 1984, and resided in four urban areas of Michigan in 1984. Cases were selected from the Michigan Kidney Registry and excluded men with diabetic, congenital, and obstructive nephropathies. Controls were selected by random-digit dialing and were pair-matched to cases for age, race, and area of residence. Telephone interviews were conducted with 69 percent of eligible cases and 79 percent of eligible controls. Risk of ESRD was significantly related to phenacetin or acetaminophen consumption (odds ratio(OR) = 2.66), moonshine consumption (OR = 2.43), a family history of renal disease (OR = 9.30); and regular occupational exposures to solvents (OR = 1.51) or silica (OR = 1.67). Particular occupational exposures with elevated risk were solvents used as cleaning agents and degreasers (OR = 2.50) silica exposure in foundries or brick factories (OR = 1.92), and silica exposure during sandblasting (OR = 3.83). Little or no trend of increased risk with duration of exposure was found for these occupational exposures, with the exception of silica in sandblasting. Limitations of these data include representativeness of cases, possible overreporting by cases, and misclassification of exposures inherent in self-reports. Handle: RePEc:aph:ajpbhl:1990:80:2:153-157_8 Template-Type: ReDIF-Article 1.0 Title: Carbon monoxide in indoor ice skating rinks: Evaluation of absorption by adult hockey players Journal: American Journal of Public Health Author-Name: Levesque, B. Author-Name: Dewailly, E. Author-Name: Lavoie, R. Author-Name: Prud'Homme, D. Author-Name: Allaire, S. Year: 1990 Volume: 80 Issue: 5 Pages: 594-598 Abstract: We evaluated alveolar carbon monoxide (CO) levels of 122 male, adult hockey players active in recreational leagues of the Quebec City region (Canada), before and after 10 weekly 90-minute games in 10 different rinks. We also determined exposure by quantifying the average CO level in the rink during the games. Other variables documented included age, pulmonary function, aerobic capacity, and smoking status. Environmental concentrations varied from 1.6 to 131.5 parts per million (ppm). We examined the absorption/exposure relationship using a simple linear regression model. In low CO exposure levels, physical exercise lowered the alveolar CO concentration. However, we noted that for each 10 ppm of CO in the ambient air, the players had adsorbed enough CO to raise their carboxyhemoglogin (COHb) levels by 1 percent. This relationship was true both for smokers and non-smokers. We suggest that an average environmental concentration of 20 ppm of CO for the duration of a hockey game (90 minutes) should be the reference limit not to be exceeded in indoor skating rinks. Handle: RePEc:aph:ajpbhl:1990:80:5:594-598_7 Template-Type: ReDIF-Article 1.0 Title: Noble purpose, grand design, flawed execution, mixed results: Soviet socialized medicine after seventy years Journal: American Journal of Public Health Author-Name: Field, M.G. Year: 1990 Volume: 80 Issue: 2 Pages: 144-145 Handle: RePEc:aph:ajpbhl:1990:80:2:144-145_2 Template-Type: ReDIF-Article 1.0 Title: Work-related psychosocial stress and risk of preterm, low birthweight delivery Journal: American Journal of Public Health Author-Name: Homer, C.J. Author-Name: James, S.A. Author-Name: Siegel, E. Year: 1990 Volume: 80 Issue: 2 Pages: 173-177 Abstract: We investigated whether work-related psychologic stress - defined as work characterized by both high psychologic demands and limited control over the response to these demands - increases a woman's risk of delivering a preterm, low birthweight infant. We studied 786 employed pregnant women included in the National Longitudinal Survey of Labor Market Experience, Youth Cohort (NLSY), a nationally representative sample of 12,686 young adults. Data concerning work status, job title, and other factors affecting pregnancy outcome were obtained from the NLSY. Assessment of job experience was based on job title, using an established catalogue of occupation characteristics. After accounting for the physical exertion entailed in a job, occupational psychologic stress as measured by job title was not associated with perterm, low birthweight delivery for the sample as a whole (Relative risk = 1.16, 95% confidence interval .45, 2.95). For those women who did not want to remain in the work force, work-related stress increased their risk of experiencing this outcome (RR = 8.1, 95% CI 1.5, 50.2). Personal motivation toward work, as well as the physical effort of work, should be considered in evaluating the impact of a job's psychologic characteristics on pregnancy outcome. Handle: RePEc:aph:ajpbhl:1990:80:2:173-177_2 Template-Type: ReDIF-Article 1.0 Title: Incorporation of pyrazinamide into community-wide treatment of tuberculosis Journal: American Journal of Public Health Author-Name: Nolan, C.M. Year: 1990 Volume: 80 Issue: 12 Pages: 1525-1526 Handle: RePEc:aph:ajpbhl:1990:80:12:1525-1526_5 Template-Type: ReDIF-Article 1.0 Title: Freestanding birth centers: Safe, sensitive care Journal: American Journal of Public Health Author-Name: Ernst, E.K.M. Year: 1990 Volume: 80 Issue: 3 Pages: 352 Handle: RePEc:aph:ajpbhl:1990:80:3:352_4 Template-Type: ReDIF-Article 1.0 Title: HIV seropositivity of needles from shooting galleries in South Florida Journal: American Journal of Public Health Author-Name: Chitwood, D.D. Author-Name: McCoy, C.B. Author-Name: Inciardi, J.A. Author-Name: McBride, D.C. Author-Name: Comerford, M. Author-Name: Trapido, E. Author-Name: McCoy, H.V. Author-Name: Page, J.B. Author-Name: Griffin, J. Author-Name: Fletcher, M.A. Author-Name: Ashman, M.A. Year: 1990 Volume: 80 Issue: 2 Pages: 150-152 Abstract: Needle/syringe combinations were collected from three shooting galleries in South Florida and tested for the presence of antibodies to HIV-1. Fifteen of 148 needles (10.1 percent) tested positive for HIV-1 antibody. Seropositivity rates did not vary by the day of the week of collection, nor by shooting gallery from which they were collected. When the needle appeared to contain blood residue, 20.0 percent were positive versus 5.1 percent with no blood residue. These findings suggest that needles/syringes used in shooting galleries are likely to serve as reservoirs and/or vectors of transmission of the HIV-1 virus, and that although visual inspection of the needle/syringe may be useful in lessening the change for transmission, even the visually 'clean' needles may result in transmission of infection. Handle: RePEc:aph:ajpbhl:1990:80:2:150-152_0 Template-Type: ReDIF-Article 1.0 Title: Case-control study of lung cancer and truck driving in the teamsters union Journal: American Journal of Public Health Author-Name: Steenland, N.K. Author-Name: Silverman, D.T. Author-Name: Hornung, R.W. Year: 1990 Volume: 80 Issue: 6 Pages: 670-674 Abstract: We conducted a case-control study of lung cancer deaths in the Teamsters Union to compare the risk of different occupations within the teamsters, after controlling for smoking and other confounders. Occupations with no presumed exposure to diesel fumes were used as the nonexposed group. The study population consisted of 996 cases and 1,08 controls who had died in 1982-83 after applying for pensions. Next of kin provided information on smoking, work history, and other potential confounders. Work history data were also obtained from the Teamsters Union. While no single job category had a significant excess risk compared to the non-exposed group, certain sub-groups were elevated. The odds ratio for those with long-term employment as long-haul truckers after 1959 (an approximate date for the introduction of diesel engines) was 1.55 (95% CI: 0.97, 2.47). Long-term drivers of primarily diesel trucks had an odds ratio of 1.89 (95% CI: 1.04, 3.42). Overall, our results suggest that diesel truck drivers have an excess risk of lung cancer compared to other teamsters in jobs outside the trucking industry. However, our findings were not uniformly consistent and our data have many limitations, the most important of which is the lack of data on exposure to diesel fumes. Handle: RePEc:aph:ajpbhl:1990:80:6:670-674_1 Template-Type: ReDIF-Article 1.0 Title: Cryptosporidium infection in Oregon public health clinic patients 1985-88: The value of statewide laboratory surveillance Journal: American Journal of Public Health Author-Name: Skeels, M.R. Author-Name: Sokolow, R. Author-Name: Hubbard, C.V. Author-Name: Andrus, J.K. Author-Name: Baisch, J. Year: 1990 Volume: 80 Issue: 3 Pages: 305-308 Abstract: To evaluate the utility of statewide laboratory Cryptosporidium surveillance, we screened stools from all 5,256 patients evaluated at local health departments for parasitic disease from January 1985 through June 1988. Fifty-seven patients (1.1 percent) were found to have Cryptosporidium. Seasonal peaks in positivity were observed in the spring, summer, and early autumn months. In children, younger age was associated with higher positivity rate of cryptosporidiosis. As a result of these surveillance efforts, Oregon's first known outbreak of cryptosporidiosis was detected and investigated during 1988. Twenty-five persons were infected, including children, parents, and staff associated with two day care centers. The cost of routine screening for Cryptosporidium was $1.13 per specimen in our laboratory, and we consider it useful. Handle: RePEc:aph:ajpbhl:1990:80:3:305-308_6 Template-Type: ReDIF-Article 1.0 Title: Infant feeding practices: An evaluation of the impact of a health education course Journal: American Journal of Public Health Author-Name: Shoham-Yakubovich, I. Author-Name: Pliskin, J.S. Author-Name: Carr, D. Year: 1990 Volume: 80 Issue: 6 Pages: 732-734 Abstract: We assessed the impact of health education course on infant feeding actices in the West Bank territories by comparing mothers who had attended the course (n = 102) with mothers not exposed to the course (n = 133). After adjustment for child's age, maternal age and education, parity, and birth site, course participants were more likely than non-participants to breastfeed, as well as to start supplementation by semi-solid foods at the recommended time. Handle: RePEc:aph:ajpbhl:1990:80:6:732-734_5 Template-Type: ReDIF-Article 1.0 Title: II. Acculturation, access to care, and use of preventive services by Hispanics: Findings from HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Solis, J.M. Author-Name: Marks, G. Author-Name: Garcia, M. Author-Name: Shelton, D. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 11-19 Abstract: Use of preventive health services (physical, dental, and eye examinations, Pap smear and breast examinations) among Mexican American, Cuban American, and Puerto Rican adults (ages 20-74) was investigated with data from the HHANES. Analyses focused on the relative importance of two predictors of recency of screening: access to services (health insurance coverage, having a routine place for care, type of faciity used, having a regular provider, travel time) and acculturation (spoken and written language, ethnic identification). Regression analyses controlling for age, education, and income indicated that utilization of the preventive services was predicted more strongly by access to care than by acculturation. For each Hispanic group, having a routine place for health care, health insurance coverage, and a regular provider were each significantly associated with greater recency of screening. Type of facility used and travel time produced less consistent effects. These results replicate past studies that have demonstrated the important link between institutional access and use of health services. Of the acculturation variables, language but not ethnic identification (which was measured only for the Mexican Americans) predicted use. This latter finding, which has been demonstrated in other studies as well, suggests that the effect of language on screening practices should not be interpreted as a cultural factor, but as an access factor, i.e., use of English favors access to services. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:11-19_4 Template-Type: ReDIF-Article 1.0 Title: Dietary intake of Americans reporting adherence to a low cholesterol diet (NHANES II) Journal: American Journal of Public Health Author-Name: Schectman, G. Author-Name: McKinney, W.P. Author-Name: Pleuss, J. Author-Name: Hoffman, R.G. Year: 1990 Volume: 80 Issue: 6 Pages: 698-703 Abstract: We studied the dietary intake of persons age 18 and over participating in the 1976-80 National Health and Nutrition Examination Survey (NHANES II). We compared the diets of those on a 'low cholesterol' diet (dieters, n = 296) with the diets of individuals not following a special diet (non-dieters, n = 10,052). Dietary intakes were assessed by 24-hour recall and food frequency reports and were adjusted for differences in age, sex, race, education, smoking, and socioeconomic status by multivariate statistical techniques. Dieters consumed 16 percent (99% confidence interval- -24, -9) fewer calories than non-dieters, and had decreased intake of saturated fat by 25 percent (-34, -15) and cholesterol by 21 percent (-32, -10). However, their intake of vitamin A, thiamine, riboflavin, niacin, calcium, and iron were not significantly different from non-dieters and their ascorbic acid intake was 18 percent (1, 36) higher. The nutrient density (nutrient/1000 kcal) among dieters was increased over non-dieters by 35 percent (-3, 72) for vitamin A, 35 percent (1, 70) for thiamine, 30 percent (-4, 65) for riboflavin, 27 percent (9,44) for niacin, 60 percent (40, 80) for vitamin C, 14 percent for calcium (-5, 32), and 15 percent for iron (6, 25). Compared with non-dieters, dieters consumed 27 percent (9, 45) more poultry and 39 percent (12, 66) more fish, but consumed 30 percent (-44, -16) less eggs and 15 percent (-24, -6) less meat. Handle: RePEc:aph:ajpbhl:1990:80:6:698-703_1 Template-Type: ReDIF-Article 1.0 Title: Lead risks overlooked in sandblasters? Journal: American Journal of Public Health Author-Name: Schirmer, J. Year: 1990 Volume: 80 Issue: 10 Pages: 1275 Handle: RePEc:aph:ajpbhl:1990:80:10:1275_3 Template-Type: ReDIF-Article 1.0 Title: Demographic characteristics, risk behaviors, and HIV seroprevalence among intravenous drug users by site of contact: Results from a community-wide HIV surveillance project Journal: American Journal of Public Health Author-Name: McCusker, J. Author-Name: Kobloin, B. Author-Name: Lewis, B.F. Author-Name: Sullivan, J. Year: 1990 Volume: 80 Issue: 9 Pages: 1062-1067 Abstract: We investigated differences in behaviors important for human immunodeficiency virus (HIV) transmission and HIV antibody status among 927 recent needle users enrolled in a multi-site HIV surveillance project in Worcester, Massachusetts. Subjects were enrolled at drug abuse treatment centers, other clinical sites, and a men's jail. Subjects at drug treatment centers reported less risky injection practices unexplained by demographic variables. Risky sexual practices were in general reported more frequently by men at the jail than men at other sites. However, HIV status showed little relation to enrollment site. These results have implications both for targeting of acquired immunodeficiency syndrome (AIDS) prevention programs to needle users not in drug abuse treatment and for potential selection bias in studies of intravenous drug users. Handle: RePEc:aph:ajpbhl:1990:80:9:1062-1067_7 Template-Type: ReDIF-Article 1.0 Title: Routine communication in sexually transmitted disease clinics: An observational study Journal: American Journal of Public Health Author-Name: Roter, D.L. Author-Name: Knowles, N. Author-Name: Somerfield, M. Author-Name: Baldwin, J. Year: 1990 Volume: 80 Issue: 5 Pages: 605-606 Abstract: Sixty SRD patients were followed during the course of their clinic visit which averaged 2.75 professional contacts. Based on audiotape analysis, virtually all patients received a diagnosis; however, 25 percent of the patients did not receive any information about treatment or prevention, and only 57 percent of patients were given complete information. Patient recall of the information they were given averaged about 43 percent. Patients not seen by a physician during their clinic visit achieved higher recall rates than patients seen by a physician. Handle: RePEc:aph:ajpbhl:1990:80:5:605-606_9 Template-Type: ReDIF-Article 1.0 Title: The incidence of Haemophilus influenzae meningitis in a midwestern metropolitan county Journal: American Journal of Public Health Author-Name: Rice, R.B. Author-Name: Walling, A.D. Author-Name: Kallail, K.J. Year: 1990 Volume: 80 Issue: 2 Pages: 215-216 Abstract: The incidence of H. influenzae meningitis in children under five years of age was monitored during the years 1983-87 by a retrospective study of records from all hospitals serving a metropolitan county in Kansas. The mean annual incidence rate for the five years studied was 26.0 per 100,000. This compares with a mean of 56.0 per 100,000 measured in the same county during 1979-82. Handle: RePEc:aph:ajpbhl:1990:80:2:215-216_3 Template-Type: ReDIF-Article 1.0 Title: Tuberculosis infection in urban adolescents: Results of a school-based testing program Journal: American Journal of Public Health Author-Name: Barry, M.A. Author-Name: Shirley, L. Author-Name: Grady, M.T. Author-Name: Weidhaas Etkind, S. Author-Name: Almeida, C. Author-Name: Bernardo, J. Author-Name: Lamb, G.A. Year: 1990 Volume: 80 Issue: 4 Pages: 439-441 Abstract: In 1986-87 a pilot tuberculosis (TB) skin testing program was introduced for seventh and tenth grade students in the Boston (Massachusetts) public schools. The 8.9 percent tuberculin positivity rate in tenth grade students was significantly higher than the 5.1 percent rate found in seventh graders. A majority of those who were skin positive were born outside the United States. These results suggest that tuberculin tesing in an urban school setting may identify a significant number of candidates for TB preventive therapy, particularly among tenth grade students and those who are foreign-born. Handle: RePEc:aph:ajpbhl:1990:80:4:439-441_1 Template-Type: ReDIF-Article 1.0 Title: VIII. Patterns of cigarette smoking among Hispanics in the United States: Results from HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Haynes, S.G. Author-Name: Harvey, C. Author-Name: Montes, H. Author-Name: Nickens, H. Author-Name: Cohen, B.H. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 47-54 Abstract: In the 1982-84 Hispanic Health and Nutrition Examination Survey, the prevalence of cigarette smoking was examined among Mexican Americans, Puerto Ricans, and Cuban Americans in the United States. Among 20-74 years olds, the age-adjusted smoking rates for Mexican American, Puerto Rican, and Cuban American men were high - 42.5, 39.8, and 41.6 percent, respectively. Quite striking among Cuban American men was the high smoking rate among 20-34 year olds (50.1 percent), the highest smoking rate in the three Hispanic groups compared. The age-adjusted smoking rates for Mexican American, Puerto Rican, and Cuban American women were much lower than those for men - 23.8, 30.3, and 24.4 percent, respectively. Both Puerto Rican and Cuban American men were more likely to be heavy smokers (52.3 and 64.1 percent, respectively, smoking a pack or more a day) as compared to the Mexican Americans (33.8 percent smoking a pack or more a day). The pattern was the same for women, with Mexican American women being lighter smokers (18.8 percent smoking a pack or more a day) as compared to heavy smoking among Puerto Rican and Cuban American women (35.1 and 48.6 percent, respectively, smoking a pack or more a day). Given the health hazards of smoking, future research and intervention are required for those groups with high exposure to cigarette smoking. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:47-54_9 Template-Type: ReDIF-Article 1.0 Title: HIV antibody testing among adults in the United States: Data from 1988 NHIS Journal: American Journal of Public Health Author-Name: Hardy, A.M. Author-Name: Dawson, D.A. Year: 1990 Volume: 80 Issue: 5 Pages: 586-589 Abstract: Data collected from 21,168 adults using the 1988 AIDS supplement to National Health Interview Survey were examined to determine awareness of and experience with HIV antibody testing in the United States. Three-fourths of adults knew of the blood test for HIV antibodies; awareness was lower among Blacks, Hispanics, older adults, and those less educated. Overall, 17 percent of adults had been tested; of these, 73 percent because of blood donation, 14 percent through other non-voluntary programs (such as military induction), and 16 percent sought testing voluntarily. While a smaller proportion of Black and Hispanic adults had been tested, they were more likely than their White non-Hispanic counterparts to have been tested voluntarily. Persons who reported belonging to groups with high-risk behaviors were also more likely to have been voluntarily tested. Most of those tested voluntarily received their test results, but only one-third also received prevention information. Three percent of adults plan to be tested voluntarily in the next year; about half will seek testing through their doctor or health maintenance organization. Handle: RePEc:aph:ajpbhl:1990:80:5:586-589_7 Template-Type: ReDIF-Article 1.0 Title: Benzene, benzo(a)pyrene, and lead in smoke from tobacco products other than cigarettes Journal: American Journal of Public Health Author-Name: Appel, B.R. Author-Name: Guirguis, G. Author-Name: Kim, I.-S. Author-Name: Garbin, O. Author-Name: Fracchia, M. Author-Name: Flessel, C.P. Author-Name: Kizer, K.W. Author-Name: Book, S.A. Author-Name: Warriner, T.E. Year: 1990 Volume: 80 Issue: 5 Pages: 560-564 Abstract: Benzene, benzo(a)pyrene (BaP), and lead in mainstream smoke from cigars, roll-your-own (RYO) cigarette and pipe tobaccos were sampled to evaluate their potential health significance. Results with reference cigarettes were consistent with published values, providing support for the methodology employed. The emissions of benzene and BaP, expressed as mass emitted per gram of tobacco consumed, were similar for all products evaluated; for benzene, the mean values for cigars, RYO cigarette and pipe tobaccos were 156 ± 52, 68 ± 11, and 242 ± 126 μg/g, respectively. Mean values for BaP were 42 ± 7 and 48 ± 4 ng/g for cigars and RYO cigarette tobacco, respectively. Lead values were below the limit of reliable quantitation in all cases. The mean benzene concentrations in a puff ranged from 1 to 2 x 105 μg/m3 for cigars, RYO cigarette and pipe tobaccos. For BaP, the puff concentration averaged about 60 μg/m3 for cigars and RYO cigarette tobacco. The results suggest that smoking cigars, pipes or RYO cigarettes leads to potential exposures which exceed the No Significant Risk levels of benzene and BaP set pursuant to California's Proposition 65. These tobacco products are now required to bear a health hazard warning when sold in California. We recommend that this be adopted as national policy. Handle: RePEc:aph:ajpbhl:1990:80:5:560-564_2 Template-Type: ReDIF-Article 1.0 Title: AIDS risk behavior patterns among gay men in small southern cities Journal: American Journal of Public Health Author-Name: Kelly, J.A. Author-Name: St. Lawrence, J.S. Author-Name: Brasfield, T.L. Author-Name: Stevenson, L.Y. Author-Name: Diaz, Y.E. Author-Name: Hauth, A.C. Year: 1990 Volume: 80 Issue: 4 Pages: 416-418 Abstract: Men entering gay bars in three small southern cities were administered questionnaires to assess AIDS (acquired immunodeficiency syndrome) risk knowledge, perceived norms concerning the social acceptability of AIDS risk precautions, and personal sexual behavior. Seventy-seven percent (N = 355) of male patrons completed the measures. While risk knowledge levels were high, respondents did not perceive strong norms favoring risk reduction precautions. Rates of risk behavior were considered higher than those reported for gay men in large urban epicenters. Handle: RePEc:aph:ajpbhl:1990:80:4:416-418_5 Template-Type: ReDIF-Article 1.0 Title: Feasibility of a telephone survey to study a minority community: Hispanics in San Francisco Journal: American Journal of Public Health Author-Name: Marin, G. Author-Name: Vanoss, B. Author-Name: Perez-Stable, E.J. Year: 1990 Volume: 80 Issue: 3 Pages: 323-326 Abstract: In two random digit dialing surveys conducted among Hispanics using a modified Mitofsky-Waksberg procedure, we found low refusal rates (4.7% and 3.1%), low assumed noncontact rate (14.0% and 18.3%), and high response rates (88.6% and 88.4%) with limited investment in time (1.58 hours and 1.66 hours per completed interview). These results suggest that Hispanics are willing to participate in telephone surveys and that this method may be feasible and useful for research and evaluation purposes. Handle: RePEc:aph:ajpbhl:1990:80:3:323-326_1 Template-Type: ReDIF-Article 1.0 Title: Methods omitted to calculate confidence intervals (I) Journal: American Journal of Public Health Author-Name: Sullivan, K.M. Year: 1990 Volume: 80 Issue: 6 Pages: 752-753 Handle: RePEc:aph:ajpbhl:1990:80:6:752-753_9 Template-Type: ReDIF-Article 1.0 Title: Risk factors and non-differential misclassification (I: Reply) Journal: American Journal of Public Health Author-Name: Irwin, K.L. Author-Name: Grendon, J. Author-Name: Kobayashi, J. Author-Name: Veazie, M. Year: 1990 Volume: 80 Issue: 8 Pages: 1001 Handle: RePEc:aph:ajpbhl:1990:80:8:1001_4 Template-Type: ReDIF-Article 1.0 Title: Potential for Lyme disease in Maine: Deer survey of distribution of Ixodes dammini, the tick vector Journal: American Journal of Public Health Author-Name: Smith Jr., R.P. Author-Name: Rand, P.W. Author-Name: Lacombe, E.H. Year: 1990 Volume: 80 Issue: 3 Pages: 333-335 Abstract: A survey of deer brought to tagging stations at 24 sites in Maine revealed the presence of the deer tick, Ixodes dammini, on 5.1 percent of deer. Ticks were found almost exclusively on deer from southwest coastal sites in the state. The potential for endemic Lyme disease in coastal Maine merits further study. Handle: RePEc:aph:ajpbhl:1990:80:3:333-335_5 Template-Type: ReDIF-Article 1.0 Title: Diapering decisions: A community education project Journal: American Journal of Public Health Author-Name: Primomo, J. Year: 1990 Volume: 80 Issue: 6 Pages: 743-744 Handle: RePEc:aph:ajpbhl:1990:80:6:743-744_2 Template-Type: ReDIF-Article 1.0 Title: Prevalence of markers for hepatitis B and hepatitis D in a municipal house of correction Journal: American Journal of Public Health Author-Name: Barry, M.A. Author-Name: Gleavy, D. Author-Name: Herd, K. Author-Name: Schwingl, P.J. Author-Name: Werner, B.G. Year: 1990 Volume: 80 Issue: 4 Pages: 471-473 Abstract: Following an outbreak of hepatitis B (HBV) in a municipal house of correction, HBV markers were detected in 173/406 (43 percent) inmates and 10/129 (8 percent) staff. Of the 173 HBV-infected inmates, 14 (8 percent) had hepatitis D (HDV) markers compared to 0/10 staff members. Intravenous drugs use (IVDU) was most strongly associated with HBV marker presence. Increasing duration of imprisonment, history of hepatitis B and especially IVDU were associated with the prevalence of HDV markers. Handle: RePEc:aph:ajpbhl:1990:80:4:471-473_2 Template-Type: ReDIF-Article 1.0 Title: Estimating the mortality cost of AIDS: Do estimates of earnings differ? Journal: American Journal of Public Health Author-Name: Begley, C.E. Author-Name: Crane, M.M. Author-Name: Perdue, G. Year: 1990 Volume: 80 Issue: 10 Pages: 1268-1270 Abstract: The future earnings of male Texans dying of AIDS in 1987 were estimated using: national earnings profiles; earnings derived from occupations listed on death certificates; and earnings reported by persons with AIDS who responded to a survey. Mortality cost estimates using the two sources of actual earnings differed by a modest amount in comparison to the estimate using national earnings profiles. Handle: RePEc:aph:ajpbhl:1990:80:10:1268-1270_4 Template-Type: ReDIF-Article 1.0 Title: The AIDS-related experiences and practices of primary care physicians in Los Angeles: 1984-89 Journal: American Journal of Public Health Author-Name: Lewis, C.E. Author-Name: Montgomery, K. Year: 1990 Volume: 80 Issue: 12 Pages: 1511-1513 Abstract: Telephone interviews of random samples of Los Angeles primary care physicians in 1984, 1986, and 1989 obtained information about their AIDS-related practice experiences, and sexual history taking. Data from mid-1989 reveal almost 74 percent have worked up at least one patient for AIDS or HIV infection in the past six months and 39.5 percent are caring for at least one patient with AIDS or AIDS-related complex. Self-reported use of appropriate sexual history questions has improved substantially over this five-year period. Handle: RePEc:aph:ajpbhl:1990:80:12:1511-1513_5 Template-Type: ReDIF-Article 1.0 Title: Maintenance of safer sexual behaviors and predictors of risky sex: The San Francisco men's health study Journal: American Journal of Public Health Author-Name: Ekstrand, M.L. Author-Name: Coates, T.J. Year: 1990 Volume: 80 Issue: 8 Pages: 973-977 Abstract: This paper describes the sexual behavior changes made by 686 gay and bisexual men in San Francisco between 1984 and 1988, focusing on the individual maintenance of this behavior change over time. There were drastic reductions in insertive and receptive unprotective anal intercourse over time and the vast majority of subjects were able to maintain these changes for at least 12 months prior to the last interview. A total of 12 percent of participants admitted to relapsing to unprotected receptive anal intercourse following initial behavior change; 10 percent reported engaging in unprotected receptive anal sex during every year of the study period. Men were more likely to practice unprotected anal intercourse in 1988 if at baseline they were younger, practiced unprotected anal intercourse, reported more sex partners, did not have a close friend or lover with AIDS, and engaged in fewer other health-related behaviors. Handle: RePEc:aph:ajpbhl:1990:80:8:973-977_4 Template-Type: ReDIF-Article 1.0 Title: On borderline statistical significance (I) Journal: American Journal of Public Health Author-Name: Reasor, M.J. Year: 1990 Volume: 80 Issue: 8 Pages: 1002 Handle: RePEc:aph:ajpbhl:1990:80:8:1002_4 Template-Type: ReDIF-Article 1.0 Title: Influenza epidemics and anencephaly Journal: American Journal of Public Health Author-Name: Saxen, L. Author-Name: Holmberg, P.C. Author-Name: Kurppa, K. Author-Name: Kuosma, E. Author-Name: Pyhala, R. Year: 1990 Volume: 80 Issue: 4 Pages: 473-475 Abstract: To explore the postulated association between maternal influenza and congenital defects of the central nervous system, 14 virologically verified epidemics in Finland, 1969-82, were studied. Mothers of 248 anencephalic children were grouped into those whose first trimester had occurred during an epidemic period and those whose pregnancy had commenced during a non-epidemic period. No significant differences in prevalence of anencephaly were noted in these groups. Handle: RePEc:aph:ajpbhl:1990:80:4:473-475_6 Template-Type: ReDIF-Article 1.0 Title: Impact of the human immunodeficiency virus epidemic on mortality trends in young men, United States Journal: American Journal of Public Health Author-Name: Buehler, J.W. Author-Name: Devine, O.J. Author-Name: Berkelman, R.L. Author-Name: Chevarley, F.M. Year: 1990 Volume: 80 Issue: 9 Pages: 1080-1086 Abstract: Following a long-term decline, death rates in men 25-44 years of age increased from 212 deaths/100,000 in 1983 to 236 deaths/100,000 in 1987. To assess the impact of human immunodeficiency virus (HIV) infections on this trend and to identify causes that are increasing in association with the HIV epidemic, we analyzed national mortality statistics and compared death rates in states with high and low incidence of acquired immunodeficiency syndrome (AIDS). In 1987, there were 10,248 deaths with HIV infection. AIDS, or conditions in the AIDS surveillance definition assigned as the underlying cause, representing 11 percent of deaths for men in this age group compared to less than 1 percent in 1980. In addition, deaths with other underlying causes, such as other infections, drug abuse, and unknown/unspecified causes, had diverging and higher rates in states with high versus low AIDS incidence. In the absence of deaths due to HIV/AIDS and excess deaths due to these associated conditions, we estimate that death rates for men 25-44 years of age would have been 201-209/100,000 in 1987. For 1987, approximately 70-90 percent of HIV-related deaths were reported through national AIDS surveillance. The HIV epidemic has led to a reversal in mortality trends and to increases in various causes of death for young men. Handle: RePEc:aph:ajpbhl:1990:80:9:1080-1086_8 Template-Type: ReDIF-Article 1.0 Title: The effects of psychosocial work organization on patterns of cigarette smoking among male chemical plant employees Journal: American Journal of Public Health Author-Name: Green, K.L. Author-Name: Johnson, J.V. Year: 1990 Volume: 80 Issue: 11 Pages: 1368-1371 Abstract: We tested the hypothesis that job strain (the combination of high psychological job demands and low work control) is positively associated with smoking prevalence and intensity in a study group of 389 males employed in a chemical plant, using a self-administered questionnaire. In a logistic regression analysis which controlled for a number of sociodemographic factors, job strain was not found to be associated with smoking cessation. However, among smokers, those in higher-strain jobs smoked more heavily than those in lower-strain positions (OR 1.70, 95% CI = 1.10, 2.61) and were more likely to have increased the amount they smoke (OR 3.72, 95% CI = 1.92, 7.17). Handle: RePEc:aph:ajpbhl:1990:80:11:1368-1371_7 Template-Type: ReDIF-Article 1.0 Title: Congenital syphilis: Reporting and reality Journal: American Journal of Public Health Author-Name: Zenker, P.N. Author-Name: Berman, S.M. Year: 1990 Volume: 80 Issue: 3 Pages: 271-272 Handle: RePEc:aph:ajpbhl:1990:80:3:271-272_0 Template-Type: ReDIF-Article 1.0 Title: The present and the future of AIDS and tuberculosis in Illinois Journal: American Journal of Public Health Author-Name: Cote, T.R. Author-Name: Nelson, M.R. Author-Name: Anderson, S.P. Author-Name: Martin, R.J. Year: 1990 Volume: 80 Issue: 8 Pages: 950-953 Abstract: The relation between the acquired immune deficiency syndrome (AIDS) and tuberculosis (TB) was examined by matching the Illinois AIDS and TB registries. The match group was examined and compared with patients with only one disease by race, method of human immunodeficiency virus (HIV) transmission, site of tuberculous disease, radiographic findings, and results of Mantoux tests. The time of TB diagnosis was centrally distributed around the time of AIDS diagnosis; from this, it was determined that 4.1 percent of AIDS patients develop active TB. Projections for future AIDS cases were made by fitting a polynomial model to historical data. These projections were then used to predict the future impact of AIDS-related TB upon state TB rates. The rise in TB rates calls for special efforts to minimize this impact. Handle: RePEc:aph:ajpbhl:1990:80:8:950-953_9 Template-Type: ReDIF-Article 1.0 Title: New FDA drug approval policies and HIV vaccine development Journal: American Journal of Public Health Author-Name: Mariner, W.K. Year: 1990 Volume: 80 Issue: 3 Pages: 336-341 Abstract: The need for new drugs to treat AIDS has caused the federal Food and Drug Administration to modify its procedures for reviewing and approving investigational drugs. Even researchers with reservations about the FDA's new policies are receptive to the idea that the drug review process in the United States could be improved, and the same may be true for the procedures by which vaccines are reviewed. Mariner explains why, because of the differences between drugs and vaccines, the FDA's new drug review policies should not be applied to investigational vaccines to prevent HIV infection. Experimental vaccines warrant separate treatment to protect the healthy subjects who receive them. Mariner argues that the FDA should make an explicit decision to continue to review candidate HIV vaccines in its vaccine unit, separately from drugs, with stricter standards of safety and efficacy. Handle: RePEc:aph:ajpbhl:1990:80:3:336-341_9 Template-Type: ReDIF-Article 1.0 Title: Prevalence and restrictiveness of smoking policies in King County, Washington, manufacturing worksites Journal: American Journal of Public Health Author-Name: Kinne, S. Year: 1990 Volume: 80 Issue: 12 Pages: 1498-1500 Abstract: This study examined prevalence of smoking policies and of significant smoking restrictions in a 1988 random sample of 1,528 manufacturing companies in the Seattle, Washington area, and related these characteristics to worksite size and industry type. Sixty-nine percent of companies had formal smoking policies and 85 percent regulated smoking to some degree. Workforce size was directly related to prevalence of significant smoking restrictions, but when type of industry was controlled, the linear trend in the size/prevalence relationship was sustained in only three of the 18 industry groupings. Handle: RePEc:aph:ajpbhl:1990:80:12:1498-1500_9 Template-Type: ReDIF-Article 1.0 Title: Smoking and consistently high use of medical care among older HMO members Journal: American Journal of Public Health Author-Name: Freeborn, D.K. Author-Name: Mullooly, J.P. Author-Name: Pope, C.R. Author-Name: McFarland, B.H. Year: 1990 Volume: 80 Issue: 5 Pages: 603-605 Abstract: Smoking behavior of consistently high and low users of medical care services compared in two groups of older health maintenance organization (HMO) members continuously enrolled for five years and a subgroup who were continuously enrolled for 10 years. Smokers and former smokers, combined, were more likely than never-smokers to be consistently high users of ambulatory services (52 percent vs 34 percent in the five-year group, and 45 percent vs 30 percent in the 10-year group). Handle: RePEc:aph:ajpbhl:1990:80:5:603-605_7 Template-Type: ReDIF-Article 1.0 Title: Dietary vitamin C intake and cigarette smoking Journal: American Journal of Public Health Author-Name: Gridley, G. Author-Name: McLaughlin, J.K. Author-Name: Blot, W.J. Year: 1990 Volume: 80 Issue: 12 Pages: 1526 Handle: RePEc:aph:ajpbhl:1990:80:12:1526_1 Template-Type: ReDIF-Article 1.0 Title: Swaddling and acute respiratory infections Journal: American Journal of Public Health Author-Name: Yurdakok, K. Author-Name: Yavuz, T. Author-Name: Taylor, C.E. Year: 1990 Volume: 80 Issue: 7 Pages: 873-875 Abstract: In Turkey and China the ancient practice of swaddling is still commonly practices. Both countries have extremely high rates op pneumonia, especially during the neonatal period. Preliminary evidence on the possibility that swaddling may interfere with normal respiratory function and thereby predispose to pneumonia was gathered in a teaching health center in Ankara. Babies who had been swaddled for at least three months were four times more likely to have developed pneumonia (confirmed radiologically) and upper respiratory infections than babies who were unswaddled. These preliminary findings were highly significant and are being followed up by further studies. Handle: RePEc:aph:ajpbhl:1990:80:7:873-875_7 Template-Type: ReDIF-Article 1.0 Title: Local survey of HIV+ individuals Journal: American Journal of Public Health Author-Name: Gustafson, D.H. Author-Name: Tillotson, T. Author-Name: Bosworth, K. Year: 1990 Volume: 80 Issue: 8 Pages: 1000 Handle: RePEc:aph:ajpbhl:1990:80:8:1000_8 Template-Type: ReDIF-Article 1.0 Title: Development and validation of a food use checklist for evaluation of community nutrition interventions Journal: American Journal of Public Health Author-Name: Kristal, A.R. Author-Name: Abrams, B.F. Author-Name: Thornquist, M.D. Author-Name: Disogra, L. Author-Name: Croyle, R.T. Author-Name: Shattuck, A.L. Author-Name: Henry, H.J. Year: 1990 Volume: 80 Issue: 11 Pages: 1318-1322 Abstract: We developed a new dietary assessment instrument, the Food Behavior Checklist (FBC), which measures food use related to adopting lower-fat and higher-fiber diets. The FBC is a simplification of the 24-hour diet recall that consists of 19 simple yes/no questions about foods consumed during the previous day. To develop the FBC, an expert committee generated a list of foods based on our intervention program, and we used focus groups and random-digit dialing pretests to refine the format and clarify items. To validate the FBC, we compared responses of 96 women on the FBC to information collected during a professionally administered 24-hour diet recall. For most items, agreement between the FBC and 24-hour recall, based on the kappa statistic, was good to excellent. Agreement was poor for items requiring detailed knowledge about food composition (e.g. high-fiber cereal). There was a trend to over-report general food categories (e.g. luncheon meats) but not specific food items (e.g. ice cream). In an embedded randomized study, we found that a set of introductory items designed to serve as a memory retrieval cue did not improve agreement between the FBC and 24-hour recall. These data provide preliminary evidence supporting the use of short checklist questionnaires on the previous day's food use as a means to assess diet at the group or community level. This relatively inexpensive and rapid measure can be used to inform the design of public health nutrition programs and as an evaluation tool in intervention research. Handle: RePEc:aph:ajpbhl:1990:80:11:1318-1322_1 Template-Type: ReDIF-Article 1.0 Title: Quality of death certificates: Studying or burying. Response from Dr. Moriyama (I: Reply) Journal: American Journal of Public Health Author-Name: Moriyama, I.M. Year: 1990 Volume: 80 Issue: 6 Pages: 751-752 Handle: RePEc:aph:ajpbhl:1990:80:6:751-752_9 Template-Type: ReDIF-Article 1.0 Title: Onset of fertility-related events during adolescence: A prospective comparison of Mexican American and non-Hispanic white females Journal: American Journal of Public Health Author-Name: Aneshensel, C.S. Author-Name: Becerra, R.M. Author-Name: Fielder, E.P. Author-Name: Schuler, R.H. Year: 1990 Volume: 80 Issue: 8 Pages: 959-963 Abstract: Ethnic differences in the first occurrence of fertility-related events are assessed for non-Hispanic White and Mexican American female adolescents. A community-based sample of 1,023 female ages 13 to 19 years was interviewed in 1984-85; 874 (85.4 percent) were reinterviewed approximately two years later. Mexico-born Mexican Americans have the lowest rate of early sexual intercourse, but the highest rate of early births because they are most likely to become pregnant if sexually active, and most likely to have a birth if pregnant. Non-Hispanic Whites have the highest rate of early sexual intercourse, but the lowest rate of early births because pregnany non-Hispanic whites terminate pregnancies most often. US-born Mexican Americans are intermediate between the other two groups. Delays in the onset of sexual activity among Mexican Americans are not converted into corresponding delays in first pregnancies and births. Early marriage among Mexico-born Mexican Americans, however, accounts for much of the ethnic difference in early fertility. Handle: RePEc:aph:ajpbhl:1990:80:8:959-963_2 Template-Type: ReDIF-Article 1.0 Title: Incentives and competition in a worksite smoking cessation intervention Journal: American Journal of Public Health Author-Name: Jason, L.A. Author-Name: Jayaraj, S. Author-Name: Blitz, C.C. Author-Name: Michaels, M.H. Author-Name: Klett, L.E. Year: 1990 Volume: 80 Issue: 2 Pages: 205-206 Abstract: We evaluated a worksite smoking cessation program that employed multicomponents including support groups, incentives, and competition. The combination of incentives and other components increased participation rates to over 80%. Forty-two percent of smokers were abstinent at six months, compared to 13 percent of a control group (difference 29 percent, 95% CI 9, 49). Handle: RePEc:aph:ajpbhl:1990:80:2:205-206_7 Template-Type: ReDIF-Article 1.0 Title: Longevity and left-handedness (I: Reply) Journal: American Journal of Public Health Author-Name: Coren, S. Year: 1990 Volume: 80 Issue: 3 Pages: 353 Handle: RePEc:aph:ajpbhl:1990:80:3:353_6 Template-Type: ReDIF-Article 1.0 Title: Demographic and dietary determinants of constipation in the US population Journal: American Journal of Public Health Author-Name: Sandler, R.S. Author-Name: Jordan, M.C. Author-Name: Shelton, B.J. Year: 1990 Volume: 80 Issue: 2 Pages: 185-189 Abstract: We investigated the association between self-reported constipation and several demographic and dietary variables in 15,014 men and women 12-74 years of age examined between 1971-75 during the first Health and Nutrition Examination Survey. Overall, 12.8 percent reported constipation. Self-reported constipation correlated poorly with stool frequency. Nine percent of those with daily stools and 30.6 percent of those with four to six stools/week, reported constipation. Constipation was more frequent in Blacks (17.3 percent), women (18.2 percent), and those over age 60 (23.3 percent); after adjusting for age, sex, and race it was more prevalent in those with daily inactivity, little leisure exercise, low income, and poor education. Constipated subjects reported lower consumption of cheese, dry beans and peas, milk, meat and poultry, beverages (sweetened, carbonated and noncarbonated), and fruits and vegetables. They reported higher consumption of coffee or tea. They consumed fewer total calories even after controlling for body mass and exercise. Handle: RePEc:aph:ajpbhl:1990:80:2:185-189_4 Template-Type: ReDIF-Article 1.0 Title: The effect of a patient education program on emergency room use for inner-city children with asthma Journal: American Journal of Public Health Author-Name: Shields, M.C. Author-Name: Griffin, K.W. Author-Name: McNabb, W.L. Year: 1990 Volume: 80 Issue: 1 Pages: 36-38 Abstract: An educational program for children with asthma designed to reduce emergency room (ER) use enrolled all eligible children (n = 253 primarily low-income Black) within a health maintenance organization (HMO) who had used the hospital or ER for asthma during the pre-enrollment period and randomized them into two groups. Twenty-four of the experimental group patients had 55 ER visits and 18 of the control patients had 39 ER visits during the first 12 months post-intervention. This program did not achieve its goal. Handle: RePEc:aph:ajpbhl:1990:80:1:36-38_7 Template-Type: ReDIF-Article 1.0 Title: Health status of migrant farmworkers: A literature review and commentary Journal: American Journal of Public Health Author-Name: Rust, G.S. Year: 1990 Volume: 80 Issue: 10 Pages: 1213-1217 Abstract: I made a computerized search of MEDLINE files from 1966 through October 1989 followed by a review of this literature. Four hundred eighty-five articles were scanned; 152 were found specifically related to migrant families, while another 51 articles addressed the health of agricultural workers or farmers in general. Solid data exist on dental health, nutrition and, to a lesser extent, childhood health. Data also were prominent in several disease categories including certain infectious diseases, pesticide exposures, occupational dermatoses, and lead levels in children. Estimates of the size of the migrant and seasonal farmworker population vary widely. Basic health status indicators such as age-related death rates are unknown. Prevalence rates of the most common cause of death in the United States have yet to be studied. More research is needed into the health problems and health status of migrant and seasonal farmworker families. Handle: RePEc:aph:ajpbhl:1990:80:10:1213-1217_2 Template-Type: ReDIF-Article 1.0 Title: A case report of lead paint poisoning during renovation of a Victorian farmhouse Journal: American Journal of Public Health Author-Name: Marino, P.E. Author-Name: Landrigan, P.J. Author-Name: Graef, J. Author-Name: Nussbaum, A. Author-Name: Bayan, G. Author-Name: Boch, K. Author-Name: Boch, S. Year: 1990 Volume: 80 Issue: 10 Pages: 1183-1185 Abstract: We describe a series of four cases of childhood lead poisoning and two cases of adult lead toxicity in a professional family exposed to lead dust and fume during renovation of a rural farmhouse. Initial blood lead levels in the children ranged from 2.70 to 4.20 μM/L (56 to 87 μm/dl) and all four required chelation therapy. Lead-based paint poisoning, a well recognized entity among young children in poor, urban neighborhoods, is not confined exclusively to such areas. Handle: RePEc:aph:ajpbhl:1990:80:10:1183-1185_2 Template-Type: ReDIF-Article 1.0 Title: An epidemiologic postmarketing surveillance study of prescription acne medications Journal: American Journal of Public Health Author-Name: Facklam, D.P. Author-Name: Gardner, J.S. Author-Name: Neidert, G.L. Author-Name: Westland, M.M. Year: 1990 Volume: 80 Issue: 1 Pages: 50-53 Abstract: After the Food and Drug Administration approved a topical antibiotic for the treatment of acne, we began a postmarketing surveillance study to measure the frequency of antibiotic-associated colitis and diarrhea in acne patients treated with topical antibiotics and low doses of oral antibiotics. Pharmacists recruited 13,465 patients who presented a prescription for an acne medication, and we obtained detailed information on the use of the medications, perceived acceptability, and the occurrence of new health events from 6,453 with computer-assisted telephone interviews. Three cases (< 0.1%) of antibiotic-associated diarrhea and one case (< 0.1%) of antibiotic-associated colitis were confirmed. We conclude that this methodology can provide further information about the safety of a drug once it is in customary use, at a fraction of the cost of Phase III clinical trials. Handle: RePEc:aph:ajpbhl:1990:80:1:50-53_5 Template-Type: ReDIF-Article 1.0 Title: Salmonella arizona infections in Latinos associated with rattlesnake folk medicine Journal: American Journal of Public Health Author-Name: Waterman, S.H. Author-Name: Juarez, G. Author-Name: Carr, S.J. Author-Name: Kilman, L. Year: 1990 Volume: 80 Issue: 3 Pages: 286-289 Abstract: In 1987 two Los Angeles County (California) hospitals reported four Latino patients with serious Salmonella arizona (Salmonella subgroup 3) infections who gave a medical history of taking rattlesnake capsules prior to illness. Capsules supplied by the patients or household members grew Salmonella arizona. We reviewed surveillance data for this Salmonella species and conducted a case-control study to determine the magnitude of this public health problem. Eighteen (82 percent) of the 22 Latino cases in 1986 and 1987 who were questioned reported ingesting snake capsules compared to two (8 percent) of 24 matched Latino controls with non-subgroup 3 salmonellosis or shigellosis (matched pair odds ratio = 18.0, CI = 4.2, 76.3). An average of 18 cases per year of Salmonella arizona were reported in the county between 1980 and 1987. In this investigation the majority of S. arizona cases reporting snake capsule ingestion had underlying illnesses such as acquired immunodeficiency syndrome (AIDS), diabetes, arthritis, cancer. The capsules were obtained primarily from Tijuana, Mexico and from Los Angeles, California pharmacies in Latino neighborhoods. Despite publicity and attempts to remove the capsules from sale in California, Salmonella arizona cases associated with snake-capsule ingestion continue to occur. Handle: RePEc:aph:ajpbhl:1990:80:3:286-289_6 Template-Type: ReDIF-Article 1.0 Title: Shooting galleries and AIDS: Infection probabilities and 'tough' policies Journal: American Journal of Public Health Author-Name: Des Jarlais, D.C. Author-Name: Friedman, S.R. Year: 1990 Volume: 80 Issue: 2 Pages: 142-144 Handle: RePEc:aph:ajpbhl:1990:80:2:142-144_8 Template-Type: ReDIF-Article 1.0 Title: Increase in condom sales following AIDS education and publicity, United States Journal: American Journal of Public Health Author-Name: Moran, J.S. Author-Name: Janes, H.R. Author-Name: Peterman, T.A. Author-Name: Stone, K.M. Year: 1990 Volume: 80 Issue: 5 Pages: 607-608 Abstract: Data from a national probability sample of drug stores show that condom sales rose from 240 million annually in 1986 to 299 million in 1988. The greatest increase occurred in 1987 after the Surgeon General's report on AIDS was released. Sales of latex condoms with spermicidorose 116 percent. Sales of other types of condoms increased less. These data suggest that Americans are using more condoms and probably more effective condoms in response to AIDS education. Handle: RePEc:aph:ajpbhl:1990:80:5:607-608_3 Template-Type: ReDIF-Article 1.0 Title: Drug addiction and pregnancy: Policy crossroads Journal: American Journal of Public Health Author-Name: Chavkin, W. Year: 1990 Volume: 80 Issue: 4 Pages: 483-487 Handle: RePEc:aph:ajpbhl:1990:80:4:483-487_8 Template-Type: ReDIF-Article 1.0 Title: Some sources of error in the coding of birth weight. Journal: American Journal of Public Health Author-Name: Brunskill, A.J. Year: 1990 Volume: 80 Issue: 1 Pages: 72-73 Abstract: Three types of error in coding birth weight to computer tapes are described: 1) confusion of ounces with pounds, 2) mistaken reading of one pound as eleven pounds, and 3) errors in placement of the decimal. All will allocate low birth weight infants to high birth weight categories. Examination of the reported gestational age of the infant or of the reported cause of death may allow these errors to be detected. Handle: RePEc:aph:ajpbhl:1990:80:1:72-73_6 Template-Type: ReDIF-Article 1.0 Title: VII. Acculturation and alcohol consumption in the Mexican American population of the southwestern United States: Findings from HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Markides, K.S. Author-Name: Ray, L.A. Author-Name: Stroup-Benham, C.A. Author-Name: Trevino, F. Year: 1990 Volume: 80 Issue: SUPPL. Pages: 42-46 Abstract: Data from the Southwestern sample of the Hispanic HANES are employed to evaluate the relationship of acculturation into the larger society with alcohol consumption. As in previous work, acculturation was not found to be related to alcohol consumption of Mexican American men, but was positively related to the consumption of younger Mexican American women. Among middle-aged women, acculturation was not important. However, we found evidence that middle-aged women might be turning to alcohol in response to marital disruption and poverty. In addition, middle-aged women who are not employed are less frequent drinkers but those who drink are heavier drinkers than employed women. Handle: RePEc:aph:ajpbhl:1990:80:SUPPL.:42-46_1 Template-Type: ReDIF-Article 1.0 Title: Results of an intervention to improve compliance with referrals for evaluation of suspected malignancies at Neighborhood Public Health Centers Journal: American Journal of Public Health Author-Name: Manfredi, C. Author-Name: Lacey, L. Author-Name: Warnecke, R. Year: 1990 Volume: 80 Issue: 1 Pages: 85-87 Abstract: A study was conducted at Neighborhood Health Centers to evaluate procedures to improve compliance with referrals of patient at risk for cancer. Intervention consisted of a standardized communication from the exit nurse, a patient form to be returned after compliance, and one written and one telephone reminder as needed. Compliance was 68.2 percent in a control group and 89.0 percent among patients who received the experimental intervention, a significant increase of 20.8 percent (95% CI: 12.5, 29.1). Handle: RePEc:aph:ajpbhl:1990:80:1:85-87_5 Template-Type: ReDIF-Article 1.0 Title: Fecal contamination of shanty town toddlers in households with non-corralled poultry, Lima, Peru Journal: American Journal of Public Health Author-Name: Marquis, G.S. Author-Name: Ventura, G. Author-Name: Gilman, R.H. Author-Name: Porras, E. Author-Name: Miranda, E. Author-Name: Carbajal, L. Author-Name: Pentafiel, M. Year: 1990 Volume: 80 Issue: 2 Pages: 146-149 Abstract: We used direct observer techniques to measure the frequency with which toddler-aged children were contaminated by poultry feces in homes in a peri-urban shanty town in Lima, Peru. The mean number of fowl was 5.4 (SD 3.1), with 10.0 (SD 10.7) poultry defecations per 12 hours. Toddlers' hand contant with poultry feces occurred a mean of 2.9 (SD 3.0) times/12 hours. A mean of 3.9 (SD 4.6) feces-to-mouth episodes per household/12 hours occurred both by direct hand-to-mouth contamination and indirectly by handling soiled objects which were then placed in the mouth. There was a strong correlation between feces-to-hand contamination and feces-to-mouth contamination (r = 0.94). There was also an association between feces-to-mouth contamination and the number of stools deposited in the house (r = 0.66). For each additional chicken stool deposited during the day, there was an average increase of 0.27 in feces-to-mouth episodes. We collected feces from 68 infected chickens and found viable Campylobacter jejuni for up to 48 hours after deposition. Yet, a survey of 108 families demonstrated that free-roaming poultry were often not thought of as a health risk for children. An intervention program to reduce oral-fecal contamination should emphasize that all poultry be corralled and not allowed access into the house. Handle: RePEc:aph:ajpbhl:1990:80:2:146-149_0 Template-Type: ReDIF-Article 1.0 Title: A comparison of homeless, community-wide, and selected distressed samples on the CES-Depression Scale Journal: American Journal of Public Health Author-Name: Ritchey, F.J. Author-Name: La Gory, M. Author-Name: Fitzpatrick, K.M. Author-Name: Mullis, J. Year: 1990 Volume: 80 Issue: 11 Pages: 1384-1386 Abstract: Center for Epidemiological Studies (CES) Depression Scale results for surveys of homeless, community-wide and selected distressed samples are compared. Nearly four times the percentage of homeless fit the criterion for clinical caseness (a score of 16+) compared to the general population (74 to 19 percent). None of the distressed samples exhibited a higher rate except psychiatric patients diagnosed as acutely depressive. High rates of depression have implications for social policies directed toward homelessness. Handle: RePEc:aph:ajpbhl:1990:80:11:1384-1386_6 Template-Type: ReDIF-Article 1.0 Title: A crisis of community anxiety and mistrust: The medfly eradication project in Santa Clara County, California, 1981-82 Journal: American Journal of Public Health Author-Name: Kahn, E. Author-Name: Jackson, R.J. Author-Name: Lyman, D.O. Author-Name: Stratton, J.W. Year: 1990 Volume: 80 Issue: 11 Pages: 1301-1304 Abstract: Public anxiety of near panic proportions was created by the announcement of a plan to commence aerial application of malathion bait over a large urban area in California for the eradication of the Mediterranean fruit fly within four days. A risk assessment had reported the project entailed no significant risk to health but environmentalist groups and the media ignored the report. We describe the successful measures taken by State health workers to counteract the anxiety which itself constituted a serious public health problem. The most important measure was the rapid convening of a Health Advisory Committee composed of recognized experts and local professionals and leaders to provide an authoritative, respected and sympathetic voice to deal with the community's concerns. These experiences may be of value to other communities facing unwarranted anxiety over perceived environmental hazards. Handle: RePEc:aph:ajpbhl:1990:80:11:1301-1304_6 Template-Type: ReDIF-Article 1.0 Title: Homelessness and housing policy: A game of musical chairs Journal: American Journal of Public Health Author-Name: Sclar, E.D. Year: 1990 Volume: 80 Issue: 9 Pages: 1039-1040 Handle: RePEc:aph:ajpbhl:1990:80:9:1039-1040_1 Template-Type: ReDIF-Article 1.0 Title: A case-control study of the effectiveness of bicycle safety helmets in preventing facial injury Journal: American Journal of Public Health Author-Name: Thompson, D.C. Author-Name: Thompson, R.S. Author-Name: Rivara, F.P. Author-Name: Wolf, M.E. Year: 1990 Volume: 80 Issue: 12 Pages: 1471-1474 Abstract: In a case-control study we sought to assess the potential effectiveness of helmets in preventing facial injuries. Our study included 212 bicyclists with facial injuries and 319 controls with injuries to other body areas, who were treated in emergency rooms of five Seattle area hospitals over a one-year period. Using regression analyses to control for age, sex, education and income, accident severity, and cycling experience we found no definite effect of helmets on the risk of serious facial injury (odds ratio 0.81; 95 percent confidence interval = 0.45, 1.5), but protection against serious injuries to the upper face (odds ratio 0.27; 95% CI = 0.1, 0.8). No protection was found against serious injuries to the lower face. The independent effect of helmet use on facial injury was difficult to isolate due to the association of head and facial injuries. Our results suggest that bicycle helmets as presently designed may have some protective effect against serious upper facial injuries. Handle: RePEc:aph:ajpbhl:1990:80:12:1471-1474_6 Template-Type: ReDIF-Article 1.0 Title: Infectious disease control in a long-term refugee camp: The role of epidemiologic surveillance and investigation Journal: American Journal of Public Health Author-Name: Elias, C.J. Author-Name: Alexander, B.H. Author-Name: Sokly, T. Year: 1990 Volume: 80 Issue: 7 Pages: 824-828 Abstract: This report demonstrates the role of epidemiologic surveillance and investigation in the control of infectious diseases in a long-term refugee camp. The applications of simple epidemiologic methods in a refugee camp on the Thai-Cambodian border are described for a one-year period. The development of a Health Information Office facilitated the collection of demographic and vital statistics data, administration of a disease surveillance system, regular monitoring of hospital and outpatient discharge diagnoses, and investigation of disease outbreaks. This office also organized community health education campaigns and disease control efforts. Examples of specific disease investigations are provided to demonstrate the utility of epidemiologic surveillance in the control of infectious disease. We conclude that simple epidemiologic methods play an important role in health planning in long-term refugee camps. Handle: RePEc:aph:ajpbhl:1990:80:7:824-828_0 Template-Type: ReDIF-Article 1.0 Title: The Framingham disability study: Relationship of various coronary heart disease manifestations to disability in older persons liniving in the community Journal: American Journal of Public Health Author-Name: Pinsky, J.L. Author-Name: Jette, A.M. Author-Name: Branch, L.G. Author-Name: Kannel, W.B. Author-Name: Feinleib, M. Year: 1990 Volume: 80 Issue: 11 Pages: 1363-1368 Abstract: The relation between coronary heart disease and disability was examined in 2,576 community-dwelling women and men ages 55-88 years. These Framingham Study participants were originally recruited in 1948-51 for an examination of cardiovascular disease. Twenty-seven years later, remaining members of the cohort were interviewed to ascertain physical abilities, and a score on a disability scale was assigned. Multivariate logistic analyses examined disability in relation to uncomplicated angina pectoris (AP), complicated AP, and coronary heart disease other than AP, controlling for possible confounders. In younger and older women and men, uncomplicated and complicated AP were associated with disability. Coronary heart disease other than AP was associated with disability only in the younger men. Congestive heart failure predicted disability only in the women. These results suggest that onset of AP should be recognized as a critical point in the development of disability and that AP is a better predictor of disability than is myocardial infarction or coronary insufficiency. Handle: RePEc:aph:ajpbhl:1990:80:11:1363-1368_2 Template-Type: ReDIF-Article 1.0 Title: On ambulatory care Journal: American Journal of Public Health Author-Name: Masson, V. Year: 1990 Volume: 80 Issue: 10 Pages: 1277 Handle: RePEc:aph:ajpbhl:1990:80:10:1277_3 Template-Type: ReDIF-Article 1.0 Title: Lead exposure in indoor firing ranges (I) Journal: American Journal of Public Health Author-Name: Stern, A.H. Year: 1990 Volume: 80 Issue: 3 Pages: 353-354 Handle: RePEc:aph:ajpbhl:1990:80:3:353-354_0 Template-Type: ReDIF-Article 1.0 Title: Unpublished nurse practice data sought Journal: American Journal of Public Health Author-Name: Waddell, D.L. Year: 1990 Volume: 80 Issue: 3 Pages: 352-353 Handle: RePEc:aph:ajpbhl:1990:80:3:352-353_8 Template-Type: ReDIF-Article 1.0 Title: Misclassification of childhood homicide on death certificates Journal: American Journal of Public Health Author-Name: Lapidus, G.D. Author-Name: Gregorio, D.I. Author-Name: Hansen, H. Year: 1990 Volume: 80 Issue: 2 Pages: 213-214 Abstract: Suspect classification of homicide deaths of Connecticut residents under 20 years of age was noted for 29 percent of cases examined. Misclassification was attributed to incomplete or erroneous information recorded on the death certificates, rather than errors in the designation of ICD-9 homicide codes. The results have important implications in the interpretation of vital statistics when homicide is listed as the cause of death and underscore the value of record linkage systems. Handle: RePEc:aph:ajpbhl:1990:80:2:213-214_4 Template-Type: ReDIF-Article 1.0 Title: Long-term effectiveness of mass media led antismoking campaigns in Australia Journal: American Journal of Public Health Author-Name: Pierce, J.P. Author-Name: Macaskill, P. Author-Name: Hill, D. Year: 1990 Volume: 80 Issue: 5 Pages: 565-569 Abstract: A community antismoking campaign began in Sydney, Australia in 1983, and in Melbourne in 1984. These campaigns purchased prime-time television advertising spots to set the community agenda. An intense effort was made to ensure that antismoking activities were maximized at the school, organizational, and community level. Smoking prevalences in both cities from 1981 were fitted with a statistical model to identify any underlying trend, to assess any immediate impact, and to assess the longer term effect of continuing to conduct such campaigns, i.e. to identify any change in the underlying trend. During the years before the antismoking campaigns, there was no observable trend in smoking prevalence in either city. At the beginning of the campaigns, there was an immediate drop of more than two percentage points in male and female smoking prevalence in both cities. Thereafter, a decline of about 1.5 percentage points per year was observed among males. No post campaign trend was observed in smoking prevalence for women in either city. These data support conducting coordinated community campaigns to reduce current smoking prevalence. Handle: RePEc:aph:ajpbhl:1990:80:5:565-569_4 Template-Type: ReDIF-Article 1.0 Title: The relationship of smoking cessation to coronary heart disease and lung cancer in the Multiple Risk Factor Intervention Trial (MRFIT) Journal: American Journal of Public Health Author-Name: Ockene, J.K. Author-Name: Kuller, L.H. Author-Name: Svendsen, K.H. Author-Name: Meilahn, E. Year: 1990 Volume: 80 Issue: 8 Pages: 954-958 Abstract: The impact of smoking cessation on coronary heart disease (CHD) and lung cancer was assessed after 10.5 years of follow-up in the 12,866 men in the Multiple Risk Factor Intervention Trial (MRFIT). Those men who died of lung cancer (n = 119) were either cigarette smokers at entry or ex-smokers; no lung cancer deaths occurred among the 1,859 men who reported never smoking cigarettes. The risk of lung cancer for smokers, adjusted for selected baseline variables using a Cox proportional hazards model, increased as the number of cigarettes smoked increased (B = 0.0203, SE = 0.0076). There was not the same graded response for CHD among smokers at entry. The risk of CHD death was greater among smokers than nonsmokers (RR = 1.57) (B = -0.0034, S.E. = 0.0048). After one year of cessation, the relative risk of dying of CHD for the quitters as compared to non-quitters (RR = 0.63) was significantly lower even after adjusting for baseline differences and changes in other risk factors. The relative risk for smokers who quit for at least the first three years of the trial was even lower compard to non-quitters (RR = 0.38). However, the relative risk for lung cancer for quitters versus non-quitters was close to 1 both for quitters at 12 months and at three years. These data support the benefits of cessation in relation to CHD and are consistent with other epidemiologic studies which suggest that the lag time for beneficial effect of smoking cessation on lung cancer may be as long as 20 years. Handle: RePEc:aph:ajpbhl:1990:80:8:954-958_3 Template-Type: ReDIF-Article 1.0 Title: The prevention of intellectual impairment in children of impoverished families: Findings of a randomized trial of educational day care Journal: American Journal of Public Health Author-Name: Martin, S.L. Author-Name: Ramey, G.T. Author-Name: Ramey, S. Year: 1990 Volume: 80 Issue: 7 Pages: 844-847 Abstract: We estimated the effects of an experimental educational day care program on the intellectual development of preschoolers from 86 high-risk families in a randomly allocated longitudinal study. At six through 54 months of age, the IQs of experimental program children ranged from 7.9 to 20.1 points higher than those of control children when maternal mental retardation and home environment effects were controlled; at every age, a greater proportion of the experimental program children had normal range IQs (> 84). In 13 children with retarded mothers, none of six experimental program children, but six of seven control children, had IQ scores below normal. Handle: RePEc:aph:ajpbhl:1990:80:7:844-847_7 Template-Type: ReDIF-Article 1.0 Title: Developing AIDS education for women in county WIC clinics Journal: American Journal of Public Health Author-Name: McDonald, M. Author-Name: Kleppel, L. Author-Name: Jenssen, D. Year: 1990 Volume: 80 Issue: 11 Pages: 1391-1392 Handle: RePEc:aph:ajpbhl:1990:80:11:1391-1392_9 Template-Type: ReDIF-Article 1.0 Title: Sentinel Health Events (Occupational): Analysis of death certificates among residents of Nassau County, NY between 1980-82 for occupationally related causes of death Journal: American Journal of Public Health Author-Name: Feldman, J.P. Author-Name: Gerber, L.M. Year: 1990 Volume: 80 Issue: 2 Pages: 158-161 Abstract: Death certificates for residents of Nassau County, New York dying between 1980 and 1982 were examined for causes of death defined as Sentinel Health Events (Occupational) {SHE(O)}. Of 16,193 deaths from all causes, 2,286 (14.1 percent) were identified as SHE(O) deaths; 142 required no match because the cause of death was inherently related to the occupation or industry. Malignant neoplasms of the trachea, bronchus, or lung were the most frequently occurring SHE(O), accounting for 60 percent of all SHE(O) deaths and 81 percent of matched SHE(O) deaths. The construction industry was associated with the vast majority of such deaths. Handle: RePEc:aph:ajpbhl:1990:80:2:158-161_0 Template-Type: ReDIF-Article 1.0 Title: Behavioral change in longitudinal studies: Adoption of condom use by homosexual/bisexual men Journal: American Journal of Public Health Author-Name: Joseph, J.G. Author-Name: Adib, S.M. Author-Name: Koopman, J.S. Author-Name: Ostrow, D.G. Year: 1990 Volume: 80 Issue: 12 Pages: 1513-1514 Abstract: We compared reporting serial cross-sectional prevalence of sexual behavior over time, to reporting individual patterns of behavioral change in a cohort of homosexual men at a six-month interval. Aggregate prevalence rates underestimated the magnitude of change to safer practices, and failed to provide information on relapse to less safe practices. We conclude that it is important to report data based on individual fluctuations in behavior for the evaluation of change over time. Handle: RePEc:aph:ajpbhl:1990:80:12:1513-1514_7 Template-Type: ReDIF-Article 1.0 Title: Circumferences never went away. Journal: American Journal of Public Health Author-Name: Jelliffe, D.B. Author-Name: Jelliffe, E.F. Year: 1989 Volume: 79 Issue: 11 Pages: 1571-1572 Handle: RePEc:aph:ajpbhl:1989:79:11:1571-1572_9 Template-Type: ReDIF-Article 1.0 Title: A note of caution re: circumferences. Journal: American Journal of Public Health Author-Name: Garn, S.M. Year: 1989 Volume: 79 Issue: 11 Pages: 1572 Handle: RePEc:aph:ajpbhl:1989:79:11:1572_5 Template-Type: ReDIF-Article 1.0 Title: AMA policy on chiropractic. Journal: American Journal of Public Health Author-Name: Cherkin, D. Year: 1989 Volume: 79 Issue: 11 Pages: 1569-1570 Handle: RePEc:aph:ajpbhl:1989:79:11:1569-1570_5 Template-Type: ReDIF-Article 1.0 Title: Health care for the indigent. Journal: American Journal of Public Health Author-Name: Adams, N. Year: 1989 Volume: 79 Issue: 10 Pages: 1435-1436 Handle: RePEc:aph:ajpbhl:1989:79:10:1435-1436_5 Template-Type: ReDIF-Article 1.0 Title: Environmental tobacco smoke and legal issues. Journal: American Journal of Public Health Author-Name: Halfen, L.N. Year: 1989 Volume: 79 Issue: 10 Pages: 1433-1434 Handle: RePEc:aph:ajpbhl:1989:79:10:1433-1434_0 Template-Type: ReDIF-Article 1.0 Title: The expense of testing in a teaching hospital: the predominant role of high-cost tests. Journal: American Journal of Public Health Author-Name: Hartley, R.M. Author-Name: Markowitz, M.A. Author-Name: Komaroff, A.L. Year: 1989 Volume: 79 Issue: 10 Pages: 1389-1391 Abstract: We analyzed all 32,206 tests ordered in a random sample of 1,000 patients admitted to a teaching hospital. The analysis examined costs instead of charges, included professional costs in addition to hospital costs, and considered the effect of combining tests that are ordered as a panel (e.g., cardiac enzymes) or as part of a procedure (e.g., bronchoscopy). High-cost tests (costing more than $100) accounted for only 4 percent of the total number of tests ordered, but for nearly 50 percent of total test costs. The pattern varied by clinical service: high-cost tests accounted for 31, 47, and 51 percents of total test costs on the obstetrics, medicine, and surgery services, respectively. It would seem to be efficient to concentrate on the use of high-cost tests in attempting to foster cost-effective use of diagnostic technologies. Handle: RePEc:aph:ajpbhl:1989:79:10:1389-1391_4 Template-Type: ReDIF-Article 1.0 Title: A nation of suspects: drug testing and the Fourth Amendment. Journal: American Journal of Public Health Author-Name: Glantz, L.H. Year: 1989 Volume: 79 Issue: 10 Pages: 1427-1431 Handle: RePEc:aph:ajpbhl:1989:79:10:1427-1431_5 Template-Type: ReDIF-Article 1.0 Title: Risk to passive smokers. Journal: American Journal of Public Health Author-Name: Holcomb, L.C. Year: 1989 Volume: 79 Issue: 10 Pages: 1432-1433 Handle: RePEc:aph:ajpbhl:1989:79:10:1432-1433_8 Template-Type: ReDIF-Article 1.0 Title: Mail surveys of physicians. Journal: American Journal of Public Health Author-Name: Toffler, W.M. Author-Name: Sinclair, A. Year: 1989 Volume: 79 Issue: 10 Pages: 1434 Handle: RePEc:aph:ajpbhl:1989:79:10:1434_1 Template-Type: ReDIF-Article 1.0 Title: Sport fish consumption advisories. Journal: American Journal of Public Health Author-Name: Anderson, H.A. Author-Name: Liebenstein, L. Year: 1989 Volume: 79 Issue: 10 Pages: 1434-1435 Handle: RePEc:aph:ajpbhl:1989:79:10:1434-1435_4 Template-Type: ReDIF-Article 1.0 Title: Alcohol consumption and problem drinking in white male veterans and nonveterans Journal: American Journal of Public Health Author-Name: Richards, M.S. Author-Name: Goldberg, J. Author-Name: Robin, M.B. Author-Name: Anderson, R.J. Year: 1989 Volume: 79 Issue: 8 Pages: 1011-1015 Abstract: The relation between veteran status and 15 indicators of alcohol consumption and problem drinking is examined using data from the 1977, 1983, and 1985 National Health Interview Surveys conducted by the National Center for Health Statistics. After simultaneous adjustment for age, region of the US, urbanization, ethnicity, marital status, education, and income, a greater proportion of White male veterans than White male nonveterans were heavy drinkers and a smaller proportion were abstainers. This association appeared in all three survey years; further, veterans consistently reported a high daily consumption level (the equivalent of approximately six bottles of beer, five glasses of wine, or four mixed drinks) compared to nonveterans. Among White male veterans, 6.9 percent reported family or marital problems and 13.9 percent reported motor vehicle crashes or violations compared to 4.4 percent and 8.9 percent, respectively, among nonveterans. The same pattern was observed for lifetime prevalences of alcoholism (veterans have nearly two and a half times the lifetime prevalence of nonveterans), cirrhosis of the liver, and unspecified alcohol-related problems. Handle: RePEc:aph:ajpbhl:1989:79:8:1011-1015_8 Template-Type: ReDIF-Article 1.0 Title: A note from the tobacco industry. Journal: American Journal of Public Health Author-Name: Gantt, R.C. Author-Name: Lincoln, J.E. Year: 1989 Volume: 79 Issue: 9 Pages: 1307 Handle: RePEc:aph:ajpbhl:1989:79:9:1307_0 Template-Type: ReDIF-Article 1.0 Title: Comment on changes in alcohol-related inpatient care. Journal: American Journal of Public Health Author-Name: Ernst, T. Year: 1989 Volume: 79 Issue: 9 Pages: 1309 Handle: RePEc:aph:ajpbhl:1989:79:9:1309_8 Template-Type: ReDIF-Article 1.0 Title: Practical tips on reducing hazards of falls. Journal: American Journal of Public Health Author-Name: Miller, J.M. Year: 1989 Volume: 79 Issue: 8 Pages: 1056 Handle: RePEc:aph:ajpbhl:1989:79:8:1056_6 Template-Type: ReDIF-Article 1.0 Title: Smoking literature and literacy levels. Journal: American Journal of Public Health Author-Name: Jaycox, S. Year: 1989 Volume: 79 Issue: 8 Pages: 1058 Handle: RePEc:aph:ajpbhl:1989:79:8:1058_3 Template-Type: ReDIF-Article 1.0 Title: On shock absorbent insoles to prevent bone fractures. Journal: American Journal of Public Health Author-Name: Ruffin 4th., M.R. Year: 1989 Volume: 79 Issue: 8 Pages: 1056-1057 Handle: RePEc:aph:ajpbhl:1989:79:8:1056-1057_2 Template-Type: ReDIF-Article 1.0 Title: Gonorrhea rates: what denominator is most appropriate? Journal: American Journal of Public Health Author-Name: Marx, R. Author-Name: Aral, S.O. Year: 1989 Volume: 79 Issue: 8 Pages: 1057-1058 Handle: RePEc:aph:ajpbhl:1989:79:8:1057-1058_6 Template-Type: ReDIF-Article 1.0 Title: Award program needed for injury control research. Journal: American Journal of Public Health Author-Name: Wheatley, G.M. Year: 1989 Volume: 79 Issue: 7 Pages: 903-904 Handle: RePEc:aph:ajpbhl:1989:79:7:903-904_5 Template-Type: ReDIF-Article 1.0 Title: Lead exposure in children vs adults. Journal: American Journal of Public Health Author-Name: Bois, F.Y. Author-Name: Tozer, T.N. Author-Name: Benet, L.Z. Author-Name: Zeise, L. Year: 1989 Volume: 79 Issue: 7 Pages: 904 Handle: RePEc:aph:ajpbhl:1989:79:7:904_8 Template-Type: ReDIF-Article 1.0 Title: Community-based, community-oriented maternity care. Journal: American Journal of Public Health Author-Name: Sakala, C. Year: 1989 Volume: 79 Issue: 7 Pages: 897-898 Handle: RePEc:aph:ajpbhl:1989:79:7:897-898_1 Template-Type: ReDIF-Article 1.0 Title: The President's Commission on AIDS: what did it do? Journal: American Journal of Public Health Author-Name: Gebbie, K.M. Year: 1989 Volume: 79 Issue: 7 Pages: 868-870 Abstract: A member of the President's Commission on the Human Immunodeficiency Virus Epidemic reviews the Commission's work. Gebbie, who represented the public health community, briefly summarizes what the Commission did and did not accomplish in attempting to carry out its charge to "advise the President and Secretary of Health and Human Service and other relevant cabinet heads on public health dangers including medical, legal, ethical, social and economic impact, from the spread of the HIV and resulting illnesses." She concludes with an argument for increased funding for state public health departments which have a major role to play in controlling the HIV/AIDS epidemic. Handle: RePEc:aph:ajpbhl:1989:79:7:868-870_0 Template-Type: ReDIF-Article 1.0 Title: Screening adolescent male detainees. Journal: American Journal of Public Health Author-Name: Braslow, C.A. Author-Name: Safyer, S. Author-Name: Cohen, M.D. Year: 1989 Volume: 79 Issue: 7 Pages: 902-903 Handle: RePEc:aph:ajpbhl:1989:79:7:902-903_3 Template-Type: ReDIF-Article 1.0 Title: Behavior of clients of prostitutes. Journal: American Journal of Public Health Author-Name: Leonard, T.L. Author-Name: Freund, M. Author-Name: Platt, J.J. Year: 1989 Volume: 79 Issue: 7 Pages: 903 Handle: RePEc:aph:ajpbhl:1989:79:7:903_9 Template-Type: ReDIF-Article 1.0 Title: Correctly defining and assessing the causes of hospital dumping. Journal: American Journal of Public Health Author-Name: Koetting, M.J. Year: 1989 Volume: 79 Issue: 6 Pages: 780 Handle: RePEc:aph:ajpbhl:1989:79:6:780_1 Template-Type: ReDIF-Article 1.0 Title: Comments received on Walker's 'Odd man out' approach. Journal: American Journal of Public Health Author-Name: Sullivan, K.M. Author-Name: Williamson, D.F. Author-Name: Foster, D.A. Year: 1989 Volume: 79 Issue: 6 Pages: 781 Handle: RePEc:aph:ajpbhl:1989:79:6:781_4 Template-Type: ReDIF-Article 1.0 Title: Reactivation of imperialism (American tobacco in Taiwan) Journal: American Journal of Public Health Author-Name: Sheh, C.Y. Year: 1989 Volume: 79 Issue: 6 Pages: 782 Handle: RePEc:aph:ajpbhl:1989:79:6:782_2 Template-Type: ReDIF-Article 1.0 Title: Smoking among hospital nurses. Journal: American Journal of Public Health Author-Name: Cooreman, J. Author-Name: Pretet, S. Author-Name: Levallois, M. Author-Name: Marsac, J. Author-Name: Perdrizet, S. Year: 1989 Volume: 79 Issue: 6 Pages: 782 Handle: RePEc:aph:ajpbhl:1989:79:6:782_8 Template-Type: ReDIF-Article 1.0 Title: Increasing response rates in physicians' mail surveys: an experimental study. Journal: American Journal of Public Health Author-Name: Maheux, B. Author-Name: Legault, C. Author-Name: Lambert, J. Year: 1989 Volume: 79 Issue: 5 Pages: 638-639 Abstract: It is becoming increasingly difficult to obtain high response rates in physicians' mail surveys. In 1983-84, we tested the effectiveness of two techniques among 604 Quebec physicians who had not responded to an initial letter. A handwritten thank you note at the bottom of the letter accompanying the questionnaire and a more personalized mailout package increased response rates by 40.7 per cent and 53.1 per cent, respectively, compared to control groups. Handle: RePEc:aph:ajpbhl:1989:79:5:638-639_5 Template-Type: ReDIF-Article 1.0 Title: Estrogen use and gallstone disease. Journal: American Journal of Public Health Author-Name: Jorgensen, T. Year: 1989 Volume: 79 Issue: 5 Pages: 654 Handle: RePEc:aph:ajpbhl:1989:79:5:654_5 Template-Type: ReDIF-Article 1.0 Title: Recent reduction in male urethritis in France. Journal: American Journal of Public Health Author-Name: Massari, V. Author-Name: Valleron, A.J. Year: 1989 Volume: 79 Issue: 5 Pages: 655 Handle: RePEc:aph:ajpbhl:1989:79:5:655_1 Template-Type: ReDIF-Article 1.0 Title: Hunting firearm injuries. Journal: American Journal of Public Health Author-Name: Kraus, J.F. Year: 1989 Volume: 79 Issue: 5 Pages: 654-655 Handle: RePEc:aph:ajpbhl:1989:79:5:654-655_7 Template-Type: ReDIF-Article 1.0 Title: Community screening for HIV infection in Finland. Journal: American Journal of Public Health Author-Name: Pönkä, A. Author-Name: Cantell, K. Author-Name: Kantanen, M.L. Author-Name: Leinikki, P. Author-Name: Vartiainen, E. Author-Name: Haikala, O. Author-Name: Hovi, S. Author-Name: Weckström, P. Year: 1989 Volume: 79 Issue: 4 Pages: 522 Handle: RePEc:aph:ajpbhl:1989:79:4:522_8 Template-Type: ReDIF-Article 1.0 Title: Opportunities for lay midwifery practice. Journal: American Journal of Public Health Author-Name: Starzyk, P.M. Year: 1989 Volume: 79 Issue: 4 Pages: 520-521 Handle: RePEc:aph:ajpbhl:1989:79:4:520-521_8 Template-Type: ReDIF-Article 1.0 Title: Professional midwifery. Journal: American Journal of Public Health Author-Name: Myers, S.J. Author-Name: Myers-Ciecko, J. Year: 1989 Volume: 79 Issue: 4 Pages: 520 Handle: RePEc:aph:ajpbhl:1989:79:4:520_4 Template-Type: ReDIF-Article 1.0 Title: Smokeless tobacco: less seen at 1988 World Series. Journal: American Journal of Public Health Author-Name: Sussman, S. Author-Name: Barovich, M. Year: 1989 Volume: 79 Issue: 4 Pages: 521-522 Handle: RePEc:aph:ajpbhl:1989:79:4:521-522_5 Template-Type: ReDIF-Article 1.0 Title: Accuracy of recalled smoking data Journal: American Journal of Public Health Author-Name: Krall, E.A. Author-Name: Valadian, E. Author-Name: Dwyer, J.T. Author-Name: Gardner, J. Year: 1989 Volume: 79 Issue: 2 Pages: 200-202 Abstract: Validity of recalled cigarette data was assessed among 87 middle-aged adults by comparing recall to longitudinal records. Agreement on smoking status an amount smoked 20 years ago occurred for 87 per cent and 71 per cent of subjects, respectively. Corresponding proportions for 32-year recall were 84 per cent and 55 per cent. Gender did not influence recall accuracy. Ex-smokers tended to make the most errors. Accuracy of recalled smoking information 20 years ago was comparable to that of alcohol status and consumption frequency category. Handle: RePEc:aph:ajpbhl:1989:79:2:200-202_9 Template-Type: ReDIF-Article 1.0 Title: Project LEAN. Journal: American Journal of Public Health Author-Name: Samuels, S.E. Author-Name: Green, L.W. Author-Name: Tarlov, A.R. Year: 1989 Volume: 79 Issue: 3 Pages: 350 Handle: RePEc:aph:ajpbhl:1989:79:3:350_8 Template-Type: ReDIF-Article 1.0 Title: Children's health promotion. Journal: American Journal of Public Health Author-Name: Bradford, B.J. Year: 1989 Volume: 79 Issue: 2 Pages: 233 Handle: RePEc:aph:ajpbhl:1989:79:2:233_5 Template-Type: ReDIF-Article 1.0 Title: Susceptibility to respiratory conditions Journal: American Journal of Public Health Author-Name: Cooreman, J. Author-Name: Keller, J.B. Author-Name: Higgins, M.W. Year: 1989 Volume: 79 Issue: 12 Pages: 1679 Handle: RePEc:aph:ajpbhl:1989:79:12:1679_5 Template-Type: ReDIF-Article 1.0 Title: Television viewing and obesity in adult males Journal: American Journal of Public Health Author-Name: Tucker, L.A. Author-Name: Friedman, G.M. Year: 1989 Volume: 79 Issue: 4 Pages: 516-518 Abstract: We estimated the extent to which time spent watching television is associated with obesity and super-obesity among 6,138 employed adult males. After adjustment for age, smoking status, length of work week, measured physical fitness, and reported weekly hours of exercise, people who viewed TV more than three hours/day were twice as likely to be obese as those who viewed less than 1 hour/day. Those who viewed for 1 to 2 hours daily had a relative risk of 1.60 (1.21, 2.11). Physical fitness consistently confounded the associations between TV viewing and obesity/super-obesity, but the other control variables did not do so. Handle: RePEc:aph:ajpbhl:1989:79:4:516-518_8 Template-Type: ReDIF-Article 1.0 Title: The persistent threat of lead: A singular opportunity Journal: American Journal of Public Health Author-Name: Needleman, H.L. Year: 1989 Volume: 79 Issue: 5 Pages: 643-645 Abstract: Recent data have demonstrated health effects of lead in children at doses previously believed to be harmless. Data from epidemiological studies in many countries, and from experimental studies of animals given lead, demonstrate psychological impairment at blood lead concentrations of 0.5-0.7 μmol/L. Current estimates are that 17 per cent of American children (3-4 million) exceed the level of 0.7 μmol/L. Lead exposure is not a problem for urban poor children alone, but inner-city minorities have a higher rate of exposure. The overabundance of lead coexists in the same area with two serious shortages: affordable housing and jobs. It is argued that a program to train unemployed inner-city residents in safe de-leading, while expensive, makes hygienic, economic, and common sense. Handle: RePEc:aph:ajpbhl:1989:79:5:643-645_6 Template-Type: ReDIF-Article 1.0 Title: The broader message of Accutane Journal: American Journal of Public Health Author-Name: Shulman, S.R. Year: 1989 Volume: 79 Issue: 11 Pages: 1565-1568 Handle: RePEc:aph:ajpbhl:1989:79:11:1565-1568_9 Template-Type: ReDIF-Article 1.0 Title: The influence of smoking on vitamin C status in adults Journal: American Journal of Public Health Author-Name: Schectman, G. Author-Name: Byrd, J.C. Author-Name: Gruchow, H.W. Year: 1989 Volume: 79 Issue: 2 Pages: 158-162 Abstract: To further define the relation between smoking and vitamin C status, the dietary and serum vitamin C levels of 11,592 respondents in the second National Health and Nutrition Examination Survey (NHANES II) were analyzed. Smokers of 20 cigarettes daily had the lowest vitamin C dietary intake (79 mg, 95% CI: 73, 84) and serum levels (0.82 mg/dl, 95% CI: 0.77, 0.86; 46.6 μmol/L, 95% CI: 43.7, 48.8), while smokers of 1-19 cigarettes daily had decreased vitamin C intake (97 mg; 95% CI: 90, 104 mg) and serum levels (0.97 mg/dl, 95% CI: 0.92, 1.03; 55.1 μmol/L, 95% CI: 52.2, 58.5) compared to respondents who had never smoked (109 mg, 95% CI: 105, 113 and 1.15 mg/dl, 95% CI: 1.11, 1.18; 65.3 μmol/L, 95% CI: 63.0, 67.0, respectively). This inverse association between both intake and serum levels of vitamin C and smoking was independent of age, sex, body weight, race, and alcoholic beverage consumption. Following further adjustment for dietary vitamin C intake, the negative correlation between cigarette smoking and serum vitamin C levels persisted. The risk of severe hypovitaminosis C (serum levels ≤ 0.2 mg/dl; 11.4 μmol/L) was increased in smokers, particularly when not accompanied by vitamin supplementation (odds ratio 3.0, 95% CI: 2.5, 3.6). These data suggest that even though smoking adversely affects preferences for vitamin C rich foods, the inverse association between smoking and serum vitamin C levels occurs independently of dietary intake. Handle: RePEc:aph:ajpbhl:1989:79:2:158-162_4 Template-Type: ReDIF-Article 1.0 Title: Major trauma in geriatric patients Journal: American Journal of Public Health Author-Name: Champion, H.R. Author-Name: Copes, W.S. Author-Name: Buyer, D. Author-Name: Flanagan, M.E. Author-Name: Bain, L. Author-Name: Sacco, W.J. Year: 1989 Volume: 79 Issue: 9 Pages: 1278-1282 Abstract: Contemporary trauma to the elderly, its severity and associated mortality and morbidity in 111 United States and Canadian trauma centers are described. Three-thousand eight-hundred thirty-three (3,833) trauma patients age 65 years or older are compared to 42,944 injured patients under age 65. Although both groups had equivalent measures of injury severity, the older group had higher case fatality and complication rates and longer hospital stays. The results raise important questions regarding the triage, acute care, accurate prediction of outcome, and hospital reimbursement for the elderly injured patient, with implications for care evaluation, quality assurance, and the long-term viability of trauma centers and systems of care. Handle: RePEc:aph:ajpbhl:1989:79:9:1278-1282_6 Template-Type: ReDIF-Article 1.0 Title: Factors affecting place of death of hospice and non-hospice cancer patients Journal: American Journal of Public Health Author-Name: Moinpour, C.M. Author-Name: Polissar, L. Year: 1989 Volume: 79 Issue: 11 Pages: 1549-1551 Abstract: We identified factors associated with death at home for 28,828 hospice and non-hospice cancer patients in 13 counties of western Washington State. Hospice participation was found to be the variable most strongly associated with death at home. Admission to hospice appears to override the tendency for certain subgroups of patients, such as the extreme elderly and those diagnosed close to death, to die in an instiutional setting. These findings are discussed with respect to the problem of selection bias. Handle: RePEc:aph:ajpbhl:1989:79:11:1549-1551_4 Template-Type: ReDIF-Article 1.0 Title: Person-years of life lost due to cancer in the United States, 1970 and 1984 Journal: American Journal of Public Health Author-Name: Horm, J.W. Author-Name: Sondik, E.J. Year: 1989 Volume: 79 Issue: 11 Pages: 1490-1493 Abstract: The number of deaths due to cancer in the United States reached an all-time high of 453,450 deaths in 1984 and, due to the dynamics of population growth, will continue to increase if the risk of dying from cancer does not change. Between 1970 and 1984, the total Person-Years of Life Lost (PYLL), the sum of the differences between the actual age at death and the expected remaining lifetime for each person who died of cancer, increased for most cancer sites as well as for all sites combined. In 1984, 6,881,281 person-years of life were lost due to cancer deaths, up from 5,303,668 in 1970. The exceptions are those cancers for which there has been major progress in either prevention or treatment; e.g., stomach and cervix uteri (prevention) and testicular, Hodgkin's disease, leukemia, and childhood cancer (treatment). The Average Years of Life Lost (AYLL) per person dying from cancer in 1984 was generally less than in 1970. Overall, each person who died from cancer in 1984 died 15.2 years earlier than his/her life expectancy. The greatest loss was for those who died of childhood cancers (66.9 years earlier), followed by testicular cancer (35.8 years earlier). The least loss relative to the expectation of life was for those who died of prostate cancer. The 25,400 men who died from prostate cancer in 1984 died an average of nine years earlier than otherwise expected. Handle: RePEc:aph:ajpbhl:1989:79:11:1490-1493_8 Template-Type: ReDIF-Article 1.0 Title: Nicotine intake in young smokers: Longitudinal study of saliva cotinine concentrations Journal: American Journal of Public Health Author-Name: McNeill, A.D. Author-Name: Jarvis, M.J. Author-Name: Stapleton, J.A. Author-Name: West, R.J. Author-Name: Bryant, A. Year: 1989 Volume: 79 Issue: 2 Pages: 172-175 Abstract: Smoking habits and smoke intake were studied over three consecutive years in 197 girls, initially aged 11 to 14 years. Saliva cotinine concentrations in girls who were smokers throughout the three years increased over each year of the study, the greatest increase occurring during movement from occasional to daily smoking. Cigarette consumption also increased over the two years. For a group of continuing daily smokers (n = 23), inhalation of smoke per cigarette as indexed by the ratio of cotinine concentration to average daily cigarettes consumption did not change over time. Cotinine concentrations in 16 girls who were smoking on a daily basis within a year of starting to smoke suggested the early development of inhalation. Our findings suggest that young smokers learn to inhale cigarette smoke very early in their smoking careers, that further increases in smoke intake mainly reflect increased cigarette consumption, and that the pharmacological effects of nicotine are already important in reinforcing their smoking. Handle: RePEc:aph:ajpbhl:1989:79:2:172-175_4 Template-Type: ReDIF-Article 1.0 Title: Why clinical trials of AIDS vaccines are premature Journal: American Journal of Public Health Author-Name: Mariner, W.K. Year: 1989 Volume: 79 Issue: 1 Pages: 86-91 Abstract: Considering the current state of scientific knowledge and the fact that no relevant animal model exists for demonstrating a vaccine's probable efficacy, the fundamental prerequisites for testing experimental AIDS vaccines in human beings have not been met. The ethical obligations of informed consent, patient confidentiality, and the balancing of risks and benefits are examined in a call for more public debate on the issue before clinical trials are begun. Handle: RePEc:aph:ajpbhl:1989:79:1:86-91_1 Template-Type: ReDIF-Article 1.0 Title: Preventing alcohol-impaired driving through community self-regulation training Journal: American Journal of Public Health Author-Name: Worden, J.K. Author-Name: Flynn, B.S. Author-Name: Merrill, D.G. Author-Name: Waller, J.A. Author-Name: Haugh, L.D. Year: 1989 Volume: 79 Issue: 3 Pages: 287-290 Abstract: A community education program was designed to train the individual drinker to self-regulate his or her blood-alcohol concentration (BAC) below a level of impairment (.05 g/dl or 11 mmol/L). Drink calculators (cardboard wheels and wallet cards) were disseminated to customers of bars and licensed beverage outlets; bartenders and counter clerks were trained to demonstrate use of the calculators and demonstrations were presented in television spots. Program components were evaluated in three matched Vermont communities, one receiving the full community education program, one receiving the TV spots only, and one serving as control. After six months of intervention, a roadside survey of nighttime drivers (N=892) indicated 5.3 per cent fewer drivers with BACs above 0.05 g/dl in the community program group and 1.0 per cent fewer in the TV-only group compared to the control group; however, substantially fewer drivers were found above .00 BAC in either program community than in the control. Drivers reporting heavy drinking and youthful drivers both indicated higher utilization of the materials than did other drivers. Although limited in scale and duration, this study suggests that a community education program can be effective in preventing alcohol-impaired driving. Handle: RePEc:aph:ajpbhl:1989:79:3:287-290_0 Template-Type: ReDIF-Article 1.0 Title: Improving the surveillance of occupational disease Journal: American Journal of Public Health Author-Name: Landrigan, P.J. Year: 1989 Volume: 79 Issue: 12 Pages: 1601-1602 Handle: RePEc:aph:ajpbhl:1989:79:12:1601-1602_0 Template-Type: ReDIF-Article 1.0 Title: Business recession, alcohol consumption, drinking and driving laws: Impact on Oklahoma motor vehicle fatalities and fatal crashes Journal: American Journal of Public Health Author-Name: Muller, A. Year: 1989 Volume: 79 Issue: 10 Pages: 1366-1370 Abstract: In 1982, Oklahoma enacted a series of drinking and driving laws. In the ensuing years, motor vehicle fatalities and fatal crashes were reduced by one-third. Factors contributing to this reduction were eamined using interrupted time series analysis of monthly rates of motor vehicle deaths and fatal crashes for the period January 1980 to December 1986. Decreasing per capita alcohol consumption and increased unemployment apparently account for most of the fatality and fatal crash reduction in Oklahoma. The enactment of two traffic safety laws - one specifying the illegal blood alcohol concentration level (BAC law) and the other facilitating license withdrawal from suspected drunk drivers (administrative per se law) - together reduced Oklahoma traffic deaths and fatal crashes by about 9 percent. The effectiveness of the laws appeared to be greatest in the first two years following their enactment. Handle: RePEc:aph:ajpbhl:1989:79:10:1366-1370_8 Template-Type: ReDIF-Article 1.0 Title: Local Public Health and the State Journal: American Journal of Public Health Author-Name: Pickett, G. Year: 1989 Volume: 79 Issue: 8 Pages: 967-968 Handle: RePEc:aph:ajpbhl:1989:79:8:967-968_0 Template-Type: ReDIF-Article 1.0 Title: II. Use of direct surveys in the surveillance of occupational illness and injury Journal: American Journal of Public Health Author-Name: Ehrenberg, R.L. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 12-14 Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:12-14_8 Template-Type: ReDIF-Article 1.0 Title: Incidence, causes and severity of injuries in Aquitaine, France: A community-based study of hospital admissions and deaths Journal: American Journal of Public Health Author-Name: Tiret, L. Author-Name: Garros, B. Author-Name: Maurette, P. Author-Name: Nicaud, V. Author-Name: Thicoipe, M. Author-Name: Hatton, F. Author-Name: Erny, P. Year: 1989 Volume: 79 Issue: 3 Pages: 316-321 Abstract: This paper reports the results of a study of injuries conducted during a one-year period within a defined geographic population of 2.7 million persons (Aquitaine, France). Cases were defined as unintentional or intentional injuries, either resulting in immediate death before reaching hospital or requiring hospital admission. During the one-year period, 1,181 deaths were registered and 8,190 hospital admissions occurred during the sample periods. The three leading causes of injury were falls (40 per cent), traffic accidents (27 per cent), and poisonings (15 per cent). The overall incidence of injuries was 136 per 10,000 person years. Incidence by sex and age was assessed for the main external causes. The ratios of nonfatal to fatal cases were calculated by sex and age and by external cause. The origin of the injury was suicide in 14 per cent of cases and assault or homicide in 3 per cent. The severity of injuries, assessed using an automatic computation of the Injury Severity Score (ISS), ranged from 1 to 66 with a mean of 6.9. Substantial variations of ISS were observed according to external cause. At the 8th day following admission, 31 per cent of hospital-treated patients were still hospitalized and 0.8 per cent had died in hospital. The outcome correlated well with the ISS. Handle: RePEc:aph:ajpbhl:1989:79:3:316-321_3 Template-Type: ReDIF-Article 1.0 Title: VIII. Injury surveillance Journal: American Journal of Public Health Author-Name: Hanrahan, L.P. Author-Name: Moll, M.B. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 38-45 Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:38-45_6 Template-Type: ReDIF-Article 1.0 Title: Health care for the homeless in a national health program Journal: American Journal of Public Health Author-Name: Reuler, J.B. Year: 1989 Volume: 79 Issue: 8 Pages: 1033-1035 Abstract: To assess the impact of adoption of a national health program on homeless care in the United States, care for this group in Britain's National Health Service (NHS) was evaluated. Although hospital and medication charges are eliminated, primary care for the homeless lacks central government directive, suffers from overlap of statutory agencies and mechanistic biases, is disproportionately delivered in emergency rooms, and has relied on advocacy by the non-profit sector. Disadvantages of this void in NHS provision are marginalization of the homeless and continuation of a two-class care system. Removal of financial barriers to care by enactment of a national health program in the US would not solve all issues related to delivery of quality care for the homeless unless its structure addressed the special needs of disenfranchised groups. Handle: RePEc:aph:ajpbhl:1989:79:8:1033-1035_7 Template-Type: ReDIF-Article 1.0 Title: A prospective follow-up study of cancer mortality in relation to serum DDT Journal: American Journal of Public Health Author-Name: Austin, H. Author-Name: Keil, J.E. Author-Name: Cole, P. Year: 1989 Volume: 79 Issue: 1 Pages: 43-46 Abstract: Serum DDT and DDE levels were measured in 919 subjects in 1974 and 1975. Two-hundred and nine of the subjects died, including 54 from cancer, during a 10-year prospective follow-up period. There was no relation between either overall mortality or cancer mortality and increasing serum DDT levels. There was weak evidence of a positive relation between respiratory cancer mortality and serum DDT. The literature on DDT and human cancer is reviewed, and it is concluded that the evidence does not support the opinion that DDT is a human carcinogen. Handle: RePEc:aph:ajpbhl:1989:79:1:43-46_3 Template-Type: ReDIF-Article 1.0 Title: Maternal smoking during pregnancy: No association with congenital malformations in Missouri 1980-83 Journal: American Journal of Public Health Author-Name: Malloy, M.H. Author-Name: Kleinman, J.C. Author-Name: Bakewell, J.M. Author-Name: Schramm, W.F. Author-Name: Land, G.H. Year: 1989 Volume: 79 Issue: 9 Pages: 1243-1246 Abstract: Using a multisource birth defects registry developed by the Missouri Center for Health Statistics for the years 1980-83, we examined the relation between maternal smoking during pregnancy and the occurrence of congenital malformations. There were 288,067 live singleton births in this data set of which 10,223 had one or more congenital malformations. When adjusted for potential confounders the odds ratio for congenital malformations in the infants of women who smoked during pregnancy was not increased (odds ratio = 0.98, 95% confidence interval = 0.94 - 1.03). We examined the relation between smoking and groups of malformations using the International Classification of Diseases, 9th Revision, as well as analyzing for certain specific malformations within each group and found no increased risk for infants of smokers. Handle: RePEc:aph:ajpbhl:1989:79:9:1243-1246_5 Template-Type: ReDIF-Article 1.0 Title: Geographic variation in the occurrence of hip fractures among the elderly White US population Journal: American Journal of Public Health Author-Name: Bacon, W.E. Author-Name: Smith, G.S. Author-Name: Baker, S.P. Year: 1989 Volume: 79 Issue: 11 Pages: 1556-1558 Abstract: Geographic variations in hip fracture rates across the nine US Census Divisions were examined using data for elderly Whites from the 1979-85 National Hospital Discharge Survey. Rates varied considerably and were highest in the West North Central Division where rates for females were 50 percent higher than the US rate. Reasons for the geographic variations in hip fracture rates are unknown but do not appear to be closely related to latitude or fall-related deaths. Handle: RePEc:aph:ajpbhl:1989:79:11:1556-1558_9 Template-Type: ReDIF-Article 1.0 Title: Compensation as a risk factor for lung cancer in smokers who switch from nonfilter to filter cigarettes Journal: American Journal of Public Health Author-Name: Augustine, A. Author-Name: Harris, R.E. Author-Name: Wynder, E.L. Year: 1989 Volume: 79 Issue: 2 Pages: 188-191 Abstract: The likelihood of increasing the number of cigarettes per day (cpd), a common method of compensation, in smokers switching from nonfilter to filter cigarettes, was examined in newly diagnosed and histologically confirmed lung cancer cases including all cell types; 1,242 lung cancer cases and 2,300 sex and age matched hospital controls were interviewed in 20 hospitals from nine United States cities between 1969 and 1984. The mean increase in cpd for lung cancer cases was about twice that of controls. Using switchers who did not increase cpd as the referent group, there was a linear dose-response relationship between the odds of lung cancer and increasing level of compensation. The odds ratio increased from 1.19 to 2.37 in males and from 1.66 to 3.83 in females corresponding to increase of 1-10 to 21+cpd after switching. Findings from this study suggest that increasing cpd after switching to filter cigarettes is an important risk factor for lung cancer that needs to be emphasized in epidemiologic studies. Proponents of the idea that switching cigarettes is of some benefit, should also advocate that individuals who continue smoking should avoid compensation after switching. Handle: RePEc:aph:ajpbhl:1989:79:2:188-191_9 Template-Type: ReDIF-Article 1.0 Title: The role of secondary vaccine failures in measles outbreaks Journal: American Journal of Public Health Author-Name: Mathias, R.G. Author-Name: Meekison, W.G. Author-Name: Arcand, T.A. Author-Name: Schechter, M.T. Year: 1989 Volume: 79 Issue: 4 Pages: 475-478 Abstract: An outbreak of measles in 1985-86 in a community where measles vaccine trials had been carried out from 1974-76 allowed the assessment of the role of secondary vaccine failures in previously immunized children. A total of 188 children from the vaccine trial were followed. Of these, 175 seroconverted initially while 13 (6 per cent) required re-immunization (primary failure). A total of 13 cases of measles, eight of which were laboratory and/or physician-confirmed, were reported in this cohort. Of these, nine cases occurred in the 175 subjects who had hemagglutination inhibition test (HI) and neutralizing antibody responses following the initial immunization. These nine cases represent secondary vaccine failures. An additional four cases occurred in 13 subjects with primary vaccine failure. We conclude that secondary vaccine failures occur and that while primary failures account for most cases, secondary vaccine failures contribute to the occurrence of measles cases in an epidemic. A booster dose of measles vaccine may be necessary to reduce susceptibility to a sufficiently low level to allow the goal of measles elimination to be achieved. Handle: RePEc:aph:ajpbhl:1989:79:4:475-478_6 Template-Type: ReDIF-Article 1.0 Title: Pap smear screening at the workplace Journal: American Journal of Public Health Author-Name: Grazzini, G. Author-Name: Cecchini, S. Author-Name: Bartoli, D. Author-Name: Ciatto, S. Year: 1989 Volume: 79 Issue: 11 Pages: 1570-1571 Handle: RePEc:aph:ajpbhl:1989:79:11:1570-1571_7 Template-Type: ReDIF-Article 1.0 Title: Application of clearance concepts to the assessment of exposure to lead in drinking water Journal: American Journal of Public Health Author-Name: Bois, F.Y. Author-Name: Tozer, T.N. Author-Name: Zeise, L. Author-Name: Benet, L.Z. Year: 1989 Volume: 79 Issue: 7 Pages: 827-831 Abstract: This paper explores the application of clearance concepts to environmental toxicology. Lead, for which a clearance of about 0.5 ml/min is estimated from published data, is chosen as an example. An index for the contribution of drinking water to total exposure is developed using these concepts. For lead, this index is shown to increase with the concentration of the metal in water; it is higher for children than for adults. At the maximum contaminant level (MCL) of 10 μg/L proposed by the US Environmental Protection Agency (EPA), the average contribution from lead in drinking water is estimated to be 7 percent. The contribution in children is about twice as great. At and above the current MCL of 50 μg/L, drinking water becomes a major source of lead exposure. Handle: RePEc:aph:ajpbhl:1989:79:7:827-831_8 Template-Type: ReDIF-Article 1.0 Title: Costs related to ER use Journal: American Journal of Public Health Author-Name: Birnbaum, P.S. Year: 1989 Volume: 79 Issue: 12 Pages: 1680-1681 Handle: RePEc:aph:ajpbhl:1989:79:12:1680-1681_3 Template-Type: ReDIF-Article 1.0 Title: Use of clinic versus private family planning care by low-income women: Access, cost, and patient satisfaction Journal: American Journal of Public Health Author-Name: Radecki, S.E. Author-Name: Bernstein, G.S. Year: 1989 Volume: 79 Issue: 6 Pages: 692-697 Abstract: Use of private physicians versus public family planning facilities by poverty level and near poverty level women was examined by means of a sample survey conducted in low-income areas of Los Angeles County. Utilization differed by race/ethnicity, with Hispanics more likely to go to federally subsidized family planning clinics (primarily county-run), Whites and Blacks to private physicians. Private family planning offers easier access, greater convenience, and higher satisfaction, albeit at almost double the cost. Clinic usage is influenced by lack of a regular source of medical care and lack of insurance coverage more than poverty level per se. Clinic patients report greater patient education regarding contraceptive methods, but less general medical care during clinic visits. They are more likely than private patients to express a desire for a different source of family planning care. Handle: RePEc:aph:ajpbhl:1989:79:6:692-697_9 Template-Type: ReDIF-Article 1.0 Title: Self-report and medical record report agreement of selected medical conditions in the elderly Journal: American Journal of Public Health Author-Name: Bush, T.L. Author-Name: Miller, S.R. Author-Name: Golden, A.L. Author-Name: Hale, W.E. Year: 1989 Volume: 79 Issue: 11 Pages: 1554-1556 Abstract: This study assessed agreement between self- and medical record report of medical conditions in an elderly population. Medical charts of 120 participants in a screening program were abstracted, and the questionnaire report of eight major conditions was compared with the medical record. There was substantial or moderate agreement between self-report and medical record report for each condition, although strength of agreement varied by condition. Self-report by elderly individuals compares favorably with medical record report of medical conditions. Handle: RePEc:aph:ajpbhl:1989:79:11:1554-1556_6 Template-Type: ReDIF-Article 1.0 Title: The ethics of screening for early intervention in HIV disease Journal: American Journal of Public Health Author-Name: Levine, C. Author-Name: Bayer, R. Year: 1989 Volume: 79 Issue: 12 Pages: 1661-1667 Abstract: The potential for early medical intervention to slow or prevent the development of AIDS in HIV-positive individuals has led to calls for widespread testing of asymptomatic at-risk persons. Levine and Bayer discuss the ethical aspects of these proposals, distinguishing among the justifications for screening and evaluating each independently. They present current clinical evidence for early intervention and explore its potential risks and benefits. Using the ethical principles of respect for persons, the harm principle, beneficience, and justice, they analyze the justifications for and the limits of screening infants, adolescents, and adults for HIV seropositivity. Levine and Bayer conclude that while there are clinical and ethical grounds for establishing voluntary screening programs, conditions of informed consent and confidentiality must be met, and protection from discrimination and provision of follow-up services for infected individuals are essential. Handle: RePEc:aph:ajpbhl:1989:79:12:1661-1667_0 Template-Type: ReDIF-Article 1.0 Title: How free care improved vision in the health insurance experiment Journal: American Journal of Public Health Author-Name: Lurie, N. Author-Name: Kamberg, C.J. Author-Name: Brook, R.H. Author-Name: Keeler, E.B. Author-Name: Newhouse, J.P. Year: 1989 Volume: 79 Issue: 5 Pages: 640-642 Abstract: We studied reasons for the improvement in the functional vision of enrollees receiving free care in the Rand Health Insurance Experiment. Among low income enrollees, 78 per cent on the free plan and 59 per cent on the cost-sharing plans had an eye examination; the proportions of those obtaining lenses were 30 per cent and 20 per cent, respectively. Visual acuity outcomes of low income vs non-poor enrollees were more adversely affected by enrollment in cost-sharing plans. Free care resulted in improved vision by increasing the frequency of eye examination and lens purchases. Handle: RePEc:aph:ajpbhl:1989:79:5:640-642_5 Template-Type: ReDIF-Article 1.0 Title: Accuracy of perceptions of heart attack risk: What influences perceptions and can they be changed? Journal: American Journal of Public Health Author-Name: Avis, N.E. Author-Name: Smith, K.W. Author-Name: McKinlay, J.B. Year: 1989 Volume: 79 Issue: 12 Pages: 1608-1612 Abstract: Using perceived risk of a heart attack, we examined the relative importance of perceived risk factors and sociodemographic variables on subjects' perception of heart attack risk, the relationship between perceived and objectively measured heart attack risk, and the effect of health risk appraisal (HRA) feedback on risk perceptions. Data derive from a random sample of 732 Greater Boston, Massachusetts area men and women ages 25-65 years, who participated in a field trial of health risk appraisal instruments. At baseline and approximately two months later, all respondents completed a questionnaire assessing their own health-related behavior, risk factors, and perception of heart attack risk. At baseline, respondents also completed one of our HRA instruments. Physiologic measures of cholesterol, blood pressures, and weight were taken at either baseline or follow-up visit. Results showed that respondents used established risk factors in estimating overall risk; that compared to objective measures of risk, a high percentage of respondents displayed an optimistic bias; and that HRA feedback had some effect on perception of heart attack risk for those at high risk. Implications of these results for health promotion are discussed. Handle: RePEc:aph:ajpbhl:1989:79:12:1608-1612_7 Template-Type: ReDIF-Article 1.0 Title: Breastfeeding trends in the Philippines, 1973 and 1983 Journal: American Journal of Public Health Author-Name: Popkin, B.M. Author-Name: Akin, J.S. Author-Name: Flieger, W. Author-Name: Wong, E.L. Year: 1989 Volume: 79 Issue: 1 Pages: 32-35 Abstract: This paper examines comparable national surveys of breastfeeding from the Philippines carried out in 1973 and 1983. The probability of breastfeeding at selected infant ages is estimated, using the weighted life table. The conclusions are that a 5 per cent decline in the proportion of infants ever breast-fed occurred during the referenced period, and that median length of breastfeeding remained essentially the same. Handle: RePEc:aph:ajpbhl:1989:79:1:32-35_3 Template-Type: ReDIF-Article 1.0 Title: Caffeinated beverages and low birthweight: A case-control study Journal: American Journal of Public Health Author-Name: Caan, B.J. Author-Name: Goldhaber, M.K. Year: 1989 Volume: 79 Issue: 9 Pages: 1299-1300 Abstract: A case-control study, examining the effect of first trimester maternal caffeine consumption on low birthweight, was performed in the Kaiser Permanente Medical Care Program. Heavy consumption (> 3 servings/day) of coffee, cola and > 300 mg/day of caffeine from all sources (coffee, tea and cola) was associated with a marginally increased risk of low birthweight. Our data support previous findings of a modest effect of caffeine consumption on fetal growth. Handle: RePEc:aph:ajpbhl:1989:79:9:1299-1300_7 Template-Type: ReDIF-Article 1.0 Title: A survey of smoking and quitting patterns among black americans Journal: American Journal of Public Health Author-Name: Orleans, C.T. Author-Name: Schoenbach, V.J. Author-Name: Salmon, M.A. Author-Name: Strecher, V.J. Author-Name: Kalsbeek, W. Author-Name: Quade, D. Author-Name: Brooks, E.F. Author-Name: Konrad, T.R. Author-Name: Blackmon, C. Author-Name: Watts, C.D. Year: 1989 Volume: 79 Issue: 2 Pages: 176-181 Abstract: A sample of adult Black policyholders of the nation's largest Black-owned life insurance company was surveyed in 1986 to add to limited data on smoking and quitting patterns among Black Americans, and to provide direction for cessation initiatives targeted to Black smokers. Forty per cent of 2,958 age-eligible policyholders for whom current addresses were available returned a completed questionnaire. Population estimates for smoking status agree closely with national estimates for Blacks age 21-60 years: 50 per cent never-smokers; 36 per cent current smokers; 14 per cent ex-smokers. Current and ex-smokers reported a modal low-rate/high nicotine menthol smoking pattern. Current smokers reported a mean of 3.8 serious quit attempts, a strong desire and intention to quit smoking and limited past use of effective quit smoking treatments and self-help resources. Correlates of motivation to quit smoking were similar to those found among smokers in the general population, including smoking-related illnesses and medical advice to quit smoking, previous quit attempts, beliefs in smoking-related health harms/quitting benefits, and expected social support for quitting. Methodological limitations and implications for the design of needed Black-focused quit smoking initiatives are discussed. Handle: RePEc:aph:ajpbhl:1989:79:2:176-181_7 Template-Type: ReDIF-Article 1.0 Title: Carcinogenicity of dark liquor Journal: American Journal of Public Health Author-Name: Rothman, K.J. Author-Name: Cann, C.I. Author-Name: Fried, M.P. Year: 1989 Volume: 79 Issue: 11 Pages: 1516-1520 Abstract: To investigate whether the non-alcohol content of distilled alcoholic beverages affects the carcinogenicity of the beverage, we concluded an epidemiologic study of laryngeal and hypopharyngeal cancer. We interviewed 384 cases (or spouses, for deceased cases), and compared their responses with those of 876 controls. We classed distilled liquors as dark or light, a rough division according to content of potentially carcinogenic compounds in the beverages. The relative effect on hypopharyngeal cancer risk was much stronger for those who reported high consumption of dark liquor (relative risk = 4.4, 90% confidence interval = 2.9, 6.8) than for those reporting comparable consumption of light liquor (relative risk = 1.3, 90% CI = 0.8, 2.1). For laryngeal cancer, consumption of dark liquor had a smaller effect, and there was little distinction between the effects of dark and light liquor. The data appear consistent with the theory that the non-alcoholic content of distilled alcoholic beverages is a determinant of cancer risk, and that alcoholic beverages act topically rather than systemically in their carcinogenic action. Handle: RePEc:aph:ajpbhl:1989:79:11:1516-1520_4 Template-Type: ReDIF-Article 1.0 Title: Relation between vegetarian/nonvegetarian diets and blood pressure in Black and White adults Journal: American Journal of Public Health Author-Name: Melby, C.L. Author-Name: Goldflies, D.G. Author-Name: Hyner, G.C. Author-Name: Lyle, R.M. Year: 1989 Volume: 79 Issue: 9 Pages: 1283-1288 Abstract: We examined the possible interaction of race and diet on blood pressure (BP) in volunteer Black Seventh Day Adventists compared to volunteer White church members. Height, weight, waist and hip circumference, and resting seated BP were recorded in Black vegetarians (n = 55; age: 54.7 ± 16.9 yrs), Black nonvegetarians (n = 59; 56.1 ± 14.1 yrs), White vegetarians (n = 164, 52.2 ± 16.7 yrs), and White nonvegetarians (n = 100; 52.6 ± 15.6 yrs) attending a regional conference. Forty-four percent of the Black nonvegetarians were medicated hypertensives, compared to only 18 percent of the Black vegetarians, 7 percent of White vegetarians, and 22 percent of the White nonvegetarians. Black vegetarians exhibited lower age and sex-adjusted systolic BP (x̄ = 122.9/74.4 mm Hg) than Black nonvegetarians (x̄ = 132.2/75.9 mm Hg). After further adjusting BP for body mass index and waist/hip ratio, the systolic BP among Black vegetarians remained lower (122.8) than Black nonvegetarians (129.7) but higher than that of the Whites who showed no diet-related BP differences. Handle: RePEc:aph:ajpbhl:1989:79:9:1283-1288_3 Template-Type: ReDIF-Article 1.0 Title: Acceptance of hepatitis B vaccine among dentists. Journal: American Journal of Public Health Author-Name: Maguire, B. Author-Name: Gerbert, B. Author-Name: Greene, J. Year: 1989 Volume: 79 Issue: 1 Pages: 101-102 Handle: RePEc:aph:ajpbhl:1989:79:1:101-102_2 Template-Type: ReDIF-Article 1.0 Title: The deadliest plague Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1989 Volume: 79 Issue: 7 Pages: 821-822 Handle: RePEc:aph:ajpbhl:1989:79:7:821-822_8 Template-Type: ReDIF-Article 1.0 Title: Behavior of clients of prostitutes Journal: American Journal of Public Health Author-Name: Leonard, T.L. Author-Name: Freund, M. Author-Name: Platt, J.J. Year: 1989 Volume: 79 Issue: 9 Pages: 1309-1310 Handle: RePEc:aph:ajpbhl:1989:79:9:1309-1310_1 Template-Type: ReDIF-Article 1.0 Title: First births to older mothers, 1970-86 Journal: American Journal of Public Health Author-Name: Ventura, S.J. Year: 1989 Volume: 79 Issue: 12 Pages: 1675-1677 Handle: RePEc:aph:ajpbhl:1989:79:12:1675-1677_3 Template-Type: ReDIF-Article 1.0 Title: Education for AIDS prevention: Not our only voluntary weapon Journal: American Journal of Public Health Author-Name: Cates Jr., W. Author-Name: Bowen, G.S. Year: 1989 Volume: 79 Issue: 7 Pages: 871-874 Abstract: Authorities frequently state that education is the 'only' method we have to stop the AIDS (acquired immunodeficiency syndrome) epidemic until a vaccine and/or curative therapy is available. We suggest that education, while critically important to our efforts to stop transmission of the human immunodeficiency virus (HIV), needs to be bolstered by additional voluntary approaches. Control of parenteral drug use, prevention of ulcerative sexually transmitted diseases, provision of expanded contraceptive services to seropositive reproductive age women, and reinforcement of risk-reduction behaviors through extended follow-up interventions are required as well. The support of these voluntary programs is a necessary complement to education approaches which impact on HIV transmission and eventually on the AIDS epidemic. Handle: RePEc:aph:ajpbhl:1989:79:7:871-874_6 Template-Type: ReDIF-Article 1.0 Title: Chronic stressors and maternal depression: Implications for prevention Journal: American Journal of Public Health Author-Name: Orr, S.T. Author-Name: James, S.A. Author-Name: Burns, B.J. Author-Name: Thompson, B. Year: 1989 Volume: 79 Issue: 9 Pages: 1295-1296 Abstract: We report on the use of an instrument to measure exposure to stressors among 149 women presenting with their children for pediatric care at an urban primary care center. Overall, 38.3 percent of the women had significant levels of depressive symptoms; 71.4 percent of those in the 'high stress' group had an adjusted prevalence odds ratio of 5.00 [95% CI = 2.12, 11.82]. We conclude that screening in the pediatric office is feasible for identifying women at high risk of becoming depressed. Handle: RePEc:aph:ajpbhl:1989:79:9:1295-1296_5 Template-Type: ReDIF-Article 1.0 Title: Cryptosporidiosis and surface water Journal: American Journal of Public Health Author-Name: Gallaher, M.M. Author-Name: Herndon, J.L. Author-Name: Nims, L.J. Author-Name: Sterling, C.R. Author-Name: Grabowski, D.J. Author-Name: Hull, H.F. Year: 1989 Volume: 79 Issue: 1 Pages: 39-42 Abstract: In the period July throughout October, 1986, 78 laboratory-confirmed cases of cryptosporidiosis were identified in New Mexico. To determine possible risk factors for development of this disease, we conducted a case-control study; 24-case-patients and 46 neighborhood controls were interviewed. Seventeen (71 per cent) of the 24 case-patients were females, seven (29%) were males; their ages ranged from 4 months to 44 years, median 3 years. There was a strong association between drinking surface water and illness: five of the 24 case-patients, but none of the 46 controls drank untreated surface water. Among children, illness was also associated with attending a day care center where other children were ill (odds ratio = 13.1). Handle: RePEc:aph:ajpbhl:1989:79:1:39-42_4 Template-Type: ReDIF-Article 1.0 Title: Unintentional deaths from carbon monoxide in motor vehicle exhaust: West Virginia Journal: American Journal of Public Health Author-Name: Baron, R.C. Author-Name: Backer, R.C. Author-Name: Sopher, I.M. Year: 1989 Volume: 79 Issue: 3 Pages: 328-330 Abstract: We investigated the circumstances of unintended carbon monoxide deaths from motor vehicle exhaust. Of 64 episodes involving 82 deaths investigated by the West Virginia Office of the Chief Medical Examiner, 1978-84, 50 occurred outdoors in older vehicles with defective exhaust systems and 14 occurred in enclosed or semi-enclosed home garages. Blood alcohol was detected in 50 (68 per cent) of 74 victims tested; 34 had blood alcohol concentrations ≥ 0.10 g/dl. We suggest increasing public awareness of the hazards of motor vehicle exhaust and enforcing vehicle inspection regulations. Handle: RePEc:aph:ajpbhl:1989:79:3:328-330_8 Template-Type: ReDIF-Article 1.0 Title: Metholated cigarette use among multiphasic examinees, 1979-86 Journal: American Journal of Public Health Author-Name: Sidney, S. Author-Name: Tekawa, I. Author-Name: Friedman, G.D. Year: 1989 Volume: 79 Issue: 10 Pages: 1415-1416 Abstract: Mentholated cigarette use was studied in relation to age and race in 29,037 current smokers who were Kaiser Permanente Medical Care Program members. The percentages of mentholated cigarette users were much higher in Blacks and Asians than in Whites, especially in the younger age groups. A marked inverse relationship between mentholated cigarette use and age was present in Blacks and Asians; metholated cigarette use showed little difference with age in Whites. Handle: RePEc:aph:ajpbhl:1989:79:10:1415-1416_7 Template-Type: ReDIF-Article 1.0 Title: Evaluation of a community-wide incentive program to promote safety restraint use Journal: American Journal of Public Health Author-Name: Foss, R.D. Year: 1989 Volume: 79 Issue: 3 Pages: 304-306 Abstract: A program was designed and evaluated to determine the feasibility of implementing an incentive campaign to promote safety restraint use, primarily among children up to age 13. During a five-month period, community residents were eligible to win monthly prizes and a grand prize by buckling up all automobile occupants when driving. Systematic monitoring of traffic and a telephone survey indicate that the program was minimally effective, reaching the attention of only about half the families with children in the community despite extensive advertising. Effects of the program on seat belt use closely paralleled airing of radio announcements, appear to have been confined primarily to children under age four, and tailed off somewhat after the initial response. Handle: RePEc:aph:ajpbhl:1989:79:3:304-306_7 Template-Type: ReDIF-Article 1.0 Title: Use of smokeless tobacco, cigarette smoking, and hypercholesterolemia Journal: American Journal of Public Health Author-Name: Tucker, L.A. Year: 1989 Volume: 79 Issue: 8 Pages: 1048-1050 Abstract: The primary purpose of this study was to determine the extent to which regular use of smokeless tobacco is associated with hypercholesterolemia (≥ 6.2 mmol/L) among 2,840 adult males. The confounding effects of age, education, physical fitness, body fatness, and other tobacco use were also examined. After adjustment, smokeless tobacco users were 2.5 times, heavy smokers were 2 times and mild/moderate smokers were 1.5 times more likely to have hypercholesterolemia than non-users of tobacco. Cigarette smokers did not differ significantly from users of smokeless tobacco regarding hypercholesterolemia. Users of smokeless tobacco were younger and less educated compared to non-users of tobacco, while smokers were less educated and less physically fit. Handle: RePEc:aph:ajpbhl:1989:79:8:1048-1050_9 Template-Type: ReDIF-Article 1.0 Title: Patient literacy and the readability of smoking education literature Journal: American Journal of Public Health Author-Name: Meade, C.D. Author-Name: Byrd, J.C. Year: 1989 Volume: 79 Issue: 2 Pages: 204-206 Abstract: This study was designed to determine if primary care clinic patients red at a level congruent to the reading grade level of available smoking literature. Reading estimates of smoking education literature (N = 49) ranged from grade 3 to college level (median = 9.5). Reading skills of 258 smoking patients were estimated by reported years of schooling (median = 10), and by scores on the Wide-Range Achievement Test (median = 6). A serious disparity existed between the reading estimates of smoking education literature and the literacy skills of patients in our sample. Handle: RePEc:aph:ajpbhl:1989:79:2:204-206_3 Template-Type: ReDIF-Article 1.0 Title: Utilization of hospital services by cardiovascular patients, Alberta, Canada Journal: American Journal of Public Health Author-Name: Bay, K.S. Author-Name: Maher, M. Author-Name: Lee, S.J.K. Year: 1989 Volume: 79 Issue: 6 Pages: 759-764 Abstract: Using hospital discharge records, and United States DRG (diagnosis related groups) data, we studied hospital utilization by cardiovascular patients, associated hospital expenditures, and the per capita cost of treating cardiovascular diseases in Alberta, Canada between 1971 and 1986. Expressed in constant 1984 Canadian dollars, the estimated total hospital cost increased from $84 million in 1971 to $131 million in 1986; during this period the Province of Alberta spent about $51 Canadian per resident each year for cardiovascular hospital services. It was noted that rural residents consumed a higher volume of resources per capita than their urban counterparts. A patient origin-destination analysis indicated an increasing dependence of rural patients on urban hospitals for secondary or tertiary care, underscoring the effects of medical technology on referral patterns. Handle: RePEc:aph:ajpbhl:1989:79:6:759-764_1 Template-Type: ReDIF-Article 1.0 Title: A contrasting view on rheumatoid arthritis Journal: American Journal of Public Health Author-Name: Callahan, L.F. Author-Name: Pincus, T. Author-Name: Wolfe, F. Year: 1989 Volume: 79 Issue: 9 Pages: 1308 Handle: RePEc:aph:ajpbhl:1989:79:9:1308_5 Template-Type: ReDIF-Article 1.0 Title: Increased suppressor T cells in probable transmitters of human immunodeficiency virus infection Journal: American Journal of Public Health Author-Name: Seage III, G.R. Author-Name: Horsburgh Jr., C.R. Author-Name: Hardy, A.M. Author-Name: Mayer, K.H. Author-Name: Barry, M.A. Author-Name: Groopman, J.E. Author-Name: Jaffe, H.W. Author-Name: Lamb, G.A. Year: 1989 Volume: 79 Issue: 12 Pages: 1638-1642 Abstract: To evaluate behavioral and immunologic factors related to transmission of human immunodeficiency virus (HIV) by homosexual intercourse, we studied a population of 329 homosexual/bisexual men (155 partner-pairs) seen in a community health center and medical outpatient clinic. Logistic regression analysis showed that behavioral risk factors for infection in the 130 HIV-infected men included: receptive anal intercourse (OR 4.6, 95% CI-1.8, 12.1); receptive fisting (OR 2.5, CI-1.1, 7.0); nitrite use (OR 2.3, CI-1.2, 4.6); history of gonorrhea or syphilis (OR 2.3, CI-1.4, 3.9); and history of sexual contact with men from areas with many AIDS cases (OR 1.9, CI-1.0, 3.5). Comparing seven men who were probable transmitters of HIV and 11 men who had not transmitted HIV to their uninfected partners despite unprotected insertive anal intercourse, we found no differences in HIV isolation from peripheral blood mononuclear cells, circulating HIV antigen detection, or presence of neutralizing antibody to HIV. Helper T-cell numbers were not significantly different between the two groups, but transmitters had more suppressor T-cells than did nontransmitters. Handle: RePEc:aph:ajpbhl:1989:79:12:1638-1642_8 Template-Type: ReDIF-Article 1.0 Title: Current medical, legal and demographic perspectives on artificial reproduction in Czechoslovakia Journal: American Journal of Public Health Author-Name: Heitlinger, A. Year: 1989 Volume: 79 Issue: 1 Pages: 57-61 Abstract: This paper examines artificial reproduction (AR) within a broad comparative perspective and with specific reference to Czechoslovak law, medicine, and demography. It proceeds from an analysis of the social context that gives rise to technologies of AR to a review of the two principal technologies, artificial insemination (AI) and in vitro fertilization (IVF). A final section briefly discusses some of the implications of AR for new judicial conceptions of motherhood and fatherhood. Handle: RePEc:aph:ajpbhl:1989:79:1:57-61_1 Template-Type: ReDIF-Article 1.0 Title: Older people in the United States who receive help with basic acitivties of daily living Journal: American Journal of Public Health Author-Name: Kovar, M.G. Author-Name: Hendershot, G. Author-Name: Mathis, E. Year: 1989 Volume: 79 Issue: 6 Pages: 778-779 Handle: RePEc:aph:ajpbhl:1989:79:6:778-779_9 Template-Type: ReDIF-Article 1.0 Title: Variations in the reporting of gestational age at induced termination of pregnancy Journal: American Journal of Public Health Author-Name: Petersen, D.J. Author-Name: Alexander, G.R. Author-Name: Powell-Griner, E. Author-Name: Tompkins, M.E. Year: 1989 Volume: 79 Issue: 5 Pages: 603-606 Abstract: Utilizing the 1980 Induced Abortion File maintained by the National Center for Health Statistics, we compared gestational age from date of last normal menses and the physician-based estimate of gestational age. An average .51 week difference between the two methods was observed. Beyond seven weeks gestation, the date of last normal menses value was underestimated by the physician-based estimate with a markedly greater divergence after 20 weeks. A relatively greater underestimation of the date of last normal menses interval by the physician estimate was apparent for Whites after 13 weeks. The date of last normal menses value for non-state residents was overestimated across the entire range of the date of last normal menses gestational age distribution until 21 weeks. Handle: RePEc:aph:ajpbhl:1989:79:5:603-606_3 Template-Type: ReDIF-Article 1.0 Title: Determinants of stopping smoking: Italian National Health Survey Journal: American Journal of Public Health Author-Name: Negri, E. Author-Name: La Vecchia, C. Year: 1989 Volume: 79 Issue: 9 Pages: 1307-1308 Handle: RePEc:aph:ajpbhl:1989:79:9:1307-1308_6 Template-Type: ReDIF-Article 1.0 Title: Outbreaks of hepatitis A among illicit drug users, Oklahoma, 1984-87 Journal: American Journal of Public Health Author-Name: Harkess, J. Author-Name: Gildon, B. Author-Name: Istre, G.R. Year: 1989 Volume: 79 Issue: 4 Pages: 463-466 Abstract: Transmission of hepatitis A has been described in many settings, although few outbreaks have been reported among illicit drug users. We report six unrelated outbreaks of hepatitis A among users of marijuana and intravenously administered methamphetamine. Although the exact mode of transmission could not be determined, practices associated with illicit drug use may have facilitated transmission of hepatitis A. These outbreaks and other recent information indicate that illicit drug users may be at increased risk of acquiring hepatitis A infection. Handle: RePEc:aph:ajpbhl:1989:79:4:463-466_6 Template-Type: ReDIF-Article 1.0 Title: Validity of telephone surveys in assessing cigarette smoking in young adults Journal: American Journal of Public Health Author-Name: Luepker, R.V. Author-Name: Pallonen, U.E. Author-Name: Murray, D.M. Author-Name: Pirie, P.L. Year: 1989 Volume: 79 Issue: 2 Pages: 202-204 Abstract: Self-reports of cigarette smoking in a sample of young adults, ages 17 to 21 (n = 359) obtained by telephone were validated by home interview and saliva cotinine measurement. While most subjects were in agreement for their reported behaviors, the telephone methodology underestimated cigarette smoking rates by 3 to 4 per cent. Reported quitting by telephone was an unstable category with 35 per cent of quitters reporting smoking on home interview. Reliance on telephone methods alone may underestimate smoking behavior. Validation of surveys, preferably by biochemical methods, is recommended. Handle: RePEc:aph:ajpbhl:1989:79:2:202-204_8 Template-Type: ReDIF-Article 1.0 Title: Worksite health promotion Journal: American Journal of Public Health Author-Name: Levenstein, C. Year: 1989 Volume: 79 Issue: 1 Pages: 11 Handle: RePEc:aph:ajpbhl:1989:79:1:11_0 Template-Type: ReDIF-Article 1.0 Title: Uncompensated emergency care in hospital markets in Los Angeles County Journal: American Journal of Public Health Author-Name: Melnick, G.A. Author-Name: Mann, J. Author-Name: Golan, I. Year: 1989 Volume: 79 Issue: 4 Pages: 514-516 Abstract: A survey of hospital emergency rooms in Los Angeles County was conducted in March 1987. Analysis of the distribution of uninsured emergency care patients revealed that private hospitals play a significant frontline role in terms of entry into the hospital system for patients who are unable to pay - almost one-half of such patients were treated in the emergency rooms of private hospitals. Hospitals serving markets in which a higher proportion of residents had incomes below the poverty level provided a greater share of uncompensated emergency room services. Handle: RePEc:aph:ajpbhl:1989:79:4:514-516_7 Template-Type: ReDIF-Article 1.0 Title: Frequency of worksite health promotion activities Journal: American Journal of Public Health Author-Name: Fielding, J.E. Author-Name: Piserchia, P.V. Year: 1989 Volume: 79 Issue: 1 Pages: 16-20 Abstract: The first National Survey of Worksite Health Promotion Activities surveyed a random sample of all private sector worksites with 50 or more employees, stratified by number of employers, geographic location, and type of industry. The 1,358 completed interviews constituted a response rate of 83.1 per cent. Of responding worksites 65.5 per cent had one or more areas of health promotion activity with slightly more than 50 per cent of activities initiated within the previous five years. Overall prevalence by type of activity included health risk assessment (29.5 per cent), smoking cessation (35.6 per cent), blood pressure control and treatment (16.5 per cent), exercise/fitness (22.1 per cent), weight control (14.7 per cent), nutrition education (16.8 per cent), stress management (26.6 per cent), back problem prevention and care (28.5 per cent), and off-the-job accident prevention (19.8 per cent). Mean number of activities across all worksites was 2.1 and for worksites with activities, 3.2. Activity frequency increased with worksite size, was highest in the western region (2.34) and lowest in the northeast (1.96), and varied considerably by industry type. The majority of worksites paid the entire cost of these activities. Handle: RePEc:aph:ajpbhl:1989:79:1:16-20_1 Template-Type: ReDIF-Article 1.0 Title: A case-control study of pedestrian and bicyclist injuries in childhood Journal: American Journal of Public Health Author-Name: Pless, I.B. Author-Name: Verreault, R. Author-Name: Tenina, S. Year: 1989 Volume: 79 Issue: 8 Pages: 995-998 Abstract: We identified children ages 0 to 14 years injured in traffic as pedestrians or bicyclists in Montreal, Canada. Two hundred children with injuries who received a score of 2 or more on the Maximum Abbreviated Injury Severity scale were considered as cases and compared with 400 uninjured children seen in the same hospitals for non-traumatic reasons. Systematic, blinded interviews and tests were conducted with parents to determine the role of a series of social, familial, personal, and behavioral characteristics. After adjustment for age, gender and socioeconomic area of residence, logistic regression analyses showed higher risks of injury to be related to fewer years of parents' education, a history of accident to a family member, an environment judged as unsafe, and poor parental supervision. Absence of physical health problems, fewer family preventive behaviors and reported lack of cautiousness were also related to a higher risk, whereas neither aggressivity nor behavioral disturbance, whether internalizing or externalizing, showed any such relation. These data suggest that the child's personality and behavior are weaker risk factors for pedestrian and bicyclist injuries than are family and neighborhood characteristics. Handle: RePEc:aph:ajpbhl:1989:79:8:995-998_0 Template-Type: ReDIF-Article 1.0 Title: A comparative evaluation of a restrictive smoking policy in a general hospital Journal: American Journal of Public Health Author-Name: Biener, L. Author-Name: Abrams, D.B. Author-Name: Follick, M.J. Author-Name: Dean, L. Year: 1989 Volume: 79 Issue: 2 Pages: 192-195 Abstract: The impact of a restrictive smoking policy on the behavior and attitudes of smokers and non-smokers was assessed by surveying random cross-sectional samples of hospital employees before, six months after and 12 months after the policy was implemented, and comparing responses with those of empolyees of a hospital with no restrictive policy. Effectiveness of policy implementation was also evaluated. Results indicated that the policy was well-publicized and was approved by virtually all the non-smokers and the majority of the smokers. Following implementation, employees in the smoking policy hospital were less likely to report being bothered by smoke at their work stations than were employees of the comparison hospital. Six months and one year after the policy change, smokers reported lower smoking rates while at work, although quit smoking rates and home smoking rates were similar in both hospitals. Handle: RePEc:aph:ajpbhl:1989:79:2:192-195_4 Template-Type: ReDIF-Article 1.0 Title: Potential for exposure to tick bites in recreational parks in a lyme disease endemic area Journal: American Journal of Public Health Author-Name: Falco, R.C. Author-Name: Fish, D. Year: 1989 Volume: 79 Issue: 1 Pages: 12-15 Abstract: Eight recreational parks located in a Lyme disease endemic area of southern New York State were surveyed for the presence of ticks during the summer of 1985 by drag sampling. Ixodes dammini, the primary vector of Lyme disease in the northeast, was found in all but one park and accounted for 580 (91.8 per cent) of the 632 ticks collected. Of these, 18 per cent were larvae, 80 per cent were nyphms, and 2 per cent were adults. An I. dammini encounter distance, defined as the mean number of meters traveled before encountering a nymphal or adult I. dammini on a drag cloth, ranged from 36 m in high-risk parks, to infinity (no tick encounters). Generally, areas of high use presented higher encounter distances (lower risk) than those of the entire park. Two of the three parks with the highest annual attendance also had the highest I. dammini population indices as projected from our sampling regimen. These results indicate that recreational parks in Lyme disease endemic areas represent a substantial human risk for tick bites and Lyme disease. Handle: RePEc:aph:ajpbhl:1989:79:1:12-15_8 Template-Type: ReDIF-Article 1.0 Title: Improving the homogeneity of diagnosis-related groups (DRGs) by using clinical laboratory, demographic, and discharge data Journal: American Journal of Public Health Author-Name: Goldman, E.S. Author-Name: Easterling, M.J. Author-Name: Sheiner, L.B. Year: 1989 Volume: 79 Issue: 4 Pages: 441-444 Abstract: For 48 of the most common diagnosis-related groups (DRGs) at our hospital, we examined the ability of clinical laboratory tests, demographic data, and ICD-9-CM codes, which provide a measure of severity of illness, to predict patients' length of stay (LOS) more accurately than DRGs alone. For 10 of 20 medical DRGs and 13 of 23 surgical DRGs examined, we were able to increase the ability to predict LOS by at least 10 per cent. The laboratory tests that proved most predictive of LOS over all DRGs were the mean serum sodium, potassium, bicarbonate, and albumin. The system is data driven, objective, and flexible, thus ensuring its utility for the purpose of equitable reimbursement. Handle: RePEc:aph:ajpbhl:1989:79:4:441-444_1 Template-Type: ReDIF-Article 1.0 Title: Determinants of community-based coverage: Periodic vitamin A supplementation Journal: American Journal of Public Health Author-Name: Tarwotjo, I. Author-Name: West Jr., K.P. Author-Name: Mele, L. Author-Name: Nur, S. Author-Name: Nendrawati, H. Author-Name: Kraushaar, D. Author-Name: Tilden, R.L. Author-Name: Djunaedi, E. Author-Name: Koesdiono Author-Name: Pandji, A. Author-Name: Sommer, A. Author-Name: Taylor, H.R. Author-Name: Hawkins, B. Author-Name: Satibi, I. Author-Name: Flumenbaum, W. Author-Name: Loedin, A.A. Year: 1989 Volume: 79 Issue: 7 Pages: 847-849 Abstract: Factors related to preschool child receipt of vitamin A during the first year of a semi-annual vitamin A capsule delivery program were investigated in 229 villages in Aceh, Indonesia. Coverage was higher in villages which were more rural and less economically developed. Highest performance was achieved by village distributors who represented the local status quo in this rural area (farmers, or non-farmers with minimum education) rather than more upwardly mobile, highly educated residents. Household or child-level characteristics were not associated with coverage. This information may be useful for planning direct service programs in the community. Handle: RePEc:aph:ajpbhl:1989:79:7:847-849_7 Template-Type: ReDIF-Article 1.0 Title: Predictors of healthy aging: Prospective evidence from the Alameda County Study Journal: American Journal of Public Health Author-Name: Guralnik, J.M. Author-Name: Kaplan, G.A. Year: 1989 Volume: 79 Issue: 6 Pages: 703-708 Abstract: Long-term predictors of high levels of physical functioning were examined in a representative sample of Alameda County, California residents followed from 1965 through 1984. The cohort investigated in this study was born between 1985 and 1919, with survivors being age 65 to 89 at the time of follow-up. A scale of physcial functioning was developed from a comprehensive set of questionnaire items which assessed the full spectrum of physical functioning. Those scoring in the top 20 percent, defined as healthy aging, were compared to the remainder of the cohort, including those who died and those with lower levels of functioning at follow-up. After adjustment for age and functional status at baseline, the following variables were predictive of high functioning at follow-up 19 years later: race (those not Black), higher family income level, absence of hypertension, absence of arthritis, absence of back pain, being a non-smoker, having normal weight, and consuming moderate amounts of alcohol. Sex did not predict high function because of the counterbalancing effects of higher survival in females but greater likelihood of high functioning among surviving males. Handle: RePEc:aph:ajpbhl:1989:79:6:703-708_0 Template-Type: ReDIF-Article 1.0 Title: A microcomputer-based vital records data base with interactive graphic assessment for states and localities Journal: American Journal of Public Health Author-Name: Wartenberg, D. Author-Name: Agamennone, V.J. Author-Name: Ozonoff, D. Author-Name: Berry, R.J. Year: 1989 Volume: 79 Issue: 11 Pages: 1531-1536 Abstract: Vital records data bases describe large populations over long periods of time, yet their organization and size often preclude or discourage their use. We constructed a microcomputer-based data base of all singleton births in Massachusetts, 1975-84. The original data were stored in 700,000 records, each 174 bytes long, occupying a total of over 120 megabytes (MB). By removing redundant information and unique identifiers, and packing the data, we store 21 fields of this information in a 16-byte record resulting in a data base of 11.1 MB, a saving of over 90 percent of disk space. By using programs written expressly for this data base, we can display a birth weight frequency plot of the entire data set in under 65 seconds on an IBM-compatible PC-AT. Comparable assessments in SAS-PC took over 105 minutes and in main frame SAS on an AS-9000 took over 37 CPU seconds. Implementing similar systems for state registries on births, deaths, cancers, and birth defects potentially offers investigators easy access to vast stores of information and would enable public health officials to produce timely reports, initiate a variety of surveillance activities, and respond rapidly to residents' inquiries about clusters and anomalous disease patterns. Handle: RePEc:aph:ajpbhl:1989:79:11:1531-1536_3 Template-Type: ReDIF-Article 1.0 Title: Changes in alcohol-related inpatient care in Stockholm county in relation to socioeconomic status during a period of decline in alcohol consumption Journal: American Journal of Public Health Author-Name: Romelsjo, A. Author-Name: Diderichsen, F. Year: 1989 Volume: 79 Issue: 1 Pages: 52-56 Abstract: Alcohol sales in Stockholm County decreased by 18 per cent from 1976 to 1981. The socioeconomic status of inpatients treated for alcohol psychosis, alcoholism, alcohol intoxication, liver cirrhosis, and pancreatitis was studied by linking data from the National Housing and Population Censuses in 1975 and 1980 with the inpatient care registers for 1976 and 1981. In both years, all rates were highest for people outside the labor market and lowest among white collar employees. The employment rate for those aged 25-44 years and treated in 1981 for alcohol psychosis, alcoholism, and alcohol intoxication - already low in 1975 - had drifted further downward by 1980. Total rates of inpatient treatment for alcohol-related diagnoses generally declined but the gap between blue collar workers and white collar workers widened. We conclude that the goal for national alcohol policy, suggested by the WHO - a reduction of per capita consumption - should be combined with additional measures that will reach all social groups. Handle: RePEc:aph:ajpbhl:1989:79:1:52-56_4 Template-Type: ReDIF-Article 1.0 Title: Warnings unheeded: A history of child lead poisoning Journal: American Journal of Public Health Author-Name: Rabin, R. Year: 1989 Volume: 79 Issue: 12 Pages: 1668-1674 Abstract: Child lead poisoning has been a major public health issue only for the last 20-25 years. However, awareness that lead-based paint is a source of lead poisoning in children dates back to the first few years of the twentieth century. Articles in medical journals and textbooks appeared in the United States and elsewhere, recounting cases of children poisoned by the lead piant in their homes on woodwork, baby cribs, and other furniture. The number of positively diagnosed cases was limited both by the imprecision of diagnostic tools and physicians' lack of familiarity with the sings and symptoms of plumbism in children. Nevertheless, a number of hospitals and at least one large city health department recorded numerous cases of child lead poisoning in the 1920s and 1930s. The mounting evidence in those years made it clear that child lead poisoning was a serious public health hazard. And the activities and statements of the lead industry's representatives left little doubt that they were aware of the dangers of lead paint. Nevertheless, the lead paint companies continued to manufacture and sell their product well past 1940. Handle: RePEc:aph:ajpbhl:1989:79:12:1668-1674_2 Template-Type: ReDIF-Article 1.0 Title: Delayed blood regeneration in lead exposure: An effect on reserve capacity Journal: American Journal of Public Health Author-Name: Grandjean, P. Author-Name: Jensen, B.M. Author-Name: Sando, S.H. Author-Name: Jorgensen, P.J. Author-Name: Antonsen, S. Year: 1989 Volume: 79 Issue: 10 Pages: 1385-1388 Abstract: Twenty-five lead-exposed Danish battery production workers and 25-age-matched controls were examined to evaluate subclinical effects on blood formation. Blood lead levels averaged 2.14 μmol/L and 0.35 μmol/L in the two groups; the lead workers also showed high levels of erythrocyte protoporphyrin, as compared to the controls. Otherwise, the hematological parameters indicated an appropriate iron status and no other deviations. From all subjects, 0.45 L of blood was bled as part of a normal blood donation. Five and 11 days later, reticulocyte counts were significantly higher in the control group than in the lead-exposed workers. On day 15, the lead workers showed a significant delay in blood regeneration, as evidenced by lower hemoglobin concentration, and erythrocyte and reticulocyte counts. The lead exposure in the present study was within legal limits, and lead-induced anemia would be expected only at much higher exposure levels. Thus, despite the normal hematological findings in the initial examination, the lead exposure caused a decreased reserve capacity for blood formation, and this effect became evident only after the blood loss. Handle: RePEc:aph:ajpbhl:1989:79:10:1385-1388_0 Template-Type: ReDIF-Article 1.0 Title: Risk of carotid endarterectomy in the elderly Journal: American Journal of Public Health Author-Name: Fisher, E.S. Author-Name: Malenka, D.J. Author-Name: Solomon, N.A. Author-Name: Bubolz, T.A. Author-Name: Whaley, F.S. Author-Name: Wennberg, J.E. Year: 1989 Volume: 79 Issue: 12 Pages: 1617-1620 Abstract: We used the Medicare claims files to describe operative mortality for 2,089 New England residents over the age of 65 who underwent carotid endarterectomy in 1984 and 1985. For patients ages 65 to 69, the risk of death within 30 days of surgery was 1.1 percent, (95% confidence interval = 0.5, 2.1), for those ages 70 to 74, 2.8 percent (1.7, 4.4), for those ages 75 to 79, 3.2 percent (1.8, 5.2), and for those over age 80, 4.7 percent (2.3, 8.5). Nearly 80 percent of patients underwent surgery at hospitals performing 40 or fewer carotid endarterectomies per year on the Medicare population. The adjusted odds ratio for 30 day mortality for patients undergoing surgery in these low-volume hospitals was 2.8 (95% CI = 1.1, 7.2) compared to higher volume hospitals. Although the Medicare claims data provided only limited data about post-operative strokes, analysis of post-operative stroke risk supported these findings. Handle: RePEc:aph:ajpbhl:1989:79:12:1617-1620_8 Template-Type: ReDIF-Article 1.0 Title: Geographic variation in the onset of decline of male ischemic heart disease mortality in the Netherlands Journal: American Journal of Public Health Author-Name: Mackenbach, J.P. Author-Name: Looman, C.W.N. Author-Name: Kunst, A.E. Year: 1989 Volume: 79 Issue: 12 Pages: 1621-1627 Abstract: We studied variation in the year of onset of ischemic heart disease mortality decline among regions (n = 39) in the Netherlands. Using loglinear regression methods, a quadratic regression model was fitted to the observed numbers of male deaths in each region in the period 1950-84, controlling for changes in age-structure of populations. The quadratic regression model proved inadequate to describe the mortality experience of females. For the country as a whole, the estimated year of onset of male ischemic heart disease mortality decline is 1973.9. The difference between the earliest and the late region is almost nine years (1970.0 and 1978.9, respectively). An early onset of decline (≤1972) is only found in the urbanized, western part of the country. A later (≥1975) onset of decline is characteristically found in more peripheral regions in the South-West and South-East, as well as in the North. Exploratory correlation and regression analyses show that both average income and percent of population living in larger cities have independent, negative associations with the year of onset of male ischemic heart disease mortality decline. We argue that regional variation in the timing of lifestyle changes is a more plausible explanation of these observations than regional variation in the timing of medical care improvements. Handle: RePEc:aph:ajpbhl:1989:79:12:1621-1627_5 Template-Type: ReDIF-Article 1.0 Title: The power of policy: The relationship of smoking policy to adolescent smoking Journal: American Journal of Public Health Author-Name: Pentz, M.A. Author-Name: Brannon, B.R. Author-Name: Charlin, V.L. Author-Name: Barrett, E.J. Author-Name: MacKinnon, D.P. Author-Name: Flay, B.R. Year: 1989 Volume: 79 Issue: 7 Pages: 857-862 Abstract: This study examined the effects of smoking policy on 4,807 adolescents in 23 schools over a two-county area in California. Amounts and prevalence rates of adolescents smoking were measured with a self-report survey and a biochemical measure; school smoking policy was measured with two independent surveys of school staff. Policy effects were evaluated with multiple and logistic regression analyses controlling for school-level socioeconomic status and environmental support for teaching and administration. Of the 23 schools, 100 percent had a formal written and regularly enforced policy component restricting student smoking on school grounds, 94 percent restricted students leaving school grounds, 65 percent restricted smoking near school grounds, and 57 percent had a smoking prevention education plan. Schools with policies having all four versus less than four components, high versus low emphasis on prevention, and a low versus high emphasis on cessation reported lower amounts of smoking in the last week and in the last 24 hours. Punitive consequences of policy violation had no effect. Results were compared to school staff observations of adolescent smoking, and school archival records of student smoking violations in the last year. Results suggest that school smoking policy is associated with decreased amounts of smoking in adolescents. Handle: RePEc:aph:ajpbhl:1989:79:7:857-862_4 Template-Type: ReDIF-Article 1.0 Title: Determinants of needle sharing among intravenous drug users Journal: American Journal of Public Health Author-Name: Magura, S. Author-Name: Grossman, J.I. Author-Name: Lipton, D.S. Author-Name: Siddiqi, Q. Author-Name: Shapiro, J. Author-Name: Marion, I. Author-Name: Amann, K.R. Year: 1989 Volume: 79 Issue: 4 Pages: 459-462 Abstract: Data from 110 IV-drug abusing persons in methadone maintenance were analyzed to determine the correlates of needle sharing. Sharing was directly related to peer group behavior, attitudes conductive to sharing, economic motivation to share, not owning injection equipment, and fatalism about developing AIDS. Sharers were aware of their AIDS risk. Indicated measures to reduce needle sharing would be positive peer support groups to help resist pressures to share, legal and free access to fresh injection equipment, education on the utility of risk reduction, and increased treatment options for IV cocaine users. Handle: RePEc:aph:ajpbhl:1989:79:4:459-462_5 Template-Type: ReDIF-Article 1.0 Title: Evidence for limits on the acceptability of lowest-tar cigarettes Journal: American Journal of Public Health Author-Name: Kozlowski, L.T. Year: 1989 Volume: 79 Issue: 2 Pages: 198-199 Abstract: The sales of the lowest yield cigarettes (1-3 mg tar) seem to have been particularly resistant to the effects of promotion and advertising, while the sales of other low-yield cigarettes (4-9 mg tar) seem to have been increased by promotional efforts. This finding is consistent with the existent of a boundary of tar and nicotine acceptability below which consumers in general are not prepared to go. Use of lower tar cigarettes may be helpful for those who cannot stop smoking, but, since 1979, the percentage of cigarettes under 16 mg tar has changed little. Handle: RePEc:aph:ajpbhl:1989:79:2:198-199_9 Template-Type: ReDIF-Article 1.0 Title: Smoking and health: A 25-year perspective Journal: American Journal of Public Health Author-Name: Warner, K.E. Year: 1989 Volume: 79 Issue: 2 Pages: 141-143 Handle: RePEc:aph:ajpbhl:1989:79:2:141-143_6 Template-Type: ReDIF-Article 1.0 Title: Age of initiation and switching patterns between smokeless tobacco and cigarettes among college students in the United States Journal: American Journal of Public Health Author-Name: Glover, E.D. Author-Name: Laflin, M. Author-Name: Edwards, S.W. Year: 1989 Volume: 79 Issue: 2 Pages: 207-208 Abstract: A stratified, random, multi-stage, cluster sample of physical activity classes among 72 colleges and universities throughout the United States yielded 5,894 usable responses (males = 2,888); (females = 3,006). Twenty-three percent of the students who began smoking before the age of 10 were current smokers, while 61 per cent of those who began using smokeless tobacco before the age of 10 were current smokeless tobacco users. College students were more likely to switch from smokeless tobacco to cigarettes than from smoking cigarettes to smokeless tobacco. Handle: RePEc:aph:ajpbhl:1989:79:2:207-208_4 Template-Type: ReDIF-Article 1.0 Title: Inappropriate comparisons of incidence and prevalence in epidemiologic research Journal: American Journal of Public Health Author-Name: Flanders, W.D. Author-Name: O'Brien, T.R. Year: 1989 Volume: 79 Issue: 9 Pages: 1301-1303 Abstract: Several epidemiologists have published papers in major medical journals in which they compare incidence rates and prevalence and use these comparisons to support conclusions regarding questions of major public health importance. Although these papers have been criticized in published correspondence, we believe that continued use and advocacy of such comparisons by some epidemiologists has created the need for a full discussion of this practice. In this commentary, we review basic differences between incidence and prevalence and show that direct comparison of these two measures is inappropriate for conceptual, theoretical, and practical reasons. Handle: RePEc:aph:ajpbhl:1989:79:9:1301-1303_4 Template-Type: ReDIF-Article 1.0 Title: International comparisons of trends in cigarette smoking prevalence Journal: American Journal of Public Health Author-Name: Pierce, J.P. Year: 1989 Volume: 79 Issue: 2 Pages: 152-157 Abstract: Data on smoking prevalence since 1974 are presented for the United States, Canada, Great Britain, Australia, Norway and Sweden. During this period, sex-specific prevalence has decreased in all the countries studied, with the exception of Norway, where women showed an increase. There was also a considerable decline in uptake of smoking by the young over this period, suggesting that the observed decline in prevalence is likely to continue. In the United States, the rate of decline in adult smoking prevalence has been linear. This linear pattern is probably similar in prevalence in most other countries studied, with the notable exception of Australia, which demonstrated no change for the majority of the period. Among the six countries studied, the United States had neither the lowest smoking prevalence nor the fastest rate of decline over the period. Differential patterns of change infer that the successful public health interventions in some countries are not being applied in others. While the lack of change in Australia prior to 1983 is surprising, this was followed by a sizable drop in smoking prevalence for both higher and lower eductional groups in conjunction with the introduction of mass media-led antismoking campaigns. Most of the other countries report an ever increasing gap in prevalence between higher and lower eductional groups. These findings suggest that all countries might benefit from a greater exchange of antismoking ideas and public health action. Handle: RePEc:aph:ajpbhl:1989:79:2:152-157_8 Template-Type: ReDIF-Article 1.0 Title: Problems in measurement of accuracy of cause-of-death statistics Journal: American Journal of Public Health Author-Name: Moriyama, I.M. Year: 1989 Volume: 79 Issue: 10 Pages: 1349-1350 Handle: RePEc:aph:ajpbhl:1989:79:10:1349-1350_5 Template-Type: ReDIF-Article 1.0 Title: Family physicians' views of chiropractors: Hostile or hostpitable? Journal: American Journal of Public Health Author-Name: Cherkin, D. Author-Name: MacCornack Berg, F.A.A.O. Year: 1989 Volume: 79 Issue: 5 Pages: 636-637 Abstract: Family physicians in the State of Washington were surveyed about their knowledge and views about chiropractors; 79 per cent (476) responded. Sixty-six per cent indicated discomfort with what they believed chiropractors do while acknowledging their effectiveness for some patients; 25 per cent viewed chiropractors as an excellent source of care for some musculoskeletal problems and only 3 per cent dismissed chiropractors as quacks that patients should avoid; 57 per cent admitted having encouraged patients to see a chiropractor. These views are less negative than those of organized medicine. Handle: RePEc:aph:ajpbhl:1989:79:5:636-637_0 Template-Type: ReDIF-Article 1.0 Title: Lead toxicity and iron deficiency in Utah migrant children Journal: American Journal of Public Health Author-Name: Ratcliffe, S.D. Author-Name: Lee, J. Author-Name: Lutz, L.J. Author-Name: Woolley, F.R. Author-Name: Baxter, S. Author-Name: Civish, F. Author-Name: Johnson, M. Year: 1989 Volume: 79 Issue: 5 Pages: 631-633 Abstract: We determined the frequency of presumptive iron deficiency and lead toxicity in 198 Utah migrant children, ages 9-72 months, during the summer of 1985. There were no confirmed cases of lead toxicity. Thirteen per cent of those tested and 30 per cent of the children ages 9-23 months were iron deficient. Hematocrit determinations accurately predicted iron deficiency in only 35 per cent of the children confirmed to have this disorder via erythrocyte protoporphyrin screening. Handle: RePEc:aph:ajpbhl:1989:79:5:631-633_1 Template-Type: ReDIF-Article 1.0 Title: Health effects of the war in two rural communities in Nicaragua Journal: American Journal of Public Health Author-Name: Broholm, C. Author-Name: Clements, C. Author-Name: DiPrete, L. Author-Name: Epstein, P. Author-Name: Fine, A. Author-Name: Halloran, M.E. Author-Name: Karchere, M. Author-Name: Liebman, J. Author-Name: Loevinsohn, B. Author-Name: Marley, J. Author-Name: Meyers, A. Author-Name: Prado, L. Author-Name: Tracy, M. Author-Name: Wilcox, M. Author-Name: Jimenez, M. Author-Name: Montiel, H. Author-Name: Perez, R. Year: 1989 Volume: 79 Issue: 4 Pages: 424-429 Abstract: We report on a pilot study to assess the effects of low intensity war in Nicaragua on the health of the civilian population. The study compared data from two regions in Nicaragua, one in an area of intense conflict, the other further removed from the war's violence. Information was obtained from a questionnaire administered to female heads of randomly selected households; structured interviews with community leaders and health workers; group discussions with community residents; and a review of regional and municipal death records. Height and mid-upper arm circumference of children were measured, and immunization records reviewed. The war has had a serious negative effect on the lives of the civilian population in both the war zone and the non-war zone, with the effects most severe in the war zone. In both communities, over half of the respondents reported the death of a friend or relative. In the war zone community, over one-fourth of respondents reported attacks on family members in non-combat situations around their homes. Death by firearms was the leading cause of death in persons over age 6 in the war zone. Vaccination coverage, nutritional indices, and familial disruption were worse in the war zone community. The findings suggest that continued funding of the Nicaraguan contra forces by the United States may be harming the ostensible beneficiaries of that policy, and that use of such low intensity conflict as a foreign policy tool should be questioned. Handle: RePEc:aph:ajpbhl:1989:79:4:424-429_1 Template-Type: ReDIF-Article 1.0 Title: Trends in dental fluorosis and dental caries prevalences in Newburgh and Kingston, NY Journal: American Journal of Public Health Author-Name: Kumar, J.V. Author-Name: Green, E.L. Author-Name: Wallace, W. Author-Name: Carnahan, T. Year: 1989 Volume: 79 Issue: 5 Pages: 565-569 Abstract: A study was undertaken in New York State to determine the changes in dental fluorosis prevalence from 1955 to 1986 in fluoridated Newburgh and non-fluoridated Kingston children. The frequency and severity of dental fluorosis among 884 7-14-year-old children were measured by two dentists utilizing Dean's Index. Data regarding residential and fluoride history were obtained from the parents of participants. Among the Newburgh residents, the prevalence of dental fluorosis (very mild to moderate) varied from a low of 5 per cent for the 9-10-year-old group to a high of 9.4 per cent for 11-12-year-olds. Except for the 13-14-year-old group, children in non-fluoridated Kingston had the lowest dental fluorosis prevalence rates. A comparison of Dean's Community Fluorosis Indices to the 1955 baseline data obtained from studies conducted after 10 years of fluoridation in Newburgh revealed no changes of consequence among Newburgh residents. However, the changes are apparent for Kingston residents, indicating the availability of fluorides in non-fluoridated areas. The increased risk for dental fluorosis for Kingston residents appears to be from the use of fluoride tablets. An analysis of dental caries data revealed that caries prevalence declined substantially in both fluoridated and non-fluoridated areas. Handle: RePEc:aph:ajpbhl:1989:79:5:565-569_0 Template-Type: ReDIF-Article 1.0 Title: Survival analysis of hemophilia-associated AIDS cases in the US Journal: American Journal of Public Health Author-Name: Stehr-Green, J.K. Author-Name: Holman, R.C. Author-Name: Mahoney, M.A. Year: 1989 Volume: 79 Issue: 7 Pages: 832-835 Abstract: Using national hemophilia-associated AIDS (acquired immunodeficiency syndrome) surveillance data and the life table method of survival analysis, the median length of survival of hemophilic patients in the United States after the diagnosis of AIDS was 11.7 months; the cumulative probability of survival at one year was 49.2 ± 2.0 percent; at two years, 28.9 ± 2.3 percent. Patients 13-29 years of age at the time of diagnosis had the longest survival and those 60 years and older had the shortest. Patients diagnosed since 1986 survived longer than those diagnosed before 1986. Length of survival did not differ significantly by race, coagulation disorder, AIDS manifestation at the time of diagnosis, or region of residence. Seven patients survived more than 36 months after AIDS was diagnosed. These patients were similar to those surviving for a shorter duration except that they were more likely to have met only the 1987 revision of the Centers for Disease Control AIDS surveillance case definition (as opposed to the 1985 case definition). Results of this study suggest that survival among hemophilic patients after the diagnosis of AIDS is similar to that reported by other investigators for other AIDS risk groups, excluding patients with Kaposi's sarcoma. Handle: RePEc:aph:ajpbhl:1989:79:7:832-835_6 Template-Type: ReDIF-Article 1.0 Title: XI. The role of occupational health clinics in surveillance of occupational disease Journal: American Journal of Public Health Author-Name: Welch, L. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 58-60 Abstract: Academic occupational health centers can support state-based occupational disease surveillance by playing a role in case identification and management, physician education, workplace investigation, and surveillance case criteria development. The existing centers can also serve as a model for developing new clinics. As plans for developing surveillance continue, the role of these centers should be explicitly defined, and they should be included in helping to develop mechanisms for reporting. In all these ways, the centers can significantly enhance the development of a national surveillance system for occupational disease. Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:58-60_3 Template-Type: ReDIF-Article 1.0 Title: Reducing the threat of hip fracture Journal: American Journal of Public Health Author-Name: Ford, A.B. Year: 1989 Volume: 79 Issue: 3 Pages: 269-270 Handle: RePEc:aph:ajpbhl:1989:79:3:269-270_6 Template-Type: ReDIF-Article 1.0 Title: Determinants of polychlorinated biphenyls (PCBs), polybrominated biphenyls (PBBs), and dichlorodiphenyl trichloroethane (DDT) levels in the sera of young children Journal: American Journal of Public Health Author-Name: Jacobson, J.L. Author-Name: Humphrey, H.E.B. Author-Name: Jacobson, S.W. Author-Name: Schantz, S.L. Author-Name: Mullin., M.D. Author-Name: Welch, R. Year: 1989 Volume: 79 Issue: 10 Pages: 1401-1404 Abstract: Serum samples from 285 4-year-old Michigan children were evaluated for levels of 11 environmental contaminants. Polychlorinated biphenyls (PCBs) were found in half the samples tested; polybrominated biphenyls (PBBs) in 13-21 percent; dichlorodiphenyl trichloroethane (DDT), in more than 70 percent. Nursing (Mothers' milk) was the principal source of these exposures. Congener-specific analysis documented the presence of at least one highly toxic PCB congener, 2,3',4,4',5-pentachlorobiphenyl. The data demonstrate the multigenerational impact of female exposure to persistent organic environmental contaminants. Handle: RePEc:aph:ajpbhl:1989:79:10:1401-1404_8 Template-Type: ReDIF-Article 1.0 Title: Acute hazardous materials release Journal: American Journal of Public Health Author-Name: Binder, S. Author-Name: Bonzo, S. Year: 1989 Volume: 79 Issue: 12 Pages: 1681 Handle: RePEc:aph:ajpbhl:1989:79:12:1681_0 Template-Type: ReDIF-Article 1.0 Title: Evaluating community interventions to reduce drunken driving Journal: American Journal of Public Health Author-Name: Graitcer, P.L. Year: 1989 Volume: 79 Issue: 3 Pages: 271 Handle: RePEc:aph:ajpbhl:1989:79:3:271_0 Template-Type: ReDIF-Article 1.0 Title: Coronary arteriography and coronary bypass survey among whites and other racial groups relative to hospital-based incidence rates for coronary artery disease: Findings from NHDS Journal: American Journal of Public Health Author-Name: Ford, E. Author-Name: Cooper, R. Author-Name: Castaner, A. Author-Name: Simmons, B. Author-Name: Mar, M. Year: 1989 Volume: 79 Issue: 4 Pages: 437-440 Abstract: To assess racial differences in health care utilization for coronary artery disease (CAD) the data of the National Hospital Discharge Survey (NHDS) from 1979-84 were examined. Discharge rates for acute myocardial infarction (AMI) were utilized as a measure of hospital-based incidence and relative need for the designated cardiac procedures. Although 35-74 year old Black men had discharge rates of AMI that were 77 per cent of those observed for White men, they underwent coronary arteriography half as often and were only a third as likely to have coronary artery bypass graft (CABG) surgery. Black women in this age range were hospitalized at a slightly higher rate than White women for AMI, yet experienced a 19 per cent lower rate of coronary arteriography and a 52 per cent lower rate of CABG surgery. These data suggest a racial bias in the pattern of care delivered for CAD in US hospitals at the present time. Handle: RePEc:aph:ajpbhl:1989:79:4:437-440_1 Template-Type: ReDIF-Article 1.0 Title: Deaths from all causes in non-smokers who lived with smokers Journal: American Journal of Public Health Author-Name: Sandler, D.P. Author-Name: Comstock, G.W. Author-Name: Helsing, K.J. Author-Name: Shore, D.L. Year: 1989 Volume: 79 Issue: 2 Pages: 163-167 Abstract: Mortality associated with passive smoking was evaluated in 12-year study of 27,891 white adult smokers and 19,035 never smokers identified in 1963. Death rates were calculated using an estimate of the person-years at risk. Adjusted for age, marital status, education, and quality of housing, the stimulated relative risks of death from all causes were 1.17 (approximate 95% confidence interval 1.01, 1.36) for men and 1.15 (1.06, 1.24) for women with passive exposure. These relative risks were similar to those for ex-smokers and for pipe or cigar smokers. Risks increased slightly with level of exposure. The relative risk from passive smoking was greatest for men under age 50 (RR = 2.09, 1.31-3.34). Risks from passive smoking were slightly elevated for several causes among men and women, and may be broader than those previously reported. On the other hand, these small nonspecific increases in death rates may reflect other characteristics of passive smokers that increase mortality. Handle: RePEc:aph:ajpbhl:1989:79:2:163-167_2 Template-Type: ReDIF-Article 1.0 Title: Two variants of coronary atherosclerosis in six populations Journal: American Journal of Public Health Author-Name: Tracy, R.E. Author-Name: Kissling, G.E. Author-Name: Oalmann, M.C. Year: 1989 Volume: 79 Issue: 5 Pages: 575-581 Abstract: Coronary arteries and aortas obtained at autopsy in six populations were examined microscopically. Two variants of atherosclerosis could be separately quantified by objective morphometry. These two variants, fibroplasia and atheronecrosis, were both found to increase with age and to correlate with each other from one autopsy to the next after age adjustment. Despite the correlation of these two variables among individuals, the measures of fibroplasia and atheronecrosis did not correlate with each other across population groupings. A positive correlation of this kind between some populations was canceled by an inverse correlation between other populations. For example, Manila was the population with the greatest intimal fibroplasia in the coronary arteries at each age, and Sao Paulo was among those with the least intimal fibroplasia. Nevertheless, Sao Paulo showed the greatest tendency toward atheronecrosis, while Manila was among the populations with the least tendency toward atheronecrosis. The possibility arises, therefore, that the subjects from Sao Paulo were exposed to a different assortment of etiologic agents than were the subjects from Manila, and that their arteries, therefore, manifested a different kind of atherosclerosis. Handle: RePEc:aph:ajpbhl:1989:79:5:575-581_0 Template-Type: ReDIF-Article 1.0 Title: A study of battered women presenting in an emergency department Journal: American Journal of Public Health Author-Name: McLeer, S.V. Author-Name: Anwar, R. Year: 1989 Volume: 79 Issue: 1 Pages: 65-66 Abstract: Medical records of female trauma patients were retrospectively reviewed prior to introducing a protocol for enhancing identification of battered women; 5.6 per cent of 359 female trauma patients were identified as having injuries caused by battering; 30 per cent of 412 patients following use of the protocol were so identified. Standardized protocols for identifying battered women among female trauma patients should be instituted in emergency departments. Handle: RePEc:aph:ajpbhl:1989:79:1:65-66_6 Template-Type: ReDIF-Article 1.0 Title: What do we really know about AIDS control? Journal: American Journal of Public Health Author-Name: Judson, F.N. Year: 1989 Volume: 79 Issue: 7 Pages: 878-882 Abstract: For the near term, control of the AIDS epidemic depends entirely upon altering the human behavior which results in HIV transmission. How best to achieve the required changes has been controversial with approaches ranging from education/information only, to a vast array of largely unproven voluntary behavior modification techniques, to mandatory testing and restrictive measures. Given the complexity of human behavior and the reality of a still uncontrolled epidemic, at least among poor urban drug using minotiries, there is a legitimate role for most approaches and any promising behavior modification strategy deserves evaluation. However, because voluntarism will not work for some individuals, society still must choose between effective public health law - including restrictive measures - now, and a much larger reservoir of HIV infection and more deaths from AIDS for many generations to come. Handle: RePEc:aph:ajpbhl:1989:79:7:878-882_2 Template-Type: ReDIF-Article 1.0 Title: Does maternal employment affect breast-feeding? Journal: American Journal of Public Health Author-Name: Kurinij, N. Author-Name: Shiono, P.H. Author-Name: Ezrine, S.F. Author-Name: Rhoads, G.G. Year: 1989 Volume: 79 Issue: 9 Pages: 1247-1250 Abstract: A prospective survey of maternal employment and breast-feeding initiation and duration was conducted among 668 Black and 511 White women who delivered their first child in Washington, DC. Ninety-one percent of White women (n = 511) and 80 percent of Black women (n = 668) reported working during pregnancy. Black women who planned to return to work part time vs full time were more likely to breast-feed rather than formula-feed (adjusted odds ratio, 2.3; 95% confidence intervals (CI) = 1.4, 3.7). Using Cox regression, Black women who returned to work had a shorter duration of breast-feeding than those not returning to work (hazard ratio = 0.5 (CI = 0.3, 0.9)). Black and White women returning to professional occupations had a longer duration of breast-feeding compared to women returning to sales or technical positions (hazard ratio for Black women = 2.4 (CI = 1.4, 4.4); hazard ratio for White women = 1.6 (CI = 1.0, 2.5)). In addition, White women in professional occupations had a longer duration of breast-feeding than women in clerical positions (hazard ratio = 1.7 (CI = 1.1, 2.6)). Until employers in the United States develop a maternity policy which does not discourage breast-feeding, the recommended six months of breast-feeding will be difficult to achieve for most employed women. Handle: RePEc:aph:ajpbhl:1989:79:9:1247-1250_4 Template-Type: ReDIF-Article 1.0 Title: Accuracy of women's self-report of their last Pap smear Journal: American Journal of Public Health Author-Name: Sawyer, J.A. Author-Name: Earp, J.A. Author-Name: Fletcher, R.H. Author-Name: Daye, F.F. Author-Name: Wynn, T.M. Year: 1989 Volume: 79 Issue: 8 Pages: 1036-1037 Abstract: We compared interview data and physician records on when women last had a Pap smear in a sample of 98 rural Black women. We found 20 per cent of women could not accurately report on whether a Pap smear had been done within three years (sensitivity = 0.95, specificity = 0.47). Source of gynecological care and perceived barriers to obtaining a Pap smear but not education were associated with inaccurate reports. Self-report may be a misleading measure of Pap smear screening in comparable groups of women. Handle: RePEc:aph:ajpbhl:1989:79:8:1036-1037_4 Template-Type: ReDIF-Article 1.0 Title: An outbreak of an enterovirus-like illness at a community wading pool: Implications for public health inspection programs Journal: American Journal of Public Health Author-Name: Lenaway, D.D. Author-Name: Brockmann, R. Author-Name: Dolan, G.J. Author-Name: Cruz-Uribe, F. Year: 1989 Volume: 79 Issue: 7 Pages: 889-890 Abstract: In June 1987, following an outbreak of an illness among children participating in a swim class, investigation revealed that 26 children who had swum in the outdoor wading pool were more likely to be ill than those who had not (OE 12.1, 95% CI = 2.9, 74.2). The pool chlorination system was operating improperly prior to onset of illness and chlorine levels were at or very near zero. This report emphasizes the need for operators and inspectors to give special attention to disinfection of wading pools. Handle: RePEc:aph:ajpbhl:1989:79:7:889-890_8 Template-Type: ReDIF-Article 1.0 Title: Breast cancer incidence in young women by estrogen receptor status and race Journal: American Journal of Public Health Author-Name: Stanford, J.L. Author-Name: Greenberg, R.S. Year: 1989 Volume: 79 Issue: 1 Pages: 71-73 Abstract: A population-based study was utilized to calculate breast cancer incidence rates in White and Black women, ages 30 to 54, according to tumor estrogen receptor status. Both racial groups had higher incidence curves for estrogen receptor negative breast cancer between ages 30 and 49. There was an excess of receptor negative cancer in young Black women, an observation that may help explain the racial disparity in breast cancer survival. Handle: RePEc:aph:ajpbhl:1989:79:1:71-73_6 Template-Type: ReDIF-Article 1.0 Title: The impact of media coverage of Nancy Reagan's experience on breast cancer screening Journal: American Journal of Public Health Author-Name: Lane, D.S. Author-Name: Polednak, A.P. Author-Name: Burg, M.A. Year: 1989 Volume: 79 Issue: 11 Pages: 1551-1552 Abstract: In surveys of random samples of women 50 years of age and older residing in two communities in Long Island, New York, both within-subject (cohort) and independent-sample comparisons were made before and after the media announcements of Nancy Reagan's breast cancer. Knowledge of lifetime risk of breast cancer increased significantly only in the cohort comparison, while selfperception of risk did not increase. Small proportions of women surveyed, however, reportedly were influenced to contact a health professional (6-8 percent) and to have their first mammogram (1.5-2 percent) which they attributed directly to Mrs. Reagan's experience with breast cancer. Handle: RePEc:aph:ajpbhl:1989:79:11:1551-1552_3 Template-Type: ReDIF-Article 1.0 Title: Six-year follow-up of the first Waterloo school smoking prevention trial Journal: American Journal of Public Health Author-Name: Flay, B.R. Author-Name: Koepke, D. Author-Name: Thomson, S.J. Author-Name: Santi, S. Author-Name: Best, J.A. Author-Name: Brown, K.S. Year: 1989 Volume: 79 Issue: 10 Pages: 1371-1376 Abstract: This paper reports six-year follow-up data from the first large-scale randomized trial of the social influences approach to smoking prevention. In 1979, 22 schools were randomly assigned to program or control conditions. Students in program schools received a social influences curriculum in six core and two maintenance sessions in grade 6, two booster sessions in grade 7, and one booster session in grade 8. All students were assessed at pretest (T1), immediate posttest (T2), end of grade 6 (T3), beginning and end of grade 7 (T4 and T5), end of grade 8 (T6), and grades 11 and 12 (T7 and T8). Ninety percent of study students were relocated and data obtained from over 80 percent of them at T8. Program effects on experimental smoking observed in grades 7 and 8 had completely decayed by T8, six years after the beginning of the program. Grade 6 smoking experience and social risk were each strong predictors of T8 smoking behavior. Subjects who had left school were smoking at more than twice the rate of subjects still in high school (grade 12) at T8. We discuss implications of the results. Handle: RePEc:aph:ajpbhl:1989:79:10:1371-1376_1 Template-Type: ReDIF-Article 1.0 Title: Recurrent outbreaks of giardiasis in a child day care center, Wisconsin Journal: American Journal of Public Health Author-Name: Steketee, R.W. Author-Name: Reid, S. Author-Name: Cheng, T. Author-Name: Stoebig, J.S. Author-Name: Harrington, R.G. Author-Name: Davis, J.P. Year: 1989 Volume: 79 Issue: 4 Pages: 485-490 Abstract: In the 19-month period September 1983-March 1985, three outbreaks of giardiasis occurred in one large child day care center. Control measures instituted during each outbreak included case finding; pharmacologic treatment and follow-up testing of stool specimens for cases of giardia infection in day care children and staff, and their household contacts; facilitating and stressing personal and environmental hygiene, including altering diapering practices and teaching appropriate hand washing techniques. In the first, second, and third outbreaks, overall attack rates (stool analysis positive for Giardia lamblia) were determined for those persons with ≥2 stool specimens submitted; attack rates in children were 47, 17, and 37 per cent, respectively; for tested staff, the rates were 35, 13, and 9 per cent; and for tested household contacts were 18, 9, and 5 per cent. Attack rates were highest for ambulatory diapered children, children attending the day care center ≥40 hours per week, and children who were infected with G. lamblia in the most recent previous outbreak. Despite extensive efforts to identify cases, a cure rate of >90 per cent in treated cases, and improvements in personal and environmental hygiene practices, G. lamblia infections recurred in outbreak proportions. Handle: RePEc:aph:ajpbhl:1989:79:4:485-490_6 Template-Type: ReDIF-Article 1.0 Title: Population-based study of unintentional injury incidence and impact during childhood Journal: American Journal of Public Health Author-Name: Rivara, F.P. Author-Name: Calonge, N. Author-Name: Thompson, R.S. Year: 1989 Volume: 79 Issue: 8 Pages: 990-994 Abstract: We report a prospective study of medically treated unintentional injuries ascertained in an HMO population of children and adolescents 19 years of age and younger over a one-year period. The overall rate of medically treated injuries was 247 per 1,000, 147/1,000 for those treated in the clinic, and 100/1,000 for those treated in the emergency room (ER). Overall, 2.5 percent of patients were hospitalized. The highest rates of injury were for falls (60 per 1,000), recreational activities (57 per 1,000) and competitive sports (49 per 1,000). The site of care varied little by injury diagnosis or etiology, with the exception that sprains/strains, fractures, and injuries due to play and sports were more commonly treated in the clinic. The impact of trauma on activity was considerable, with 55.9 percent of injuries resulting in restricted activity, 10.6 percent in ≥2 days of school missed, and 6.7 percent in ≥2 days spent in bed. Handle: RePEc:aph:ajpbhl:1989:79:8:990-994_1 Template-Type: ReDIF-Article 1.0 Title: An outbreak of syphilis on an Indian reservation: descriptive epidemiology and disease-control measures Journal: American Journal of Public Health Author-Name: Gerber, A.R. Author-Name: King, L.C. Author-Name: Dunleavy, G.J. Author-Name: Novick, L.F. Year: 1989 Volume: 79 Issue: 1 Pages: 83-85 Abstract: From January 1983 through January 1985, 88 cases of early adult syphilis and five cases of congenital syphilis were identified among residents of a southwestern Indian reservation. The male-to-female ratio of primary and secondary syphilis cases was 1.7:1; over 90 per cent of women were of childbearing age. Using community health workers to determine the social circles of infected persons was effective in identifying persons at risk; treatment of partners of infected persons prior to development of seroreactivity contributed to the successful control of this outbreak. Handle: RePEc:aph:ajpbhl:1989:79:1:83-85_4 Template-Type: ReDIF-Article 1.0 Title: Transmission of enteric disease associated with wastewater irrigation: A prospective epidemiological study Journal: American Journal of Public Health Author-Name: Shuval, H.I. Author-Name: Wax, Y. Author-Name: Yekutiel, P. Author-Name: Fattal, B. Year: 1989 Volume: 79 Issue: 7 Pages: 850-852 Abstract: We conducted a prospective epidemiological study of possible enteric disease transmission by aerosolized pathogens from sprinkler irrigation of partially treated wastewater in 20 kibbutzim (collective agricultural settlements) in Israel between March 1981 and February 1982. Medical data were collected from the patients' files and daily logs of physicians and nurses at each kibbutz clinic (total population 10,231). Episodes of enteric disease were similar in the kibbutzim most exposed to wastewater aerosols (11.6 per 100 person-year) and the kibbutzim not exposed to wastewater in any form (11.0 per 100 person-year). No excess of enteric disease was seen among wastewater contact workers or their families as compared with the unexposed. No negative health effects were detected in this study which involved a large population, including many young children, exposed to treated wastewater aerosols generated at distances of 300-600 m. Handle: RePEc:aph:ajpbhl:1989:79:7:850-852_8 Template-Type: ReDIF-Article 1.0 Title: What President Bush can do about family planning Journal: American Journal of Public Health Author-Name: Dryfoos, J.G. Year: 1989 Volume: 79 Issue: 6 Pages: 689-690 Handle: RePEc:aph:ajpbhl:1989:79:6:689-690_2 Template-Type: ReDIF-Article 1.0 Title: Mortality among children and youth Journal: American Journal of Public Health Author-Name: Fingerhut, L.A. Author-Name: Kleinman, J.C. Year: 1989 Volume: 79 Issue: 7 Pages: 899-901 Handle: RePEc:aph:ajpbhl:1989:79:7:899-901_6 Template-Type: ReDIF-Article 1.0 Title: A comparison of gestational age reporting methods based on physician estimate and date of last normal menses from fetal death reports Journal: American Journal of Public Health Author-Name: Alexander, G.R. Author-Name: Petersen, D.J. Author-Name: Powell-Griner, E. Author-Name: Tompkins, M.E. Year: 1989 Volume: 79 Issue: 5 Pages: 600-602 Abstract: Utilizing 10,587 cases from the 1980 National Center for Health Statistics Fetal Death Statistics File, we examined the comparability of two methods of determining the gestational age of a fetal death, the calculated interval from date of last normal menses (DLNM) and the physician's estimate. The physician estimated gestational age distribution exhibits even number digit preference and a distinct clustering at the 40-week value. The DLNM distribution appears more smoothly distributed but with a more pronounced post-term tail. An exact agreement between the two methods is observed in only 27.9 per cent of the cases. A 1.7 week mean difference between the methods indicates a systematic underestimation by physician reported gestational age when compared to that calculated from the DLNM, potentially biasing gestational age distributions when the physician estimate is substituted for cases with a missing DLNM. Over 8 per cent of cases 20+ weeks by DLNM are estimated as <20 weeks by the physician. This underestimation has important implications for the completeness of reporting of fetal deaths on vital records and the comparability of fetal death rates. Further, it may limit investigations of the completeness of reporting of <500 gram live births. Handle: RePEc:aph:ajpbhl:1989:79:5:600-602_2 Template-Type: ReDIF-Article 1.0 Title: A comparison of perceived and objective CVD risk in a general population Journal: American Journal of Public Health Author-Name: Niknian, M. Author-Name: McKinlay, S.M. Author-Name: Rakowski, W. Author-Name: Carleton, R.A. Year: 1989 Volume: 79 Issue: 12 Pages: 1653-1654 Abstract: This report examines correspondence between perceived and objective (American Heart Association's RISKO) risk of heart attack and stroke in a randomly selected sample from two surveys (n = 4,171) conducted in each of two New England cities, in 1981-82 and 1983-84, respectively. Results confirmed prior reports that people tend to underestimate their CVD (cardiovascular disease) risk and showed that estimates of those at lowest risk were most accurate. Handle: RePEc:aph:ajpbhl:1989:79:12:1653-1654_5 Template-Type: ReDIF-Article 1.0 Title: Breast cancer screening legislation in the United States: A commentary Journal: American Journal of Public Health Author-Name: Thompson, G.B. Author-Name: Kessler, L.G. Author-Name: Boss, L.P. Year: 1989 Volume: 79 Issue: 11 Pages: 1541-1543 Abstract: We discuss some of the issues emerging from a powerful legislative movement for preventive services over the past three years. During this time an increasing number of states passed, considered, or are currently developing breast cancer screening legislation. Most of these laws require some form of third party payment for mammography or establish breast cancer screening programs. The legislation varies markedly with regard to periodicity of examinations, ages covered, type and extent of third party coverage, dosage regulation, and radiographic equipment standards. This shows a need for common standards. Legislation provides an essential incentive for a public health response to a serious problem, but more than laws are needed. Health care providers and the general public need to be aware and take advantage of the coverage provided as a result of legislation. Moreover, public health officials need to be aware that such legislation may lead to a demand for services that exceeds present capacity to deliver them. Handle: RePEc:aph:ajpbhl:1989:79:11:1541-1543_6 Template-Type: ReDIF-Article 1.0 Title: Survey of cause-of-death query criteria used by state vital statistics programs in the US and the efficacy of the criteria used by the Oregon vital statistics program Journal: American Journal of Public Health Author-Name: Hopkins, D.D. Author-Name: Grant-Worley, J.A. Author-Name: Bollinger, T.L. Year: 1989 Volume: 79 Issue: 5 Pages: 570-574 Abstract: A survey of the 52 vital statistics registration areas in the United States revealed that at least 23 did not fulfill the minimum cause-of-death query guidelines recommended by the National Center for Health Statistics. The Oregon Center for Health Statistics is one of only a few that query certifying physicians at a comprehensive level. During August 1986-July 1987, a total of 2,453 of 23,238 death certificates were returned to the certifiers for additional information, not including those returned in a tobacco use study. More than one-half (56.1 per cent) resulted in new and more specific underlying cause-of-death data. Only 5.2 per cent of the queries were unanswered. One probable result of Oregon's program is that the state has the highest percentage of liver cirrhosis and disease deaths attributed to alcohol abuse in the United States, Nationally, 41.7 per cent of all liver disease and cirrhosis deaths in 1984 were listed as due to alcohol compared to 82.4 per cent in Oregon. The state's total liver cirrhosis and disease death rate (12.0 per 100,000 population) is only marginally higher than the United States rate (11.6). The query program also serves to locate maternal deaths that would otherwise not be reported, as well as to provide more accurate cause-of-death statistics in general. Handle: RePEc:aph:ajpbhl:1989:79:5:570-574_4 Template-Type: ReDIF-Article 1.0 Title: Reflections on curative health care in Nicaragua Journal: American Journal of Public Health Author-Name: Slater, R.G. Year: 1989 Volume: 79 Issue: 5 Pages: 646-651 Abstract: Improved health care in Nicaragua is a major priority of the Sandinista revolution; it has been pursued by major reforms of the national health care system, something few developing countries have attempted. In addition to its internationally recognized advances in public health, considerable progress has been made in health care delivery by expanding curative medical services through training more personnel and building more facilities to fulfill a commitment to free universal health coverage. The very uneven quality of medical care is the leading problem facing curative medicine now. Underlying factors include the difficulty of adequately training the greatly increased number of new physicians. Misdiagnosis and mismanagement continue to be major problems. The curative medical system is not well coordinated with the preventive sector. Recent innovations include initiation of a 'medicina integral' residency, similar to family practice. Despite its inadequacies and the handicaps of war and poverty, the Nicaraguan curative medical system has made important progress. Handle: RePEc:aph:ajpbhl:1989:79:5:646-651_9 Template-Type: ReDIF-Article 1.0 Title: Beliefs about AIDS as determinants of preventive practices and of support for coercive measures Journal: American Journal of Public Health Author-Name: Allard, R. Year: 1989 Volume: 79 Issue: 4 Pages: 448-452 Abstract: We performed a telephone survey to explore relations between knowledge, beliefs (as defined in the Health Belief Model) and reported AIDS-preventive practices in a sample of 1,072 persons ages 18-65, living in the Montreal health region. AIDS-preventive practices were more frequent among the young or single, and among those with one of four health beliefs: perceiving oneself as particularly susceptible to AIDS, perceiving the disease as particularly severe, perceiving it as particularly amenable to prevention, and having a strong general health motivation. Support for coercive measures to control the AIDS epidemic was widespread but was stronger among the less educated, married people, and those with a high level of one of the following beliefs about AIDS: perceived severity, susceptibility, curability, or barriers to treatment. AIDS-preventive practices and support for coercion under epidemic conditions share their most important modifiable determinants: perceived severity of AIDS and perceived susceptibility to it. This finding suggests that emphasizing them, as is done so often in public educational campaigns about AIDS, may indeed promote preventive practices, but may also unwittingly increase support for coercive measures toward people with the disease or at high risk of it. Handle: RePEc:aph:ajpbhl:1989:79:4:448-452_1 Template-Type: ReDIF-Article 1.0 Title: Barriers to implementation of a prenatal care program for low income women Journal: American Journal of Public Health Author-Name: Miller, C.L. Author-Name: Margolis, L.H. Author-Name: Schwethelm, B. Author-Name: Smith, S. Year: 1989 Volume: 79 Issue: 1 Pages: 62-64 Abstract: By the middle of the second year of the Michigan Prenatal/Postpartum Care (PPC) program to provide pregnancy-related services to low income women who were ineligible for Medicaid or other insurance, only 25 per cent of the participating health departments were enrolling greater than 90 per cent of contracted potential clients. Using a survey of program directors and relevant state documents, we identified several barriers to successful implementation; institutional (program complexity, high levels of administrative concerns along with low levels of communication between local health departments and providers); economic (inadequate resources for provider reimbursement, outreach, transportation, high-risk pregnancies, or administrative overhead); psychological (servicing populations with multiple and hard to care for problems, potential discomfort of low income women with traditional providers); and informational (insufficient information about the program infiltrating the target community). Handle: RePEc:aph:ajpbhl:1989:79:1:62-64_6 Template-Type: ReDIF-Article 1.0 Title: Factors in hepatitis A transmission Journal: American Journal of Public Health Author-Name: Schade, C.P. Author-Name: Lambert, E.Y. Author-Name: Harkess, J.R. Year: 1989 Volume: 79 Issue: 11 Pages: 1571 Handle: RePEc:aph:ajpbhl:1989:79:11:1571_5 Template-Type: ReDIF-Article 1.0 Title: Declining rates of amebiasis in Los Angeles County: A sentinel for decreasing acquired immunodeficiency syndrome (AIDS) incidence? Journal: American Journal of Public Health Author-Name: Sorvillo, F.J. Author-Name: Lieb, L. Author-Name: Mascola, L. Author-Name: Waterman, S.H. Year: 1989 Volume: 79 Issue: 11 Pages: 1563-1564 Abstract: In Los Angeles County from 1983-1988, rates of amebiasis declined 65 percent among White males 15-44 years. No such decline occurred among White females 15-44 years or White males <15. Reported acquired immunodeficiency syndrome (AIDS) cases in the district of highest AIDS incidence has followed the initial decline in amebiasis by four years. Amebiasis trends may be a useful predictor of human immunodeficiency virus (HIV) transmission and future rates of AIDS among gay men. Handle: RePEc:aph:ajpbhl:1989:79:11:1563-1564_6 Template-Type: ReDIF-Article 1.0 Title: Sero survey of human immunodeficiency virus infection in women at a family planning clinic: Absence of infection in an indigent population in San Francisco Journal: American Journal of Public Health Author-Name: Darney, P.D. Author-Name: Myhra, W. Author-Name: Atkinson, E.S. Author-Name: Meier, J. Year: 1989 Volume: 79 Issue: 7 Pages: 883-885 Abstract: To determine the seroprevalence of human immunodeficiency virus (HIV) in contracepting women, 1,308 consecutive attendees at an inner-city family planning clinic completed a risk factor questionnaire and were then asked to have an HIV test. None of the 1,000 women tested was seropositive. Preventive efforts in family planning clinics are likely to be productive because few contraceptors, including those with risk factors, are already infected. The factors which determine differences in HIV positivity between childbearing and contracepting women, who are similar in demographic and HIV risk characteristics, warrant further investigation. Handle: RePEc:aph:ajpbhl:1989:79:7:883-885_3 Template-Type: ReDIF-Article 1.0 Title: Breast cancer screening by mammography: Utilization and associated factors Journal: American Journal of Public Health Author-Name: Zapka, J.G. Author-Name: Stoddard, A.M. Author-Name: Costanza, M.E. Author-Name: Greene, H.L. Year: 1989 Volume: 79 Issue: 11 Pages: 1499-1502 Abstract: The status of mammography screening experience and factors related to utilization were examined in six towns serviced by physician staffs at five hospitals. Data were collected via random digit dial telephone interview of a probability sample of 1184 women, aged 45-75 years. The results showed that 55% of the women reported ever having had a mammogram. Of those who had ever had a mammogram, 21% reported that the mammogram in the past year was their first one. Of those women who are over 50 and had ever had a mammogram, 57% reported one in the past year. Analyses demonstrated that a combination of demographic factors, certain beliefs and knowledge, having a regular physician, social interaction and media exposure are independently related to ever having a mammogram, and to having one in the past year. Despite anecdotal and empirical evidence that the proportion of women ever having had a mammogram has substantially increased in the past several years, increasing utilization among older and lower-income women provides a challenge for public health. Handle: RePEc:aph:ajpbhl:1989:79:11:1499-1502_4 Template-Type: ReDIF-Article 1.0 Title: Differences in the timeliness of diagnosis, breast and cervical cancer, San Francisco 1974-85 Journal: American Journal of Public Health Author-Name: Saunders, L.D. Year: 1989 Volume: 79 Issue: 1 Pages: 69-70 Abstract: Cancer registry data for San Francisco (1974-85) were used to identify women at greater risk of late diagnoses for breast and cervical cancers by age and ethnicity. For breast cancer, Black women were at greater risk for late diagnoses. For cervical cancer, women of all ethnic groups ages 50-69 years and Japanese and Filipino women were at greater risk for late diagnoses. Handle: RePEc:aph:ajpbhl:1989:79:1:69-70_0 Template-Type: ReDIF-Article 1.0 Title: The reliability of self-reported cigarette consumption in the United States Journal: American Journal of Public Health Author-Name: Hatziandreu, E.J. Author-Name: Pierce, J.P. Author-Name: Fiore, M.C. Author-Name: Grise, V. Author-Name: Novotny, T.E. Author-Name: Davis, R.M. Year: 1989 Volume: 79 Issue: 8 Pages: 1020-1023 Abstract: To investigate the possibility that self-reported smoking is not a valid measure for assessing trends in smoking prevalence, we compared total self-reported cigarette consumption with the adjusted consumption data from cigarette excise taxes as reported by the US Department of Agriculture (USDA) for the period 1974 through 1985. Self-reported consumption was calculated by using data from the National Health Interview Surveys (NHIS) for adults and from the National Household Surveys on Drug Abuse for adolescents. For this period, the average ratio of self-reported cigarette consumption to the USDA estimate of consumption was 0.72 (range = 0.69 to 0.78). There was no statistical difference in this consumption ratio from year to year, indicating no apparent increase in the underreporting of cigarette smoking in these surveys. We conclude that cross-sectional surveys of self-reported smoking status remain a reliable surveillance tool for monitoring changes in population smoking behavior. Handle: RePEc:aph:ajpbhl:1989:79:8:1020-1023_0 Template-Type: ReDIF-Article 1.0 Title: Mathematical models and scientific reality in occurrence rates for disease Journal: American Journal of Public Health Author-Name: Feinstein, A.R. Author-Name: Chan, C.K. Author-Name: Esdaile, J.M. Author-Name: Horwitz, R.I. Author-Name: McFarlane, M.J. Author-Name: Wells, C.K. Year: 1989 Volume: 79 Issue: 9 Pages: 1303-1304 Handle: RePEc:aph:ajpbhl:1989:79:9:1303-1304_4 Template-Type: ReDIF-Article 1.0 Title: The prevention of silicosis and prediction of its future prevalence in China Journal: American Journal of Public Health Author-Name: Lou, J. Author-Name: Zhou, C. Year: 1989 Volume: 79 Issue: 12 Pages: 1613-1616 Abstract: We studied the effects of preventive and therapeutic interventions on the 18-year cumulative incidence of silicosis of 26,603 dust-exposed workers in seven Chinese mines and industrial plants. Cumulative silicosis incidence decreased from 36.1 percent in workers employed before 1950 to 1.5 percent in workers employed after 1960. From the 1950s to 1970s, eight-year cumulative incidence of tuberculosis decresed from 54.7 percent to 16.7 percent and case fatality of silicosis patients dropped from 53.9 percent to 18.3 percent. From 1950s to 1980s, the average age at the detection of silicosis increased from 41.3 to 52.7 and the average survival time of silicosis patients prolonged from 2.0 to 12.2 years. Workers over age 40 who began exposure to dust before 1960 will be the main source of new silicosis patients in future. Most exposed new cases of silicosis will occur within the next 15 years. The silicosis population will remain unchanged for the next 20 years and will decrease dramatically after 25 years. There will be few silicosis patients in 30 years and new cases of silicosis will be difficult to find in 45 years. These results how that the preventive and therapeutic actions against silicosis in China have been effective. Handle: RePEc:aph:ajpbhl:1989:79:12:1613-1616_0 Template-Type: ReDIF-Article 1.0 Title: Mumps in the US Army 1980-86: Should recruits be immunized? Journal: American Journal of Public Health Author-Name: Arday, D.R. Author-Name: Kanjarpane, D.D. Author-Name: Kelley, P.W. Year: 1989 Volume: 79 Issue: 4 Pages: 471-474 Abstract: The US Army's experience with mumps hospitalizations was examined for the years 1980 through 1986. One hundred fifty-two cases among active duty Army soldiers were identified. Mumps rates declined from 3.85 per 100,000 active duty soldiers per year in 1980 to 1.28 in 1985, but an outbreak during 1986 caused rates to jump to 6.65. Attack rates were found to decline dramatically with increasing age or length of military service, with 74 per cent of cases occurring in soldiers with three years or less of service. Rates for Blacks and Whites were similar, but were higher for other minorities. Complications reported were mild. A cost-benefit analysis, assuming all recruits were to be vaccinated, estimated average annual vaccination program costs of $286,789; this figure exceeds average annual reported hospitalized mumps disease costs of $61,525 by a factor of 4.7. Mumps attack rates would have to reach at least 15.0 per 100,000 per year before savings would equal recruit vaccination costs. Failure to show that a vaccine program would be cost-saving may be due to limitations in identifying cases or to the requirement that all recruits be immunized regardless of prior immune status. It is likely that a program to immunize susceptible individuals alone would show benefit. Handle: RePEc:aph:ajpbhl:1989:79:4:471-474_4 Template-Type: ReDIF-Article 1.0 Title: Fatal unintended carbon monoxide poisoning in West Virginia from nonvehicular sources Journal: American Journal of Public Health Author-Name: Baron, R.C. Author-Name: Backer, R.C. Author-Name: Sopher, I.M. Year: 1989 Volume: 79 Issue: 12 Pages: 1656-1658 Abstract: Based on medical examiner reports and state vital records, 1987-84, nonvehicular carbon monoxide (CO) caused 62 unintended deaths, representing 42 percent of all unintended fatal CO poisonings in West Viriginia. Sources were almost always heating or cooking appliances associated with incomplete combustion of fuels (methane, butane, or propane) not commonly recognized for their potential to produce CO. Hazards included failure to provide recommended venting, neglected maintenance, or use in small areas without natural ventilation. Handle: RePEc:aph:ajpbhl:1989:79:12:1656-1658_1 Template-Type: ReDIF-Article 1.0 Title: Race/ethnic-specific AIDS risk in New York City, 1981-87 Journal: American Journal of Public Health Author-Name: Vermund, S.H. Author-Name: Drucker, E. Author-Name: Blum, S. Year: 1989 Volume: 79 Issue: 12 Pages: 1679-1680 Handle: RePEc:aph:ajpbhl:1989:79:12:1679-1680_5 Template-Type: ReDIF-Article 1.0 Title: Multivariate prediction of total and cardiovascular mortality in an obese Polynesian population Journal: American Journal of Public Health Author-Name: Crews, D.E. Year: 1989 Volume: 79 Issue: 8 Pages: 982-986 Abstract: The effects of body weight and blood pressure on the risk of total mortality and mortality from cardiovascular diseases (CVD) were examined in a prospective sample of 5,866 adult residents of American Samoa, a Polynesian population noted for exhibiting high levels of obesity. Data collected during 1975-76 were linked to mortality records from 1976 through 1981. In logistic regression models which did not include blood pressure, percent of desirable weight was an important risk factor for mortality from CVD, but it was not an important risk factor when diastolic blood pressure was included in the model. Percent of desirable weight was not related to mortality from all causes combined in either Samoan men or women. Age and diastolic blood pressure were predictors of total and CVD mortality in men and women. These results, in an obese population, suggest that body weight and obesity are not independently related to excess mortality in the very obese, although they may associate with high blood pressure. These results also suggest that relations between physiological characteristics and mortality may vary with cultural, genetic, or other factors not examined in this study. Handle: RePEc:aph:ajpbhl:1989:79:8:982-986_8 Template-Type: ReDIF-Article 1.0 Title: Impact of the AIDS epidemic on morbidity and mortality among intravenous drug users in a New York City methadone maintenance program Journal: American Journal of Public Health Author-Name: Selwyn, P.A. Author-Name: Hartel, D. Author-Name: Wasserman, W. Author-Name: Drucker, E. Year: 1989 Volume: 79 Issue: 10 Pages: 1358-1362 Abstract: To examine the impact of the AIDS epidemic on morbidity and mortality in a defined population of intravenous drug users, we analyzed overall and cause-specific death rates, AIDS incidence, and acute medical hospitalizations among patients in a long-term methadone maintenance program in New York City for the years 1984 through 1987 (midyear population for each year 828 to 891; demographic characteristics did not differ). The number of deaths while in treatment increased from 11 (13.3/1000) in 1984 to 39 (44.2/1000) in 1987. Deaths from AIDS increased from 3.6/1000 to 14.7/1000, deaths due to bacterial pneumonia/sepsis from 3.6/1000 to 13.6/1000; deaths from cirrhosis, drug overdose, trauma, and other causes remained relatively stable. AIDS incidence rose from six cases/1000 in 1984 to 20.4 1000 in 1987. Hospitalizations for AIDS, pneumonia, tuberculosis, and endocarditis/sepsis increased from 84.9/1000 in 1986 to 144.8/1000 in 1987. These data suggest that the AIDS epidemic has had a profound effect on patterns of morbidity and mortality among intravenous drug users in this methadone program population. Drug treatment programs may be important sites for targeting clinical services for drug users with AIDS, although the increasing burden of AIDS-related disease will require expansion of existing funding and treatment resources. Handle: RePEc:aph:ajpbhl:1989:79:10:1358-1362_6 Template-Type: ReDIF-Article 1.0 Title: Psychological defenses and control of AIDS Journal: American Journal of Public Health Author-Name: Archer, V.E. Year: 1989 Volume: 79 Issue: 7 Pages: 876-878 Abstract: The well known psychological defenses of avoidance, repression, and denial against the knowledge that one has, or might have, a fatal disease used by a high percentage of individuals, must be considered in control programs for the human immunodeficiency virus (HIV). Current programs of education, voluntary testing, and counseling do not consider this defense mechanism and may therefore provide inadequate control. Compulsory HIV testing programs and development of an 'HIV Parole' system may be needed if the current HIV epidemic worsens. Handle: RePEc:aph:ajpbhl:1989:79:7:876-878_8 Template-Type: ReDIF-Article 1.0 Title: VII. Hazard surveillance at NIOSH Journal: American Journal of Public Health Author-Name: Sundin, D.S. Author-Name: Frazier, T.M. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 32-37 Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:32-37_3 Template-Type: ReDIF-Article 1.0 Title: The Hawaii Chlamydia Network Project: A successful program incorporating close intra-agency cooperation Journal: American Journal of Public Health Author-Name: Katz, A.R. Year: 1989 Volume: 79 Issue: 4 Pages: 505-507 Abstract: The Hawaii State Department of Health's Chlamydia Network Project screened 272 asymptomatic females for chlamydia; 20 (7.4 per cent) were found to be positive. When interviewed, 75 per cent (15/20) of the cases gave information such that their sexual partner(s) could be located. Ninety per cent (14/16) of the locatable partners were brought to examination within seven days. Keys to success were the training of family planning clinic staff in STD (sexually transmitted disease) control methods, and close intra-agency cooperation. Handle: RePEc:aph:ajpbhl:1989:79:4:505-507_8 Template-Type: ReDIF-Article 1.0 Title: Risk reduction among intravenous drug users in Amsterdam under the influence of AIDS Journal: American Journal of Public Health Author-Name: Van Der Hoek, J.A.R. Author-Name: Van Haastrecht, H.J.A. Author-Name: Coutinho, R.A. Year: 1989 Volume: 79 Issue: 10 Pages: 1355-1357 Handle: RePEc:aph:ajpbhl:1989:79:10:1355-1357_3 Template-Type: ReDIF-Article 1.0 Title: Toward quantifying the health of the elderly Journal: American Journal of Public Health Author-Name: Brody, J.A. Year: 1989 Volume: 79 Issue: 6 Pages: 685-686 Handle: RePEc:aph:ajpbhl:1989:79:6:685-686_8 Template-Type: ReDIF-Article 1.0 Title: Innovations in health care: antisepsis as a case study Journal: American Journal of Public Health Author-Name: Larson, E. Year: 1989 Volume: 79 Issue: 1 Pages: 92-99 Abstract: An innovation often occurs in several arenas almost simultaneously, after being preceded by a long preparatory period when information and experience are accrued to the point at which opinion is influenced to change. Nevertheless, the introduction of an innovation is usually accompanied by resistance and hostility. This article traces the development of the concept and practice of antisepsis in health care, with emphasis on the contributions of three individuals who were contemporaries practicing in different health care fields, but who apparently were uninfluenced by each others' work. Semmelweis, a Hungarian obstetrician, recognized the importance of person-to-person transmission of infectious agents and effected dramatic reductions in puerperal mortality by requiring antiseptic handwashing. Lister, a Scottish surgeon, was the first physician to apply the germ theory to clinical practice and developed the techniques of antiseptic surgery and wound care, resulting in dramatic reductions in surgical mortality. Nightingale, a British nurse, initiated sanitary reforms in hospitals, schools, and military camps in England and abroad, incorporating high levels of environmental and personal hygiene. These reforms were also succeeded by dramatic reductions in mortality. In light of historical and current evidence of efficacy and the evidence of continued inadequacies in practice, it seems reasonable to speculate that further reductions in nosocomial infection rates are possible by a more careful application among individual practitioners of the basic principles of antisepsis. Handle: RePEc:aph:ajpbhl:1989:79:1:92-99_1 Template-Type: ReDIF-Article 1.0 Title: The acceptance and completion of mammography by older Black women Journal: American Journal of Public Health Author-Name: Burack, R.C. Author-Name: Liang, J. Year: 1989 Volume: 79 Issue: 6 Pages: 721-726 Abstract: We assessed the relation of patient characteristics, knowledge and beliefs to the utilization of mammography in an inner-city setting by 187 Black women over the age of 50. Thirty per cent of those who were offered mammography initially declined the offer and 40 per cent were subsequently unable to complete the procedure. Patient interviews were used to derive 27 potential knowledge and health belief predictor scales. In multiple regression analysis, two health belief scales and two knowledge scales accounted for 15 per cent of the observed variance in the model of acceptance. The strongest predictor of subsequent completion was initial acceptance. The presence of breast symptoms and two health belief scales together with initial acceptance accounted for 26 per cent of variance in the model of completion. These results suggest that the successful accomplishment of mammography requires coordinated efforts at the level of the provider, patient, and setting. Health beliefs may influence the patient's behavior in this process, but their effect appears to be modest. Handle: RePEc:aph:ajpbhl:1989:79:6:721-726_7 Template-Type: ReDIF-Article 1.0 Title: Effects of the antismoking campaign: An update Journal: American Journal of Public Health Author-Name: Warner, K.E. Year: 1989 Volume: 79 Issue: 2 Pages: 144-151 Abstract: In the absence of the antismoking campaign, adult per capita cigarette consumption in 1987 would have been an estimated 79-89 per cent higher than the level actually experienced. The smoking prevalence of all birth cohorts of men and women born during this century is well below that which would have been expected in the absence of the campaign. As a consequence, in 1985 an estimated 56 million Americans were smokers; without the campaign, an estimated 91 million would have been smokers. As a result of campaign-induced decisions not to smoke, between 1964 and 1985 an estimated 789,200 Americans avoided or postponed smoking-related deaths and gained an average of 21 additional years of life expectancy each; collectively this represents more than 16 million person-years of additional life. The greatest health benefit lies in the future, however, as younger individuals reach the ages at which smoking claims its greatest toll, and as middle-aged former smokers realize relative reductions in smoking mortality risks as a result of long-term abstinence from smoking. For example, campaign-induced decisions not to smoke made prior to 1986 will result in the postponement or avoidance of an estimated 2.1 million smoking-related deaths between 1986 and the year 2000. Handle: RePEc:aph:ajpbhl:1989:79:2:144-151_6 Template-Type: ReDIF-Article 1.0 Title: The provision of services to persons with mental retardation and subsequent infection with human immunodeficiency virus (HIV) Journal: American Journal of Public Health Author-Name: Kastner, T.A. Author-Name: Hickman, M.L. Author-Name: Bellehumeur, D. Year: 1989 Volume: 79 Issue: 4 Pages: 491-494 Abstract: We present the first reported cases of individuals with mental retardation who have subsequently become infected with human immunodeficiency virus (HIV). The implications of this finding for agencies which provide services to persons with mental retardation are described. Where conflicts arise, the authors propose that ethical review committees provide consultation to service agencies who must ultimately determine how they will provide for the needs of their clients. Handle: RePEc:aph:ajpbhl:1989:79:4:491-494_5 Template-Type: ReDIF-Article 1.0 Title: Is testicular cancer incidence in blacks increasing? Journal: American Journal of Public Health Author-Name: Van den Eeden, S.K. Author-Name: Weiss, N.S. Year: 1989 Volume: 79 Issue: 11 Pages: 1553-1554 Abstract: Using data collected by the Surveillance, Epidemiology and End Results Program (SEER) from 1973-84, we found no evidence of an increase in the incidence of testicular cancer in Blacks, in contrast to an increase of nearly 33 percent in Whites. Handle: RePEc:aph:ajpbhl:1989:79:11:1553-1554_3 Template-Type: ReDIF-Article 1.0 Title: The sociologic context of occupational health in South Africa Journal: American Journal of Public Health Author-Name: Myers, J.E. Author-Name: Macun, I. Year: 1989 Volume: 79 Issue: 2 Pages: 216-224 Abstract: The early history of the occupational health system in South Africa is outlined up to the early 1970s which mark a political and social transition in the society. Relevant demographic and social data are provided, and the roles and mutual relations of capital, labor, state, and academic sectors are discussed. During the past 15 years there has been heightened occupational health activity. Major legislative activity has included several commissions, the promulgation of new laws and regulations governing the workplace, and deregulatory measures in a contradictory mix. Conflictual relations between social forces are illustrated by two examples involving the introduction of safety representatives in the workplace, and compensation for occupational lung disease. The implications of wider political and ecomonic realities are analyzed, and current and probably future trends in the evolution of the occupational health system are identified. Handle: RePEc:aph:ajpbhl:1989:79:2:216-224_8 Template-Type: ReDIF-Article 1.0 Title: Influenza immunization in the elderly: Knowledge and attitudes do not explain physician behavior Journal: American Journal of Public Health Author-Name: McKinney, W.P. Author-Name: Barnas, G.P. Year: 1989 Volume: 79 Issue: 10 Pages: 1422-1424 Abstract: The records of 847 elderly clinic patients were reviewed and the 95 primary care physicians who managed their care were surveyed to determine factors related to their ordering of influenza immunization. Overall, 41 percent of the eligible patients were offered vaccine (range 0-90 percent). Physician offering of vaccine was unrelated to patient age, sex, or race but was higher in patients seen on multiple visits (47 vs 39 percent) and in those vaccinated during the prior year (61 vs 35 percent). Physician offering of vaccine was not associated with perceived incidence of severe side effects or estimates of vaccine efficacy. Handle: RePEc:aph:ajpbhl:1989:79:10:1422-1424_5 Template-Type: ReDIF-Article 1.0 Title: Homicide, suicide, motor vehicle crash, and fall mortality: United States' experience in comparative perspective Journal: American Journal of Public Health Author-Name: Rockett, I.R.H. Author-Name: Smith, G.S. Year: 1989 Volume: 79 Issue: 10 Pages: 1396-1400 Abstract: US mortality data on motor vehicle crashes, falls, suicide, and homicide for 1980 are compared with corresponding data for France, Japan, West Germany, and the United Kingdom. Unadjusted and age-specific death rates are presented, together with age-adjusted rates of years of life lost (YLL). A large male excess in rates is typical outside the fall category. Motor vehicle crashes are the predominant cause of YLL, and the United States manifests the highest YLL rates for each sex. US fall death rates at the older ages are exceeded by those of France and West Germany. The elderly generally manifest the greatest risk of suicide; American females exhibit a unique rate decline after ages 45-54 years, however. Beyond early adulthood, US suicide rates are lower than those of France, Japan, and West Germany. US homicide rates dwarf those of the comparison countries with 16- to 29-fold differentials separating prime-risk American males aged 25-34 years from their foreign counterparts. Handle: RePEc:aph:ajpbhl:1989:79:10:1396-1400_7 Template-Type: ReDIF-Article 1.0 Title: Cigarette smoking among San Francisco Hispanics: The role of acculturation and gender Journal: American Journal of Public Health Author-Name: Marin, G. Author-Name: Perez-Stable, E. Author-Name: Vanoss Marin, B. Year: 1989 Volume: 79 Issue: 2 Pages: 196-198 Abstract: We conducted a phone survey of 1,669 San Francisco Hispanics ages 15 to 64 years. The age-adjusted overall smoking prevalence was 25.4 per cent (95% CI = 23.3, 27.5) with more men (32.4 per cent) smoking than women (16.8 per cent). Age-adjusted smoking rates were higher among the less acculturated males (37.5 vs 26.7 per cent) and among acculturated females (22.6 vs 13.6 per cent). The more acculturated, however, smoked a greater number of cigarettes per day independent of gender. Community-based smoking cessation interventions, adapted to local conditions, may have a greater potential for success among Hispanics. Handle: RePEc:aph:ajpbhl:1989:79:2:196-198_3 Template-Type: ReDIF-Article 1.0 Title: Evaluation of the efficacy of simulation games in traffic safety education of kindergarten children Journal: American Journal of Public Health Author-Name: Renaud, L. Author-Name: Suissa, S. Year: 1989 Volume: 79 Issue: 3 Pages: 307-309 Abstract: Using a simulation game designed to teach children to obey certain traffic safety rules, an experimental study was conducted with 136 five-year-old children in four Quebec schools. Within each classroom, subjects were randomly divided into four groups: three intervention groups and one control group. Each of the experimental groups was subjected to a different intervention with outcome measured using three instruments related to attitudes, behavior, and transfer of learning of pedestrian traffic safety. Results suggest that simulation games including role-playing/group dynamics and modeling/training can change attitudes and modify behavior in the area of pedestrian traffic safety in children of this age. Handle: RePEc:aph:ajpbhl:1989:79:3:307-309_1 Template-Type: ReDIF-Article 1.0 Title: Tea and premenstrual syndrome in the People's Republic of China Journal: American Journal of Public Health Author-Name: MacKay Rossignol, A. Author-Name: Zhang, J. Author-Name: Chen, Y. Author-Name: Xiang, Z. Year: 1989 Volume: 79 Issue: 1 Pages: 67-69 Abstract: We evaluated the hypothesis that tea consumption causes premenstrual syndrome by studying 188 nursing students and tea factory workers in the People's Republic of China via questionnaires distributed in classes (nursing students) or during routine physical examinations (tea factory workers). Analysis of the data revealed that tea consumption is strongly related to the prevalence of premenstrual syndrome and that the effects are dose-dependent. Handle: RePEc:aph:ajpbhl:1989:79:1:67-69_2 Template-Type: ReDIF-Article 1.0 Title: Biological markers of overall aging Journal: American Journal of Public Health Author-Name: Butler, R.N. Year: 1989 Volume: 79 Issue: 6 Pages: 687 Handle: RePEc:aph:ajpbhl:1989:79:6:687_6 Template-Type: ReDIF-Article 1.0 Title: Lead exposure and radiator repair work Journal: American Journal of Public Health Author-Name: Lussenhop, D.H. Author-Name: Parker, D.L. Author-Name: Barklind, A. Author-Name: McJilton, C. Year: 1989 Volume: 79 Issue: 11 Pages: 1558-1560 Abstract: In 1986, the ambient air for lead in radiator repair shops in the Minneapolis-St. Paul metropolitan area exceeded the Occupational Safety and Health Administration (OSHA) action level in nine of 12 shops sampled by Minnesota OSHA. We therefore sought to determine the prevalence of lead exposure/toxicity in this industry. Thirty-five radiator shops were identified, 30 were visited, and 53 workers were studied. The mean blood lead level was 1.53 (range 0.24-2.80). Seventeen individuals had blood lead levels ≥ 1.93 μmol/L (40 μg/dl). The mean zinc protoporphyrin level (ZPP) was 0.55 μmol/L (range 0.16-1.43). No single worksite or personal characteristic was a strong determinant of either blood lead or ZPP level. Handle: RePEc:aph:ajpbhl:1989:79:11:1558-1560_9 Template-Type: ReDIF-Article 1.0 Title: Fluoridation referendum in La Crosse, Wisconsin: Contributing factors to success Journal: American Journal of Public Health Author-Name: Jones, R.B. Author-Name: Mormann, D.N. Author-Name: Durtsche, T.B. Year: 1989 Volume: 79 Issue: 10 Pages: 1405-1408 Abstract: Residents of La Crosse, Wisconsin approved a public referendum in favor of water fluoridation on April 5, 1988. The vote, 57 percent supportive, culminated a two-year community effort. Three public referenda had been defeated in the past. Contributing to the success of this recent campaign were: broad-based community support led by a 34-member Citizens for Better Dental Health in La Crosse Committee; American Dental Association/Wisconsin Division of Health/US Public Health Service consultation and support; knowledgeable and supportive press coverage; the timing of the ballot to coincide with the Wisconsin Presidential Primary; and local chiropractic support to offset chiropractic anti-fluoridation leadership. La Crosse, population 50,000, was the largest fluoride-deficient community in a nine-state upper Midwest area. Handle: RePEc:aph:ajpbhl:1989:79:10:1405-1408_1 Template-Type: ReDIF-Article 1.0 Title: Effect of a gatekeeper plan on health services use and charges: A randomized trial Journal: American Journal of Public Health Author-Name: Martin, D.P. Author-Name: Diehr, P. Author-Name: Price, K.F. Author-Name: Richardson, W.C. Year: 1989 Volume: 79 Issue: 12 Pages: 1628-1632 Abstract: A randomized trial was conducted to determine the effectiveness of a health care plan which uses physicians as gatekeepers to control health services use and charges. New enrollees in United Healthcare (UHC), an independent practice association, were randomly assigned to the standard UHC plan requiring a gatekeeper, or to an alternate plan with equal benefits but without a gatekeeper. Individuals in both plans were similar in demographic characteristics, perceived health status, and other health insurance coverage. The gatekeeper plan had 6 percent lower total changes per enrollee than the plan without a gatekeeper. There were minor differences in hospital use and charges. Ambulatory charges were $21 lower per person per year in the plan with a gatekeeper (95% CI = -39.9, -2.1) and these were due to .3 fewer visits to specialists (95% CI = -0.50, -0.10). We conclude that a health plan which incorporates incentives and penalties for physicians to act as gatekeepers can reduce the cost of ambulatory services by limiting specialist visits. Handle: RePEc:aph:ajpbhl:1989:79:12:1628-1632_1 Template-Type: ReDIF-Article 1.0 Title: Personality risk factors for cocaine abuse Journal: American Journal of Public Health Author-Name: Yates, W.R. Author-Name: Fulton, A.I. Author-Name: Gabel, J.M. Author-Name: Brass, C.T. Year: 1989 Volume: 79 Issue: 7 Pages: 891-892 Abstract: To evaluate the role of personality in cocaine abuse, 59 adults meeting DSM-III criteria for cocaine abuse were compared to similar-aged non-cocaine alcohol abusers and community controls on a DSM-III measure of personality. Cocaine abusers were more likely than non-cocaine alcohol abusers to display narcissistic personality traits (Odds ratio 6.86, 95% CI = 4.52, 15.60). Handle: RePEc:aph:ajpbhl:1989:79:7:891-892_7 Template-Type: ReDIF-Article 1.0 Title: Improving cause-of-death statistics Journal: American Journal of Public Health Author-Name: Rosenberg, H.M. Year: 1989 Volume: 79 Issue: 5 Pages: 563-564 Handle: RePEc:aph:ajpbhl:1989:79:5:563-564_4 Template-Type: ReDIF-Article 1.0 Title: Doctor strikes and other signs of discontent Journal: American Journal of Public Health Author-Name: Mechanic, D. Year: 1989 Volume: 79 Issue: 9 Pages: 1218-1219 Handle: RePEc:aph:ajpbhl:1989:79:9:1218-1219_8 Template-Type: ReDIF-Article 1.0 Title: State-specific progress toward the 1990 objective for the nation for cigarette smoking prevalence Journal: American Journal of Public Health Author-Name: Remington, P.L. Author-Name: Novotny, T.E. Author-Name: Williamson, D.F. Author-Name: Anda, R.F. Year: 1989 Volume: 79 Issue: 10 Pages: 1416-1419 Abstract: We predicted the smoking prevalences for 1990 for each state in the US, assuming that the decline in each state from 1985-1990 would be the same as the decline in the US from 1965-1985. In 1985, only three states had smoking prevalences less thn 25 percent. Based upon the observed decline in smoking in the US from 1965-1985 of 0.5 percent per year, we predict that only seven states will have smoking prevalences less than 25 percent by 1990. States need to consider current smoking prevalence and achievable rates of decline when setting objectives for 1990 and beyond. Handle: RePEc:aph:ajpbhl:1989:79:10:1416-1419_5 Template-Type: ReDIF-Article 1.0 Title: Coverage gaps in seat belt use laws Journal: American Journal of Public Health Author-Name: Wells, J.K. Author-Name: Williams, A.F. Author-Name: Fields, M. Year: 1989 Volume: 79 Issue: 3 Pages: 332-333 Abstract: Some seat belt use laws exempt occupants in certain seating positions and in certain types of vehicles, or both. A state-by-state analysis was conducted of the extent to which passenger vehicle occupants killed before the laws went into effect would have been covered by the laws subsequently passed. Only five states had laws that covered all passenger vehicle occupants; the majority excluded 4 to 8 per cent and six states excluded 14 per cent or more. More inclusive laws can reduce injuries and save lives. Handle: RePEc:aph:ajpbhl:1989:79:3:332-333_5 Template-Type: ReDIF-Article 1.0 Title: A recent increase of breastfeeding duration in Jakarta, Indonesia Journal: American Journal of Public Health Author-Name: Joesoef, M.R. Author-Name: Annest, J.L. Author-Name: Utomo, B. Year: 1989 Volume: 79 Issue: 1 Pages: 36-38 Abstract: Comparison of breastfeeding practices from two similar surveys conducted in Jakarta, Indonesia shows an increase in breastfeeding duration from 14.4 months in 1976 to 19.8 months in 1983. This increase was predominantly among noneducated women (20.3 months among noneducated women versus 0.9 months among women with greater than elementary education). Among working women breastfeeding duration declined slightly (1.1 months). Unlike industrialized countries where increases in breastfeeding have occurred initially among the higher socioeconomic groups, recent increases in Jakarta have occurred initially among the lower socioeconomic groups. If breastfeeding practices among working or better educated women who delivered mostly in hospitals or clinics are to be improved, the breastfeeding promotion programs should be targeted to these groups. Handle: RePEc:aph:ajpbhl:1989:79:1:36-38_4 Template-Type: ReDIF-Article 1.0 Title: The association of age-related macular degeneration and lens opacities in the aged Journal: American Journal of Public Health Author-Name: Liu, I.Y. Author-Name: White, L. Author-Name: LaCroix, A.Z. Year: 1989 Volume: 79 Issue: 6 Pages: 765-769 Abstract: Data from 3,087 persons age 45 or older in the National Health and Nutrition Survey, 1971-74, showed that subjects with lens opacifying disease had an increased odds for age-related macular degeneration (AMD) compared to those who had no lens opacities. The crude odds ratio for aphakic patients was 4.6 (95% CI = 2.5, 8.6). The association remained after controlling for age, sex, and systolic blood pressure (a common risk factor) in a logistic regression model. These data are consistent with the hypothesis that light-induced damage may contribute to both lens and retinal disease and suggest that cataract extraction without implantation of ultra-violet/blue light absorbing intraocular lens may place subjects at increased risk of AMD. Handle: RePEc:aph:ajpbhl:1989:79:6:765-769_0 Template-Type: ReDIF-Article 1.0 Title: Race and the prevalence of syphilis seroreactivity in the United States population: A national sero-epidemiologic study Journal: American Journal of Public Health Author-Name: Hahn, R.A. Author-Name: Magder, L.S. Author-Name: Aral, S.O. Author-Name: Johnson, R.E. Author-Name: Larsen, S.A. Year: 1989 Volume: 79 Issue: 4 Pages: 467-470 Abstract: We used the 1978 National Health and Nutrition Examination Survey to examine the prevalence of positive syphilis serologies in the US population. Analysis of risk markers - gender, age, marital status, education, income, and residence - indicates that all except gender are associated with syphilis seroreactivity, independent of race. Controlling for associated risk markers, the Black-White odds ratio of syphilis seroreactivity is 4.7 (95% CI = 2.7, 8.2). Current knowledge of racial differences in sexual and health care behavior does not explain the Black-White difference in the prevalence of syphilis seroreactivity. Handle: RePEc:aph:ajpbhl:1989:79:4:467-470_4 Template-Type: ReDIF-Article 1.0 Title: Two episodes of acute illness in a machine shop Journal: American Journal of Public Health Author-Name: Sinks, T. Author-Name: Kerndt, P.R. Author-Name: Wallingford, K.M. Year: 1989 Volume: 79 Issue: 8 Pages: 1024-1028 Abstract: Following an explosion in a machine shop and temporary plant closure, on the day the plant returned to full operations a degreaser malfunctioned. Workers in the assembly room were exposed to trichloroethylene levels later estimated to have exceeded 220 ppm (OSHA PEL 100 ppm). The plant was evacuated and the degreaser taken out of operation. Blood testing for carbon monoxide (CO) on five employees found carboxyhemoglobin levels in excess of normal. The plant reopened the following morning. Over the next two weeks, 15 employees were seen by the plant nurses for similar complaints; although all returned to work, their carboxyhemoglobin levels, later found to be inaccurate, were reported by a local medical clinic to range from 13.7 to 20.0 percent. At the end of the second week, another outbreak of illness occurred, but carboxyhemoglobin, trichloroethylene, fluorocarbons, and methylene chloride were not elevated in all 17 persons tested; plant-wide monitoring for CO found no elevated levels. During the first outbreak of illness, cases were 2.26 times as likely to have entered the assembly room as noncases. During the second outbreak, cases were no more likely than noncases to have entered the assembly room. We believe the explosion, earlier toxic exposures and illness, and the misleading blood test results led to plant-wide anxiety which culminated in a collective stress reaction and the second outbreak. An open meeting with all employees, informing them of our findings, provided reassurance and no further episodes of illness occurred in this workforce. Handle: RePEc:aph:ajpbhl:1989:79:8:1024-1028_3 Template-Type: ReDIF-Article 1.0 Title: Evaluation of radiation safety in 29 Central Ohio veterinary practices Journal: American Journal of Public Health Author-Name: Moritz, S.A. Author-Name: Wilkins III, J.R. Author-Name: Hueston, W.D. Year: 1989 Volume: 79 Issue: 7 Pages: 895-896 Abstract: A sample of 29 veterinary practices in Central Ohio were visited to assess radiation safety practices and observance of state regulations. Lead aprons and gloves were usually available, but gloves were not always worn. Protective thyroid collars and lead glasses were not available in any practice, lead shields in only five practices, and lead-lined walls and doors in only two practices. Eighteen practices had none of the required safety notices posted. Handle: RePEc:aph:ajpbhl:1989:79:7:895-896_5 Template-Type: ReDIF-Article 1.0 Title: Fluoridation then and now Journal: American Journal of Public Health Author-Name: Corbin, S.B. Year: 1989 Volume: 79 Issue: 5 Pages: 561-563 Handle: RePEc:aph:ajpbhl:1989:79:5:561-563_6 Template-Type: ReDIF-Article 1.0 Title: Acute illnesses among Los Angeles County lifeguards according to worksite exposures Journal: American Journal of Public Health Author-Name: Sullivan, C.S.B. Author-Name: Barron, M.E. Year: 1989 Volume: 79 Issue: 11 Pages: 1561-1563 Abstract: Due to public concern regarding the potential adverse health effects of exposure to Santa Monica Bay waters, a case-control study of acute illnesses among Los Angeles County lifeguards was conducted. Workers' compensation claimants (N = 112) were matched to healthy lifeguards working in the same year and having the same job classification. Conditional logistic regression showed that the southernmost worksites of the bay were associated with all acute illnesses (OR = 14.4, 95% CI = 4.7, 44.8) and with ear infections (OR = 12.5, 95% CI = 2.9, 53.4). Handle: RePEc:aph:ajpbhl:1989:79:11:1561-1563_3 Template-Type: ReDIF-Article 1.0 Title: Lesson from silicosis control in China Journal: American Journal of Public Health Author-Name: Wegman, D.H. Author-Name: Wegman, M.E. Year: 1989 Volume: 79 Issue: 12 Pages: 1599-1600 Handle: RePEc:aph:ajpbhl:1989:79:12:1599-1600_1 Template-Type: ReDIF-Article 1.0 Title: Survival experience of aged hip fracture patients Journal: American Journal of Public Health Author-Name: Magaziner, J. Author-Name: Simonsick, E.M. Author-Name: Kashner, T.M. Author-Name: Hebel, J.R. Author-Name: Kenzora, J.E. Year: 1989 Volume: 79 Issue: 3 Pages: 274-278 Abstract: Hip fracture has long been considered a major threat to survival in aged populations. This report describes the survival experience of 814 aged, community dwelling hip fracture patients treated in seven Baltimore hospitals between 1984 and 1986: 4.3 per cent died during hospitalization; 8.2, 12.6, and 17.4 per cent died within three, six and 12 months after fracture, respectively. The mortality rate for the entire population approaches expected mortality approximately six months post-fracture, but varies by age and sex. The most important factors predicting mortality are presence of serious concomitant illness and marked delirium (in the absence of dementia) at the time of hospital admission. The authors suggest that medical factors that may contribute to patient disorientation be investigated and treated, when possible, in an effort to improve the survival status of hip fracture patients. Handle: RePEc:aph:ajpbhl:1989:79:3:274-278_2 Template-Type: ReDIF-Article 1.0 Title: Lead absorption in indoor firing range users Journal: American Journal of Public Health Author-Name: Valway, S.E. Author-Name: Martyny, J.W. Author-Name: Miller, J.R. Author-Name: Cook, M. Author-Name: Mangione, E.J. Year: 1989 Volume: 79 Issue: 8 Pages: 1029-1032 Abstract: To determine if users of indoor firing ranges may be at risk from lead exposure, we studied a law enforcement trainee class during three months of firearms instruction. Blood lead levels were obtained before training and at four-week intervals during training. Air lead levels were measured three times during instruction. Blood lead levels rose from a pre-training mean of 0.31 μmol/L to 2.47 μmol/L. Mean air lead levels were above 2,000 μg/m3, more than 40 times the Occupational Safety and Health Administration's standard of 50 μg/m3. Cumulative exposure to lead and the change in blood lead were positively correlated. Control measures need to be studied to determine their efficacy in decreasing or eliminating this health risk. Handle: RePEc:aph:ajpbhl:1989:79:8:1029-1032_8 Template-Type: ReDIF-Article 1.0 Title: Excessive burden of end-state renal disease among Canadian Indians: A national survey Journal: American Journal of Public Health Author-Name: Young, T.K. Author-Name: Kaufert, J.M. Author-Name: McKenzie, J.K. Author-Name: Hawkins, A. Author-Name: O'Neil, J. Year: 1989 Volume: 79 Issue: 6 Pages: 756-758 Abstract: Analysis of data from the Canadian National Renal Failure Register indicates that Canadian Natives are at much higher risk for end-stage renal disease (ESRD) than the Canadian population in general. Using two population estimates for the total Native population, the age-standardized incidence rate of newly registered ESRD cases between 1981 and 1986 among Natives was at least 2.5 times (and may be as high as four times) the national rate. Natives were particularly at higher risk for ESRD to diabetes, glomerulonephritis, and pyelonephritis, whereas for the other causes the risk was no different from that of other Canadians. As technologically sophisticated treatment facilities are only available in major urban centers, Native ESRD patients and their families living in remote areas of Canada are faced with major psychosocial disruptions of relocation. Handle: RePEc:aph:ajpbhl:1989:79:6:756-758_2 Template-Type: ReDIF-Article 1.0 Title: Quality of death certificates in Valencia, Spain Journal: American Journal of Public Health Author-Name: Benavides, F.G. Author-Name: Bolumar, F. Author-Name: Peris, R. Year: 1989 Volume: 79 Issue: 10 Pages: 1352-1354 Abstract: Certificates of 1,454 deaths occurring over 11 months were retrieved from the Civil Register in Valencia, Spain. Relevant medical information was systematically gathered from hospital records, questionnaires, and Coroner reports. We compared the underlying cause of death (UCD) from the original death certificate, and a reference cause of death (RCD) determined by a panel of experts based on all available information. Overall, 80.2 percent of the certificates were concordant for disease category, but there was a great disparity among some specific disease categories. Handle: RePEc:aph:ajpbhl:1989:79:10:1352-1354_9 Template-Type: ReDIF-Article 1.0 Title: A randomized trial of a serialized self-help smoking cessation program for pregnant women in an HMO Journal: American Journal of Public Health Author-Name: Ershoff, D.H. Author-Name: Mullen, P.D. Author-Name: Quinn, V.P. Year: 1989 Volume: 79 Issue: 2 Pages: 182-187 Abstract: We report the results of a population-based randomized clinical trial that tested the effectiveness of a prenatal self-help smoking cessation program. The intervention consisted predominately of printed materials received through the mail. The population (n = 242) consisted of a socioeconomically and ethnically diverse group of pregnant women enrolled in a large health maintenance organization (HMO) who reported they were smoking at the time of their first prenatal visit. Biochemical confirmation of continuous abstinence achieved prior to the 20th completed week of pregnancy and lasting through delivery revealed 22.2 per cent of the women in the eight-week serialized program quit versus 8.6 per cent of controls with usual care. The adjusted odds ratio was 2.80 (95 per cent CI = 1.17, 6.69). We conclude that a low-cost prenatal self-help intervention can significantly affect the public health problem of smoking during pregnancy and its associated risks for maternal and child health. Handle: RePEc:aph:ajpbhl:1989:79:2:182-187_8 Template-Type: ReDIF-Article 1.0 Title: Hypertension in Israeli adolescents: Prevalence according to weight, sex and parental origin Journal: American Journal of Public Health Author-Name: Shohat, M. Author-Name: Shohat, T. Author-Name: Mimouni, M. Author-Name: Nitzan, M. Author-Name: Danon, Y.L. Year: 1989 Volume: 79 Issue: 5 Pages: 582-585 Abstract: We studied the prevalence of hypertension in 57,499 male and 35,803 female Israeli military recruits and its relation with sex, weight, and parents' ethnic origin. The overall prevalence of systolic hypertension (>140 mmHg) was 1.75 per cent for males and 0.32 per cent for females. The prevalence of diastolic hypertension (>90 mmHg) was 0.41 per cent for males and 0.06 per cent for females. For males, the prevalence of systolic and diastolic hypertension increased with weight, exponentially. Males of Ashkenazi origin had a significantly higher prevalence of hypertension (systolic 2.52 per cent, diastolic 0.55 per cent) compared with those of Sephardi origin (systolic 1.12 per cent, diastolic 0.3 per cent). The prevalence of adolescents with systolic or diastolic blood pressure greater than the mean +2SD of ech weight group ranged between 1.5-2.3 per cent. Handle: RePEc:aph:ajpbhl:1989:79:5:582-585_9 Template-Type: ReDIF-Article 1.0 Title: Occupational exposure to human immunodeficiency virus (HIV) and hepatitis B virus (HBV) among embalmers: A pilot seroprevalence study Journal: American Journal of Public Health Author-Name: Turner, S.B. Author-Name: Kunches, L.M. Author-Name: Gordon, K.F. Author-Name: Travers, P.H. Author-Name: Mueller, N.E. Year: 1989 Volume: 79 Issue: 10 Pages: 1425-1426 Abstract: We performed a serosurvey of 133 embalmers in an urban area where human immunodeficiency virus (HIV) infection is prevalent. Although we found histories of needlesticks to be common, and the seropositivity rate of hepatitis B virus (HBV) (13%) was approximately twice that of a blood donor comparison group, HIV antibody was uniformly absent in 129 embalmers who denied HIV risk factors, and present in one of four with self-described risk behaviors. The risk of HBV infection was higher among embalmers who have worked more than 10 years, relative risk (RR) 16.2 (95% confidence interval 2.1, 126.5), did not routinely wear gloves, RR 9.8 (CI 3.4, 28.5), or are employed in the city of Boston, RR 4.7 (CI 1.8, 12.0). Handle: RePEc:aph:ajpbhl:1989:79:10:1425-1426_8 Template-Type: ReDIF-Article 1.0 Title: Assessing lead exposure from drinking water Journal: American Journal of Public Health Author-Name: Houk, V.N. Author-Name: Ing, R.T. Author-Name: Falk, H. Year: 1989 Volume: 79 Issue: 7 Pages: 823-824 Handle: RePEc:aph:ajpbhl:1989:79:7:823-824_2 Template-Type: ReDIF-Article 1.0 Title: Fatal violence among spouses in the United States, 1976-85 Journal: American Journal of Public Health Author-Name: Mercy, J.A. Author-Name: Saltzman, L.E. Year: 1989 Volume: 79 Issue: 5 Pages: 595-599 Abstract: In this paper we examine patterns and trends in homicides between marriage partners in the United States for 1976 through 1985 using data from the Federal Bureau of Investigation's Supplemental Homicide Reports (FBI-SHR). We identified 16,595 spouse homicides accounting for 8.8 per cent of all homicides reported to the FBI-SHR during this 10-year period. The rate of spouse homicide for this 10-year period was 1.6 per 100,000 married persons. The risk of being killed by one's spouse was 1.3 times greater for wives than for husbands. Black husbands were at greater risk of spouse homicide victimization than Black wives or White spouses of either sex. The risk of victimization was greater for spouses in interracial than in intraracial marriages and increased as age differences between spouses increased. From 1976 through 1985, the risk of spouse homicide declined by more than 45.0 per cent for both Black husbands and wives but remained relatively stable for White husbands and wives. Demographic patterns in the risk of spouse homicide were similar to those reported for nonfatal spouse abuse suggesting that the causes of spouse homicide and nonfatal spouse abuse may be similar. Handle: RePEc:aph:ajpbhl:1989:79:5:595-599_5 Template-Type: ReDIF-Article 1.0 Title: Nurse-midwifery practice in the United States, 1982 and 1987 Journal: American Journal of Public Health Author-Name: Adams, C.J. Year: 1989 Volume: 79 Issue: 8 Pages: 1038-1039 Abstract: Surveys of certified nurse-midwives living in the United States were conducted on behalf of the American College of Nurse-Midwives for 1982 and 1987. Most of the respondents were providing prenatal and family planning care. The 1982 respondents conducted 1.8 percent of the deliveries that took place in the United States during 1982 and 1988 respondents conducted 2.5 percent of all 1987 United States deliveries. Handle: RePEc:aph:ajpbhl:1989:79:8:1038-1039_0 Template-Type: ReDIF-Article 1.0 Title: Acculturation and low birthweight among Latinos in the Hispanic HANES Journal: American Journal of Public Health Author-Name: Scribner, R. Author-Name: Dwyer, J.H. Year: 1989 Volume: 79 Issue: 9 Pages: 1263-1267 Abstract: Self reports from 1,645 Latino mothers of Mexican descent who participated in the Hispanic Health and Nutrition Examination Survey (HHANES) were used to relate the birthweight of their infants to the HHANES acculturation index. After controlling for parity, a one point increase on the acculturation scale was found to be associated with a 1.19 (95% CI = 1.05, 1.34) increase in risk of maternal low birthweight (LBW)(1.98 risk increase for four points). The estimated relative risk increased to 1.34 (1.12, 1.60) with controls for age at interview, wealth, city size, and years of education; controlling for current smoking status reduced the relative risk to 1.31. US-born respondents were also at increased risk relative to Mexican-born, but this relation was explained by acculturation. The effect of education was found to depend on level of acculturation. Years of education was unrelated to risk among the Mexican-oriented, while increased education was associated with reduced risk in the US-oriented. These results suggest that factors associated with a Mexican cultural orientation may be protective against the risk of LBW. Handle: RePEc:aph:ajpbhl:1989:79:9:1263-1267_9 Template-Type: ReDIF-Article 1.0 Title: Left-handedness and accident-related injury risk Journal: American Journal of Public Health Author-Name: Coren, S. Year: 1989 Volume: 79 Issue: 8 Pages: 1040-1041 Abstract: Self-reported injuries among left-handed and right-handed people were compared in a survey of 1,896 college students in British Columbia, Canada. Left-handers were more likely to report having an injury requiring medical attention during the last two years (OR = 1.89, 95% CI = 1.39, 2.58). Relative risk was highest for left-handed males when driving motor vehicles (OR = 2.35, CI = 1.25, 4.43). Regardless of handedness, males had slightly higher relative risks of injury than females. Handle: RePEc:aph:ajpbhl:1989:79:8:1040-1041_4 Template-Type: ReDIF-Article 1.0 Title: Stress reduction training changed number of sexual partners but not immune function in men with HIV Journal: American Journal of Public Health Author-Name: Coates, T.J. Author-Name: McKusick, L. Author-Name: Kuno, R. Author-Name: Stites, D.P. Year: 1989 Volume: 79 Issue: 7 Pages: 885-887 Abstract: We tested the impact of stress management training on sexual behavior and immune functioning in 64 gay men infected with human immunodeficiency virus (HIV). Subjects randomized to the stress management group met for eight two-hour sessions and one all day retreat to learn systematic relaxation, health behavior change, and stress management skills. Compared to those randomized to a wait list control, treatment subjects reported significantly fewer sexual partners in the prior month at post-test (1.10 vs 2.29 for controls). There were no differences between groups in lymphocyte numbers and function. Handle: RePEc:aph:ajpbhl:1989:79:7:885-887_0 Template-Type: ReDIF-Article 1.0 Title: Cost-effectiveness of antibiotic prophylaxis for dental procedures in patients with artificial joints Journal: American Journal of Public Health Author-Name: Tsevat, J. Author-Name: Durand-Zaleski, I. Author-Name: Pauker, S.G. Year: 1989 Volume: 79 Issue: 6 Pages: 739-743 Abstract: We performed a cost-effectiveness analysis to evaluate whether patients with artificial joints should take penicillin, erythromycin, or no antibiotics before dental procedures. We modeled the risk of anaphylaxis from penicillin, the risks and consequences of an artificial joint infection, and the actual variable costs of hospitalization and antibiotics. Penicillin prophylaxis is slightly less expensive than erythromycin prophylaxis but is both more expensive and less effective than no prophylaxis. Erythromycin prophylaxis, the most effective, is the most expensive strategy. The marginal cost effectiveness of erythromycin prophylaxis compared to no prophylaxis is $12,900 per quality-adjusted year of life saved. Sensitivity analysis demonstrates that the risk of developing a joint infection is the key parameter in the analysis. Based on our estimated risk of developing a joint infection, the cost-effectiveness of antibiotic prophylaxis with erythromycin compares favorably with other medical interventions. Thus, until a definitive study to quantify the risk is conducted, patients with artificial joints should take prophylactic erythromycin when they undergo dental procedures. Handle: RePEc:aph:ajpbhl:1989:79:6:739-743_1 Template-Type: ReDIF-Article 1.0 Title: Longitudinal study of physical ability in the oldest-old Journal: American Journal of Public Health Author-Name: Harris, T. Author-Name: Kovar, M.G. Author-Name: Suzman, R. Author-Name: Kleinman, J.C. Author-Name: Feldman, J.J. Year: 1989 Volume: 79 Issue: 6 Pages: 698-702 Abstract: Based on 1984 data from the Longitudinal Study on Aging, one-third of White persons aged 80 or older living in the community (N = 1,791) were defined as having no difficulty in walking 1/4 of a mile, in lifting 10 pounds, in climbing 10 steps without resting, or in stooping, crouching or kneeling. Physical ability was associated with lower risk of death over two years mean follow-up; Relative odds (RO) = .4 (95 percent confidence interval = .4, .6) and in survivors, lower utilization of hospitals RO = .4(CI = .3, .7), physicians RO = .6 (CI = .5, .8) and nursing homes RO = .3 (CI = .2, .5) compared with those having difficulty on any of the four functional measures included in the definition of physical ability. Fifty percent of the women and 42 percent of the men physically able at the time of the baseline survey in 1984 remained physically able at follow-up. Contineud physical ability in this group was associated with never having had cardiovascular disease RO = 2.1 (CI = 1.2, 3.7), never having had arthritic complaints RO = 1.9 (CI = 1.2, 2.7), a body mass index less than the 75th percentile RO = 1.8 (CI = 1.2, 2.9), younger age (for each decade of age, RO = 2.0 (CI = 1.1, 3.6), and higher level of education (greater than 13 years versus 0-6 years) RO = 2.4 (CI = 1.2, 4.7). These correlates include factors amenable to preventive measures and highlight the need to consider the heterogeneity of the oldest-old in formulating programs aimed at prevention and postponement of disability. Handle: RePEc:aph:ajpbhl:1989:79:6:698-702_8 Template-Type: ReDIF-Article 1.0 Title: Results of routine restaurant inspections can predict outbreaks of foodborne illness: The Seattle-King County experience Journal: American Journal of Public Health Author-Name: Irwin, K. Author-Name: Ballard, J. Author-Name: Grendon, J. Author-Name: Kobayashi, J. Year: 1989 Volume: 79 Issue: 5 Pages: 586-590 Abstract: To analyze the association between the results of routine inspections and foodborne outbreaks in restaurants, we conducted a matched case-control study using available data from Seattle-King County, Washington. Case restaurants were facilities with a reported foorborne outbreak between January 1, 1986 and March 31, 1987 (N = 28). Two control restaurants with no reported outbreaks during this period were matched to each case restaurant on county health district and date of routine inspection (N = 56). Data from the routine inspection that preceded the outbreak (for case restaurants) or the date-matched routine inspection (for control restaurants) were abstracted from computerized inspection records. Case restaurants had a significantly lower mean inspection score (83.8 on a 0 to 100 point scale) than control restaurants (90.9). Restaurants with poor inspection scores and violations of proper temperature controls of potentially hazardous foods were, respectively, five and ten times more likely to have outbreaks than restaurants with better results. Although this study demonstrates that Seattle-King County's routine inspection form can successfully identify restaurants at increased risk of foodborne outbreaks, it also illustrates that more emphasis on regulation and education is needed to prevent outbreaks in restaurants with poor inspection results. Handle: RePEc:aph:ajpbhl:1989:79:5:586-590_3 Template-Type: ReDIF-Article 1.0 Title: Modeling and variable selection in epidemiologic analysis Journal: American Journal of Public Health Author-Name: Greenland, S. Year: 1989 Volume: 79 Issue: 3 Pages: 340-349 Abstract: This paper provides an overview of problems in multivariate modeling of epidemiologic data, and examines some proposed solutions. Special attention is given to the task of model selection, which involves selection of the model form, selection of the variables to enter the model form, selection of the variables to enter the model, and selection of the form of these variables in the model. Several conclusions are drawn, among them: a) model and variable forms should be selected based on regression diagnostic procedures, in addition to goodness-of fit tests; b) variable-selection algorithms in current packaged programs, such as conventional stepwise regression, can easily lead to invalid estimates and tests of effect; and c) variable selection is better approached by direct estimation of the degree of confounding produced by each variable than by significance-testing algorithms. As a general rule, before using a model to estimate effects, one should evaluate the assumptions implied by the model against both the data and prior information. Handle: RePEc:aph:ajpbhl:1989:79:3:340-349_6 Template-Type: ReDIF-Article 1.0 Title: One year follow-up of the Chicago televised smoking cessation program Journal: American Journal of Public Health Author-Name: Flay, B.R. Author-Name: Gruder, C.L. Author-Name: Warnecke, R.B. Author-Name: Jason, L.A. Author-Name: Peterson, P. Year: 1989 Volume: 79 Issue: 10 Pages: 1377-1380 Abstract: We compared the relative effectiveness of four different conditions of self-help and social support provided to people attempting to quit smoking in conjunction with a televised cessation program: Smokers ready to quit were able to request written manuals from hardware stores to accompany a televised program. At worksites we provided the written manual to all workers. At a random half of the worksites, we also provided training to discussion leaders who subsequently led discussions among smokers attempting to quit with the program. At health maintenance organization sites we invited smokers who had requested program maternals to participate in similar group discussions at health centers. In this paper we report one year follow-up results for the above four groups and compare them with previously reported results of a self-help manual alone. Results for the television plus manual condition were better than those of past studies (25 percent non-smoking prevalence and 10 percent continuous cessation one year after the program) and considerably better than the manual alone. None of the other conditions designed to supplement the manual plus television produced better long-term outcomes; we explore reasons for this. The program did encourage and help over 50,000 Chicago smokers to attempt quitting with the American Lung Association manual, 100 times as many as would have done so without the televised program. At least 15 other similar programs implemented since 1984 multiply this effect. Handle: RePEc:aph:ajpbhl:1989:79:10:1377-1380_3 Template-Type: ReDIF-Article 1.0 Title: Caffeine and premenstrual syndrome Journal: American Journal of Public Health Author-Name: Phillis, J.W. Year: 1989 Volume: 79 Issue: 12 Pages: 1680 Handle: RePEc:aph:ajpbhl:1989:79:12:1680_7 Template-Type: ReDIF-Article 1.0 Title: Gonorrhea rates: what denominator is most appropriate? Journal: American Journal of Public Health Author-Name: Ayiomamitis, A. Year: 1989 Volume: 79 Issue: 1 Pages: 101 Handle: RePEc:aph:ajpbhl:1989:79:1:101_5 Template-Type: ReDIF-Article 1.0 Title: The complexities and perplexities of cost containment Journal: American Journal of Public Health Author-Name: Vladeck, B.C. Year: 1989 Volume: 79 Issue: 11 Pages: 1477-1480 Handle: RePEc:aph:ajpbhl:1989:79:11:1477-1480_8 Template-Type: ReDIF-Article 1.0 Title: Effects of a geriatric nurse practitioner on process and outcome of nursing home care Journal: American Journal of Public Health Author-Name: Kane, R.L. Author-Name: Garrard, J. Author-Name: Skay, C.L. Author-Name: Radosevich, D.M. Author-Name: Buchanan, J.L. Author-Name: McDermott, S.M. Author-Name: Arnold, S.B. Author-Name: Kepferle, L. Year: 1989 Volume: 79 Issue: 9 Pages: 1271-1277 Abstract: We compared measures of quality of care and health services utilization in 30 nursing homes employing geriatric nurse practitioners with those in 30 matched control homes. Information for this analysis came from reviews of samples of patient records drawn at comparable periods before and after the geriatric NPs were employed. The measures of geriatric nurse practitioner impact were based on comparisons of changes from pre-NP to post-NP periods. Separate analyses were done for newly admitted and long-stay residents; a subgroup of homes judged to be best case examples was analyzed separately as well as the whole sample. Favorable changes were seen in two out of eight activity of daily living (ADL) measures; five of 18 nursing therapies; two of six drug therapies; six of eight tracers. There was some reduction in hospital admissions and total days in geriatric NP homes. Overall measures of medical attention showed a mixed pattern with some evidence of geriatric NP care substituted for physician care. These findings suggest that the geriatric NP has a useful role in nursing home care. Handle: RePEc:aph:ajpbhl:1989:79:9:1271-1277_8 Template-Type: ReDIF-Article 1.0 Title: Process and measurement issues in health risk appraisal Journal: American Journal of Public Health Author-Name: Kirscht, J.P. Year: 1989 Volume: 79 Issue: 12 Pages: 1598-1599 Handle: RePEc:aph:ajpbhl:1989:79:12:1598-1599_6 Template-Type: ReDIF-Article 1.0 Title: In touch: Telephone message system for teenagers Journal: American Journal of Public Health Author-Name: Siegel, L. Year: 1989 Volume: 79 Issue: 1 Pages: 100 Handle: RePEc:aph:ajpbhl:1989:79:1:100_9 Template-Type: ReDIF-Article 1.0 Title: Human cryptosporidiosis associated with an epizootic in calves Journal: American Journal of Public Health Author-Name: Reif, J.S. Author-Name: Wimmer, L. Author-Name: Smith, J.A. Author-Name: Dargatz, D.A. Author-Name: Cheney, J.M. Year: 1989 Volume: 79 Issue: 11 Pages: 1528-1530 Abstract: An outbreak of human cryptosporidiosis occurred among previously healthy persons in a veterinary medical teaching hospital. Human illness began after admission of calves from a farm which had been experiencing an epizootic of neonatal diarrhea due to Cryptosporidium. The clinical syndrome in humans was characterized by watery diarrhea, abdominal cramping, flatulence, and headache. Cryptosporidiosis was confirmed by zinc sulfate flotation of fecal specimens in four persons, three of whom had been responsible for the care and treatment of infected calves. A fourth patient had washed her husband's soiled clothing and appeared to have been infected indirectly through fomite contamination. Among 112 persons surveyed, 26 (23.2 percent) had a diarrheal illness during the outbreak and nine met the case definition of a diarrheal illness lasting at least three days. These persons were more likely to have had contact with a calf with diarrhea than were 52 referents who did not become ill during the outbreak. Handle: RePEc:aph:ajpbhl:1989:79:11:1528-1530_3 Template-Type: ReDIF-Article 1.0 Title: Partner notification in the control of human immunodeficiency virus infection Journal: American Journal of Public Health Author-Name: Potterat, J.J. Author-Name: Spencer, N.E. Author-Name: Woodhouse, D.E. Author-Name: Muth, J.B. Year: 1989 Volume: 79 Issue: 7 Pages: 874-876 Abstract: Partner notification should be standard public health practice in the control of human immunodeficiency virus (HIV) infection. A universal partner notification program for the United States is affordable, operationally manageable, and can effectively reach high-risk persons. Such a focused approach personalizes the epidemic and probably enhances the efficacy of risk reduction messages. Confidentiality protections are attainable. Voluntary partner notification is acceptable to our constituents; while counseling is 'mandatory', testing is optional. Evidence of partner notification's usefulness as a case prevention tool should be a by-product of program outcomes and not a prerequisite for its implementation. Handle: RePEc:aph:ajpbhl:1989:79:7:874-876_8 Template-Type: ReDIF-Article 1.0 Title: Hearing loss among high school farm students Journal: American Journal of Public Health Author-Name: Broste, S.K. Author-Name: Hansen, D.A. Author-Name: Strand, R.L. Author-Name: Stueland, D.T. Year: 1989 Volume: 79 Issue: 5 Pages: 619-622 Abstract: To study the prevalence of hearing loss among teen-aged farm children in central Wisconsin, audiometric threshold testing of 872 vocational agriculture students was carried out over a three-year period. The results indicate an increased prevalence of hearing loss among students actively involved in farm work, as compared to their peers not involved in farm work. Findings also suggest that use of hearing protection may reduce the risk of hearing loss among students who work on the farm, although few students report the use of such devices. These data also suggest that the hearing loss often observed in adult farmers may begin in childhood. Handle: RePEc:aph:ajpbhl:1989:79:5:619-622_7 Template-Type: ReDIF-Article 1.0 Title: Factors associated with participation in a community senior health promotion program: A pilot study Journal: American Journal of Public Health Author-Name: Buchner, D.M. Author-Name: Pearson, D.C. Year: 1989 Volume: 79 Issue: 6 Pages: 775-777 Abstract: Factors associated with participation in a community senior health promotion program were studied in 103 participants and a population-based control group of 531 non-participants. Compared to controls, participants had similar physical health status, but lower mental and social health status. Both men and women participants reported more depressive symptoms, lower positive affect, and lower social participation. Mental and social health may be important yet under-studied factors influencing participation in community health promotion programs. Handle: RePEc:aph:ajpbhl:1989:79:6:775-777_0 Template-Type: ReDIF-Article 1.0 Title: Comments on meta-analysis. Journal: American Journal of Public Health Author-Name: Lowenfels, A.B. Year: 1989 Volume: 79 Issue: 1 Pages: 102-103 Handle: RePEc:aph:ajpbhl:1989:79:1:102-103_7 Template-Type: ReDIF-Article 1.0 Title: Restaurant inspections may not predict outbreaks of foodborne illness: Reply Journal: American Journal of Public Health Author-Name: Irwin, K. Author-Name: Ballard, J. Author-Name: Veazie, M. Author-Name: Grendon, J. Author-Name: Yuen, G. Year: 1989 Volume: 79 Issue: 12 Pages: 1678-1679 Handle: RePEc:aph:ajpbhl:1989:79:12:1678-1679_7 Template-Type: ReDIF-Article 1.0 Title: National trends in the use of preventive health care by women Journal: American Journal of Public Health Author-Name: Makuc, D.M. Author-Name: Freid, V.M. Author-Name: Kleinman, J.C. Year: 1989 Volume: 79 Issue: 1 Pages: 21-26 Abstract: This study investigates national changes between 1973-74 and 1985 in women's use of three preventive health services based on data from the National Health Interview Survey. Smoothed proportions of women with recent preventive care were estimated using weighted least squares for subgroups categorized by age (20-39, 40-59, 60-79), race (White, Black), income (poor, nonpoor), and year of interview. Older women and Black women experienced the largest increases in recent use of clinical breast examinations and Pap tests. Between 1973 and 1985 changes in recent breast examination ranged from zero for White women ages 20-39 years to a 23 percentage point increase (95% CI = 17,30) for Black women ages 60-79 years. A similar pattern was found for Pap testing. Changes between 1974 and 1985 in recent blood pressure testing ranged from zero for women ages 20-39 years to an 8 percentage point increase (95% CI = 6,10) for women ages 60-79 years. Despite the increases among older women, in 1985 recent use of breast exams and Pap tests remained lower among older women. Further, the poor remained less likely than the nonpoor to have recent preventive care (except blood pressure testing among older women). Most women without recent cancer screening tests had a recent physician contact, highlighting the need for greater emphasis on cancer prevention by health care providers. Handle: RePEc:aph:ajpbhl:1989:79:1:21-26_0 Template-Type: ReDIF-Article 1.0 Title: A new epidemiologic and laboratory classification system for paralytic poliomyelitis cases Journal: American Journal of Public Health Author-Name: Sutter, R.W. Author-Name: Brink, E.W. Author-Name: Cochi, S.L. Author-Name: Kew, O.M. Author-Name: Orenstein, W.A. Author-Name: Biellik, R.J. Author-Name: Hinman, A.R. Year: 1989 Volume: 79 Issue: 4 Pages: 495-498 Abstract: An epidemiologic classification of paralytic poliomyelitis cases (ECPPC) has been in use in the United States since 1976. In 1985, this classification system was reviewed because of recent changes in the epidemiology of paralytic poliomyelitis and improved laboratory capability to definitively characterize poliovirus strains. An alternative classification system was devised, the epidemiologic and laboratory classification of paralytic polio cases (ELCPPC), that incorporated virus isolation and strain characterization with epidemiologic information. Reported paralytic poliomyelitis cases for 1980-86 were classified by both the ECPPC and the ELCPPC classification systems. The new ELCPPC system classified 91 per cent of the reported cases as vaccine-associated, while the ECPPC system classified only 71 per cent of the reported cases as vaccine-associated. The proposed classification system provides more specific and useful information particularly concerning vaccine-associated paralytic poliomyelitis. Handle: RePEc:aph:ajpbhl:1989:79:4:495-498_0 Template-Type: ReDIF-Article 1.0 Title: The relationship between women's attitudes about condoms and their use: Implications for condom promotion programs Journal: American Journal of Public Health Author-Name: Valdiserri, R.O. Author-Name: Arena, V.C. Author-Name: Proctor, D. Author-Name: Bonati, F.A. Year: 1989 Volume: 79 Issue: 4 Pages: 499-501 Abstract: A survey of 759 women attending contraceptive care clinics revealed that a majority of women endorsed condom use as an important way to reduce the spread of AIDS (acquired immunodeficiency syndrome); 82 per cent reported past use of condoms, but only 14 per cent reported using condoms in addition to another form of contraception to prevent infection with sexually transmitted pathogens, including HIV (human immunodeficiency virus). Acceptance of condom advertisement, perceived male and peer acceptance of condoms, and the effect of condom use on the enjoyment of sexual intercourse predicted condom use. Handle: RePEc:aph:ajpbhl:1989:79:4:499-501_5 Template-Type: ReDIF-Article 1.0 Title: Tuberculosis surveillance in a state prison system Journal: American Journal of Public Health Author-Name: Spencer, S.S. Author-Name: Morton, A.R. Year: 1989 Volume: 79 Issue: 4 Pages: 507-509 Abstract: After four inmates at two New Mexico prisons converted their tuberculosis skin tests, a mass screening program was carried out at all of the State's adult correctional facilities (2,240 inmates). Previously unknown converters were found with a disproportionally high per cent of converters (6.8 per cent and 6.3 per cent) and reactors (14.4 per cent and 12.2 per cent) at the first two prisons. No index cases were found. State policy has been revised to include two-stage skin testing of new inmates, annual testing thereafter, and screening of all new correctional staff. Handle: RePEc:aph:ajpbhl:1989:79:4:507-509_7 Template-Type: ReDIF-Article 1.0 Title: Gastrointestinal effects of water reuse of public park irrigation Journal: American Journal of Public Health Author-Name: Durand, R. Author-Name: Schwebach, G. Year: 1989 Volume: 79 Issue: 12 Pages: 1659-1660 Abstract: To investigate the gastrointestinal effects of employing recycled water as an irrigation source for urban public parks, we studied subjects active in parks irrigated with potable water, nonpotable water of wastewater origin, and nonpotable water of runoff origin. Wet grass conditions during activity and elevated densities of common indicator bacteria, but not exposure to nonpotable irrigation water per se, were found associated with an increased rate of gastrointestinal illness. Handle: RePEc:aph:ajpbhl:1989:79:12:1659-1660_0 Template-Type: ReDIF-Article 1.0 Title: The relationship of park maintenance and accessibility to dogs to the presence of Toxocara spp. ova in the soil Journal: American Journal of Public Health Author-Name: Ludlam, K.E. Author-Name: Platt, T.R. Year: 1989 Volume: 79 Issue: 5 Pages: 633-634 Abstract: Three parks in St. Joseph/Benton Harbor, Michigan, were examined for the presence of Toxocara spp. ova in the soil. Nineteen per cent (22/114) of the samples contained ova, and mean density (eggs/5 g soil) was 0.73. The density of two samples, collected at the base of playground equipment in one park, was >2.1, which is considered sufficient for human infection. Subjective assessments of park maintenance and accessibility to dogs were not good indicators of the presence of Toxocara spp. ova. Handle: RePEc:aph:ajpbhl:1989:79:5:633-634_0 Template-Type: ReDIF-Article 1.0 Title: Birthplace and the risk of AIDS among Hispanics in the United States Journal: American Journal of Public Health Author-Name: Selik, R.M. Author-Name: Castro, K.G. Author-Name: Pappaioanou, M. Author-Name: Buehler, J.W. Year: 1989 Volume: 79 Issue: 7 Pages: 836-839 Abstract: To extend previous work showing that the risk of AIDS (acquired immunodeficiency syndrome) is higher in US Hispanics than in Whites who are not Hispanic, we compared US residents born in different Latin American countries. We computed the cumulative incidence (CI) of AIDS and the distribution of cases by mode of exposure. Cases were those reported to the Centers for Disease Control between June 1, 1981 and December 12, 1988, and populations specific for birthplace were from the 1980 census. The reference group was the White population that was not Hispanic, CI 25.7/100,000. We estimated a similar rate in Mexican-born persons (25.3/100,000). In the South and West, the rate in Mexican-born Hispanics was half the reference rate. In each US region, the CI of AIDS in heterosexual intravenous drug abuser (IVDAs) in Puerto Rican-born persons was several times greater than that in other Latin American-born persons. Puerto Rican-born persons were only Latin American-born persons in whom most cases were in the heterosexual IVDAs. The data suggest that resources for preventing AIDS in Hispanics are needed most in those of Puerto Rican ethnicity for AIDS related to intravenous drug abuse. Handle: RePEc:aph:ajpbhl:1989:79:7:836-839_4 Template-Type: ReDIF-Article 1.0 Title: Blood alcohol tests, prevalence of involvement, and outcomes following brain injury Journal: American Journal of Public Health Author-Name: Kraus, J.F. Author-Name: Morgenstern, H. Author-Name: Fife, D. Author-Name: Conroy, C. Author-Name: Nourjah, P. Year: 1989 Volume: 79 Issue: 3 Pages: 294-299 Abstract: We collected data on all residents of San Diego County, California who were hospitalized for or died from a brain injury in 1981. The objectives were to assess the frequency of blood alcohol concentration (BAC) testing and the associations of BAC prevalence with the external cause of the brain injury and case outcome. We found that high BAC levels were most frequent among brain-injured subjects between the ages of 25 and 44 and among those subjects involved in motor vehicle crashes and assaults. Contrary to expectations, injury severity and hospital mortality were inversely related to BAC level, controlling for other predictors. We believe that these inverse associations might be due to differential rates of BAC testing by severity. Among brain-injured survivors with more severe injuries, however, we found that BAC level was positively associated with the prevalence of physician-diagnosed neurological impairment at discharge and with the length of hospitalization. Handle: RePEc:aph:ajpbhl:1989:79:3:294-299_0 Template-Type: ReDIF-Article 1.0 Title: Psychiatric disorders and 15-month mortality in a community sample of older adults Journal: American Journal of Public Health Author-Name: Bruce, M.L. Author-Name: Leaf, P.J. Year: 1989 Volume: 79 Issue: 6 Pages: 727-730 Abstract: The relation between psychiatric disorders, defined by the Diagnostic Interview Schedule (DIS), and mortality over 15 months is compared in 3007 adults age 55 and over in the New Haven Epidemiologic Catchment Area (ECA) project. Our results indicate that the odds of dying are more than four times greater for individuals with affective disorders than for others in the sample, controlling for age, sex and physical health. Cause of death is also examined. There were no suicides or deaths from external causes. Handle: RePEc:aph:ajpbhl:1989:79:6:727-730_1 Template-Type: ReDIF-Article 1.0 Title: Exposure to occupational hazards among Hispanics, Blacks, and non-Hispanic Whites in California Journal: American Journal of Public Health Author-Name: Robinson, J.C. Year: 1989 Volume: 79 Issue: 5 Pages: 629-630 Abstract: Relative risks of exposure to each of six types of occupational injuries and illnesses for Hispanic and Black workers compared to Whites who are not Hispanic were calculated using 1986 California data. Among males, Hispanics faced relative risks of exposure to all hazards adjusted for education and years of work experience of 1.33 (95% CI 1.22, 1.45), while Blacks faced relative risks of 1.17 (1.0, 1.37). Among females, adjusted relative risks were 1.19 (1.09, 1.29) for Hispanics and 1.31 (1.15, 1.50) for Blacks. Handle: RePEc:aph:ajpbhl:1989:79:5:629-630_8 Template-Type: ReDIF-Article 1.0 Title: Records, recall loss, and recall bias in pregnancy: a comparison of interview and medical records data of pregnant and postnatal women Journal: American Journal of Public Health Author-Name: Bryant, H.E. Author-Name: Visser, N. Author-Name: Love, E.J. Year: 1989 Volume: 79 Issue: 1 Pages: 78-80 Abstract: To determine the agreement between interview-based and medical records data concerning illnesses and medications early in pregnancy, we compared the interviews of 202 women with the ongoing records collected during their pregnancies. Substantial underrecording of most transient illnesses was found. Fewer short-term illnesses were reported by postpartum women than still-pregnant women, suggesting the potential for recall bias or loss. Handle: RePEc:aph:ajpbhl:1989:79:1:78-80_0 Template-Type: ReDIF-Article 1.0 Title: Ethnic variation in cholecystectomy rates and outcomes, Manitoba, Canada, 1972-84 Journal: American Journal of Public Health Author-Name: Cohen, M.M. Author-Name: Young, T.K. Author-Name: Hammarstrand, K.M. Year: 1989 Volume: 79 Issue: 6 Pages: 751-755 Abstract: We used population-based data from the Province of Manitoba's universal health insurance plan to compare the cholecystectomy experience of Native Americans and non-Natives from 1972 to 1984. The age-adjusted cholecystectomy rates for Native females were higher than for non-Native females with the peak rate occurring at age 30-39 for Native Americans and at age 60-69 for non-Natives. The rates for males were three times lower than for females and did not differ between Natives and non-Natives. Native Americans were more likely readmitted to hospital for surgical complications than non-Natives and this held true after controlling for age, sex, rural versus urban residence, teaching versus non-teaching hospital, multiple discharge diagnoses or complex versus simple cholecystectomy (relative odds 1.46, 95 per cent confidence interval 1.17, 1.18). The explanation for the relatively high rates of cholecystectomy among Native American females may be related to high rates of known risk factors for gallstone disease (such as obesity and high parity). However, the higher rates of surgical complications require further study. Handle: RePEc:aph:ajpbhl:1989:79:6:751-755_4 Template-Type: ReDIF-Article 1.0 Title: Nulliparity, decade of first birth, and breast cancer in Connecticut cohorts, 1855 to 1945: An ecological study Journal: American Journal of Public Health Author-Name: Hahn, R.A. Author-Name: Moolgavkar, S.H. Year: 1989 Volume: 79 Issue: 11 Pages: 1503-1507 Abstract: Risk of breast cancer increases with age at first birth, and is lower in women who bear their first children while young than in nulliparous women. While previous studies have investigated risk of breast cancer in birth cohorts by examining partial aspects of cohort childbearing, the present ecological study assesses total cohort childbearing risk in Connecticut women born between 1855 and 1945. In each cohort, the proportion of women nulliparous and first bearing children in their twenties, thirties, and forties are weighted by relative risks associated with these events as ascertained in previous studies. Summed cohort childbearing risks are compared to the incidence of breast cancer in women 40 years of age and older in the same cohorts. Changes in decade of first birth and nulliparity do not explain the changes in breast cancer incidence observed: while cohort childbearing risk has declined over the period examined, breast cancer incidence has increased in the same cohorts. Alternative explanations for cohort increases in breast cancer incidence are reviewed. Handle: RePEc:aph:ajpbhl:1989:79:11:1503-1507_0 Template-Type: ReDIF-Article 1.0 Title: Risk factors associated with participation in the Ontario, Canada doctor's strike Journal: American Journal of Public Health Author-Name: Kravitz, R.L. Author-Name: Shapiro, M.F. Author-Name: Linn, L.S. Author-Name: Sivarajan Froelicher, E.S. Year: 1989 Volume: 79 Issue: 9 Pages: 1227-1233 Abstract: To identify factors associated with participation in the 1986 Ontario, Canada doctors' strike, we surveyed 1,028 physicians; 69 percent responded, of whom 42 percent participated in the strike. Risk factors for participation included income greater than $135,000, being a surgeon or gynecologist, having previously 'opted out' of the Ontario Health Insurance Plan, being professionally dissatisfied, being politically conservative, favoring political activism by physicians, holding a positive view of the social consequences of extra-billing, and perceiving family, associates, patients and the public to favor the strike. Eighty percent of strikers, but 32 percent of non-strikers, met criteria we established for four strike-prone groups: the 'economically rational', the 'ideologically committed', the 'professionally disaffected', and the 'socially malleable'. Respondents belonging to one or more of these groups were much more likely to have participated in the strike (64 percent vs 17 percent). Strategies to deal with physician militancy should address the multiplicity of motives that appeared to have influenced doctors in Ontario. Handle: RePEc:aph:ajpbhl:1989:79:9:1227-1233_3 Template-Type: ReDIF-Article 1.0 Title: American Indian youth and drugs, 1976-87: A continuing problem Journal: American Journal of Public Health Author-Name: Beauvais, F. Author-Name: Oetting, E.R. Author-Name: Wolf, W. Author-Name: Edwards, R.W. Year: 1989 Volume: 79 Issue: 5 Pages: 634-636 Abstract: Continuing surveillance of drug use among American Indian adolescents living on reservations shows them to have rates of use higher than those of their non-Indian counterparts. Marijuana use is particularly high among Indian students. By the 7th grade a significant number of Indian youth have tried drugs, particularly marijuana and alcohol, and there are few significant differences by gender. Based on observed patterns of use, intervention strategies need to begin in the elementary school years and target both males and females equally. Handle: RePEc:aph:ajpbhl:1989:79:5:634-636_6 Template-Type: ReDIF-Article 1.0 Title: Physician ratings of appropriate indications for three procedures: Theoretical indications vs indications used in practice Journal: American Journal of Public Health Author-Name: Park, R.E. Author-Name: Fink, A. Author-Name: Brook, R.H. Author-Name: Chassin, M.R. Author-Name: Kahn, K.L. Author-Name: Merrick, N.J. Author-Name: Kosecoff, J. Author-Name: Solomon, D.H. Year: 1989 Volume: 79 Issue: 4 Pages: 445-447 Abstract: We previously reported substantial disagreement among expert physician panelists about the appropriateness of performing six medical and surgical procedures for a large number of theoretical indications. A recently completed community-based medical records study of about 4,500 patients who had one of three procedures - coronary angiography, upper gastrointestinal endoscopy, and carotid endarterectomy - shows that many of the theoretical indications are seldom or never used in practice. However, we find that there is also substantial disagreement (5, 25, or 32 per cent for angiography, endoscopy, or endarterectomy, respectively) about the appropriateness of indications used in actual cases if disagreement is defined by first discarding the two extreme of nine ratings, then looking for at least one rating near the bottom (1 to 3) and one near the top (7 to 9) of the 9-point scale. Patients should know that a substantial percentage of procedures are performed for indications about which expert physicians disagree. Handle: RePEc:aph:ajpbhl:1989:79:4:445-447_0 Template-Type: ReDIF-Article 1.0 Title: Model Standards impact on local health department performance in California Journal: American Journal of Public Health Author-Name: Spain, C. Author-Name: Eastman, E. Author-Name: Kizier, K.W. Year: 1989 Volume: 79 Issue: 8 Pages: 969-974 Abstract: An evaluation of a state-local negotiation process to implement Model Standards in 18 California local health departments was conducted during 1985-87. Model Standards specific to California were developed by state and local public health officials for seven programs. Nine counties participated in state-local negotiations to set performance standards in these seven programs. During the two-year effort, greater use of Model Standards and more improvement in local program performance occurred in local health departments that participated in the state-local negotiation process. The use of Model Standards appeared to contribute to establishing program priorities, emphasizing the measurement of outcomes, improving data management systems, and evaluating the current performance of programs. While this state-local negotiation process is suggested as the preferred approach to encouraging the use of Model Standards in local health departments, it must be recognized that this process requires time and commitment of resources from both the state and local levels. Handle: RePEc:aph:ajpbhl:1989:79:8:969-974_0 Template-Type: ReDIF-Article 1.0 Title: Cognitive research improves questionnaires Journal: American Journal of Public Health Author-Name: Jobe, J.B. Author-Name: Mingay, D.J. Year: 1989 Volume: 79 Issue: 8 Pages: 1053-1055 Handle: RePEc:aph:ajpbhl:1989:79:8:1053-1055_8 Template-Type: ReDIF-Article 1.0 Title: Polymedicine use among community resident older women: How much of a problem? Journal: American Journal of Public Health Author-Name: Cadigan, D.A. Author-Name: Magaziner, J. Author-Name: Fedder, D.O. Year: 1989 Volume: 79 Issue: 11 Pages: 1537-1540 Abstract: In a community-based study of older women describing the prevalence of specific medication combinations, the risk of deleterious consequence from polymedicine was concentrated in a minority of older women. There were few prevalent medication combinations, and many of the more common combinations were unavoidable. These results suggest that broad, community-based drug education programs may be less effective than those targeting medical providers and multi-drug users. Handle: RePEc:aph:ajpbhl:1989:79:11:1537-1540_0 Template-Type: ReDIF-Article 1.0 Title: III. Development of a standard questionnaire for occupational health research Journal: American Journal of Public Health Author-Name: Ehrenberg, R.L. Author-Name: Sniezek, J.E. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 15-17 Abstract: Direct surveys of groups of workers can provide valuable occupational health surveillance data, but this requires consistent collection of data. As part of efforts to improve the standardization of such methodology, NIOSH is developing a standard occupational health questionnaire. This questionnaire will be designed to collect demographic and occupational history information in addition to information about the presence of a spectrum of work-related conditions. The questionnaire will have a modular structure and will consist of a core questionnaire and a series of condition-specific modules. Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:15-17_5 Template-Type: ReDIF-Article 1.0 Title: X. Surveillance for work-related adverse reproductive outcomes Journal: American Journal of Public Health Author-Name: Bregman, D.J. Author-Name: Anderson, K.E. Author-Name: Buffler, P. Author-Name: Salg, J. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 53-57 Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:53-57_3 Template-Type: ReDIF-Article 1.0 Title: Backcountry water treatment to prevent giardiasis Journal: American Journal of Public Health Author-Name: Ongerth, J.E. Author-Name: Johnson, R.L. Author-Name: MacDonald, S.C. Author-Name: Frost, F. Author-Name: Stibbs, H.H. Year: 1989 Volume: 79 Issue: 12 Pages: 1633-1637 Abstract: This study was conducted to provide current information on the effectiveness of water treatment chemicals and filters for control of Giardia cysts in areas where treated water is not available. Four filters and seven chemicals treatments were evaluated for both clear and turbid water at 10°C. Three contact disinfection devices were also tested for cyst inactivation. Filters were tested with 1-liter volumes of water seeded with 3 x 104 cysts of G. lamblia produced in gerbils inoculated with in vitro cultured trophozoites; the entire volume of filtrate was examined for cyst passage. Chemical treatments were evaluated at concentrations specified by the manufacturer and for contact times that might be expected of hikers (30 minutes) and campers (eight hours, i.e., overnight). Two of the four filter devices tested were 100 percent effective for Giardia cyst removal. Of the other two filters, one was 90 percent effective and the other considerably less effective. Among the seven disinfection treatments, the iodine-based chemicals were all significantly more effective than the chlorine-based chemicals. None of the chemical treatments achieved 99.9 percent cyst inactivation with only 30-minute contact. After an eight-hour contact each of the iodine but none of the chlorine preperations achieved at least 99.9 percent cyst inactivation. None of the contact disinfection devices provided appreciable cyst inactivation. Heating water to at least 70°C for 10 minutes was na acceptable alternative treatment. Handle: RePEc:aph:ajpbhl:1989:79:12:1633-1637_9 Template-Type: ReDIF-Article 1.0 Title: Injury control in perspective Journal: American Journal of Public Health Author-Name: Waller, J.A. Year: 1989 Volume: 79 Issue: 3 Pages: 272-273 Handle: RePEc:aph:ajpbhl:1989:79:3:272-273_9 Template-Type: ReDIF-Article 1.0 Title: Self-reported diabetes in Mexican Americans: HHANES 1982-84 Journal: American Journal of Public Health Author-Name: Perez-Stable, E.J. Author-Name: McMillen, M.M. Author-Name: Harris, M.I. Author-Name: Juarez, R.Z. Author-Name: Knowler, W.C. Author-Name: Stern, M.P. Author-Name: Haynes, S.G. Year: 1989 Volume: 79 Issue: 6 Pages: 770-772 Abstract: In the Hispanic Health and Nutrition Examination Survey (HHANES) of 3,928 Mexican Americans ages 20-74 years, the age-adjusted prevalence of self-reported diabetes was 6.8 percent among men and 7.6 percent among women. Comparable age-adjusted rates for the US population in a national survey were 2.9 percent in men and 3.8 percent in women. The prevalence of diabetes in Mexican Americans is greater in older age groups, was similar in men and women, and among women only was inversely associated with education. Handle: RePEc:aph:ajpbhl:1989:79:6:770-772_7 Template-Type: ReDIF-Article 1.0 Title: The effect of occupational, marital and parental roles on mortality: The Alameda County study Journal: American Journal of Public Health Author-Name: Kotler, P. Author-Name: Wingard, D.L. Year: 1989 Volume: 79 Issue: 5 Pages: 607-612 Abstract: This study investigated the impact of combining marital, parental, and occupational roles upon 18-year risk of mortality from all causes. The respondents were 3,700 participants in the Human Population Laboratory cohort ages 35-64 who completed a comprehensive health and psychosocial questionnaire in 1965 and were followed for mortality status through 1982. Employment status and type of employment were not found to predict mortality risk among women. Contrary to the multiple roles hypothesis, there was virtually no impact upon mortality of increasing numbers of children among employed women, except possibly among single working parents. The major impact of children was felt by housewives who had significantly elevated risks when a child was present in the home or when they had four or more children. Neither the number of children nor the presence of a child in the home affected mortality risk of men. Controlling for a variety of factors thought to be related to mortality in a logistic regression analysis did not change the foregoing relation. Handle: RePEc:aph:ajpbhl:1989:79:5:607-612_7 Template-Type: ReDIF-Article 1.0 Title: HIV seroprevalence in intravenous drug users: Los Angeles, California, 1986 Journal: American Journal of Public Health Author-Name: Mascola, L. Author-Name: Lieb, L. Author-Name: Iwakoshi, K.A. Author-Name: McAllister, D. Author-Name: Siminowski, T. Author-Name: Giles, M. Author-Name: Run, G. Author-Name: Fannin, S.L. Author-Name: Strantz, I.H. Year: 1989 Volume: 79 Issue: 1 Pages: 81-82 Abstract: To estimate the seroprevalence and investigate risk behaviors for HIV (human immunodeficiency virus) infection in intravenous drug users in Los Angeles County, a stratified, random sample of 790 clients, enrolled in either methadone maintenance or detoxification programs, were studied. Thirteen study participants (1.8 per cent) were seropositive; of these, five were homosexual/bisexual males and three were female prostitutes. Ninety-five per cent of all participants reported sharing needles. Risk reduction education efforts must be expanded before the HIV antibody prevalence rate increases. Handle: RePEc:aph:ajpbhl:1989:79:1:81-82_9 Template-Type: ReDIF-Article 1.0 Title: Traffic safety effects of sobriety checkpoints and other local DWI programs in New Jersey Journal: American Journal of Public Health Author-Name: Levy, D. Author-Name: Shea, D. Author-Name: Asch, P. Year: 1989 Volume: 79 Issue: 3 Pages: 291-293 Abstract: We examined the efficacy of three Driving While Intoxicated (DWI) programs in New Jersey from 1980 through 1985, using covariance analyasis of county data. Road blocks, the major component of the Strike Force program, were associated with a drop of 10-15 per cent in the single vehicle nighttime crash rate and showed a relatively stable effect over time. DWI Task Force, an education program, was associated with a 6-10 per cent total decline in the crash rate and declining impact over time. SOBER, another education program, was associated with a small effect in the first year and little or no effect thereafter. Handle: RePEc:aph:ajpbhl:1989:79:3:291-293_5 Template-Type: ReDIF-Article 1.0 Title: The continuing saga of lyme disease Journal: American Journal of Public Health Author-Name: Benenson, A.S. Year: 1989 Volume: 79 Issue: 1 Pages: 9-11 Handle: RePEc:aph:ajpbhl:1989:79:1:9-11_7 Template-Type: ReDIF-Article 1.0 Title: Illness associated with child day care: A study of incidence and cost Journal: American Journal of Public Health Author-Name: Bell, D.M. Author-Name: Gleiber, D.W. Author-Name: Mercer, A.A. Author-Name: Phifer, R. Author-Name: Guinter, R.H. Author-Name: Cohen, A.J. Author-Name: Epstein, E.U. Author-Name: Narayanan, M. Year: 1989 Volume: 79 Issue: 4 Pages: 479-484 Abstract: We studied 843 children under 36 months of age enrolled in a prepaid health plan from September 1985 through March 1986, to identify characteristics of day care which might be risk factors for infection and to describe the resulting economic costs. Children cared for in their own home had a mean of 2.03 infections diagnosed during the study period. Adjusted rates of excess infection (95 per cent CI) for children cared for in other settings were: -.09 (-.73, .54) in relatives' homes; 10 (-.51, .71) in day care homes; .79 (.13, 1.45) in day care centers; .60 (-.24, 1.46) in mother's day out programs; and .66 (-.01, 1.34) in multiple settings. Children in day care centers were 4.5 times more likely to be hospitalized than those in other settings (95 per cent CI = 1.55, 13.00), primarily due to an increased rate of tympanostomy tube placement (relative risk 3.79, 95 per cent CI = 1.04, 13.36). The strongest predictor of illness risk was the number of other children in the room. The mean monthly cost of medical care was $32.94 for children in the highest risk settings compared with $19.78 for those in other settings. Illness in a child in our study accounted for 40 per cent of parental absenteeism from work; the mean number of days lost per month was 0.52 for parents of children in day care centers compared with 0.37 for those of children in other forms of full time care outside the home. Handle: RePEc:aph:ajpbhl:1989:79:4:479-484_1 Template-Type: ReDIF-Article 1.0 Title: Costs related to ER use: Reply Journal: American Journal of Public Health Author-Name: Hurley, R.E. Year: 1989 Volume: 79 Issue: 12 Pages: 1681 Handle: RePEc:aph:ajpbhl:1989:79:12:1681_1 Template-Type: ReDIF-Article 1.0 Title: Comprehensive health care for high-risk adolescents: An evaluation study Journal: American Journal of Public Health Author-Name: Earls, F. Author-Name: Robins, L.N. Author-Name: Stiffman, A.R. Author-Name: Powell, J. Year: 1989 Volume: 79 Issue: 8 Pages: 999-1005 Abstract: This study was designed to evaluate the effectiveness of a large scale program to improve health care for high-risk adolescents. Seven clinics, funded to provide comprehensive primary care to adolescents, were compared to three non-funded clinics. The majority of the 2,788 adolescent patients sampled in these clinics were female (78 percent) and Black (71 percent). Each patient was initially interviewed at the time of a clinic visit and reinterviewed 12 months later; their medical records were systematically reviewed. As expected, the funded clinics detected and treated a wider range of medical and behavioral problems than the comparison clinics, a finding that was based on the self-reports of patients and confirmed by documentation in the medical records. However, improvements in life-style and in specific medical outcomes were not observed. To build on the limited success of this program, efforts are needed to encourage more males to receive care and to develop more specific interventions for patients in this age group. Handle: RePEc:aph:ajpbhl:1989:79:8:999-1005_1 Template-Type: ReDIF-Article 1.0 Title: Suicide risk among women with alcohol problems Journal: American Journal of Public Health Author-Name: Lisansky Gomberg, E.S. Year: 1989 Volume: 79 Issue: 10 Pages: 1363-1365 Abstract: The current study compares 301 alcoholic women, ages 20 to 50, interviewed in 21 treatment facilities, and a control group of nonalcoholic women matched for age and socioeconomic status of family of origin. A significant higher percentage of alcoholic women (40.0% vs 8.8%) reported having made suicide attempts, a difference of 31.2 percentage points (95% CI = 23.9, 38.5). Age comparisons within the alcoholic sample show the percentage of younger alcoholic women attempting suicide to be twice as great as the percentage of the alcoholic women suicide attempters in their forties. Such age differences were not found among the nonalcoholic control group. The findings suggest that youthfulness and alcohol/drug abuse are the critical combination for high risk. Awareness of the suicide attempt risk potential is necessary both for emergency room personnel and for substance abuse facility workers. Handle: RePEc:aph:ajpbhl:1989:79:10:1363-1365_5 Template-Type: ReDIF-Article 1.0 Title: Catholicism and fertility in Puerto Rico Journal: American Journal of Public Health Author-Name: Herold, J.M. Author-Name: Westoff, C.F. Author-Name: Warren, C.W. Author-Name: Seltzer, J. Year: 1989 Volume: 79 Issue: 9 Pages: 1258-1262 Abstract: This paper examines the association between fertility and religious affiliation among Puerto Ricans. Bongaarts' proximate determinants framework is used to compare religious categories on behaviors that directly affect fertility. We found no difference in recent fertility between Catholics and non-Catholics in Puerto Rico (total fertility rate = 2.5). We also found Catholics and non-Catholics to be similar on age at first marriage (23.3 and 23.4 years, respectively), contraceptive use (71 percent and 69 percent of married women currently contracepting), and breast-feeding practices (mean duration of breast-feeding of 4.4 and 4.3 months). Differences were observed between less committed and more committed Catholics in total fertility rate, age at first marriage, and contraceptive use, but these differences were not large and were in the opposite direction from the expected. Our findings support the theory of convergence of Catholic and non-Catholic fertility for the US. Our discrepancy with findings from the National Survey of Family Growth is evidence of the cultural diversity in the US Hispanic population and indicates the importance of disaggregating by ethnicity or national origin when studying this population. Handle: RePEc:aph:ajpbhl:1989:79:9:1258-1262_1 Template-Type: ReDIF-Article 1.0 Title: Needle exchange programs: A medical or a policy dilemma? Journal: American Journal of Public Health Author-Name: Ginzburg, H.M. Year: 1989 Volume: 79 Issue: 10 Pages: 1350-1351 Handle: RePEc:aph:ajpbhl:1989:79:10:1350-1351_3 Template-Type: ReDIF-Article 1.0 Title: Bowel function and breast cancer in US women Journal: American Journal of Public Health Author-Name: Micozzi, M.S. Author-Name: Carter, C.L. Author-Name: Albanes, D. Author-Name: Taylor, P.R. Author-Name: Licitra, L.M. Year: 1989 Volume: 79 Issue: 1 Pages: 73-75 Abstract: We studied bowel function in relation to 123 breast cancer cases among 7,702 women from the US NHANES I Epidemiologic Follow-up Study. Results suggest a slight increased risk of breast cancer for both decreased frequency of bowel movements (relative risk = 1.5, 95% confidence interval = 0.8, 2.7) and firm stool consistency (RR = 1.8, 95% CI = 1.0, 3.2). These observations are consistent with an hypothesized association between constipation and increased risk of breast cancer. Handle: RePEc:aph:ajpbhl:1989:79:1:73-75_6 Template-Type: ReDIF-Article 1.0 Title: Fetal death ratios in a prospective study compared to state fetal death certificate reporting Journal: American Journal of Public Health Author-Name: Goldhaber, M.K. Year: 1989 Volume: 79 Issue: 9 Pages: 1268-1270 Abstract: A cohort of 6,254 pregnancies surviving at least 20 weeks of gestation was identified through pregnancy testing and follow-up at three Kaiser Permanente medical offices in northern California in 1981-82. Fetal death ratios per 1,000 live births were 12.1 for all fetal deaths versus 5.0 for the subset of fetal deaths reported to the California state registrar. Only fetal deaths resulting in overnight hospitalization of the mother were reported. Seventy-nine percent of fetal deaths over 28 completed weeks since the last menstrual period (LMP) were reported versus only 10 percent between 20 and 28 completed weeks since the LMP. Ninety-three percent of fetuses over 400 grams were reported. The unreported fetal deaths were mainly those perceived by attending physicians as spontaneous abortion, especially missed or incomplete spontaneous abortion. Physicians apparently preferred the label of spontaneous abortion over stillbirth or fetal death whenever fetal maturity could not be substantiated, regardless of prior estimates of the date of the LMP. Fetuses as large and developed as potentially viable infants were the most likely to be reported. Handle: RePEc:aph:ajpbhl:1989:79:9:1268-1270_0 Template-Type: ReDIF-Article 1.0 Title: Physical activity and risk of cancer in the NHANES I population Journal: American Journal of Public Health Author-Name: Albanes, D. Author-Name: Blair, A. Author-Name: Taylor, P.R. Year: 1989 Volume: 79 Issue: 6 Pages: 744-750 Abstract: We studied the relation between self-reported physical activity and cancer in the first National Health and Nutrition Examination Survey (NHANES I) cohort, originally examined between 1971-75, and followed prospectively through the Epidemiologic Follow-up Study (NHEFS), conducted between 1982-84. Among 5,138 men and 7,407 women 25-74 years old, for nonrecreational activity we observed increased risk of cancer among inactive individuals compared to very active persons (for men, relative risk [RR] 1.8, 95% confidence interval [CI] = 1.4, 2.4; for women RR 1.3, 95% CI = 1.0, 1.8). These findings were unchanged after adjustment for cigarette smoking, body mass index (BMI), and other potential confounders. Sites which demonstrated stronger inactivity-cancer associations included colorectum (RR 1.6, 95% CI = 0.7, 3.5) and lung (RR 1.6; 95% CI = 1.2, 3.5) among men, and breast (postmenopausal) (RR 1.7; 95% CI = 0.8, 2.9) and cervix (RR 5.2; 95% CI = 1.4, 14.5) among women, although these findings for women were based on relatively few cases. The association between inactivity and cancer was greater among persons of moderate (or lower) BMI, those cases occurring three or more years after baseline, and, in women, those more than 60 years old. In contrast, recreational exercise showed little relation to cancer, with the exception of prostate cancer. The results suggest that inactive individuals are at increased risk of cancer. Handle: RePEc:aph:ajpbhl:1989:79:6:744-750_4 Template-Type: ReDIF-Article 1.0 Title: The impact of Medicaid on physician use by low-income children Journal: American Journal of Public Health Author-Name: Rosenbach, M.L. Year: 1989 Volume: 79 Issue: 9 Pages: 1220-1226 Abstract: This study evaluated the determinants of physician use by low-income children, with an emphasis on the effect of Medicaid. Data are from the 1980 National Medical Care Utilization and Expenditure Survey. Regression analysis revealed that Medicaid children were more likely than both privately insured and uninsured children to visit an office-based physician. Also, Medicaid children with at least one visit to any setting had a higher number of visits than uninsured children. Such factors as age, health status, number of children in the family, educational status, and income also accounted for differences within the low-income population. The results suggest that access to physicians' services (including office-based physicians) can be increased by expanding Medicaid eligibility to uninsured low-income children and by improving private health insurance benefits among the underinsured. Handle: RePEc:aph:ajpbhl:1989:79:9:1220-1226_9 Template-Type: ReDIF-Article 1.0 Title: Induced abortion and the risk of subsequent ectopic pregnancy Journal: American Journal of Public Health Author-Name: Holt, V.L. Author-Name: Daling, J.R. Author-Name: Voigt, L.F. Author-Name: McKnight, B. Author-Name: Stergachis, A. Author-Name: Chu, J. Author-Name: Weiss, N.S. Year: 1989 Volume: 79 Issue: 9 Pages: 1234-1238 Abstract: This study assessed the effect of legal induced abortion on ectopic pregnancy risk by using a comparison group of reproductive-age women who were at risk of becoming pregnant during the same time period the women with ectopic pregnancy conceived. Cases were members of Group Health Cooperative of Puget Sound who were hospitalized for ectopic pregnancy from October 1981 through September 1986 (N = 211). Controls were randomly selected members matched to cases on age and county of residence (N = 457). All subjects in this analysis had had one or more prior pregnancies. Eigthy-eight cases (41.7 per cent) and 177 controls (38.7 per cent) had a history of one or more induced abortions. The relative risk of ectopic pregnancy associated with one abortion was 0.9 (95 per cent confidence interval 0.6, 1.3), adjusted for age, county, reference date, religion, gravidity, age at first pregnancy, lifetime number of sexual partners, and miscarriage history. Among women with two or more prior pregnancies, the risk associated with two or more abortions was 1.2 (0.6,2.4). Controlling for pelvic inflammatory disease and use of intrauterine devices did not alter these risks. We conclude that legal abortion as performed in the US since 1970 has little or no influence on a women's risk of ectopic pregnancy in subsequent pregnancies. Handle: RePEc:aph:ajpbhl:1989:79:9:1234-1238_3 Template-Type: ReDIF-Article 1.0 Title: Risk of AIDS among lesbians Journal: American Journal of Public Health Author-Name: Dicker, B.G. Year: 1989 Volume: 79 Issue: 11 Pages: 1569 Handle: RePEc:aph:ajpbhl:1989:79:11:1569_9 Template-Type: ReDIF-Article 1.0 Title: HIV testing in prisoners: Is mandatory testing mandatory? Journal: American Journal of Public Health Author-Name: Andrus, J.K. Author-Name: Fleming, D.W. Author-Name: Knox, C. Author-Name: McAlister, R.O. Author-Name: Skeels, M.R. Author-Name: Conrad, R.E. Author-Name: Horan, J.M. Author-Name: Foster, L.R. Year: 1989 Volume: 79 Issue: 7 Pages: 840-842 Abstract: We studied 977 newly incarcerated Oregon inmates to compare voluntary versus mandatory human immunodeficiency virus antibody (HIVAb) testing in the prison setting. All inmates were offered HIVAb counseling and testing. Blood drawn for routine syphilis serology from those who declined this offer was also tested for HIVAb after personal identifiers had been removed. Only 1.2 percent (12) prisoners were HIV positive. However, 62.5 percent (611) inmates were at risk for HIV infection by being an intravenous drug user, a male homosexual, or hepatitis B core antibody (HBcAb) positive. The ratio of at-risk, as yet uninfected inmates to those already HIV infected was 53 to 1. Two-thirds of all inmates including those at-risk chose to receive counseling and testing. In areas where most at-risk inmates are not yet infected, it may be more appropriate for HIV prevention activities in prison to focus on voluntary programs that emphasize education and counseling rather than mandatory programs that emphasize testing. Handle: RePEc:aph:ajpbhl:1989:79:7:840-842_2 Template-Type: ReDIF-Article 1.0 Title: Passive smoking: A review of medical and legal issues Journal: American Journal of Public Health Author-Name: Byrd, J.C. Author-Name: Shapiro, R.S. Author-Name: Schiedermayer, D.L. Year: 1989 Volume: 79 Issue: 2 Pages: 209-215 Abstract: This paper summarizes the medical effects of passive smoking and reviews the role of litigation, legislation, and private regulation in the area of ETS. Handle: RePEc:aph:ajpbhl:1989:79:2:209-215_5 Template-Type: ReDIF-Article 1.0 Title: Prevention of childhood injuries: Evaluation of the Statewide Childhood Injury Prevention Program (SCIPP) Journal: American Journal of Public Health Author-Name: Guyer, B. Author-Name: Gallagher, S.S. Author-Name: Chang, B.-H. Author-Name: Azzara, C.V. Author-Name: Cupples, L.A. Author-Name: Colton, T. Year: 1989 Volume: 79 Issue: 11 Pages: 1521-1527 Abstract: We evaluated the effectiveness of a community-based injury prevention program designed to reduce the incidence of burns, falls in the home, motor vehicle occupant injuries, and poisonings and suffocations among children ages 0-5 years. Between September 1980 and June 1982, we implemented five injury prevention projects concurrently in nine Massachusetts cities and towns; five sites, matched on selected demographic characteristics, were control communities. An estimated 42 percent of households with children ages 0-5 years were exposed to one or more of the interventions over the two-year period in the nine communities. Participation in safety programs increased three-fold in the intervention communities and two-fold in the control communities. Safety knowledge and practices increased in both intervention and control communities. Households that reported participatory exposure to the interventions had higher safety knowledge and behavior scores than those that received other community exposure or no exposure to intervention activities. We found a distinct reduction in motor vehicle occupant injuries among children ages 0-5 years in the intervention compared with control communities, associated with participatory exposure of about 55 percent of households with children ages 0-5 years. We have no evidence that the coordinated intervention programs reduced the other target injuries - although exposure to prevention messages was associated with safety behaviors for burns and poisonings. Handle: RePEc:aph:ajpbhl:1989:79:11:1521-1527_8 Template-Type: ReDIF-Article 1.0 Title: The consumer product safety commission's opposition to consumer product safety: Lessons for public health advocates Journal: American Journal of Public Health Author-Name: Christoffel, T. Author-Name: Christoffel, K.K. Year: 1989 Volume: 79 Issue: 3 Pages: 336-339 Handle: RePEc:aph:ajpbhl:1989:79:3:336-339_7 Template-Type: ReDIF-Article 1.0 Title: Emergency room use and primary care case management: Evidence from four medicaid demonstration programs Journal: American Journal of Public Health Author-Name: Hurley, R.E. Author-Name: Freund, D.A. Author-Name: Taylor, D.E. Year: 1989 Volume: 79 Issue: 7 Pages: 843-846 Abstract: Claims-based utilization data collected in four Medicaid demonstration programs are used to examine the impact of primary care case management on patterns of reliance on the emergency room as a source of services. The experience of stratified random samples of AFDC (Aid to Families with Dependent Children) adults and children in the demonstration programs is compared with that of equivalent samples from comparison groups in traditional Medicaid programs. Data were analyzed in multivariate models controlling for person characteristics in a pre/post, demonstration/comparison design. Results indicated large reductions in the proportion of persons with at least one emergency room visit ranging from 27 to 37 per cent for children and 30 to 45 per cent for adults. Use levels for persons with at least one ER visit are less substantially affected. The findings suggest that gatekeeping designs can alter patterns of enrollee use with respect to the emergency room and some discussion of these implications is presented. Handle: RePEc:aph:ajpbhl:1989:79:7:843-846_8 Template-Type: ReDIF-Article 1.0 Title: Long-term care initiatives: Success in Hennepin County, Minnesota Journal: American Journal of Public Health Author-Name: Lindberg, G. Author-Name: Monson, T. Year: 1989 Volume: 79 Issue: 4 Pages: 519 Handle: RePEc:aph:ajpbhl:1989:79:4:519_9 Template-Type: ReDIF-Article 1.0 Title: I. Surveillance in occupational illness and injury: Concepts and content Journal: American Journal of Public Health Author-Name: Baker, E.L. Author-Name: Honchar, P.A. Author-Name: Fine, L.J. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 9-11 Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:9-11_3 Template-Type: ReDIF-Article 1.0 Title: The relation of body fat distribution, as assessed by six girth measurements, to diabetes mellitus in women Journal: American Journal of Public Health Author-Name: Freedman, D.S. Author-Name: Rimm, A.A. Year: 1989 Volume: 79 Issue: 6 Pages: 715-720 Abstract: Independently of the amount of adipose tissue, certain patterns of fat distribution increase the risk of non-insulin-dependent diabetes. Although the ratio of waist to hip (WHR) circumferences has been consistently related to diabetes mellitus, it is possible that only two measures do not completely characterize fat topography. The current study, therefore, examines the cross-sectional relation of six girths (waist, hip, neck, bust, wrist, and ankle) to diabetes mellitus in 43,595 women. As compared with non-diabetics, Quetelet index (kg/m2) and all circumferences were elevated among diabetics. Stratified analyses showed that WHR, and waist, neck, and bust girths were consistently related to diabetes independently of the degree of overweight. As estimated from a logistic regression model that simultaneously controlled for age and all anthropometric variables, the prevalence of diabetes mellitus was positively related to Quetelet index, and to the waist, bust, and neck girths, with odds ratios (ORs) ranging from 1.4 to 2.6. However, diabetes was inversely related to hip (OR = 0.61) and ankle (OR = 0.73) girths; p < 0.005 for each association. Although cross-sectional in nature, these results suggest that an adverse body fat distribution is not limited to the abdominal region, but that a relative preponderance of adipose tissue in various regions of the upper body is associated with diabetes mellitus in women. Handle: RePEc:aph:ajpbhl:1989:79:6:715-720_2 Template-Type: ReDIF-Article 1.0 Title: Immunization coverage and social differentiation in urban Senegal Journal: American Journal of Public Health Author-Name: Fassin, D. Author-Name: Jeannee, E. Year: 1989 Volume: 79 Issue: 4 Pages: 509-511 Abstract: We studied sociocultural factors associated with immunization coverage among a random sample of 500 mothers in the underprivileged suburbs of Dakar, Senegal. Factors associated with immunization of children under age 5 were maternal educational level and socioeconomic conditions (especially husband's regular salary); maternal age on arrival in town was more influential than total number of resident years in town; no effect of ethnicity was evident. Handle: RePEc:aph:ajpbhl:1989:79:4:509-511_4 Template-Type: ReDIF-Article 1.0 Title: The inaccessibility of seat belts in taxicabs Journal: American Journal of Public Health Author-Name: Davis, R.M. Year: 1989 Volume: 79 Issue: 3 Pages: 330-331 Abstract: The accessibility of seat belts was determined in a total sample of 200 taxicabs waiting to pick up passengers at eight city airports. A rear belt was 'accessible' (able to be fastened within 10 seconds) in 111 (55.5 per cent) taxicabs. The proportion varied by city from 16.0 per cent (New York City) to 96.0 per cent (Minneapolis-St. Paul) and was higher for taxicabs in cities covered by mandatory state seat belt legislation. Handle: RePEc:aph:ajpbhl:1989:79:3:330-331_3 Template-Type: ReDIF-Article 1.0 Title: V. The selection and definition of targeted work-related conditons for surveillance under SENSOR Journal: American Journal of Public Health Author-Name: Matte, T.D. Author-Name: Baker, E.L. Author-Name: Honchar, P.A. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 21-25 Abstract: Lists of reportable conditions and case definitions are important tools for epidemiologic surveillance. As part of an initiative to encourage occupational disease surveillance systems linked to intervention at the state level, we have proposed a list of target conditions and are developing a set of standard epidemiologic case definitions. Experience gained from state health department pilot projects using SENSOR and other surveillance approaches will be used to promote effective condition-specific surveillance strategies on a wider scale. Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:21-25_3 Template-Type: ReDIF-Article 1.0 Title: Prevalence of depressive symptoms in a Japanese occupational setting: A preliminary study Journal: American Journal of Public Health Author-Name: Iwata, N. Author-Name: Okuyama, Y. Author-Name: Kawakami, Y. Author-Name: Saito, K. Year: 1989 Volume: 79 Issue: 11 Pages: 1486-1489 Abstract: We measured the prevalence of depressive symptoms in 2,190 Japanese tax office workers using the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D). Score distribution by sex was more symmetrical and the mean score of each sex higher than in the United States population. A high level of depressive symptoms was found in 15.2 percent of males and 10.6 percent of females by controlling for age and marital status. Males aged 50 years and over had more depressive symptoms than other male age groups. Perceived stress, related both to family life and the workplace, was associated with a high level of depressive symptoms. 'Long-distance marriage' ('business bachelorhood'), peculiar to Japanese occupations, had little influence on depressive symptomatology. Handle: RePEc:aph:ajpbhl:1989:79:11:1486-1489_4 Template-Type: ReDIF-Article 1.0 Title: Sexual behavior changes and HIV antibody in a cohort of New York City gay men Journal: American Journal of Public Health Author-Name: Martin, J.L. Author-Name: Garcia, M.A. Author-Name: Beatrice, S.T. Year: 1989 Volume: 79 Issue: 4 Pages: 501-503 Abstract: A sample of 357 gay/bisexual men, ages 20 to 65, were interviewed in 1985 regarding their sexual patterns over the course of the AIDS (acquired immunodeficiency syndrome) epidemic. Within four months after the interview, men were tested for antibody to HIV (human immunodeficiency virus) and 36 per cent were found positive. Cessation of receptive anal intercourse was associated with HIV negative antibody status, (OR > 3.0). Reducing the number of sexual partners, becoming monogamous, or eliminating other forms of sexual contact were not related to risk of HIV. Handle: RePEc:aph:ajpbhl:1989:79:4:501-503_8 Template-Type: ReDIF-Article 1.0 Title: Prevalence of diabetes in a Navajo Indian community Journal: American Journal of Public Health Author-Name: Sugarman, J. Author-Name: Percy, C. Year: 1989 Volume: 79 Issue: 4 Pages: 511-513 Abstract: The age- and sex-adjusted prevalence of non-insulin-dependent diabetes mellitus (NIDDM) of 494 (76 per cent) Navajo adults living in a reservation community was 10.2 per cent, approximately 60 per cent greater than the estimated prevalence (6.4 per cent) in the general US population. The screening protocol utilized likely undertestimates the prevalence of NIDDM in this population. A high proportion of Navajo people were overweight when compared to the general US population. Handle: RePEc:aph:ajpbhl:1989:79:4:511-513_5 Template-Type: ReDIF-Article 1.0 Title: Assessing quality of care: Another step forward Journal: American Journal of Public Health Author-Name: Morehead, M.A. Year: 1989 Volume: 79 Issue: 4 Pages: 415-416 Handle: RePEc:aph:ajpbhl:1989:79:4:415-416_6 Template-Type: ReDIF-Article 1.0 Title: Childhood injury deaths: National analysis and geographic variations Journal: American Journal of Public Health Author-Name: Waller, A.E. Author-Name: Baker, S.P. Author-Name: Szocka, A. Year: 1989 Volume: 79 Issue: 3 Pages: 310-315 Abstract: Twenty-three causes of injury mortality in children ages 0-14 in the United States were analyzed by age, race, sex, and state of residence for the years 1980-85. Motor vehicles caused 37 per cent of all injury related deaths and were the leading cause of injury mortality in every group except children younger than one year, for whom homicide was the leading cause. Male death rates were at least four times female rates for suicide, unintentional firearm injury and injuries related to farm machinery or motorcycles. The drowning rate among Whites was almost twice that of Blacks for ages 1-4, but in the 10-14 year age group the drowning rate for Blacks was over three times that of whites. In general, the highest injury death rates were in the mountain states and the south. Between 1980 and 1985, the suicide rate in the 10-14 year age group more than doubled. Handle: RePEc:aph:ajpbhl:1989:79:3:310-315_7 Template-Type: ReDIF-Article 1.0 Title: Elevated blood levels of carcinogens in passive smokers Journal: American Journal of Public Health Author-Name: Maclure, M. Author-Name: Katz, R.B.-A. Author-Name: Bryant, M.S. Author-Name: Skipper, P.L. Author-Name: Tannenbaum, S.R. Year: 1989 Volume: 79 Issue: 10 Pages: 1381-1384 Abstract: The hypothesis that involuntary exposure to tobacco smoke - passive smoking - results in greater risk of cancer was assessed by measuring the levels of two known carcinogens in the blood of 57 nonsmokers with varying degrees of involuntary exposure, including six heavily exposed bartenders. The concentrations of hemoglobin adducts of 4-aminobiphenyl, a bladder carcinogen, were significantly higher in subjects with confirmed involuntary exposure (plasma cotinine concentrations between 2 and 23 ng/ml) compared with subjects with undetectable levels of cotinine. Similarly, adducts of 3-aminobiphenyl were significantly elevated in subjects with confirmed exposure. The odds of 3-aminobiphenyl adduct levels exceeding 2 pg/g of hemoglobin were 6:7 among the confirmed exposed, compared with the odds of 2:42 among subjects with undetectable cotinine (odds ratio = 18; 95 percent confidence interval = 3.3, 94). The validity of the assay was demonstrated by showing striking declines in adduct levels among quitting smokers. Handle: RePEc:aph:ajpbhl:1989:79:10:1381-1384_7 Template-Type: ReDIF-Article 1.0 Title: Health care cost containment measures and mortality in Hennepin County's Medicaid elderly and all elderly Journal: American Journal of Public Health Author-Name: Lindberg, G.L. Author-Name: Lurie, N. Author-Name: Bannick-Mohrland, S. Author-Name: Sherman, R.E. Author-Name: Farseth, P.A. Year: 1989 Volume: 79 Issue: 11 Pages: 1481-1485 Abstract: In Minnesota, several health care cost containment measures occurred about the time Medicare's Prospective Payment System (PPS) was implemented. These included a moratorium on additional nursing home beds, preadmission screening of nursing home applicants, and rapid growth in HMO (health maintenance organization) enrollment by Medicare recipients. Hospital days per elderly Medicaid recipient decreased by 38 percent for those in nursing homes and by 35 percent for those not in nursing homes from 1982 to 1984. By 1986, hospital days per recipient had decreased 53 and 55 percent, respectively, from the 1982 level. Age-adjusted mortality rates for elderly Medicaid nursing home residents for the period 1977 through 1986 showed an increasing trend after 1982. Estimated age-adjusted mortality rates for the entire County population, which had decreased steadily from 1970 to 1982, rose significantly above the projected rate in 1984, 1985, 1986, and 1987. We conclude that, coincident with the institution of the PPS and other health care cost containment measures, use of hospital care has fallen for all elderly Medicaid recipients, age-adjusted mortality rates among those in nursing homes have increased, and the mortality rate trend for the total Hennepin County elderly population has stopped declining. Handle: RePEc:aph:ajpbhl:1989:79:11:1481-1485_1 Template-Type: ReDIF-Article 1.0 Title: To tell or not to tell: The ethical dilemmas of HIV test notification in epidemiologic research Journal: American Journal of Public Health Author-Name: Avins, A.L. Author-Name: Lo, B. Year: 1989 Volume: 79 Issue: 11 Pages: 1544-1548 Abstract: Epidemiologic studies involving HIV (human immunodeficiency virus) antibody testing create ethical dilemmas, particularly about notifying asymptomatic seropositive subjects. Four study designs address this problem: mandatory notification, optional notification, anonymous testing, and blind testing. No single design consistently optimizes the trade-off between valid and ethical research. Each strategy differs substantially from the others in its effects on response rates, bias, ability to perform longitudinal studies, numbers of subjects who learn their test results, and the number of subjects counseled about HIV risk reduction. Both local institutional review boards and potential subjects of study (and their sexual partners) should participate in decisions regarding the conduct of sensitive AIDS (acquired immunodeficiency syndrome) research. Handle: RePEc:aph:ajpbhl:1989:79:11:1544-1548_5 Template-Type: ReDIF-Article 1.0 Title: Resistance to sexual assault: who resists and what happens? Journal: American Journal of Public Health Author-Name: Siegel, J.M. Author-Name: Sorenson, S.B. Author-Name: Golding, J.M. Author-Name: Burnam, M.A. Author-Name: Stein, J.A. Year: 1989 Volume: 79 Issue: 1 Pages: 27-31 Abstract: To determine who resists sexual assaults and what happens, data were examined from a probability sample of 3,132 adult community residents of Los Angeles, California. Seventy-five per cent of the respondents reporting an assault (n = 365) indicated that they had attempted to resist their most recent assault; talking was the most frequently used resistance strategy. The strongest predictor to emerge in the multivariate analyses of resistance was timing of assault: respondents assaulted only in childhood were less likely to resist than either respondents assaulted only in adulthood, or respondents assaulted in both phases. Univariate analyses indicated that resistance reduced the probability of sexual contact, however multivariate analysis suggested that assailant use of force was the most important determinant of assault outcome. Handle: RePEc:aph:ajpbhl:1989:79:1:27-31_8 Template-Type: ReDIF-Article 1.0 Title: The AIDS action committee SafetyNet(C) program: Small group parties for safer sex education Journal: American Journal of Public Health Author-Name: Wertz, D.C. Author-Name: Silvia, A.M. Author-Name: Dreyer, J. Author-Name: Epperly, J. Author-Name: Sandison, G. Author-Name: La Charite, C. Year: 1989 Volume: 79 Issue: 9 Pages: 1305-1306 Handle: RePEc:aph:ajpbhl:1989:79:9:1305-1306_7 Template-Type: ReDIF-Article 1.0 Title: Sample size and power based on the population attributable fraction Journal: American Journal of Public Health Author-Name: Browner, W.S. Author-Name: Newman, T.B. Year: 1989 Volume: 79 Issue: 9 Pages: 1289-1294 Abstract: Most methods for calculating sample size use the relative risk (RR) to indicate the strength of the association between exposure and disease. For measuring the public health importance of a possible association, the population attributable fraction (PAF) - the proportion of disease incidence in a population that is attributable to an exposure - is more appropriate. We determined sample size and power for detecting a specified PAF in both cohort and case-control studies and compared the results with those obtained using conventional estimates based on the relative risk. When an exposure is rare, a study that has little power to detect a small RR often has adequate power to detect a small PAF. On the other hand, for common exposures, even a relatively large study may have inadequate power to detect a small PAF. These comparisons emphasize the importance of selecting the most pertinent measure of association, either relative risk or population attributable fraction, when calculating power and sample size. Handle: RePEc:aph:ajpbhl:1989:79:9:1289-1294_1 Template-Type: ReDIF-Article 1.0 Title: High prevalence of hepatitis B virus infection in rural black adults in Mseleni, South Africa Journal: American Journal of Public Health Author-Name: Karim, S.S.A. Author-Name: Thejpal, R. Author-Name: Singh, B. Year: 1989 Volume: 79 Issue: 7 Pages: 893-894 Abstract: A community-based study in northern Natal/Kwa-Zulu, South Africa, assessed the prevalence of hepatitis B virus (HBV) infection in rural Black adults. The prevalence of HBV carriers was 4.4 percent in women (N = 342) and 7.1 percent in men (N = 99). At least one marker of HBV infection was present in 81 percent of women and 86 percent of men. The relative risk (RR) of HBV marker positivity in women due to scarification, adjusted for the presence of pierced ears, was 1.37 (95% CI = 0.9, 2.1). Risk factors such as scarification and pierced earlobes need to be further investigated to assess their role in the transmission of the HBV. Handle: RePEc:aph:ajpbhl:1989:79:7:893-894_4 Template-Type: ReDIF-Article 1.0 Title: Demographic change in a corporate health benefits population, 1983-87 Journal: American Journal of Public Health Author-Name: Kintner, H.J. Year: 1989 Volume: 79 Issue: 12 Pages: 1655-1656 Abstract: This paper describes changes in the population for which General Motors provide health benefits using data from domestic personnel records. Total population size grew from 2.01 million in 1983 to 2.14 million in 9187, twice as fast as the US population. Dependents, particularly spouses, fueled the population growth. Trends suggest that nonworker eligibility for employer-provided health benefits may receive more attention in health care cost containment efforts. Handle: RePEc:aph:ajpbhl:1989:79:12:1655-1656_2 Template-Type: ReDIF-Article 1.0 Title: Sensitivity and specificity of clinical case definitions for pertussis. Journal: American Journal of Public Health Author-Name: Sullivan, K.M. Year: 1989 Volume: 79 Issue: 1 Pages: 102 Handle: RePEc:aph:ajpbhl:1989:79:1:102_0 Template-Type: ReDIF-Article 1.0 Title: The external costs of a sedentary life-style Journal: American Journal of Public Health Author-Name: Keeler, E.B. Author-Name: Manning, W.G. Author-Name: Newhouse, J.P. Author-Name: Sloss, E.M. Author-Name: Wasserman, J. Year: 1989 Volume: 79 Issue: 8 Pages: 975-981 Abstract: Using data from the National Health Interview Survey and the RAND Health Insurance Experiment, we estimated the external costs (costs borne by others) of a sedentary life-style. External costs stem from additional payments received by sedentary individuals from collectively financed programs such as health insurance, sick-leave coverage, disability insurance, and group life insurance. Those with sedentary life-styles incur higher medical costs, but their life expectancy at age 20 is 10 months less so they collect less public and private pensions. The pension costs come late in life, as do some of the medical costs, and so the estimate of the external cost is sensitive to the discount rate used. At a 5 percent rate of discount, the lifetime subsidy from others to those with a sedentary life style is $1,900. Our estimate of the subsidy is also sensitive to the assumed effect of exercise on mortality. The subsidy is a rationale for public support of recreational facilities such as parks and swimming pools and employer support of programs to increase exercise. Handle: RePEc:aph:ajpbhl:1989:79:8:975-981_6 Template-Type: ReDIF-Article 1.0 Title: Cross-cultural differences in psychiatric disorder Journal: American Journal of Public Health Author-Name: Robins, L.N. Year: 1989 Volume: 79 Issue: 11 Pages: 1479-1480 Handle: RePEc:aph:ajpbhl:1989:79:11:1479-1480_4 Template-Type: ReDIF-Article 1.0 Title: Risk of fatal rollover in utility vehicles relative to static stability Journal: American Journal of Public Health Author-Name: Robertson, L.S. Year: 1989 Volume: 79 Issue: 3 Pages: 300-303 Abstract: The risk of fatal rollover of utility vehicles per 100,000 registered vehicles relative to cars during 1982-87 was strongly correlated to the static stability of the vehicles. Distance between the center of the tires divided by twice the height of center of gravity explained 62 per cent of the variation in fatal rollover rates where rollover was the first harmful event. Statistical controls for 20 major risk factors indicated no correlations that would defiate the correlation between stability and rollover. Low stability utility vehicles roll over more often on the road suggesting that the lateral force of turning is often the tipping force. Handle: RePEc:aph:ajpbhl:1989:79:3:300-303_4 Template-Type: ReDIF-Article 1.0 Title: The mortality consequences of raising the speed limit to 65 mph on rural interstates Journal: American Journal of Public Health Author-Name: Baum, H.M. Author-Name: Lund, A.K. Author-Name: Wells, J.K. Year: 1989 Volume: 79 Issue: 10 Pages: 1392-1395 Abstract: As of April 1987, states were permitted to raise the speed limit on rural interstates to 65 mph without incurring federal sanctions; 38 states elected to do so in 1987. Fatality data for the months when the new limit was in effect in 1987 were compared with fatalities in the same months of 1982-86 on rural interstates and other rural roads. Fatalities on rural interstates in the states with increased speed limits in 1987 were conservatively estimated to be 15 percent higher than they would have been if the states had retained the 55 mph limit (95% CI = 6, 24). Among states that retained the 55 mph limit, fatalities on rural interstates were 6 percent lower than expected (95% CI = -23, 13). Handle: RePEc:aph:ajpbhl:1989:79:10:1392-1395_2 Template-Type: ReDIF-Article 1.0 Title: IV. Sentinel Event Notification System for Occupational Risks (SENSOR): The concept Journal: American Journal of Public Health Author-Name: Baker, E.L. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 18-20 Abstract: Although many states have laws that require health providers to report cases of occupational illness and injury, most states do not maintain a comprehensive system that actively identifies and targets potential sources of case reports and then responds to such reports. NIOSH has developed a Sentinel Event Notification System for Occupational Risks (SENSOR) that uses targeted sources of sentinel providers to recognize and report selected occupational disorders to a state surveillance center. SENSOR is a cooperative state-federal effort designed to develop local capability for preventing selected occupational disorders. To demonstrate the feasibility of this approach, NIOSH initially funded seven SENSOR projects in 1987 and three additional projects in early 1988. Currently, these projects are in the preliminary stages of organization and start-up, with some having begun to receive case reports. As funds become available, NIOSH intends to gradually expand the scope of the program to include additional states of the next several years. Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:18-20_7 Template-Type: ReDIF-Article 1.0 Title: Accidental ingestions of oral prescription drugs: A multicenter survey Journal: American Journal of Public Health Author-Name: Jacobson, B.J. Author-Name: Rock, A.R. Author-Name: Cohn, M.S. Author-Name: Litovitz, T. Year: 1989 Volume: 79 Issue: 7 Pages: 853-856 Abstract: Accidental ingestion of oral prescription drugs by children under age five continues to be a public health problem. A telephone survey of 1,866 ingestion incidents reported to nine poison control centers was conducted in the spring of 1986. Accidental ingestion occurred most often with a two-year-old child (42 per cent) in their own home (82 per cent). Thirty-five per cent of the toxic drugs ingested at home belonged to someone other than the immediate family, most often a grandparent. Toxic drugs were more often out of their usual storage location and in non-child-resistant prescription packaging, a nonprescription container, or in no container. Twenty-two per cent of all child-resistant packages were non-functional. Overall, at least 61 per cent of all medications had no child-resistant barrier at the time of ingestion. Accessible storage locations such as the kitchen counter, table top, or top of a dresser or bedside table greatly increased the risk of accidental ingestion. These results suggest the need for effective child-resistant packaging that is easier for all adults to use. Handle: RePEc:aph:ajpbhl:1989:79:7:853-856_8 Template-Type: ReDIF-Article 1.0 Title: Cigarette and smokeless tobacco use among Connecticut adolescents Journal: American Journal of Public Health Author-Name: Kegeles, S.S. Author-Name: Burleson, J.A. Author-Name: Miozza, J. Year: 1989 Volume: 79 Issue: 10 Pages: 1413-1414 Abstract: Despite data that the rate of boys' cigarette use has declined nationwide, boys' total tobacco use may actually have remained high because of their substantial use of smokeless tobacco. We surveyed anonymously a random sample of entire classes of grade 7-12 boys and girls from 59 Connecticut towns concerning tobacco use. Despite girls' higher daily cigarette use, boys' total daily tobacco use was higher than that of girls in grades 7-9, and only slightly lower in grades 10-12. Handle: RePEc:aph:ajpbhl:1989:79:10:1413-1414_9 Template-Type: ReDIF-Article 1.0 Title: Reducing knee morbidity among carpetlayers Journal: American Journal of Public Health Author-Name: Tanaka, S. Author-Name: Lee, S.T. Author-Name: Halperin, W.E. Author-Name: Thun, M. Author-Name: Smith, A.B. Year: 1989 Volume: 79 Issue: 3 Pages: 334-335 Abstract: Carpetlayers have a high prevalence of occupational knee morbidity, partly attributable to their use of the knee kicker to stretch carpet for wall-to-wall installation. While a mechanical alternative 'power stretcher' is available, knee kickers are still widely used. A questionnaire survey indicated that unavailability of the mechanical stretcher at installation sites was a major factor for continued use of the knee kicker. Strategies to reduce use of the knee kicker are discussed. Handle: RePEc:aph:ajpbhl:1989:79:3:334-335_4 Template-Type: ReDIF-Article 1.0 Title: The return of circumferences in health appraisal Journal: American Journal of Public Health Author-Name: Garn, S.M. Year: 1989 Volume: 79 Issue: 6 Pages: 688 Handle: RePEc:aph:ajpbhl:1989:79:6:688_7 Template-Type: ReDIF-Article 1.0 Title: The homeless and the changing British National Health Service Journal: American Journal of Public Health Author-Name: Reid, J. Year: 1989 Volume: 79 Issue: 8 Pages: 965-966 Handle: RePEc:aph:ajpbhl:1989:79:8:965-966_6 Template-Type: ReDIF-Article 1.0 Title: Health care in the United States: A course for refugee health workers Journal: American Journal of Public Health Author-Name: Meyers, A.R. Author-Name: Lett, S. Author-Name: Grigg-Saito, D. Author-Name: Sabati, C. Year: 1989 Volume: 79 Issue: 8 Pages: 1051-1052 Handle: RePEc:aph:ajpbhl:1989:79:8:1051-1052_6 Template-Type: ReDIF-Article 1.0 Title: Immunity to diphtheria and tetanus in inner-city women of childbearing age Journal: American Journal of Public Health Author-Name: Koblin, B.A. Author-Name: Townsend, T.R. Year: 1989 Volume: 79 Issue: 9 Pages: 1297-1298 Abstract: This study was conducted to determine immunity to diphtheria and tetanus in 232 inner-city women experiencing a recent birth. Forty-three (18.5 percent) of the women had levels of diphtheria antitoxin below the protective level (< 0.01 unit/ml), whereas only 10 (4.3 percent) had insuficient levels of tetanus antitoxin. The percent of women susceptible increased with age, with 33 percent and 25 percent of women over the age of 30 years susceptible to diphtheria and tetanus, respectively. Handle: RePEc:aph:ajpbhl:1989:79:9:1297-1298_6 Template-Type: ReDIF-Article 1.0 Title: IX. Occupational disease surveillance with existing data sources Journal: American Journal of Public Health Author-Name: Melius, J.M. Author-Name: Sestito, J.P. Author-Name: Seligman, P.J. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 46-52 Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:46-52_1 Template-Type: ReDIF-Article 1.0 Title: Psychoactive drug use in a general population sample, Sweden: Correlates with perceived health, psychiatric diagnoses, and mortality in an automated record-linkage study Journal: American Journal of Public Health Author-Name: Allgulander, C. Year: 1989 Volume: 79 Issue: 8 Pages: 1006-1010 Abstract: Three person-based computer files were linked to provide a data-set of a random sample of 32,679 Swedes, drawn for interviews regarding perceived health, socioeconomic conditions, and psychoactive drug use. All diagnoses from inpatient psychiatric care in the sample during a 15-year period and the causes of death after the sampling point were combined with the interview responses. Among those admitted for inpatient psychiatric care, substance abuse was an infrequent diagnosis; the majority of schizophrenics and of those with an affective disorder appeared not to medicate regularly; survey non-responders had higher rates of mental disorders than responders. Drug use correlated with both subjective and objective measures of mental ill health. The rate of prescription drug abuse was low. Automated record-linkage is a feasible method to generate hypotheses about mental health in the general population. Handle: RePEc:aph:ajpbhl:1989:79:8:1006-1010_5 Template-Type: ReDIF-Article 1.0 Title: Olfactory function in chemical workers exposed to acrylate and methacrylate vapors Journal: American Journal of Public Health Author-Name: Schwartz, B.S. Author-Name: Doty, R.L. Author-Name: Monroe, C. Author-Name: Frye, R. Author-Name: Barker, S. Year: 1989 Volume: 79 Issue: 5 Pages: 613-618 Abstract: An investigation of the olfactory function of 731 workers at a chemical facility which manufactures acrylates and methacrylates was undertaken using a standardized quantitative test. In a cross-sectional analysis of the data, no associations of chemical exposure with olfactory test scores were observed. A nested case-control study designed to evaluate the cumulative effects of exposure on olfactory function, however, revealed elevated crude exposure odds ratios (95% confidence interval) of 2.0 (1.1, 3.8) for all workers and 6.0 (1.7, 21.5) for workers who never smoked cigarettes. Logistic regression analysis, adjusting for multiple confounders, revealed exposure odds ratios of 2.8 (1.1, 7.0) and 13.5 (2.1, 87.6) in these same groups, respectively, and a dose-response relationship between olfactory dysfunction and cumulative exposure scores - semi-quantitative indices of lifetime exposure to the acrylates. The data also revealed decreasing exposure odds ratios with increasing duration since last exposure to these chemicals, suggesting that the effects may be reversible. Handle: RePEc:aph:ajpbhl:1989:79:5:613-618_5 Template-Type: ReDIF-Article 1.0 Title: Respiratory disease associated with community air pollution and a steel mill, Utah Valley Journal: American Journal of Public Health Author-Name: Arden Pope III, C. Year: 1989 Volume: 79 Issue: 5 Pages: 623-628 Abstract: This study assessed the association between hospital admissions and fine particulate pollution (PM10) in Utah Valley during the period April 1985-February 1988. This time period included the closure and reopening of the local steel mill, the primary source of PM10. An association between elevated PM10 levels and hospital admissions for pneumonia, pleurisy, bronchitis, and asthma was observed. During months when 24-hour PM10 levels exceeded 150 μg/m3, average admissions for children nearly tripled; in adults, the increase in admissions was 44 per cent. During months with mean PM10 levels greater than or equal to 50 μg/m3 average admissions for children and adults increased by 89 and 47 per cent, respectively. During the winter months when the steel mill was open, PM10 levels were nearly double the levels experienced during the winter months when the mill was closed. This occurred even though relatively stagnant air was experienced during the winter the mill was closed. Children's admissions were two to three times higher during the winters when the mill was open compared to when it was closed. Regression analysis also revealed that PM10 levels were strongly correlated with hospital admissions. They were more strongly correlated with children's admissions than with adult admissions and were more strongly correlated with admissions for bronchitis and asthma than with admissions for pneumonia and pleurisy. Handle: RePEc:aph:ajpbhl:1989:79:5:623-628_7 Template-Type: ReDIF-Article 1.0 Title: XII. Challenges for the future Journal: American Journal of Public Health Author-Name: Baker, E.L. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 61-63 Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:61-63_9 Template-Type: ReDIF-Article 1.0 Title: Cocaine and heroin dependence compared: Evidence from an epidemiologic field surgery Journal: American Journal of Public Health Author-Name: Anthony, J.C. Author-Name: Petronis, K.R. Year: 1989 Volume: 79 Issue: 10 Pages: 1409-1410 Abstract: Analyzing self-report interview data from a multi-site collaborative study of mental disorders in the community, we examined suspected differences between 611 cocaine users and 126 heroin users in relation to indicators of drug dependence. Cocaine users were less likely to report dependence-related problesm as compared to heroin users. These epidemiologic sample data underscore concerns about the generalizability of published clinical sample data on self-reported cocaine dependence. Handle: RePEc:aph:ajpbhl:1989:79:10:1409-1410_9 Template-Type: ReDIF-Article 1.0 Title: The relationship of smoking and ectopic pregnancy Journal: American Journal of Public Health Author-Name: Handler, A. Author-Name: Davis, F. Author-Name: Ferre, C. Author-Name: Yeko, T. Year: 1989 Volume: 79 Issue: 9 Pages: 1239-1242 Abstract: A case-control study, using data abstracted between 1983 and 1987 from a large perinatal registry, was conducted to explore the relationship between smoking and ectopic pregnancy. Women with ectopic pregnancy (n = 634) seen at University of Illinois Perinatal Network Hospitals were compared to women who were delivered of a single live-born infant (n = 4287). Adjusted for age and race, women who reported smoking during pregnancy had a greater than twofold risk of ectopic pregnancy (Odds Ratio = 2.5, 95% confidence interval = 1.9, 3.2) compared to women who never smoked. The estimated relative risk rose from 1.4 (95% CI = 0.8, 2.5) for a woman smoking fewer than 10 cigarettes a day to 5.0 (95% CI = 2.9, 8.7) at one and a half or more packs of cigarettes per day (p-value for trend <0.001). Although further basic and epidemiologic research is necessary, the observed dose-response relation strengthens the argument that smoking may be a causal factor in the development of ectopic pregnancy. Handle: RePEc:aph:ajpbhl:1989:79:9:1239-1242_5 Template-Type: ReDIF-Article 1.0 Title: Editor's annual report - Manuscript requirements Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1989 Volume: 79 Issue: 4 Pages: 413-414 Handle: RePEc:aph:ajpbhl:1989:79:4:413-414_5 Template-Type: ReDIF-Article 1.0 Title: Elimination of cotinine from body fluids: Disposition in smokers and nonsmokers Journal: American Journal of Public Health Author-Name: Haley, N.J. Author-Name: Sepkovic, D.W. Author-Name: Hoffmann, D. Year: 1989 Volume: 79 Issue: 8 Pages: 1046-1048 Abstract: We have evaluated differences in the elimination of cotinine, a major nicotine metabolite, in smokers who quit smoking and never-smokers who were exposed to environmental tobacco smoke (ETS) under controlled conditions. The mean biological half-life of cotinine in urine, collected from the nine smokers was 16.5 ± 1.2 h, in never-smokers exposed to ETS, 27.3 ± 1.9 h. Differences in the mode of uptake and absorption of nicotine and possible differences in nicotine metabolism may play roles in the clearance rate differences between smokers and nonsmokers. Handle: RePEc:aph:ajpbhl:1989:79:8:1046-1048_7 Template-Type: ReDIF-Article 1.0 Title: Determinants of recovery 12 months after hip fracture: The importance of psychosocial factors Journal: American Journal of Public Health Author-Name: Mossey, J.M. Author-Name: Mutran, E. Author-Name: Knott, K. Author-Name: Craik, R. Year: 1989 Volume: 79 Issue: 3 Pages: 279-286 Abstract: The independent contributions to recovery from hip fracture of psychosocial factors including depression, personality, social connectedness, and self-rated health were studied in 219 women age 59 and older (mean age 78.5) who were community dwelling prior to fracture. Initial assessments were conducted shortly after surgery and follow up assessments 2, 6, and 12 months later. By 12 months, 15 patients had died and 15 had entered a nursing home. Substantial declines in physical functionning though not psychosocial status were observed. Only 21 per cent (compared to 81 per cent prefracture) reported walking independently; fewer than 30 per cent had regained reported prefracture levels of physical function. The proportion with elevated depression scores at 12 months was 20 per cent, down from 51 per cent following surgery; 64 per cent rated their health excellent or good at 12 months, up from 43 per cent after surgery. Poor cognitive status and post-surgical self-rated health were predictive of mortality. Among survivors, age, prefracture physical functioning, and cognitive status were associated with recovery in physical function but not psychosocial status. High post-surgery depression scores, but not the other psychosocial factors, were associated with poorer recovery in both functional and psychosocial status. These findings demonstrate the importance of depressive symptoms as one determinant of recovery from hip fracture and support the need to attend to the affective status of hip fracture patients following surgery. Handle: RePEc:aph:ajpbhl:1989:79:3:279-286_1 Template-Type: ReDIF-Article 1.0 Title: A survival analysis of hospitalization among patients with acquired immunodeficiency syndrome Journal: American Journal of Public Health Author-Name: Quesenberry Jr., C.P. Author-Name: Fireman, B. Author-Name: Hiatt, R.A. Author-Name: Selby, J.V. Year: 1989 Volume: 79 Issue: 12 Pages: 1643-1647 Abstract: Survival analysis techniques were used in estimating lifetime inpatient utilization among patients diagnosed with acquired immunodeficiency syndrome (AIDS) using data on 863 members of the Kaiser Permanente Medical Care Program in the Northern California Region diagnosed with AIDS between January 1, 1981 and June 30, 1987. Using information on both decreased and living patients, we estimated means of 40.3 lifetime inpatient days and 3.3 hospitalizations among all AIDS patients. Those presenting with Kaposi's sarcoma experienced a men of 7.6 fewer lifetime inpatient days than those presenting with Pneumocystis carinii pneumonia (95% confidence interval = .61, 14.6) and a mean of 11.0 (3.9, 18.6) fewer inpatient days than all other AIDS patients. Older patients had fewer hospital admissions than younger ones. Year of diagnosis does not appear to be related to lifetime utilization, and there is an indication that increased survival has been accompanied by decreased inpatient utilization intensity as measured on a per person-year basis. We recommend the use of survival analysis methods in the study of utilization among groups of patients with incomplete follow-up. Handle: RePEc:aph:ajpbhl:1989:79:12:1643-1647_3 Template-Type: ReDIF-Article 1.0 Title: The reliability of health risk appraisals: A field trial of four instruments Journal: American Journal of Public Health Author-Name: Smith, K.W. Author-Name: McKinlay, S.M. Author-Name: McKinlay, J.B. Year: 1989 Volume: 79 Issue: 12 Pages: 1603-1607 Abstract: A field trial was conducted to evaluate the reliability of four widely used health risk appraisals (HRAs). A total of 338 randomly selected adults aged 25 to 65 years residing in the Boston metropolitan area completed an HRA on two occasions seven to 12 weeks apart. Test-retest reliability was assessed by comparing self-reported baseline risk scores to follow-up scores for heart attack risk and selected coronary heart disease risk factor. Respondents generally gave consistent reports for family history, cigarette smoking, and relative weight (test-retest r > .75), but self-reported scores for physiologic status (blood pressure and cholesterol) and lifestile (diet, physical activity, and stress) were much less stable. Coefficients for heart attack risk and appraised age ranged from .43 to .87 for the four HRAs. The reliabilities of two self-scored instruments were greatly reduced by mathematical errors made by respondents when computing their heart attack risk scores. These results were not affected by the length of the follow up period (seven to 12 weeks). Handle: RePEc:aph:ajpbhl:1989:79:12:1603-1607_3 Template-Type: ReDIF-Article 1.0 Title: Multiple program participation: Comparison of nutrition and food assistance program benefits with food costs in Boston, Massachusetts Journal: American Journal of Public Health Author-Name: Wiecha, J.L. Author-Name: Palombo, R. Year: 1989 Volume: 79 Issue: 5 Pages: 591-594 Abstract: The values of government cash and food assistance benefits are compared to estimated food costs in Boston for households whose sole source of income is Aid to Families with Dependent Children (AFDC) and who have housing in the private sector. Methods developed by the General Accounting Office (GAO) in 1978 are replicated. GAO found that the value of combined benefits can exceed the cost of the United States Department of Agriculture's Thrifty Food Plan. Key assumptions underlying GAO's methodology are challenged, and an alternate method is applied. The new results contradict GAO's conclusions and suggest that Boston food costs exceed the combined value of benefits that AFDC households may receive, although participation in multiple food assistance programs is more beneficial than receipt of benefits from single programs. The authors conclude that food stamps and AFDC benefits indexed to actual costs of living are needed to meet the food needs of low-income families in Boston. Handle: RePEc:aph:ajpbhl:1989:79:5:591-594_9 Template-Type: ReDIF-Article 1.0 Title: Health promotion in work settings Journal: American Journal of Public Health Author-Name: Feldman, R.H.L. Year: 1989 Volume: 79 Issue: 11 Pages: 1570 Handle: RePEc:aph:ajpbhl:1989:79:11:1570_6 Template-Type: ReDIF-Article 1.0 Title: Late-stage diagnosis of breast cancer in women of lower socioeconomic status: Public health implications Journal: American Journal of Public Health Author-Name: Farley, T.A. Author-Name: Flannery, J.T. Year: 1989 Volume: 79 Issue: 11 Pages: 1508-1512 Abstract: To assess the success of breast cancer control activities in Connecticut, we examined data from the Connecticut Tumor Registry, determining differences in breast cancer stage at time of diagnosis over time and in selected subgroups. From 1982 to 1985, the percentage of women with cancer confined to the breast increased from 54.0 percent to 61.3 percent. During 1984 and 1985, lower socioeconomic status (SES) women with breast cancer were less likely than higher SES women to be diagnosed with early-stage disease (56.9 percent vs 62.7 percent). SES was estimated by census tract of residence. In the same years, the overall incidence of breast cancer was greater in higher SES women. Projections based on these incidence data found that lower SES women, as compared to higher SES women, had a higher rate of expected breast cancer deaths (24.6 vs 19.7 per 100,000) and a greater percentage of those deaths considered preventable by early detection (22 percent vs 11 percent). The rate of preventable deaths in lower SES women was 2.5 times as great as that for higher SES women (5.3 vs 2.1 per 100,000). Tumor registries can serve as useful surveillance systems to aid cancer control programs. Breast cancer early-detection programs should give special attention to lower SES women. Handle: RePEc:aph:ajpbhl:1989:79:11:1508-1512_0 Template-Type: ReDIF-Article 1.0 Title: VI. Hazard surveillance in occupational disease Journal: American Journal of Public Health Author-Name: Froines, J. Author-Name: Wegman, D. Author-Name: Eisen, E. Year: 1989 Volume: 79 Issue: SUPPL. Pages: 26-31 Abstract: We have reviewed existing data sources available for conducting hazard surveillance. Both the NIOSH NOHS/NOES and the OSHA IMIS can have significant value for hazard surveillance that is designed both to establish priorities for various preventive strategies - including intervention, research, and planning - and to complement disease surveillance. These systems also have certain limitations that affect their overall value in these regards. We have proposed alternative hazard surveillance systems that would expand the database on actual exposures in the workplace by requiring that industry systematically conduct environmental monitoring for defined substances and then provide the data to OSHA and NIOSH for use in hazard surveillance. Handle: RePEc:aph:ajpbhl:1989:79:SUPPL.:26-31_5 Template-Type: ReDIF-Article 1.0 Title: Pregnancy characteristics and outcomes of Cambodian refugees Journal: American Journal of Public Health Author-Name: Gann, P. Author-Name: Nghiem, L. Author-Name: Warner, S. Year: 1989 Volume: 79 Issue: 9 Pages: 1251-1257 Abstract: This study describes the perinatal characteristics of Cambodian refugees in Massachusetts. Data were abstracted from the records of 452 consecutive pregnancies among Cambodian women and 110 low-income Whites receiving obstetrical services at the same clinic and hospital in Lowell, Massachusetts. Pregnancies of Cambodian women were marked by a higher proportion of older mothers, grand multipares, previous adverse birth outcomes, and short interpregnancy intervals. We identified maternal anemia (29.9 percent with hemoglobin < 110 g/L) and inadequate utilization of prenatal care (32.3 percent with first visit in the 3rd trimester) as possible risk factors for the Cambodians. The prevalence of primary cesarean birth was only 6.3 percent in the Cambodians, compared to 15.6 percent in the comparison group, largely due to the infrequent occurrence of prolonged labor among multiparas. Despite the prominence of several risk factors for adverse birth outcomes in this population, major pregnancy complications were less common and the prevalence of low birthweight (6.4 percent) was close to the state average. Logistic regression analysis of risk factors for low birthweight identified young maternal age and short stature as the strongest factors operative in this community. Many of our findings are consistent with a strong cultural emphasis on managing the size of the baby to avoid a difficult labor and delivery. Handle: RePEc:aph:ajpbhl:1989:79:9:1251-1257_0 Template-Type: ReDIF-Article 1.0 Title: Improving patient comprehension of literature on smoking Journal: American Journal of Public Health Author-Name: Meade, C.D. Author-Name: Byrd, J.C. Author-Name: Lee, M. Year: 1989 Volume: 79 Issue: 10 Pages: 1411-1412 Abstract: This study was designed to determine if simplification of smoking literature improved patient comprehension. Subjects (N = 129) were randomized in three groups: to receive no smoking booklet, receive one written at the 5th grade, or the 10th grade reading level. Subjects receiving the 5th grade booklet showed 13 percent better comprehension than those receiving the 10th grade booklet, and 18 percent better than the controls. Comprehension of written smoking materials can be improved by adjustment of the reading grade level. Handle: RePEc:aph:ajpbhl:1989:79:10:1411-1412_0 Template-Type: ReDIF-Article 1.0 Title: Laws regulating tattooing Journal: American Journal of Public Health Author-Name: Stauter, R.L. Year: 1989 Volume: 79 Issue: 9 Pages: 1308-1309 Handle: RePEc:aph:ajpbhl:1989:79:9:1308-1309_8 Template-Type: ReDIF-Article 1.0 Title: Health practices of the elderly poor Journal: American Journal of Public Health Author-Name: Lubben, J.E. Author-Name: Weiler, P.G. Author-Name: Chi, I. Year: 1989 Volume: 79 Issue: 6 Pages: 731-734 Abstract: The purpose of the present study was to describe the health practices of the elderly poor and to examine the association between specific health practices and subsequent hospital use. Data came from a sample of 931 Medicaid elderly living in California. Smoking, limited social networks, and lack of regular exercise significantly increased the odds of subsequent hospital utilization. Implications of these findings, which could benefit health promotion intervention and treatment programs for the elderly, were discussed. Handle: RePEc:aph:ajpbhl:1989:79:6:731-734_5 Template-Type: ReDIF-Article 1.0 Title: Characteristics of self-selected responders to a health risk appraisal: Generalizability of corporate health assessments Journal: American Journal of Public Health Author-Name: Lynch, W.D. Author-Name: Golaszewski, T.J. Author-Name: Clearie, A. Author-Name: Vickery, D.M. Year: 1989 Volume: 79 Issue: 7 Pages: 887-888 Abstract: Selected characteristics and total medical claims of health risk appraisal (HRA) responders and non-responders were compared in a sample of employees having a three-year employment and claims history. HRA responders were younger and more likely to file medical claims that non-responders. Although mean medical claims were greater for HRA responderds than non-responders, when adjusted for age and sex this difference reflected the proportion of employees reporting claims, not a difference in the claims amount. Handle: RePEc:aph:ajpbhl:1989:79:7:887-888_5 Template-Type: ReDIF-Article 1.0 Title: Parental smoking and post-infancy wheezing in children: A prospective cohort study Journal: American Journal of Public Health Author-Name: Neuspiel, D.R. Author-Name: Rush, D. Author-Name: Butler, N.R. Author-Name: Golding, J. Author-Name: Bijur, P.E. Author-Name: Kurzon, M. Year: 1989 Volume: 79 Issue: 2 Pages: 168-171 Abstract: The contribution of parental smoking to wheezing in children was studied in a subset of all British births between April 5 and 11, 1970 (N = 9,670). Children of smoking mothers had an 18.0 per cent cumulative incidence of post-infancy wheezing through 10 years of age, compared with 16.2 per cent among children of nonsmoking mothers (risk ratio 1.11, 95% CI: 1.02, 1.21). This difference was confined to wheezing attributed to wheezy bronchitis, of which children of smokers had 7.4 percent, and those of nonsmokers had 5.2 percent (risk ratio 1.44, 95% CI: 1.24, 1.68). The incidence of wheezy bronchitis increased as mothers smoked more cigarettes. After multiple logistic regression analysis was used to control for paternal smoking, social status, sex, family allergy, crowding, breast-feeding, gas cooking and heating, and bedroom dampness, the association of maternal smoking with childhood wheezy bronchitis persisted. Some of this effect was explained by maternal respiratory symptoms and maternal depression, but not by neonatal problems, the child's allergic symptoms, or paternal respiratory symptoms. There was a 14 per cent increase in childhood wheezy bronchitis when mothers smoked over four cigarettes per day, and a 49 per cent increase when mothers smoked over 14 cigarettes daily. Handle: RePEc:aph:ajpbhl:1989:79:2:168-171_5 Template-Type: ReDIF-Article 1.0 Title: Kids and Medicaid: Progress but continuing problems Journal: American Journal of Public Health Author-Name: Waxman, H.A. Year: 1989 Volume: 79 Issue: 9 Pages: 1217-1218 Handle: RePEc:aph:ajpbhl:1989:79:9:1217-1218_7 Template-Type: ReDIF-Article 1.0 Title: Preventing AIDS and other STDs through condom promotion: A patient education intervention Journal: American Journal of Public Health Author-Name: Solomon, M.Z. Author-Name: DeJong, W. Year: 1989 Volume: 79 Issue: 4 Pages: 453-458 Abstract: We report on two studies that assessed the impact of a soap-opera style videotape on inner-city STD (sexually transmitted disease) patients' knowledge about and attitudes toward condom use, and willingness to redeem coupons for free condoms. Subjects in the first study who viewed the videotape (and participated in a brief oral recall session) had higher knowledge scores and more accepting attitudes than subjects who did not (knowledge test means of 11.1 versus 7.9, attitude index means of 13.0 versus 11.3). The intervention was most effective among those who were relatively poorly educated and, to a lesser extent, among those who reported less frequent use of condoms and fewer sex partners. In the second study, intervention group subjects were more likely than control group subjects to redeem coupons. Both groups exhibited a high level of interest in the free condoms. We argue that education and accessibility to free condoms can increase condom use and that health care providers have a vital role in promoting this form of STD prevention. Handle: RePEc:aph:ajpbhl:1989:79:4:453-458_3 Template-Type: ReDIF-Article 1.0 Title: Black/White differences in non-treatment of bladder cancer patients and implications for survival Journal: American Journal of Public Health Author-Name: Mayer, W.J. Author-Name: McWhorter, W.P. Year: 1989 Volume: 79 Issue: 6 Pages: 772-775 Abstract: Analysis of 20,764 White and 882 Black bladder cancer patients diagnosed during 1978-85 indicates that Black patients were more likely than White patients to go untreated following diagnosis after adjustment for age- and stage-at-diagnosis, sex, and tumor histology (OR = 1.80, 95% CI = 1.33, 2.43). Treatment status was found to be a significant predictor of five-year survival after adjustment (treated/untreated odds ratio = 3.16, 95% CI = 2.08, 4.79). Results suggest that differences in initial therapy may contribute to the survival differential between Black and White bladder cancer patients. Handle: RePEc:aph:ajpbhl:1989:79:6:772-775_3 Template-Type: ReDIF-Article 1.0 Title: Deaths, injuries, and evacuations from acute hazardous materials releases Journal: American Journal of Public Health Author-Name: Binder, S. Year: 1989 Volume: 79 Issue: 8 Pages: 1042-1044 Abstract: We examined reports from three surveillance systems of 587 acute releases of hazardous materials in 1986. These releases resulted in at least 115 deaths, 2,254 injuries, and 111 evacuations. Only eight (1 percent) of the 587 events were common to all three systems. Estimates of the public health consequences of hazardous materials releases coud be improved by enforcing existing laws, modifying report forms, and validating collected information. Handle: RePEc:aph:ajpbhl:1989:79:8:1042-1044_9 Template-Type: ReDIF-Article 1.0 Title: A comparison of acquired immunodeficiency syndrome and Kaposi's sarcoma incidence rates, Atlanta, 1983-86 Journal: American Journal of Public Health Author-Name: Chow, W.-H. Author-Name: Liff, J.M. Author-Name: Greenberg, R.S. Author-Name: Williams, B.O. Year: 1989 Volume: 79 Issue: 4 Pages: 503-505 Abstract: Recent temporal trends in incidence rates for acquired immunodeficiency syndrome (AIDS) and Kaposi's sarcoma were compared in metropolitan Atlanta, Georgia. From 1983 through 1986 the age-adjusted incidence rate of Kaposi's sarcoma among White males ages 25-49 increased 11-fold (2.2-24.4/100,000 person years). The annual incidence rate of AIDS increased ten-fold (11.3-113.3/100,000). These findings do not support earlier reports that the proportion of AIDS patients with Kaposi's sarcoma has decreased over time. Handle: RePEc:aph:ajpbhl:1989:79:4:503-505_5 Template-Type: ReDIF-Article 1.0 Title: The news on smoking: Newspaper coverage of smoking and health in Australia, 1987-88 Journal: American Journal of Public Health Author-Name: Chapman, S. Year: 1989 Volume: 79 Issue: 10 Pages: 1419-1421 Abstract: All newspaper articles (n = 1601) mentioning tobacco or smoking drawn from a 12-month census of 30 Australian capital city newspapers in 1987-88 were coded for content, 'slant', and apparent origin. Overall, 62 percent of articles were positive in their orientation toward smoking control objectives, 17 percent were negative, and 21 percent were neutral. Newspapers owned by Rupert Murdoch published 55.7 percent positive and 23.7 percent negative articles compared to 68.0 percent positive and 13.7 percent negative articles in the other large chain of Australian newspapers. Handle: RePEc:aph:ajpbhl:1989:79:10:1419-1421_9 Template-Type: ReDIF-Article 1.0 Title: Driver age and crash involvement Journal: American Journal of Public Health Author-Name: Williams, A.F. Author-Name: Carsten, O. Year: 1989 Volume: 79 Issue: 3 Pages: 326-327 Abstract: The youngest and oldest drivers have the highest crash risk, but the problem lies predominantly in the youngest age groups because elderly drivers have low exposure. The elderly driver problem will increase gradually as their share of the population increases but will remain relatively small. The bulk of the problem will continue to reside among drivers younger than age 65, particularly the youngest drivers. Handle: RePEc:aph:ajpbhl:1989:79:3:326-327_4 Template-Type: ReDIF-Article 1.0 Title: A case-control study of pancreatic cancer and cigarettes, alcohol, coffee and diet Journal: American Journal of Public Health Author-Name: Olsen, G.W. Author-Name: Mandel, J.S. Author-Name: Gibson, R.W. Author-Name: Wattenberg, L.W. Author-Name: Schuman, L.M. Year: 1989 Volume: 79 Issue: 8 Pages: 1016-1019 Abstract: A pancreatic cancer case-control study was conducted in the Minneapolis-St. Paul area. Family members were interviewed about the subject's usage of cigarettes, alcohol, coffee, and other dietary factors in the two years prior to death (cases, n=212) or prior to interview (controls, n=220). The adjusted odds ratio for two packs or more of cigarettes per day was 3.92 (95% CI=1.18, 13.01) and four or more drinks per day OR 2.69 (95% CI=1.00, 7.27). Coffee was not a risk factor (seven cups or more per day; OR 0.58 (95% CI=0.27, 1.27). A positive trend was observed for beef and pork consumption, and a negative trend from cruciferous vegetables. Handle: RePEc:aph:ajpbhl:1989:79:8:1016-1019_7 Template-Type: ReDIF-Article 1.0 Title: A ten-year experience in control of poliomyelitis through a combination of live and killed vaccines in two developing areas Journal: American Journal of Public Health Author-Name: Tulchinsky, T. Author-Name: Abed, Y. Author-Name: Shaheen, S. Author-Name: Toubassi, N. Author-Name: Sever, Y. Author-Name: Schoenbaum, M. Author-Name: Handsher, R. Year: 1989 Volume: 79 Issue: 12 Pages: 1648-1652 Abstract: We describe a successful program of poliomyelitis control using a combination of killed and live polio vaccines over a 10-year period in two developing areas, the West Bank and Gaza, adjacent to a relatively developed country, Israel. During the 1970s, immunization using live trivalent oral polio vaccine (OPV) in these areas covered more than 90 percent of the infant population. Nevertheless, the incidence of paralytic polio continued to be high, with many cases occurring in fully or partially immunized persons. It was thought that this could be due to interference with OPV take by other enteroviruses present in the environment due to poor sanitary conditions in these areas. A new policy combining five doses of OPV with two doses of inactivated polio vaccine (IPV) was adopted and implemented in 1978. In the 10 years since then, immunization coverage of infants increased to an estimated 95 percent and paralytic poliomyelitis had been controlled, despite exposure to wild poliovirus from neighboring countries including an outbreak in Israel in 1988. This experience suggests that wide coverage using the combination of IPV and OPV is an effective vaccination policy that may make eradication of polio possible even in developing areas. Handle: RePEc:aph:ajpbhl:1989:79:12:1648-1652_4 Template-Type: ReDIF-Article 1.0 Title: Sport fish consumption advisories and projected cancer risks in the Great Lakes basin Journal: American Journal of Public Health Author-Name: Foran, J.A. Author-Name: Cox, M. Author-Name: Croxton, D. Year: 1989 Volume: 79 Issue: 3 Pages: 322-325 Abstract: Because Great Lakes sport fish are contaminated with several toxicants, the Great Lakes states individually issue advisories, principally based on Food and Drug Administration (FDA) action levels, that suggest limiting or eliminating consumption of contaminated fish. We describe the procedures the states use to determine when to issue consumption advisories and we evaluate the associated cancer risks using EPA-IARC-OSTP risk assessment procedures. Projected cancer risks are high for consumers of small quantities of sport fish contaminated with DDT or dieldrin at their respective action levels. Projected risks at concentrations that are common but below the action levels are also substantial. We propose that sport fish with tissue concentrations of DDT or dieldrin one-fifth and one-third of the action levels should be covered by consumption advisories to warn consumers of the potential adverse health impacts. Handle: RePEc:aph:ajpbhl:1989:79:3:322-325_4 Template-Type: ReDIF-Article 1.0 Title: Public health and the new national effort: The 1988 presidential address Journal: American Journal of Public Health Author-Name: Walker Jr., B. Year: 1989 Volume: 79 Issue: 4 Pages: 419-423 Handle: RePEc:aph:ajpbhl:1989:79:4:419-423_0 Template-Type: ReDIF-Article 1.0 Title: Is early natural menopause a biologic marker of health and aging? Journal: American Journal of Public Health Author-Name: Snowdon, D.A. Author-Name: Kane, R.L. Author-Name: Beeson, W.L. Author-Name: Burke, G.L. Author-Name: Sprafka, J.M. Author-Name: Potter, J. Author-Name: Iso, H. Author-Name: Jacobs Jr., D.R. Author-Name: Phillips, R.L. Year: 1989 Volume: 79 Issue: 6 Pages: 709-714 Abstract: The relation between age at natural menopause and all-cause mortality was investigated in a sample of 5,287 White women, ages 55 to 100 years, naturally-postmenopausal, Seventh-day Adventists who had completed mailed questionnaires in 1976. The age-adjusted odds ratio of death during 1976-82 in women with natural menopause before age 40 was 1.95 (95% confidence interval = 1.24, 3.07), compared to the reference group of women reporting natural menopause at ages 50 to 54. Corresponding odds ratios of death were 1.39 (95% CI = 1.06, 1.81) for natural menopause at ages 40 to 44, and 1.03 (95% CI = 0.84, 1.25) for natural menopause at ages 45 to 49. Among 3, 166 White, 55- to 100-year-old, surgically-postmenopausal, Adventist women, there was no relation between age at surgical menopause and mortality. Logistic regression analyses indicated that findings from this study were apparently not due to confounding by smoking, over- or underweight, reproductive history, or replacement estrogen use. Handle: RePEc:aph:ajpbhl:1989:79:6:709-714_8 Template-Type: ReDIF-Article 1.0 Title: A methodology for targeting hospital cases for quality of care record reviews Journal: American Journal of Public Health Author-Name: Hannan, E.L. Author-Name: Bernard, H.R. Author-Name: O'Donnell, J.F. Author-Name: Kilburn Jr., H. Year: 1989 Volume: 79 Issue: 4 Pages: 430-436 Abstract: We tested the efficacy of selected case characteristics in targeting quality of care problems for medical record review. The case characteristics, all of which apply to patients who die in a hospital, consist primarily of procedures and DRGs (diagnosis-related groups) for which death rarely occurs, and a set of complications of surgical care. All characteristics are obtainable from combinations of the principal and secondary diagnoses and procedures in the case, and are available from discharge abstracts. The presence of a quality of care problem is confirmed through a review of the medical record by a nurse and two or more physicians. A logistic regression model that controls for various patient and hospital variables is used as a measure of each of the proposed case characteristics. The results indicate that most of the characteristics are associated with higher percentages of quality of care problems than cases chosen at random, and that the methodology has promise as a tool for targeting cases for medical record review. Handle: RePEc:aph:ajpbhl:1989:79:4:430-436_6 Template-Type: ReDIF-Article 1.0 Title: Breast cancer risk and participation in mammographic screening Journal: American Journal of Public Health Author-Name: Taplin, S. Author-Name: Anderman, C. Author-Name: Grothaus, L. Year: 1989 Volume: 79 Issue: 11 Pages: 1494-1498 Abstract: Within the context of an organized breast cancer screening program we conducted a prospective evaluation of the relation between breast cancer risk and participation in mammographic screening. The influence on participation of known breast cancer risk factors, as well as a summary risk label, (i.e. 'high', or 'moderate') were examined. The overall participation rate was 71 percent among 2,422 women, 50 to 79 years of age, invited to a centralized clinic. Multivariate analyses showed participation to be somewhat decreased among women with late menopause and definitely increased among women with any of the following factors: 1) increased age; 2) a family history of breast cancer; and 3) a previous breast biopsy. Women in the high-risk group were most likely to participate but the effect of the label was stronger among women ages 50 to 59 compared to women ages 60 to 79. The study results are generally consistent with previous findings that participants in screening programs have higher rates of breast cancer. The results also suggest the possibility that providing breast cancer risk information may encourage participation in screening. Handle: RePEc:aph:ajpbhl:1989:79:11:1494-1498_0 Template-Type: ReDIF-Article 1.0 Title: Mechanical restraints on the medical wards: Are protective devices safe? Journal: American Journal of Public Health Author-Name: Lofgren, R.P. Author-Name: MacPherson, D.S. Author-Name: Granieri, R. Author-Name: Myllenbeck, S. Author-Name: Sprafka, J.M. Year: 1989 Volume: 79 Issue: 6 Pages: 735-738 Abstract: We prospectively identified 102 mechanically restrained hospital patients and determined their hospital course. The cohort was elderly, cognitively impaired with multiple chronic diseases. The in-hospital mortality was 21 percent. Nosocomial infection developed in 12 percent and new pressure sores in 22 percent. Prolonged use of restraints (>4 days) was the strongest independent predictor of nosocomial infection (relative risk 1.8, 95% CI = 1.2, 2.8) and new pressure sores (RR 1.4, 95% CI = 1.1, 1.8) as determined by multiple logistic regression analysis. Patients placed in mechanical restraints for longer than four days experience frequent morbid events and should be monitored carefully. Handle: RePEc:aph:ajpbhl:1989:79:6:735-738_4 Template-Type: ReDIF-Article 1.0 Title: Sentinel health event surveillance: Skin cancer of the scrotum in New York State Journal: American Journal of Public Health Author-Name: Weinstein, A.L. Author-Name: Howe, H.L. Author-Name: Burnett, W.S. Year: 1989 Volume: 79 Issue: 11 Pages: 1513-1515 Abstract: Skin cancer of the scrotum is a disease that has been identified as a sentinel health event (occupational) (SHE(O)) that is necessarily occupationally related. The present paper examines the feasibility of using this disease in active cancer surveillance in New York State. After consulting cancer case reports, hospital records, death certificates, and city directories, we obtained occupational data for 17 of 22 cases of nonmelanoma skin cancer of the scrotum diagnosed between 1979 and 1984. Only three cases had occupations previously linked to scrotal cancer, while 11 of 19 cases had one or more possibly contributory medical conditions. The probable underreporting of scrotal cancer cases and incompleteness of occupational data may limit the usefulness of scrotal cancer as a sentinel health event (occupational) unless additional steps are taken. Handle: RePEc:aph:ajpbhl:1989:79:11:1513-1515_8 Template-Type: ReDIF-Article 1.0 Title: Containing mental health treatment costs through program design: A Massachusetts Study Journal: American Journal of Public Health Author-Name: Dickey, B. Author-Name: Binner, P.R. Author-Name: Leff, S. Author-Name: Uyeda, M.K. Author-Name: Schlesinger, M.J. Author-Name: Gudeman, J.E. Year: 1989 Volume: 79 Issue: 7 Pages: 863-867 Abstract: A single site pre-post study of seriously mentally ill patients treated in a public mental health system shows that annual treatment costs can be substantially reduced with the use of day hospital treatment. Two cohorts of psychiatric patients - 282 consecutive admissions to a traditional public inpatient unit in 1980, and 340 consecutive admissions to a combination of inpatient and day hospital care in 1984 - were followed 12 months after admission. The substitution of the day hospital is made possible because the facility provided a dormitory residence for those who could not go home at night. Cost savings per hospital episode are about 31 per cent when the additional costs of day hospital and residence are considered. Cost shifting from inpatient to residential sites is noted, but overall mean annual costs, when all other treatment (including additional admissions), residential and family costs were included, are reduced. Readmission rates did not rise. The generalizability of the findings is limited to public mental health centers and state hospitals. Handle: RePEc:aph:ajpbhl:1989:79:7:863-867_7 Template-Type: ReDIF-Article 1.0 Title: Necrotizing enterocolitis mortality in the United States, 1979-85 Journal: American Journal of Public Health Author-Name: Holman, R.C. Author-Name: Stehr-Green, J.K. Author-Name: Zelasky, M.T. Year: 1989 Volume: 79 Issue: 8 Pages: 987-989 Abstract: The Multiple Cause of Death Mortality data from the National Center for Health Statistics were analyzed to describe epidemiologic characteristics and trends in deaths related to necrotizing enterocolitis (NEC) among infants in the United States from 1979 to 1985. The average annual mortality rate (multiple cause mortality) for NEC was 13.1 deaths per 100,000 live births. NEC annual mortality rates decreased significantly during the study period for White and Black infants, male and female infants, and infants in the Northeast, North Central, and South regions. Black infants were approximately three times more likely to die from NEC than White infants, and the NEC infant mortality rate was highest in the South. Handle: RePEc:aph:ajpbhl:1989:79:8:987-989_0 Template-Type: ReDIF-Article 1.0 Title: Formaldehyde exposures from tobacco smoke: A review Journal: American Journal of Public Health Author-Name: Godish, T. Year: 1989 Volume: 79 Issue: 8 Pages: 1044-1045 Abstract: Reports of formaldehyde levels in mainstream, sidestream, and environmental tobacco smoke from nine studies are reviewed. Considerable disparity exists between formaldehyde production rates determined from mainstream-sidestream studies and those reporting levels in environmental tobacco smoke. Tobacco smoke does not appear to increase vapor-phase formaldehyde levels significantly in indoor environments, but formaldehyde exposure in mainstream smoke may pose a risk of upper respiratory system cancer and increase the risk of cancer in smokers. Handle: RePEc:aph:ajpbhl:1989:79:8:1044-1045_5 Template-Type: ReDIF-Article 1.0 Title: A birth cohort analysis of dental contact among elderly Americans Journal: American Journal of Public Health Author-Name: Wolinsky, F.D. Author-Name: Arnold, C.L. Year: 1989 Volume: 79 Issue: 1 Pages: 47-51 Abstract: We applied standard cohort and multiple regression techniques to data on the dental utilization rates of 129,191 elderly individuals taken from the 1972, 1973, 1976, 1977, 1980, and 1981 Health Interview Surveys. The results indicate that the marked variation in dental contact rates is a reflection of cohort succession, and not a function of aging per se. Older cohorts having lower dental contact rates are being replaced by younger cohorts having higher dental contact rates. The dental contact rates of the individual birth cohorts themselves are quite stable over time. The results also indicate that economic barriers (especially liquid assets) have become more important than ever before, especially for the oldest-old. These findings have important implications for public policy about the oral health and health care of elderly Americans. Handle: RePEc:aph:ajpbhl:1989:79:1:47-51_1 Template-Type: ReDIF-Article 1.0 Title: X-ray examinations during pregnancy: national natality surveys, 1963 and 1980 Journal: American Journal of Public Health Author-Name: Kaczmarek, R.G. Author-Name: Moore Jr., R.M. Author-Name: Keppel, K.G. Author-Name: Placek, P.J. Year: 1989 Volume: 79 Issue: 1 Pages: 75-77 Abstract: Based on 1963 and 1980 National Natality Surveys, the rate of medical x-ray examinations during pregnancy per 100 mothers fell 34.2 percent. A decrease in chest x-ray examinations accounted for almost all of the decline in total x-ray examinations. The reductions were greater for older mothers and those who were not White. While the number of births fell from 4,071,000 in 1963 to 3,612,000 in 1980, the number of pelvimetry examinations actually increased by 45,000. Handle: RePEc:aph:ajpbhl:1989:79:1:75-77_3 Template-Type: ReDIF-Article 1.0 Title: Teenage unwanted pregnancy. Journal: American Journal of Public Health Author-Name: Crum, G. Year: 1988 Volume: 78 Issue: 12 Pages: 1598-1599 Handle: RePEc:aph:ajpbhl:1988:78:12:1598-1599_1 Template-Type: ReDIF-Article 1.0 Title: Summer Olympics medical care. Journal: American Journal of Public Health Author-Name: Simone, B.M. Year: 1988 Volume: 78 Issue: 12 Pages: 1599 Handle: RePEc:aph:ajpbhl:1988:78:12:1599_9 Template-Type: ReDIF-Article 1.0 Title: The infamous Tuskegee Study. Journal: American Journal of Public Health Author-Name: Silver, G.A. Year: 1988 Volume: 78 Issue: 11 Pages: 1500 Handle: RePEc:aph:ajpbhl:1988:78:11:1500_0 Template-Type: ReDIF-Article 1.0 Title: Seroepidemiologic study of rubella in Taiwan's female population. Journal: American Journal of Public Health Author-Name: Yuan, C.F. Author-Name: Ng, H.T. Year: 1988 Volume: 78 Issue: 10 Pages: 1366-1367 Handle: RePEc:aph:ajpbhl:1988:78:10:1366-1367_2 Template-Type: ReDIF-Article 1.0 Title: Vehicle and highway hazards. Journal: American Journal of Public Health Author-Name: Bader, M. Year: 1988 Volume: 78 Issue: 10 Pages: 1367 Handle: RePEc:aph:ajpbhl:1988:78:10:1367_5 Template-Type: ReDIF-Article 1.0 Title: Estrogen use and gallstone disease. Journal: American Journal of Public Health Author-Name: Petitti, D.B. Year: 1988 Volume: 78 Issue: 10 Pages: 1365 Handle: RePEc:aph:ajpbhl:1988:78:10:1365_3 Template-Type: ReDIF-Article 1.0 Title: Native American infant mortality. Journal: American Journal of Public Health Author-Name: Bulterys, M. Year: 1988 Volume: 78 Issue: 10 Pages: 1368 Handle: RePEc:aph:ajpbhl:1988:78:10:1368_1 Template-Type: ReDIF-Article 1.0 Title: Public attitudes regarding smokefree airlines. Journal: American Journal of Public Health Author-Name: Glantz, S.A. Author-Name: Stromberg, D. Year: 1988 Volume: 78 Issue: 10 Pages: 1366 Handle: RePEc:aph:ajpbhl:1988:78:10:1366_4 Template-Type: ReDIF-Article 1.0 Title: Disease prevention: still a long way to go. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1988 Volume: 78 Issue: 10 Pages: 1277-1278 Handle: RePEc:aph:ajpbhl:1988:78:10:1277-1278_8 Template-Type: ReDIF-Article 1.0 Title: SRx: medication education program for seniors. Journal: American Journal of Public Health Author-Name: Emlet, C.A. Year: 1988 Volume: 78 Issue: 10 Pages: 1362-1363 Handle: RePEc:aph:ajpbhl:1988:78:10:1362-1363_6 Template-Type: ReDIF-Article 1.0 Title: The HIV clade. Journal: American Journal of Public Health Author-Name: Settlage, R.H. Author-Name: Grimes, D.A. Year: 1988 Volume: 78 Issue: 10 Pages: 1367-1368 Handle: RePEc:aph:ajpbhl:1988:78:10:1367-1368_0 Template-Type: ReDIF-Article 1.0 Title: Patient dumping--no one wins and we all lose. Journal: American Journal of Public Health Author-Name: Berliner, H.S. Year: 1988 Volume: 78 Issue: 10 Pages: 1279-1280 Handle: RePEc:aph:ajpbhl:1988:78:10:1279-1280_3 Template-Type: ReDIF-Article 1.0 Title: Points to progress: a ladder for adolescent success. Journal: American Journal of Public Health Author-Name: McKiernan, N.A. Year: 1988 Volume: 78 Issue: 10 Pages: 1364 Handle: RePEc:aph:ajpbhl:1988:78:10:1364_6 Template-Type: ReDIF-Article 1.0 Title: Effects of postconception spermicide use. Journal: American Journal of Public Health Author-Name: Michaels, R.A. Year: 1988 Volume: 78 Issue: 9 Pages: 1242-1243 Handle: RePEc:aph:ajpbhl:1988:78:9:1242-1243_3 Template-Type: ReDIF-Article 1.0 Title: The right to health care. Journal: American Journal of Public Health Author-Name: Norman, E.C. Year: 1988 Volume: 78 Issue: 9 Pages: 1242 Handle: RePEc:aph:ajpbhl:1988:78:9:1242_9 Template-Type: ReDIF-Article 1.0 Title: Bridging the gap between community health and school health. Journal: American Journal of Public Health Author-Name: Green, L.W. Year: 1988 Volume: 78 Issue: 9 Pages: 1149 Handle: RePEc:aph:ajpbhl:1988:78:9:1149_6 Template-Type: ReDIF-Article 1.0 Title: Pediculus pubis (crab lice) Journal: American Journal of Public Health Author-Name: Sperber, J. Author-Name: Rosen, T. Author-Name: Dunn, J.K. Author-Name: Kalter, D.C. Year: 1988 Volume: 78 Issue: 9 Pages: 1244 Handle: RePEc:aph:ajpbhl:1988:78:9:1244_3 Template-Type: ReDIF-Article 1.0 Title: Imperative for informed consent. Journal: American Journal of Public Health Author-Name: Simard, A. Author-Name: Paquette-Simard, L. Author-Name: Cogan, J. Author-Name: Chaouki, N. Year: 1988 Volume: 78 Issue: 9 Pages: 1243-1244 Handle: RePEc:aph:ajpbhl:1988:78:9:1243-1244_2 Template-Type: ReDIF-Article 1.0 Title: Resistance to innovation: the case of the community health center. Journal: American Journal of Public Health Author-Name: Roemer, M.I. Year: 1988 Volume: 78 Issue: 9 Pages: 1234-1239 Handle: RePEc:aph:ajpbhl:1988:78:9:1234-1239_2 Template-Type: ReDIF-Article 1.0 Title: The nutrition connection: why doesn't the public know? Journal: American Journal of Public Health Author-Name: Crawford, P. Year: 1988 Volume: 78 Issue: 9 Pages: 1147-1148 Handle: RePEc:aph:ajpbhl:1988:78:9:1147-1148_6 Template-Type: ReDIF-Article 1.0 Title: Reduction of HIV transmission by use of condoms. Journal: American Journal of Public Health Author-Name: Henry, K. Author-Name: Osterholm, M.T. Author-Name: MacDonald, K.L. Year: 1988 Volume: 78 Issue: 9 Pages: 1244 Handle: RePEc:aph:ajpbhl:1988:78:9:1244_4 Template-Type: ReDIF-Article 1.0 Title: Health status of Ethiopians in Israel. Journal: American Journal of Public Health Author-Name: Slater, P.E. Author-Name: Costin, C. Year: 1988 Volume: 78 Issue: 8 Pages: 985-986 Handle: RePEc:aph:ajpbhl:1988:78:8:985-986_2 Template-Type: ReDIF-Article 1.0 Title: Ascertainment bias of cervical carcinoma in situ. Journal: American Journal of Public Health Author-Name: Sun, R.K. Author-Name: Liff, J.M. Year: 1988 Volume: 78 Issue: 8 Pages: 985 Handle: RePEc:aph:ajpbhl:1988:78:8:985_3 Template-Type: ReDIF-Article 1.0 Title: Awareness of Alzheimer patients. Journal: American Journal of Public Health Author-Name: Tappen, R.M. Year: 1988 Volume: 78 Issue: 8 Pages: 987-988 Handle: RePEc:aph:ajpbhl:1988:78:8:987-988_3 Template-Type: ReDIF-Article 1.0 Title: Menthol cigarettes and esophageal cancer. Journal: American Journal of Public Health Author-Name: Hebert, J.R. Author-Name: Kabat, G.C. Year: 1988 Volume: 78 Issue: 8 Pages: 986-987 Handle: RePEc:aph:ajpbhl:1988:78:8:986-987_7 Template-Type: ReDIF-Article 1.0 Title: Visas not approved for medical delegation to South Africa. Journal: American Journal of Public Health Author-Name: Nightingale, E.O. Author-Name: Lawrence, R. Author-Name: Geiger, H.J. Author-Name: Spurlock, J. Author-Name: Hartmann, L. Author-Name: Mercer, E. Author-Name: Hannibal, K. Year: 1988 Volume: 78 Issue: 8 Pages: 989 Handle: RePEc:aph:ajpbhl:1988:78:8:989_0 Template-Type: ReDIF-Article 1.0 Title: Occupational injury trends. Journal: American Journal of Public Health Author-Name: Robertson, L.S. Year: 1988 Volume: 78 Issue: 8 Pages: 988 Handle: RePEc:aph:ajpbhl:1988:78:8:988_8 Template-Type: ReDIF-Article 1.0 Title: Education about nuclear war. Journal: American Journal of Public Health Author-Name: Sidel, V.W. Year: 1988 Volume: 78 Issue: 8 Pages: 903 Handle: RePEc:aph:ajpbhl:1988:78:8:903_9 Template-Type: ReDIF-Article 1.0 Title: "We believe in being the best". Journal: American Journal of Public Health Author-Name: Sanchez, M.E. Year: 1988 Volume: 78 Issue: 8 Pages: 981-982 Handle: RePEc:aph:ajpbhl:1988:78:8:981-982_1 Template-Type: ReDIF-Article 1.0 Title: Sludge and micro-organisms. Journal: American Journal of Public Health Author-Name: Little, M.D. Year: 1988 Volume: 78 Issue: 8 Pages: 988-989 Handle: RePEc:aph:ajpbhl:1988:78:8:988-989_8 Template-Type: ReDIF-Article 1.0 Title: Physician acceptance of the hepatitis B vaccine at a university medical center. Journal: American Journal of Public Health Author-Name: Hashimoto, F. Author-Name: Hunt, W.C. Author-Name: Brusuelas, P. Year: 1988 Volume: 78 Issue: 8 Pages: 973-974 Abstract: To examine how physicians at different training levels accepted the hepatitis B vaccine (Heptavax), we mailed questionnaires to all medical students, residents, and faculty at our university medical center. Eighty-one per cent responded; 57 per cent of those had been vaccinated. Attitudes of vaccine safety and efficacy and the perception of increased risk of getting hepatitis B were associated with having been vaccinated. The associations were strongest for the faculty and weak or negative for the medical students. Handle: RePEc:aph:ajpbhl:1988:78:8:973-974_0 Template-Type: ReDIF-Article 1.0 Title: Attempts to establish nonsmoking sections in restaurants. Journal: American Journal of Public Health Author-Name: Jason, L.A. Author-Name: Holton, E.M. Year: 1988 Volume: 78 Issue: 8 Pages: 987 Handle: RePEc:aph:ajpbhl:1988:78:8:987_3 Template-Type: ReDIF-Article 1.0 Title: Maternal PKU--a continuing problem. Journal: American Journal of Public Health Author-Name: Guthrie, R. Year: 1988 Volume: 78 Issue: 7 Pages: 771 Handle: RePEc:aph:ajpbhl:1988:78:7:771_1 Template-Type: ReDIF-Article 1.0 Title: Benefits of a community needs assessment. Journal: American Journal of Public Health Author-Name: Welch, N.M. Year: 1988 Volume: 78 Issue: 7 Pages: 850-851 Handle: RePEc:aph:ajpbhl:1988:78:7:850-851_3 Template-Type: ReDIF-Article 1.0 Title: Prejudice toward AIDS patients versus other terminally ill patients. Journal: American Journal of Public Health Author-Name: Lester, D. Year: 1988 Volume: 78 Issue: 7 Pages: 854 Handle: RePEc:aph:ajpbhl:1988:78:7:854_7 Template-Type: ReDIF-Article 1.0 Title: Methodological difficulties in dying. Journal: American Journal of Public Health Author-Name: Brody, H. Author-Name: Tomlinson, T. Author-Name: Reitemeier, P.J. Year: 1988 Volume: 78 Issue: 7 Pages: 855 Handle: RePEc:aph:ajpbhl:1988:78:7:855_2 Template-Type: ReDIF-Article 1.0 Title: Results of screening adopted Korean children for HBsAg. Journal: American Journal of Public Health Author-Name: Murray, D.L. Author-Name: Lynch, M. Author-Name: Doughty, A. Author-Name: Cho, B.K. Year: 1988 Volume: 78 Issue: 7 Pages: 855-856 Handle: RePEc:aph:ajpbhl:1988:78:7:855-856_2 Template-Type: ReDIF-Article 1.0 Title: Have the number of new HIV infections leveled off in Finland? Journal: American Journal of Public Health Author-Name: Pönkä, A. Author-Name: Tikkanen, J. Author-Name: Haikala, O. Author-Name: Suni, J. Year: 1988 Volume: 78 Issue: 7 Pages: 854-855 Handle: RePEc:aph:ajpbhl:1988:78:7:854-855_4 Template-Type: ReDIF-Article 1.0 Title: Screening suburban/rural children for lead exposure, iron deficiency. Journal: American Journal of Public Health Author-Name: Guthrie, R. Author-Name: Orfanos, A. Author-Name: Widger, K. Author-Name: Luskin, B. Author-Name: Francemone, C. Author-Name: Nadler, D. Year: 1988 Volume: 78 Issue: 7 Pages: 856-857 Handle: RePEc:aph:ajpbhl:1988:78:7:856-857_9 Template-Type: ReDIF-Article 1.0 Title: Anti-cigarette campaign: 25% participation is not a failure. Journal: American Journal of Public Health Author-Name: Klein, J.D. Year: 1988 Volume: 78 Issue: 7 Pages: 857 Handle: RePEc:aph:ajpbhl:1988:78:7:857_0 Template-Type: ReDIF-Article 1.0 Title: HIV seropositivity in i.v. drug users in Ohio. Journal: American Journal of Public Health Author-Name: Seligman, P.J. Author-Name: Campbell, R.J. Author-Name: Keeler, G.P. Author-Name: Halpin, T.J. Year: 1988 Volume: 78 Issue: 6 Pages: 720 Handle: RePEc:aph:ajpbhl:1988:78:6:720_9 Template-Type: ReDIF-Article 1.0 Title: EFNEP (Expanded Food and Nutrition Program) Journal: American Journal of Public Health Author-Name: Schuster, E. Year: 1988 Volume: 78 Issue: 6 Pages: 719-720 Handle: RePEc:aph:ajpbhl:1988:78:6:719-720_7 Template-Type: ReDIF-Article 1.0 Title: Participation in local health department investigations by public health student teams. Journal: American Journal of Public Health Author-Name: Teitelbaum, H.S. Author-Name: McLaughlin, J. Author-Name: Barnaby, L. Author-Name: Paskilas, A. Author-Name: Helgerson, S. Author-Name: DeLouise, E. Year: 1988 Volume: 78 Issue: 6 Pages: 717 Handle: RePEc:aph:ajpbhl:1988:78:6:717_9 Template-Type: ReDIF-Article 1.0 Title: Changing patterns of drug abuse in a seaport: New Orleans, 1975-85. Journal: American Journal of Public Health Author-Name: Schwartz, B.D. Author-Name: Murray, L. Author-Name: Alexander, B. Author-Name: Kauders, F.R. Author-Name: Gallant, D.M. Year: 1988 Volume: 78 Issue: 6 Pages: 720-721 Handle: RePEc:aph:ajpbhl:1988:78:6:720-721_7 Template-Type: ReDIF-Article 1.0 Title: Guidelines for HIV antibody counseling, testing. Journal: American Journal of Public Health Author-Name: Soskolne, C.L. Year: 1988 Volume: 78 Issue: 6 Pages: 721 Handle: RePEc:aph:ajpbhl:1988:78:6:721_5 Template-Type: ReDIF-Article 1.0 Title: Elimination of cotinine from body fluids. Journal: American Journal of Public Health Author-Name: Sepkovic, D.W. Author-Name: Haley, N.J. Year: 1988 Volume: 78 Issue: 6 Pages: 718-719 Handle: RePEc:aph:ajpbhl:1988:78:6:718-719_5 Template-Type: ReDIF-Article 1.0 Title: Associations between cancer and employment. Journal: American Journal of Public Health Author-Name: Davis, L.K. Author-Name: Martin, T.R. Year: 1988 Volume: 78 Issue: 5 Pages: 594 Handle: RePEc:aph:ajpbhl:1988:78:5:594_2 Template-Type: ReDIF-Article 1.0 Title: Weight x speed) + instability = hazardous trucks. Journal: American Journal of Public Health Author-Name: Robertson, L.S. Year: 1988 Volume: 78 Issue: 5 Pages: 486-487 Handle: RePEc:aph:ajpbhl:1988:78:5:486-487_3 Template-Type: ReDIF-Article 1.0 Title: The case for the NEDEL (the no epidemiologically detectable exposure level) Journal: American Journal of Public Health Author-Name: Binder, S. Year: 1988 Volume: 78 Issue: 5 Pages: 589-590 Handle: RePEc:aph:ajpbhl:1988:78:5:589-590_9 Template-Type: ReDIF-Article 1.0 Title: Effects of reduced toxicity of car exhaust. Journal: American Journal of Public Health Author-Name: Lester, D. Author-Name: Clarke, R.V. Year: 1988 Volume: 78 Issue: 5 Pages: 594 Handle: RePEc:aph:ajpbhl:1988:78:5:594_9 Template-Type: ReDIF-Article 1.0 Title: Home health care: house calls revisited. Journal: American Journal of Public Health Author-Name: Blazer, D. Year: 1988 Volume: 78 Issue: 3 Pages: 238-239 Handle: RePEc:aph:ajpbhl:1988:78:3:238-239_5 Template-Type: ReDIF-Article 1.0 Title: Is the Florida safety belt law effective? Journal: American Journal of Public Health Author-Name: Thyer, B.A. Author-Name: Landis, J. Year: 1988 Volume: 78 Issue: 3 Pages: 323 Handle: RePEc:aph:ajpbhl:1988:78:3:323_2 Template-Type: ReDIF-Article 1.0 Title: Beware of snowy roofs! Journal: American Journal of Public Health Author-Name: Eriksson, A. Author-Name: Björnstig, U. Author-Name: Kullenberg, K. Year: 1988 Volume: 78 Issue: 3 Pages: 322 Handle: RePEc:aph:ajpbhl:1988:78:3:322_7 Template-Type: ReDIF-Article 1.0 Title: Discontinuation of Bendectin. Journal: American Journal of Public Health Author-Name: Jick, S.S. Author-Name: Garrison, J.M. Year: 1988 Volume: 78 Issue: 3 Pages: 322-323 Handle: RePEc:aph:ajpbhl:1988:78:3:322-323_4 Template-Type: ReDIF-Article 1.0 Title: Solomon Jacob Axelrod, MD, MPH, national leader in medical care organization (September 25, 1912-September 21, 1987). Journal: American Journal of Public Health Author-Name: Feingold, E. Author-Name: Wegman, M.E. Year: 1988 Volume: 78 Issue: 3 Pages: 324 Handle: RePEc:aph:ajpbhl:1988:78:3:324_1 Template-Type: ReDIF-Article 1.0 Title: The indomitable spirit. Journal: American Journal of Public Health Author-Name: Silver, G.A. Year: 1988 Volume: 78 Issue: 3 Pages: 237 Handle: RePEc:aph:ajpbhl:1988:78:3:237_5 Template-Type: ReDIF-Article 1.0 Title: An evaluation of the American Lung Association's home video smoking cessation program Journal: American Journal of Public Health Author-Name: Marston, A.R. Author-Name: Bettencourt, B.A. Year: 1988 Volume: 78 Issue: 9 Pages: 1226-1227 Abstract: One hundred and one participants reeived In Control: A Home Video Freedom from Smoking® Program. Of 53 completing self-treatment, 31 were verified by CO testing as abstinent one month after completion. Twenty-one per cent of the sample (40 per cent of those completing treatment) had not smoked in the past three months prior to 12 month follow up and 16 per cent of the total sample (30 per cent of those completing treatment) had not smoked at all in the past 11 months. Handle: RePEc:aph:ajpbhl:1988:78:9:1226-1227_2 Template-Type: ReDIF-Article 1.0 Title: Cotinine in serum, saliva, and urine of nonsmokers, passive smokers, and active smokers Journal: American Journal of Public Health Author-Name: Wall, M.A. Author-Name: Johnson, J. Author-Name: Jacob, P. Author-Name: Benowitz, N.L. Year: 1988 Volume: 78 Issue: 6 Pages: 699-701 Abstract: Cotinine was measured in the serum, saliva, and urine of nonsmokers, passive smokers, and active smokers. Serum and saliva could not discriminate between nonsmokers and passive smokers. Mean urine cotinine was higher in passive smokers than nonsmokers but there was a great deal of intersubject overlap. Cotinine in all body fluids could separate active smokers from the other two groups. Among smokers, light smokers had lower levels than heavier smokers. Handle: RePEc:aph:ajpbhl:1988:78:6:699-701_7 Template-Type: ReDIF-Article 1.0 Title: Evaluating the risks of cesarean section: Low Apgar score in repeat C-section and vaginal deliveries Journal: American Journal of Public Health Author-Name: Burt, R.D. Author-Name: Vaughan, T.L. Author-Name: Daling, J.R. Year: 1988 Volume: 78 Issue: 10 Pages: 1312-1314 Abstract: Data from Washington State birth certificates from 1980-83 were used to estimate excess risk to the infant delivered via repeat cesarean section independently of any risk associated with the indication for the procedure. Using a case-control design, we compared the method of delivery of all infants with low (0-6) five-minute Apgar scores born to multiparous mothers after uncomplicated pregnancies and births to that of similar infants with a high score (7-10), frequency matched by birthweight. Of the 1,030 infants with low Apgar score, 127 (12.3 per cent) were delivered via repeat cesarean section, in contrast to 98 (9.8 per cent) of 998 controls with high Apgar score. In a regression model controlling for birthweight, gestational length, maternal age, and income the relative risk was 1.29 (95% confidence interval 0.97, 1.72). Excess risk was highest among babies of normal (2500-4000 grams) birthweight. While a number of limitations inherent in the source of data require cautious interpretation of these results, we conclude that some excess risk of low Apgar score may be associated with repeat cesarean section procedure. Handle: RePEc:aph:ajpbhl:1988:78:10:1312-1314_8 Template-Type: ReDIF-Article 1.0 Title: AIDS and public health Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1988 Volume: 78 Issue: 4 Pages: 364-366 Handle: RePEc:aph:ajpbhl:1988:78:4:364-366_2 Template-Type: ReDIF-Article 1.0 Title: The development of worker-controlled occupational health centers in Canada Journal: American Journal of Public Health Author-Name: Yassi, A. Year: 1988 Volume: 78 Issue: 6 Pages: 689-693 Abstract: Over the past decade worker-controlled occupational health centres have been established in three Canadian provinces. This development has been a response to the slowness in recognizing occupational medicine in the Canadian medical community, the limited availability and questionable acceptibility of existing services, as well as the growth of worker control in occupational health matters generally. The history, funding, organizational structure, personnel, resources, and programs of these worker-controlled centers are outlined, illustrating the extensive programs that can be provided despite small budgets of these operations. Advantages to workers include direct access to resources as well as expert professional advice with the focus on work place hazards. Furthermore, the centers provide for extensive interaction among workers on their common concerns. Disadvantages of the model include restricted access to work places associated with frequent distrust of employers. Employer-based and university-based models are compared to worker-controlled centers, and it is suggested that the latter may influence the pattern of practice of occupational health as well as the ability of workers and their unions to promote improved occupational health and safety conditions. Handle: RePEc:aph:ajpbhl:1988:78:6:689-693_9 Template-Type: ReDIF-Article 1.0 Title: Smallpox: Ten years gone Journal: American Journal of Public Health Author-Name: Hopkins, D.R. Year: 1988 Volume: 78 Issue: 12 Pages: 1589-1595 Handle: RePEc:aph:ajpbhl:1988:78:12:1589-1595_2 Template-Type: ReDIF-Article 1.0 Title: National trends in coverage and utilization of mental health, alcohol, and substance abuse services within managed health care systems Journal: American Journal of Public Health Author-Name: Lubotsky Levin, B. Author-Name: Glasser, J.H. Author-Name: Jaffe, C.L. Year: 1988 Volume: 78 Issue: 9 Pages: 1222-1223 Abstract: This study reports the results of a 1986 national survey of mental health, alcohol, and substance abuse services within health maintenance organizations in the United States. Ninety-seven percent of responding health maintenance organizations (HMOs) offered mental health service coverage and two-thirds of responding HMOs offered alcohol and substance abuse service coverage. Annual mean mental health hospitalization was 36.90 days per 1,000 members and annual mean ambulatory mental health utilization was 0.29 physician encounters per member. Handle: RePEc:aph:ajpbhl:1988:78:9:1222-1223_1 Template-Type: ReDIF-Article 1.0 Title: Next-of-kin attitudes regarding participation in an epidemiologic case-control study Journal: American Journal of Public Health Author-Name: Heuser, L. Author-Name: Severson, R.K. Author-Name: Watson, T.J. Year: 1988 Volume: 78 Issue: 11 Pages: 1474-1476 Abstract: We assessed next-of-kin's attitudes about participating in an epidemiologic case-control study of adult acute non-lymphocytic leukemia. Responses from a mailed questionnaire indicated that 95 per cent were glad they participated. While 74 per cent benefited, 18.5 per cent were bothered in some way. Results concerning the need to obtain physician permission before contacting next-of-kin were inconclusive; however, 8 of 10 females contacted by the case's physician considered consent necessary. Handle: RePEc:aph:ajpbhl:1988:78:11:1474-1476_2 Template-Type: ReDIF-Article 1.0 Title: The rising long-term trend in occupational injury rates Journal: American Journal of Public Health Author-Name: Robinson, J.C. Year: 1988 Volume: 78 Issue: 3 Pages: 276-281 Abstract: Establishment survey data for the United States as a whole and worker's compensation data for the State of California were used to document long-term trends in occupational injury and acute illness rates. After declining throughout the first half of the century, national rates of disabling injuries in manufacturing, construction, and the trade sector have risen sharply in recent decades. Injury rates in mining show no strong trend either up or down since 1960. Increases over recent years have been especially pronounced for strains and sprains, cuts, lacerations and punctures, bone fractures, and acute illnesses. Injury rates in the manufacturing sector are strongly influenced by general economic conditions - rising sharply with business upsurges and declining during recessions. Increases in the rate of unemployement, which decrease worker and labor union bargaining power, are associated with increases in injury rates within manufacturing. Handle: RePEc:aph:ajpbhl:1988:78:3:276-281_5 Template-Type: ReDIF-Article 1.0 Title: The accuracy of industry data from death certificates for workplace homicide victims Journal: American Journal of Public Health Author-Name: Davis, H. Year: 1988 Volume: 78 Issue: 12 Pages: 1579-1581 Abstract: This study compared death certificate data on usual industry for workplace homicide victims in five urban Texas counties, with medical examiners' data on the industries where victims were working when injured. The overall positive predictive value of the death certificate data was 72 per cent. Death certificate data on usual industry underestimated the number of victims working in high-risk industries when injured, partly because of victims whose usual industry was recorded as student, housewife, or military personnel. Handle: RePEc:aph:ajpbhl:1988:78:12:1579-1581_4 Template-Type: ReDIF-Article 1.0 Title: Characteristics influencing informed consent on a congenital malformations registry Journal: American Journal of Public Health Author-Name: Law, C. Author-Name: Robertson, M.O. Author-Name: Panny, S.R. Author-Name: Wulff, L.M. Year: 1988 Volume: 78 Issue: 5 Pages: 572-573 Abstract: Maryland law requires that all babies born with 'sentinel birth defects' be reported to the State Department of Health, but mothers may deny consent for further contact. Consent was not strongly related to maternal age, race, or self-reported data on exposures, smoking, and drugs but was much less likely if the infant was dead. Selection bias in congenital malformations research may lead to underrepresentation of lethal defects, but self-reported data appear to be unbiased. Handle: RePEc:aph:ajpbhl:1988:78:5:572-573_3 Template-Type: ReDIF-Article 1.0 Title: Decision analysis and polio immunization policy Journal: American Journal of Public Health Author-Name: Hinman, A.R. Author-Name: Koplan, J.P. Author-Name: Orenstein, W.A. Author-Name: Brink, E.W. Year: 1988 Volume: 78 Issue: 3 Pages: 301-303 Abstract: Dr. Salk's comments on our paper fall into four major categories: our use of the techniques of decision analysis, the assumptions we used, the fact that we did not include individual and social values in the model, and the way in which vaccine policies are developed in the United States. We believe that the methods were used correctly, that assumptions we used are defensible, and that our conclusions were both appropriate and appropriately worded. We explicitly did not include individual and social values since we were addressing the scientific and epidemiologic issues rather than ethical and moral issues. Vaccine policy development in the United States is carried out in public forums with opportunity for presentation of all sides of an issue. Handle: RePEc:aph:ajpbhl:1988:78:3:301-303_0 Template-Type: ReDIF-Article 1.0 Title: Service use and costs for medicare beneficiaries in risk-based HMOs and CMPs: Some interim results from the National Medicare Competition Evaluation Journal: American Journal of Public Health Author-Name: Rossiter, L.F. Author-Name: Nelson, L.M. Author-Name: Adamache, K.W. Year: 1988 Volume: 78 Issue: 8 Pages: 937-943 Abstract: The Health Care Financing Administration (HCFA) initiated the Medicare Competition Demonstrations in 1982 in anticipation of congressional intent to establish a national program. Interim results on the 1984 service use and cost experience of the health maintenance organizations (HMOs) and competitive medical plans (CMPs) participating in the demonstrations indicate that Medicare enrollees in the demonstration experienced a median of 1,951 hospital days per 1,000 person years, 57 per cent of the median of 3,432 days per 1,000 in the local markets from which the plans drew enrollment. Independent practice association (IPA) HMOs experienced higher hospital use rates than staff and group model HMOs. These comparisons are not adjusted for various risk factors, the absence of which were likely to favor the demonstration plans. Plans with lower hospital service use were federally qualified and had been operating for more than five years. The median total annual revenue per enrollee across all plans was $2,312, compared to median annual expenses per enrollee of $2,250. The distribution of median annual expenses per enrollee by ($1,038/enrollee), medical expenses $720/enrollee), supplemental services expenses ($154/enrollee, and administrative and other expenses ($295/enrollee). Future analysis, using beneficiary-level data, will examine the impact of the demonstration and the nature and extent of evident biased selection and will compare the quality of care in the demonstrations to that in the fee-for-service sector. Handle: RePEc:aph:ajpbhl:1988:78:8:937-943_8 Template-Type: ReDIF-Article 1.0 Title: An overview of Japanese occupational health Journal: American Journal of Public Health Author-Name: Reich, M.R. Author-Name: Frumkin, H. Year: 1988 Volume: 78 Issue: 7 Pages: 809-816 Abstract: This paper provides an overview of Japanese occupational health and evaluates the current situation from three perspectives. Major occupational health hazards are assessed using four sources of data, showing patterns similar to those found in other advanced industrial societies. Institutional structures for occupational health policy are then examined, illustrating strengths and weaknesses of the Japanese legal and administrative systems. Trade union activities are presented, indicating the constraints of enterprise unions, and the tendency for a greater orientation toward compensation than prevention. Significant occupational health problems persist among marginal workers in Japan, including women and various minority groups. The analysis demonstrates a record for occupational health in Japan considerably more mixed than the conventional view. Handle: RePEc:aph:ajpbhl:1988:78:7:809-816_6 Template-Type: ReDIF-Article 1.0 Title: Nuclear education in public health and nursing Journal: American Journal of Public Health Author-Name: Winder, A.E. Author-Name: Stanitis, M.A. Year: 1988 Volume: 78 Issue: 8 Pages: 967-968 Abstract: Twenty-three public health schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty public health schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of public health report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention. Handle: RePEc:aph:ajpbhl:1988:78:8:967-968_8 Template-Type: ReDIF-Article 1.0 Title: A procedure for linking psychosocial job characteristics data to health surveys Journal: American Journal of Public Health Author-Name: Schwartz, J.E. Author-Name: Pieper, C.F. Author-Name: Karasek, R.A. Year: 1988 Volume: 78 Issue: 8 Pages: 904-909 Abstract: A system is presented for linking information about psychosocial characteristics of job situations to national health surveys. Job information can be imputed to individuals on surveys that contain three-digit US Census occupation codes. Occupational mean scores on psychosocial job characteristics - control over task situation (decision latitude), psychological work load, physical exertion, and other measures - for the linkage system are derived from US national surveys of working conditions (Quality of Employment Surveys 1969, 1972, and 1977). This paper discusses a new method for reducing the biases in multivariate analyses that are likely to arise when utilizing linkage systems based on mean scores. Such biases are reduced by modifying the linkage system to adjust imputed individual scores for demographic factors such as age, education, race, marital status and, implicitly, sex (since men and women have separate linkage data bases). Statistics on the linkage system's efficiency and reliability are reported. All dimensions have high inter-survey reproducibility. Despite their psychosocial nature, decision latitude and physical exertion can be more efficiently imputed with the linkage system than earnings (a non-psychosocial job characteristic). The linkage system presented here is a useful tool for initial epidemiological studies of the consequences of psychosocial job characteristics and constitutes the methodological basis for the subsequent paper. Handle: RePEc:aph:ajpbhl:1988:78:8:904-909_4 Template-Type: ReDIF-Article 1.0 Title: Health advertising: Prevention for profit Journal: American Journal of Public Health Author-Name: Freimuth, V.S. Author-Name: Hammond, S.L. Author-Name: Stein, J.A. Year: 1988 Volume: 78 Issue: 5 Pages: 557-561 Abstract: The National Cancer Institute (NCI) estimates on the basis of current knowledge alone that, at a minimum, 30,000 lives could be saved in the year 2000 if Americans would modify their dietary habits. A recent innovative way of responding to this challenge was the Kellogg Company/NCI All-Bran advertising campaign. This paper will describe the campaign, and its impact on consumers, cereal industry sales, food industry advertising practices, health regulatory policy, and the organizational credibility of both NCI and Kellogg. For the past three years, Kellogg has included NCI's cancer prevention messages in their advertisements for All-Bran cereal and on their bran cereal boxes. This collaborative effort has stimulated considerable controversy over whether the health claims made on the cereal label are in violation of federal food labeling regulations. Meanwhile, research has demonstrated the positive impact of the campaign on consumer's knowledge and behavior regarding fiber as well as on Kellogg's profits. Other manufacturers are anxious to jump on the 'branwagon'; however unanswered questions remain about this new approach to health advertising. Handle: RePEc:aph:ajpbhl:1988:78:5:557-561_8 Template-Type: ReDIF-Article 1.0 Title: A prospective study of incident comprehensive medical home care use among the elderly Journal: American Journal of Public Health Author-Name: Branch, L.G. Author-Name: Wetle, T.T. Author-Name: Scherr, P.A. Author-Name: Cook, N.R. Author-Name: Evans, D.A. Author-Name: Hebert, L.E. Author-Name: Nesbitt Masland, E. Author-Name: Keough, M.E. Author-Name: Taylor, J.O. Year: 1988 Volume: 78 Issue: 3 Pages: 255-259 Abstract: This prospective study directly examines, in a defined community population, the extent to which a wide array of characteristics predict utilization of an important long-term care (LTC) service - medical home care - over a two-year interval among the cohort of 3,706 people aged 65 of older. The overall age-sex adjusted rate of two-year incident home care use was 3.2 per cent. For both men and women, the rates among the aged 85 or older group were approximately 12 times the rates of those aged 65 to 74. The multivariate predictors of incident home care, adjusted for age and sex, were five: receiving help with at least one activity of daily living (ADL), being dependent in Rosow-Breslau functional health areas, being homebound, more errors in mental status items, and no involvement with social groups. The dominance of indicators of frailty in physical function and cognitive function are consistent with the predictors of another group of LTC clients, those who subsequently enter nursing homes. However, in the present study the ratios of medical home care use were similar for those living alone and for those living with others in the multivariate model, suggesting the possibility of differences between home care and institutional LTC clients. Handle: RePEc:aph:ajpbhl:1988:78:3:255-259_5 Template-Type: ReDIF-Article 1.0 Title: Feline plague in New Mexico: Risk factors and transmission to humans Journal: American Journal of Public Health Author-Name: Eidson, M. Author-Name: Tierney, L.A. Author-Name: Rollag, O.J. Author-Name: Becker, T. Author-Name: Brown, T. Author-Name: Hull, H.F. Year: 1988 Volume: 78 Issue: 10 Pages: 1333-1335 Abstract: The epidemiologic features of 60 cases of feline plague from 1977-1985 in New Mexico are reviewed. The most frequent clinical presentation was lethargy, anorexia, fever and enlarged lymph nodes or abscesses. A history of hunting rodents was reported in 75 per cent of all cases. Five human plague cases were associated with five feline cases. Recommendations are presented for prevention of plague infection and transmission to humans, including restraining cats from roaming and hunting by neutering and keeping them indoors, treating them for fleas, and seeking medical care for febrile illnesses, especially when accompanied by enlarged lymph nodes. Handle: RePEc:aph:ajpbhl:1988:78:10:1333-1335_2 Template-Type: ReDIF-Article 1.0 Title: Live or inactivated poliomyelitis vaccine: An analysis of benefits and risks Journal: American Journal of Public Health Author-Name: Hinman, A.R. Author-Name: Koplan, J.P. Author-Name: Orenstein, W.A. Author-Name: Brink, E.W. Author-Name: Nkowane, B.M. Year: 1988 Volume: 78 Issue: 3 Pages: 291-295 Abstract: Using decision analysis we evaluated the benefits and risks of continued primary reliance on oral poliomyelitis vaccine (OPV) compared to use of inactivated poliovirus vaccine (IPV). We followed a hypothetical cohort of 3.5 million children from birth to age 30 assuming 95 per cent coverage with 98 per cent effective vaccine. Primary reliance on IPV would result in more cases of paralytic poliomyelitis as well as more susceptibles remaining in the population than would be expected with continuing OPV use (74.1 vs 10.0 cases and 5.9 per cent vs 1.1 per cent susceptibles, respectively). However, with OPV use, most cases of paralysis seen would be associated with the vaccine. Our analysis supports a continuation of current US policy primary reliance on OPV but the conclusion is heavily dependent on assumptions of risk of exposure to wild virus in the United States. Major declines in risk of exposure to wild virus could alter the balance significantly. Handle: RePEc:aph:ajpbhl:1988:78:3:291-295_2 Template-Type: ReDIF-Article 1.0 Title: Patterns of blood donations among individuals at risk for AIDS, 1984 Journal: American Journal of Public Health Author-Name: Seage III, G.R. Author-Name: Barry, M.A. Author-Name: Landers, S. Author-Name: Silvia, A.M. Author-Name: Lamb, G.A. Year: 1988 Volume: 78 Issue: 5 Pages: 576-577 Abstract: Of 978 respondents to an anonymous questionnaire targeted to reach homosexuals in Boston during October 1984, 88 (9 per cent) reported recent blood donation. When compared to non-recent donors, high-risk respondents who were recent blood donors were younger, less open about their sexual preference, and more likely to obtain their information about AIDS (acquired immunodeficiency syndrome) from television and newspapers. These results suggest that particular subgroups of the population at risk for AIDS would benefit from expanded educational programs. Handle: RePEc:aph:ajpbhl:1988:78:5:576-577_4 Template-Type: ReDIF-Article 1.0 Title: Concerns of medical and pediatric house officers about acquiring AIDS from their patients Journal: American Journal of Public Health Author-Name: Link, R.N. Author-Name: Feingold, A.R. Author-Name: Charap, M.H. Author-Name: Freemen, K. Author-Name: Shelov, S.P. Year: 1988 Volume: 78 Issue: 4 Pages: 455-459 Abstract: To assess the degree of house officers' concerns about acquiring AIDS (acquired immunodeficiency syndrome) from their patients, we surveyed 263 medical and pediatric interns and residents in four housestaff training programs affiliated with seven New York City hospitals with large AIDS patient populations; 258 questionnaires (98 per cent) were returned. Thirty-six per cent of medical and 17 per cent of pediatric house officers reported percutaneous exposures to needles contaminated with blood of AIDS patients. Forty-eight per cent of medical and 30 per cent of pediatric house officers reported a moderate to major concern about acquiring AIDS from their patients. Greater concern about personal risk was noted in those house officers who were earlier in their residency training, who reported having treated a greater number of AIDS patients, and who were in medicine rather than pediatrics programs. Twenty-five per cent of all respondents reported that they would not continue to care for AIDS patients if given a choice. The results demonstrate a substantial degree of concern about acquiring AIDS among house officers caring for AIDS patients and suggest the need for housestaff program administrators to formally address these concerns. Handle: RePEc:aph:ajpbhl:1988:78:4:455-459_1 Template-Type: ReDIF-Article 1.0 Title: Uniform minimum data sets: In search of demographic comparability Journal: American Journal of Public Health Author-Name: Trevino, F.M. Year: 1988 Volume: 78 Issue: 2 Pages: 126-127 Handle: RePEc:aph:ajpbhl:1988:78:2:126-127_5 Template-Type: ReDIF-Article 1.0 Title: Hypertensive emergency: Case criteria, sociodemographic profile, and previous care of 100 cases Journal: American Journal of Public Health Author-Name: Bennett, N.M. Author-Name: Shea, S. Year: 1988 Volume: 78 Issue: 6 Pages: 636-640 Abstract: To study the frequency, cost, sociodemographic profile, and previous care correlates of hospital admissions for hypertensive emergency, we used specific case criteria to identify a series of 100 cases at Presbyterian Hospital in New York City. Approximately 58 cases were admitted per year. Mean length of hospital stay was 11.8 days, 75 per cent of patients received intensive care, and estimated annual hospital charges were $438,828 (1986 dollars). Cases had severe hypertension on admission (mean systolic blood pressure, 229.8 mmHg; mean diastolic blood pressure, 143 mmHg). Two-thirds had clinical evidence of acute arteriolitis. Cases were predominantly young, male, Black of Hispanic, and of lower socioeconomic status. At least 93 per cent of cases were previously diagnosed, and at least 83 per cent were aware of their diagnosis of hypertension. Improved management of chronic hypertension rather than more intensive screening may be a useful strategy to reduce the incidence of hypertensive emergency. Handle: RePEc:aph:ajpbhl:1988:78:6:636-640_8 Template-Type: ReDIF-Article 1.0 Title: Weight control program reinforces smoking cessation Journal: American Journal of Public Health Author-Name: Balamuth Wittsten, A. Author-Name: Guarino, M.A. Author-Name: Lisbin, J. Author-Name: Dougherty, M.-F. Year: 1988 Volume: 78 Issue: 9 Pages: 1240-1241 Handle: RePEc:aph:ajpbhl:1988:78:9:1240-1241_2 Template-Type: ReDIF-Article 1.0 Title: How safe is sex? (Reply to Kristal) Journal: American Journal of Public Health Author-Name: Darrow, W.W. Author-Name: Rutherford III, G.W. Year: 1988 Volume: 78 Issue: 1 Pages: 91-92 Handle: RePEc:aph:ajpbhl:1988:78:1:91-92_2 Template-Type: ReDIF-Article 1.0 Title: Problems with surveillance methods for alcoholism: Differences in coding systems among federal, state, and private agencies Journal: American Journal of Public Health Author-Name: Westermeyer, J. Year: 1988 Volume: 78 Issue: 2 Pages: 130-133 Abstract: Social indicator systems can serve as a social accounting method to guide public policy on alcoholism, utilizing data which are routinely collected at public expense. An attempt to develop an alcoholism social indicator system for Minnesota demonstrated many differences in the coding schemes used by various state agencies and institutions. These findings have relevance to other social indicator systems being developed to assess public policies regarding the people's health. Handle: RePEc:aph:ajpbhl:1988:78:2:130-133_4 Template-Type: ReDIF-Article 1.0 Title: Optimum cutoff points for biochemical validation of smoking status Journal: American Journal of Public Health Author-Name: Cummings, S.R. Author-Name: Richard, R.J. Year: 1988 Volume: 78 Issue: 5 Pages: 574-575 Abstract: Selection of cutoff points for tests to validate smoking cessation should take account of the prevalence of deception. When the prevalence of deception is relatively low, the cutoff points to validate quitting should be relatively high. Many studies have used cutoff points that are too low and may have underestimated cessation rates. We present a method for determining the best cutoff points that takes account of the prevalence of deception. Handle: RePEc:aph:ajpbhl:1988:78:5:574-575_8 Template-Type: ReDIF-Article 1.0 Title: A comparison of injury date and death date in 42,698 suicides Journal: American Journal of Public Health Author-Name: Phillips, D.P. Author-Name: Sanzone, A.G. Year: 1988 Volume: 78 Issue: 5 Pages: 541-543 Abstract: The date of death was compared with the date of injury (the onset of the suicidal act) for 42,698 California suicides, 1973-85. Findings revealed 92.6 per cent of all California suicides occurred within one day of the injury date. Graphs of daily suicides by injury date and by death date displayed essentially identical patterns around the holidays, by date of the week, and after publicized suicide stories. These findings suggest that the difference between date of death and date of injury need not be taken into consideration in the analysis fo temporal fluctuations, as was previously supposed. Handle: RePEc:aph:ajpbhl:1988:78:5:541-543_8 Template-Type: ReDIF-Article 1.0 Title: Pit and fissure sealant use in private practice: Influence of state practice acts Journal: American Journal of Public Health Author-Name: Cohen, L. Author-Name: Romberg, E. Author-Name: LaBelle, A. Year: 1988 Volume: 78 Issue: 3 Pages: 316-317 Abstract: To study the influence of the delegation of sealant procedures to auxiliaries on sealant use, we queried a national sample of general dentists and pedodontists. A large percentage (34-58 per cent) of both groups were unaware or mistaken in their perception of the legality of delegating sealants. Although perception of legality to delegate was associated with increased sealant use, a large percentage (33-59 per cent) of both groups did not delegate even when it was perceived legal to do so. Handle: RePEc:aph:ajpbhl:1988:78:3:316-317_5 Template-Type: ReDIF-Article 1.0 Title: Food choices and the cancer guidelines Journal: American Journal of Public Health Author-Name: Patterson, B.H. Author-Name: Block, G. Year: 1988 Volume: 78 Issue: 3 Pages: 282-286 Abstract: Twenty-four hour dietary recall data from 11,658 adult respondents in the second National Health and Nutrition Examination Survey (NHANES II) (1976-80) were used to examine the American diet in relation to certain of the cancer dietary guidelines from the National Academy of Sciences and the American Cancer Society. The per cent who reported consuming any food in those food groups considered protective was small: cruciferous vegetables (18 per cent); fruits and vegetables high in vitamin A (21 per cent); high fiber breads and cereals (16 per cent). The per cent consuming foods potentially increasing cancer risk was high: red meat (55 per cent); bacon and lunch meats (43 per cent). Proportions of persons eating fruits and vegetables increased with income. Diets were closer to the guidelines for females than males, for Blacks than Whites, and for older than younger Americans. Handle: RePEc:aph:ajpbhl:1988:78:3:282-286_4 Template-Type: ReDIF-Article 1.0 Title: Patient characteristics and eligibility in a veterans administration ambulatory care triage clinic Journal: American Journal of Public Health Author-Name: Feussner, J.R. Author-Name: McFall, S.L. Author-Name: Cockrell III, W.E. Year: 1988 Volume: 78 Issue: 9 Pages: 1224-1225 Abstract: We surveyed 5,225 consecutive patients presenting to a Veterans Administration (VA) Ambulatory Care Triage Clinic to ascertain the characteristics of patients and to assess the role of eligibility in determining disposition from triage. Most patients (66 per cent) had non-service connected (low eligibility) conditions and had no health insurance (64 per cent). Lack of service connected priority (high eligibility) did not influence access to hospitalization (8.3 per cent) or longitudinal outpatient care (24.5 per cent). The study suggests that veterans with no health insurance, with low eligibility for VA service, use the VA triage clinic for episodic medical care. Handle: RePEc:aph:ajpbhl:1988:78:9:1224-1225_6 Template-Type: ReDIF-Article 1.0 Title: Reducing teenage childbearing Journal: American Journal of Public Health Author-Name: Henshaw, S.K. Year: 1988 Volume: 78 Issue: 6 Pages: 619-620 Handle: RePEc:aph:ajpbhl:1988:78:6:619-620_4 Template-Type: ReDIF-Article 1.0 Title: Setting AIDS priorities: The need for a closer alliance of public health and clinical approaches toward the control of AIDS Journal: American Journal of Public Health Author-Name: Henry, K. Year: 1988 Volume: 78 Issue: 9 Pages: 1210-1212 Abstract: The approach to the acquired immune deficiency syndrome (AIDS) taken by public health departments and clinicians varies. Public health programs often neglect the human side of AIDS while clinicians often overlook public health issues. Current research on AIDS has failed to address many fundamental questions including: the biology of the human immunodeficiency virus (HIV) in semen; whether present antiretroviral therapy has any effect on sexual infectivity; and whether adequate counseling was given to persons in HIV discordant partner studies. These unanswered basic questions highlight how research efforts framed from clinical, basic science, or public health viewpoints may have too narrow a focus. Three suggestions are made: 1) additional studies about the biology of HIV in the genital tract need to be conducted; 2) clinical trials studying drug therapy of HIV infection need to assess effect on HIV in the genital tract; 3) clinicians involved in studies and care of HIV infection need to implement educational strategies minimizing transmission of HIV from their patients. More interaction between public health and clinical approaches toward AIDS is needed. Handle: RePEc:aph:ajpbhl:1988:78:9:1210-1212_4 Template-Type: ReDIF-Article 1.0 Title: Awareness, use, and impact of the 1984 Joint National Committee consensus report on high blood pressure Journal: American Journal of Public Health Author-Name: Hill, M.N. Author-Name: Levine, D.M. Author-Name: Whelton, P.K. Year: 1988 Volume: 78 Issue: 9 Pages: 1190-1194 Abstract: A random sample of Maryland physicians stratified by practice specialty (family, general, internal medicine, cardiology, and nephrology) was surveyed before and one year after dissemination of the 1984 Report of the Third Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (The JNC III Report). Fourty-four per cent of the total eligible sample responded to both questionnaires. One year after publication, 62 per cent of physicians participating in both parts of the study were aware of the report. Although availability of a copy (58 per cent), familiarity with the recommendations (81 per cent), and the extent to which care was based on the guidelines (65 per cent) were high, use of the report in practice (17 per cent) and the amount of change in practice behavior required to adhere to the guidelines (18 per cent) were low. Prior to publication of the report, more than two-thirds of responding physicians were found to be practicing in a manner congruent with nine of ten treatment recommendations studied. One year after JNC III's release, they reported practice behavior which was not significantly different. It seems that this consensus report codified, rather than changed, practice behavior in this sample. Handle: RePEc:aph:ajpbhl:1988:78:9:1190-1194_3 Template-Type: ReDIF-Article 1.0 Title: A cost-effectiveness analysis of exercise as a health promotion activity Journal: American Journal of Public Health Author-Name: Hatziandreu, E.I. Author-Name: Koplan, J.P. Author-Name: Weinstein, M.C. Author-Name: Caspersen, C.J. Author-Name: Warner, K.E. Year: 1988 Volume: 78 Issue: 11 Pages: 1417-1421 Abstract: We used cost-effectiveness analysis to estimate the health and economic implications of exercise in preventing coronary heart disease (CHD). We assumed that nonexercisers have a relative risk of 2.0 for a CHD event. Two hypothetical cohorts (one with exercise and the other without exercise) of 1,000 35-year-old men were followed for 30 years to observe differences in the number of CHD events, life expectancy, and quality-adjusted life expectancy. We used jogging as an example to calculate cost, injury rates, adherence, and the value of time spent. Both direct and indirect costs associated with exercise, injury, and treating CHD were considered. We estimate that exercising regularly results in 78.1 fewer CHD events and 1,138.3. Quality Adjusted Life Years (QALYs) gained over the 30-year study period. Under our base case assumptions, which include indirect costs such as time spent in exercise, exercise does not produce economic savings. However, the cost per QALY gained of $11,313 is favorable when compared with other preventive or therapeutic interventions for CHD. The value of time spent is a crucial factor, influencing whether exercise is a cost-saving activity. In an alternative model, where all members of the cohort exercise for one year, and then only those who like it or are neutral continue, exercise produces net economic savings as well as reducing morbidity. Handle: RePEc:aph:ajpbhl:1988:78:11:1417-1421_8 Template-Type: ReDIF-Article 1.0 Title: The right to health care - Gains and gaps Journal: American Journal of Public Health Author-Name: Roemer, R. Year: 1988 Volume: 78 Issue: 3 Pages: 241-247 Abstract: The impact on health services of the individual rights and collective responsibility embodied in the U.S. Constitution is examined in the areas of environmental protection, development of health resources, personal health promotion, and social financing of health care costs. Patterns of delivery of health care have shifted from predominantly individualistic ambulatory care to group practice increasingly associated with the prepayment of costs and the establishment of community health centers. Problems remain in the need for more integration of medical and social services in institutions and in the community, more comprehensive community health centers not restricted to the poor, and quality control measures to regulate health maintenance organizations. The role of the law in advances in health care and the achievements of the American Public Health Association are also discussed. Handle: RePEc:aph:ajpbhl:1988:78:3:241-247_8 Template-Type: ReDIF-Article 1.0 Title: Time of exposure and risk of HIV infection in homosexual partners of men with AIDS Journal: American Journal of Public Health Author-Name: Osmond, D. Author-Name: Bacchetti, P. Author-Name: Chaisson, R. Author-Name: E. Author-Name: Kelly, T. Author-Name: Stempel, R. Author-Name: Carlson, J. Author-Name: Moss, A.R. Year: 1988 Volume: 78 Issue: 8 Pages: 944-948 Abstract: We interviewed, and tested for HIV antibody, 117 homosexual men who had been regular sexual partners of men who developed acquired immunodeficiency syndrome (AIDS); 85 tested seropositive. Receptive anal intercourse with the index AIDS case and number of different sexual partners with whom subjects were anally receptive were both risk factors. Controlling for the number of partners with whom subjects were anally receptive, we found that the odds ratio of receptive anal intercourse with the case was infinite (95% confidence intervals, 3.3-∞) if sexual contact continued up to or beyond the time of diagnosis, while the odds ratio was 1.0 (95% CI 0.3-3.2) if contact ceased before the case's AIDS diagnosis. Risk was not associated with the duration or frequency of contact. Our data suggest that the potential for sexual transmission from an HIV-infected person may be greater close to or after the onset of disease. Handle: RePEc:aph:ajpbhl:1988:78:8:944-948_6 Template-Type: ReDIF-Article 1.0 Title: Minorities and AIDS: Knowledge, attitudes, and misconceptions among Black and Latino adolescents Journal: American Journal of Public Health Author-Name: DiClemente, R.J. Author-Name: Boyer, C.B. Author-Name: Morales, E.S. Year: 1988 Volume: 78 Issue: 1 Pages: 55-57 Abstract: White adolescents in San Francisco high schools were more knowledgeable than Black adolescents about the cause, transmission, and prevention of AIDS (acquired immunodeficiency syndrome), and Black adolescents were more knowledgeable than their Latino peers. Black and Latino adolescents were approximately twice as likely as White adolescents to have misconceptions about the casual transmission of AIDS. Less knowledge about AIDS and prevalent misconceptions were associated with greater levels of perceived risk of contracting AIDS. Handle: RePEc:aph:ajpbhl:1988:78:1:55-57_2 Template-Type: ReDIF-Article 1.0 Title: Birthweight-specific infant mortality for native Americans compared with whites, six states, 1980 Journal: American Journal of Public Health Author-Name: Vanlandingham, M.J. Author-Name: Buehler, J.W. Author-Name: Hogue, C.J.R. Author-Name: Strauss, L.T. Year: 1988 Volume: 78 Issue: 5 Pages: 499-503 Abstract: We used data from the National Infant Mortality Surveillance (NIMS) project to compare birthweights and birthweight-specific mortality risks among Native American and White infants. Because race categories in NIMS were limited to White, Black, and all, we studied six states in which greater than 85 per cent of newborns who were neither White nor Black were Native American. In these states, the infant mortality risk (IMR) among Native Americans was 15.3 deaths per 1,000 live births compared with 8.7 deaths among Whites, relative risk (RR) = 1.8 (95% CI = 1.5-2.0). The percentage of Native American infants with <2,500 g birthweights was 5.8 per cent versus 5.0 per cent for White infants. Birthweight-specific neonatal mortality risks were similar for the two race groups, but birthweight-specific postneonatal mortality risks (PNMRs) were more than three times as high among Native Americans compared with Whites for infants of ≥2,500 g birthweight. PNMRs were elevated for most causes of death and for all categories for maternal age, educational attainment, trimester prenatal care began, and number of previous live births. Leading causes of postneonatal death among Native Americans of ≥2,500 g birthweight were sudden infant death syndrome and infections. Handle: RePEc:aph:ajpbhl:1988:78:5:499-503_6 Template-Type: ReDIF-Article 1.0 Title: The preventability of 'premature mortality': An investigation of early diabetes deaths Journal: American Journal of Public Health Author-Name: Will, J.C. Author-Name: Connell, F.A. Year: 1988 Volume: 78 Issue: 7 Pages: 831-833 Abstract: Certifying physicians were surveyed regarding the 40 diabetic deaths under 45 years of age occurring in Washington State between July 1 and December 31, 1984. At most, it is estimated that three deaths may have been prevented by more accessible, timely or careful medical management immediately prior to death. Over 50 per cent of decedents were reported to be financially disadvantaged and 81 per cent had significant psychological problems. The role of these psychosocial factors needs further delineation. Handle: RePEc:aph:ajpbhl:1988:78:7:831-833_7 Template-Type: ReDIF-Article 1.0 Title: Incidence of depression and anxiety: The Stirling County study Journal: American Journal of Public Health Author-Name: Murphy, J.M. Author-Name: Olivier, D.C. Author-Name: Monson, R.R. Author-Name: Sobol, A.M. Author-Name: Leighton, A.H. Year: 1988 Volume: 78 Issue: 5 Pages: 534-540 Abstract: Prevalence studies in psychiatric epidemiology outnumber incidence investigations by a wide margin. This report gives descriptive information about the incidence of depression and anxiety disorders in a general population. Using data gathered in a 16-year follow-up of an adult sample selected as part of the Stirling County Study (Canada), the incidence of these types of disorders was found to be approximately nine cases per 1,000 persons per year. The data suggest that for every man who became ill for the first time with one of these disorders, three women became ill. Incidence tended to be higher among relatively young persons. These incidence rates are consistent with prevalence rates of approximately 10 per cent to 15 per cent for depression and anxiety disorders aggregated together, given an estimated average duration of illness of about 10 years. It is concluded that these incidence rates are fairly realistic in view of evidence that disorders of these types tend to be chronic. Handle: RePEc:aph:ajpbhl:1988:78:5:534-540_0 Template-Type: ReDIF-Article 1.0 Title: Impact and costs of varicella prevention in a University Hospital Journal: American Journal of Public Health Author-Name: Weber, D.J. Author-Name: Rutala, W.A. Author-Name: Parham, C. Year: 1988 Volume: 78 Issue: 1 Pages: 19-23 Abstract: Information regarding all patient and staff exposures to varicella-zoster virus (VZV) was prospectively accumulated from 1/1/86 to 12/31/86 at North Carolina Memorial Hospital. During this period of time 37 sources of exposure to VZV were reported: 10 outside and 27 within the hospital. Index cases of nosocomial exposure included: 12 patients with zoster, 9 patients with varicella, two staff with varicella, three visitors with varicella, and one staff with zoster. One hundred and twenty patients received nosocomial exposure; 28 had no history of VZV infection (23 per cent), of whom 11 were serosusceptible (39 per cent). Sources of nosocomial patient exposure included: other patients (85 per cent), staff (14 per cent), and a single visitor (1 per cent). More than 300 employees received nosocomial exposure; 158 had no history of VZV infection, of whom 49 were serosusceptible (31 per cent). Only a single employee and no patients developed clinical varicella as a result of nosocomial exposure. Costs associated with VZV control during 1986 totalled $55,934: $39,658 for work furloughs, $9,800 for serologies, $4,293 for patient isolation, $155 for varicella-zoster immune globulin, and $2,028 for infection control personnel time. These costs should be considered as part of any benefit-cost analysis of varicella immunization of health care personnel. Handle: RePEc:aph:ajpbhl:1988:78:1:19-23_8 Template-Type: ReDIF-Article 1.0 Title: The quality of care is related to death rates: Hospital inpatient management of infants with acute gastroenteritis in Jamaica Journal: American Journal of Public Health Author-Name: Walker, G.J.A. Author-Name: Ashley, D.E.C. Author-Name: Hayes, R.J. Year: 1988 Volume: 78 Issue: 2 Pages: 149-152 Abstract: The quality of care of random samples of about 40 infants admitted with acute gastroenteritis to each of five hospitals in Jamaica was assessed. Low levels of adherence to consensus care criteria appeared to be correlated with high levels of hospital-specific severity standardized mortality ratios X100 (SSMRs); poor adherence, SSMR 127-230; intermediate adherence, SSMR 95; good adherence, SSMR 14. The main deficiencies in care at certain hospitals were: non-weighing of infants, incomplete physical examination, inadequate estimation of fluid requirements, and irregular recording of fluid intake. To improve the effective care of infants with gastroenteritis, a quality assurance program is required. Handle: RePEc:aph:ajpbhl:1988:78:2:149-152_7 Template-Type: ReDIF-Article 1.0 Title: Marriage to a smoker and lung cancer risk. Journal: American Journal of Public Health Author-Name: Gantt, R. Author-Name: Lincoln, J.E. Year: 1988 Volume: 78 Issue: 1 Pages: 99-100 Handle: RePEc:aph:ajpbhl:1988:78:1:99-100_4 Template-Type: ReDIF-Article 1.0 Title: Seating position in cars and fatality risk Journal: American Journal of Public Health Author-Name: Evans, L. Author-Name: Frick, M.C. Year: 1988 Volume: 78 Issue: 11 Pages: 1456-1458 Abstract: Fatality risk in passenger cars according to seating position (front versus rear; left versus center or right) was examined using Fatal Accident Reporting System (FARS) data for 1975 through 1985. Comparing the fatality risk of unrestrained occupants matched in sex and age (within three years) revealed effects attributable to seating position, and not to occupant characteristics correlated with use of different seats. Fatality risk to drivers was the same as fatality risk to right front passengers to within 1 per cent; this was so for crashes in all directions and for frontal crashes. Fatality risk in rear seats was (26 ± 2) per cent lower than in front seats, and lower in center compared to outboard seats by (22 ± 4) per cent for front seats and (15 ± 4) per cent for rear seats. The center rear seat was associated with the lowest fatality risk. Handle: RePEc:aph:ajpbhl:1988:78:11:1456-1458_4 Template-Type: ReDIF-Article 1.0 Title: Smaller packs of cigarettes Journal: American Journal of Public Health Author-Name: Chapman, S. Year: 1988 Volume: 78 Issue: 1 Pages: 92-93 Handle: RePEc:aph:ajpbhl:1988:78:1:92-93_5 Template-Type: ReDIF-Article 1.0 Title: Dental care and dental health: NHIS Journal: American Journal of Public Health Author-Name: Kovar, M.G. Author-Name: Jack, S. Author-Name: Bloom, B. Year: 1988 Volume: 78 Issue: 11 Pages: 1496-1497 Handle: RePEc:aph:ajpbhl:1988:78:11:1496-1497_8 Template-Type: ReDIF-Article 1.0 Title: Sexual activity among US women of reproductive age Journal: American Journal of Public Health Author-Name: Bachrach, C.A. Author-Name: Horn, M.C. Year: 1988 Volume: 78 Issue: 3 Pages: 320-321 Handle: RePEc:aph:ajpbhl:1988:78:3:320-321_4 Template-Type: ReDIF-Article 1.0 Title: Vaginal birth after cesarean (VBAC) in the 1980s Journal: American Journal of Public Health Author-Name: Placek, P.J. Author-Name: Taffel, S.M. Year: 1988 Volume: 78 Issue: 5 Pages: 512-515 Abstract: The incidence of vaginal birth after cesarean (VBAC) and characteristics of VBAC births are investigated using 1980-85 National Hospital Discharge Survey Data collected by the National Center for Health Statistics. Only 3.4 per cent of mothers with previous cesarean delivery had VBAC in their subsequent 1980 delivery; this increased to 6.6 per cent in 1985. Because VBAC is a relatively infrequent event, 1980-85 data were combined and indicate that in this period 4.9 per cent of mothers with previous cesarean had a vaginal birth in their subsequent delivery. Combined 1980-85 VBAC rates are under 10 per cent for all age, race, marital status region, hospital size, hospital ownership, and expected source of payment groups. Between 1980 and 1985, over 1.4 million repeat cesareans were performed for mothers having a live birth. Evidence suggests that potentially over 500,000 of these repeat cesareans could have been VBACs (over and above the 74,000 VBACs which occurred). VBAC mothers' mean length of hospital stay is 3.2 days, which compares closely with 3.0 days for other vaginal deliveries, but both contrast sharply with 5.6 days for repeat cesareans and 6.0 days for primary cesareans. Except for the uterine scar from the previous cesarean, VBAC mothers appear to have about the same history and frequency of complications as mothers with other vaginal deliveries. If the 500,000 repeat cesareans had been VBACs, surgical fees and costs for 1.2 million days of hospital stay would have been averted over the 1980-85 period. Handle: RePEc:aph:ajpbhl:1988:78:5:512-515_3 Template-Type: ReDIF-Article 1.0 Title: Smoking and risk of gallstone disease. Journal: American Journal of Public Health Author-Name: Math, M.V. Year: 1988 Volume: 78 Issue: 1 Pages: 100 Handle: RePEc:aph:ajpbhl:1988:78:1:100_2 Template-Type: ReDIF-Article 1.0 Title: Prevention of lower extremity stress fractures: A controlled trial of a shock absorbent insole Journal: American Journal of Public Health Author-Name: Gardner Jr., L.I. Author-Name: Dziados, J.E. Author-Name: Jones, B.H. Author-Name: Brundage, J.F. Author-Name: Harris, J.M. Author-Name: Sullivan, R. Author-Name: Gill, P. Year: 1988 Volume: 78 Issue: 12 Pages: 1563-1567 Abstract: A prospective controlled trial was carried out to determine the usefulness of a viscoelastic polymer insole in prevention of stress fractures and stress reactions of the lower extremities. The subjects were 3,025 US Marine recruits who were followed for 12 weeks of training at Parris Island, South Carolina. Polymer and standard mesh insoles were systematically distributed in boots that were issued to members of odd and even numbered platoons. The most important finding was that an elastic polymer insole with good shock absorbency properties did not prevent stress reactions of bone during a 12-week period of vigorous physical training. To control for the confounding effects of running in running shoes, which occurred for about one and one-half hours per week for the first five weeks, we also examined the association of age of shoes and cost of shoes with injury incidence. A slight trend of increasing stress injuries by increasing age of shoes was observed. However, this trend did not account for the similarity of rates in the two insole groups. In addition, we observed a strong trend of decreasing stress injury rate by history of increasing physical activity, as well as a higher stress injury rate in White compared to Black recruits. The results of the trial were not altered after controlling for these factors. This prospective study confirms previous clinical reports of the association of stress fractures with physical activity history. The clinical application of a shock absorbing insole as a preventive for lower extremity stress reactions is not supported in these uniformly trained recruits. The findings are relevant to civilian populations. Handle: RePEc:aph:ajpbhl:1988:78:12:1563-1567_4 Template-Type: ReDIF-Article 1.0 Title: Physical activity and coronary heart disease in middle-aged and elderly men: The Honolulu Heart Program Journal: American Journal of Public Health Author-Name: Donahue, R.P. Author-Name: Abbott, R.D. Author-Name: Reed, D.M. Author-Name: Yano, K. Year: 1988 Volume: 78 Issue: 6 Pages: 683-685 Abstract: The relationship of physical activity to the development of definite coronary heart disease was examined separately in middle-aged (45-64 years) and elderly men (65-69 years) participating in the Honolulu Heart Program. After 12 years of follow-up, results indicate that increased levels of physical activity reported at study entry were inversely related to the risk of definite coronary heart disease in both age groups. In particular, among those aged 45 to 64 years, the rate of definite coronary heart disease in men who led active styles was 30 per cent lower than the rate experienced by those who were less active (relative risk, 0.69; 95% confidence interval, 0.53, 0.88). In those older than 64 years, the rate of definite coronary heart disease in active men was less than half the rate experienced by those who led more sedentary life styles (relative risk, 0.43; 95% CI, 0.19, 0.99). These results continued to hold up when controlling for several cardiovascular risk factors and potentially confounding variables, supporting earlier observations that physical activity is beneficial in middle-age, and further suggesting that benefits may extend to the elderly male population as well. Handle: RePEc:aph:ajpbhl:1988:78:6:683-685_3 Template-Type: ReDIF-Article 1.0 Title: A risk profile comparison of runaway and non-runaway youth Journal: American Journal of Public Health Author-Name: Yates, G.L. Author-Name: MacKenzie, R. Author-Name: Pennbridge, J. Author-Name: Cohen, E. Year: 1988 Volume: 78 Issue: 7 Pages: 820-821 Abstract: All initial visits (N = 765) to an outpatient medical clinic during calendar year 1985 were analyzed. Six hundred and fifty-five of these visits made by non-runaway youth were compared to 100 visits made by runaways. Based on data from the Childrens Hospital Adolescent Risk Profile Interview, runaway street youth are at greater risk for a wide variety of medical problems and of health-compromising behaviors including suicide and depression, prostitution, and drug use. The implications for public health and social policy are discussed. Handle: RePEc:aph:ajpbhl:1988:78:7:820-821_5 Template-Type: ReDIF-Article 1.0 Title: Association of electronic fetal monitoring during labor with cesarean section rate and with neonatal morbidity and mortality Journal: American Journal of Public Health Author-Name: McCusker, J. Author-Name: Harris, D.R. Author-Name: Hosmer Jr., D.W. Year: 1988 Volume: 78 Issue: 9 Pages: 1170-1174 Abstract: Data from the 1980 National Natality Survey by the National Center for Health Statistics were used to assess the relation of electronic fetal monitoring (EFM) during labor with cesarean section rates and neonatal morbidity and mortality. In univariate analyses, EFM was associated with higher cesarean section rates, lower five-minute Apgar scores, and a higher rate of respiratory distress. Logistic regression analysis controlling for other risk factors for poor neonatal outcome indicated that the association of EFM with higher cesarean section rates persisted (odds ratio 1.45, 95% CI 1.16, 1.81), except in certain pregnancies at very high risk for cesarean section. EFM was associated with an Apgar score less than 6 at five minutes only if delivery was by cesarean section. EFM was not found to be independently associated with respiratory distress. Neither univariate nor multivariate analyses found an association of EFM with neonatal mortality. These results suggest that EFM may identify hypoxic infants, who are frequently delivered by cesarean section. The lack of association of EFM with beneficial neonatal outcomes is consistent either with lack of effect of EFM or with uncontrolled selection bias. Handle: RePEc:aph:ajpbhl:1988:78:9:1170-1174_3 Template-Type: ReDIF-Article 1.0 Title: Selection of elderly controls using random digit dialing Journal: American Journal of Public Health Author-Name: Olsen, G.W. Author-Name: Mandel, J.S. Year: 1988 Volume: 78 Issue: 11 Pages: 1487-1488 Abstract: The experience of identifying and soliciting elderly male controls, using a nonclustered random digit dialing procedure in a case-control study, is presented. For elderly controls (ages 65-84) 3.5 times more residential telephone numbers were required than for controls encompassing a much broader age range (ages 40-84). This is a function of the proportion of elderly in the population and their lower response to telephone identification. Elderly controls, age 70 and older, also had lower participation rates. Handle: RePEc:aph:ajpbhl:1988:78:11:1487-1488_7 Template-Type: ReDIF-Article 1.0 Title: Polio immunization policy in the United States: A new challenge for a new generation Journal: American Journal of Public Health Author-Name: Salk, D. Year: 1988 Volume: 78 Issue: 3 Pages: 296-300 Abstract: The primary reason that live poliovirus vaccine is recommended in the United States today is because it may immunize contacts who have not otherwise chosen to be vaccinated. This policy places contacts at risk of paralysis from an untested, unlicensed 'spread virus' vaccine and places infants at risk for an unproven, theoretical benefit to others, not themselves. The licensed killed poliovirus vaccine provides equivalent protection to those vaccinated, with no risk to recipients or contacts. The preceding analysis by Hinman, et al, is an interesting exercise in modeling, but many of their assumptions are open to question. Their sweeping conclusions are not justified by the type of analysis performed, which should yield an overall assessment of a decision environment not a single optimal choice. No measure of perceived social consequence of patient attitude is included, although this is of central importance today. Their report lends an aura of credibility to one conclusion, but this credibility is illusory at best. The major social issue today is not which vaccine to use, but how should polio immunization policy be evaluated. Handle: RePEc:aph:ajpbhl:1988:78:3:296-300_7 Template-Type: ReDIF-Article 1.0 Title: Maternal smoking and low birthweight in the reproductive history of women in Puerto Rico, 1982 Journal: American Journal of Public Health Author-Name: Becerra, J.E. Author-Name: Smith, J.C. Year: 1988 Volume: 78 Issue: 3 Pages: 268-272 Abstract: In 1982, a representative sample of 3,175 women ages 15 to 49 years living in Puerto Rico were interviewed and complete reproductive histories obtained. Births to mothers who started smoking regularly at some time before delivery and who were still smoking at the time of the interview (the exposure definition) were compared with unexposed births. Our analysis of 4,444 single, live births delivered in public and private hospitals from 1946 through 1982 demonstrates that births to smoking women aged 20 and older delivering in public hospitals were 2.5 times more likely to weigh less than 2,500 grams (95% confidence interval (CI) = 1.9, 2.3), and on the average weighed 207 grams less (95% CI = 130, 284) than births to a comparable group of nonsmoking mothers. However, we found no other difference in birthweight between newborns of smoking and nonsmoking women when comparing their births within the same hospital category and age group. The data in this study suggest that the effect of smoking on birthweight among to Puerto Rican women may be modified by maternal age and by whether the infant was born in a private or public hospital. Handle: RePEc:aph:ajpbhl:1988:78:3:268-272_1 Template-Type: ReDIF-Article 1.0 Title: Associations between alcoholic beverage consumption and hospitalization, 1983 National Health Interview Survey Journal: American Journal of Public Health Author-Name: Longnecker, M.P. Author-Name: MacMahon, B. Year: 1988 Volume: 78 Issue: 2 Pages: 153-156 Abstract: Data collected in the Alcohol Supplement and core 1983 National Health Interview Survey were used to examine associations between alcoholic beverage consumption and hospitalization. Hospitalizations in acute facilities (excluding hospitalizations for delivery) in the past 12 months, were treated as dichotomous (any vs none) and examined in relation to alcohol consumption in a logistic regression model adjusting for age, race, income, and smoking. Findings are based on 17,600 individuals meeting inclusion criteria. The adjusted odds ratio of having one or more hospitalization for current drinkers relative to life-long abstainers in females was 0.67 (95 per cent confidence interval 0.57-0.79) and in males was 0.74 (0.57-0.96). U-shaped relationships between level of current alcohol intake and odds of hospitalization were found. While some causes of hospitalization are clearly increased among drinkers, the overall acute care hospitalization experience of moderate drinkers appears to be favorable. Handle: RePEc:aph:ajpbhl:1988:78:2:153-156_1 Template-Type: ReDIF-Article 1.0 Title: Ethnic differences in female overweight: Data from the 1985 National Health Interview Survey Journal: American Journal of Public Health Author-Name: Dawson, D.A. Year: 1988 Volume: 78 Issue: 10 Pages: 1326-1329 Abstract: Ethnic differences in female overweight were analyzed using data from the 1985 National Health Inverview Survey. The sample consisted of approximately 17,000 women, ages 18 and over. After adjusting for age and poverty status, there were clear differences in the proportions of women 20 per cent or more overweight among Black, Hispanic and other White women (35, 26 and 20 per cent, respectively). Black women were less likely than White women to perceive themselves as overweight when categorized by actual weight relative to ideal weight: however, within categories of weight relative to other women of the same ethnic group, all women not Hispanic were equally likely to consider themselves overweight. There was no difference by ethnicity in the proportion of women trying to lose weight among those who perceived themselves as overweight. These findings have implications for programs designed to modify weight, since they suggest that women use ethnic-specific standards in assessing overweight. Handle: RePEc:aph:ajpbhl:1988:78:10:1326-1329_2 Template-Type: ReDIF-Article 1.0 Title: DTP immunization status and tetanus antitoxin titers of Mexican American children ages six months through eleven years Journal: American Journal of Public Health Author-Name: Gergen, P.J. Author-Name: Ezzati, T. Author-Name: Russell, H. Year: 1988 Volume: 78 Issue: 11 Pages: 1446-1450 Abstract: Data from the Mexican American portion of the Hispanic Health and Nutrition Examination Survey (HHANES), conducted in 1982-1983, were analyzed for the number of diphtheria, tetanus, and pertussis (DTP) immunizations reported for Mexican American children 6 months-11 years of age and for levels of tetanus antitoxin titers in Mexican American children 4-11 years of age. In Mexican American children 6 months-11 years, 98.2 per cent had one or more DTP immunizations reported (95 per cent CI: 97.5, 98.9%); 85.1 per cent had three or more DTP immunizations reported (95 per cent CI: 83.2, 87.0%). The reported immunization coverage in Mexican American children was corroborated by the tetanus antitoxin titers which were above the minimum protective level (≥ 0.01 IU/ml) in 99.6 per cent of the 4-11 year olds. Using the American Academy of Pediatrics' (AAP) recommendations for the number of DTP immunizations, 61.1 per cent of the children 6 months-11 years of age had the age-appropriate number of immunizations (95 per cent CI: 58.5, 63.7%). AAP immunization completion rates were higher for children who: had a source of care reported (62.1 vs 44.3%; 95% CI of the difference: 7.1, 28.5); had insurance coverage (63.5 vs 56.1%; 95% CI of the difference: 2, 12.8); lived in a standard metropolitan statistical area (SMSA)-not central city as compared to SMSA-central city or not SMSA (66.6 vs 57.1%; 95% CI of the difference: 4.3, 14.7); and had 12 or more completed years of education for the head of the household (65.4 vs 58.3%; 95% CI of the difference: 1.8, 12.4). These four predictors were used to identify subgroups within the Mexican American population at high risk for incomplete immunization status. Handle: RePEc:aph:ajpbhl:1988:78:11:1446-1450_2 Template-Type: ReDIF-Article 1.0 Title: Social inequalities in the decline of coronary mortality Journal: American Journal of Public Health Author-Name: Wing, S. Year: 1988 Volume: 78 Issue: 11 Pages: 1415-1416 Handle: RePEc:aph:ajpbhl:1988:78:11:1415-1416_9 Template-Type: ReDIF-Article 1.0 Title: Investigation of possible health effects of community exposure to fermenting wood chips Journal: American Journal of Public Health Author-Name: Birkhead, G. Author-Name: Vogt, R.L. Author-Name: Hudson, P.J. Year: 1988 Volume: 78 Issue: 3 Pages: 318-319 Abstract: We conducted a case-control study of emergency room (ER) patients to evaluate whether asthma is caused by living near a wood-chip fueled power plant that released wood-chip fermentation products. Only eight (29 per cent) of 28 asthma patients seen in the ER during an 11-week period lived within 1.5 miles of the plant compared with 18 (34 per cent) of 54 control patients matched for severity of diagnosis and seen during the same period (Mantel-Haenszel odds ratio controlling for age = 0.96). Handle: RePEc:aph:ajpbhl:1988:78:3:318-319_3 Template-Type: ReDIF-Article 1.0 Title: Racial trends in syphilis among men with same-sex partners in Atlanta, Georgia Journal: American Journal of Public Health Author-Name: Landrum, S. Author-Name: Beck-Sague, C. Author-Name: Kraus, S. Year: 1988 Volume: 78 Issue: 1 Pages: 66-67 Abstract: Early syphilis cases attributable to homosexual transmission declined in DeKalb County, Georgia, from 191 in 1981 to 97 in 1985. This decline occurred only among White men with same sex partners (SSP); early syphilis among Black men with same sexual partners has risen. This pattern is consistent with the hypothesis that changes in sexual behavior instituted by White men at risk of acquiring HTLV-III/LAV infection may have resulted in decreased incidence of early syphilis among those men. Handle: RePEc:aph:ajpbhl:1988:78:1:66-67_8 Template-Type: ReDIF-Article 1.0 Title: Morbidity and use of ambulatory care services among poor and nonpoor children Journal: American Journal of Public Health Author-Name: Newacheck, P.W. Author-Name: Starfield, B. Year: 1988 Volume: 78 Issue: 8 Pages: 927-933 Abstract: Using data from the Child Health Supplement to the 1981 National Health Interview Survey, illness and use of physician services are compared for children under 18 years old in three family income groups. The results indicate that although annual prevalence of many health problems does not differ greatly by income level, disability as measured by bed days is greater among low income children. A substantial minority of children from all socioeconomic levels are afflicted by multiple health problems. The impact of multiple conditions, as measured by days spent ill in bed, appears much greater for children from low income families. Use of physician services was found to be similar for children of all socioeconomic levels when no significant health problems were present, but low income children with health problems used fewer physician visits on an adjusted basis than their higher income counterparts. Handle: RePEc:aph:ajpbhl:1988:78:8:927-933_1 Template-Type: ReDIF-Article 1.0 Title: Mortality from lung cancer and chronic obstructive pulmonary disease in New Mexico, 1958-82 Journal: American Journal of Public Health Author-Name: Samet, J.M. Author-Name: Wiggins, C.L. Author-Name: Key, C.R. Author-Name: Becker, T.M. Year: 1988 Volume: 78 Issue: 9 Pages: 1182-1186 Abstract: We examined mortality from lung cancer and from chronic obstructive pulmonary disease in Hispanic White, Other White, and Native American residents of New Mexico during the period 1958-82. Age-specific mortality was calculated by combining death certificate data with population estimates based on the 1960, 1970, and 1980 censuses that were adjusted for inconsistencies in the designation of race and ethnicity. In Other Whites, age-adjusted mortality rates from lung cancer and from chronic obstructive pulmonary increased disease progressively in males and females. Mortality rates for both diseases also increased in Hispanics during the study period, but the most recent rates for Hispanics were well below those for Other Whites. Age-specific mortality rates for lung cancer declined for more recently born Hispanic women at older ages. In Native Americans, rates for both diseases were low throughout the study period and did not show consistent temporal trends. Handle: RePEc:aph:ajpbhl:1988:78:9:1182-1186_1 Template-Type: ReDIF-Article 1.0 Title: Maternal mortality surveillance Journal: American Journal of Public Health Author-Name: Entman, S.S. Author-Name: Atrash, H.K. Author-Name: Koonin, L.M. Author-Name: Smith, J.C. Year: 1988 Volume: 78 Issue: 11 Pages: 1499-1500 Handle: RePEc:aph:ajpbhl:1988:78:11:1499-1500_8 Template-Type: ReDIF-Article 1.0 Title: Sexual behavior and risks of HIV infection Journal: American Journal of Public Health Author-Name: Kristal, A.R. Year: 1988 Volume: 78 Issue: 1 Pages: 91 Handle: RePEc:aph:ajpbhl:1988:78:1:91_1 Template-Type: ReDIF-Article 1.0 Title: Effects of the North Carolina Prematurity Prevention Program among public patients delivering at New Hanover Memorial Hospital Journal: American Journal of Public Health Author-Name: Covington, D.L. Author-Name: Carl, J. Author-Name: Daley, J.G. Author-Name: Cushing, D. Author-Name: Churchill, M.P. Year: 1988 Volume: 78 Issue: 11 Pages: 1493-1495 Abstract: Twelve per cent of the 487 women who delivered in one hospital prior to implementation of the North Carolina Prematurity Prevention Program had low-birthweight births compared with 9.5 per cent of the 748 women who delivered during the program. Controlling for known risk factors, both low- and very-low birthweight births among Whites (Odds Ratio 2.0 and 3.7 respectively) and very-low-birthweight births among Blacks (OR 2.9) were reduced. Handle: RePEc:aph:ajpbhl:1988:78:11:1493-1495_6 Template-Type: ReDIF-Article 1.0 Title: Evidence and scientific research Journal: American Journal of Public Health Author-Name: Goodman, S.N. Author-Name: Royall, R. Year: 1988 Volume: 78 Issue: 12 Pages: 1568-1574 Abstract: This commentary reviews the arguments for and against the use of p-values put forward in the Journal and other forums, and shows that they are all missing both a measure and concept of 'evidence'. The mathematics and logic of evidential theory are presented, with the log-likelihood ratio used as the measure of evidence. The profoundly different philosophy behind evidential methods (as compared to traditional ones) is presented, as well as a comparative example showing the difference between the two approaches. The reasons why we mistakenly ascribe evidential meaning to p-values and related measures are discussed. Unfamiliarity with the technology and philosophy of evidence is seen as the main reason why certain arguments about p-values persist, and why they are frequently contradictory and confusing. Handle: RePEc:aph:ajpbhl:1988:78:12:1568-1574_5 Template-Type: ReDIF-Article 1.0 Title: Selecting patients when resources are limited: A study of US medical directors of kidney dialysis and transplantation facilities Journal: American Journal of Public Health Author-Name: Kilner, J.F. Year: 1988 Volume: 78 Issue: 2 Pages: 144-147 Abstract: This study reports and discusses responses of 453 medical directors of renal dialysis and transplantation facilities to detailed patient selection questionnaires. The questionnaires examine selection criteria being used today as well as those which would be employed were resources to remain or become scarce relative to need. Selection criteria examined (and the number of directors supporting them when resources are limited) are: qualitative prognosis, psychological stability, likelihood of medical benefit, quantitative prognosis, medical benefit (virtually all); willingness, age (very large majority); unique moral duties, disproportionate resources, environment, progress of science, social value (majority); ability to pay, random selection, constituency (very large minority); sex (virtually none). Qualitative prognosis, quantitative prognosis, medical benefit, ability to pay, and especially age are the criteria employed today whose influence would increase if resources are further limited. Some of the ethical implications of various criteria are discussed. Handle: RePEc:aph:ajpbhl:1988:78:2:144-147_8 Template-Type: ReDIF-Article 1.0 Title: Within month variability in use of soup kitchens in New York State Journal: American Journal of Public Health Author-Name: Thompson, F.E. Author-Name: Taren, D.L. Author-Name: Andersen, E. Author-Name: Casella, G. Author-Name: Lambert, J.K.J. Author-Name: Campbell, C.C. Author-Name: Frongillo Jr., E.A. Author-Name: Spicer, D. Year: 1988 Volume: 78 Issue: 10 Pages: 1298-1301 Abstract: This paper describes the variation in use of soup kitchens throughout the month using data from the New York State Nutritional Surveillance Program. Excluding November, December, and May, when holiday meals created a different pattern of use, number of meals served in soup kitchens generally increased toward the end of the month, averaging 43 per cent higher for Upstate and 14 per cent higher for New York City in the last week as compared to the first week of the month. The overall increase throughout the month and difference in magnitude of increase between Upstate and New York City corresponds to the timing of income maintenance benefits distribution. Distribution of most public assistance benefits occurs at the beginning of each month in Upstate, whereas it is staggered in New York City throughout the month. Handle: RePEc:aph:ajpbhl:1988:78:10:1298-1301_9 Template-Type: ReDIF-Article 1.0 Title: International developments in abortion laws: 1977-88 Journal: American Journal of Public Health Author-Name: Cook, R.J. Author-Name: Dickens, B.M. Year: 1988 Volume: 78 Issue: 10 Pages: 1305-1311 Abstract: During the period between 1977 and the first quarter of 1988, 35 countries liberalized their abortion laws and four countries limited grounds for the procedure. Most legislation has extended abortion eligibility through traditional indications such as danger to maternal health or fetal handicap, but a number of other indications have been created such as adolescence, advanced maternal age, family circumstances, and AIDS or HIV infection. A number of countries have redesigned their abortion laws as part of a comprehensive package to facilitate access to and delivery of contraception voluntary sterilization, and abortion services. Abortion litigation has increased and stimulated the liberalization of abortion provisions and the support of women's autonomous choice within the law. In Canada, the entire criminal prohibition of abortion was held unconstitutional for violating women's integrity and security. In contrast, Latin American and other constitutional developments may limit legal abortion to instances of danger to women's lives. Handle: RePEc:aph:ajpbhl:1988:78:10:1305-1311_0 Template-Type: ReDIF-Article 1.0 Title: Hemolytic-uremic syndrome: A population-based study in Washington, DC and Baltimore, Maryland Journal: American Journal of Public Health Author-Name: Kinney, J.S. Author-Name: Gross, T.P. Author-Name: Porter, G.C. Author-Name: Rogers, M.F. Author-Name: Schonberger, L.B. Author-Name: Hurwitz, E.S. Year: 1988 Volume: 78 Issue: 1 Pages: 64-65 Abstract: A population-based study of hemolytic-uremic syndrome (HUS) revealed that 20 child residents of Washington, DC and Baltimore, Maryland were hospitalized with HUS from January 1979 through September 1983. The number of cases peaked during the summer and fall; none occurred during the winter. Incidence of hospitalized cases was higher in Whites and girls than in Blacks or boys, and the average annual incidence was 1.08 cases/100,000 children <5 year old. This study demonstrates that HUS is not unique to the West Coast, as previously suggested. Handle: RePEc:aph:ajpbhl:1988:78:1:64-65_1 Template-Type: ReDIF-Article 1.0 Title: Sociodemographic and behavioral characteristics of HIV antibody-positive blood donors Journal: American Journal of Public Health Author-Name: Cleary, P.D. Author-Name: Singer, E. Author-Name: Rogers, T.F. Author-Name: Avorn, J. Author-Name: Van Devanter, N. Author-Name: Soumerai, S. Author-Name: Perry, S. Author-Name: Pindyck, J. Year: 1988 Volume: 78 Issue: 8 Pages: 953-957 Abstract: This paper describes the sociodemographic and behavioral characteristics of 173 blood donors who were confirmed by Western blot tests to have antibodies to human immunodeficiency virus (HIV), the etiologic agent for acquired immunodeficiency syndrome (AIDS). Seropositive donors were predominately young, unmarried, and male, and major risk factors could be identified for almost all donors. However, more than 20 per cent of the study participants were women, and many participants were not aware that they were at risk of infection. The heterogeneity of the study population, the lack of awareness among many subjects of risk factors and self-exclusion procedures and the high level of distress among many subjects after notification, emphasize the need for intensive, well-designed education and support programs. Handle: RePEc:aph:ajpbhl:1988:78:8:953-957_6 Template-Type: ReDIF-Article 1.0 Title: Use of a leukocyte esterase dipstick to detect Chlamydia trachomatis and Neisseria gonorrhoeae urethritis in asymptomatic adolescent male detainees Journal: American Journal of Public Health Author-Name: O'Brien, S.F. Author-Name: Bell, T.A. Author-Name: Farrow, J.A. Year: 1988 Volume: 78 Issue: 12 Pages: 1583-1584 Abstract: We tested 91 asymptomatic adolescent male detainees in a short-stay detention facility in Seattle, Washington for the presence of leukocyte esterase in first-catch urine and for Chlamydia trachomatis and Neisseria gonorrhoeae infection. C. trachomatis was isolated from 10 subjects (11 per cent) and N. gonorrhoeae from five (5 per cent). Dipsticks detected leukocyte esterase in the urine of all 15 subjects with either infection and of 13 subjects with neither infection. Detection of leukocyte esterase was 100 per cent sensitive, 83 per cent specific, and 54 per cent predictive for the presence of either organism. Handle: RePEc:aph:ajpbhl:1988:78:12:1583-1584_4 Template-Type: ReDIF-Article 1.0 Title: Prevalence of hepatitis B markers among pregnant Hispanic women in migrant/seasonal work in Oregon Journal: American Journal of Public Health Author-Name: Fehrs, L.J. Author-Name: Eisele, L. Author-Name: Conrad, R. Author-Name: Foster, L.R. Author-Name: Fleming, D. Year: 1988 Volume: 78 Issue: 8 Pages: 971-972 Abstract: We screened 303 Hispanic pregnant women who were migrant or seasonal agricultural workers in Oregon for the presence of Hepatitis B serological markers. One carrier was identified (0.3 per cent, 95% confidence interval [CI] .02%, 2.1%). Evidence of previous HB infection was present in 5.3 per cent (16/303) of the women (95% CI 3.2%, 8.6%), rates similar to those for the general US population. Handle: RePEc:aph:ajpbhl:1988:78:8:971-972_9 Template-Type: ReDIF-Article 1.0 Title: The persistence of Shigella flexneri in the United States: Increasing role of adult males Journal: American Journal of Public Health Author-Name: Tauxe, R.V. Author-Name: McDonald, R.C. Author-Name: Hargrett-Bean, N. Author-Name: Blake, P.A. Year: 1988 Volume: 78 Issue: 11 Pages: 1432-1435 Abstract: The annual reported isolation rate of Shigella flexneri decreased from 1964 to 1973, but has remained constant since then at 1 per 100,000. Between 1975 and 1985, the median age of males from whom S. flexneri was isolated rose from 5 to 26 years. During this time, the isolation rate of S. flexneri rose more than five-fold among men, did not change in adult women, and decreased in children. By 1985, 23 per cent of reported S. flexneri isolates came from men aged 20-49. Increased male homosexual transmission of S. flexneri is a possible explanation for these findings. Handle: RePEc:aph:ajpbhl:1988:78:11:1432-1435_9 Template-Type: ReDIF-Article 1.0 Title: Nurse administration of sleep medication: A comparison of registered nurses and licensed practical nurses Journal: American Journal of Public Health Author-Name: Robers, P.A. Author-Name: Moore, T.S. Author-Name: Svarstad, B.L. Year: 1988 Volume: 78 Issue: 12 Pages: 1581-1583 Abstract: This study examines differences in the administration of PRN (pro re nata or give 'as needed') sleep medication between licensed practical nurses and registered nurses working in long-term care facilities. Work characteristics, characteristics of the residents cared for, and the extent of orders and administration of PRN sleep medications were similar in the two groups. No significant differences in the administration of PRN sleep medication were found. Handle: RePEc:aph:ajpbhl:1988:78:12:1581-1583_3 Template-Type: ReDIF-Article 1.0 Title: The stability of health status in rheumatoid arthritis: A five-year study of patients with established disease Journal: American Journal of Public Health Author-Name: Meenan, R.F. Author-Name: Kazis, L.E. Author-Name: Anderson, J.J. Year: 1988 Volume: 78 Issue: 11 Pages: 1484-1487 Abstract: We employed a health status measure to describe the outcomes of rheumatoid arthritis patients over five years. Of the 410 rheumatoid arthritis patients who were originally administered the Arthritis Impact Measurement Scales (AIMS), 299 completed a follow-up five years later. Data were analyzed using nine health status scales, three components of health status, and an overall arthritis impact item. Results for survivors indicated that there were no clinically important deteriorations in any of these measures. In fact, small improvements on most measures were found. The health status changes were similar for patients originally in a clinical trial and for those receiving routine specialty care. Age was found to positively relate to improvements in psychological status and overall arthritis impact, but we were unable to demonstrate any consistent effects of sex, marital status, education, or disease duration. Our results contrast with other studies that have noted major declines over time in the health status of patients with rheumatoid arthritis. Furthermore, level of education was not a major determinant of morbidity in this group. These results suggest that health status in certain patients with rheumatoid arthritis is more stable than previously thought. This has implications for both clinical practice and clinical research in rheumatology. Handle: RePEc:aph:ajpbhl:1988:78:11:1484-1487_0 Template-Type: ReDIF-Article 1.0 Title: A comparison of women in and out of a prematurity prevention project in a North Carolina perinatal care region Journal: American Journal of Public Health Author-Name: Buescher, P.A. Author-Name: Meis, P.J. Author-Name: Ernest, J.M. Author-Name: Moore, M.L. Author-Name: Michielutte, R. Author-Name: Sharp, P. Year: 1988 Volume: 78 Issue: 3 Pages: 264-267 Abstract: We assessed a prematurity prevention project in a North Carolina region with 21,000 annual births in terms of its impact on low birthweight. Project records were matched to birth certificates in order to compare characteristics of women in and out of the program who received prenatal care from private providers. A logistic regression analysis, in which the effects of race, marital status, age, and other risk factors for low birthweight were statistically controlled, showed that women not in the project were 1.32 times (95% Confidence Interval 1.14, 1.54) as likely as project participants to have a birth under 2500 grams. The relative risk for non-participants for a birth under 1500 grams was 1.87 (95% CI 1.25, 2.80). Strengths and limitations of the study are discussed. The results are consistent with previous work examinating the etiologies of low birthweight in private versus public patients. Handle: RePEc:aph:ajpbhl:1988:78:3:264-267_2 Template-Type: ReDIF-Article 1.0 Title: The effect of sunglasses on ocular exposure to ultraviolet radiation Journal: American Journal of Public Health Author-Name: Rosenthal, F.S. Author-Name: Bakalian, A.E. Author-Name: Lou, C. Author-Name: Taylor, H.R. Year: 1988 Volume: 78 Issue: 1 Pages: 72-74 Abstract: Thirty-two pairs of inexpensive sunglasses were examined for their effectiveness in preventing ultraviolet radiation (UVR) from reaching the eyes. The transmission of UVB (290-310 nm) by all of the sunglass lenses was less than 2 per cent. However, in measurements performed with mannikins wearing the sunglasses, up to 14.1 per cent of the incident UVR passed through to the eyes. When the sunglasses were moved 6 mm from the forehead, the per cent reaching the eyes ranged from 3.7 t0 44.8 per cent. Although sunglasses are somewhat more effective than untinted prescription eyewear in attenuating ocular exposure, the amount of attenuation is highly variable and depends mainly on their size, shape, and wearing position. Handle: RePEc:aph:ajpbhl:1988:78:1:72-74_5 Template-Type: ReDIF-Article 1.0 Title: More frequent diagnosis of acute myocardial infarction among Navajo Indians Journal: American Journal of Public Health Author-Name: Klain, M. Author-Name: Coulehan, J.L. Author-Name: Arena, V.C. Author-Name: Janett, R. Year: 1988 Volume: 78 Issue: 10 Pages: 1351-1352 Abstract: In an earlier study, we failed to confirm a clinical impression that the incidence of acute myocardial infarction (AMI) was increasing in Navajo men. Extending our data collection an additional three years, through 1986, we observed that the attack rate in men more than doubled and there was a gradual increase among women. Most Navajos who sustain AMI are hypertensive (51 per cent), diabetic (50 per cent) or both (31 per cent), but few smoke cigarettes. Handle: RePEc:aph:ajpbhl:1988:78:10:1351-1352_3 Template-Type: ReDIF-Article 1.0 Title: Prescribing of noncontraceptive estrogens and progestins in the United States, 1974-86 Journal: American Journal of Public Health Author-Name: Hemminki, E. Author-Name: Kennedy, D.L. Author-Name: Baum, C. Author-Name: McKinlay, S.M. Year: 1988 Volume: 78 Issue: 11 Pages: 1479-1481 Abstract: This paper describes changes in the prescribing in noncontraceptive estrogens and progestins, using data from pharmaceutical marketing surveys. The number of estrogen prescriptions decreased from 1975 to 1980, and then increased through 1986. Progestin use has increased since 1982; concomitant use of estrogens and progestins increased over time and was common in 1986. The trends suggest that the use of estrogens, particularly the combined use of estrogens and progestins, will continue to increase. Handle: RePEc:aph:ajpbhl:1988:78:11:1479-1481_5 Template-Type: ReDIF-Article 1.0 Title: Toward justice in health care Journal: American Journal of Public Health Author-Name: Bayer, R. Author-Name: Callahan, D. Author-Name: Caplan, A.L. Author-Name: Jennings, B. Year: 1988 Volume: 78 Issue: 5 Pages: 583-588 Abstract: The demands of equity and efficiency require a program of universal health insurance in the United States through which all workers will be provided by their employers with health insurance for themselves and their dependents, unemployment will no longer result in the loss of health insurance protection, and federal standards for Medicaid eligibility will be instituted. Issues raised by the assessment of insurance coverage and establishment of uniform standards are discussed within the context of the ethical foundations of medical necessity, schemes for sharing the burden of cost, and the conflict between technological advances and the limitation of resources. Cost containment measures now most prominently on the public agenda represent an unfortunate trend toward exacerbating inequalities by making the patient the main cost container. Moral priority must be given to remedying the patterns of inequality that characterize the American health care system. Handle: RePEc:aph:ajpbhl:1988:78:5:583-588_3 Template-Type: ReDIF-Article 1.0 Title: The paradoxes of organ transplantation Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1988 Volume: 78 Issue: 6 Pages: 621-622 Handle: RePEc:aph:ajpbhl:1988:78:6:621-622_8 Template-Type: ReDIF-Article 1.0 Title: Purple burps and the filtration of drinking water supplies Journal: American Journal of Public Health Author-Name: Jakubowski, W. Year: 1988 Volume: 78 Issue: 2 Pages: 123-125 Handle: RePEc:aph:ajpbhl:1988:78:2:123-125_7 Template-Type: ReDIF-Article 1.0 Title: The perfectibility of public programs: Real lessons from large-scale demonstration projects Journal: American Journal of Public Health Author-Name: Schlesinger, M. Year: 1988 Volume: 78 Issue: 8 Pages: 899-902 Handle: RePEc:aph:ajpbhl:1988:78:8:899-902_5 Template-Type: ReDIF-Article 1.0 Title: Public health in the field - the rescue is at hand Journal: American Journal of Public Health Author-Name: Tilson, H.H. Year: 1988 Volume: 78 Issue: 12 Pages: 1529-1530 Handle: RePEc:aph:ajpbhl:1988:78:12:1529-1530_2 Template-Type: ReDIF-Article 1.0 Title: Screening blood donors for human immunodeficiency virus antibody: Cost-benefit analysis Journal: American Journal of Public Health Author-Name: Eisenstaedt, R.S. Author-Name: Getzen, T.E. Year: 1988 Volume: 78 Issue: 4 Pages: 450-454 Abstract: The costs benefits of screening blood donors for antibody to human immunodeficiency virus (HIV) are assessed. Total costs, including testing, discarding processed blood, marginal donor recruiting, notifying and evaluating positive donors, are $36,234,000 annually for 10 million donors in 1986. Screening these donors will prevent 292 cases of transfusion-transmitted acquired immune deficiency syndrome (TT-AIDS), saving the costs of therapy and loss of earnings for total benefits of $43,490,480, a benefit:cost ratio of 1.2:1. Net economic benefits of $0.73 per donor will arise from the program. Caculated benefits will rise as increased numbers of infected recipients are diagnosed with longer follow-up or as partially effective therapy increases the cost of caring for patients with AIDS. Changes in test sensitivity, follow-up procedures, estimated value of life, and testing costs will also alter these projections, but none as dramatically as a change in the overall specificity of the screening process. The cost per case of TT-AIDS prevented, $124,089, and cost per year of life extended, $10,885, are comparable to costs of other screening programs. Handle: RePEc:aph:ajpbhl:1988:78:4:450-454_2 Template-Type: ReDIF-Article 1.0 Title: Inadequate utilization of routine electronic RBC counts to identify beta thalassemia carriers Journal: American Journal of Public Health Author-Name: Shalev, O. Author-Name: Yehezkel, E. Author-Name: Rachmilewitz, E.A. Year: 1988 Volume: 78 Issue: 11 Pages: 1476-1477 Abstract: We investigated physician awareness of the diagnosis of beta thalassemia minor as suggested by RBC indices obtained from routine electronic counts; and, the knowledge of the carriers of their genetic trait. Out of 17,000 counts, 324 were compatible with the diagnosis of beta thalassemia minor, but, only 175 (54 per cent) were identified by physicians as possibly thalassemic and in 47 of these (27 per cent) was the diagnosis verified. Twenty-four of 39 interviewed patients in whom the diagnosis of beta thalassemia minor was established knew about their carrier state. Handle: RePEc:aph:ajpbhl:1988:78:11:1476-1477_9 Template-Type: ReDIF-Article 1.0 Title: Emergency department patient 'dumping': An analysis of interhospital transfers to the regional medical center at Memphis, Tennessee Journal: American Journal of Public Health Author-Name: Kellermann, A.L. Author-Name: Hackman, B.B. Year: 1988 Volume: 78 Issue: 10 Pages: 1287-1292 Abstract: To study the extent and nature of transfers of emergency department (ED) patients because of inability to pay, we audited all telephone requests and actual patient transfers from private hospital EDs and their affiliated free-standing emergency centers to the ED of the Regional Medical Center at Memphis (the Med), a publicly subsidized hospital, between June 1 and August 31, 1986. Transfers to the Med's 'special care' centers were assumed to represent tertiary care referrals and were excluded. During the 92-day study interval, ED physicians at the Med handled 190 telephone requests for transfer. Requesting physicians explicitly identified 'no money' or 'no insurance' as the primary reason for transfer in 89 per cent of 164 cases in which these data were recorded. Thirty-seven per cent of requests were refused; half were too unstable or required an intensive care unit (ICU) bed when none were available. One hundred forty-six transfers (55 per cent) arrived without prior telephone authorization, most by private automibile. Almost all transferred patients (91 per cent) were sent for primarily economic reasons. One out of four was found to be unstable on arrival by explicit clinical criteria. Eighty-two patients transferred for economic reasons (34 per cent) required emergency hospitalization and accountred for 564 bed days during a period of extreme inpatient crowding. Three patients died prior to discharge. Two had been transferred for primarily economic reasons. Handle: RePEc:aph:ajpbhl:1988:78:10:1287-1292_8 Template-Type: ReDIF-Article 1.0 Title: Health insurance and AIDS: The status of state regulatory activity Journal: American Journal of Public Health Author-Name: Faden, R.R. Author-Name: Kass, N.E. Year: 1988 Volume: 78 Issue: 4 Pages: 437-438 Abstract: Information collected by the National Gay Rights Advocates in 1986 and by the authors in the spring of 1987 was used to determine the extent to which the states currently regulate the practices of the health insurance industry specific to acquired immunodeficiency syndrome (AIDS). Of the 10 states reporting the greatest number of AIDS cases, six prohibit insurers form denying coverage to group policy applicants because of human immunodeficiency virus (HIV) infection. These findings refer only to the status of state regulatory activity specific to AIDS. Handle: RePEc:aph:ajpbhl:1988:78:4:437-438_6 Template-Type: ReDIF-Article 1.0 Title: Monitoring the diffusion of a technology: Coronary artery bypass surgery in Ontario Journal: American Journal of Public Health Author-Name: Anderson, G.M. Author-Name: Lomas, J. Year: 1988 Volume: 78 Issue: 3 Pages: 251-254 Abstract: Technology assessment involves not only examining technologies before they are released but also their diffusion into practice once they have been released. In this study we show how basic analysis of a large administrative data set, combined with a review of evidence on effectiveness, can be used as the first step in technology assessment. We analyze the use of coronary artery bypass surgery (CABS) in the province of Ontario, Canada. The annual number of procedures increased 52 per cent over a seven-year period between 1979 and 1985. Large increases in CABS rates in the over-65 population accounted for more than half of this increase in procedures. Increased rates of surgery in the over-65 population are unlikely to be caused by increased prevalence of coronary artery disease and may be the result of a change in clinical attitude toward the use of CABS. This change is discussed in the context of the evidence on the effectiveness and cost-effectiveness of CABS. We conclude that there is a need to carefully monitor and evaluate the use of technologies especially in the elderly. Handle: RePEc:aph:ajpbhl:1988:78:3:251-254_8 Template-Type: ReDIF-Article 1.0 Title: Divergence of the recent trends in coronary mortality for the four major race-sex groups in the United States Journal: American Journal of Public Health Author-Name: Sempos, C. Author-Name: Cooper, R. Author-Name: Kovar, M.G. Author-Name: McMillen, M. Year: 1988 Volume: 78 Issue: 11 Pages: 1422-1427 Abstract: Since 1976 there has been a leveling off or slowdown in the rate of decline in coronary heart disease (CHD) mortality. The age-adjusted absolute annual rate of decline in CHD mortality rates during 1968-75 (Δ rate/100,000 population/year) was virtually identical for White males (-7.54), Black males (-7.85), and Black females (-7.20), and somewhat lower for White females (-4.25). During 1976-85, however, the secular trends diverged considerably. Age-adjusted rates continued to decline at the same annual rate for White males, while the decline was approximately half as steep for the other three race-sex groups. During 1976-85 there was also a leveling off in the average annual per cent change in age-adjusted CHD mortality for Black males and females and White females when compared to 1968-75, while there was no change for White males. As a result, more than 40,000 White and Black females and Black males died of CHD in 1985 than would have died if CHD rates would have continued to decline at the 1968-75 trends. All comparisons were based on a reclassification of cause-of-death codes to maximize comparability between the 8th and 9th Revisions of the International Classification of Disease. These results suggest that the factors which have led to the continued decline in coronary heart disease may not have influenced all the demographic groups in this country equally over the last decade. Handle: RePEc:aph:ajpbhl:1988:78:11:1422-1427_0 Template-Type: ReDIF-Article 1.0 Title: 'Hypertensive emergency': A useful diagnostic category Journal: American Journal of Public Health Author-Name: Hickler, R.B. Year: 1988 Volume: 78 Issue: 6 Pages: 623-624 Handle: RePEc:aph:ajpbhl:1988:78:6:623-624_9 Template-Type: ReDIF-Article 1.0 Title: 1986 C-sections rise; VBACs inch upward Journal: American Journal of Public Health Author-Name: Placek, P.J. Author-Name: Taffel, S.M. Author-Name: Moien, M. Year: 1988 Volume: 78 Issue: 5 Pages: 562-563 Handle: RePEc:aph:ajpbhl:1988:78:5:562-563_9 Template-Type: ReDIF-Article 1.0 Title: History of blood transfusion, tattooing, acupuncture and risk of hepatitis B surface antigenaemia among Chinese men in Singapore Journal: American Journal of Public Health Author-Name: Phoon, W.-O. Author-Name: Fong, N.-P. Author-Name: Lee, J. Year: 1988 Volume: 78 Issue: 8 Pages: 958-960 Abstract: To determine whether a history of blood transfusion, tattooing, and acupuncture is associated with an increased risk of hepatitis B surface antigenaemia, a study of 6,328 Chinese men between 35 and 65 years of age was undertaken in Singapore. The age-adjusted odds ratios were 1.44 (95% CI: 1.14, 1.83) for blood transfusion, 1.14 (95% CI: 0.80, 1.63) for tattooing, and 0.88 (95% CI: 0.71, 1.11) for acupuncture. Using no history of any of the three percutaneous procedures as reference, the age-adjusted odds ratio for blood transfusion only was 1.40, 95% CI: 1.07, 1.84, and for blood transfusion plus tattooing was 2.59, 95% CI: 1.18, 5.70. The proportion of HBsAg positive cases attributable to blood transfusion and tattooing, as measured by the population attributable risk, are 4.1 and 0.7 per cent, respectively. Handle: RePEc:aph:ajpbhl:1988:78:8:958-960_1 Template-Type: ReDIF-Article 1.0 Title: Properties of saliva cotinine in young adult light smokers Journal: American Journal of Public Health Author-Name: Carey, K.B. Author-Name: Abrams, D.B. Year: 1988 Volume: 78 Issue: 7 Pages: 842-843 Abstract: The half-life of saliva cotinine and its accuracy at detecting light or intermittent smoking were examined. Five subjects provided daily saliva samples for 23 days and quit smoking on day 4. An average of 2.8 days was required for saliva cotinine to drop below the cutoff for classification as a smoker. All smokers smoked intermittently at various times after day 9. In most cases the smoking of one or two cigarettes was detected in the saliva sample on subsequent days. Saliva cotinine was sensitive to low rates of smoking and to intermittent smoking. Handle: RePEc:aph:ajpbhl:1988:78:7:842-843_6 Template-Type: ReDIF-Article 1.0 Title: Long-term weight loss maintenance: Assessment of a behavioral and supplemented fasting regimen Journal: American Journal of Public Health Author-Name: Hovell, M.F. Author-Name: Koch, A. Author-Name: Hofstetter, C.R. Author-Name: Sipan, C. Author-Name: Faucher, P. Author-Name: Dellinger, A. Author-Name: Borok, G. Author-Name: Forsythe, A. Author-Name: Felitti, V.J. Year: 1988 Volume: 78 Issue: 6 Pages: 663-666 Abstract: This analysis assessed 18-30-month weight loss maintenance following treatment with both behavior modification and supplemented fasting procedures for 400 patients. Fifty-five per cent of the patients who started treatment discontinued prior to completing the program. Patients who completed treatment lost a mean of 83.9 per cent of their excess weight, but regained an average of 59 per cent to 82 per cent of the initial excess weight by 30 months following start of treatment. The combination of behavior modification and supplemented fasting regimens was a successful means of effecting weight loss. However, there appeared to be limited weight loss maintenance. Behavioral epidemiological studies are needed to identify variables responsible for maintenance of weight loss. Handle: RePEc:aph:ajpbhl:1988:78:6:663-666_5 Template-Type: ReDIF-Article 1.0 Title: Characteristics of childhood homicide in Ohio, 1974-84 Journal: American Journal of Public Health Author-Name: Muscat, J.E. Year: 1988 Volume: 78 Issue: 7 Pages: 822-824 Abstract: Childhood homicide deaths in Ohio from 1974 to 1984 were examined using Ohio Vital Statistics records and US Census Data. Homicide rates varied from 25/100,000 for Black infant males to 0.8/100,000 for White femals ages 5-9. Child battering was the leading cause of death for children <5 years. Firearms accounted for 56 per cent of homicide deaths for children 10-14 years of age. The childhood homicide rates in the four largest Ohio cities were substantially higher in areas with low socioeconomic indicators. Handle: RePEc:aph:ajpbhl:1988:78:7:822-824_7 Template-Type: ReDIF-Article 1.0 Title: Wife's level of education and husband's risk of primary cardiac arrest Journal: American Journal of Public Health Author-Name: Strogatz, D.S. Author-Name: Siscovick, D.S. Author-Name: Weiss, N.S. Author-Name: Rennert, G. Year: 1988 Volume: 78 Issue: 11 Pages: 1491-1493 Abstract: Data from a case-control study were analyzed to examine wife's education and risk of primary cardiac arrest in the husband. Men whose wives had more than 12 years of education had 80 per cent the rate of men with less educated wives (odds ratio = 0.8, 95% confidence interval = 0.5, 1.3), after adjustment for risk factors. There was no evidence of a status incongruity effect. These data are inconsistent with reports of positive associations between wife's education and coronary heart disease. Handle: RePEc:aph:ajpbhl:1988:78:11:1491-1493_6 Template-Type: ReDIF-Article 1.0 Title: Congenital limb reduction defects in the agricultural setting Journal: American Journal of Public Health Author-Name: Schwartz, D.A. Author-Name: LoGerfo, J.P. Year: 1988 Volume: 78 Issue: 6 Pages: 654-659 Abstract: To ascertain whether parental involvement in agricultural work and residence in an agricultural setting are associated with the development of congenital limb reduction defects, we carried out a case-control study using California birth records from 1982, 1983, and 1984. Cases with limb reduction defects (N = 237) and randomly selected controls (N = 475) were compared regarding parental occupation and maternal county of residence. After adjustment for potential confounders in a multivariate analysis, the estimated relative risk (RR) of parenting a child with a limb reduction defect among parents involved in agricultural work was 0.9 (95 per cent confidence limits = 0.4, 1.7). The RR among mothers who resided in a county of high agricultural productivity as compared with minimal agricultural productivity was 1.7 (95% CL = 1.1, 2.7), while the RR associated with residence in a county with high pesticide use as compared with minimal pesticide use was 1.9 (95% CL = 1.2, 3.1). When we limited the cases to children with limb reduction defects who had at least one additional anomaly (n = 79) and compared them to the control births, the corresponding RRs were 1.6 (95% CL = 0.7, 3.6) for parental involvement in agricultural work,2.4 (CL = 1.2, 4.7) for county agricultural productivity, and 3.1 (CL = 1.5, 6.5) for county pesticide use. Handle: RePEc:aph:ajpbhl:1988:78:6:654-659_2 Template-Type: ReDIF-Article 1.0 Title: Socioenvironmental characteristics associated with the onset of decline of ischemic heart disease mortality in the United States Journal: American Journal of Public Health Author-Name: Wing, S. Author-Name: Casper, M. Author-Name: Riggan, W. Author-Name: Hayes, C. Author-Name: Tyroler, H.A. Year: 1988 Volume: 78 Issue: 8 Pages: 923-926 Abstract: The relation of community socioenvironmental characteristics to timing of the onset of decline of ischemic heart disease (IHD) mortality was investigated among the 507 State Economic Areas of the continental United States. Onset of decline was measured using data for White men aged 35-74 and classified as early (1968 or before) vs late (after 1968). Ten socioenvironmental characteristics derived from US Census Bureau data were strongly related to onset of decline. Areas with the poorest socioenvironmental conditions were two to 10 times more likely to experience late onset than those areas with the highest levels. We found that income-related characteristics could account for most of the difference in onset of decline of IHD between metropolitan and non-metropolitan places. We conclude that community socioenvironmental characteristics provide the context for changes in risk factors and medical care. Handle: RePEc:aph:ajpbhl:1988:78:8:923-926_6 Template-Type: ReDIF-Article 1.0 Title: Pathogenic micro-organisms and helminths in sewage products, Arabian Gulf, country of Bahrain Journal: American Journal of Public Health Author-Name: Amin, O.M. Year: 1988 Volume: 78 Issue: 3 Pages: 314-315 Abstract: Fecal and sludge samples from the Arabian Gulf country of Bahrain contained poliomyelitis and coxackie viruses, coliform bacteria, Escherichia coli, Salmonella spp., Shigella sonni, fecal streptococci, Balantidium coli, Ascaris lumbricoides and Hymenolepis nana eggs, and Stongyloides stercoralis. Sludge produced in the central sewage treatment plant is used for agricultural purposes and poses a threat to public health. Recommendations to reduce the potential health hazards are made. Handle: RePEc:aph:ajpbhl:1988:78:3:314-315_4 Template-Type: ReDIF-Article 1.0 Title: Promoting breastfeeding at a migrant health center Journal: American Journal of Public Health Author-Name: Young, S.A. Author-Name: Kaufman, M. Year: 1988 Volume: 78 Issue: 5 Pages: 523-525 Abstract: A program to promote breastfeeding was introduced at a migrant health center in North Carolina. Strategies for promoting breastfeeding as a feeding method particularly suited to the migrant lifestyle were identified and implemented. Donated layettes were used to encourage attendance of prenatal patients at a class on breastfeeding. Women planning to breastfeed were given cards to alert the delivering hospital of their intention. These hospitals were provided with bilingual flipcharts to use in communicating with non-English speaking patients. Of the 158 women who came to the center for one or more prenatal visits, 101 attended a class or received individual counseling on breastfeeding; during this 13-month period, 52 per cent of 64 women who attended the class were breastfeeding at time of their hospital discharge (Mexican-Americans 60%, Black Americans 44%). In a comparison of similar ethnic distribution, the corresponding rate was 10%. Handle: RePEc:aph:ajpbhl:1988:78:5:523-525_1 Template-Type: ReDIF-Article 1.0 Title: Competition for Medicaid dollars Journal: American Journal of Public Health Author-Name: Brody SJ. Year: 1988 Volume: 78 Issue: 1 Pages: 97-98 Handle: RePEc:aph:ajpbhl:1988:78:1:97-98_3 Template-Type: ReDIF-Article 1.0 Title: Case shifting and the Medicare Prospective Payment System Journal: American Journal of Public Health Author-Name: Sloan, F.A. Author-Name: Morrisey, M.A. Author-Name: Valvona, J. Year: 1988 Volume: 78 Issue: 5 Pages: 553-556 Abstract: We assessed impacts of the Medicare Prospective Payment System (PPS) during its first two years of operation (1984-85) on 467 hospitals using data from the Commission on Professional and Hospital Activities and from the American Hospital Association. Medicare discharges as a per cent of total discharges remained constant between 1983 and 1985, but the per cent of uninsured patients increased, especially at large public hospitals. The number of Medicare and total discharges per hospital declined. The number of complex diagnosis related groups (DRGs) increased, both for Medicare and non-Medicare. This trend began before the implementation of PPS and affected all types of hospitals. There was also an appreciable increase in case mix types of hospitals. There was also an appreciable increase in case mix severity within specific DRGs during 1980-85. The proportion of total patients received from or transferred to other hospitals rose after 1983, but these increases were very small. The per cent of Medicare patients admitted through the emergency room increased, especially after 1983. By contrast, the share of total non-Medicare admissions through the emergency room (ER) remained stable. Although the growth of the number of uninsured and Medicare patients admitted through the ER predate PPS, they may be influenced by it and warrant further monitoring. Handle: RePEc:aph:ajpbhl:1988:78:5:553-556_3 Template-Type: ReDIF-Article 1.0 Title: Fecundity and infertility in the United States Journal: American Journal of Public Health Author-Name: Mosher, W.D. Year: 1988 Volume: 78 Issue: 2 Pages: 181-182 Handle: RePEc:aph:ajpbhl:1988:78:2:181-182_4 Template-Type: ReDIF-Article 1.0 Title: Decreased incidence of hip fracture in Hispanics, Asians, and Blacks: California hospital discharge data Journal: American Journal of Public Health Author-Name: Silverman, S.L. Author-Name: Madison, R.E. Year: 1988 Volume: 78 Issue: 11 Pages: 1482-1483 Abstract: We examined the incidence of hip fracture in Non-Hispanic White, Hispanic, Black, and Asian Americans for the years 1983 and 1984 using a data base which contains a summary of all hospitalizations for the State of California. We found a consistently lower risk for hip fracture after age 60 in Hispanic, Black, and Asian American females than in White females who were not Hispanic. Overall age-adjusted hip fracture rates in Hispanic, Black, and Asian females were 49.7, 57.3, and 85.4, respectively, and 140.7/100,000 in White females who were not Hispanic. These differences were not found in males, although Whites (not Hispanic) had the highest incidence of hip fractures among males. Handle: RePEc:aph:ajpbhl:1988:78:11:1482-1483_1 Template-Type: ReDIF-Article 1.0 Title: Wading pools: a source of drowning. Journal: American Journal of Public Health Author-Name: Crane, N.T. Year: 1988 Volume: 78 Issue: 1 Pages: 97-98 Handle: RePEc:aph:ajpbhl:1988:78:1:97-98_9 Template-Type: ReDIF-Article 1.0 Title: Health family trees: A tool for finding and helping young family members of coronary and cancer prone pedigrees in Texas and Utah Journal: American Journal of Public Health Author-Name: Williams, R.R. Author-Name: Hunt, S.C. Author-Name: Barlow, G.K. Author-Name: Chamberlain, R.M. Author-Name: Weinberg, A.D. Author-Name: Cooper, H.P. Author-Name: Carbonari, J.P. Author-Name: Gotto Jr., A.M. Year: 1988 Volume: 78 Issue: 10 Pages: 1283-1286 Abstract: We report on the feasibility and utility of a new approach for identifying the small percentage of families in the general population with strong familial predisposition to early coronary heart disease, strokes, and common familial cancers (breast, colon, lung), using the 'Health Family Tree', a medical family history. A total of 24,332 'trees' were completed by parents and students in 37 high schools in 14 urban and rural communities in Texas and Utah during the years 1980-86. Completed 'trees' were obtained from 68 per cent of all enrolled students. High-risk families, included 1,796 families with early coronary disease (7.5 per cent of all student families or 3.7 per cent of their parents' families), 870 stroke families (3.6 per cent), and 415 cancer prone families (1.7 per cent). Among these 3,081 high-risk families there were 8,245 family members already reported to have been diagnosed by a physician to have the familial disease of interest and 43,269 high risk unaffected siblings and offspring of these persons. The average cost per identified high-risk unaffected person was under $10. We conclude that the 'Health Family Tree' is a feasible and cost-effective way to find high-risk families. Handle: RePEc:aph:ajpbhl:1988:78:10:1283-1286_6 Template-Type: ReDIF-Article 1.0 Title: Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES) Journal: American Journal of Public Health Author-Name: Karasek, R.A. Author-Name: Theorell, T. Author-Name: Schwartz, J.E. Author-Name: Schnall, P.L. Author-Name: Pieper, C.F. Author-Name: Michela, J.L. Year: 1988 Volume: 78 Issue: 8 Pages: 910-918 Abstract: Assocations between psychosocial job characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used which imputes to census occupation codes, job characteristic information from national surveys of job characteristics (US Department of Labor, Quality of Employment Surveys). Controlling for age, we find that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load (a multiplicative product term isolating 20 per cent of the population) have a higher prevalence of myocardial infarction in both data bases. In a logistic regression analysis, using job measures adjusted for demographic factors and controlling for age, race, education, systolic blood pressure, serum cholesterol, smoking (HANES only), and physical exertion, we find a low decision latitude/high psychological demand multiplicative product term associated with MI in both data bases. Additional multiple logistic regressions show that low decision latitude is associated with increased prevalence of MI in both the HES and the HANES. Psychological workload and physical exertion are significant only in the HANES. Handle: RePEc:aph:ajpbhl:1988:78:8:910-918_2 Template-Type: ReDIF-Article 1.0 Title: HIV counseling and testing: Does it work? Journal: American Journal of Public Health Author-Name: Cates Jr., W. Author-Name: Handsfield, H.H. Year: 1988 Volume: 78 Issue: 12 Pages: 1533-1534 Handle: RePEc:aph:ajpbhl:1988:78:12:1533-1534_6 Template-Type: ReDIF-Article 1.0 Title: Fatal occupational injuries in US industries, 1984: Comparison of two national surveillance systems Journal: American Journal of Public Health Author-Name: Stout-Wiegand, N. Year: 1988 Volume: 78 Issue: 9 Pages: 1215-1217 Abstract: This paper compares the results of analyses of 1984 fatalities as identified in the National Institute for Occupational Safety and Health (NIOSH) National Traumatic Occupational Fatality (NTOF) data base with those of the Bureau of Labor Statistics Annual Survey of Occupational Injuries and Illnesses (AS) for 1984. The fatality rates for industries were similar in both analyses; however, differences in number of injuries suggest underrepresentation in the AS of fatal injuries in several, high-risk industries. Differences and similarities in methods and results between the two national surveillance systems are described and their application to research and injury prevention are discussed. Handle: RePEc:aph:ajpbhl:1988:78:9:1215-1217_8 Template-Type: ReDIF-Article 1.0 Title: Parental son preference in seeking medical care for children less than five years of age in a rural community in Bangladesh Journal: American Journal of Public Health Author-Name: Hossain, M.M. Author-Name: Glass, R.I. Year: 1988 Volume: 78 Issue: 10 Pages: 1349-1350 Abstract: We examined drug purchases for children less than five years of age from privately owned pharmacies in Matlab, a rural area in Bangladesh. The male to female incidence rate ratio was 1.71 (95 per cent confidence intervals = 1.27, 2.28) for overall drug purchase, and 2.94 (95% CI = 1.14, 7.73) for purchase of drugs prescribed by physicians. Our findings support and extend previous observations in this community of parental son preference in caring for children. Handle: RePEc:aph:ajpbhl:1988:78:10:1349-1350_6 Template-Type: ReDIF-Article 1.0 Title: Why does family homelessness occur? A case-control study Journal: American Journal of Public Health Author-Name: Bassuk, E.L. Author-Name: Rosenberg, L. Year: 1988 Volume: 78 Issue: 7 Pages: 783-788 Handle: RePEc:aph:ajpbhl:1988:78:7:783-788_7 Template-Type: ReDIF-Article 1.0 Title: Mental disorder and social policy. Journal: American Journal of Public Health Author-Name: Lemkau, P.V. Year: 1988 Volume: 78 Issue: 1 Pages: 93-94 Handle: RePEc:aph:ajpbhl:1988:78:1:93-94_2 Template-Type: ReDIF-Article 1.0 Title: State Medicaid coverage of AZT and AIDS-related policies Journal: American Journal of Public Health Author-Name: Buchanan, R.J. Year: 1988 Volume: 78 Issue: 4 Pages: 432-436 Abstract: Medicaid programs are paying for 23 per cent of the health care costs of AIDS patients nationally, and approximately 40 per cent of all AIDS patients will become dependent on Medicaid to pay for their health care. The state Medicaid programs were surveyed by mail for this research in mid 1987 to determine if the states covered AZT (Retrovir), if limits apply to this coverage, if the states have or are developing AIDS-related policies, and if hospice care is a benefit. Forty-four states cover AZT (two additional states cover AZT only during inpatient hospital care), with most Medicaid programs placing some limit on coverage or reimbursement. Most states do not have special Medicaid coverage for AIDS care nor are they developing proposals or policies for this care. However, a number of states are developing or implementing AIDS-related policies through their Medicaid programs. These policies can become models for other Medicaid programs to follow if the incidence of AIDS increases in their states. Handle: RePEc:aph:ajpbhl:1988:78:4:432-436_5 Template-Type: ReDIF-Article 1.0 Title: Condoms, spermicides, and the transmission of human immunodeficiency virus: A review of the literature Journal: American Journal of Public Health Author-Name: Feldblum, P.J. Author-Name: Fortney, J.A. Year: 1988 Volume: 78 Issue: 1 Pages: 52-54 Abstract: The authors review studies that have been done, or work that bears indirectly, on the effectiveness of condoms and spermicides in preventing the transmission of HIV. They follow with recommendations for future research. Handle: RePEc:aph:ajpbhl:1988:78:1:52-54_2 Template-Type: ReDIF-Article 1.0 Title: Prostitutes and AIDS: A health department priority? Journal: American Journal of Public Health Author-Name: Rosenberg, M.J. Author-Name: Weiner, J.M. Year: 1988 Volume: 78 Issue: 4 Pages: 418-423 Abstract: With increasing competition for resources, health departments are faced with the question of whether to target female prostitutes as a high priority component of AIDS prevention strategy. Prostitutes are considered to be a reservoir for transmission of certain sexually transmitted diseases (STDs). However, a variety of studies suggest that human immunodeficiency virus (HIV) infection in prostitutes follows a different pattern than that for STDs: HIV infection in non-drug using prostitutes tends to be low or absent, implying that sexual activity alone does not place them at high risk, while prostitutes who use intravenous drugs are far more likely to be infected with HIV. Emerging data from heterosexual groups similarly suggest a low rate of heterosexual transmission, particularly from women to men. Prostitutes who do not use intravenous drugs probably face their highest risk from steady partners who may be infected with HIV and other STDs and with whom barrier protection is generally not used. Nevertheless, there are good reasons for health departments to place high priority on prevention efforts directed to prostitutes: 1) prostitutes often have other risky behaviors such as drug use; and 2) prostitutes are reachable, being a group which is already in the health care system administered by health departments. Handle: RePEc:aph:ajpbhl:1988:78:4:418-423_1 Template-Type: ReDIF-Article 1.0 Title: Drinking water source, diarrheal morbidity, and child growth in villages with both traditional and improved water supplies in rural Lesotho, Southern Africa Journal: American Journal of Public Health Author-Name: Esrey, S.A. Author-Name: Habicht, J.-P. Author-Name: Latham, M.C. Author-Name: Sisler, D.G. Author-Name: Casella, G. Year: 1988 Volume: 78 Issue: 11 Pages: 1451-1455 Abstract: This study examined the growth and morbidity rates of young children in relation to exclusive and non-exclusive use of improved water supplies in rural Lesotho, southern Africa. Data were collected for 247 children 60 months of age and under between July 1984 and February 1985 in 10 villages that had an improved water supply at least one year prior to investigation. Children whose families relied exclusively on the new water supply for their drinking and cooking needs grew 0.438 cm and 235 g more in six months than children whose families supplemented the new water supply with the use of contaminated traditional water for drinking and cooking. The difference in growth was greater among children over 12 months of age at the start of the evaluation than among infants. This may be explained partly by lower rates for Giardia lamblia, the most commonly identified pathogen in stools in older children. Among infants, similar rates of Campylobacter, the most commonly isolated pathogen among infants, may have prevented larger differences. Results suggest that improved drinking water supplies can benefit preschool children's health after infancy, but only if they are functioning and utilized exclusively for drinking and cooking purposes. Handle: RePEc:aph:ajpbhl:1988:78:11:1451-1455_5 Template-Type: ReDIF-Article 1.0 Title: Hospital charges for people with AIDS in Washington State: Utilization of a statewide hospital discharge data base Journal: American Journal of Public Health Author-Name: Lafferty, W.E. Author-Name: Hopkins, S.G. Author-Name: Honey, J. Author-Name: Harwell, J.D. Author-Name: Shoemaker, P.C. Author-Name: Kobayashi, J.M. Year: 1988 Volume: 78 Issue: 8 Pages: 949-952 Abstract: We analyzed Washington State inpatient hospital utilization for 165 AIDS (acquired immunodeficiency syndrome) cases with 344 hospitalizations from July 1984 through December 1985. We found that mean charges per hospitalization were $9,166 and mean length of stay was 13.3 days. In addition, evaluation of two diagnosis-related groups (DRGs 079 and 398) commonly used for AIDS hospitalization showed that AIDS hospitalizations were substantially more expensive than non-AIDS hospitalizations within the same diagnosis-related group. AIDS-specific diagnosis-related groups may be necessary to achieve a balance between inpatient charges and reimbursements. Handle: RePEc:aph:ajpbhl:1988:78:8:949-952_5 Template-Type: ReDIF-Article 1.0 Title: Patterns of sexual behavior and condom use in a cohort of homosexual men Journal: American Journal of Public Health Author-Name: Schechter, M.T. Author-Name: Craib, K.J.P. Author-Name: Willoughby, B. Author-Name: Douglas, B. Author-Name: McLeod, W.A. Author-Name: Maynard, M. Author-Name: Constance, P. Author-Name: O'Shaughnessy, M. Year: 1988 Volume: 78 Issue: 12 Pages: 1535-1538 Abstract: To measure the magnitude of risk reduction within a cohort of homosexual men, questionnaire responses in April 1984-March 1985 were compared to those in October 1986-September 1987. A total of 361 subjects wre eligible (231 seronegative, 130 seropositive). The annual number of sex partners declined significantly from a median of 8.0 to 5.0 with no difference between the serologic groups. The numbers of subjects reporting no receptive anal intercourse increased as did condom use during anal receptive intercourse. More seronegatives than seropositives subjects reported no condom use during receptive and intercourse with regular partners (45.7 per cent versus 23.4 per cent), and with casual partners (14.9 per cent versus 1.5 per cent). Among subjects with the most casual sexual contact at the second visit, 33.3 per cent of seronegatives and 29.2 per cent of seropositives did not report usual condom use during receptive anal intercourse with casual partners. Although we have documented marked risk reductions, safe sex practices are still not universal, and a few individuals continue to put themselves at extremely high risk. Handle: RePEc:aph:ajpbhl:1988:78:12:1535-1538_0 Template-Type: ReDIF-Article 1.0 Title: Past and present preferred prescribing practices of hormone replacement therapy among Los Angeles gynecologists: Possible implications for public health Journal: American Journal of Public Health Author-Name: Ross, R.K. Author-Name: Paganini-Hill, A. Author-Name: Roy, S. Author-Name: Chao, A. Author-Name: Henderson, B.E. Year: 1988 Volume: 78 Issue: 5 Pages: 516-519 Abstract: Usual prescribing strategies of hormone replacement therapy for postmenopausal women by Los Angeles area gynecologists, both now and 10 years ago, were investigated by a mail survey. Of the 330 gynecologists who responded, estrogen therapy is currently used as a routine by nearly all (95 per cent), for women both with and without a uterus. Over three-fourths of these physicians favor use of 0.625 mg of conjugated equine estrogen. The estrogen is combined with cyclic progestin therapy, usually 10 mg of medroxyprogesterone acetate, by 86 per cent of gynecologists using estrogen for women with a uterus, and by 47 per cent for women without a uterus. Although conjugated equine estrogens were used widely for both groups of patients 10 years ago, a higher dose generally was preferred. Use of progestin therapy was uncommon (less than 20 per cent) for any postmenopausal patients at that time. Although the most common monthly therapeutic regimen for estrogen/progestin therapy is estrogen for days 1-25 and progestin for days 16-25, there is wide variation in prescribing strategies. We present these findings in the context of the probable effects of estrogen/progestin therapy on various chronic disease outcomes. Handle: RePEc:aph:ajpbhl:1988:78:5:516-519_4 Template-Type: ReDIF-Article 1.0 Title: Correlates of reported smoke detector usage in an inner-city population: Participants in a smoke-detector give-away program Journal: American Journal of Public Health Author-Name: Shaw, K.N. Author-Name: McCormick, M.C. Author-Name: Kustra, S.L. Author-Name: Ruddy, R.M. Author-Name: Casey, R.D. Year: 1988 Volume: 78 Issue: 6 Pages: 650-653 Abstract: As part of a smoke detector give-away program, 388 adults were surveyed to characterize smoke detector ownership in a low-income population and to identify those who would acquire a free smoke detector following their child's visit to the hospital. Factors associated with smoke detector ownership included higher education, home ownership (vs public housing), knowledge of the city smoke detector law, and the practice of other injury prevention measures. Regardless of ownership, the majority of parents (82 per cent) acquired a free smoke detector, but those previously without a smoke detector were more likely to do so. These characteristics of smoke detector usage and acquisition should be considered in targeting future intervention strategies. Handle: RePEc:aph:ajpbhl:1988:78:6:650-653_7 Template-Type: ReDIF-Article 1.0 Title: Spermicide use and pregnancy outcome Journal: American Journal of Public Health Author-Name: Strobino, B. Author-Name: Kline, J. Author-Name: Warburton, D. Year: 1988 Volume: 78 Issue: 3 Pages: 260-263 Abstract: The relation between periconceptional vaginal spermicide use and sex ratio at birth, birthweight, and the frequency of congenital anomalies was examined in a cohort of 2,712 New York City obstetric patients, 149 of whom (5.5 per cent) became pregnant while using spermicides or had used spermicides before and after conception. Periconceptional spermicide use was not associated with any important variation in the expected sex ratio at birth, nor with major or minor congenital anomalies. Exposure to spermicides in the periconceptional period, defined dichotomously as present or absent, was not associated with decreased birthweight in male or female infants. There was a slight decrease in birthweight among female infants with increasing duration of postconceptional spermicide use; an estimated 7.4 grams decrease with each day of use. The size of the effect and its selectivity by sex suggest a chance finding. Handle: RePEc:aph:ajpbhl:1988:78:3:260-263_2 Template-Type: ReDIF-Article 1.0 Title: Toxic shock syndrome: Incidence and geographic distribution from a hospital medical records reporting system Journal: American Journal of Public Health Author-Name: Miday, R.K. Author-Name: Wilson, E.R. Year: 1988 Volume: 78 Issue: 5 Pages: 578-580 Abstract: A large database of hospital records maintained by the Commission on Professional and Hospital Activities Professional Activity Study (CPHA-PAS) was used to estimate the temporal incidence and geographic distribution of toxic shock syndrome (TSS). The CPHA-PAS hospital-diagnosed incidence was 3.5 times the reported TSS incidence, with a gradual decrease over the time period 1981-83. Marked differences in the regional occurrence of cases may provide clues to the etiology of this complex disease. Handle: RePEc:aph:ajpbhl:1988:78:5:578-580_9 Template-Type: ReDIF-Article 1.0 Title: Cocaine and herion dependence compared in poly-drug abusers Journal: American Journal of Public Health Author-Name: Hasin, D.S. Author-Name: Grant, B.F. Author-Name: Endicott, J. Author-Name: Harford, T.C. Year: 1988 Volume: 78 Issue: 5 Pages: 567-569 Abstract: Concerns about cocaine dependence are increasing, in some ways replacing heroin as the focus of highest concern. We compared cocaine and heroin dependence by levels of cocaine and heroin use in poly-drug users. While dependence indicators differed markedly between regular and sporadic users of these drugs, cocaine dependence indicators did not differ from heroin dependence indicators. Implications of the findings are discussed. Handle: RePEc:aph:ajpbhl:1988:78:5:567-569_9 Template-Type: ReDIF-Article 1.0 Title: Behavioral risk factors for HIV infection among homosexual men at a Boston community health center Journal: American Journal of Public Health Author-Name: McCusker, J. Author-Name: Stoddard, A.M. Author-Name: Mayer, K.H. Author-Name: Cowan, D.N. Author-Name: Groopman, J.E. Year: 1988 Volume: 78 Issue: 1 Pages: 68-71 Abstract: Social and behavioral factors associated with human immunodeficiency virus (HIV) infection were analyzed using cross-sectional data from homosexual and bisexual male clients of a Boston community health center. Partners from California, and a previous period of greater sexual activity (a 'high period'), were independently associated with positive HIV antibody status, as were the frequency of receptive anogenital contact, both during the 'high period' and during the last six months. Handle: RePEc:aph:ajpbhl:1988:78:1:68-71_6 Template-Type: ReDIF-Article 1.0 Title: Blood alcohol measurements in the emergency department: Who needs them? Journal: American Journal of Public Health Author-Name: Simel, D.L. Author-Name: Feussner, J.R. Year: 1988 Volume: 78 Issue: 11 Pages: 1478-1479 Abstract: We surveyed North Carolina emergency physicians to determine current medical practices regarding the use of blood alcohol concentrations using a hypothetical scenario. Most physicians (88 per cent) would not have obtained blood alcohol concentrations in a patient who had alcohol on his breath but was coherent and cooperative. For marginally impaired patients, more liberal use of blood alcohol concentrations and explicit instructions to avoid driving while impaired might improve patient care and promote highway safety. Handle: RePEc:aph:ajpbhl:1988:78:11:1478-1479_5 Template-Type: ReDIF-Article 1.0 Title: Patterns of mental health utilization over time in a fee-for-service population Journal: American Journal of Public Health Author-Name: McGuire, T.G. Author-Name: Fairbank, A. Year: 1988 Volume: 78 Issue: 2 Pages: 134-136 Abstract: This paper examines the multi-year patterns of ambulatory mental health care in a population of individuals continuously eligible to receive care in a fee-for-service setting. Among the 14,000 individuals eligible for all three years, 14 per cent used outpatient mental health services during at least one of the three years. Almost 70 per cent of the individuals with some use in 1980 used services during 1981 or 1982. The heaviest use of outpatient mental health and other physician services is among the persons using services in all three years. Our data are compared with three years of data reported by Kessler in an HMO (health maintenance organization) setting. The probability that a non-user becomes a user in roughly the same in the fee-for-service and HMO populations, but the probability of continuing use in next years is much less in the HMO. This finding, that the 'HMO effect' on mental health care is primarily on the visits per user rather than on the number of users, is consistent with other research. Handle: RePEc:aph:ajpbhl:1988:78:2:134-136_3 Template-Type: ReDIF-Article 1.0 Title: The impact of AIDS on state and local health departments: Issues and a few answers Journal: American Journal of Public Health Author-Name: Judson, F.N. Author-Name: Vernon Jr., T.M. Year: 1988 Volume: 78 Issue: 4 Pages: 387-393 Abstract: Owing to large differences in the incidence of AIDS (acquired immunodeficiency syndrome) and in public health resources and priorities, the impact of AIDS on state and local health departments has been variable. Nonetheless, health departments everywhere are being held responsible for surveillance and control of the HIV (human immunodeficiency virus) epidemic which we believe requires, at minimum, convenient, free HIV testing and counseling; expanded HIV sevices in sexually transmitted diseases clinics and substance treatment centers; locally oriented AIDS information/education; notification of persons unknowingly exposed to HIV; restrictive measures for HIV-infected persons who, afer counseling, persist in exposing others; regulation or closure of public establishments in which HIV transmission is likely to result; and confidential reporting of all HIV test results to public health departments. In Colorado new legislation was passed to require reporting of HIV test results, to provide the reports with near absolute protections against unauthorized disclosure, and to modify quarantine statutes to incorporate rights to due process, appeals, and confidentiality. States in which there is a legal basis for discrimination against gay men will need to rectifey this problem first. There is no evidence that reporting of HIV infections in Colorado has adversely affected the rate at which persons with HIV risk behaviors volunteer to be tested. For Denver and Colorado Departments of Health, more than 70 per cent of the estimated $2,796,000 expended in AIDS activities during 1987 was federal. Handle: RePEc:aph:ajpbhl:1988:78:4:387-393_2 Template-Type: ReDIF-Article 1.0 Title: Sensitivity and specificity of clinical case definitions for pertussis Journal: American Journal of Public Health Author-Name: Patriarca, P.A. Author-Name: Biellik, R.J. Author-Name: Sanden, G. Author-Name: Burstyn, D.G. Author-Name: Mitchell, P.D. Author-Name: Silverman, P.R. Author-Name: Davis, J.P. Author-Name: Manclark, C.R. Year: 1988 Volume: 78 Issue: 7 Pages: 833-836 Abstract: We evaluated the diagnostic performance of 15 clinical case definitions for pertussis in 233 patients who developed acute respiratory illness during community outbreaks in Wisconsin and Delaware. Using results from culture (Regan-Lowe media) and serology (Ig-class-specific ELISA) as diagnostic standards, cough for ≥14 days was both sensitive (84 per cent-92 per cent) and specific (63 percent-90 per cent) in identifying patients with pertussis. This definition may be useful in monitoring pertussis outbreaks and for investigating contacts of culture-positive cases. Handle: RePEc:aph:ajpbhl:1988:78:7:833-836_9 Template-Type: ReDIF-Article 1.0 Title: Prevalence of the misuse of ultra-low-tar cigarettes by blocking filter vents Journal: American Journal of Public Health Author-Name: Kozlowski, L.T. Author-Name: Pope, M.A. Author-Name: Lux, J.E. Year: 1988 Volume: 78 Issue: 6 Pages: 694-695 Abstract: Evidence from tar-stain patterns in 135 cigarette filters discarded in ashtrays in public areas of shopping malls was used to estimate the prevalence of behaviorally blocked air dilution vents in ultra-low-yield cigarettes. Nineteen per cent (± 4, standard errors of the mean) of the filters had been blocked extremely, 39 per cent (± 5 SEM) had been blocked to some degree, and 42 per cent (± 5 SEM) had not been blocked at all. Smokers, health practitioners, and researchers need to be warned of the risks of vent blocking. Handle: RePEc:aph:ajpbhl:1988:78:6:694-695_3 Template-Type: ReDIF-Article 1.0 Title: State laws and the practice of lay midwifery Journal: American Journal of Public Health Author-Name: Butter, I.H. Author-Name: Kay, B.J. Year: 1988 Volume: 78 Issue: 9 Pages: 1161-1169 Abstract: A national survey was conducted to assess the current status and characteristics of state legislation regulating the practice of lay midwives. As of July 1987, 10 states have prohibitory laws, five states have grandmother clauses authorizing practicing midwives under repealed statutes, five states have enabling laws which are not used, and 10 states explicitly permit lay midwives to practice. In the 21 remaining states, the legal status of midwives is unclear. Much of the enabling legislation restricts midwifery practice often resulting in situations similar to those in states with prohibitory laws. Given the growth of an extensive grassroots movement of lay midwives committed to quality of care, this outcome suggests that 21 states with no legislation may provide better opportunities for midwifery practice than states with enabling laws. Handle: RePEc:aph:ajpbhl:1988:78:9:1161-1169_0 Template-Type: ReDIF-Article 1.0 Title: Teenage fathers and the fathers of infants of urban, teenage mothers Journal: American Journal of Public Health Author-Name: Hardy, J.B. Author-Name: Duggan, A.K. Year: 1988 Volume: 78 Issue: 8 Pages: 919-922 Abstract: Data from Certificates of Live Birth, for recorded resident births in Baltimore in 1983, were used to describe fathers whose child was born to a teenage mother. Four groups were identified: 1) both father and mother were teenagers (12 per cent); 2) only the mother was a teenager (14 per cent); 3) only the father was a teenager (2 per cent); 4) both parents were aged 20 years of above (72 per cent). The fathers in the first three groups appeared at serious educational and financial disadvantage as compared with those where neither parent was a teenager. Within the teenage parent groups, White fathers had lower educational attainment than Black; one in four White fathers was married vs less than 5 per cent of Black. Although limited in scope, the data indicate that disadvantages associated with being a teenage father or the father of an infant born by a teenage mother are clear cut. Handle: RePEc:aph:ajpbhl:1988:78:8:919-922_3 Template-Type: ReDIF-Article 1.0 Title: Short interpregnancy interval and the risk of low birthweight Journal: American Journal of Public Health Author-Name: Klebanoff, M.A. Year: 1988 Volume: 78 Issue: 6 Pages: 667-670 Abstract: The effect of interpregnancy interval on the birthweight of the subsequent child was investigated in a cohort of 5,938 women who registered for two consecutive pregnancies in the Collaborative Perinatal Project. Mean birthweight increased from 3,101 grams for intervals of <3 months to 3,193 grams for intervals of 15-17.9 months and remained stable thereafter (p for trend = 0.006). However, women with shorter intervals were younger, lighter weight, and less educated at the beginning of the first pregnancy than were women with longer intervals; the birthweight of their previous child was lower, and they were of marginally lower socioeconomic status. Adjustment for confounders reduced the maximum difference in mean birthweight by interval length from 92 to 39 grams, and blunted the trend for lower birthweights with shorter intervals (p = 0.45). Similarly, adjustment reduced the increased risk of low birthweight among women with the shortest intervals from 52 per cent to 12 per cent. We conclude that a short interpregnancy interval is primarily a marker for a woman who is otherwise at high risk, and that modification of this interval alone may be unlikely to have a major impact on low birthweight. Handle: RePEc:aph:ajpbhl:1988:78:6:667-670_4 Template-Type: ReDIF-Article 1.0 Title: Correcting spontaneous abortion rates for the presence of induced abortion Journal: American Journal of Public Health Author-Name: Figa-'Talamanca, I. Author-Name: Repetto, F. Year: 1988 Volume: 78 Issue: 1 Pages: 40-42 Abstract: This paper introduces a method for correcting spontaneous abortion rates by taking into consideration the fact that a number of spontaneous abortions are 'prevented' by induced abortions. This correction may be important in settings of high induced abortion incidence. The method is then applied to the data of the Italian region of Lombardy. The results obtained are compared to those obtained with previous correction methods, and it is concluded that the present method is useful and appropriate when data on induced and spontaneous abortions are available by gestational age. Handle: RePEc:aph:ajpbhl:1988:78:1:40-42_3 Template-Type: ReDIF-Article 1.0 Title: A survey of measured levels and dietary sources of selected organochlorine pesticide residues and metabolites in human sera from a rural population Journal: American Journal of Public Health Author-Name: Stehr-Green, P.A. Author-Name: Farrar, J.A. Author-Name: Burse, V.W. Author-Name: Royce, W.G. Author-Name: Wohlleb, J.C. Year: 1988 Volume: 78 Issue: 7 Pages: 828-830 Abstract: We measured serum levels of 11 pesticide residues and metabolites in 85 rural-dwelling persons. In general, the serum levels increased with age, with males having slightly higher levels than females. Consumption of eggs from home-raised hens contributed substantially to increased serum concentrations of trans-nonachlor, heptachlor epoxide, and oxychlordane; consumption of home-grown root vegetables likewise contributed to increased serum concentrations of trans-nonachlor and oxychlordane. Health risks, if any, that may be attributable to these 'background' levels of exposure remain to be fully characterized in this, and all other, affected populations. Handle: RePEc:aph:ajpbhl:1988:78:7:828-830_1 Template-Type: ReDIF-Article 1.0 Title: Feelings and frequencies: Two kinds of probability in public health research Journal: American Journal of Public Health Author-Name: Poole, C. Year: 1988 Volume: 78 Issue: 12 Pages: 1531-1533 Handle: RePEc:aph:ajpbhl:1988:78:12:1531-1533_9 Template-Type: ReDIF-Article 1.0 Title: Job strain, work place social support, and cardiovascular disease: A cross-sectional study of random sample of the Swedish Working Population Journal: American Journal of Public Health Author-Name: Johnson, J.V. Author-Name: Hall, E.M. Year: 1988 Volume: 78 Issue: 10 Pages: 1336-1342 Abstract: This cross-sectional study investigates the relationship between the psychosocial work environment and cardiovascular disease (CVD) prevalence in a randomly selected, representative sample of 13,779 Swedish male and female workers. It was found that self-reported psychological job demands, work control, and co-worker social support combined greater then multiplicatively in relation to CVD prevalence. An age-adjusted prevalence ratio (PR) of 2.17 (95% CI-1.32, 3.56) was observed among workers with high demands, low control, and low social support compared to a low demand, high control, and high social support reference group. PRs of approximately 2.00 were observed in this group after consecutively controlling for the effects of age together with 11 other potential confounding factors. The magnitude of the age-adjusted PRs was greatest for blue collar males. Dure to the cross-sectional nature of the study design, causal inferences cannot be made. The limitations of design and measurement are discussed in the context of the methodological weaknesses of the work stress field. Handle: RePEc:aph:ajpbhl:1988:78:10:1336-1342_0 Template-Type: ReDIF-Article 1.0 Title: Hemophilia-associated AIDS in the United States, 1981 to September 1987 Journal: American Journal of Public Health Author-Name: Stehr-Green, J.K. Author-Name: Holman, R.C. Author-Name: Jason, J.M. Author-Name: Evatt, B.L. Year: 1988 Volume: 78 Issue: 4 Pages: 439-442 Abstract: Between January 1, 1981 and September 4, 1987, 407 cases of hemophilia-associated acquired immunodeficiency syndrome (AIDS) had been reported to the Centers for Disease Control. The number of cases diagnosed each year nearly doubled, except in 1986, when cases increased only 50 per cent. Demographic characteristics of the patients did not change over time. The majority (74 per cent) had severe hemophilia and 97 per cent received commercially produced concentrated clotting factors. The cumulative incidence of AIDS between 1981 and September 1987 for persons with severe hemophilia A was substantially greater than that for persons with severe hemophilia B (4.2 cases vs 1.9 cases per 100 persons). Handle: RePEc:aph:ajpbhl:1988:78:4:439-442_4 Template-Type: ReDIF-Article 1.0 Title: Judging maturity in the courts: The Massachusetts consent statute Journal: American Journal of Public Health Author-Name: Yates, S. Author-Name: Pliner, A.J. Year: 1988 Volume: 78 Issue: 6 Pages: 646-649 Abstract: This study examined the Case Summary Questionnaires completed by attorneys representing minors at judicial consent for abortion hearings in Massachusetts and filed with the Women's Bar Association. The 477 Case Summaries filed between December 1981 and June 1985 were analyzed to provide a more systematic account of how the judicial consent statute is applied in the courtroom. After hearings which typically lasted 12 minutes, only nine minors were judged immature. No evidence for a discernible pattern justifying these rulings emerged from an examination of petitioner and court characteristics such as age, length of hearing, number of weeks pregnant, or presiding judge. Further, 11 lawyers privately reported they found their clients immature. In only instance, however, did the lawyer and judge identify the same adolescent. The findings add to a growth body of research that calls into question the ability of the consent statute to protect the best interest of the minors involved. Handle: RePEc:aph:ajpbhl:1988:78:6:646-649_6 Template-Type: ReDIF-Article 1.0 Title: Suicides in Alaska: Firearms and alcohol Journal: American Journal of Public Health Author-Name: Hlady, W.G. Author-Name: Middaugh, J.P. Year: 1988 Volume: 78 Issue: 2 Pages: 179-180 Abstract: A manual review of death certificates and autopsy records identified 195 suicides in Alaska during 1983-84. Native males, 20-24 years old, had the highest rate of suicide (257 per 100,000 person-years). Gunshot wounds caused 76 per cent of all suicide deaths; 79 per cent of Native and 48 per cent of White suicides had detectable levels of blood alcohol. Suicide by firearms was weakly associated with blood alcohol levels above 100 mg/dl (odds ratio 1.3, 95 per cent confidence interval 1.11-1.47). Handle: RePEc:aph:ajpbhl:1988:78:2:179-180_8 Template-Type: ReDIF-Article 1.0 Title: The choice of weapons in firearm suicides Journal: American Journal of Public Health Author-Name: Wintemute, G.J. Author-Name: Teret, S.P. Author-Name: Kraus, J.F. Author-Name: Wright, M.W. Year: 1988 Volume: 78 Issue: 7 Pages: 824-826 Abstract: We report on the firearms used in 235 suicides in Sacramento County, California, during 1983-85. Handguns were used in 69 per cent of firearm suicides - 65 per cent for males, 88 per cent of females - and in all such deaths among women ages 35 and older. We tested the hypothesis that the choice of firearms by persons committing suicide at home would passively reflect the reported prevalence of firearms by type in households in the region. Handguns were used more frequently (rate ratio 2.00; 95% CI = 1.69, 2.39), and rifles and shotguns less frequently than expected. Handle: RePEc:aph:ajpbhl:1988:78:7:824-826_5 Template-Type: ReDIF-Article 1.0 Title: Surveillance of condom distribution and usage in Baltimore, Maryland Journal: American Journal of Public Health Author-Name: Kalter, H.D. Author-Name: Shekar, S. Author-Name: Glasser, D. Author-Name: Dwyer, D.M. Author-Name: Storck, C. Author-Name: Crutcher, J.M. Year: 1988 Volume: 78 Issue: 12 Pages: 1596-1597 Handle: RePEc:aph:ajpbhl:1988:78:12:1596-1597_5 Template-Type: ReDIF-Article 1.0 Title: Hunting firearm injuries, North Carolina Journal: American Journal of Public Health Author-Name: Cole, T.B. Author-Name: Patetta, M.J. Year: 1988 Volume: 78 Issue: 12 Pages: 1585-1586 Abstract: To determine the percentage of unintentional firearm-related injuries associated with hunting and to identify risk factors, we conducted a retrospective, descriptive survey of all hunting firearm injuries identified by two North Carolina surveillance systems. Almost one-third of unintentional shooting deaths are hunting-related, and young hunters appear to be at greatest risk of injury. Safety instruction and wearing highly visible clothing should be encouraged; controlled studies should test the effectiveness of these preventive measures. Handle: RePEc:aph:ajpbhl:1988:78:12:1585-1586_1 Template-Type: ReDIF-Article 1.0 Title: The promotion of exercise Journal: American Journal of Public Health Author-Name: Ibrahim, M.A. Author-Name: Yankauer, A. Year: 1988 Volume: 78 Issue: 11 Pages: 1413-1414 Handle: RePEc:aph:ajpbhl:1988:78:11:1413-1414_5 Template-Type: ReDIF-Article 1.0 Title: Venereal disease control by health departments in the past: Lessons for the present Journal: American Journal of Public Health Author-Name: Cutler, J.C. Author-Name: Arnold, R.C. Year: 1988 Volume: 78 Issue: 4 Pages: 372-376 Abstract: Programs of venereal disease (VD) control developed from the outset of World War I, through the 1930s and then World War II and its aftermath, are examined for their relevance to the problems posed today by AIDS. In light of past experience, "control" of AIDS, not eradication, is the most that can be expected from the public and health community reaction of increased federal funding in support of research and treatment, promotion of self-protective sexual behavior, and the attempt by public health professionals to approach the problem as one of health and related economic costs, rather than to assume a judgmental attitude. The involvement of all levels of government; the community at large; and the medical, educational, industrial, and social work sectors is essential for the success of a public health program which not only integrates new medical discoveries but also responds to the panicky reactions of the public and some health professionals to the AIDS patient. Handle: RePEc:aph:ajpbhl:1988:78:4:372-376_9 Template-Type: ReDIF-Article 1.0 Title: Fatal pedestrian injuries to young children: A different pattern of injury Journal: American Journal of Public Health Author-Name: Brison, R.J. Author-Name: Wicklund, K. Author-Name: Mueller, B.A. Year: 1988 Volume: 78 Issue: 7 Pages: 793-795 Handle: RePEc:aph:ajpbhl:1988:78:7:793-795_8 Template-Type: ReDIF-Article 1.0 Title: Behavioral aspects of cigarette smoking among industrial college men of Shanghai, China Journal: American Journal of Public Health Author-Name: Li, V.C. Author-Name: HU, J.-H. Author-Name: Zhou, M. Author-Name: Zheng, J. Year: 1988 Volume: 78 Issue: 12 Pages: 1550-1553 Abstract: A questionnaire survey was conducted among 7,665 students and staff in the factory-operated industrial colleges in Shanghai, China. Response rate was 95.7 per cent. The proportion of smokers among the men was 50.5 per cent; only 0.33 per cent of the women reported they were smokers. Male smokers began smoking upon entering the work force, where social interaction encourages cigarette smoking. Seventy per cent of the male smokers smoked fewer than 10 cigarettes per day. Only 4.3 per cent perceived themselves as very addicted; 3.4 per cent reported they had no confidence in their ability to control the amount they smoke. The Chinese smokers are more likely to succeed in giving up cigarette smoking for at least one day, as well as for longer periods, compared to US smokers. The number of cigarettes smoked may be related to the individual's purchasing power. For China, strategic timeliness in legislative action and education is urgently needed to combat the high prevalence of cigarette smoking in males, at extremely high risk. Handle: RePEc:aph:ajpbhl:1988:78:12:1550-1553_2 Template-Type: ReDIF-Article 1.0 Title: Children of migrant farm work families are at high risk for maltreatment: New York State study Journal: American Journal of Public Health Author-Name: Alvarez, W.F. Author-Name: Doris, J. Author-Name: Larson III, O. Year: 1988 Volume: 78 Issue: 8 Pages: 934-936 Abstract: Utilizing a crosstabulation between data collected by the Migrant Student Records Transfer System and the New York State Central Register, it was determined that 298 of the 7,408 migrant children, age 18 years or younger, censused in 1982 were on file as having been maltreated in 1982. This rate, 40.2 per 1,000, is substantially higher than the rate found for upstate New York children (5.5). Maltreatment rates also varied by migrant status and household composition. Handle: RePEc:aph:ajpbhl:1988:78:8:934-936_7 Template-Type: ReDIF-Article 1.0 Title: Health problems of homeless children in New York City Journal: American Journal of Public Health Author-Name: Alperstein, G. Author-Name: Rappaport, C. Author-Name: Flanigan, J.M. Year: 1988 Volume: 78 Issue: 9 Pages: 1232-1233 Abstract: We reviewed the outpatient medical records of 265 homeless children less than 5 years of age in New York City and compared them with children of similar low socioeconomic status (SES) attending the same pediatric clinic. The frequency of health problems among the homeless children, including delayed immunizations, elevated blood lead levels, the rate of admission to hospital, and the rate of child abuse and neglect reports, exceeded those for the comparison groups. Handle: RePEc:aph:ajpbhl:1988:78:9:1232-1233_1 Template-Type: ReDIF-Article 1.0 Title: Parent involvement with children's health promotion: The Minnesota home team Journal: American Journal of Public Health Author-Name: Perry, C.L. Author-Name: Luepker, R.V. Author-Name: Murray, D.M. Author-Name: Kurth, C. Author-Name: Mullis, R. Author-Name: Crockett, S. Author-Name: Jacobs Jr., D.R. Year: 1988 Volume: 78 Issue: 9 Pages: 1156-1160 Abstract: This study compares the efficacy of a school-based program to an equivalent home-based program with 2,250 third grade students in 31 urban schools in Minnesota in order to detect changes in dietary fat and sodium consumption. The school-based program, Hearty Heart and Friends, involved 15 sessions over five weeks in the third grade classrooms. The home-based program, the Home Team, involved a five-week correspondence course with the third graders, where parental involvement was necessary in order to complete the activities. Outcome measures included anthropometric, psychosocial and behavioral assessments at school, and dietary recall, food shelf inventories, and urinary sodium data collected in the students' homes. Participation rates for all aspects of the study were notably high. Eighty-six per cent of the parents participated in the Home Team and 71 per cent (nearly 1,000 families) completed the five-week course. Students in the school-based program had gained more knowledge at posttest than students in the home-based program or controls. Students in the home-based program, however, reported more behavior change, had reduced the total fat, saturated fat, and nonsaturared fat in their diets, and had more of the encouraged foods on their food shelves. The data converge to suggest the feasibility and importance of parental involvement for health behavior changes with children of this age. Handle: RePEc:aph:ajpbhl:1988:78:9:1156-1160_7 Template-Type: ReDIF-Article 1.0 Title: Variables influencing condom use in a cohort of gay and bisexual men Journal: American Journal of Public Health Author-Name: Valdiserri, R.O. Author-Name: Lyter, D. Author-Name: Leviton, L.C. Author-Name: Callahan, C.M. Author-Name: Kingsley, L.A. Author-Name: Rinaldo, C.R. Year: 1988 Volume: 78 Issue: 7 Pages: 801-805 Abstract: Nine hundred fifty-five of 1,384 (69 per cent) gay and bisexual men enrolled in a prospective study of the natural history of human immunodeficiency virus (HIV) infection who reported engaging in anal intercourse in the past six months were surveyed about condom use practices for both insertive (IAI) and receptive anal intercourse (RAI). The following results were obtained: 23 per cent of the men reported that they always used condoms for IAI and 21 per cent for RAI; 32 per cent sometimes used condoms for IAI; 28 per cent sometimes used condoms for RAI; 45 per cent never used condoms for IAI; and 50 per cent never used condoms for RAI. Multiple logistic regression analysis revealed that the following variables were associated with both insertive and receptive condom use: condom acceptability; a history of multiple and/or anonymous partners in the past six months, and the number of partners with whom one is 'high' (drugs/alcohol) during sex. Knowledge of positive HIV serostatus was more strongly associated with receptive than with insertive use. Condom use is a relatively complex health-related behavior, and condom promotion programs should not limit themselves to stressing the dangers of unprotected intercourse. Handle: RePEc:aph:ajpbhl:1988:78:7:801-805_1 Template-Type: ReDIF-Article 1.0 Title: AIDS in historical perspective: Four lessons from the history of sexually transmitted diseases Journal: American Journal of Public Health Author-Name: Brandt, A.M. Year: 1988 Volume: 78 Issue: 4 Pages: 367-371 Abstract: Four lessons from the social history of sexually transmitted disease in the U.S. are assessed for their relevance to the current AIDS epidemic: fear of disease will powerfully influence medical approaches and public health policy, education will not control the AIDS epidemic, compulsory public health measures will not control the epidemic, and the development of effective treatment and vaccines will not immediately or easily end the AIDS epidemic. Diseases are complex bio-ecological problems that may be mitigated only by addressing a range of scientific, social, and political considerations; no single intervention will address the complexities of the AIDS epidemic. Handle: RePEc:aph:ajpbhl:1988:78:4:367-371_9 Template-Type: ReDIF-Article 1.0 Title: Effect of DRGs on three-month readmission rate of geriatric patients with congestive heart failure Journal: American Journal of Public Health Author-Name: Rich, M.W. Author-Name: Freedland, K.E. Year: 1988 Volume: 78 Issue: 6 Pages: 680-682 Abstract: We reviewed the three-month hospital readmission rates of 410 patients ages 70 years or older discharged alive with a first time diagnosis of congestive of congestive heart failure during the period January 1983-June 1986. The mean age was 79.8 years, 59.5 per cent were women. Mean length of initial hospital stay decreased from 10.8 days in 1983 to 7.8 days in 1986. One hundred-nineteen patients (29 per cent) were rehospitalized at least once within three months of initial discharge. The readmission rates by year were: 1983, 40.0 per cent; 1984, 27.5 per cent; 1985, 21.4 per cent; 1986, 23.2 per cent. During this same interval, the percentage of patients referred for home health care services increased from 3.3 per cent in 1983 to 13.0 per cent in 1984, 5.8 percent in 1985, and 12.5 per cent in 1986. Thus decreased length of hospital stay was associated with a parallel decline in early readmission rate and increased utilization of home health care services. Although this study has important methodologic limitations, the data suggest that shorter hosptial stays under the DRG system are not necessarily associated with an increased rate of early rehospitalization. Handle: RePEc:aph:ajpbhl:1988:78:6:680-682_4 Template-Type: ReDIF-Article 1.0 Title: Mandatory driver training and road safety: The Quebec experience Journal: American Journal of Public Health Author-Name: Potvin, L. Author-Name: Champagne, F. Author-Name: Laberge-Nadeau, C. Year: 1988 Volume: 78 Issue: 9 Pages: 1206-1209 Abstract: In January 1983, the Quebec Government made driver training courses mandatory for any person seeking a first driver's license. Using accident and licensure data over a five-year period, we conducted an evaluation of the impact of the enactment of mandatory driver training on: the risk of accident for newly licensed drivers; the mortality and morbidity of these accidents; the number of new drivers; and the mean age of licensure. Results of our time series analyses show that this legislation had no appreciable effect on the risk of accident or on the mortality/morbidity rate per accident for newly licensed drivers aged 18 and over. However, since 1983, the number of women under 18 years of age getting their first driver's license has increased by 20 per cent, and their mean age has decreased from over 18 to under 18. Mandatory driver training may have increased the numbers and risks of accidents for young, primarily female, drivers. Handle: RePEc:aph:ajpbhl:1988:78:9:1206-1209_7 Template-Type: ReDIF-Article 1.0 Title: HIV seropositivity and IVDUs: Ethnic/gender comparisons Journal: American Journal of Public Health Author-Name: Lewis, D.K. Author-Name: Watters, J.K. Year: 1988 Volume: 78 Issue: 11 Pages: 1499 Handle: RePEc:aph:ajpbhl:1988:78:11:1499_0 Template-Type: ReDIF-Article 1.0 Title: The epidemiology of life and death: A critic commentary Journal: American Journal of Public Health Author-Name: Newman, T.B. Author-Name: Browner, W.S. Year: 1988 Volume: 78 Issue: 2 Pages: 161-162 Handle: RePEc:aph:ajpbhl:1988:78:2:161-162_7 Template-Type: ReDIF-Article 1.0 Title: A pilot outreach program for small quantity generators of hazardous waste Journal: American Journal of Public Health Author-Name: Brown, M.S. Author-Name: Kelley, B.G. Author-Name: Gutensohn, J. Year: 1988 Volume: 78 Issue: 10 Pages: 1343-1346 Abstract: The Massachusetts Department of Environmental Management initiated a pilot project to improve compliance with hazardous waste regulations and management of hazardous wastes with auto body shops around the state. The program consisted of mass mailings, a series of workshops throughout the state, a coordinated inspection program by the state regulatory agency, and technology transfer. At the start of the program in January 1986, approximately 650 of the estimated 2,350 auto body shops in the state had notified EPA of their waste generating activities; by January 1987, approximately 1,200 shops had done so. Suggestions for improving program efforts include tailoring the outreach effort to the industry, government-sponsored research and development directed at the needs of small firms, mandatory participation in hazardous waste transportation programs, and better coordination by EPA of its information collection and distribution program. Handle: RePEc:aph:ajpbhl:1988:78:10:1343-1346_2 Template-Type: ReDIF-Article 1.0 Title: Period, age, and cohort effects of substance use among young Americans: A decade of change, 1976-86 Journal: American Journal of Public Health Author-Name: O'Malley, P.M. Author-Name: Bachman, J.G. Author-Name: Johnston, L.D. Year: 1988 Volume: 78 Issue: 10 Pages: 1315-1321 Abstract: In an earlier article in this Journal, we reported analyses that differentiate among period, age, and cohort effects on substance use among Americal youth 18 to 24 years old, from the high school classes of 1976 to 1982 during the period of 1976 to 1982. The present analyses extend the classes and years to 1986, and the age range to 18-28. A cohort-sequential design is employed, based on annual surveys of nationally representative samples of high school seniors, plus annual follow-up surveys of each senior class. Twelve different classes of drugs, both licit and illicit, are examined. Several different types of period, age, and cohort effects over the last decade are identified. Alcohol use (monthly and occasions of heavy use), and the use of marijuana, cocaine, amphetamines, methaqualone, barbiturates, LSD, psychedelics other than LSD, and tranquilizers all showed period effects. Occasions of heavy drinking, cigarette smoking, monthly and daily use of alcohol, and annual prevalence of cocaine, amphetamines, barbiturates, LSD, and narcotics other than heroin showed age effects. Class effects were seen for cigarette smoking and daily marijuana use. Handle: RePEc:aph:ajpbhl:1988:78:10:1315-1321_5 Template-Type: ReDIF-Article 1.0 Title: Erythema infectiosum (fifth disease) occurrence in Iowa Journal: American Journal of Public Health Author-Name: Naides, S.J. Year: 1988 Volume: 78 Issue: 9 Pages: 1230-1231 Abstract: Review of Iowa school nurse surveillance for erythema infectiosum, or fifth disease (FD), since 1973 demonstrated occurrence yearly except 1985 without a clear pattern of disease spread. We conclude that FD is more common than previously recognized. Failure to identify cases representing the background incidence of disease may account for underreporting. Handle: RePEc:aph:ajpbhl:1988:78:9:1230-1231_7 Template-Type: ReDIF-Article 1.0 Title: Screening prospective blood donors for AIDS risk factors: Will sufficient donors be found? Journal: American Journal of Public Health Author-Name: Gregorio, D.I. Author-Name: Linden, J.V. Year: 1988 Volume: 78 Issue: 11 Pages: 1468-1471 Abstract: Using data from various sources - we estimate that 14 to 19 per cent of American males 17-75 have personal histories that place them at high risk of transmitting the HIV infection while an additional 2 per cent of adult females may be similarly affected. Because roughly one fourth of either group may already by unsuited to give blood, we estimate that 10-14 per cent of adult males, and 1 per cent of females would be specifically deferred from giving blood because of personal histories of high-risk behavior. Local adjustments in the assumptions underlying these estimates are needed to apply them to given communities. Handle: RePEc:aph:ajpbhl:1988:78:11:1468-1471_6 Template-Type: ReDIF-Article 1.0 Title: Seroprevalence of HIV antibody among individuals entering the Iowa prison system Journal: American Journal of Public Health Author-Name: Glass, G.E. Author-Name: Hausler, W.J. Author-Name: Loeffelholz, P.L. Author-Name: Yesalis III, C.E. Year: 1988 Volume: 78 Issue: 4 Pages: 447-449 Abstract: From January 1 to April 30, 1986, all individuals entering the Iowa prison system were tested for antibody to the human immunodeficiency virus (HIV). Sera were collected on 363 newly incarcerated inmates, 389 inmates returning to prison, and 107 forensic psychiatric patients. Three of the 859 serum samples (0.3 per cent) tested during this study were reactive by ELISA (enzyme-linked immunosorbent assay) testing, but none reactive by the Western blot. Analysis for AIDS risk factors included a high prior IV-drug use rate (22-50 per cent) and a low admitted homosexuality rate in a predominantly young white male population. Handle: RePEc:aph:ajpbhl:1988:78:4:447-449_6 Template-Type: ReDIF-Article 1.0 Title: Smoking prevalence in a cohort of adolescents, including absentees, dropouts, and transfers Journal: American Journal of Public Health Author-Name: Pirie, P.L. Author-Name: Murray, D.M. Author-Name: Luepker, R.V. Year: 1988 Volume: 78 Issue: 2 Pages: 176-178 Abstract: This study reports daily smoking rates among older adolescents obtained by a unique follow-up of a cohort originally identified in the seventh grade. Those no longer in their original school districts were located and interviewed by telephone. Smoking rates among dropouts exceeded 70 per cent in all age-sex groups. Smoking rates among transfers were as high as those among absentees. Including these subgroups raised smoking prevalence rates among older adolescents substantially. Handle: RePEc:aph:ajpbhl:1988:78:2:176-178_8 Template-Type: ReDIF-Article 1.0 Title: Laboratory-acquired infections and injuries in clinical laboratories: A 1986 survey Journal: American Journal of Public Health Author-Name: Vesley, D. Author-Name: Hartmann, H.M. Year: 1988 Volume: 78 Issue: 9 Pages: 1213-1215 Abstract: A mail survey of all 54 US State and Territorial Public Health Laboratories and the 165 Hospital Clinical Laboratories in Minnesota was carried out, soliciting information on laboratory-acquired infections and injuries for calendar year 1986. The aggregate infection incidence rates were 3.5/1,000 full-time equivalent (FTE) workers for hospital laboratories and 1.43/1,000 for public health laboratories. Injury rates were 21.2/100 FTE workers for hospital laboratories and 7.21/100 for public health labs. Handle: RePEc:aph:ajpbhl:1988:78:9:1213-1215_1 Template-Type: ReDIF-Article 1.0 Title: Prevalence of cardiovascular disease risk factors in Blacks and Whites: The Minnesota Heart Survey Journal: American Journal of Public Health Author-Name: Sprafka, J.M. Author-Name: Folsom, A.R. Author-Name: Burke, G.L. Author-Name: Edlavitch, S.A. Year: 1988 Volume: 78 Issue: 12 Pages: 1546-1549 Abstract: Two cross-sectional surveys were conducted in 1985 and 1986 to measure the prevalence of coronary heart disease (CHD) risk factors in Blacks and Whites. A home interview was followed by a survey center visit. Participation rates were 78 per cent and 90 per cent for the home interview and 65 per cent and 68 per cent for the survey center visit. Adjusted for age and education, systolic and diastolic blood pressure was 3 to 4 mmHg higher in Blacks. Hypertension was more prevalent in Blacks than Whites (44 per cent vs 28 per cent); serum total cholesterol was approximately 0.4 mmol/l lower in Black than White men and 0.08 mmol/l lower in Black than White women. Among men, more Blacks than Whites were current cigarette smokers (44 per cent vs 30 per cent); however, White smokers smoked more cigarettes per day (26 vs 17). Similar differences were noted for women, although the prevalence and quantity of cigarette consumption was less than men. The excess prevalence of these CHD risk factors in Blacks, especially among women, may explain their elevated CHD and stroke mortality rates in the Twin Cities. Handle: RePEc:aph:ajpbhl:1988:78:12:1546-1549_6 Template-Type: ReDIF-Article 1.0 Title: Comparing state-only expenditures for AIDS Journal: American Journal of Public Health Author-Name: Rowe, M.J. Author-Name: Ryan, C.C. Year: 1988 Volume: 78 Issue: 4 Pages: 424-429 Abstract: The State AIDS Policy Center at the Intergovernmental Health Policy Project (IHPP) at George Washington University surveyed all 50 states to determine state AIDS (acquired immunodeficiency syndrome) expenditures, without Medicaid or federal funds, for fiscal 1984-88. During this period, state-only expenditures increased 15-fold, to $156.3 million. Between fiscal 1986-1988, the distribution of state funding for AIDS patient care and support services doubled from 16 to 35 per cent and the number of states supplementing federal funds for testing and counseling increased from eight to 20. Five states continue to account for the largest AIDS appropriations. Of these, California leads in funding research; New York, Florida, and New Jersey have directed funds to provide care and services to IV (intravenous) drug users, prisoners, and children. The average state expenditure per diagnosed AIDS case is $3,323 and an increasing number of states with relatively low case loads are appropriating funds beyond this level. Across states, AIDS expenditures per person average $.65 and $.21 for education, testing and counseling - below the level recommended by the Institute of Medicine for AIDS prevention activities. Some jurisdictions support AIDS activities indirectly by shifting resources, often from their STD (sexually transmitted disease) programs - this trend deserves conatinuing review given the rise in STD cases and their relationship to diagnosed AIDS. Handle: RePEc:aph:ajpbhl:1988:78:4:424-429_8 Template-Type: ReDIF-Article 1.0 Title: The impact of Medicare on early cancer detection in the elderly Journal: American Journal of Public Health Author-Name: Grover, S.A. Author-Name: Cook, E.F. Author-Name: Goldman, L. Year: 1988 Volume: 78 Issue: 1 Pages: 58-60 Abstract: In an analysis of 23 sex-specific tumors in the Connecticut Tumor Registry, only seven tumors showed more than a 20 per cent increase in the ratio of localized tumors detected post-Medicare (1967-75) versus ante-Medicare (1960-65) in the 65-75 year age group compared to the 60-64 year age group. Of these seven, the information was more convincing for lung cancer in males. Overall, however, Medicare had little if any impact on early tumor diagnosis in the elderly. Handle: RePEc:aph:ajpbhl:1988:78:1:58-60_3 Template-Type: ReDIF-Article 1.0 Title: Transmission of hepatitis B virus from adopted Asian children to their American families Journal: American Journal of Public Health Author-Name: Friede, A. Author-Name: Harris, J.R. Author-Name: Kobayashi, J.M. Author-Name: Shaw Jr., F.E. Author-Name: Shoemaker-Nawas, P.C. Author-Name: Kane, M.A. Year: 1988 Volume: 78 Issue: 1 Pages: 26-29 Abstract: In 1985, 6,991 Asian children were adopted by Americans. To estimate the risk that such children may transmit hepatitis B virus to their adoptive families, we conducted a cumulative-incidence follow-up study in the State of Washington. We examined the association between having adopted a hepatitis B surface antigen (HBsAg)-seropositive Asian child and aserologic evidence of past or present hepatitis B virus infection in adoptive family members. Seven (9 per cent) of 77 family members exposed to an HBsAg-seropositive child had evidence of past or present infection compared with four (2 per cent) of 232 nonexposed (relative risk = 5.3; 90% confidence limits [CL] = 2.0-13.9). The risk was higher for those with prolonged exposure and was entirely restricted to parents. Handle: RePEc:aph:ajpbhl:1988:78:1:26-29_7 Template-Type: ReDIF-Article 1.0 Title: Perinatal and infant mortality rates and place of birth in Italy, 1980 Journal: American Journal of Public Health Author-Name: Parazzini, F. Author-Name: La Vecchia, C. Year: 1988 Volume: 78 Issue: 6 Pages: 706-707 Abstract: In 1980, the ratio of home birth to public hospital perinatal and neonatal mortality rates decreased from Northern to Southern Italy, being inversely related to the proportion of home deliveries and probably reflecting the effect of planned versus unplanned home births. The post neonatal mortality rate in Southern Italy was about four times as high in children born at home (9.5/1,000 live births) than in those delivered in public hospitals (2.6/1,000 live births, probably reflecting differences in the socioeconomic status according to the birthplace selection in various regions. Handle: RePEc:aph:ajpbhl:1988:78:6:706-707_4 Template-Type: ReDIF-Article 1.0 Title: Epidemic giardiasis caused by a contaminated public water supply Journal: American Journal of Public Health Author-Name: Kent, G.P. Author-Name: Greenspan, J.R. Author-Name: Herndon, J.L. Author-Name: Mofenson, L.M. Author-Name: Harris, J.-A.S. Author-Name: Eng, T.R. Author-Name: Waskin, H.A. Year: 1988 Volume: 78 Issue: 2 Pages: 139-143 Abstract: In the period November 1, 1985 to January 31, 1986, 703 cases of giardiasis were reported in Pittsfield, Massachusetts (population 50,265). The community obtained its water from two main reservoirs (A and B) and an auxiliary reservoir (C). Potable water was chlorinated but not filtered. The incidence of illness peaked approximately two weeks after the city began obtaining a major portion of its water from reservoir C, which had not been used for three years. The attack rate of giardiasis for residents of areas supplied by reservoir C was 14,3/1000, compared with 7.0/1000 in areas that received no water from reservoir C. A case-control study showed that persons with giardiasis were more likely to be older and to have drunk more municipal water than household controls. A community telephone survey indicated that over 3,800 people could have had diarrhea that might have been caused by Giardia, and 95 per cent of households were either using alternate sources of drinking water or boiling municipal water. Environment studies identified Giardia cysts in the water of reservoir C. Cysts were also detected in the two other reservoirs supplying the city, but at lower concentrations. This investigation highlights the risk of giardiasis associated with unfiltered surface water systems. Handle: RePEc:aph:ajpbhl:1988:78:2:139-143_1 Template-Type: ReDIF-Article 1.0 Title: Racial/ethnic differences in the risk of AIDS in the United States Journal: American Journal of Public Health Author-Name: Selik, R.M. Author-Name: Castro, K.G. Author-Name: Pappaioanou, M. Year: 1988 Volume: 78 Issue: 12 Pages: 1539-1545 Abstract: We analyzed the variation in the risk of AIDS in US Blacks, Hispanics, and other racial/ethnic groups relative to that in Whites (non-Hispanic) by geographic area and mode of acquiring HIV infection, based on data reported between June 1, 1981 and January 18, 1988 to the Centers for Disease Control and 1980 US census data. Relative risks (RRs) in Blacks and Hispanics were highest in the northeast region, and higher in suburbs than in central cities of metropolitan areas. RRs in Blacks and Hispanics were greatest for AIDS directly or indirectly associated with intravenous-drug abuse by heterosexuals (range: 5.7-26.9) and were also high for AIDS associated with male bisexuality (range: 2.5-4.8), suggesting that these behaviors may be more prevalent in Blacks and Hispanics than in Whites. Prevention strategies should take into account these racial/ethnic differences. Handle: RePEc:aph:ajpbhl:1988:78:12:1539-1545_0 Template-Type: ReDIF-Article 1.0 Title: Geographic distribution of human immunodeficiency virus markers in parenteral drug abusers Journal: American Journal of Public Health Author-Name: Lange, W.R. Author-Name: Snyder, F.R. Author-Name: Lozovsky, D. Author-Name: Kaistha, V. Author-Name: Kaczaniuk, M.A. Author-Name: Jaffe, J.H. Author-Name: Primm, B.J. Author-Name: Brown, L. Author-Name: Luney, C.M. Author-Name: Poe, T. Author-Name: Payte, J.T. Author-Name: Hall, S.W. Author-Name: Crowley, T.J. Author-Name: Brewster, J.T. Author-Name: Tennant, F.S. Author-Name: Clabough, D. Year: 1988 Volume: 78 Issue: 4 Pages: 443-446 Abstract: Drug abuse treatment programs in six regions of the United States collaborated in a study aimed at monitoring trends in the seroprevalence of human immunodeficiency virus (HIV) antibodies. The wide disparities in HIV seroprevalence in the face of similarities in drug using behavior have important implications for prevention. In the New York City area (Harlem, Brooklyn), 61 per cen of samples (N = 280) obtained in late 1986 were positive, up from 50 per cent of samples (N = 585) in early 1985. In Baltimore, Maryland, 29 per cent of samples (N = 184) representing 11 programs were positive. In contrast, samples from programs distant from the Northeast corridor had far lower rates: Denver, Colorado 5 per cent (N = 100); San Antonio, Texas 2 per cent (N = 106); Southern California, 1.5 per cent (N = 413); and Tampa, Florida, 0 per cent (N = 102). Contrary to expectations, there was no corresponding difference in reported lifetime needle sharing experiences, which ranged from 70 per cent in New York to 99 per cent in San Antonio. HIV seropositivity was associated only with geographic location and ethnicity; however, because needle sharing is practiced by parenteral drug abusers in areas where seroprevalence is still relatively low, these areas are potentially vulnerable to the same catastrophic spread seen in the Northeast. A window of opportunity exists where prompt, vigorous, and aggressive efforts at prevention could have major impact. Handle: RePEc:aph:ajpbhl:1988:78:4:443-446_5 Template-Type: ReDIF-Article 1.0 Title: Improving the life-course development of socially disadvantaged mothers: A randomized trial of nurse home visitation Journal: American Journal of Public Health Author-Name: Olds, D.L. Author-Name: Henderson Jr., C.R. Author-Name: Tatelbaum, R. Author-Name: Chamberlin, R. Year: 1988 Volume: 78 Issue: 11 Pages: 1436-1445 Abstract: We evaluated a comprehensive program of prenatal and postpartum nurse home visitation for socially disadvantaged women bearing first children. Eigthy-five per cent of the participating women were either teenagers (< 19 years at registration), unmarried, or of low socioeconomic status. Women were randomly assigned to either nurse home visitation or comparison services (free transportation for prenatal and well-child care and/or sensory and developmental screening for the child). During the first four years after delivery of their first child, in contrast to their counterparts in the comparison group, nurse-visited White women who had not graduated from high school when they registered in the study returned to school more rapidly; nurse-visited, poor, unmarried White women showed an 82 per cent increase in the number of months they were employed, had 43 per cent fewer subsequent pregnancies, and postponed the birth of second children an average of 12 months longer. Handle: RePEc:aph:ajpbhl:1988:78:11:1436-1445_4 Template-Type: ReDIF-Article 1.0 Title: Calories, fat and cholesterol: Intake patterns in the US population by race, sex and age Journal: American Journal of Public Health Author-Name: Block, G. Author-Name: Rosenberger, W.F. Author-Name: Patterson, B.H. Year: 1988 Volume: 78 Issue: 9 Pages: 1150-1155 Abstract: Nutrient intakes were investigated for Blacks and Whites using data from the NHANES II survey (1976-80). Intake of energy, total fat, saturated fat, dietary cholesterol, P/S ratio, and per cent of calories derived from total and saturated fat are examined by sex and age, both in absolute terms and per unit of body weight. For most age and sex categories, Blacks are found to have a lower intake of energy and fats than Whites; however, Blacks have a consistently higher intake of dietary cholesterol. The ratio of polyunsaturated fats to saturated fats is higher in females than in males, but all age-sex groups are substantially below recommended levels. Per cent of calories from total and saturated fat are similar in most age-sex groups. Possible explanations of the observed patterns include activity level and metabolic differences. Handle: RePEc:aph:ajpbhl:1988:78:9:1150-1155_5 Template-Type: ReDIF-Article 1.0 Title: Smokeless tobacco use and attitudes toward smokeless tobacco among Native Americans and other adolescents in the Northwest Journal: American Journal of Public Health Author-Name: Hall, R.L. Author-Name: Dexter, D. Year: 1988 Volume: 78 Issue: 12 Pages: 1586-1588 Abstract: A survey of 1,180 sixth, ninth, and eleventh graders in three school districts in the State of Washington found that 34 per cent of male Native Americans, 24 per cent of female Native Americans, 20 per cent of male non-natives and 4 per cent of female non-natives are current users of smokeless tobacco products. In all areas and groups, the best predictor of whether an adolescent is a user is the use pattern of friends. Handle: RePEc:aph:ajpbhl:1988:78:12:1586-1588_1 Template-Type: ReDIF-Article 1.0 Title: Medical treatment of homeless hypertensives Journal: American Journal of Public Health Author-Name: Michael, M. Author-Name: Brammer, S. Year: 1988 Volume: 78 Issue: 1 Pages: 94 Handle: RePEc:aph:ajpbhl:1988:78:1:94_8 Template-Type: ReDIF-Article 1.0 Title: Marital status and the risk of suicide Journal: American Journal of Public Health Author-Name: Smith, J.C. Author-Name: Mercy, J.A. Author-Name: Conn, J.M. Year: 1988 Volume: 78 Issue: 1 Pages: 78-80 Abstract: No recent United States study has previously calculated national suicide rates by marital status for specific age, race, and sex categories in order to better identify high-risk groups for suicide. We used national vital statistics and census data to calculate marital-status-specific rates. Results show that for each marital status group, by age and sex, married persons have the lowest suicide rates and young widowed males have exceptionally high rates. Handle: RePEc:aph:ajpbhl:1988:78:1:78-80_3 Template-Type: ReDIF-Article 1.0 Title: New laws ameliorate OB crisis in Missouri Journal: American Journal of Public Health Author-Name: Harmon, R.G. Year: 1988 Volume: 78 Issue: 1 Pages: 95-96 Handle: RePEc:aph:ajpbhl:1988:78:1:95-96_5 Template-Type: ReDIF-Article 1.0 Title: A cluster of unexplained deaths in a nursing home in Florida Journal: American Journal of Public Health Author-Name: Sacks, J.J. Author-Name: Herndon, J.L. Author-Name: Lieb, S.H. Author-Name: Sorhage, F.E. Author-Name: McCaig, L.F. Author-Name: Withum, D.G. Year: 1988 Volume: 78 Issue: 7 Pages: 806-808 Abstract: In the two-week period November 13-27, 1984, 12 patients died in a 54-bed nursing home in Florida; based on previous mortality patterns, 2.5 deaths would have been expected for the whole month. There was no similar increase in deaths in November 1984 and no comparable monthly death rate for any of 69 nursing homes in the same county from 1976-84. Comparison of the 12 deaths in November with 28 deaths that occurred during the previous 10 months and with 31 surviving patients who were continuously present in the nursing home between November 12-28, 1984 revealed that the patients who died in November were more likely to have had onset of the terminal event during the night shift, had a recent visitor, and had an admitting diagnosis of organic brain syndrome. The abrupt increase in the death rate for November 1984 was not associated with a measurable change in population characteristics, an outbreak of infectious disease, or changes in procedures or the environment. Reviews of employee schedules revealed a consistent and strong association between the duty times of two nurses and the onsets of the terminal episode and the times of patient deaths. Continuing epidemiologic surveillance of adverse outcomes in nursing homes is recommended. Handle: RePEc:aph:ajpbhl:1988:78:7:806-808_2 Template-Type: ReDIF-Article 1.0 Title: Non-contraceptive estrogen use and the risk of gallstone disease in women Journal: American Journal of Public Health Author-Name: Kakar, F. Author-Name: Weiss, N.S. Author-Name: Strite, S.A. Year: 1988 Volume: 78 Issue: 5 Pages: 564-566 Abstract: We interviewed 102 women, ages 41-74 years who underwent gallstone surgery between January 1979 and September 1980, and 98 controls selected from the membership files of a large prepaid health care plan in Western Washington, about their past use of certain medications, reproductive history, and physical and demographic characteristics. The risk of gallstone disease among women who used estrogens for at least one year prior to diagnosis of their condition, relative to that of other women, was 1.18 (95% CI: 0.65-2.13). Standardization for the effects of age, race, obesity, parity, thiazide use, and history of high blood pressure did not alter appreciably the estimate of relative risk. Among estrogen users, the duration of use was similar in cases and controls. Our findings suggest that if non-contraceptive estrogen use is a risk factor for gallstone disease (requiring surgery) in women, its effect is very small. Handle: RePEc:aph:ajpbhl:1988:78:5:564-566_5 Template-Type: ReDIF-Article 1.0 Title: The prevalence of bulimia nervosa in the US College Student population Journal: American Journal of Public Health Author-Name: Drewnowski, A. Author-Name: Hopkins, S.A. Author-Name: Kessler, R.C. Year: 1988 Volume: 78 Issue: 10 Pages: 1322-1325 Abstract: A phone survey to determine the prevalence of bulimia nervosa was conducted with a national probability sample of 1,007 male and female students from a stratified sample of 53 universities and colleges in the continental United States. Using the revised (DSM IIIR) diagnostic criteria, 1 per cent of the women and 0.2 per cent of the men were classified as bulimic. Bulimia was most prevalent (2.2 per cent prevalence rate) among undergraduate women living in group housing on campus. Handle: RePEc:aph:ajpbhl:1988:78:10:1322-1325_5 Template-Type: ReDIF-Article 1.0 Title: Blood pressure and social class in a Jamaican community Journal: American Journal of Public Health Author-Name: Dressler, W.W. Author-Name: Grell, G.A.C. Author-Name: Gallagher, P.N. Author-Name: Viteri, F.E. Year: 1988 Volume: 78 Issue: 6 Pages: 714-716 Abstract: A study of social factors and blood pressure was conducted in a Jamaican community among a sample of 199 persons ages 30 to 50. After controlling for obesity, age, and respondent tension (and other covariates), interaction effects of social class x sex for systolic and diastolic blood pressure were found. Blood pressure increased with increasing social class for males and decreased with increasing social class for females. Handle: RePEc:aph:ajpbhl:1988:78:6:714-716_5 Template-Type: ReDIF-Article 1.0 Title: Visits to physicians before and after exposure to urea formaldehyde foam insulation Journal: American Journal of Public Health Author-Name: L'Abbe, K.A. Author-Name: Hoey, J.R. Author-Name: Hanley, J. Author-Name: Wacholder, S. Author-Name: Nantel, A. Year: 1988 Volume: 78 Issue: 11 Pages: 1489-1491 Abstract: The average number of visits to a physician made by a sample of 351 residents of homes insulated with urea formaldehyde foam insulation in Montreal in the one year period before exposure was 5.25, and in the year following 5.62, an increase of 7 per cent (odds ratio 1.07, 95% CI = 1.00, 1.15). The increase in visits in the post insulation year was limited to subjects who had the product installed in the winter (OR = 1.48, 95% CI = 1.18, 1.85), and was not seen for study subjects who insulated their homes during other seasons of the year. Handle: RePEc:aph:ajpbhl:1988:78:11:1489-1491_6 Template-Type: ReDIF-Article 1.0 Title: The social and economic correlates of pregnancy resolution among adolescence in New York City, by race and ethnicity: A multivariate analysis Journal: American Journal of Public Health Author-Name: Joyce, T. Year: 1988 Volume: 78 Issue: 6 Pages: 626-631 Abstract: This study utilizes a data set combining vital records from live birth and induced abortion certificates in New York City in 1984 to examine the correlates of the two outcomes among pregnant adolescents. Four groups totaling 31,207 teenagers were examined: Black non-Latinos (51 per cent), White non-Latinos (17 per cent), Puerto Ricans (25 per cent), and non-Puerto Rican Latinos (8 per cent). Multivariate regressions were fit for each group. Simulations based on the regressions reveal that the proportion of live births plus induced abortions among unmarried 18-year-olds, on Medicaid, with a previous live birth, no previous induced abortions, and nine years of completed schooling was .55 in the case of Puerto Ricans, .34 for non-Puerto Rican Latinos, .60 for Blacks, and .51 for Whites. For nulliparous adolescence of the same age and marital status, with an additional year of schooling, but not on Medicaid, and with a previous induced abortion, the fraction of pregnancies that were terminated rose in .84 in the case of Puerto Ricans, .81 for non-Puerto Rican Latinos, .87 for Blacks, and .96 for Whites. The results suggest that attitudes toward abortion as proxied by previous induced terminations substantially increase the likelihood of aborting as well as narrow the racial and ethnic differences with respect to pregnancy resolution. Handle: RePEc:aph:ajpbhl:1988:78:6:626-631_6 Template-Type: ReDIF-Article 1.0 Title: Incidence of hypertension in the Framingham Study Journal: American Journal of Public Health Author-Name: Dannenberg, A.L. Author-Name: Garrison, R.J. Author-Name: Kannel, W.B. Year: 1988 Volume: 78 Issue: 6 Pages: 676-679 Abstract: Incidence and trends in incidence of definite hypertension were analyzed based on 30 years follow-up of 5,209 subjects in the Framington Heart Study cohort. Based on pooling of 15 two-year periods, hypertension incidence per biennium increased with age in men from 3.3 per cent at ages 30-39 to 6.2 per cent at ages 70-79, and in women from 1.5 per cent at ages 30-39 to 8.6 per cent at ages 70-79. No consistent trend in incidence rates was evident for either sex from the 1950s through the 1970s. The proportion of hypertensive subjects receiving antihypertensive medication has increased since 1954-58 and exceeded 80 per cent for both men and women ages 60-89 years in 1979-81. Incidence data presented in this report may serve as a baseline for assessing the impact of future public health efforts in the primary prevention of hypertension. Handle: RePEc:aph:ajpbhl:1988:78:6:676-679_8 Template-Type: ReDIF-Article 1.0 Title: Public health at the 1984 Summer Olympics: The Los Angeles County experience Journal: American Journal of Public Health Author-Name: Weiss, B.P. Author-Name: Mascola, L. Author-Name: Fannin, S.L. Year: 1988 Volume: 78 Issue: 6 Pages: 686-688 Abstract: During the 1984 Summer Olympic Games, the Los Angeles County Department of Health Services used its active disease surveillance system to monitor disease occurrence and other health concerns. Reports were collected by telephone three times a week from 198 participating facilities including hospitals, prepaid health plans, private physicians, and Olympic sites. Background data were obtained two months preceding the Olympic events. Less illness was recorded during the Olympics than during the same period for the preceding years. Handle: RePEc:aph:ajpbhl:1988:78:6:686-688_3 Template-Type: ReDIF-Article 1.0 Title: Fractures and lifestyle: Effect of cigarette smoking, alcohol intake, and relative weight on the risk of hip and forearm fractures in middle-aged women Journal: American Journal of Public Health Author-Name: Hemenway, D. Author-Name: Colditz, G.A. Author-Name: Willett, W.C. Author-Name: Stampfer, M.J. Author-Name: Speizer, F.E. Year: 1988 Volume: 78 Issue: 12 Pages: 1554-1558 Abstract: Cigarette smoking, alcohol consumption and low relative weight are often cited as risk factors for osteoporosis. In a prospective cohort study of 96,508 middle-aged nurses 35 to 59 years of age we found that smoking was not a risk factor for hip and forearm fracture. Women who drank more than 15 grams of alcohol per day and whose relative weight was less than 21 kg/m2 were at increased risk of fractures, but these risk factors were not independent. Only the combination of alcohol intake and thinness substantially increased the likelihood of fracture. The low weight women consuming more than one drink per day comprised but 4 per cent of our population of middle-class women and sustained 6 per cent of the fractures. Handle: RePEc:aph:ajpbhl:1988:78:12:1554-1558_2 Template-Type: ReDIF-Article 1.0 Title: Hepatitis B screening in a New York City obstetrics service Journal: American Journal of Public Health Author-Name: Friedman, S.M. Author-Name: DeSilva, L.P. Author-Name: Fox, H.E. Author-Name: Bernard, G. Year: 1988 Volume: 78 Issue: 3 Pages: 308-310 Abstract: A cross-sectional chart review study was performed of hepatitis B virus (HBV) surface antigen screening of 532 women admitted to a New York City hospital obstetrics service from 1984 to 1985. Comparison of serologic results to risk factors for hepatitis B revealed that women born outside the United States and those with a positive test for or history of a sexually transmitted disease were more likely to be infected with HBV. Obstetric clinics with large immigrant populations should consider screening all patients for HBV. Handle: RePEc:aph:ajpbhl:1988:78:3:308-310_6 Template-Type: ReDIF-Article 1.0 Title: Crash involvement of large trucks by configuration: A case-control study Journal: American Journal of Public Health Author-Name: Stein, H.S. Author-Name: Jones, I.S. Year: 1988 Volume: 78 Issue: 5 Pages: 491-498 Abstract: For a two-year period, large truck crashes on the interstate system in Washington State were investigated using a case-control method. For each large truck involved in a crash, three trucks were randomly selected for inspection from the traffic stream at the same time and place as the crash but one week later. The effects of truck and driver characteristics on crashes were assessed by comparing their relative frequency among the crash-involved and comparison sample trucks. Double trailer trucks were consistenly overinvolved in crashes by a factor of two to three in both single and multiple vehicle crashes. Single unit trucks pulling trailers also were overinvolved. Doubles also had a higher frequency of jackknifing compared to tractor-trailers. The substantial overinvolvement of doubles in crashes was found regardless of driver age, hours of driving, cargo weight, or type of fleet. Younger drivers, long hours of driving, and operating empty trucks were also associated with higher crash involvement. Handle: RePEc:aph:ajpbhl:1988:78:5:491-498_2 Template-Type: ReDIF-Article 1.0 Title: Health promotion in the United States and Canada: Smoking, exercise, and other health-related behaviors Journal: American Journal of Public Health Author-Name: Schoenborn, C.A. Author-Name: Stephens, T. Year: 1988 Volume: 78 Issue: 8 Pages: 983-984 Handle: RePEc:aph:ajpbhl:1988:78:8:983-984_7 Template-Type: ReDIF-Article 1.0 Title: Drug abuse discharges from non-federal short-stay hospitals Journal: American Journal of Public Health Author-Name: Gfroerer, J.C. Author-Name: Adams, E.H. Author-Name: Moien, M. Year: 1988 Volume: 78 Issue: 12 Pages: 1559-1562 Abstract: An analysis of inpatient drug abuse cases was done using the National Hospital Discharge Survey (NHDS). An estimated two million discharges with a drug abuse diagnosis occurred in non-federal short-stay hospitals during 1979-85, a figure which is believed to be an underestimate. Compared to other hospital inpatients, drug abuse inpatients are more likely to be male, ages 15-44, and other than white race. Increases in hospital use for drug abuse treatment were found to have occurred between 1979 and 1985, with discharge rates per 10,000 population increasing from 3.1 to 6.0 for drug dependence and from 3.8 to 7.7 for nondependent drug abuse. Concurrent increases in availability of hospital-based inpatient drug and alcohol treatment programs and insurance coverage for drug abuse treatment were found to have occurred during the same period. Handle: RePEc:aph:ajpbhl:1988:78:12:1559-1562_0 Template-Type: ReDIF-Article 1.0 Title: Incidence of tooth loss among elderly Iowans Journal: American Journal of Public Health Author-Name: Hunt, R.J. Author-Name: Hand, J.S. Author-Name: Kohout, F.J. Author-Name: Beck, J.D. Year: 1988 Volume: 78 Issue: 10 Pages: 1330-1332 Abstract: This study investigated the 18-month incidence of tooth loss in a random sample of 451 dentate noninstitutionalized Iowans aged 65 and older residing in two rural counties. They had a mean of 19.0 teeth at baseline and lost an average of 0.4 teeth during the subsequent 18 months. Twenty-one per cent of the population lost at least one tooth. Four people had all their teeth extracted. Of the teeth present at baseline, 1.9 per cent subsequently were extracted. The highest incidence of tooth loss occurred among mandibular molars (3.7 per cent), followed by maxillary premolars and canines (3.1 per cent each). The best predictors of tooth loss were previous coronal and root caries. Handle: RePEc:aph:ajpbhl:1988:78:10:1330-1332_8 Template-Type: ReDIF-Article 1.0 Title: Urban hospital cesarean section delivery rates in Paraiba State, Brazil, 1977-81 Journal: American Journal of Public Health Author-Name: Rodrigues, J. Year: 1988 Volume: 78 Issue: 6 Pages: 704-705 Abstract: Paraiba State, Brazil is one of the poorest areas in that country; many of the hospitals are not high quality and medical training is not comparable to that of developed countries. Nevertheless, the rate of cesarean section delivery in urban hospitals has risen from 19.0 per cent in 1977 to 28.5 in 1981. Despite the larger volume of obstetric services in government hospitals, these hospitals had lower cesarean section rates than private hospitals, both profit and non-profit. Handle: RePEc:aph:ajpbhl:1988:78:6:704-705_9 Template-Type: ReDIF-Article 1.0 Title: Community health effects of a municipal water supply hyperfluoridation accident Journal: American Journal of Public Health Author-Name: Petersen, L.R. Author-Name: Denis, D. Author-Name: Brown, D. Author-Name: Hadler, J.L. Author-Name: Helgerson, S.D. Year: 1988 Volume: 78 Issue: 6 Pages: 711-713 Abstract: For 12 hours, excess hydrofluorosilicic acid was diverted to a 127-home community water supply. Fluoride levels peaked at 51 parts per million (ppm). Water acidification caused copper to leach from the domestic plumbing; raising copper levels to 25-41 ppm. Fifty-two (33 per cent) of those who drank hyperfluoridated water developed mild gastroenteritis. Vomiting was uncommon and symptom onsets usually occurred >30 minutes after drinking water; suggesting that fluoride, rather than copper, caused illness. Skin contact with hyperfluoridated water caused itching and skin rashes. Handle: RePEc:aph:ajpbhl:1988:78:6:711-713_7 Template-Type: ReDIF-Article 1.0 Title: Acculturation and alcohol consumption among Mexican Americans: A three-generation study Journal: American Journal of Public Health Author-Name: Markides, K.S. Author-Name: Krause, N. Author-Name: Mendes de Leon, C.F. Year: 1988 Volume: 78 Issue: 9 Pages: 1178-1181 Abstract: Data from a three-generation study of Mexican Americans conducted in the San Antonio, Texas area are utilized to examine the influence of acculturation into the larger society on alcohol consumption. Acculturation was not related to alcohol consumption in the older generation. In the middle generation, it was related to lower alcohol consumption among men, a well as among women. In the younger generation, acculturation was related to more drinking among women, but not among men. Within-family analysis showed that the alcohol consumption of members of the younger generation was associated with the consumption of their parents, particularly in the case of younger women. Handle: RePEc:aph:ajpbhl:1988:78:9:1178-1181_8 Template-Type: ReDIF-Article 1.0 Title: AIDS, policy analysis, and the electorate: The role of schools of public health Journal: American Journal of Public Health Author-Name: Krieger, N. Author-Name: Lashof, J.C. Year: 1988 Volume: 78 Issue: 4 Pages: 411-415 Abstract: Current debates concerning appropriate policy to combat the epidemic of acquired immunodeficiency syndrome (AIDS) have raised critical questions regarding the role that schools of public health and individual public health professionals should play, if any, in AIDS-related policy analysis and social advocacy. In the summer of 1986, the School of Public Health at the University of California at Berkeley initiated a telegram sent by the Deans of all 23 schools of public health to protest US Department of Justice AIDS policy and, in the subsequent fall, the school expanded its public educational role in an unprecedented manner by initiating and issuing, with California's other three schools of public health, a policy analysis of Proposition 64, the LaRouche AIDS Quarantine Initiative. That analysis exposed the proposition's fallacious claims regarding casual transmission of AIDS and served to educate the electorate on the likely public health impact of this deleterious legislation. Based on these experiences, and in light of ongoing national controversy regarding AIDS, we believe schools of public health have an important role to play in policy analysis, and individual public health professionals have a role to play in social advocacy. Handle: RePEc:aph:ajpbhl:1988:78:4:411-415_7 Template-Type: ReDIF-Article 1.0 Title: Political violence, health, and health services in South Africa Journal: American Journal of Public Health Author-Name: Herman, A.A. Year: 1988 Volume: 78 Issue: 7 Pages: 767-768 Handle: RePEc:aph:ajpbhl:1988:78:7:767-768_2 Template-Type: ReDIF-Article 1.0 Title: Day care center illness: Policy and practice in North Carolina Journal: American Journal of Public Health Author-Name: Landis, S.E. Author-Name: Earp, J.A.L. Year: 1988 Volume: 78 Issue: 3 Pages: 311-313 Abstract: We surveyed 62 North Carolina day care centers (DDCs) to determine their policies for excluding children. We found that the addition of a temperature of 100-101°F to each of eight symptoms was associated with an increase in the percentage of DCCs choosing 'immediate pick-up'. Non-profit centers were more likely to send children home (70 per cent) than for-profit centers (48 per cent). Centers with and without written illness policies did not differ in their management of sick children. Handle: RePEc:aph:ajpbhl:1988:78:3:311-313_8 Template-Type: ReDIF-Article 1.0 Title: The value of water supply and sanitation in development: An assessment Journal: American Journal of Public Health Author-Name: Okun, D.A. Year: 1988 Volume: 78 Issue: 11 Pages: 1463-1467 Abstract: The attractiveness of oral rehydration therapy (ORT), a new and simple ministration that averts many child deaths from diarrhea among children, is diverting attention among donor agencies from the importance of water supply and sanitation (WS&S) in developing nations. The principal factor that led to the adoption of ORT is its apparent low cost per diarrheal death averted in children when compared with WS&S. However, WS&S provides many more benefits that are essential to sustaining the lives saved by ORT and vital to maintaining and enhancing the lives of adults and children. Among many other benefits WS&S prevents spread of the causes of diarrhea, controls many other water- and sanitation-related diseases, releases women from the heavy and time-consuming burden of carrying water from distant sources, and improves the quality of life in the community. Cost comparisons between WS&S and ORT are misleading. WS&S is a long-term investment in preventive health while ORT is a response to an immediate life-threatening situation. WS&S interventions eliminate unsanitary conditions leading to illness and death while ORT has no effect on the causes of diarrheal morbidity. The costs of WS&S are not high: $5 to $10 per capita annually. Without WS&S and hygiene education ORT programs are not likely to effect long-term improvement in child health status. ORT and WS&S programs are complementary; one should not displace the other. Handle: RePEc:aph:ajpbhl:1988:78:11:1463-1467_3 Template-Type: ReDIF-Article 1.0 Title: Eradication of head lice with a single treatment Journal: American Journal of Public Health Author-Name: DiNapoli, J.B. Author-Name: Austin, R.D. Author-Name: Englender, S.J. Author-Name: Gomez, M.P. Author-Name: Barrett, J.F. Year: 1988 Volume: 78 Issue: 8 Pages: 978-980 Abstract: Single application of Nix(TM) (permethrin 1% creme rinse) and Rid® were compared as treatments for Pediculosis capitis in 435 patients, the majority of whom were children. Seven days after the treatment, 98 per cent of the permethrin-treated and 85 per cent of the Rid-treated patients were free of lice. At 14 days, prior to nit removal, 96 per cent of the permethrin-treated and 62 per cent of the Rid-treated patients were still lice free. Seventeen (7 per cent) permethrin-treated and 32 (16 per cent) Rid-treated patients were reported to have adverse experiences. Handle: RePEc:aph:ajpbhl:1988:78:8:978-980_9 Template-Type: ReDIF-Article 1.0 Title: Bicyclists, helmets and head injuries: A rider-based study of helmet use and effectiveness Journal: American Journal of Public Health Author-Name: Wasserman, R.C. Author-Name: Waller, J.A. Author-Name: Monty, M.J. Author-Name: Emery, A.B. Author-Name: Robinson, D.R. Year: 1988 Volume: 78 Issue: 9 Pages: 1220-1221 Abstract: We interviewed 516 bicyclists over age 10 regarding helmet use and head injuries. Although 19 per cent owned helmets, only 8 per cent were wearing them when interviewed. Riders wearing helmets were more highly educated and reported higher car seat belt use. Nearly 4 per cent of the bicyclists reported striking their heads in a cycling mishap during the previous 18 months; those wearing helmets at the time of the mishap were less likely to have sustained head injuries. Handle: RePEc:aph:ajpbhl:1988:78:9:1220-1221_6 Template-Type: ReDIF-Article 1.0 Title: Elimination of cotinine from body fluids: Implications for noninvasive measurement of tobacco smoke exposure Journal: American Journal of Public Health Author-Name: Jarvis, M.J. Author-Name: Russell, M.A.H. Author-Name: Benowitz, N.L. Author-Name: Feyerabend, C. Year: 1988 Volume: 78 Issue: 6 Pages: 696-698 Abstract: Cotinine elimination from plasma, saliva, and urine was studied over 11 days in five subjects (three nonsmokers and two occasional smokers). Half-lives for cotinine averaged 16-19 hours in the different body fluids (range 10 to 27 hours between subjects). There was no tendency for the half-life in saliva to be longer than in plasma or urine. We conclude that choice of body fluid for cotinine assay in smoking studies should depend on practical rather than pharmacokinetic considerations. Handle: RePEc:aph:ajpbhl:1988:78:6:696-698_0 Template-Type: ReDIF-Article 1.0 Title: Hair dye use and risk of leukemia and lymphoma Journal: American Journal of Public Health Author-Name: Cantor, K.P. Author-Name: Blair, A. Author-Name: Everett, G. Author-Name: VanLier, S. Author-Name: Burmeister, L. Author-Name: Dick, F.R. Author-Name: Gibson, R.W. Author-Name: Schuman, L. Year: 1988 Volume: 78 Issue: 5 Pages: 570-571 Abstract: Data from a population-based case-control study of incident leukemia and non-Hodgkin's lymphoma among adult men in Iowa and Minnesota were used to evaluate risk associated with hair dye use. The relative risk for ever using hair dyes was 1.8 (95% confidence interval [CI] = 1.1-2.7) among leukemia patients, and 2.0 (CI = 1.3-3.0) among cases with non-Hodgkin's lymphoma. There was a suggestion of increased risk with extent of hair dye use. Given the widespread use of hair coloring products, these observations deserve more detailed evaluation in populations where the exposure is relatively common. Handle: RePEc:aph:ajpbhl:1988:78:5:570-571_6 Template-Type: ReDIF-Article 1.0 Title: Medical costs of ambulatory patients with the AIDS-Related Complex (ARC) and/or generalized lymphadenopathy syndrome (GLS) related to HIV infection, 1984-1985 Journal: American Journal of Public Health Author-Name: Seage III., G.R. Author-Name: Landers, S. Author-Name: Mayer, K.H. Author-Name: Barry, M.A. Author-Name: Lamb, G.A. Author-Name: Epstein, A.M. Year: 1988 Volume: 78 Issue: 8 Pages: 969-970 Abstract: A cost-of-illness study July 1, 1984-June 30, 1985 evaluating 28 patients with AIDS-Related Complex (ARC) and/or Generalized Lymphadenopathy Syndrome (GLS) found the average cost to be $489 per patient per year. None of the ARC or GLS patients in our study was hospitalized during the one year period, and none progressed to AIDS. No AIDS-specific treatment such as AZT was available at the time this study was completed. Handle: RePEc:aph:ajpbhl:1988:78:8:969-970_6 Template-Type: ReDIF-Article 1.0 Title: Sexually active adolescents and condoms: Changes over one year in knowledge, attitudes and use Journal: American Journal of Public Health Author-Name: Kegeles, S.M. Author-Name: Adler, N.E. Author-Name: Irwin Jr., C.E. Year: 1988 Volume: 78 Issue: 4 Pages: 460-461 Abstract: Over a year when public health information regarding AIDS intensified, changes in perceptions and use of condoms in a sample of sexually active adolescents in San Francisco were examined. Although perceptions that condoms prevent sexually transmitted diseases (STDs) and the value and importance placed on avoiding STDs remained high, these were reflected in increased intentions to use condoms nor in increased use. Handle: RePEc:aph:ajpbhl:1988:78:4:460-461_0 Template-Type: ReDIF-Article 1.0 Title: The New England Maternal PKU Project: Identification of at-risk women Journal: American Journal of Public Health Author-Name: Waisbren, S.E. Author-Name: Doherty, L.B. Author-Name: Bailey, I.V. Author-Name: Rohr, F.J. Author-Name: Levy, H.L. Year: 1988 Volume: 78 Issue: 7 Pages: 789-792 Abstract: Young women with phenylketonuria (PKU) are at risk for bearing children with mental retardation, microcephaly, heart defects, and low birthweight. These effects may be prevented if a low phenylalaline diet is maintained prior to and throughout pregnancy. This report describes the procedures of the New England Regional Maternal PKU Project for identifying and locating this population of at-risk women. Newborn screening records, routine umbilical cord blood screening and PKU Clinic records provided most of the identifying information. We identified 235 women with hyperphenylalaninemia, ages 12 to 44 years. Of these, 183 had PKU or atypical PKU while 52 had non-PKU mild hyperphenylalaninemia. The 235 women represent 88 per cent of the expected number of women with hyperphenylalaninemia in New England. We identified more than the expected number of those with PKU but only 57 per cent of the expected number with mild hyperphenylalaninemia. Developing a national registry, as well as screening women who utilize birth control clinics or prenatal clinics, may be helpful. Implementing routine umbilical cord blood screening programs may be beneficial in efforts to identify women with hyperphenylalaninemia who have a child and may want more children in the future. Handle: RePEc:aph:ajpbhl:1988:78:7:789-792_6 Template-Type: ReDIF-Article 1.0 Title: Needle sharing among IVDUs at risk for AIDS Journal: American Journal of Public Health Author-Name: Des Jarlais, D.C. Author-Name: Friedman, S.R. Year: 1988 Volume: 78 Issue: 11 Pages: 1498 Handle: RePEc:aph:ajpbhl:1988:78:11:1498_2 Template-Type: ReDIF-Article 1.0 Title: Giardia transmission in a swimming pool Journal: American Journal of Public Health Author-Name: Porter, J.D. Author-Name: Ragazzoni, H.P. Author-Name: Buchanon, J.D. Author-Name: Waskin, H.A. Author-Name: Juranek, D.D. Author-Name: Parkin, W.E. Year: 1988 Volume: 78 Issue: 6 Pages: 659-662 Abstract: In the fall of 1985, an outbreak of giardiasis occurred among several swimming groups at an indoor pool in northeast New Jersey. Nine clinical cases were identified, eight of whom had Giardia positive stool specimens. All were female; seven were adults (>18 years) and two were children. The attack rate was highest (39 per cent, 5/13) for the ladies lap group who had exposure on one day. These cases had no direct contact with children or other risk factors for acquiring Giardia. Infection most likely occurred following the ingestion of swimming pool water contamined with Giardia cysts. The source of Giardia contamination was a handicapped child who had a fecal accident in the pool. He was a member of a group that swam at the same time as the ladies lap group. A stool survey of the handicapped group showed that of the 20 persons tested, nine were positive for Giardia, including the specimen from this child. Examination of the pool records showed that no chlorine levels had been taken on the day of the fecal accident and that on the following day the chlorine level was zero. This is the second report of Giardia transmission among swimming pool attendees. It emphasizes the need to maintain appropriate chlorine levels in swimming pools and to institute measures to clear pools after a fecal accident. Handle: RePEc:aph:ajpbhl:1988:78:6:659-662_6 Template-Type: ReDIF-Article 1.0 Title: Water supply and sanitation (WS&S) and the quality of life Journal: American Journal of Public Health Author-Name: Koch-Weser, D. Year: 1988 Volume: 78 Issue: 11 Pages: 1411-1412 Handle: RePEc:aph:ajpbhl:1988:78:11:1411-1412_0 Template-Type: ReDIF-Article 1.0 Title: Physical fitness in children: A survey method based on parental report Journal: American Journal of Public Health Author-Name: Murphy, J.K. Author-Name: Alpert, B.S. Author-Name: Christman, J.V. Author-Name: Willey, E.S. Year: 1988 Volume: 78 Issue: 6 Pages: 708-710 Abstract: In the present study of 213 healthy children, the relation between parental reports of activity level and laboratory-determined physical fitness was examined. Results indicated that parental reports of activity level were associated with fitness for the entire sample. The association was most consistent among White children who resided in a household that was headed by their father. Handle: RePEc:aph:ajpbhl:1988:78:6:708-710_3 Template-Type: ReDIF-Article 1.0 Title: Child care and children's illness Journal: American Journal of Public Health Author-Name: Johansen, A.S. Author-Name: Leibowitz, A. Author-Name: Waite, L.J. Year: 1988 Volume: 78 Issue: 9 Pages: 1175-1177 Abstract: This paper uses nationally representative data from the Child Health Supplement of the 1981 National Health Interview Survey to test the hypothesis that the larger the groups in which children receive care, the more days per year they spend in bed due to illness. We estimate a model of annual bed days for children ages six months to two and one-half years old, and separately for children two and one-half to five years old. Our results show significantly higher numbers of bed days for children in day care centers than for children at home for both age groups, controlling for confounding factors. Children in family day care have significantly more bed days than those at home, but only among the younger sample. The negative effect of family day care is less than that of child care centers. Although the relative effect of group care is to increase annual bed days by 30 to 19 per cent, the absolute effect is modest with children in group care having 1.3 to .6 more bed days per year. Handle: RePEc:aph:ajpbhl:1988:78:9:1175-1177_2 Template-Type: ReDIF-Article 1.0 Title: Smoking by blacks and whites: Socioeconomic and demographic differences Journal: American Journal of Public Health Author-Name: Novotny, T.E. Author-Name: Warner, K.E. Author-Name: Kendrick, J.S. Author-Name: Remington, P.L. Year: 1988 Volume: 78 Issue: 9 Pages: 1187-1189 Abstract: Using data from the 1985 National Health Interview Survey for persons aged 25-64 years, we controlled simultaneously for socioeconomic status (SES), demographic factors, and race in multivariate logistic regression analyses. We found that the odds of ever smoking are not higher for Blacks compared with Whites, when the other variables are controlled. By contrast, the odds of heavy smoking for Blacks are far less than for Whites, while Blacks are significantly less likely than Whites to quit smoking regardless of SES or demographic factors. Smoking cessation and prevention programs must be planned with these behavioral, SES, and demographic differences in mind. Handle: RePEc:aph:ajpbhl:1988:78:9:1187-1189_8 Template-Type: ReDIF-Article 1.0 Title: Nosocomial varicella: Worth preventing, but how? Journal: American Journal of Public Health Author-Name: Preblud, S.R. Year: 1988 Volume: 78 Issue: 1 Pages: 13-15 Handle: RePEc:aph:ajpbhl:1988:78:1:13-15_3 Template-Type: ReDIF-Article 1.0 Title: Lower respiratory tract illness in the first two years of life: Epidemiologic patterns and costs in a suburban pediatric practice Journal: American Journal of Public Health Author-Name: McConnochie, K.M. Author-Name: Hall, C.B. Author-Name: Barker, W.H. Year: 1988 Volume: 78 Issue: 1 Pages: 34-39 Abstract: The epidemiologic patterns and the economic impact of acute lower respiratory tract illness (LRTI) in children under age two were studied using data collected from November 1, 1971-August 30, 1975 in a suburban pediatric practice in Monroe County, New York. LRTI was responsible for 23 illness episodes per 100 child-years among children in their first two years of life. This indicates that a cohort of 100 children might be anticipated to have 46 LRTI episodes from birth until their second birthday. The majority of episodes correlated with the presence of four viruses in the community, most commonly respiratory syncytial virus. The minimal, estimated direct cost of LRTI in the first two years of life based on 1984 cost data was equivalent to $35.14 for every child and was comprised of hospitalization cost ($19.68) and ambulatory care cost ($15.46). Hospitalization costs attributable to LRTI comprised at least 2.5 per cent of all hospitalization costs in this age group. Immunization against the four most common respiratory viruses, at a reasonable cost per child immunized, would appear to be cost beneficial. Handle: RePEc:aph:ajpbhl:1988:78:1:34-39_9 Template-Type: ReDIF-Article 1.0 Title: Diabetes in Utah among adults: Interaction between diabetes and other risk factors for microvascular and macrovascular complications Journal: American Journal of Public Health Author-Name: Schumacher, M.C. Author-Name: Smith, K.R. Year: 1988 Volume: 78 Issue: 9 Pages: 1195-1201 Abstract: From a telephone survey of the health status of a random sample of the general population of Utah, we identified 255 people with adult onset diabetes. We compared them to 622 non-diabetic controls, matched for age, sex, and urban-rural county of residence. We examined diabetes as a risk for heart diseases, stroke, and blindness and its interaction with other known risk factors. Diabetes interacted with smoking history so as to increase the risk of stroke, heart disease, and blindness. Diabetes also interacted with hypertension in their effect on the prevalence of blindness and, to a small extent, heart disease. Among the diabetics, duration of diabetes was associated with macrovascular and microvascular complications developing after the diagnosis of diabetes. Those with longer duration of disease showed an increase in risk for microvascular (kidney disease, blindness) and macrovascular (heart disease, stroke, amputations) complications. Although the estimates were imprecise, the effect of duration on macrovascular complications was greater among diabetics with a history of hypertension; the effect on microvascular complications was greater among smokers. The findings are compared to previous studies and the utility of diabetes prevalence data is discussed. Handle: RePEc:aph:ajpbhl:1988:78:9:1195-1201_0 Template-Type: ReDIF-Article 1.0 Title: Not saints, but healers: The legal duties of health care professionals in the AIDS epidemic Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1988 Volume: 78 Issue: 7 Pages: 844-849 Abstract: Albert Camus closes his narrative of The Plague by observing of those who 'fought against its terror and relentless onslaughts' that although they were 'unable to be saints', they refused 'to bow down to pestilences, [and strove] their utmost to be healers'. Neither law nor ethics expects sainthood or martyrdom of health care professionals. Nor can the law force people to be courageous or virtuous. But the law does set a minimum standard of conduct below which health care professionals cannot fall without risking lawsuits, loss of license, or loss of employment. This essay explores the legal framework within which health care professionals must work as 'healers' in the AIDS (acquired immunodeficiency syndrome) epidemic, and suggests ways in which the law can reinforce an ethic of professionalism in the face of this modern plague. Handle: RePEc:aph:ajpbhl:1988:78:7:844-849_9 Template-Type: ReDIF-Article 1.0 Title: Physical activity and coronary heart disease among asymptomatic hypercholesterolemic men (The Lipid Research Clinics Coronary Primary Prevention Trial) Journal: American Journal of Public Health Author-Name: Siscovick, D.S. Author-Name: Ekelund, L.G. Author-Name: Hyde, J.S. Author-Name: Johnson, J.L. Author-Name: Gordon, D.J. Author-Name: LaRosa, J.C. Year: 1988 Volume: 78 Issue: 11 Pages: 1428-1431 Abstract: We examined the relation between reported regular strenuous exercise or hard physical labor and the incidence of coronary heart disease (CHD) death and nonfatal myocardial infarction among 1,533 hypercholesterolemic men aged 35-39 years who were in the placebo group of the Lipid Research Clinics Coronary Primary Prevention Trial. The mean follow-up of the cohort was 7.4 years. The men were free of clinical heart disease at entry; men with an abnormal resting electrocardiogram or graded exercise test also were excluded. Regular physical activity was not associated with the incidence of CHD (RR = .94, 95% CI = .68, 1.38) in this study population. Adjustment by the proportional hazards model for age, low-density lipoprotein cholesterol, smoking, family history of CHD, and occupation did not alter this finding. This observation suggests that reported regular physical activity may not be related to the risk of coronary heart disease among asymptomatic, hypercholesterolemic, middle-aged men. Handle: RePEc:aph:ajpbhl:1988:78:11:1428-1431_2 Template-Type: ReDIF-Article 1.0 Title: The impact of political violence on health and health services in Cape Town, South Africa, 1986: Methodological problems and preliminary results Journal: American Journal of Public Health Author-Name: Yach, D. Year: 1988 Volume: 78 Issue: 7 Pages: 772-776 Abstract: Cape Town, South Africa experienced an upsurge in the level of political violence from May to July of 1986. To determine the impact of the political violence on health and health services, selected routinely available information was analyzed, a community survey was conducted of 1,540 randomly selected households in high, medium, and low impact areas (defined using police and community reports), and a survey of 162 nurses (75 per cent response rate) working in clinic and maternity services in Cape Town's townships was undertaken. Methodological problems were encountered in relation to sampling, interviewer allocation to areas, and access to routinely available information. Nevertheless, a consistent picture emerged from the studies that: demonstrated the impact of political violence on attendance at routine health service facilities (for hypertension, tuberculosis, immunizations, antenatal and postnatal services); highlighted the disruptions caused to basic services in high impact areas (water, street lighting, sanitation and transport); documented the problems experienced by nurses in performing their usual services and by patients obtaining access to their services; showed that high impact areas had three times higher rates of gunshot wounds than low impact areas during the period. Handle: RePEc:aph:ajpbhl:1988:78:7:772-776_7 Template-Type: ReDIF-Article 1.0 Title: Prevention of AIDS and HIV infection: Needs and priorities for epidemiologic research Journal: American Journal of Public Health Author-Name: Allen, J.R. Author-Name: Curran, J.W. Year: 1988 Volume: 78 Issue: 4 Pages: 381-386 Abstract: By the end of 1987, almost 50,000 cases of acquired immunodeficiency syndrome (AIDS) will have been reported in the United States. Although the primary epidemiology of the disease has been described, much work remains to be done to complete our understanding of the dynamics of transmission and infection with the causative virus, human immunodeficiency virus (HIV). At the state and local level, the highest priorities for epidemiologic research are to understand better the precise populations at risk of prevalent and incident HIV infection, and to use the information to direct and monitor specific prevention programs that are likely to be effective for the populations at risk. These parallel efforts - sophisticated investigative epidemiologic research and applied epidemiologic and serosurveillance studies - must be expanded rapidly and continued for the forseeable future if we are to accomplish the goal of preventing further spread of HIV. Handle: RePEc:aph:ajpbhl:1988:78:4:381-386_6 Template-Type: ReDIF-Article 1.0 Title: Hysterectomy in the United States, 1965-84 Journal: American Journal of Public Health Author-Name: Pokras, R. Author-Name: Hufnagel, V.G. Year: 1988 Volume: 78 Issue: 7 Pages: 852-853 Handle: RePEc:aph:ajpbhl:1988:78:7:852-853_1 Template-Type: ReDIF-Article 1.0 Title: Childhood acute respiratory tract infections deserve our attention. Journal: American Journal of Public Health Author-Name: Denny, F.W. Year: 1988 Volume: 78 Issue: 1 Pages: 16-17 Handle: RePEc:aph:ajpbhl:1988:78:1:16-17_1 Template-Type: ReDIF-Article 1.0 Title: Suicides and pesticides in Sri Lanka Journal: American Journal of Public Health Author-Name: Berger, L.R. Year: 1988 Volume: 78 Issue: 7 Pages: 826-828 Abstract: Sri Lanka has one of the highest rates of suicide in the world (29 per 100,000 population in 1980). Suicides are especially frequent among youth adults, both male and female. Compared to the US, the suicide rate for males ages 15 to 24 years in Sri Lanka is nearly four times greater; the female rate nearly 13 times greater. The most common mode of suicide is ingestion of liquid pesticides. Handle: RePEc:aph:ajpbhl:1988:78:7:826-828_0 Template-Type: ReDIF-Article 1.0 Title: Secular trends of obesity in early life: The Bogalusa Heart Study Journal: American Journal of Public Health Author-Name: Shear, C.L. Author-Name: Freedman, D.S. Author-Name: Burke, G.L. Author-Name: Harsha, D.W. Author-Name: Webber, L.S. Author-Name: Berenson, G.S. Year: 1988 Volume: 78 Issue: 1 Pages: 75-77 Abstract: Secular changes in height and weight measurements were examined in five- to 14-year-olds from 1973 to 1984. The age-sex specific 85th percentile was used to classify persons as overweight (based on ponderal index; kg/m3). Secular increases in weight (2.5 kg), and ponderosity (0.5-0.7 kg/m3) were found. Gains in ponderosity over the 11-year period were greater at the 75th percentile than at the 25th percentile, and the prevalence of overweight increased from 15 per cent to 24 per cent. Handle: RePEc:aph:ajpbhl:1988:78:1:75-77_6 Template-Type: ReDIF-Article 1.0 Title: Compliance with OSHA record-keeping requirements Journal: American Journal of Public Health Author-Name: Seligman, P.J. Author-Name: Sieber Jr., W.L. Author-Name: Pedersen, D.H. Author-Name: Sundin, D.S. Author-Name: Frazier, T.M. Year: 1988 Volume: 78 Issue: 9 Pages: 1218-1219 Abstract: The Occupational Safety and Health Act of 1970 requires employers to maintain records of workplace injuries and ilnesses. To assess compliance with the law, data from the National Occupational Exposure Survey (NOES) were examined. Of the 4,185 companies with 11 or more employees, 75 per cent maintained OSHA Form 200 designed for recording illnesses and injuries. The number of employees and the presence of a union were positive determinants in the record maintenance. Of companies with 500 or more employees, 95 per cent kept records compared with 60 per cent of companies with between 11 and 99 employees. Handle: RePEc:aph:ajpbhl:1988:78:9:1218-1219_0 Template-Type: ReDIF-Article 1.0 Title: Involuntary and voluntary psychiatric patients: A pilot study of resource consumption Journal: American Journal of Public Health Author-Name: Perlman, B.P. Author-Name: Kentera, A. Author-Name: Thornton, J.C. Author-Name: Griffith, B. Year: 1988 Volume: 78 Issue: 10 Pages: 1347-1348 Abstract: This pilot study compares the resources utilized caring for 'voluntary' and 'involuntary' patients in a community hospital inpatient psychiatric unit. 'Voluntary' patients committed less episodes of violence. 'Emergency involuntaries' experienced more episodes or restraint and were involved in more violent episodes than 'other involuntaries'. A critical predictor of behavior was whether patients were brought to the hospital by police. Implications for public policy and psychiatric DRGs (diagnosis related groups) are discussed. Handle: RePEc:aph:ajpbhl:1988:78:10:1347-1348_2 Template-Type: ReDIF-Article 1.0 Title: Studying patterns of cancer care: How useful is the medical record? Journal: American Journal of Public Health Author-Name: Feigl, P. Author-Name: Glaefke, G. Author-Name: Ford, L. Author-Name: Diehr, P. Author-Name: Chu, J. Year: 1988 Volume: 78 Issue: 5 Pages: 526-533 Abstract: Records of hospital inpatients were abstracted for 5,000 newly diagnosed cancer patients admitted in 1982-83 to 17 Comprehensive Cancer Centers and 17 Community Hospital Oncology Programs. Generally available data items (silent record rate less than 5 per cent for the typical institution) included: age, race, sex, dates of hospitalization, zip code of residence, pathological stage, dates of biopsy and surgery, numbers of nodes examined and positive, certain diagnostic procedures, and some radiotherapy descriptors. For other data items, there was enormous variability in completeness and high institution-to-institution variation. Record completeness did not differ consistently between comprehensive and community cancer centers. We conclude that the hospital patient record is useful for tracking the frequency of surgical and related events. However, studies of diagnostic and therapeutic procedures should not rely solely on the hospital medical record due to the high rates of silent records. Handle: RePEc:aph:ajpbhl:1988:78:5:526-533_3 Template-Type: ReDIF-Article 1.0 Title: The epidemiology of S. sonnei and S. flexneri in Pima County, Arizona: An exploratory study Journal: American Journal of Public Health Author-Name: McCombie, S.C. Author-Name: Funk, D.B. Author-Name: Browning, J.A. Author-Name: Nolan, P.A. Year: 1988 Volume: 78 Issue: 9 Pages: 1227-1229 Abstract: Investigation of 189 cases of shigellosis reported to the Pima County Arizona Health Department in 1986 revealed that 23 per cent of cases could be attributed to travel to Mexico, and 10 per cent to day care attendees and their household contacts. No source of infection or high-risk activity could be demonstrated for 43 per cent of the cases. Households in which S. flexneri occurred were more likely to be characterized by crowded living situations and to have no known source of infection. Handle: RePEc:aph:ajpbhl:1988:78:9:1227-1229_5 Template-Type: ReDIF-Article 1.0 Title: Tobacco advertisements in physicians' offices: A pilot study of physician attitudes Journal: American Journal of Public Health Author-Name: Radovsky, L. Author-Name: Barry, P.P. Year: 1988 Volume: 78 Issue: 2 Pages: 174-175 Abstract: A pilot study evaluated the feasibility of a campaign to eliminate magazines advertising cigarettes from doctors' office waiting rooms. Only six of 51 waiting rooms visited did not contain cigarette ads. Only 25 per cent of physicians interviewed would participate in a subscription-cancellation campaign; they expressed doubt that this would influence patients' smoking behavior. This suggests that such a campaign will fail unless it is possible to change physicians' beliefs in its effectiveness. Handle: RePEc:aph:ajpbhl:1988:78:2:174-175_7 Template-Type: ReDIF-Article 1.0 Title: Breast self-examination: Improving competence and frequency in a classroom setting Journal: American Journal of Public Health Author-Name: Dorsay, R.H. Author-Name: Cuneo, W.D. Author-Name: Somkin, C.P. Author-Name: Tekawa, I.S. Year: 1988 Volume: 78 Issue: 5 Pages: 520-522 Abstract: We conducted a prospective study of 459 women to determine if a one-session class in breast self-examination (BSE) can improve competence and frequency. Women who attended the class were randomly assigned to one of two groups. We assessed three areas of competence of BSE in one group immediately before the class, in the other group immediately after the class, and in both groups at follow-up one year later. Of the 459 women who attended the class, 286 returned for the one-year follow-up. All three areas of competence measured showed significant improvement in the group tested immediately after the class compared with the group tested just before the class. Competence scores at the one-year follow-up remained twice as high as those before the class although there was a decrease in competence from just after the class. Younger women proved more competent in performing BSE than did older women. At one year, participants further reported performing BSE nearly twice as often as before the class. We conclude that competent BSE can be learned and frequency of BSE can be increased from a one-session class. Handle: RePEc:aph:ajpbhl:1988:78:5:520-522_2 Template-Type: ReDIF-Article 1.0 Title: Correlates of smokeless tobacco use in a male adolescent population Journal: American Journal of Public Health Author-Name: Jones, R.B. Author-Name: Moberg, D.P. Year: 1988 Volume: 78 Issue: 1 Pages: 61-63 Abstract: This paper identifies the correlates of smokeless tobacco use in a sample of 1,030 males representative of 7th through 12th grade students of Dane County (Madison), Wisconsin. Variables independently associated with frequent use of smokeless tobacco were: being White, living in other than a two-parent home; performing poorly in school; smoking cigarettes; consuming beer, wine, or hard liquor; and deviant/delinquent behavior. Participation in team sports was associated with some 'experimentation' with smokeless products. Handle: RePEc:aph:ajpbhl:1988:78:1:61-63_2 Template-Type: ReDIF-Article 1.0 Title: The status of cancer cluster investigations undertaken by State Health Departments Journal: American Journal of Public Health Author-Name: Warner, S.C. Author-Name: Aldrich, T.E. Year: 1988 Volume: 78 Issue: 3 Pages: 306-307 Abstract: A survey of state health departments indicates the number of cancer cluster reports received is associated with the size of the state, the presence of a population-based tumor registry, and the existence of a centralized system for response. Cancer cluster investigations, have generally been unproductive in terms of etiologic discoveries yet they may have important benefits in terms of public education, allaying public anxiety about environmental concerns and engendering good will toward government agencies. Handle: RePEc:aph:ajpbhl:1988:78:3:306-307_6 Template-Type: ReDIF-Article 1.0 Title: Vaccination against poliomyelitis: Present possibilities and future prospects Journal: American Journal of Public Health Author-Name: Melnick, J.L. Year: 1988 Volume: 78 Issue: 3 Pages: 304-305 Handle: RePEc:aph:ajpbhl:1988:78:3:304-305_0 Template-Type: ReDIF-Article 1.0 Title: The San Francisco Men's Health Study: Continued decline in HIV seroconversion rates among homosexual/bisexual men Journal: American Journal of Public Health Author-Name: Winkelstein Jr., W. Author-Name: Wiley, J.A. Author-Name: Padian, N.S. Author-Name: Samuel, M. Author-Name: Shiboski, S. Author-Name: Ascher, M.S. Author-Name: Levy, J.A. Year: 1988 Volume: 78 Issue: 11 Pages: 1472-1474 Abstract: The incidence of infection by the human immunodeficiency virus (HIV) has been monitored since 1984 in an area probability sample of homosexual/bisexual men drawn from a six-kilometer square area of San Francisco were the epidemic of acquired immunodeficiency syndrome (AIDS) has been most severe. Annualized HIV seroconversion rates in previously uninfected cohort members have declined by 88 per cent during the first six months of 1985 to 0.7 per cent during the last six months of 1987. Concurrent declines of approximately 80 per cent in the prevalence of sexual behaviors associated with HIV transmission were also observed in the sample. Handle: RePEc:aph:ajpbhl:1988:78:11:1472-1474_7 Template-Type: ReDIF-Article 1.0 Title: AIDS and behavioral change to reduce risk: A review Journal: American Journal of Public Health Author-Name: Becker, M.H. Author-Name: Joseph, J.G. Year: 1988 Volume: 78 Issue: 4 Pages: 394-410 Abstract: Published reports describing behavioral changes in response to the threat of AIDS (acquired immunodeficiency syndrome) are reviewed. These studies demonstrate rapid, profound, but expectably incomplete alterations in the behavior of both homosexual/bisexual males and intravenous drug users. This is true in the highest risk metropolitan areas such as New York City and in areas with lower AIDS incidence. Risk reduction is occurring more frequently though the modification of sexual or drug-use behavior than through its elimination. In contrast to aggregate data, longitudinal descriptions of individual behavior demonstrate considerable instability or recidivism. Behavioral change in the potentially vulnerable heterosexual adolescent and young adult populations is less common, as is risk reduction among urban minorities. Reports of AIDS-related knowledge and attitudes generally parallel the pattern of behavioral changes. Nonetheless, few studies investigate the relationship of knowledge and attitudes to risk reduction. Future studies should provide much-needed information about the determinants as well as the magnitude of behavioral changes required to reduce the further spread of AIDS. Handle: RePEc:aph:ajpbhl:1988:78:4:394-410_1 Template-Type: ReDIF-Article 1.0 Title: Lead-induced neuropathy. Journal: American Journal of Public Health Author-Name: Bickis, U. Year: 1988 Volume: 78 Issue: 1 Pages: 95 Handle: RePEc:aph:ajpbhl:1988:78:1:95_7 Template-Type: ReDIF-Article 1.0 Title: The estimated predictive value of screening for illicit drugs in the workplace Journal: American Journal of Public Health Author-Name: Wells, V.E. Author-Name: Halperin, W. Author-Name: Thun, M. Year: 1988 Volume: 78 Issue: 7 Pages: 817-819 Abstract: This paper estimates the predictive values of screening tests for six illicit drugs of common concern in the workplace (amphetamines, barbiturates, cocaine, hallucinogens, marijuana, and opiates) using published information on test sensitivity and specificity and survey data on prevalence. Estimated predictive values (negative) were generally high, whereas the estimated predictive value of a positive test ranged from 1 per cent for amphetamines to 100 per cent for hallucinogens and was only 38 per cent for marijuana, the most prevalent drug. Handle: RePEc:aph:ajpbhl:1988:78:7:817-819_6 Template-Type: ReDIF-Article 1.0 Title: C-section rate related to payment source. Journal: American Journal of Public Health Author-Name: Kizer, K.W. Author-Name: Ellis, A. Year: 1988 Volume: 78 Issue: 1 Pages: 96-97 Handle: RePEc:aph:ajpbhl:1988:78:1:96-97_0 Template-Type: ReDIF-Article 1.0 Title: On food assistance programs and nutrition education. Journal: American Journal of Public Health Author-Name: Sterne, B.C. Year: 1988 Volume: 78 Issue: 1 Pages: 98 Handle: RePEc:aph:ajpbhl:1988:78:1:98_1 Template-Type: ReDIF-Article 1.0 Title: The 1989 revisions of the US Standard Certificate of Live Birth and Death and the US Standard Report of Fetal Death Journal: American Journal of Public Health Author-Name: Freedman, M.A. Author-Name: Gay, G.A. Author-Name: Brockert, J.E. Author-Name: Potrzebowski, P.W. Author-Name: Rothwell, C.J. Year: 1988 Volume: 78 Issue: 2 Pages: 168-172 Abstract: The US Standard Certificate and Reports are models used by state vital statistics offices to develop documents for the collection of data about vital events. The 1989 revisions incorporate some major modifications to previous versions. Both the Standard Certificate of Live Birth and the Standard Report of Fetal Death utilize a checkbox format to elicit information on medical and other risk factors affecting the pregnancy, complications of labor and/or delivery, obstetric procedures, method of delivery, congenital anomalies, and abnormal conditions of the newborn. Revisions to the Standard Certificate of Death include modifications to the medical certification section and the addition of decendent's educational attainment. Items requesting information about Hispanic origin are added to all of these documents. The raionale behind these changes and their intended use are discussed. Handle: RePEc:aph:ajpbhl:1988:78:2:168-172_7 Template-Type: ReDIF-Article 1.0 Title: Years of potential life lost (YPLL) before age 65 in Italy Journal: American Journal of Public Health Author-Name: Arca, M. Author-Name: Di Orio, F. Author-Name: Forastiere, F. Author-Name: Tasco, C. Author-Name: Perucci, C.A. Year: 1988 Volume: 78 Issue: 9 Pages: 1202-1205 Abstract: The Italian death rates and years of potential life lost (YPLL) for all causes and for 12 selected aggregations of causes are reported for 1979 and 1983, with the latter compared to United States data. Cancer is the leading cause of YPLL in Italy (23.8 per cent of total YPLL), followed by unintentional injuries (16.3 per cent) and heart disease (11.2 per cent). Rates of YPLL for all causes decreased 12.0 per cent from 1979 to 1983, the strongest declines in absolute terms being observed for prematurity and unintentional injuries, and in percentage decline for pneumonia and influenza, and infectious diseases; during the same period, YPLL for diabetes increased. The rates of YPLL are higher for males than for females (rate ratio = 1.9) especially for causes related to lifestyle factors. Premature mortality is lower in Italy than in the USA, because of the striking difference in mortality from injuries and heart diseases. Handle: RePEc:aph:ajpbhl:1988:78:9:1202-1205_1 Template-Type: ReDIF-Article 1.0 Title: Sunlight and other risk factors for cataracts: An epidemiologic study Journal: American Journal of Public Health Author-Name: Collman, G.W. Author-Name: Shore, D.L. Author-Name: Shy, C.M. Author-Name: Checkoway, H. Author-Name: Luria, A.S. Year: 1988 Volume: 78 Issue: 11 Pages: 1459-1462 Abstract: A case control study was conducted in North Carolina to explore the relation between individual exposure to sunlight and the risk of cataracts. One hundred thirteen cases and 161 controls aged 40-69 at diagnosis were studied. Sunlight exposure was inferred from interview data on residency and time spent in the sun, combined with solar radiation data from the National Climatic Data Center. Sunlight exposure was very slightly related to all types of opacities combined. Although the numbers of cases with each type of opacity was small, the risk of cataracts was slightly increased in medium and high exposure categories for persons having cortical or posterior subcapsular opacities only, but not nuclear sclerotic changes. Persons with dark brown or hazel eyes are at increased risk. An unexpected finding was that persons who reported using tranquilizers for six months were at increased risk. Handle: RePEc:aph:ajpbhl:1988:78:11:1459-1462_9 Template-Type: ReDIF-Article 1.0 Title: Repeal of the Massachusetts seat belt law Journal: American Journal of Public Health Author-Name: Hingson, R. Author-Name: Levenson, S.M. Author-Name: Heeren, T. Author-Name: Mangione, T. Author-Name: Rodgers, C. Author-Name: Schiavonne, T. Author-Name: Hertz, R.P. Year: 1988 Volume: 78 Issue: 5 Pages: 548-552 Abstract: In November 1986, the Massachusetts mandatory seat belt use law was repealed in a referendum by a 53 per cent to 47 per cent vote. In an anonymous random digit telephone survey of 1,046 adults in Massachusetts in summer 1986, while the law was in effect, 61 per cent of respondents had said they would vote in favor of the law. A post-repeal follow-up of 80 per cent of these persons revealed initial supporters and opponents of the law were equally likely to vote, but 15 per cent of the summer supporters switched their opinions and voted for repeal, compared to only 4 per cent of summer opponents who switched. In addition, a separate survey of 167 households that had refused to answer the summer survey indicated that survey nonrespondents were more likely to vote against the law than for it. Those opposing the law saw it as an infringement on personal liberty and believed it was not effective in reducing injury and death. Handle: RePEc:aph:ajpbhl:1988:78:5:548-552_5 Template-Type: ReDIF-Article 1.0 Title: Usefulness of comprehensive feasibility studies in environmental epidemiology investigations: A case study in Minnesota Journal: American Journal of Public Health Author-Name: Bender, A.P. Author-Name: Williams, A.N. Author-Name: Sprafka, J.M. Author-Name: Mandel, J.S. Author-Name: Straub, C.P. Year: 1988 Volume: 78 Issue: 3 Pages: 287-290 Abstract: Episodes of public water supply contamination with industrial or agricultural chemicals frequently give rise to public concerns about adverse health effects. These concerns may precipitate epidemiologic or clinical investigations requiring large expenditures of state and federal resources regardless of whether such investigations are justified by scientific criteria. An alternative is a comprehensive feasibility study, utilizing all available information to determine whether large-scale studies are warranted or feasible. At a relatively modest cost, a feasibility study allows health officials to identify information needs and deficiencies, outline potential study options and costs, clearly establish the rationale for a proposed study or, conversely, prevent unwarranted expenditures of public resources. Furthermore, a feasibility study may in itself resolve many community and scientific concerns. This article provides a case study of the usefulness of a formal feasibility study in a situation involving an elevated cancer rate and contaminated municipal water supply wells surrounding a federal superfund site. Handle: RePEc:aph:ajpbhl:1988:78:3:287-290_3 Template-Type: ReDIF-Article 1.0 Title: The impact of an oral rehydration therapy program in Southern Thailand Journal: American Journal of Public Health Author-Name: Jintaganont, P. Author-Name: Stoeckel, J. Author-Name: Butaras, S. Year: 1988 Volume: 78 Issue: 10 Pages: 1302-1305 Handle: RePEc:aph:ajpbhl:1988:78:10:1302-1305_0 Template-Type: ReDIF-Article 1.0 Title: Estimates of pregnancies and pregnancy rates for the United States, 1976-85 Journal: American Journal of Public Health Author-Name: Ventura, S.J. Author-Name: Taffel, S.M. Author-Name: Mosher, W.D. Year: 1988 Volume: 78 Issue: 5 Pages: 506-511 Abstract: After increasing by 9 per cent in the period 1976-80 in the United States, pregnancy rates declined by 4 per cent between 1980 and 1984 (from 111.9 to 107.3 pregnancies per 1,000 women aged 15-44 years). Between 1984 and 1985, the rate rose by less than 1 per cent to 108.2. More detailed data by age and race, available only through 1983, indicate that the decline in the 1980-83 period was not shared by all age groups. For example, pregnancy rates continued to increase for women in their thirties, and teenage pregnancy remained substantially the same. In 1983, 61 per cent of all pregnancies ended in live birth, 26 per cent in induced abortion, and 13 per cent in fetal loss. Pregnancy rates in that year were two-thirds higher for women of races other than White than for White women, and pregnancies of other-than-White women were more likely to terminate as an induced abortion or fetal loss. However, White teenagers and teenagers of other races were about equally likely to have their pregnancy end in induced abortion or fetal loss. Handle: RePEc:aph:ajpbhl:1988:78:5:506-511_5 Template-Type: ReDIF-Article 1.0 Title: Do regional variations in prevalence of cryptosporidiosis occur? The central Ohio experience Journal: American Journal of Public Health Author-Name: Hamoudi, A.C. Author-Name: Qualman, S.J. Author-Name: Marcon, M.J. Author-Name: Hribar, M. Author-Name: Juhling McClung, H. Author-Name: Murray, R.D. Author-Name: Cannon, H.J. Year: 1988 Volume: 78 Issue: 3 Pages: 273-275 Abstract: We screened 2,780 consecutive stool specimens submitted for routine ova and parasite examination to assess the prevalence of cryptosporidiosis in pediatric patient population in central Ohio. The stools were prepared by formalin-ethyl acetate concentration followed by cold Kinyoun acid-fast stain of the sediment. In addition, 912 consecutive intestinal biopsies were monitored for the presence of the parasite. Cryptosporidium oocytes were found in only 0.3 per cent of stool specimens (seven specimens from three patients) and in none of the intestinal biopsies. Due to this low prevalence of cryptosporidiosis, we conclude that routine screening of stool specimens for Cryptosporidium sp. is unnecessary in our patient population. Screening should be targeted to immune compromised patients and patients with persistent diarrhea and no apparent etiology. Our study also supports the concept that there are geographic variations in the prevalence of cryptosporidiosis. Handle: RePEc:aph:ajpbhl:1988:78:3:273-275_4 Template-Type: ReDIF-Article 1.0 Title: Hemorrhage, infection, toxemia, and cardiac disease, 1954-85: Causes for their declining role in maternal mortality Journal: American Journal of Public Health Author-Name: Sachs, B.P. Author-Name: Brown, D.A.J. Author-Name: Driscoll, S.G. Author-Name: Schulman, E. Author-Name: Acker, D. Author-Name: Ransil, B.J. Author-Name: Jewett, J.F. Year: 1988 Volume: 78 Issue: 6 Pages: 671-675 Abstract: Hemorrhage, infection, toxemia, and cardiac disease are no longer the leading causes of maternal death. We studied factors causing their decline in incidence using data collected by the Committee on Maternal Welfare of the Massachusetts Medical Society between 1954 and 1985. The dramatic decline in incidence of these conditions in the Commonwealth during the study period appears to have been due to both legislative actions and improvements in medical practice. The legislative actions included licensing of maternity services, blood banks, and legalization of abortion. Cardiac-related mortality has declined due to a reduction in the prevalence of rheumatic heart disease. Changes in clinical practice that stand out were the aggressive control of the hypertensive component of toxemia leading to a reduced incidence of intracranial hemorrhage, the prompt recourse to blood transfusion for hemorrhage, and the use of broad spectrum. Handle: RePEc:aph:ajpbhl:1988:78:6:671-675_4 Template-Type: ReDIF-Article 1.0 Title: Optimistic biases in public perceptions of the risk from radon Journal: American Journal of Public Health Author-Name: Weinstein, N.D. Author-Name: Klotz, M.L. Author-Name: Sandman, P.M. Year: 1988 Volume: 78 Issue: 7 Pages: 796-800 Handle: RePEc:aph:ajpbhl:1988:78:7:796-800_5 Template-Type: ReDIF-Article 1.0 Title: Place of birth: a woman's choice. Journal: American Journal of Public Health Author-Name: Ernst, E.K. Year: 1988 Volume: 78 Issue: 1 Pages: 95 Handle: RePEc:aph:ajpbhl:1988:78:1:95_5 Template-Type: ReDIF-Article 1.0 Title: Health professionals and hospital administrators in organ procurement: Attitudes, reservations, and their resolutions Journal: American Journal of Public Health Author-Name: Prottas, J. Author-Name: Batten, H.L. Year: 1988 Volume: 78 Issue: 6 Pages: 642-645 Abstract: The responses of hospital administrators, directors of nursing, intensive care unit nurses, and neurosurgeons are reported to a range of inquiries designed to measure their commitment to organ procurement and thereby identify impediments limiting their cooperation with organ procurement efforts. Descriptive and multivariate statistical techniques are used to analyze data collected from each group. We find general approval for organ procurement but serious hesitation about dealing with donor families, particularly among physicians. Physician support for donation, moreover, is the strongest predictor of other professionals, attitudes toward donation. Neurosurgeons and intensive care unit nurses who believe organ procurement is a professional responsibility have the fewest reservations about facilitating organ donation. Handle: RePEc:aph:ajpbhl:1988:78:6:642-645_8 Template-Type: ReDIF-Article 1.0 Title: An epidemiologic investigation of the relationship between DBCP contamination in drinking water and birth rates in Fresno County, California Journal: American Journal of Public Health Author-Name: Wong, O. Author-Name: Whorton, D. Author-Name: Gordon, N. Author-Name: Morgan, R.W. Year: 1988 Volume: 78 Issue: 1 Pages: 43-46 Abstract: This report describes an epidemiologic investigation of the relationship between DBCP (dibromochloropropane) contamination in drinking water and birth rates between 1978 and 1982 in Fresno County, California. Census tracts in the county were categorized according to DBCP level in their drinking water. Standardized birth ratios and relative birth ratios (adjusted for age, race, per cent Hispanic, and parity) were calculated for these census tracts. No relation between birth ratios and DBCP contamination in drinking water was found. Handle: RePEc:aph:ajpbhl:1988:78:1:43-46_4 Template-Type: ReDIF-Article 1.0 Title: Changes in the distribution of physicians in rural areas of Minnesota, 1965-85 Journal: American Journal of Public Health Author-Name: Dennis, T. Year: 1988 Volume: 78 Issue: 12 Pages: 1577-1579 Abstract: The purpose of this study was to assess changes in the physician-population ratio in non-SMSA Minnesota counties between 1965 and 1985 using county specific data published by the American Medical Association. The physician-population ratio actually decreased by 2 per cent for primary care physicians and by 11 per cent for family practitioners in the non-SMSA counties. The large increase in the number of physicians in Minnesota has not translated into improved access to primary care physicians in Minnesota's rural areas. Handle: RePEc:aph:ajpbhl:1988:78:12:1577-1579_1 Template-Type: ReDIF-Article 1.0 Title: Clinical and financial effects of psychoeducational care provided by staff nurses to adult surgical patients in the post-DRG environment Journal: American Journal of Public Health Author-Name: Devine, E.C. Author-Name: O'Connor, F.W. Author-Name: Cook, T.D. Author-Name: Wenk, V.A. Author-Name: Curtin, T.R. Year: 1988 Volume: 78 Issue: 10 Pages: 1293-1297 Abstract: A three-hour, two-stage workshop for staff nurses on providing patient education and psychosocial support was evaluated in terms of its effects on patient welfare and recovery. Subjects were 148 persons who had either a cholecystecomy, other abdominal surgery, or transurethral resection of the prostate (TURP). Two hundred and six additional control subjects were obtained from a nearby hospital. Both hospitals were owned by the same corporation and had many of the same surgeons. After the workshop, experimental subjects used fewer sedatives or antiemetics, fewer hypnotics, and were discharged from the hospital of the avrage half a day sooner. Handle: RePEc:aph:ajpbhl:1988:78:10:1293-1297_1 Template-Type: ReDIF-Article 1.0 Title: Gonorrhea rates: What denominator is most appropriate? Journal: American Journal of Public Health Author-Name: Aral, S.O. Author-Name: Schaffer, J.E. Author-Name: Mosher, W.D. Author-Name: Cates Jr., W. Year: 1988 Volume: 78 Issue: 6 Pages: 702-793 Abstract: We used traditional crude population denominators and four different definitions of sexual activity to calculate progressively more refined gonorrhea rates among reproductive age women. Refining denominators to take sexual activity into account had the largest impact on morbidity rates for young women. Traditional denominators severely underestimate gonorrhea rates in teenagers, and understate the real magnitude of gonorrhea risk among sexually active teenagers. Handle: RePEc:aph:ajpbhl:1988:78:6:702-793_8 Template-Type: ReDIF-Article 1.0 Title: Compliance with fecal occult blood testing: The role of restrictive diets Journal: American Journal of Public Health Author-Name: Joseph, A. Year: 1988 Volume: 78 Issue: 7 Pages: 839-841 Abstract: In this clinical trial, 786 patients screened for colorectal cancer with fecal occult blood testing were assigned to either a 'diet' or 'no diet' group to examine the effect of advice to restrict intake of red meat and peroxidase-containing vegetables on patient compliance and positivity rates. Restrictive diets did not significantly decrease compliance. Interviews of patients in the 'diet' group demonstrated that the majority followed instructions. Positivity rates were similar in the two groups, and clinically significant lesions were found with comparable frequency. Handle: RePEc:aph:ajpbhl:1988:78:7:839-841_4 Template-Type: ReDIF-Article 1.0 Title: Problems associated with collecting drinking water quality data for community studies: A case example, Fresno County, California Journal: American Journal of Public Health Author-Name: Whorton, M.D. Author-Name: Morgan, R.W. Author-Name: Wong, O. Author-Name: Larson, S. Author-Name: Gordon, N. Year: 1988 Volume: 78 Issue: 1 Pages: 47-51 Abstract: This paper discussed methodology in developing exposure data for the water supply contaminant dibromochloropropane (DBCP) in Fresno County, California. There are 532 drinking water systems (49 large and 483 small) within Fresno County plus 14,000 private wells. We determined the number of wells per system, the output per well, and the population served by each system. The task of deriving water quality estimates for each census tract was complicated by the fact that a single census tract can be served by more than one system; each system usually has more than one well; and a single well can have several episodes of testing for various contaminants. We calculated a series of weighted averages for concentrations of DBCP, arsenic, and nitrates for each census tract, using water production figures for each well as the weighting factor. Water quality data were derived from a total of 14,861 laboratory reports, although the majority did not report on all contaminants. Mean DBCP levels ranged from 0.0041 ppb to 5.7543 ppb among the census tracts. We found no correlation between DBCP levels per census tract compared to either arsenic or nitrates. We believe that we made as complete an exposure assessment as practically feasible. Handle: RePEc:aph:ajpbhl:1988:78:1:47-51_8 Template-Type: ReDIF-Article 1.0 Title: Poverty, race, and hospitalization for childhood asthma Journal: American Journal of Public Health Author-Name: Wissow, L.S. Author-Name: Gittelsohn, A.M. Author-Name: Szklo, M. Author-Name: Starfield, B. Author-Name: Mussman, M. Year: 1988 Volume: 78 Issue: 7 Pages: 777-782 Abstract: This study uses Maryland hospital discharge data for the period 1979-82 to determine whether Black children are more likely to be hospitalized for asthma and whether this difference persists after adjustment for poverty. The average annual asthma discharge rate was 1.95/1000 children aged 1-19; 3.75/1000 for Black children, and 1.25/1000 for White. Medicaid-enrolled children of both races had increased discharge rates for asthma compared to those whose care was paid for by other sources: 5.68/1000 vs 2.99/1000 for Blacks, and 3.10/1000 vs 1.11/1000 for Whites. When ecologic analysis were performed, populations of Black and White children had nearly equal asthma discharge rates after adjustment for poverty. The statewide adjustment rate was 2.70/1000 (95% CL = 1.93, 3.78) for Black children and 2.10/1000 (1.66, 2.66) for White children. Among Maryland counties and health planning districts, variation in asthma discharge rates was not associated with the supply of hospital beds or the population to primary-care physician ratio. We conclude that Black children are at increased risk of hospitalization for asthma, but that some or all of this increase is related to poverty rather than to race. Handle: RePEc:aph:ajpbhl:1988:78:7:777-782_8 Template-Type: ReDIF-Article 1.0 Title: Effects of HIV antibody test knowledge on subsequent sexual behaviors in a cohort of homosexually active men Journal: American Journal of Public Health Author-Name: McCusker, J. Author-Name: Stoddard, A.M. Author-Name: Mayer, K.M. Author-Name: Zapka, J. Author-Name: Morrison, C. Author-Name: Saltzman, S.P. Year: 1988 Volume: 78 Issue: 4 Pages: 462-467 Abstract: This study assesses the effects of HIV (human immunodeficiency virus) antibody testing on subsequent (one year) sexual behavior among 270 homosexual men at a Boston community health center, 21 per cent of whom were unaware of their test result. Except for the number of steady partners, the levels of all sexual activities of all groups of study participants declined over time. No effects of test awareness of antibody status were found on protective behavior for receptive anogenital contact. Elimination of unprotected insertive anogenital contact (by elimination of the practice or by condom use) was reported somewhat more often among seropositive men who became aware of their test result. Increased negative emotional reactions were reported by HIV seropositive men who were aware of their test result. These results suggest some behavioral impact of HIV antibody test knowledge in this cohort, but may not be generalizable to other populations. Handle: RePEc:aph:ajpbhl:1988:78:4:462-467_9 Template-Type: ReDIF-Article 1.0 Title: Determination of immune status to measles, rubella, and varicella-zoster viruses among medical students: Assessment of historical information Journal: American Journal of Public Health Author-Name: Murray, D.L. Author-Name: Lynch, M.A. Year: 1988 Volume: 78 Issue: 7 Pages: 836-838 Abstract: We examined the serological susceptibility of entering medical students to measles, rubella, and varicella-zoster (VZV) viruses over a four-year period. Serological results were then compared to historical information to ascertain whether undocumented histories of disease or vaccination could be used to identify students who may not need serological testing. For measles, historical information was of no benefit in predicting immunity. For VZV and, to a greater extent, rubella, a higher seropositive rate was seen in students claiming a positive history. Handle: RePEc:aph:ajpbhl:1988:78:7:836-838_7 Template-Type: ReDIF-Article 1.0 Title: Workers' health and safety (WHS) in cross-national perspective Journal: American Journal of Public Health Author-Name: Elling, R.H. Year: 1988 Volume: 78 Issue: 7 Pages: 769-771 Handle: RePEc:aph:ajpbhl:1988:78:7:769-771_7 Template-Type: ReDIF-Article 1.0 Title: Recurrent tuberculosis: Why do patients develop disease again? United States Public Health Service cooperative survey Journal: American Journal of Public Health Author-Name: Kopanoff, D.E. Author-Name: Snider Jr., D.E. Author-Name: Johnson, M. Year: 1988 Volume: 78 Issue: 1 Pages: 30-33 Abstract: In October 1983, a retrospective survey was initiated to determine if patients reported to the Centers for Disease Control as having recurrent tuberculosis truly had recurrent disease and, if so, why they had developed tuberculosis again. Twenty-three health jurisdictions provided information on 800 patients diagnosed as having recurrent tuberculosis during 1981 and 1982. We found that 199 (25 per cent) of the cases did not meet the criteria for recurrent disease. Of the remaining 601 recurrent cases, 20 per cent had no chemotherapy prescribed for their previous episodes of tuberculosis, 20 per cent were prescribed inadequate or inappropriate therapy, and 33 per cent were not compliant with their prescribed therapy regimens. Patients who, during their original episode of tuberculosis, received the major portion of their medical care from physicians in private practice were more compliant than those treated by other health care providers. However, those same patients were more likely to have received inappropriate therapy than patients treated by other providers. Better patient and physician education, closer monitoring, and greater use of preventive therapy and directly observed therapy are necessary to resolve these problems. Handle: RePEc:aph:ajpbhl:1988:78:1:30-33_5 Template-Type: ReDIF-Article 1.0 Title: Odd man out: A graphical approach to meta-analysis Journal: American Journal of Public Health Author-Name: Walker, A.M. Author-Name: Martin-Moreno, J.M. Author-Name: Artalejo, F.R. Year: 1988 Volume: 78 Issue: 8 Pages: 961-966 Abstract: The areas of overlap of confidence intervals from several studies can be used to create summary confidence regions. These summary regions lend themselves to graphical display, have readily derivable statistical properties, and can carry information about the influence both of available studies and of hypothetical future investigations. The case of a region covered by at least N-1 out of N confidence intervals is presented in some detail. Handle: RePEc:aph:ajpbhl:1988:78:8:961-966_1 Template-Type: ReDIF-Article 1.0 Title: State-level pharmaceutical assistance programs for the elderly: a national survey Journal: American Journal of Public Health Author-Name: Berry, G.L. Author-Name: Smyer, M.A. Author-Name: Lago, D. Year: 1988 Volume: 78 Issue: 2 Pages: 157-160 Abstract: In order to put Pennsylvania's Pharmaceutical Assistance Contract for the Elderly (PACE) Program in a national context, a nationwide mail survey and telephone follow-up to each of the 58 State Unit Directors on Aging in the United States and its territories identified 10 programs. The results reported in this article are specific to the seven state-level pharmaceutical programs which were in operation during the fiscal year 1984-85. In general, the programs varied on select program characteristics and on their efforts to address major policy issues. Data from the non-program states indicated support, legislative efforts, and a high interest in fiscal concerns. The findings reflect a lack of program uniformity and have implications for program development and implementation. Suggestions on how to identify the 'optimum' or best combination of program and policy options are discussed. Handle: RePEc:aph:ajpbhl:1988:78:2:157-160_5 Template-Type: ReDIF-Article 1.0 Title: Effective and ineffective use of fear in health promotion campaigns Journal: American Journal of Public Health Author-Name: Job, R.F.S. Year: 1988 Volume: 78 Issue: 2 Pages: 163-167 Abstract: Health promotion campaigns are typically designed to elicit fear, yet the use of fear is often ineffective in achieving the desired behavior change. Campaigns which attempt to use fear as part of a punishment procedure are unlikely to succeed. Consistent with established principles of learning, fear is most likely to be effective if the campaign allows for the desired behavior to be reinforced by a reduction in the level of fear. This entails five requirements: 1) fear onset should occur before the desired behavior is offered; 2) the events upon which the fear is based should appear to be likely; 3) a specific desired behavior should be offered as part of the campaign; 4) the level of fear elicited should only be such that the desired behavior offered is sufficient to substantially reduce the fear; 5) fear offset should occur as a reinforcer for the desired behavior, confirming its effectiveness. Under some circumstances it may be difficult to ensure that these requirements are met. In general, a positive reinforcement approach may prove to be more effective than the use of fear. Handle: RePEc:aph:ajpbhl:1988:78:2:163-167_6 Template-Type: ReDIF-Article 1.0 Title: Indoor air pollution of coal fumes as a risk factor of stroke, Shanghai Journal: American Journal of Public Health Author-Name: Zhang, Z.-F. Author-Name: Yu, S.-Z. Author-Name: Zhou, G.-D. Year: 1988 Volume: 78 Issue: 8 Pages: 975-977 Abstract: A cohort of 957 male persons in Shanghai has been followed up for 12 years after they entered a screening program for coronary heart disease and stroke. During the period of study, 24 of the subjects who had no previous history of heart disease and stroke died from stroke. Risk factors for stroke were analyzed by the Cox proportional hazards model. Coal fumes were found to be an independent risk factor for stroke in addition to diastolic blood pressure, age, and cigarette smoking. Handle: RePEc:aph:ajpbhl:1988:78:8:975-977_3 Template-Type: ReDIF-Article 1.0 Title: Sleep apnea and mortality in an aged cohort Journal: American Journal of Public Health Author-Name: Bliwise, D.L. Author-Name: Bliwise, N.G. Author-Name: Partinen, M. Author-Name: Pursley, A.M. Author-Name: Dement, W.C. Year: 1988 Volume: 78 Issue: 5 Pages: 544-547 Abstract: In the aged, sleep may be a vulnerable period for death from cardiovascular causes. Because of its high prevalence in the elderly, sleep apnea has been suggested to be one mechanism contributing to such sleep-related mortality. In this study, a cohort of 198 non-institutionalized elderly individuals (X̄ age at entry = 66) were followed for periods up to 12 years after initial polysomnography. The mortality ratio for sleep apnea (defined as a Respiratory Disturbance Index of over 10 events per sleep hour) was estimated to be 2.7 (95% CI = .95, 7.47). Multiple regression with the Cox proportional hazards model suggesting that cardiovascular death was most clearly associated with age in this cohort. These results raise the possibility that 'natural' death during sleep in the elderly may be associated with specific pathophysiological events during sleep. Handle: RePEc:aph:ajpbhl:1988:78:5:544-547_0 Template-Type: ReDIF-Article 1.0 Title: Impact of HIV antibody testing on changes in sexual behavior among homosexual men in The Netherlands Journal: American Journal of Public Health Author-Name: Van Griensven, G.J.P. Author-Name: De Vroome, E.M.M. Author-Name: Tielman, R.A.P. Author-Name: Goudsmit, J. Author-Name: Van Der Noordaa, J. Author-Name: De Wolf, F. Author-Name: Coutinho, R.A. Year: 1988 Volume: 78 Issue: 12 Pages: 1575-1577 Abstract: Between October 1984 and May 1986, 746 homosexual men, living in and around Amsterdam, The Netherlands, were surveyed at three consecutive six months periods regarding their sexual behavior. At the start of the study all subjects, of whom 234 (31 per cent) were HIV-Ab seropositive, were informed about their HIV antibody status. Seropositives initially reported more sexual partners than seronegatives; they also showed a greater reduction in the number of sexual partners and the number of partners with whom all forms of sexual practices were performed than did seronegatives. In both groups subjects were more likely to terminate orogenital intercourse than anogenital intercourse and masturbation. Handle: RePEc:aph:ajpbhl:1988:78:12:1575-1577_2 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of viral hepatitis among US navy and marine corps personnel, 1984-85 Journal: American Journal of Public Health Author-Name: Dembert, M.L. Author-Name: Shaffer, R.A. Author-Name: Baugh, N.L. Author-Name: Berg, S.W. Author-Name: Zajdowicz, T. Year: 1987 Volume: 77 Issue: 11 Pages: 1446-1447 Abstract: Six hundred and twenty-nine cases of viral hepatitis (A, B, and NonA-NonB) were reported among a total of 768,832 United States Navy and Marine Corps personnel during 1984 and 1985 via a passive surveillance system. Cumulative incidence for all three hepatitis types was higher than those reported for the general population at the same time. Hepatitis B was the most common diagnosis wihtin all sex, rank, and race/ethnic description categories. Enlisted medical personnel (hospital corpsmen) had a disproportionately higher incidence of hepatitis B. Handle: RePEc:aph:ajpbhl:1987:77:11:1446-1447_7 Template-Type: ReDIF-Article 1.0 Title: Effect of government and commercial warnings on reducing prescription misuse: The case of propoxyphene Journal: American Journal of Public Health Author-Name: Soumerai, S.B. Author-Name: Avorn, J. Author-Name: Gortmaker, S. Author-Name: Hawley, S. Year: 1987 Volume: 77 Issue: 12 Pages: 1518-1523 Abstract: We analyzed trends in prescribing and overdose deaths related to propoxyphene (e.g., Darvon) before and after a 1978-80 informational campaign carried out by the US Food and Drug Administration and the drug's manufacturer through mailed warnings, face-to-face education of prescribers, press releases, and labeling changes. The goals included a reduction in propoxyphene use with alcohol or other CNS depressants, reduced prescribing of refills, and cessation of prescribing for patients at risk of abuse and misuse (suicide). We conducted time-series analyses of nationwide propoxyphene use data 1974-83 and analyzed data on drug overdose death rates covering a combined population of about 83 million. Segmented regression methods were used to determine if the informational program was associated with changes in trends of prescribing or overdose deaths. Comparison drug series were analyzed to control for other secular trends in prescribing. Nationwide propoxyphene use during the warnings continued a pre-existing decline of about 8 per cent per year, but this decline halted after the warnings. The no-refill recommendation had no impact on refill rates. The risk of overdose death per propoxyphene prescription filled has remained about constant since 1979. Sharper declines in misuse of such drugs will require stronger, more sustained regulatory or educational measures. Handle: RePEc:aph:ajpbhl:1987:77:12:1518-1523_0 Template-Type: ReDIF-Article 1.0 Title: The epidemiology and spectrum of surgical care in district hospitals of Pakistan Journal: American Journal of Public Health Author-Name: Blanchard, R.J.W. Author-Name: Blanchard, M.E.E. Author-Name: Toussignant, P. Author-Name: Ahmed, M. Author-Name: Smythe, C.M. Year: 1987 Volume: 77 Issue: 11 Pages: 1439-1445 Abstract: On-site surveys of 19 district-level hospitals in Pakistan revealed that, in 1983, 23,839 procedures were performed. There were 98 different types of operations. Thirty-eight per cent were classified as General Surgery, 30 per cent Gynecology and Operative Obstetrics, 19 per cent Urology, and 13 per cent Orthopedics. In three regions, population-based data were obtained from the 12 hospitals which provided all surgical care to discrete populations. The overall rate of surgical operations per 100,000 population was 124, 1.5 per cent to 9 per cent of the rate in western countries. The ratio of surgeons per 100,000 population was 0.36, 1/80 the ratio in the United States. There were almost twice as many operations per surgeon as in the USA. These data indicate a severe shortage of surgeons in Pakistan's district hospitals. They also provide the spectrum and relative numbers of different operations performed at the district level. This information has been useful along with other factors in designing a surgical curriculum at the Aga Khan University in Karachi, Pakistan. Handle: RePEc:aph:ajpbhl:1987:77:11:1439-1445_5 Template-Type: ReDIF-Article 1.0 Title: Multinational operations of US for-profit hospital chains: Trends and implications Journal: American Journal of Public Health Author-Name: Berliner, H.S. Author-Name: Regan, C. Year: 1987 Volume: 77 Issue: 10 Pages: 1280-1284 Abstract: The expansion of United States for-profit hospital chains into the international arena is a new and important development. Experiences with contract management of middle eastern hospitals in the early 1970s gave the American firms impetus to pursue ownership of health facilities in other parts of the world. US companies now operate over 95 foreign hospitals. The reasons for this involvement include the political receptivity of the government of the host nation; the potential for rapid growth and profits; the lack of indigenous competition; and the ability to occupy a distinct niche within the extant health services organization. The political and ideological implications of the growth of private medicine, particularly in the United Kingdom, in terms of its effects on the National Health Service are discussed. Questions for future research are posed. Handle: RePEc:aph:ajpbhl:1987:77:10:1280-1284_1 Template-Type: ReDIF-Article 1.0 Title: Seat belt use law enforcement and publicity in Elmira, New York: A reminder campaign Journal: American Journal of Public Health Author-Name: Williams, A.F. Author-Name: Preusser, D.F. Author-Name: Blomberg, R.D. Author-Name: Lund, A.K. Year: 1987 Volume: 77 Issue: 11 Pages: 1450-1451 Abstract: A three-week belt use law publicity and enforcement campaign in Elmira, New York, in November 1985, increased use from 49 per cent to 77 per cent; four months later belt use was 66 per cent. A reminder program, in April 1986, increased belt use to 80 per cent; use declined to 69 per cent four months later and to 60 per cent eight months later. Throughout these periods, belt use in Glens Falls, a comparison community, remained stable at just over 40 per cent. Handle: RePEc:aph:ajpbhl:1987:77:11:1450-1451_6 Template-Type: ReDIF-Article 1.0 Title: Determinants of quitting smoking Journal: American Journal of Public Health Author-Name: Kabat, G.C. Author-Name: Wynder, E.L. Year: 1987 Volume: 77 Issue: 10 Pages: 1301-1305 Abstract: Factors associated with quitting smoking were examined in 3,778 male and 1,486 female ever-smoking patients hospitalized with non-tobacco-related conditions interviewed between 1977 and 1985. Quitters were defined as those who had stopped smoking at least one year prior to admission. More than 80 per cent of male and female quitters had stopped more than five years prior to diagnosis. The lifetime quit rate (no. ex-smokers/no. ever smokers) x 100 was higher in males than in females, and in both sexes the quit rate increased with increasing age, education level, and occupational level. Jews had higher quit rates compared to non-Jews, and Whites had higher quit rates than Blacks. Those who were divorced or separated had lower quit rates than those who were not. In both sexes, light smokers and heavy smokers had elevated quit rates. The quit rate also increased with increasing interval between waking and smoking the first cigarette of the day. Logistic regression models were used to adjust simultaneously for the role of different variables. Handle: RePEc:aph:ajpbhl:1987:77:10:1301-1305_2 Template-Type: ReDIF-Article 1.0 Title: Computerized surveillance of errors in newborn screening practice Journal: American Journal of Public Health Author-Name: Tuerck, J.M. Author-Name: Buist, N.R.M. Author-Name: Skeels, M.R. Author-Name: Miyahira, R.S. Author-Name: Beach, P.G. Year: 1987 Volume: 77 Issue: 12 Pages: 1528-1531 Abstract: We describe the use and early results of the Oregon Public Health Laboratory computer to monitor hospital and practitioner compliance with state newborn screening recommendations. The system tracks five major categories of screening practice in which 21 types of errors affecting screening test quality have been identified. Our initial pilot study examined computer generated data for 23,717 specimens submitted by 116 Oregon birthing facilities over a four-month period. Results show that 58.3 per cent of newborn screening specimens were submitted incorrectly according to current state recommendations. Handle: RePEc:aph:ajpbhl:1987:77:12:1528-1531_5 Template-Type: ReDIF-Article 1.0 Title: Public health and the law. 'Lumping it': The hidden denominator of the medical malpractice crisis Journal: American Journal of Public Health Author-Name: Meyers, A.R. Year: 1987 Volume: 77 Issue: 12 Pages: 1544-1548 Handle: RePEc:aph:ajpbhl:1987:77:12:1544-1548_9 Template-Type: ReDIF-Article 1.0 Title: Does switching from cigarettes to pipes or cigars reduce tobacco smoke exposure? Journal: American Journal of Public Health Author-Name: Ockene, J.K. Author-Name: Pechacek, T.F. Author-Name: Vogt, T. Author-Name: Svendsen, K. Year: 1987 Volume: 77 Issue: 11 Pages: 1412-1416 Abstract: Cigarette smoking histories, reported depth of inhalation, number of pipe and cigars (PC) smoked, serum thiocyanate (SCN) and expired air carbon monoxide (CO) levels were examined in PC male smokers enrolled in the Multiple Risk Factor Intervention Trial (MRFIT). Serum SCN levels for all PC smokers were higher than for non-smokers and lower than for current cigarette smokers. Levels were related to the amount of product smoke. Prior cigarette smokers had higher SCN levels when compared to PC users who had never smoked cigarettes, smoked a larger number of tobacco products per day, and reported inhaling into the chest more often. Prospective data on baseline cigarette smokers demonstrated that smokers who stopped all tobacco products had a greater drop in SCN and CO than those who switched to PC. The findings strongly suggest that cessation of all tobacco products is the best strategy for decreasing exposure to tobacco smoke. Handle: RePEc:aph:ajpbhl:1987:77:11:1412-1416_0 Template-Type: ReDIF-Article 1.0 Title: Torture and its treatment Journal: American Journal of Public Health Author-Name: Roth Jr., E.F. Author-Name: Lunde, I. Author-Name: Boysen, G. Author-Name: Kemp Genefke, I. Year: 1987 Volume: 77 Issue: 11 Pages: 1404-1406 Abstract: Physical and psychological torture of political detainees and prisoners is currently practiced in more than 90 countries. Types of torture and the diagnosis and treatment of torture victims are described based on the experience of Copenhagen's Rigshospitalet. Handle: RePEc:aph:ajpbhl:1987:77:11:1404-1406_0 Template-Type: ReDIF-Article 1.0 Title: Occupational risk of HIV, HBV and HSV-2 infections in health care personnel caring for AIDS patients Journal: American Journal of Public Health Author-Name: Kuhls, T.L. Author-Name: Viker, S. Author-Name: Parris, N.B. Author-Name: Garakian, A. Author-Name: Sullivan-Bolyai, J. Author-Name: Cherry, J.D. Year: 1987 Volume: 77 Issue: 10 Pages: 1306-1309 Abstract: We have prospectively followed for 9-12 months, 246 female health care workers (HCWs): 102 with high exposure (HE), 43 with low exposure (LE), and 102 with no exposure (NE) to AIDS (acquired immunodeficiency syndrome) patients. No HCWs have clinical, serologic, or immunologic evidence of HIV (human immunodeficiency virus) infection. No HCWs in the HE group seroconverted to cytomegalovirus (CMV). One HCW in the HE group seroconverted to Hepatitis B virus (HBV), another HCW in the HE group seroconverted to herpes simplex virus type 2 (HSV-2) although all three groups were similar with respect to HBV and HSV-2 seropositivity. If hospital infection control practices are employed when HCWs care for AIDS patients or work with their biological specimens, the risk of occupationally acquiring a HIV, CMV, HBV or HSV-2 infection appears to be low. Handle: RePEc:aph:ajpbhl:1987:77:10:1306-1309_6 Template-Type: ReDIF-Article 1.0 Title: The development of a surveillance system to monitor emergency food relief in New York State Journal: American Journal of Public Health Author-Name: Campbell, C.C. Author-Name: Weber, J. Author-Name: Pelletier, D. Author-Name: Dodds, J.M. Year: 1987 Volume: 77 Issue: 10 Pages: 1350-1351 Abstract: A representative sample of emergency food relief (EFR) programs was selected on the basis of a census of 1,488 EFR programs in New York State. The census was a two-stage telephone survey. EFR was provided in every county although there was considerable variation in the amount of EFR per county. The soup kitchen and food pantry components of EFR had to be differentiated. The surveillance system was operational one year after the census began. Handle: RePEc:aph:ajpbhl:1987:77:10:1350-1351_8 Template-Type: ReDIF-Article 1.0 Title: Health behavior of elderly Hispanic women: Does cultural assimilation make a difference? Journal: American Journal of Public Health Author-Name: Marks, G. Author-Name: Solis, J. Author-Name: Richardson, J.L. Author-Name: Collins, L.M. Author-Name: Birba, L. Author-Name: Hisserich, J.C. Year: 1987 Volume: 77 Issue: 10 Pages: 1315-1319 Abstract: The role of cultural assimilation in Hispanic health behavior has received little empirical examination. Prior studies have operationalized assimilation primarily in terms of language preference and have obtained weak or no effects. We interviewed 603 elderly Hispanic women residing in Los Angeles to evaluate the usefulness of cultural factors as predictors of preventive health behavior (e.g., physical examination, screening for breast cancer) more rigorously. Factor analysis of responses yielded four dimensions of cultural assimilation: 'language preference', 'country of birth', 'contact with homeland', and 'attitudes about children's friends'. After controlling for education and age, no dimension of assimilation associated strongly or consistently with health behavior. Of the four dimensions, use of English language associated most closely with increased screening, although most of the effects for language were small in magnitude. These findings, coupled with those of other studies, strongly suggest that cultural factors may have little impact on the health behavior of Hispanics. Access to and availability of services, affective reactions toward screening, and sociodemographic factors are stronger determinants of Hispanic health practices. Handle: RePEc:aph:ajpbhl:1987:77:10:1315-1319_1 Template-Type: ReDIF-Article 1.0 Title: An application of the Sentinel Health Event (Occupational) concept to death certificates Journal: American Journal of Public Health Author-Name: Lalich, N.R. Author-Name: Schuster, L.L. Year: 1987 Volume: 77 Issue: 10 Pages: 1310-1314 Abstract: This article describes a computer-based application of the Sentinel Health Event (Occupational) [SHE(O)] concept, developed in conjunction with five states, to monitor deaths which are occupationally related. The states have coded their state death certificate files for industry and occupation, using the decedent's usual occupation and industry as reported on the death certificate. From these files, the SHE(O) computer program selects deaths which are likely to be work-related, based on previously published SHE(O) list of 50 disease rubrics and associated industries and occupations. The computer program matches the SHE(O) list with the recorded industry, occupation, and underlying cause of death. The program has been tested using 1984 death certificate data from Maine, upstate New York (excluding New York City), North Carolina, Pennsylvania, and Rhode Island. Approximately 1 to 2 per cent of all deaths were selected by the program, with lung cancer and coal workers' pneumonconiosis being the most frequent cause of death. The SHE(O) program may be useful for identifying deaths which are potentially occupationally related, but its utility and its application to death certificates needs further evaluation before recommending widespread use. Limitations are discussed, as well as plans for improving the application of the SHE(O) concept to death certificates. Handle: RePEc:aph:ajpbhl:1987:77:10:1310-1314_4 Template-Type: ReDIF-Article 1.0 Title: The scope of diabetes in the United States population. Journal: American Journal of Public Health Author-Name: Kovar, M.G. Author-Name: Harris, M.I. Author-Name: Hadden, W.C. Year: 1987 Volume: 77 Issue: 12 Pages: 1549-1550 Handle: RePEc:aph:ajpbhl:1987:77:12:1549-1550_6 Template-Type: ReDIF-Article 1.0 Title: Health status of Ethiopian refugees in the United States Journal: American Journal of Public Health Author-Name: Parenti, D.M. Author-Name: Lucas, D. Author-Name: Lee, A. Author-Name: Hollenkamp, R.H. Year: 1987 Volume: 77 Issue: 12 Pages: 1542-1543 Abstract: The health status of 239 Ethiopian refugees in the United States was evaluated. Over 70 per cent were males 15-30 years old. Positive PPDs (purified protein derivative of tuberculin) were observed in 72 per cent and 3.4 per cent had abnormal chest x-rays. One patient had active tuberculosis. Other laboratory abnormalities included: intestinal parasites (36.7 per cent), anemia (14.9 per cent), eosinophilia (14 per cent), positive syphilis serology (7.5 per cent), and hepatitis B surface antigenemia (9.4 per cent). The most prevalent intestinal parasites were Giardia lamblia, Trichuris trichiura, and Schistosoma mansoni. Handle: RePEc:aph:ajpbhl:1987:77:12:1542-1543_1 Template-Type: ReDIF-Article 1.0 Title: Outbreak of scombroid fish poisoning, Taiwan Journal: American Journal of Public Health Author-Name: Kow-Tong, C. Author-Name: Malison, M.D. Year: 1987 Volume: 77 Issue: 10 Pages: 1335-1336 Abstract: Fish implicated in outbreaks of scomboid poisoning have usually undergone prolonged storage at an inadequate temperature. We report an outbreak of scomboid poisoning in which fish stored on ice for two days caused illness after standing at room temperature for only three to four hours; fish from the same catch did not cause illness after standing at room temperature only one hour. This outbreak suggests scombrotoxins may be produced more rapidly than previously thought possible. Handle: RePEc:aph:ajpbhl:1987:77:10:1335-1336_8 Template-Type: ReDIF-Article 1.0 Title: Well child clinics and mass vaccination campaigns: An evaluation of strategies for improving the coverage of primary health care in a developing country Journal: American Journal of Public Health Author-Name: Loevinsohn, B.P. Author-Name: Loevinsohn, M.E. Year: 1987 Volume: 77 Issue: 11 Pages: 1407-1411 Abstract: Millions of children in developing countries are dying from diseases that could be prevented or treated by simple interventions. To examine ways to improve the delivery of these basic services, we evaluated well child clinics and mass vaccination campaigns under operational conditions in a rural area of Nicaragua. We found that mass vaccination campaigns using volunteers reached 77.1 per cent of the population under age six. At stationary well child clinics in which villages were invited to a health center and a small food ration was used as an incentive, attendance improved to 94.1 per cent. Similar attendance levels (99.2 per cent) were attained by mobile well child clinics also using a food incentive. Attendance at stationary clinics decreased with the distance of the village from the health center. However, stationary clinics took up only half as much health workers' time as mobile clinics. Our results suggest that stationary clinics employing food as an incentive could be used for villages or neighborhoods close to a health center while mobile clinics offering food should be reserved for more isolated villages. Handle: RePEc:aph:ajpbhl:1987:77:11:1407-1411_5 Template-Type: ReDIF-Article 1.0 Title: Racial contrasts in hemoglobin levels and dietary patterns related to hematopoiesis in children: The Bogalusa heart study Journal: American Journal of Public Health Author-Name: Nicklas, T.A. Author-Name: Frank, G.C. Author-Name: Webber, L.S. Author-Name: Zinkgraf, S.A. Author-Name: Cresanta, J.L. Author-Name: Gatewood, L.C. Author-Name: Berenson, G.S. Year: 1987 Volume: 77 Issue: 10 Pages: 1320-1323 Abstract: Racial differences in hemoglobin (Hgb) levels were explored in two groups of children at different maturational stages, the pre-adolescent (10-year-olds; Whites n = 160, Blacks n = 56,) and the adolescent (15-year-olds; Whites n = 60, Blacks n = 44). Mean Hgb levels were higher for Whites than Blacks in both age groups. When all the dietary components (i.e., iron, zinc, copper, folacin, ascorbic acid and vitamins B12, E and B6) were considered as a group, they accounted for 8.4 per cent of the Hgb variance in 10-year-olds and 10.1 per cent of variance in 15-year-olds. However, even after controlling for the variations in dietary patterns of the adolescents and pre-adolescents, race still accounted for a notable proportion of Hgb variance in both age groups (9.1 per cent in 10-year-olds and 7.0 per cent in 15-year-olds). Within each race, gender accounted for a greater percentage of the Hgb variance in the adolescents than in the pre-adolescents. Our results indicate that in all likelihood racial differences in Hgb levels during childhood exist independent of racial differences in intake of specific 'blood building' nutrients and maturational changes. Handle: RePEc:aph:ajpbhl:1987:77:10:1320-1323_5 Template-Type: ReDIF-Article 1.0 Title: Prevalence and accuracy of home sphygmomanometers in an urban population Journal: American Journal of Public Health Author-Name: Hahn, L.P. Author-Name: Folsom, A.R. Author-Name: Sprafka, J.M. Author-Name: Prineas, R.J. Year: 1987 Volume: 77 Issue: 11 Pages: 1459-1461 Abstract: The prevalence of ownership (7.5 per cent) and the accuracy of home sphygmomanometers were determined in a population-based survey in the Minneapolis-St. Paul metropolitan area. Sixty-four per cent of home sphygmomanometers were accurate within ±2 mm Hg of a calibrating sphygmomanometer; another 26 per cent were within ±3-6 mm Hg. These results suggest that although many home sphygmomanometers are accurate, some are very inaccurate. Health care providers should advise regular calibration when home sphygmomanometers are used for therapeutic self-management of hypertension. Handle: RePEc:aph:ajpbhl:1987:77:11:1459-1461_8 Template-Type: ReDIF-Article 1.0 Title: Hospice in transition: Kentucky 1982-85 Journal: American Journal of Public Health Author-Name: Bonham, G.S. Author-Name: Gochman, D.S. Author-Name: Burgess, L. Year: 1987 Volume: 77 Issue: 12 Pages: 1535-1536 Abstract: The ratio of hospice patients to 100 Kentuckians dying of cancer was 8 in 1982 and 12 in 1985. The primary increase occurred in the number of patients served by three hospices which became Medicare-certified during that time period. During this period, the average age of hospice patients increased, and patients became more likely to die at home. Hospices in some counties may have several about 40 per cent of terminally ill cancer patients. Handle: RePEc:aph:ajpbhl:1987:77:12:1535-1536_6 Template-Type: ReDIF-Article 1.0 Title: Use of court records for supplementing occupational disease surveillance Journal: American Journal of Public Health Author-Name: Schwartz, E. Author-Name: Landrigan, P. Year: 1987 Volume: 77 Issue: 11 Pages: 1457-1458 Abstract: To conduct surveillance of occupationally related health events, the New Hampshire Division of Public Health Services analyzes death certificates and workers' compensation claims. In an effort to bolster these limited data sources, a previously unrecognized data-set comprised of court records was explored. Court records obtained from the Federal District Court proved to be a readily accessible and detailed source of information for identifying suspected cases of asbestos-related disease and potential sources of asbestos exposure. Handle: RePEc:aph:ajpbhl:1987:77:11:1457-1458_8 Template-Type: ReDIF-Article 1.0 Title: Women's leadership status in the American Public Health Association Journal: American Journal of Public Health Author-Name: Levy, J.A. Year: 1987 Volume: 77 Issue: 12 Pages: 1537-1538 Handle: RePEc:aph:ajpbhl:1987:77:12:1537-1538_0 Template-Type: ReDIF-Article 1.0 Title: Foster home care for the frail elderly as an alternative to nursing home care: An experimental evaluation Journal: American Journal of Public Health Author-Name: Oktay, J.S. Author-Name: Volland, P.J. Year: 1987 Volume: 77 Issue: 12 Pages: 1505-1510 Abstract: This paper describes a program (Community Care Program) in which some elderly hospital patients who were candidates for nursing home placement were placed in foster homes. Caregivers were carefully trained and supervised. A total of 112 elderly inpatients were randomly assigned to placement in a nursing home or a foster care home. Patients and caregivers were interviewed at 3, 6, 9, and 12 months after placement. Community Care Program patients were more likely to maintain or improve ADL (activities of daily living) and mental status scores. They also had better nursing outcomes and were more likely to get out of the house than were nursing home patients. Nursing home patients had higher life satisfaction, and participated in more social and recreational activities. The Community Care Program was 17 per cent less costly than nursing home care. The results suggest that foster care may be a viable alternative for a segment of the nursing home population. Handle: RePEc:aph:ajpbhl:1987:77:12:1505-1510_0 Template-Type: ReDIF-Article 1.0 Title: Battered and pregnant: A prevalence study Journal: American Journal of Public Health Author-Name: Helton, A.S. Author-Name: McFarlane, J. Author-Name: Anderson, E.T. Year: 1987 Volume: 77 Issue: 10 Pages: 1337-1339 Abstract: We interviewed 290 pregnant women randomly selected from public and private prenatal clinics, 80 per cent of whom were at least five months pregnant (ages 18-43, 42 per cent Latino, 22 per cent Black). Twenty-four women reported physical battering during this pregnancy (44 reported physical battering before the current pregnancy). Eight of the 24 pregnant women had sought medical treatment for injuries sustained; none reported having been assessed by prenatal care providers for abuse. Handle: RePEc:aph:ajpbhl:1987:77:10:1337-1339_7 Template-Type: ReDIF-Article 1.0 Title: Characteristics of participants in community health promotion programs: Four-year results Journal: American Journal of Public Health Author-Name: Lefebvre, R.C. Author-Name: Harden, E.A. Author-Name: Rakowski, W. Author-Name: Lasater, T.M. Author-Name: Carleton, R.A. Year: 1987 Volume: 77 Issue: 10 Pages: 1342-1344 Abstract: Four years of participant tracking data (N = 24,995) for community-based programs targeting cardiovascular disease risk factors are presented. Over two-thirds of contacts were female; age segment representation in these programs was comparable to the city's demography. However, the data show that programs of varying formats which target specific risk factors attract different types of participants. Implications for marketing strategy are discussed. Handle: RePEc:aph:ajpbhl:1987:77:10:1342-1344_6 Template-Type: ReDIF-Article 1.0 Title: Smokers' challenge: Immediate and long-term findings of a community smoking cessation contest Journal: American Journal of Public Health Author-Name: King, A.C. Author-Name: Flora, J.A. Author-Name: Fortmann, S.P. Author-Name: Taylor, C.B. Year: 1987 Volume: 77 Issue: 10 Pages: 1340-1341 Abstract: The present study examined the effectiveness of a community-based smoking contest in helping 500 smokers maintain three months postcontest and one year postcontest abstinence. The majority were chronic smokers with a limited number of previous quit attempts. The three- and 12-month postcontest quit rates were 19 per cent and 15 per cent, respectively, rates exceeding naturally occurring community cessation rates. The contest was found to be more cost-effective than quit smoking classes. Handle: RePEc:aph:ajpbhl:1987:77:10:1340-1341_4 Template-Type: ReDIF-Article 1.0 Title: Homicide while at work: Persons, industries, and occupations at high risk Journal: American Journal of Public Health Author-Name: Kraus, J.F. Year: 1987 Volume: 77 Issue: 10 Pages: 1285-1289 Abstract: The purpose of this study is to identify and describe, epidemiologically, work-related homicides in California from 1979 through 1981. Using the California State Computer Mortality File, an algorithm was developed and a search of the death certificates was made using three factors: 'injury at work', injury at a work location, and pertinent external-cause-of-death codes. Only 30 per cent of the 466 homicide deaths identified were also found in the logs of the state Occupatioinal Safety and Health agency. The average annual rate of work-related homicides was 1.5 per 100,000 workers. The male-to-female-rate ratio was 4.2:1. Police and security guards and persons in occupations having frequent public contact involving exchange of money, particularly in late afternoon or evening hours, were at highest risk. Controlling exposures of high-risk individuals and developing strict standards for reducing such exposures might greatly reduce assaults and thus prevent senseless loss of life in the workplace. Handle: RePEc:aph:ajpbhl:1987:77:10:1285-1289_0 Template-Type: ReDIF-Article 1.0 Title: An outbreak of watermelon-borne pesticide toxicity Journal: American Journal of Public Health Author-Name: Green, M.A. Author-Name: Heumann, M.A. Author-Name: Wehr, H.M. Author-Name: Foster, L.R. Author-Name: Williams Jr., L.P. Author-Name: Polder, J.A. Author-Name: Morgan, C.L. Author-Name: Wagner, S.L. Author-Name: Wanke, L.A. Author-Name: Witt, J.M. Year: 1987 Volume: 77 Issue: 11 Pages: 1431-1434 Abstract: The largest reported United States outbreak of illness caused by a foodborne pesticide was due to aldicarb-contaminated watermelons. In Oregon, where the first episodes of toxicity were reported, 264 reports were received, and 61 definite cases were identified. Residues of aldicarb, a cholinesterase inhibitor, were found in 10 of 16 tested melons which had been eaten by persons meeting the case definition. The outbreak demonstrated the need for enhanced physician vigilance with respect to anticholinesterase intoxication. It also demonstrates the value of an established system for reporting of unusual illness to public health officials. Handle: RePEc:aph:ajpbhl:1987:77:11:1431-1434_5 Template-Type: ReDIF-Article 1.0 Title: The national score card: deaths from RDS/HMD. Journal: American Journal of Public Health Author-Name: Avery, M.E. Author-Name: Richardson, D. Year: 1987 Volume: 77 Issue: 12 Pages: 1501 Handle: RePEc:aph:ajpbhl:1987:77:12:1501_9 Template-Type: ReDIF-Article 1.0 Title: Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in human milk: Effects on growth, morbidity, and duration of lactation Journal: American Journal of Public Health Author-Name: Rogan, W.J. Author-Name: Gladen, B.C. Author-Name: McKinney, J.D. Author-Name: Carreras, N. Author-Name: Hardy, P. Author-Name: Thullen, J. Author-Name: Tingelstad, J. Author-Name: Tully, M. Year: 1987 Volume: 77 Issue: 10 Pages: 1294-1297 Abstract: We followed 858 children from birth to one year of age to determine whether the presence of polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in breast milk affected their growth or health. Neither chemical showed an adverse effect on weight or frequency of physician visits for various illnesses, although differences were seen between breast-fed and bottle-fed children, with bottle-fed children being heavier and having more frequent gastroenteritis and otitis media. Children of mothers with higher levels of DDE were breast-fed for markedly shorter times, but adjustments for possible confounders and biases did not change the findings. In absence of any apparent effect on the health of the children, we speculate that DDE may be interfering with the mother's ability to lactate, possibly because of its estrogenic properties. Handle: RePEc:aph:ajpbhl:1987:77:10:1294-1297_6 Template-Type: ReDIF-Article 1.0 Title: Workplace homicides of Texas males Journal: American Journal of Public Health Author-Name: Davis, H. Year: 1987 Volume: 77 Issue: 10 Pages: 1290-1293 Abstract: A review of Texas death certificates for 1975-84 identified 779 civilian males whose deaths were homicides that occurred in the workplace. Injuries from firearms caused 81 per cent of the deaths. The overall rate of workplace homicide was 2.1/100,000 male workers/year. Males employed in taxicab service had the highest rate of workplace homicide, 78.2/100,000 male workers/year. Males employed in certain retail trade industries, law enforcement, and the private-security industry also had high rates of workplace homicide. Male workers ≥65 years old were at especially high risk, with a workplace-homicide rate 3.5 times that of younger workers. A review of medical examiners' records in five urban counties indicated that 32 per cent of victims who had worked in eating-and-drinking places and 5 per cent of other workers had blood or cerebrospinal-fluid alcohol levels ≥0.10 g/dl. These results provide a base for designing effective strategies to prevent workplace homicides. Handle: RePEc:aph:ajpbhl:1987:77:10:1290-1293_9 Template-Type: ReDIF-Article 1.0 Title: A pseudo-epidemic of septicemia among medicare patients in Iowa Journal: American Journal of Public Health Author-Name: Helms, C.M. Year: 1987 Volume: 77 Issue: 10 Pages: 1331-1332 Abstract: Between 1980 and 1986, Medicare discharges for DRG 416 (Septicemia Age ≥ 18) increased dramatically in Iowa. The rate rose most steeply between 1983 and 1984. Relative bacteria-specific septicemia rates did not change substantially. The proportion of citing hospitals increased as did the number of citations per citing hospital. The data are best explained by increased physician-hospital reporting. A component of DRG (diagnosis related groups) 'creep' could not be excluded. Handle: RePEc:aph:ajpbhl:1987:77:10:1331-1332_5 Template-Type: ReDIF-Article 1.0 Title: On HIV transmission in homosexual/bisexual men. Journal: American Journal of Public Health Author-Name: Greenberg, W.M. Year: 1987 Volume: 77 Issue: 12 Pages: 1552-1553 Handle: RePEc:aph:ajpbhl:1987:77:12:1552-1553_9 Template-Type: ReDIF-Article 1.0 Title: Fatal occupational injuries of women, Texas 1975-84 Journal: American Journal of Public Health Author-Name: Davis, H. Author-Name: Honchar, P.A. Author-Name: Suarez, L. Year: 1987 Volume: 77 Issue: 12 Pages: 1524-1527 Abstract: A review of Texas death certificates for 1975-84 identified 348 cases of fatal occupational injuries of civilian females. Homicides accounted for 53 per cent and motor vehicle-related injuries accounted for 26 per cent of the deaths. Injuries from firearms caused 70 per cent of the homicides. One hundred thirty-three deaths occurred to women employed in the retail trade industry; of these, 77 per cent resulted from homicide. Women workers in gasoline service stations, food-bakery-and-dairy stores, and eating-and-drinking places had especially high risks of homicide. Texas female heavy-truck drivers had the highest fatal-injury rate, with motor-vehicle-related injuries causing 89 per cent of their deaths. These results indicate that effective strategies to prevent fatal occupational injuries of Texas women will need to address the problems of workplace violence and the hazards posed by motor vehicles. Handle: RePEc:aph:ajpbhl:1987:77:12:1524-1527_4 Template-Type: ReDIF-Article 1.0 Title: Men's reproductive health services in family planning settings A pilot study Journal: American Journal of Public Health Author-Name: Swanson, J.M. Author-Name: Forrest, K. Year: 1987 Volume: 77 Issue: 11 Pages: 1462-1463 Abstract: A 1984 pilot survey of administrators of 35 agencies offering family planning services revealed that all offered counseling/educational services for males, and 89 per cent offered medical/supply services for males. Nevertheless, total utilization of these services is low. Major barriers related to the provision of services to male clients are resource limitations, inadequate training, and negative or ambivalent staff attitudes; these factors may contribute to the discrepancy between service offering and utilization. Handle: RePEc:aph:ajpbhl:1987:77:11:1462-1463_4 Template-Type: ReDIF-Article 1.0 Title: Alcohol and body weight in United States adults Journal: American Journal of Public Health Author-Name: Williamson, D.F. Author-Name: Forman, M.R. Author-Name: Binkin, N.J. Author-Name: Gentry, E.M. Author-Name: Remington, P.L. Author-Name: Trowbridge, F.L. Year: 1987 Volume: 77 Issue: 10 Pages: 1324-1330 Abstract: Alcohol contributes more than 10 per cent of the total caloric intake of adult drinkers in the United States. However, the effect of alcohol on body weight has not been adequately studied in the general population. The association between weight and frequency of alcohol consumption was examined in two national cross-sectional surveys: the Second National Health and Nutrition Examination Survey (HANESII; n = 10,929) and the Behavioral Risk Factor Surveys (BRFS; n = 18,388). Linear multiple regression was used to estimate the independent effect of alcohol on weight, adjusting for smoking, age, diet practices, physical activity, race, education, and height. Among men, alcohol had only a slight effect on weight in either survey. However, among women, alcohol was associated with a substantial reduction in weight, which was as large as the effect of smoking. Compared with nondrinkers, women who consumed alcohol 7-13 times per week had the greatest reduction in weight: -3.6 kg (95% confidence limits [CL] = -5.6, -1.5 kg) in HANESIT and -3.2 kg (95% CL = -4.9, -1.5 kg) in BRFS. Alcohol confounded the association between smoking and weight, and among women it accounted for nearly 45 per cent of the weight-lowering effect of smoking. Alcohol also diminished the weight-lowering effect of smoking in men, while in women the smoking effect was slightly enhanced. Further studies are needed to understand the causal mechanisms by which alcohol is associated with body weight. Handle: RePEc:aph:ajpbhl:1987:77:10:1324-1330_7 Template-Type: ReDIF-Article 1.0 Title: Preventing rubella: Assessing missed opportunities for immunization Journal: American Journal of Public Health Author-Name: Robertson, S.E. Author-Name: Cochi, S.L. Author-Name: Bunn, G.A. Author-Name: Morse, D.L. Author-Name: Preblud, S.R. Year: 1987 Volume: 77 Issue: 10 Pages: 1347-1349 Abstract: Cases of rubella continue to occur among adults in the United States because 10-20 per cent of persons in this age group remain susceptible. To evaluate the potential preventability of these cases, we present a method for assessing missed opportunities for rubella immunization, based on immunization recommendations of the Immunization Practices Advisory Committee (ACIP) of the US Public Health Service (PHS). Immunization programs faced with limited resources can use analysis of missed opportunities to focus on those gaps in implementation contributing most to the remaining rubella cases. Handle: RePEc:aph:ajpbhl:1987:77:10:1347-1349_0 Template-Type: ReDIF-Article 1.0 Title: Hospital nurse counseling of patients who smoke Journal: American Journal of Public Health Author-Name: Goldstein, A.O. Author-Name: Hellier, A. Author-Name: Fitzgerald, S. Author-Name: Stegall, T.S. Author-Name: Fischer, P.M. Year: 1987 Volume: 77 Issue: 10 Pages: 1333-1334 Abstract: Smoking-related diseases comprise a large portion of hospital admissions. This paper reports the attitudes and behaviors of a group of hospital-based nurses toward counseling patients on smoking cessation. The majority of nurses do not counsel patients who smoke. Counseling practices vary with the smoking status of the nurse. Barriers to increased nursing participation in counseling efforts include the lack of counseling training and physician failure to utilize nurses in this role. Handle: RePEc:aph:ajpbhl:1987:77:10:1333-1334_9 Template-Type: ReDIF-Article 1.0 Title: Forecasting coronary heart disease incidence, mortality, and cost: The coronary heart disease policy model Journal: American Journal of Public Health Author-Name: Weinstein, M.C. Author-Name: Coxson, P.G. Author-Name: Williams, L.W. Author-Name: Pass, T.M. Author-Name: Stason, W.B. Author-Name: Goldman, L. Year: 1987 Volume: 77 Issue: 11 Pages: 1417-1426 Abstract: A computer simulation model was developed to project the future mortality, morbidity, and cost of coronary heart disease (CHD) in the United States population. The model contains a demographic-epidemiologic (DE) submodel, which simulates the distribution of coronary risk factors and the conditional incidence of CHD in a demographically evolving population; a 'bridge' submodel, which determines the outcome of the initial CHD event; and a disease history (DH) submodel, which simulates subsequent events in persons with a previous CHD event. The user of the model may simulate the effects of interventions, either preventive (i.e., risk factor modification) or therapeutic, upon mortality, morbidity, and cost for up to a 30-year period. If there were no future changes in risk factors or the efficacy of therapies after 1980, baseline projections indicate that the aging of the population, and especially the maturation of the post-World War II baby-boom generation, would increase CHD prevalence and annual incidence, mortality, and costs by about 40-50 per cent by the year 2010. Unprecedented reductions in risk factors would be required to offset these demographic effects on the absolute incidence of CHD. The specific forecasts could be inaccurate, however, as a consequence of erroneous assumptions or misestimated baseline data, and the model awaits validation based on actual future data. Handle: RePEc:aph:ajpbhl:1987:77:11:1417-1426_6 Template-Type: ReDIF-Article 1.0 Title: Fragmentation and reproductive freedom: Federally subsidized family planning services, 1960-80 Journal: American Journal of Public Health Author-Name: Aries, N. Year: 1987 Volume: 77 Issue: 11 Pages: 1465-1471 Abstract: This paper analyzes the evolution of the federal family planning program from 1960 to 1980. Political pressure to offer family planning raised the question how best to organize services. Longstanding providers preferred a categorical approach in order to maintain a diverse political coalition for an historically invisible service. In addition, categorical funding meant financial support for non-traditional providers. A compelling argument was also made for service integration. Given an expanded definition of health and the medicalization of contraceptive technology, the health delivery system presented itself as the appropriate service provider. Neither group prevailed. By 1980, federally supported family planning services were provided in autonomous clinics but also were integrated into existing maternal and child health programs. The debate continues but, under the Reagan Administration, terms and motivations differ from those of the past. Handle: RePEc:aph:ajpbhl:1987:77:11:1465-1471_7 Template-Type: ReDIF-Article 1.0 Title: Summary measures of occupational history: A comparison of latest occupation and industry with usual occupation and industry Journal: American Journal of Public Health Author-Name: Illis, W.R. Author-Name: Swanson, G.M. Author-Name: Satariano, E.R. Author-Name: Schwartz, A.G. Year: 1987 Volume: 77 Issue: 12 Pages: 1532-1534 Abstract: The utility of using latest occupational information as a summary of work history is assessed by comparing it to usual occupation and industry. We analyzed 5,734 complete occupational histories obtained by telephone interview as part of an ongoing occupational cancer surveillance study. Of these, 73.6 per cent reported the same usual occupation as latest occupation and 76.6 per cent the same usual industry as latest industry. Differences in match rates by race and sex, occupation and industry titles and categories suggest that bias may result in studies using latest occupation or industry as a summary measure of occupational exposures. Handle: RePEc:aph:ajpbhl:1987:77:12:1532-1534_1 Template-Type: ReDIF-Article 1.0 Title: Trends in mortality caused by respiratory distress syndrome in the United States, 1969-83 Journal: American Journal of Public Health Author-Name: Malloy, M.H. Author-Name: Hartford, R.B. Author-Name: Kleinman, J.C. Year: 1987 Volume: 77 Issue: 12 Pages: 1511-1514 Abstract: Using United States vital statistical data we examined trends in infant deaths from Respiratory Distress Syndrome/Hyaline Membrane Disease (RDS/HMD) for 1969 to 1983, by race and age at death. In order to improve comparability of diagnosis across two revisions of the International Classification of Diseases, deaths from RDS/HMD were ascertained using both underlying and associated causes of death. These data document a 2 per cent per year increase in infant mortality attributed to RDS/HMD for all races during interval I (1969-73) followed by 9 per cent per year decreases during intervals II (1974-78) and III (1979-83). However, there was a marked difference between Whites and Blacks in these trends. In the White population, RDS/HMD infant mortality increased by 2.2 per cent per year in interval I but then decreased by 10.5 per cent per year in interval II and 8.9 per cent per year in interval III. Among Blacks, on the other hand, the initial increase in RDS/HMD mortality was steeper (5.2 per cent per year) and the subsequent decreases were less (6.3 per cent per year and 8.0 per cent per year). As a result, the Black-White ratio in infant mortality attributed to RDS/HMD increased from 1.32 in 1969-73, to 1.59 in 1974-78 and to 1.72 in 1979-83. The proportion of RDS/HMD deaths that occurred in the postneonatal period increased from 1.1 per cent in interval to 3.6 per cent in interval II to 5.0 per cent in interval III. During the last interval, the decline in RDS/HMD mortality accounted for 30 per cent of the decline in overall infant mortality for both Whites and Blacks. Handle: RePEc:aph:ajpbhl:1987:77:12:1511-1514_1 Template-Type: ReDIF-Article 1.0 Title: Public health: Moving from debt to legacy 1986 presidential address Journal: American Journal of Public Health Author-Name: Foege, W.H. Year: 1987 Volume: 77 Issue: 10 Pages: 1276-1278 Handle: RePEc:aph:ajpbhl:1987:77:10:1276-1278_3 Template-Type: ReDIF-Article 1.0 Title: The international system of units (SI) in historical perspective Journal: American Journal of Public Health Author-Name: Van Assendelft, O.W. Year: 1987 Volume: 77 Issue: 11 Pages: 1400-1403 Abstract: American medical journals are shifting to selected SI (Systeme International d'Unites) units for reporting measurements. Limitation of SI units deemed suitable for use in reporting clinical laboratory results stems from recommendations put forth by the International Federation of Clinical Chemistry and the International Union of Pure and Applied Chemistry. Limitations are: 1) the liter as sole recommended unit of volume in concentration measurement; 2) substance concentration (unit mole) favored over mass concentration (submultiples of the kilogram); and 3) discouraging the use of the prefixes hecto-, deca-, deci-, and centi-. Further discussion by the American Medical Association and other organizations is required before consensus in the US medical community can be reached as to extent of and time frame for conversion to SI for reporting clinical laboratory measurements. Handle: RePEc:aph:ajpbhl:1987:77:11:1400-1403_0 Template-Type: ReDIF-Article 1.0 Title: New to the Journal from NCHS. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1987 Volume: 77 Issue: 12 Pages: 1502 Handle: RePEc:aph:ajpbhl:1987:77:12:1502_1 Template-Type: ReDIF-Article 1.0 Title: Experimentation with smokeless tobacco and cigarettes by children and adolescents: Relationship to beliefs, peer use, and parental use Journal: American Journal of Public Health Author-Name: Yopp Cohen, R. Author-Name: Sattler, J. Author-Name: Felix, M.R.J. Author-Name: Brownell, K.D. Year: 1987 Volume: 77 Issue: 11 Pages: 1454-1456 Abstract: Experimentation with both cigarettes and smokeless tobacco by children in grades 3-12 in a school district in Pennsylvania was related to peer experimentation, parental use, and personal beliefs about the harm of the product for both males and females. Experimentation with both products had begun as early as the third grade and increased with age, with a major increase in experimentation during junior high school. Nearly half the males in grades 7-12 did not believe smokeless tobacco was harmful. Handle: RePEc:aph:ajpbhl:1987:77:11:1454-1456_4 Template-Type: ReDIF-Article 1.0 Title: Impact of a newspaper mediated quit smoking program Journal: American Journal of Public Health Author-Name: Cammings., K.M. Author-Name: Sciandra, R. Author-Name: Markello, S. Year: 1987 Volume: 77 Issue: 11 Pages: 1452-1453 Abstract: We present the results of a survey conducted to evaluate the impact of a newspaper mediated smoking cessation program conducted in Buffalo, New York in January 1987. Over half of all smokers surveyed reported exposure to the newspaper series; 13 per cent reported that the series prompted them to try to quit smoking, and 4 per cent stopped smoking for at least one week. We estimate that over 9,600 smokers in Erie County, New York, stopped smoking for at least one week as a result of the newspaper's smoking cessation program. Handle: RePEc:aph:ajpbhl:1987:77:11:1452-1453_2 Template-Type: ReDIF-Article 1.0 Title: Seriousness of AIDS and screening. Journal: American Journal of Public Health Author-Name: Archer, V.E. Year: 1987 Volume: 77 Issue: 12 Pages: 1553-1554 Handle: RePEc:aph:ajpbhl:1987:77:12:1553-1554_0 Template-Type: ReDIF-Article 1.0 Title: Cesarean section rates in Italy. Journal: American Journal of Public Health Author-Name: Bertollini, R. Author-Name: Di Lallo, D. Author-Name: Rapiti, E. Author-Name: Perucci, C.A. Year: 1987 Volume: 77 Issue: 12 Pages: 1554 Handle: RePEc:aph:ajpbhl:1987:77:12:1554_0 Template-Type: ReDIF-Article 1.0 Title: Reducing antipsychotic drug prescribing for nursing home patients: A controlled trial of the effect of an educational visit Journal: American Journal of Public Health Author-Name: Ray, W.A. Author-Name: Blazer II, D.G. Author-Name: Schaffner, W. Author-Name: Federspiel Ch., F. Year: 1987 Volume: 77 Issue: 11 Pages: 1448-1450 Abstract: We conducted a statewide, controlled trial of the efficacy of an educational visit in reducing antipsychotic drug prescribing for nursing home patients. Frequent antipsychotic drug prescribers were visited by a trained physician counselor who stressed known drug risks for elderly patients and suggested techniques for reducing antipsychotic drug use. Although well-received, the visit did not reduce antipsychotic drug prescribing. This negative finding suggests that future interventions address factors within the nursing home which encourage antipsychotic drug use. Handle: RePEc:aph:ajpbhl:1987:77:11:1448-1450_6 Template-Type: ReDIF-Article 1.0 Title: Depressive symptoms and substance use among adolescent binge eaters and purgers: A defined population study Journal: American Journal of Public Health Author-Name: Killen, J.D. Author-Name: Taylor, C.B. Author-Name: Telch, M.J. Author-Name: Robinson, T.N. Author-Name: Maron, D.J. Author-Name: Saylor, K.E. Year: 1987 Volume: 77 Issue: 12 Pages: 1539-1541 Abstract: We surveyed 646 tenth grade females in Northern California to assess the prevalence of binge eating and purging behaviors. Of these, 10.3 per cent met study criteria for bulimia and an additional 10.4 per cent reported purging behaviors for weight control. Bulimics and purgers were heavier, had greater triceps and subscapular skinfold thicknesses, and reported higher rates of drunkenness, marijuana use, cigarette use, and greater levels of depressive symptomatology. Handle: RePEc:aph:ajpbhl:1987:77:12:1539-1541_9 Template-Type: ReDIF-Article 1.0 Title: A fox in the chicken coop? Epidemiologic surveillance of medical care. Journal: American Journal of Public Health Author-Name: Sapir, M. Year: 1987 Volume: 77 Issue: 12 Pages: 1551-1552 Handle: RePEc:aph:ajpbhl:1987:77:12:1551-1552_2 Template-Type: ReDIF-Article 1.0 Title: Looking after the old folks. Journal: American Journal of Public Health Author-Name: Ford, A.B. Year: 1987 Volume: 77 Issue: 12 Pages: 1499-1500 Handle: RePEc:aph:ajpbhl:1987:77:12:1499-1500_3 Template-Type: ReDIF-Article 1.0 Title: Contraceptive needs and practices among women attending an inner-city STD clinic Journal: American Journal of Public Health Author-Name: Upchurch, D.M. Author-Name: Farmer, M.Y. Author-Name: Glasser, D. Author-Name: Hook III, E.W. Year: 1987 Volume: 77 Issue: 11 Pages: 1427-1430 Abstract: To assess the potential need, interest, and benefits of provision of contraceptive services in sexually transmitted disease (STD) clinics, we surveyed 516 women attending an inner-city STD clinic regarding contraceptive and sexual practices, STD prevalence, knowledge of contraceptive-related STD prophylaxis, and interest in contraceptive services within the STD clinic setting. The study population was at high risk for unintended pregnancy and STDs; at time of interview 46 per cent of women were not contracepting and 59 per cent were treated for STD or STD exposure. Two-thirds of women had at least one prior pregnancy and 50 per cent had at least one living child. Only 26 per cent of women knew that some contraceptive methods may reduce the risk of STD acquisition: however, 62 per cent expressed interest in contraceptive methods which would reduce their risk of STD acquisition. This study suggests that provision of contraceptive services in STD clinic settings may address dual needs in a group at high risk for both unintended pregnancy and STD. Handle: RePEc:aph:ajpbhl:1987:77:11:1427-1430_5 Template-Type: ReDIF-Article 1.0 Title: Black/White differences in type of initial breast cancer treatment Journal: American Journal of Public Health Author-Name: McWhorter, W.P. Author-Name: Mayer, W.J. Year: 1987 Volume: 77 Issue: 12 Pages: 1515-1517 Abstract: The relation between race, type of initial treatment, and survival with breast cancer were investigated using 36,905 cases reported to nine registries in the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute in the years 1978-82 and followed for survival through 1984. Using the crude treatment categories of surgical/nonsurgical/untreated, Blacks were found to have received less aggressive therapy. They were more likely than Whites to be treated nonsurgically (OR = 1.4; 95% CI = 1.2-1.7) or have no cancer-directed therapy (OR = 1.7; 95% CI = 1.3-2.3), even after adjusting by logistic regression for differences in age, stage, and histology. These treatment variables strongly affected five-year survival, after adjusting for age, stage, race, and histology. This finding of racial differences in survival-associated treatment patterns demonstrates the need to consider treatment variables in studies of race and cancer survival. Handle: RePEc:aph:ajpbhl:1987:77:12:1515-1517_0 Template-Type: ReDIF-Article 1.0 Title: Comparison of tests used to distinguish smokers from nonsmokers Journal: American Journal of Public Health Author-Name: Jarvis, M.J. Author-Name: Tunstall-Pedoe, H. Author-Name: Feyerabend, C. Author-Name: Vesey, C. Author-Name: Saloojee, Y. Year: 1987 Volume: 77 Issue: 11 Pages: 1435-1438 Abstract: Questionnaire and biochemical measures of smoking were studied in 211 hospital outpatients. Eleven different tests of smoke intake were compared for their ability to categorize smokers and nonsmokers correctly. The concentration of cotinine, whether measured in plasma, saliva, or urine, was the best indicator of smoking, with sensitivity of 96-97 per cent and specificity of 99-100 per cent. Thiocyanate provided the poorest discrimination. Carbon monoxide measured as blood carboxyhaemoglobin or in expired air gave sensitivity and specificity of about 90 per cent. Sensitivities of the tests were little affected by the presence among the claimed nonsmokers of a group of 21 'deceivers' who concealed their smoking. It is concluded that cotinine is the measure of choice, but for most clinical applications carbon monoxide provides an acceptable degree of discrimination and is considerably cheaper and simpler to apply. Handle: RePEc:aph:ajpbhl:1987:77:11:1435-1438_0 Template-Type: ReDIF-Article 1.0 Title: Brain cancer and nonoccupational risk factors: A case-control study among workers at two nuclear facilities Journal: American Journal of Public Health Author-Name: Carpenter, A.V. Author-Name: Flanders, W.D. Author-Name: Frome, E.L. Author-Name: Cole, P. Author-Name: Fry, S.A. Year: 1987 Volume: 77 Issue: 9 Pages: 1180-1182 Abstract: In a nested case-control study of nuclear workers, 82 brain cancer cases were compared with 328 matched controls to investigate the possible association with nonoccupational risk factors such as histories of epilepsy or head injury. We observed a moderately strong association between brain cancer occurrence and history of epilepsy (OR = 5.7, 95 per cent CI: 1.0, 32.1), but did not find a positive association with previous head injury (OR = 0.9, 95 per cent CI: 0.2, 4.2). Handle: RePEc:aph:ajpbhl:1987:77:9:1180-1182_2 Template-Type: ReDIF-Article 1.0 Title: An evaluation of the use of medical examiner data for epidemiologic surveillance Journal: American Journal of Public Health Author-Name: Graitcer, P.L. Author-Name: Williams, W.W. Author-Name: Finton, R.J. Author-Name: Goodman, R.A. Author-Name: Thacker, S.B. Author-Name: Hanzlick, R. Year: 1987 Volume: 77 Issue: 9 Pages: 1212-1214 Abstract: To assess the value of medical examiner (ME) data bases for use in epidemiologic surveillance, we compared data from non-injury deaths that became ME cases to all non-injury deaths occurring in 1984 among Fulton County, Georgia residents. The decedents in the ME series were younger and included a large proportion of Black males. Although not representative of all deaths in a community, ME data bases include demographic and medical information that is often difficult to collect in community studies and in other surveillance systems. Handle: RePEc:aph:ajpbhl:1987:77:9:1212-1214_4 Template-Type: ReDIF-Article 1.0 Title: A measles outbreak at university medical settings involving health care providers Journal: American Journal of Public Health Author-Name: Sienko, D.G. Author-Name: Friedman, C. Author-Name: McGee, H.B. Author-Name: Allen, M.J. Author-Name: Simonsen, W.F. Author-Name: Wentworth, B.B. Author-Name: Shope, T.C. Author-Name: Orenstein, W.A. Year: 1987 Volume: 77 Issue: 9 Pages: 1222-1224 Abstract: In 1985, a measles outbreak involved 14 students and non-student contacts in Michigan. Eight transmissions occurred at university medical facilities; five of these were likely airborne transmissions. Medical students and a medical resident were involved in the outbreak's propagation. Health care providers need to be immune to measles. Measles should be suspected in young adults with compatible illnesses; persons suspected to have measles should be placed in stringent respiratory isolation to preclude airborne transmission. Handle: RePEc:aph:ajpbhl:1987:77:9:1222-1224_2 Template-Type: ReDIF-Article 1.0 Title: Diphtheria-tetanus-pertussis immunization and sudden infant death syndrome Journal: American Journal of Public Health Author-Name: Walker, A.M. Author-Name: Jick, H. Author-Name: Perera, D.R. Author-Name: Thompson, R.S. Author-Name: Knauss, T.A. Year: 1987 Volume: 77 Issue: 8 Pages: 945-951 Abstract: We compared the recency of diphtheria-tetanus-pertussis (DTP) immunization in healthy children with birthweights greater than 2500 gms who died of sudden infant death syndrome (SIDS) to that of age-matched reference children, using a modified case-control analysis. Focusing on very narrow time intervals following immunization, we found the SIDS mortality rate in the period zero to three days following DTP to be 7.3 times that in the period beginning 30 days after immununization (95 per cent confidence interval 1.7 to 31). The mortality rate of non-immunized infants was 6.5 times that of immunized infants of the same age (95 per cent CI, 2.2 to 19). The latter result and to some extent the former appear to be ascribable to known risk factors for SIDS. Although the mortality ratios for SIDS following DPT, as estimated from this study, are high the period of apparently elevated risk was very short, so that only a small proportion of SIDS cases in infants with birthweights greater than 2500 gms could be associated with DTP. Handle: RePEc:aph:ajpbhl:1987:77:8:945-951_3 Template-Type: ReDIF-Article 1.0 Title: Occupational disease surveillance data sources, 1985 Journal: American Journal of Public Health Author-Name: Muldoon, J.T. Author-Name: Wintermeyer, L.A. Author-Name: Eure, J.A. Author-Name: Fuortes, L. Author-Name: Merchant, J.A. Author-Name: Van Lier, S.F. Author-Name: Richards, T.B. Year: 1987 Volume: 77 Issue: 8 Pages: 1006-1008 Abstract: Health department epidemiologists in 50 states, New York City, and the District of Columbia were surveyed in 1985 about seven potential data sources for occupational disease surveillance. Reported sources of occupational disease data were: automated workers' compensation claims (63 per cent of the 52 respondents); provider reports (62 per cent); death certificates with occupation or industry (60 per cent); cancer registries with occupational histories (35 percent); birth certificates with parent's occupation (27 per cent); non-cancer disease registries (13 per cent); and hospital or insurance records (8 per cent). Handle: RePEc:aph:ajpbhl:1987:77:8:1006-1008_3 Template-Type: ReDIF-Article 1.0 Title: The social and economic costs of alcohol abuse in Minnesota, 1983 Journal: American Journal of Public Health Author-Name: Parker, D.L. Author-Name: Shultz, J.M. Author-Name: Gertz, L. Author-Name: Berkelman, R. Author-Name: Remington, P.L. Year: 1987 Volume: 77 Issue: 8 Pages: 982-986 Abstract: Alcohol abuse in the State of Minnesota has an impact on health, health care resources, and the economy. Alcohol abuse was related to 3.3 per cent (1,150) of deaths in Minnesota in 1983; of these, almost one-third were the result of fatal injuries. Alcohol abuse contributed to 12 per cent (33,909) of all years of potential life lost, two-thirds of which were secondary to injury. The estimated cost of alcohol abuse ranged from $1.4 billion to $2.1 billion, representing from 2.8 per cent to 4.3 per cent of all personal income of Minnesotans, from 32 per cent to 50 per cent of State expenditures, and from 26 to 39 times the alcohol excise tax revenues generated in 1983. Alcohol-related direct medical care costs were estimated to be at least $216 million, 3.8 per cent of Minnesota medical costs for 1983. Costs of reduced on-the-job productivity and short-term absenteeism related to alcohol abuse were estimated to be between $630 million and $1.2 billion. The documentation of the costs of alcohol abuse is an important step in the campaign to reduce alcohol-related deaths, morbidity, and health care costs. Handle: RePEc:aph:ajpbhl:1987:77:8:982-986_9 Template-Type: ReDIF-Article 1.0 Title: Control of non-foodborne outbreak of salmonellosis: Day care in isolation Journal: American Journal of Public Health Author-Name: Chorba, T.L. Author-Name: Meriwether, R.A. Author-Name: Jenkins, B.R. Author-Name: Gunn, R.A. Author-Name: MacCormack, J.N. Year: 1987 Volume: 77 Issue: 8 Pages: 979-981 Abstract: We report an outbreak of Salmonella typhimurium in the infant room of a day care center. Time between onset dates, clustering of cases in the room, lack of a common food exposure, lack of illness among other children and staff, and lack of community-wide infection suggested person-to-person or continuing-common-source transmission. Successful preventive measures included instruction of personnel in proper handwashing and diaper-changing procedures and cohorting of infected and non-infected children. This is the second description of a non-foodborne outbreak of salmonellosis in a day care center, and the first involving S. typhimurium. Handle: RePEc:aph:ajpbhl:1987:77:8:979-981_8 Template-Type: ReDIF-Article 1.0 Title: The recent revival of breast-feeding in the city of Sao Paulo, Brazil Journal: American Journal of Public Health Author-Name: Monteiro, C.A. Author-Name: Zuniga, H.P.P. Author-Name: D'A. Benicio, M.H. Author-Name: Rea, M.F. Author-Name: Tudisco, E.S. Author-Name: Sigulem, D.M. Year: 1987 Volume: 77 Issue: 8 Pages: 964-966 Abstract: A random sampling of children under age five in Sao Paulo, Brazil, 1984/85, disclosed the median duration of breast-feeding to be 3.5 months and the duration of exclusive breast-feeding, 2.0 months. A comparison of these figures with those of a similar survey carried out in the same city in 1973/74 revealed a substantial increase in both the frequency and duration of breast-feeding. The trend was evident in all socioeconomic strata but most marked among women from higher income and education levels. Handle: RePEc:aph:ajpbhl:1987:77:8:964-966_5 Template-Type: ReDIF-Article 1.0 Title: Strategies in primary health care. Journal: American Journal of Public Health Author-Name: Habicht, J.P. Author-Name: Berman, P.A. Year: 1987 Volume: 77 Issue: 11 Pages: 1396-1397 Handle: RePEc:aph:ajpbhl:1987:77:11:1396-1397_1 Template-Type: ReDIF-Article 1.0 Title: Preventable deaths related to floods. Journal: American Journal of Public Health Author-Name: Duclos, P. Author-Name: Isaacson, J. Year: 1987 Volume: 77 Issue: 11 Pages: 1474 Handle: RePEc:aph:ajpbhl:1987:77:11:1474_3 Template-Type: ReDIF-Article 1.0 Title: Whither family planning. Journal: American Journal of Public Health Author-Name: Dryfoos, J.G. Year: 1987 Volume: 77 Issue: 11 Pages: 1393-1395 Handle: RePEc:aph:ajpbhl:1987:77:11:1393-1395_2 Template-Type: ReDIF-Article 1.0 Title: Back to the future with SI units. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1987 Volume: 77 Issue: 11 Pages: 1398-1399 Handle: RePEc:aph:ajpbhl:1987:77:11:1398-1399_5 Template-Type: ReDIF-Article 1.0 Title: Attempts to increase return of surveys. Journal: American Journal of Public Health Author-Name: Hughes, J.R. Year: 1987 Volume: 77 Issue: 11 Pages: 1474 Handle: RePEc:aph:ajpbhl:1987:77:11:1474_6 Template-Type: ReDIF-Article 1.0 Title: An unwanted Christmas surprise: report of a field investigation on possible chemical contamination of a children's toy. Journal: American Journal of Public Health Author-Name: Sidhu, K.S. Author-Name: Scheel, R.H. Author-Name: Perry, E. Author-Name: Welch, R.L. Author-Name: Chadzynski, L. Year: 1987 Volume: 77 Issue: 11 Pages: 1472-1473 Handle: RePEc:aph:ajpbhl:1987:77:11:1472-1473_5 Template-Type: ReDIF-Article 1.0 Title: The Women's Health Care Program at Columbia University. Journal: American Journal of Public Health Author-Name: Katz, M.E. Author-Name: Gavin, K. Author-Name: Hessner, S. Year: 1987 Volume: 77 Issue: 10 Pages: 1352-1353 Handle: RePEc:aph:ajpbhl:1987:77:10:1352-1353_8 Template-Type: ReDIF-Article 1.0 Title: Interpretation of spermicide study data. Journal: American Journal of Public Health Author-Name: Mills, J.L. Year: 1987 Volume: 77 Issue: 10 Pages: 1356-1357 Handle: RePEc:aph:ajpbhl:1987:77:10:1356-1357_9 Template-Type: ReDIF-Article 1.0 Title: Occupation, smoking, and alcohol in the epidemiology of bladder cancer. Journal: American Journal of Public Health Author-Name: Brownson, R.C. Author-Name: Chang, J.C. Author-Name: Davis, J.R. Year: 1987 Volume: 77 Issue: 10 Pages: 1298-1300 Abstract: We conducted a case-control study to evaluate the effects of occupation, smoking, and alcohol consumption on bladder cancer risk. A total of 823 male cases and 2,469 age-matched controls were identified through the Missouri Cancer Registry. Relative risk estimates of 2.0 or greater were observed for janitors and cleaners, mechanics, miners, and printers. Current cigarette smoking was associated with a two-fold excess risk of bladder cancer, whereas alcohol consumption showed no association with bladder cancer risk. Handle: RePEc:aph:ajpbhl:1987:77:10:1298-1300_9 Template-Type: ReDIF-Article 1.0 Title: Physician training in Latin America. Journal: American Journal of Public Health Author-Name: Rivas, P. Year: 1987 Volume: 77 Issue: 10 Pages: 1354-1355 Handle: RePEc:aph:ajpbhl:1987:77:10:1354-1355_0 Template-Type: ReDIF-Article 1.0 Title: Foreign privatization of national health systems. Journal: American Journal of Public Health Author-Name: Roemer, M.I. Year: 1987 Volume: 77 Issue: 10 Pages: 1271-1272 Handle: RePEc:aph:ajpbhl:1987:77:10:1271-1272_0 Template-Type: ReDIF-Article 1.0 Title: Injuries in relation to chronic disease: an international view of premature mortality. Journal: American Journal of Public Health Author-Name: Rockett, I.R. Author-Name: Smith, G.S. Year: 1987 Volume: 77 Issue: 10 Pages: 1345-1346 Abstract: Injuries are compared with heart disease, cancer, and cerebrovascular disease, using 1980 mortality data for the United States, France, Japan, West Germany and the United Kingdom. Emphasis is on premature mortality, measured by a rate of potential years of life lost between ages one and 65. Injuries are the leading cause of male premature mortality, and rank first, or second to cancer, in females. The United States sustains the greatest injury losses of these five countries. Handle: RePEc:aph:ajpbhl:1987:77:10:1345-1346_8 Template-Type: ReDIF-Article 1.0 Title: Murder at work. Journal: American Journal of Public Health Author-Name: Dietz, P.E. Author-Name: Baker, S.P. Year: 1987 Volume: 77 Issue: 10 Pages: 1273-1274 Handle: RePEc:aph:ajpbhl:1987:77:10:1273-1274_5 Template-Type: ReDIF-Article 1.0 Title: Screening for HIV exposure. Journal: American Journal of Public Health Author-Name: Stankaitis, J.A. Author-Name: Bigos, J.P. Year: 1987 Volume: 77 Issue: 10 Pages: 1354 Handle: RePEc:aph:ajpbhl:1987:77:10:1354_0 Template-Type: ReDIF-Article 1.0 Title: Effects of age misstatement. Journal: American Journal of Public Health Author-Name: Ayiomamitis, A. Year: 1987 Volume: 77 Issue: 10 Pages: 1355-1356 Handle: RePEc:aph:ajpbhl:1987:77:10:1355-1356_5 Template-Type: ReDIF-Article 1.0 Title: Utilization of the health risk appraisal for a needs assessment. Journal: American Journal of Public Health Author-Name: Siegel, L.P. Year: 1987 Volume: 77 Issue: 9 Pages: 1228 Handle: RePEc:aph:ajpbhl:1987:77:9:1228_7 Template-Type: ReDIF-Article 1.0 Title: Assessing quality of institutional care. Journal: American Journal of Public Health Author-Name: Mosteller, F. Year: 1987 Volume: 77 Issue: 9 Pages: 1155-1156 Handle: RePEc:aph:ajpbhl:1987:77:9:1155-1156_1 Template-Type: ReDIF-Article 1.0 Title: Quality of death statistics. Journal: American Journal of Public Health Author-Name: Newman, D.M. Year: 1987 Volume: 77 Issue: 9 Pages: 1230 Handle: RePEc:aph:ajpbhl:1987:77:9:1230_2 Template-Type: ReDIF-Article 1.0 Title: Smoking, body weight, level of fatness. Journal: American Journal of Public Health Author-Name: Kazandjian, V.A. Year: 1987 Volume: 77 Issue: 9 Pages: 1229-1230 Handle: RePEc:aph:ajpbhl:1987:77:9:1229-1230_0 Template-Type: ReDIF-Article 1.0 Title: The St. Anthony Park Block Nurse Program. Journal: American Journal of Public Health Author-Name: Jamieson, M. Author-Name: Campbell, J.L. Year: 1987 Volume: 77 Issue: 9 Pages: 1227-1228 Handle: RePEc:aph:ajpbhl:1987:77:9:1227-1228_2 Template-Type: ReDIF-Article 1.0 Title: Nicotine from aerosol rod. Journal: American Journal of Public Health Author-Name: Slade, J. Author-Name: Connolly, G. Year: 1987 Volume: 77 Issue: 9 Pages: 1229 Handle: RePEc:aph:ajpbhl:1987:77:9:1229_9 Template-Type: ReDIF-Article 1.0 Title: Predicting charges for inpatient medical rehabilitation using severity, DRG, age and function Journal: American Journal of Public Health Author-Name: McGinnis, G.E. Author-Name: Osberg, J.S. Author-Name: DeJong, G. Author-Name: Seward, M.L. Author-Name: Branch, L.G. Year: 1987 Volume: 77 Issue: 7 Pages: 826-829 Abstract: We examined the effectiveness of using diagnosis related groups (DRGs), Severity of Illness Index (SII), age and function at admission to predict inpatient charges for medical rehabilitation. Data from our sample of 199 indicate that DRGs alone explained approximately 12 per cent of the variation in charges for inpatient rehabilitation while SII explained 26 per cent of the variation. SII, DRG, and age together yielded the highest regression coefficient, accounting for nearly 39 per cent of the variation in total charges; SII and age accounted for 36 per cent of the variation. Within DRG categories, SII was the only important predictor of inpatient charges accounting for 23 per cent of the variation in charges among stroke patients (DRG 014) and 28 per cent of the variation in charges among hip fracture patients (DRG 210). Function at admission was not a useful predictor of inpatient rehabilitation charges within DRGs. These results suggest that SII and age may be useful in developing a DRG-based prospective payment system for inpatient medical rehabilitation. Handle: RePEc:aph:ajpbhl:1987:77:7:826-829_8 Template-Type: ReDIF-Article 1.0 Title: Evaluation of a minimal-contact smoking cessation intervention in an outpatient setting Journal: American Journal of Public Health Author-Name: Janz, N.K. Author-Name: Becker, M.H. Author-Name: Kirscht, J.P. Author-Name: Eraker, S.A. Author-Name: Billi, J.E. Author-Name: Woolliscroft, J.O. Year: 1987 Volume: 77 Issue: 7 Pages: 805-809 Abstract: We examined the ability of a provider-initiated, minimal-contact intervention to modify the smoking behavior of ambulatory clinic patients. Smokers at two outpatient sites were assigned to one of three groups: provider intervention only (PI); provider intervention plus self-help manual (PI/M); and usual care (control) group (C). The physician message emphasized the patient's personal susceptibility, the physician's concern, and the patient's ability to quit (self-efficacy). The nurse consultation concentrated on benefits and barriers associated with stopping, and on strategies for cessation. Telephone interviews were conducted with the 250 participants within a few days of their clinic visit and again at one and six months. Both PI and PI/M proved to be superior to usual care in motivating attempts to quit at both one-month and six-month follow-ups, and logistic regression analyses indicated that participants receiving the self-help manual in addition to the health provider message were between two and three times more likely to quit smoking during the study period than were participants in either of the other study groups. Handle: RePEc:aph:ajpbhl:1987:77:7:805-809_6 Template-Type: ReDIF-Article 1.0 Title: Measles hospitalizations, United States, 1977-84: Comparison with national surveillance data Journal: American Journal of Public Health Author-Name: Markowitz, L.E. Author-Name: Tomasi, A. Author-Name: Sirotkin, B.I. Author-Name: Carr, R.W. Author-Name: Davis, R.M. Author-Name: Preblud, S.R. Author-Name: Orenstein, W.A. Year: 1987 Volume: 77 Issue: 7 Pages: 866-868 Abstract: Trends in measles discharges from hospitals participating in the Commission on Professional and Hospital Activities, Professional Activities Study (CPHA-PAS) from 1977 to 1984 reflected the rapid decline in measles morbidity indicated by national surveillance data with an 88 per cent decrease in hospitalizations and a 95 per cent decrease in reported cases from 1977 to 1984. Overall trends in number, age, and seasonal distribution were also generally similar. Thirty-four per cent of the hospitalizations listed respiratory complications, 8.5 per cent otitis media, and 3.4 per cent neurologic complications. Handle: RePEc:aph:ajpbhl:1987:77:7:866-868_3 Template-Type: ReDIF-Article 1.0 Title: Saliva cotinine as a measure of smoking status in field settings Journal: American Journal of Public Health Author-Name: Abrams, D.B. Author-Name: Follick, M.J. Author-Name: Biener, L. Author-Name: Carey, K.B. Author-Name: Hitti, J. Year: 1987 Volume: 77 Issue: 7 Pages: 846-848 Abstract: The accuracy and reliability of saliva cotinine as an objective measure of smoking status was examined in two field studies. In Study I, saliva was collected from smokers and nonsmokers with repeated samples taken from a randomly selected subset of the smokers. Results indicated perfect classification of smokers versus nonsmokers and acceptable reliability of repeated samples. Study II investigated the accuracy of saliva cotinine in detecting recent quitters in a worksite smoking cessation program. Saliva cotinine showed greater accuracy than expired carbon monoxide at detecting quitters, provided they were abstinent for at least seven days. From pre- to post-treatment, subject's saliva cotinine levels dropped 19 per cent while self-reported rate of smoking dropped 54 per cent. Saliva collection in the field is feasible and cotinine appears to be one of the more sensitive assays currently available for epidemiologic and clinical applications. Handle: RePEc:aph:ajpbhl:1987:77:7:846-848_2 Template-Type: ReDIF-Article 1.0 Title: Somatization in the community: Relationship to disability and use of services Journal: American Journal of Public Health Author-Name: Escobar, J.I. Author-Name: Golding, J.M. Author-Name: Hough, R.L. Author-Name: Karno, M. Author-Name: Burnam, M.A. Author-Name: Wells, K.B. Year: 1987 Volume: 77 Issue: 7 Pages: 837-840 Abstract: We tested the hypotheses that an abridged somatization construct that we had developed would be associated with use of health services, prefential use of medical over mental health services, and an index of disability. These hypotheses were tested using structured interview data from 3,132 randomly selected community respondents. We found that: respondents meeting criteria for somatization reported a heavier use of health services than non-somatizers; of those respondents meeting criteria for a psychiatric diagnosis, somatizers preferentially used medical over mental health services whereas non-somatizers reported the opposite trend; and somatizers were more likely than non-somatizers to report recent sick leave or restricted activity. Handle: RePEc:aph:ajpbhl:1987:77:7:837-840_3 Template-Type: ReDIF-Article 1.0 Title: Disease surveillance and emergency services at the 1982 World's Fair Journal: American Journal of Public Health Author-Name: Gustafson, T.L. Author-Name: Booth, A.L. Author-Name: Fricker, R.S. Author-Name: Cureton, E. Author-Name: Fowinkle, E.W. Author-Name: Hutcheson Jr., R.H. Author-Name: Schaffner, W. Year: 1987 Volume: 77 Issue: 7 Pages: 861-863 Abstract: We designed a special surveillance system to detect health complaints of visitors to the 1982 World's Fair. Heat-related illness occurred during the first month of the Fair but was substantially reduced by public education, environmental modification, and provision of additional water fountains. There was no disruption of emergency health services in the communities surrounding the Fair. Advance planning and the provision of on-site medical services can minimize the public health impact of large gatherings. Handle: RePEc:aph:ajpbhl:1987:77:7:861-863_3 Template-Type: ReDIF-Article 1.0 Title: Promoting preventive care: Changing reimbursement is not enough Journal: American Journal of Public Health Author-Name: McPhee, S.J. Author-Name: Schroeder, S.A. Year: 1987 Volume: 77 Issue: 7 Pages: 780-781 Handle: RePEc:aph:ajpbhl:1987:77:7:780-781_6 Template-Type: ReDIF-Article 1.0 Title: Stigmatization of AIDS patients by physicians Journal: American Journal of Public Health Author-Name: Kelly, J.A. Author-Name: St Lawrence, J.S. Author-Name: Smith, S. Author-Name: Hood, H.V. Author-Name: Cook, D.J. Year: 1987 Volume: 77 Issue: 7 Pages: 789-791 Abstract: A randomly selected sample of physicians in three large cities was asked to read one of four vignettes describing a patient. They then completed a set of objective attitude measures eliciting their reactions to the patient described in the vignette. The vignettes were identical except that the patient's illness was identified as either acquired immunodeficiency syndrome (AIDS) or leukemia and the patient's sexual preference as either heterosexual or homosexual. Harsh attitude judgements were associated with the AIDS portrayals, as well as much less willingness to interact even in routine conversation when the patient's illness was identified as AIDS. Increasing numbers of AIDS patients will be seeking medical attention from physicians in all areas of the country and it will be important for health care professions to develop programs which counter unreasonable stigma and prejudicial attitudes that may be associated with this illness. Handle: RePEc:aph:ajpbhl:1987:77:7:789-791_8 Template-Type: ReDIF-Article 1.0 Title: Preventive care: Do we practice what we preach? Journal: American Journal of Public Health Author-Name: Lurie, N. Author-Name: Manning, W.G. Author-Name: Peterson, C. Author-Name: Goldberg, G.A. Author-Name: Phelps, C.A. Author-Name: Lillard, L. Year: 1987 Volume: 77 Issue: 7 Pages: 801-804 Abstract: We used insurance claims from enrollees in the Rand Health Insurance Experiment to determine the amount of selected components of preventive care received by a representative sample of the non-aged population in the United States and to determine whether insurance coverage was an important determinant of that amount. Only 45 per cent of infants received timely immunization for DPT and polio; 93 per cent received some well child care by 18 months of age. In the three-year experimental period, only 4 per cent of adults had a tetanus shot, 66 per cent of women aged 17-44 and 57 per cent aged 45-65 received a Pap smear, and 2 per cent of women aged 45-65 had a mammogram. Cost sharing was associated with even less preventive care: 60 per cent of children on the free plan and 49 per cent on cost sharing plans received preventive care of any type. For adults, women on the free plan received more preventive care of several kinds, and those aged 45-65 received more Pap smears than those on cost-sharing plans. Even with free care, most enrollees did not receive adequate preventive care. Thus, free care alone, while significant, is not a sufficient incentive to providing recommended levels of preventive care. The average per person insurance charge for increasing the amount of preventive care to a level consistent with that recommended would be $22 for a complete set of immunizations by age 18 months, $9 for a Pap smear every three years, and $97 for a Pap test and mammogram every three years. Handle: RePEc:aph:ajpbhl:1987:77:7:801-804_0 Template-Type: ReDIF-Article 1.0 Title: Geographic variations in elderly hospital and surgical discharge rates, New York State Journal: American Journal of Public Health Author-Name: Pasley, B. Author-Name: Vernon, P. Author-Name: Gibson, G. Author-Name: McCauley, M. Author-Name: Andoh, J. Year: 1987 Volume: 77 Issue: 6 Pages: 679-684 Abstract: Hospital and surgical discharges for 1981, as recorded by the uniform hospital discharge data of New York State, were aggregated by county of residence and converted into age-sex adjusted rates. Elderly hospital discharge and surgery rates in New York State, 1981, varied 2.4- and 2-fold, respectively. Discharge rates of elderly with specific procedures showed even greater variation. However, proportions of highly complex and non-elective procedures performed on the elderly were similar in counties with high and low surgical rates. A multiple regression model consisting of independent dimensions of county demographic and medical resources characteristics plus a proxy variable for surgical practice styles was applied to hospital and surgery rates. Variations in elderly surgical discharge rates were found to be related to the supply of medical resources and to surgical practice styles. Handle: RePEc:aph:ajpbhl:1987:77:6:679-684_5 Template-Type: ReDIF-Article 1.0 Title: The San Francisco Men's Health Study: III. Reduction in human immunodeficiency virus transmission among homosexual/bisexual men, 1982-86 Journal: American Journal of Public Health Author-Name: Winkelstein Jr., W. Author-Name: Samuel, M. Author-Name: Padian, N.S. Author-Name: Wiley, J.A. Author-Name: Lang, W. Author-Name: Anderson, R.E. Author-Name: Levy, J.A. Year: 1987 Volume: 77 Issue: 6 Pages: 685-689 Abstract: The prevalence and incidence of infection by the human immunodeficiency virus (HIV) has been under study in a cohort of 1,034 single men recruited by area probability sampling from a six kilometer square area of San Francisco where the epidemic of acquired immunodeficiency syndrome (AIDS) has been most severe. Prevalence of infection among homosexual/bisexual study subjects increased from an estimated 22.8 per cent during the last half of 1982 to 48.6 per cent during the period July through December 1984. During three subsequent six-month periods, prevalence remained stable at approximately 50 per cent. Annual infection rates, measured by seroconversion among seronegative study subjects, decreased from an estimated 18.4 per cent per year from 1982 to 1984, to 5.4 and 3.1 per cent during the first and second halves of 1985, and to 4.2 per cent during the first six months of 1986. These declines were associated with reductions of 60 per cent or more in the prevalence of high-risk sexual practices associated with both acquiring and disseminating infection by the human immunodeficiency. Handle: RePEc:aph:ajpbhl:1987:77:6:685-689_7 Template-Type: ReDIF-Article 1.0 Title: Home health care: Who's where? Journal: American Journal of Public Health Author-Name: Phillips, E.K. Author-Name: Fisher, M.E. Author-Name: MacMillan-Scattergood, D. Author-Name: Baglioni Jr., A.J. Author-Name: Torner, J.C. Year: 1987 Volume: 77 Issue: 6 Pages: 733-734 Abstract: Referrals to two home health agencies, one public and one private, were examined over a one-year period (n = 290). Clients in the public agency required greater frequency of visits, more nursing services, and care for a longer period of time than did those in the private agency. The public agency served a large proportion of indigent and Medicaid clients. Increased service delivery with a decreased financial base may forebode an unhealthy future for traditional public home health agencies. Handle: RePEc:aph:ajpbhl:1987:77:6:733-734_9 Template-Type: ReDIF-Article 1.0 Title: An evaluation of case management Journal: American Journal of Public Health Author-Name: Franklin, J.L. Author-Name: Solovitz, B. Author-Name: Mason, M. Author-Name: Clemons, J.R. Author-Name: Miller, G.E. Year: 1987 Volume: 77 Issue: 6 Pages: 674-678 Abstract: This project explores the efficiency and effectiveness of case management as compared with the usual and customary services available to chronic mentally ill individuals in reducing readmissions to mental hospitals and improving the quality of life. A randomized pretest-posttest control group design was used to assign 417 individuals who had at least two discharges from a mental hospital to an experimental (E) group (N = 213) to receive case management services and a control (C) group (N = 204) who could receive any services but case management. After participation in the project for 12 months, 138 members of the E group and 126 members of the C group were reinterviewed. The E group received more services, cost more to maintain, and were admitted to mental hospitals more often, but concomitant improvement in quality of life indicators was not evident. Alternative explanations for the findings are discussed. Handle: RePEc:aph:ajpbhl:1987:77:6:674-678_6 Template-Type: ReDIF-Article 1.0 Title: Daily air pollution effects on children's respiratory symptoms and peak expiratory flow Journal: American Journal of Public Health Author-Name: Vedal, S. Author-Name: Schenker, B. Author-Name: Munoz, A. Author-Name: Samet, J.M. Author-Name: Batterman, S. Author-Name: Speizer, F.E. Year: 1987 Volume: 77 Issue: 6 Pages: 694-698 Abstract: To identify acute respiratory health effects associated with air pollution due to coat combustion, a subgroup of of elementary school-aged children was selected from a large cross-sectional study and followed daily for eight months. Children were selected to obtain three equal-sized groups: one without respiratory symptoms, one with symptoms of persistent wheeze, and one with cough or phlegm production but without persistent wheeze. Parents completed a daily diary of symptoms from which illness constellations of upper respiratory illness (URI) and lower respiratory illness (LRI) and the symptom of wheeze were derived. Peak expiratory flow rate (PEFR) was measured daily for nine consecutive weeks during the eight-month study period. Maximum hourly concentrations of sulfur dioxide, nitrogen dioxide, ozone, and coefficient of haze for each 24-hour period, as well as minimum hourly temperature, were correlated with daily URI, LRI, wheeze, and PEFR using multiple regression models adjusting for illness occurrence or level of PEFR on the immediately preceding day. Respiratory illness on the preceding day was the most important predictor of current illness. A drop in temperature was associated with increased URI and LRI but not with increased wheeze or with a decrease in level of PEFR. No air pollutant was strongly associated with respiratory illness or with level of PEFR, either in the group of children as a whole, or in either of the symptomatic subgroups; the pollutant concentration observed, however, were uniformly lower than current ambient air quality standards. Moreover, since exposure estimation based on monitoring of ambient air likely results in misclassification of the true exposure, the negative findings of this study must be interpreted cautiously. Handle: RePEc:aph:ajpbhl:1987:77:6:694-698_5 Template-Type: ReDIF-Article 1.0 Title: Incidental appendectomy. Journal: American Journal of Public Health Author-Name: Moore, F.D. Year: 1987 Volume: 77 Issue: 8 Pages: 1015-1016 Handle: RePEc:aph:ajpbhl:1987:77:8:1015-1016_6 Template-Type: ReDIF-Article 1.0 Title: Alternate testing sites for AIDS virus. Journal: American Journal of Public Health Author-Name: Cates Jr., W. Author-Name: Lane, J.M. Year: 1987 Volume: 77 Issue: 8 Pages: 1016 Handle: RePEc:aph:ajpbhl:1987:77:8:1016_9 Template-Type: ReDIF-Article 1.0 Title: Decline in carcinoma of the cervix. Journal: American Journal of Public Health Author-Name: Koch, M. Year: 1987 Volume: 77 Issue: 7 Pages: 879 Handle: RePEc:aph:ajpbhl:1987:77:7:879_3 Template-Type: ReDIF-Article 1.0 Title: Breast cancer information: New York State. Journal: American Journal of Public Health Author-Name: Doolittle, S. Year: 1987 Volume: 77 Issue: 7 Pages: 874 Handle: RePEc:aph:ajpbhl:1987:77:7:874_0 Template-Type: ReDIF-Article 1.0 Title: On weight classification categories. Journal: American Journal of Public Health Author-Name: Tayback, M. Year: 1987 Volume: 77 Issue: 7 Pages: 877-878 Handle: RePEc:aph:ajpbhl:1987:77:7:877-878_2 Template-Type: ReDIF-Article 1.0 Title: Orange County Farm Labor Program summary. Journal: American Journal of Public Health Author-Name: Foster, L.M. Year: 1987 Volume: 77 Issue: 7 Pages: 874-875 Handle: RePEc:aph:ajpbhl:1987:77:7:874-875_8 Template-Type: ReDIF-Article 1.0 Title: Computer program produces p-value graphics. Journal: American Journal of Public Health Author-Name: Foster, D.A. Author-Name: Sullivan, K.M. Year: 1987 Volume: 77 Issue: 7 Pages: 880-881 Handle: RePEc:aph:ajpbhl:1987:77:7:880-881_3 Template-Type: ReDIF-Article 1.0 Title: Exclusion and uncertainty. Journal: American Journal of Public Health Author-Name: Thompson, W.D. Year: 1987 Volume: 77 Issue: 7 Pages: 879-880 Handle: RePEc:aph:ajpbhl:1987:77:7:879-880_8 Template-Type: ReDIF-Article 1.0 Title: Problems associated with condom use in homosexual men. Journal: American Journal of Public Health Author-Name: Ross, M.W. Year: 1987 Volume: 77 Issue: 7 Pages: 877 Handle: RePEc:aph:ajpbhl:1987:77:7:877_4 Template-Type: ReDIF-Article 1.0 Title: Adolescents' knowledge of AIDS near AIDS epicenter. Journal: American Journal of Public Health Author-Name: Wiesman, J.M. Author-Name: Natale, J.A. Author-Name: Lin, J.C. Author-Name: Garrett, A.T. Author-Name: FitzGerald, P.J. Author-Name: Davis, K.E. Author-Name: Levin, L.S. Author-Name: Helgerson, S.D. Year: 1987 Volume: 77 Issue: 7 Pages: 876-877 Handle: RePEc:aph:ajpbhl:1987:77:7:876-877_1 Template-Type: ReDIF-Article 1.0 Title: Smoking behavior among participants in the nurses' health study Journal: American Journal of Public Health Author-Name: Myers, A.H. Author-Name: Rosner, B. Author-Name: Abbey, H. Author-Name: Willet, W. Author-Name: Stampfer, M.J. Author-Name: Bain, C. Author-Name: Lipnick, R. Author-Name: Hennekens, C. Author-Name: Speizer, F. Year: 1987 Volume: 77 Issue: 5 Pages: 628-630 Abstract: We analyzed smoking behavior of 91,651 married female nurses aged 30-55 years in 1976. The prevalence of smoking was similar among all birth cohorts. The largest percentage increase in starting to smoke occurred between ages 15 and 25 years; by age 25, 50 per cent had started smoking. The cessation rate was lowest in earlier birth cohorts and among nurses starting to smoke at earlier ages. The cessation rate increased substantially between 1963-73 compared with the period 1948-58. Handle: RePEc:aph:ajpbhl:1987:77:5:628-630_6 Template-Type: ReDIF-Article 1.0 Title: A follow-up study of gastro-intestinal diseases related to bacteriologically substandard drinking water Journal: American Journal of Public Health Author-Name: Zmirou, D. Author-Name: Ferley, J.P. Author-Name: Collin, J.F. Author-Name: Charrel, M. Author-Name: Berlin, J. Year: 1987 Volume: 77 Issue: 5 Pages: 582-584 Abstract: In a prospective follow-up study conducted in 52 French alpine villages, one weekly water sample was taken in each village provided with untreated ground water and analyzed as to the presence of four indicator bacteria: total plate count, total coliforms, thermotolerant (fecal) coliforms, and fecal streptococci. Cases of acute gastro-intestinal disease (AGID) occurring among 29,272 inhabitants were reported through physicians, pharmacists, and primary school teachers. A loglinear model identified fecal streptococcus (FS) as the best predictor; the presence of fecal coliforms enhanced the effect of FS. The total bacteria count and the total coliforms had no independent contributions. A threshold analysis suggested that any level of indicator bacteria above zero was associated with an excess of AGID. Handle: RePEc:aph:ajpbhl:1987:77:5:582-584_9 Template-Type: ReDIF-Article 1.0 Title: Maternal cigarette smoking and oral clefts: A population-based study Journal: American Journal of Public Health Author-Name: Khoury, M.J. Author-Name: Weinstein, A. Author-Name: Panny, S. Author-Name: Holtzman, N.A. Author-Name: Lindsay, P.K. Author-Name: Farrel, K. Author-Name: Eisenberg, M. Year: 1987 Volume: 77 Issue: 5 Pages: 623-625 Abstract: Analyses of 1984 data from the Maryland Birth Defects Reporting and Information System indicate that mothers of infants with oral clefts (cleft lip with or without cleft palate; and cleft palate) smoked more during pregnancy than mothers of infants with other defects (odds ratio OR of 2.56 and 2.39, respectively). There was a dose-response relation between the daily amount smoked and the risk of clefting. Adjustment for available confounding variables did not account for the association between smoking and oral clefts. Handle: RePEc:aph:ajpbhl:1987:77:5:623-625_1 Template-Type: ReDIF-Article 1.0 Title: Toxocara canis infection of children: Epidemiologic and neuropsychologic findings Journal: American Journal of Public Health Author-Name: Marmor, M. Author-Name: Glickman, L. Author-Name: Shofer, F. Author-Name: Faich, L.A. Author-Name: Rosenberg, C. Author-Name: Cornblatt, B. Author-Name: Friedman, S. Year: 1987 Volume: 77 Issue: 5 Pages: 554-559 Abstract: Sera from 4,652 children whose blood was submitted to the New York City Department of Health for lead analysis were tested for antibodies to Toxocara canis using an enzyme-linked immunosorbent assay (ELISA). Standardized to the age distribution of the study population, T. canis seropositivity (inverse titers ≥ 16) was 5.7 per cent in males and 5.1 per cent in females. T. canis antibody titers and lead exposures as measured by Centers for Disease Control lead classes were positively correlated. Children who were seropositive to T. canis (cases) were compared to seronegatives (controls) matched on age (± 6 months), sex, time-of-screening (± 3 months) and CDC lead class. Logistic regression analysis of 155 case-control pairs demonstrated elevated relative risks (RRs) for geophagia (RR = 3.14; 95% CI = 1.75, 5.64) and having had a litter of puppies in the home (RR = 5.22; 95% CI = 1.63, 16.71). Compared to controls, cases had increased eosinophil counts, serum immunoglobulin E concentrations, and anti-hemagglutinin-A titers. Small deficits in cases compared to controls were found in performance on several neuropsychological tests after adjustment for potential confounders including case-control differences in race, socioeconomic status, and current blood lead concentrations. The study thus confirmed that T. canis infection is common in urban children and suggested that infection may be associated with adverse neuropsychological effects. Handle: RePEc:aph:ajpbhl:1987:77:5:554-559_3 Template-Type: ReDIF-Article 1.0 Title: Persistence of juvenile-onset obesity over eight years: The Bogalusa Heart Study Journal: American Journal of Public Health Author-Name: Freedman, D.S. Author-Name: Shear, C.L. Author-Name: Burke, G.L. Author-Name: Srinivasan, S.R. Author-Name: Webber, L.S. Author-Name: Harsha, D.W. Author-Name: Berenson, G.S. Year: 1987 Volume: 77 Issue: 5 Pages: 588-592 Abstract: The persistence of obesity and overweight over eight years was assessed in a biracial (Black-White) cohort of 1,490 two- to 14-year-olds. Initial levels of triceps skinfold thickness (TRSF) and Rohrer index (weight/height) were moderately predictive of subsequent levels: r = 0.54 and 0.67, respectively. However, TRSF and Rohrer index tended to track most strongly in Black females (r = 0.64 and 0.72) and less well in both White females (r = 0.45 and 0.57) and preschool children (r = 0.45 and 0.54). Based on elevated levels of TRSF or Rohrer index, children were classified as obese or overweight, respectively. Of the 222 children who were initially above the 85th percentile for TRSF, 43 per cent remained obese after eight years. Persistence of overweight was slightly greater at follow-up, with 50 per cent of initially overweight children staying above the 85th percentile for Rohrer index. Severe, initial obesity/overweight (>95th percentile) and consecutively elevated levels increased the probability of remaining obese/overweight. Results indicate that moderate, juvenile-onset obesity is malleable, but that the child who is extremely obese over consecutive examinations is likely to become an obese adult. Handle: RePEc:aph:ajpbhl:1987:77:5:588-592_1 Template-Type: ReDIF-Article 1.0 Title: Effects of Maine's 1981 and Massachusetts' 1982 driving-under-the-influence legislation Journal: American Journal of Public Health Author-Name: Hingson, R. Author-Name: Heeren, T. Author-Name: Kovenock, D. Author-Name: Mangione, T. Author-Name: Meyers, A. Author-Name: Morelock, S. Author-Name: Lederman, R. Author-Name: Scotch, N.A. Year: 1987 Volume: 77 Issue: 5 Pages: 593-597 Abstract: In 1981, Maine passed a drunk driving law with mandatory penalties and a new civil charge to increase the conviction rate. One year later, Massachusetts increased drunk driving penalties, particularly for repeat offenders and intoxicated drivers involved in fatal crashes. In Maine, single-vehicle nighttime fatal crashes declined 22 per cent the year before passage of the law, and 33 per cent the year after. Maine's rates returned to pre-law levels by the third post-law year. Prior to Massachusetts' new law, single-vehicle nighttime and overall fatal crashes there also declined 20% and 22%, whereas after this law fatal crash rates did not decline further compared with the pre-law year or other New England states. Pre- and post-law surveys indicate that both laws were followed by some increases in public perceptions that drunk drivers stopped by police would be arrested, convicted, and receive automatic penalties. But, few believed it was very likely that drunk drivers would be stopped. For only two of three years studied after Maine's law did more people there report decisions not to drive because they had drunk too much. In Massachusetts, reported driving after heavy drinking declined as much the year before as the three year after its law. Handle: RePEc:aph:ajpbhl:1987:77:5:593-597_7 Template-Type: ReDIF-Article 1.0 Title: Pontiac fever outbreak associated with a cooling tower Journal: American Journal of Public Health Author-Name: Friedman, S. Author-Name: Spitalny, K. Author-Name: Barbaree, J. Author-Name: Faur, Y. Author-Name: McKinney, R. Year: 1987 Volume: 77 Issue: 5 Pages: 568-572 Abstract: In late April 1984, an outbreak of Pontiac fever was investigated in an office building in lower Manhattan (New York City). The outbreak was characterized by a high attack rate (78 per cent overall); the predominant symptoms were myalgias, chills, fatigue, fever, and headache. There was a clustering of cases in an office that was air cooled by a dedicated cooling tower separate from the remainder of the building. A high concentration of live L. Pneumophilia cells in the cooling tower was quantified. Airborne spread via settle plates placed along the air intake system and within the office was demonstrated. Legionella pneumophilia serogroup 1 antigen was found in the urine of two cases, and identical monoclonal antibody reactivity patterns of isolates from all sources was observed. Difficulty was experienced in eliminating the organism from the tower. Handle: RePEc:aph:ajpbhl:1987:77:5:568-572_1 Template-Type: ReDIF-Article 1.0 Title: On evaluation of early screening programs. Journal: American Journal of Public Health Author-Name: Darling, R.B. Year: 1987 Volume: 77 Issue: 6 Pages: 741-742 Handle: RePEc:aph:ajpbhl:1987:77:6:741-742_6 Template-Type: ReDIF-Article 1.0 Title: On disease clustering. Journal: American Journal of Public Health Author-Name: Bender, A.P. Year: 1987 Volume: 77 Issue: 6 Pages: 742 Handle: RePEc:aph:ajpbhl:1987:77:6:742_2 Template-Type: ReDIF-Article 1.0 Title: Westchester crisis counseling program. Journal: American Journal of Public Health Author-Name: Beane, R.H. Year: 1987 Volume: 77 Issue: 6 Pages: 739 Handle: RePEc:aph:ajpbhl:1987:77:6:739_7 Template-Type: ReDIF-Article 1.0 Title: Occupational safety and health training for high school industrial/ vocational education instructors. Journal: American Journal of Public Health Author-Name: Wigglesworth, D. Year: 1987 Volume: 77 Issue: 6 Pages: 739-740 Handle: RePEc:aph:ajpbhl:1987:77:6:739-740_2 Template-Type: ReDIF-Article 1.0 Title: Factors influencing return to work following hospitalization for traumatic injury Journal: American Journal of Public Health Author-Name: MacKenzie, E.J. Author-Name: Shapiro, S. Author-Name: Smith, R.T. Author-Name: Siegel, J.H. Author-Name: Moody, M. Author-Name: Pitt, A. Year: 1987 Volume: 77 Issue: 3 Pages: 329-334 Abstract: This paper describes the employment experience of 266 individuals one year after traumatic injury severe enough to require hospitalization. Of those working full-time prior to their injury, 56 per cent were employed full-time at one year; an additional 5 per cent were working part-time. Those sustaining a severe head or spinal cord injury were at highest risk of not returning to work (only 43 per cent and 21 per cent, respectively, had returned within the year). Low one-year employment rates (58 per cent) were also noted for individuals whose most severe injury was to one or more extremities. The extent and rate of return to work was examined in relation to selected socioeconomic and personal characteristics. Findings indicate that after controlling for type and severity of injury, personal income, and educational level of the injured person, as well as the identification of a strong social network as defined by the presence of one or more confidants, were important correlates of post-injury employment status. Handle: RePEc:aph:ajpbhl:1987:77:3:329-334_6 Template-Type: ReDIF-Article 1.0 Title: The epidemiology of road accidents in childhood Journal: American Journal of Public Health Author-Name: Pless, I.B. Author-Name: Verreault, R. Author-Name: Arsenault, L. Author-Name: Frappier, J.Y. Author-Name: Stulginskas, J. Year: 1987 Volume: 77 Issue: 3 Pages: 358-360 Abstract: We report the incidence of traffic injuries to children in Montreal: 33.4 per 10,000, 57 per cent pedestrians, 24.5 per cent passengers, and 18.4 per cent bicyclists. Nearly 20 per cent were hospitalized and 1.2 per cent died. One-third had MAIS scores of 2 or more with the highest rate of severe injuries found among pedestrians. Pedestrian and bicycle (but not passenger) injuries in low income areas were four to nine times greater than those in more affluent areas. Handle: RePEc:aph:ajpbhl:1987:77:3:358-360_6 Template-Type: ReDIF-Article 1.0 Title: Factors related to patient smoking status Journal: American Journal of Public Health Author-Name: Ockene, J.K. Author-Name: Hosmer, D.W. Author-Name: Williams, J.W. Author-Name: Goldberg, R.J. Author-Name: Raia III, T.J. Year: 1987 Volume: 77 Issue: 3 Pages: 356-357 Abstract: To investigate those factors associated with patients' cigarette smoking status, 455 consecutive patients seen in two specialty clinics and one general medicine clinic at a university medical center were studied. Patient's age, sex, health status, and number of previous cessation attempts discriminated current from ex-smokers. A strong interaction was observed between sex and disease status with females showing a greater impact of smoking-related disease on smoking behavior than males. Handle: RePEc:aph:ajpbhl:1987:77:3:356-357_5 Template-Type: ReDIF-Article 1.0 Title: Mortality among the elderly in the Alameda County study: Behavioral and demographic risk factors Journal: American Journal of Public Health Author-Name: Kaplan, G.A. Author-Name: Seeman, T.E. Author-Name: Cohen, R.D. Author-Name: Knudsen, L.P. Author-Name: Guralnik, J. Year: 1987 Volume: 77 Issue: 3 Pages: 307-312 Abstract: We studied the association between behavioral and demographic risk factors and 17-year mortality in members of the Alameda County (California) Study who were 60-94 years of age at baseline. In this age group, increased risk of death is associated with being male, smoking, having little leisure-time physical activity, deviating from moderate weight relative to height, and not regularly eating breakfast. These increased risks were independent of age, race, socioeconomic position (SEP), other behavioral risk factors, and baseline physical health status. Further examination of the group aged 70 or more revealed the same patterns of heightened risk. Handle: RePEc:aph:ajpbhl:1987:77:3:307-312_7 Template-Type: ReDIF-Article 1.0 Title: Counseling medical and dental patients about cigarette smoking: The impact of nicotine gum and chart reminders Journal: American Journal of Public Health Author-Name: Cohen, S.J. Author-Name: Christen, A.G. Author-Name: Katz, B.P. Author-Name: Drook, C.A. Author-Name: Davis, B.J. Author-Name: Smith, D.M. Author-Name: Stookey, G.K. Year: 1987 Volume: 77 Issue: 3 Pages: 313-316 Abstract: To investigate methods for improving and expanding the counseling of smokers by physicians and dentists, we assigned 112 physicians and 50 dentists (in separate studies) to one of the following conditions: the control or advice-only group received a one-hour lecture on the consequences and management of smoking and a booklet detailing a four-step protocol for counseling patients about smoking; three other groups received, in addition, either, protocol reminder stickers placed on their patients' charts; nicotine gum made freely available to their patients; or both chart reminders and nicotine gum. Exit interviews of 1,091 medical and 647 dental patients indicated that the presence of chart reminders and/or the availability of nicotine gum increased the time spent counseling and altered the nature of the smoking cessation counseling provided by both physicians and dentists. Handle: RePEc:aph:ajpbhl:1987:77:3:313-316_5 Template-Type: ReDIF-Article 1.0 Title: A prospective study of giardiasis and water supplies in Colorado Journal: American Journal of Public Health Author-Name: Lapham, S.C. Author-Name: Hopkins, R.S. Author-Name: White, M.C. Author-Name: Blair, J.R. Author-Name: Bissell, R.A. Author-Name: Simpson, G.L. Year: 1987 Volume: 77 Issue: 3 Pages: 354-355 Abstract: A prospective study of 484 visitors to Vail and Aspen/Snowmass, Colorado, was conducted to determine the risk of acquiring giardiasis. Of the 259 visitors to Vail, no cases of giardiasis were confirmed and only one of 12 water filtrates was positive for Giardia cysts. Of 225 visitors to Aspen/Snowmass two cases of giardiasis were confirmed and 12 of 20 water filtrates were positive for Giardia cysts. The regular occurrence of Giardia cysts in Aspen and Snowmass water was associated with lower rates of giardiasis acquisition than reported during outbreaks of waterborne giardiasis. Handle: RePEc:aph:ajpbhl:1987:77:3:354-355_0 Template-Type: ReDIF-Article 1.0 Title: Prenatal screening and pregnant women's attitudes toward the abortion of defective fetuses Journal: American Journal of Public Health Author-Name: Faden, R.R. Author-Name: Chwalow, A.J. Author-Name: Quaid, K. Author-Name: Chase, G.A. Author-Name: Lopes, C. Author-Name: Leonard, C.O. Author-Name: Holtzman, N.A. Year: 1987 Volume: 77 Issue: 3 Pages: 288-290 Abstract: We studied the attitudes of 490 pregnant women toward the abortion of defective fetuses. Three hundred of these women were participating in a prenatal screening program for neural tube defects. Although theoretical accounts of the effects of behavior on attitude would suggest that participation in a screening program would affect abortion attitudes, evidence in support of such an association was weak. The overwhelming majority of women, regardless of whether they had participated in the screening program, believed that women are justified in having an abortion in the face of fetal abnormality. There was a sharp increase in the number of screening program participants who said they would have an abortion when the probability of the fetus being affected with a neural tube defect rose from 95 per cent to 100 per cent. Handle: RePEc:aph:ajpbhl:1987:77:3:288-290_7 Template-Type: ReDIF-Article 1.0 Title: Norwalk-like gastroenteritis epidemic in a Toronto hospital Journal: American Journal of Public Health Author-Name: Leers, W.-D. Author-Name: Kasupski, G. Author-Name: Fralick, R. Author-Name: Wartman, S. Author-Name: Garcia, J. Author-Name: Gary, W. Year: 1987 Volume: 77 Issue: 3 Pages: 291-295 Abstract: An epidemic of gastroenteritis in a teaching hospital affected 57 patients and 69 staff over a 26-day period. The index case was a patient admitted with acute abdominal pain and diarrhea two days prior to the outbreak. The epidemic curve indicated person-to-person transmission. The incubation period, duration and type of symptoms were typical of Norwalk gastroenteritis, and Norwalk-like virus particles, serologically different from the prototype Norwalk virus strain, were observed in 17 of 20 fecal specimens examined by immune-electron microscopy. Handle: RePEc:aph:ajpbhl:1987:77:3:291-295_9 Template-Type: ReDIF-Article 1.0 Title: Risk factors for human immunodeficiency virus (HIV) infections in homosexual men Journal: American Journal of Public Health Author-Name: Darrow, W.W. Author-Name: Echenberg, D.F. Author-Name: Jaffe, H.W. Author-Name: O'Malley, P.M. Author-Name: Byers, R.H. Author-Name: Getchell, J.P. Author-Name: Curran, J.W. Year: 1987 Volume: 77 Issue: 4 Pages: 479-483 Abstract: To clarify risk factors for infection with the human immunodeficiency virus (HIV) we selected at random 785 homosexual men who had participated in studies of hepatitis B in San Francisco in 1978-80 for a follow-up study of the acquired immunodeficiency syndrome. Although most had not been contacted in over five years, 492 (63 per cent) were located and enrolled. The 240 (67 per cent) who had developed antibodies to HIV, as measured by an enzyme-linked immunosorbent assay (ELISA), were compared with 119 who had remained seronegative. In multivariate analyses, receptive anal intercourse with ejaculation by nonsteady sexual partners, many sexual partners per month, and other indicators of high levels of sexual activity were highly associated with seroconversions. None of the sexual practices that we studied appear to offer protection against HIV infection. Handle: RePEc:aph:ajpbhl:1987:77:4:479-483_7 Template-Type: ReDIF-Article 1.0 Title: Hepatitis B virus transmission in a public school: Effects of mentally retarded HBsAG carrier students Journal: American Journal of Public Health Author-Name: Williams, C.A. Author-Name: Weber, F.T. Author-Name: McKim, M. Author-Name: Steadham, C.I. Author-Name: Kane, M.A. Year: 1987 Volume: 77 Issue: 4 Pages: 476-478 Abstract: In 1980, 18 institutionalized children, carriers of hepatitis B virus (HBV), were enrolled into two special education schools, and staff and students were monitored for HBV markers. Eleven HBV exposures were observed and those exposed were given hepatitis B immune globulin. After 3.5 years, no remaining staff showed serological evidence of HBV infection but three of 61 susceptible students did so. The three students probably acquired the infection outside the school. At the conclusion of the project, one school located in the community decided not to institute a vaccine program for students or staff. The other school, located inside the mental retardation institution, established an organized vaccine initiative. Indications for use of hepatitis vaccine in schools should be individualized to accommodate for differences in student and staff interaction, physical design of the school, and number and behaviors of HBsAg carrier students. Handle: RePEc:aph:ajpbhl:1987:77:4:476-478_1 Template-Type: ReDIF-Article 1.0 Title: Dispersion guidelines for community residences in Westchester County. Journal: American Journal of Public Health Author-Name: Friedman, S.J. Year: 1987 Volume: 77 Issue: 5 Pages: 643-644 Handle: RePEc:aph:ajpbhl:1987:77:5:643-644_8 Template-Type: ReDIF-Article 1.0 Title: Otter Creek clean water project. Journal: American Journal of Public Health Author-Name: Mondok, J.J. Author-Name: Brenner, F.J. Year: 1987 Volume: 77 Issue: 5 Pages: 642 Handle: RePEc:aph:ajpbhl:1987:77:5:642_0 Template-Type: ReDIF-Article 1.0 Title: Asbestos examinations for construction workers. Journal: American Journal of Public Health Author-Name: Schneider, S.P. Year: 1987 Volume: 77 Issue: 5 Pages: 645-646 Handle: RePEc:aph:ajpbhl:1987:77:5:645-646_7 Template-Type: ReDIF-Article 1.0 Title: Artifacts of classification. Journal: American Journal of Public Health Author-Name: Hexter, A.C. Year: 1987 Volume: 77 Issue: 5 Pages: 645 Handle: RePEc:aph:ajpbhl:1987:77:5:645_1 Template-Type: ReDIF-Article 1.0 Title: Whirlpool folliculitis. Journal: American Journal of Public Health Author-Name: Birkhead, G. Author-Name: Vogt, R.L. Author-Name: Hudson, P.J. Year: 1987 Volume: 77 Issue: 4 Pages: 514 Handle: RePEc:aph:ajpbhl:1987:77:4:514_9 Template-Type: ReDIF-Article 1.0 Title: Fiber/fat/carbohydrates in weight loss. Journal: American Journal of Public Health Author-Name: York, E. Year: 1987 Volume: 77 Issue: 4 Pages: 514-515 Handle: RePEc:aph:ajpbhl:1987:77:4:514-515_0 Template-Type: ReDIF-Article 1.0 Title: Accidental firearm fatalities. Journal: American Journal of Public Health Author-Name: Kleck, G. Year: 1987 Volume: 77 Issue: 4 Pages: 513-514 Handle: RePEc:aph:ajpbhl:1987:77:4:513-514_2 Template-Type: ReDIF-Article 1.0 Title: The public health implications of the Bhopal disaster. Report to the Program Development Board, American Public Health Association Journal: American Journal of Public Health Author-Name: Levenstein, C. Author-Name: Ozonoff, D. Author-Name: Boden, L. Year: 1987 Volume: 77 Issue: 2 Pages: 230-236 Handle: RePEc:aph:ajpbhl:1987:77:2:230-236_1 Template-Type: ReDIF-Article 1.0 Title: Human immunodeficiency virus infection in heterosexual intravenous drug users in San Francisco Journal: American Journal of Public Health Author-Name: Chaisson, R.E. Author-Name: Moss, A.R. Author-Name: Onishi, R. Author-Name: Osmond, D. Author-Name: Carlson, J.R. Year: 1987 Volume: 77 Issue: 2 Pages: 169-172 Abstract: To investigate the risk of infection with the human immunodeficiency virus (HIV) in San Francisco, the prevalence of antibodies to HIV was determined in 281 heterosexual intravenous drug users recruited from community-based settings. Ten per cent of subjects had ELISA and Western blot confirmed seropositivity for antibodies (95 per cent CI 6.8-14.2 per cent). Analysis of behavioral factors revealed an increased risk of seropositivity in addicts who reported regularly sharing needles when injecting, particulary those sharing with two or more persons (odds ratio = 5.43;95 per cent CI 1.08-52.5). Blacks and Latinos also had a greater prevalence of seropositivity than Whites, and this finding persisted after adjustment for needle sharing (adjusted odds ratio = 2.8;95 per cent CI .84-8.59). Seropositivity was not associated with age, sex, duration of drug use, or history of prostitution. These data indicate that a new epidemic of AIDS (aquired immunodeficiency syndrome) in intravenous drug users, similar to that which has occurred among homosexuals in San Francisco, is possible. The relatively low seroprevalence in 1985 provides health officials an important opportunity to intervene and attempt to prevent widespread infection of drug users with HIV. Handle: RePEc:aph:ajpbhl:1987:77:2:169-172_6 Template-Type: ReDIF-Article 1.0 Title: Predicting experimentation with cigarettes: The childhood antecedents of smoking study (CASS) Journal: American Journal of Public Health Author-Name: Mittelmark, M.B. Author-Name: Murray, D.M. Author-Name: Luepker, R.V. Author-Name: Pechacek, T.F. Author-Name: Pirie, P.L. Author-Name: Pallonen, U.E. Year: 1987 Volume: 77 Issue: 2 Pages: 206-208 Abstract: In a two-year investigation of cigarette smoking incidence in a population of Minnesota adolescents, the perceived smoking behavior of friends at baseline was a strong predictor of smoking onset. Additional predictors included: siblings' smoking behavior, parents' education level, and seven psychosocial scales including independence and rebelliousness. Smoking prevention strategies which teach youth to cope with social influences are well founded. Results also indicate that younger adolescents may yet be dissuaded from beginning smoking by knowledge of the health consequences of smoking. Handle: RePEc:aph:ajpbhl:1987:77:2:206-208_8 Template-Type: ReDIF-Article 1.0 Title: Derivation of clinical indications for carotid endarterectomy by an expert panel Journal: American Journal of Public Health Author-Name: Merrick, N.J. Author-Name: Fink, A. Author-Name: Park, R.E. Author-Name: Brook, R.H. Author-Name: Kosecoff, J. Author-Name: Chassin, M.R. Author-Name: Solomon, D.H. Year: 1987 Volume: 77 Issue: 2 Pages: 187-190 Abstract: We used a two-round consensus panel method to derive and rate the appropriateness of comprehensive sets of detailed clincal indications for performing carotid endarterectomy. Before meeting, nine nationally influential physicians rated 675 indications; after review and discussion, they rated 864. The method did not force unanimity; our purposes were not only to encourage agreement but also to uncover areas of disagreement concerning the procedure's appropriate use. The panelists agreed on the level of appropriateness for 54 per cent of the final 864 indications and disagreed on 18 per cent. Ratings were reliably reproduced six to eight months after the completion of the process. The physicians' indications and ratings were consistent with those in the literature, and statistical analysis demonstrated that they followed logical clinical rationale. We conclude that consensus methods that do not force agreement can be used with panels of physicians to produce detailed, reliable, and valid indications. They can also identify medically controversial reasons for using a procedure that can serve as a starting point for a research agenda. Handle: RePEc:aph:ajpbhl:1987:77:2:187-190_4 Template-Type: ReDIF-Article 1.0 Title: Alcohol intake in a healthy elderly population Journal: American Journal of Public Health Author-Name: Goodwin, J.S. Author-Name: Sanchez, C.J. Author-Name: Thomas, P. Author-Name: Hunt, C. Author-Name: Garry, P.J. Year: 1987 Volume: 77 Issue: 2 Pages: 173-177 Abstract: The relationship between amount of alcohol consumption and social, psychological, and cognitive status was examined in 270 healthy, independently living men and women over age 65. Forty-eight per cent of the sample recorded some alcohol intake during a three-day diet record, with 8 per cent drinking 30 or more grams of alcohol daily. Alcohol intake was positively associated with male gender, income, and amount of education and negatively associated with any changes in social or psychological status, but was positively associated with several measurements of cognitive status. These correlations were weak, however, and tended to disappear after controlling for income, education, gender, and age. Past alcohol intake was not associated with any indicators of present social, psychological, or cognitive functioning. Handle: RePEc:aph:ajpbhl:1987:77:2:173-177_4 Template-Type: ReDIF-Article 1.0 Title: More on in-home pregnancy tests. Journal: American Journal of Public Health Author-Name: Clark, J.D. Year: 1987 Volume: 77 Issue: 3 Pages: 371 Handle: RePEc:aph:ajpbhl:1987:77:3:371_9 Template-Type: ReDIF-Article 1.0 Title: Those friendly little tanning beds and the public's health. Journal: American Journal of Public Health Author-Name: Dougherty, M.A. Author-Name: McDermott, R.J. Author-Name: Hawkins, M.J. Year: 1987 Volume: 77 Issue: 3 Pages: 370 Handle: RePEc:aph:ajpbhl:1987:77:3:370_1 Template-Type: ReDIF-Article 1.0 Title: Ethnicity and hip fracture. Journal: American Journal of Public Health Author-Name: Blumenthal, P.D. Author-Name: Marut, E. Author-Name: Gaffikin, L. Year: 1987 Volume: 77 Issue: 3 Pages: 369 Handle: RePEc:aph:ajpbhl:1987:77:3:369_8 Template-Type: ReDIF-Article 1.0 Title: Bulimic eating behaviors: association with alcohol and tobacco. Journal: American Journal of Public Health Author-Name: Frank, R.E. Author-Name: Serdula, M. Author-Name: Abel, G.G. Year: 1987 Volume: 77 Issue: 3 Pages: 369-370 Handle: RePEc:aph:ajpbhl:1987:77:3:369-370_5 Template-Type: ReDIF-Article 1.0 Title: Psychiatric diagnoses of medical service users: Evidence from the Epidemiologic Catchment Area Program Journal: American Journal of Public Health Author-Name: Kessler, L.G. Author-Name: Burns, B.J. Author-Name: Shapiro, S. Author-Name: Tischler, G.L. Author-Name: George, L.K. Author-Name: Hough, R.L. Author-Name: Bodison, D. Author-Name: Miller, R.H. Year: 1987 Volume: 77 Issue: 1 Pages: 18-24 Abstract: Based on data from the five sites of the National Institute of Mental Health-sponsored Epidemiological Catchment Area (ECA) Program, this paper examines the prevalence of psychiatric disorder among recent medical service users versus non-users, with a particular focus on affective disorders, substance abuse/dependence, and phobias. The rate of current Diagnostic Interview Schedule (DIS) disorders among medical users in all five ECA sites is 21.7 percent (slightly higher than general population rates) versus 16.7 percent among nonusers; there is generally no difference between users and nonusers with past DIS diagnoses. Affective disorders were among the most common mental disorders of medical service users, especially among females, with little variation between sites: females: users: 6.9 percent to 9.3 percent, nonusers: 3.4 percent to 6.4 percent, and males: users: 3.3 percent to 6.5 percent, nonusers: 1.2 percent to 4.1 percent. Rates of phobias among persons using medical services are also higher than among nonusers. Substance abuse disorders are at least as common among persons who use medical services (8 percent to 14 percent of male users) as among those who do not (9 percent to 11 percent of male nonusers). The high rates of affective disorders among women and of substance abuse among male medical service users underscore the need to increase the ability of general medical practitioners to recognize and manage or refer these conditions. Handle: RePEc:aph:ajpbhl:1987:77:1:18-24_0 Template-Type: ReDIF-Article 1.0 Title: Contraceptive usage during lactation in the United States: An update Journal: American Journal of Public Health Author-Name: Ford, K. Author-Name: Labbok, M. Year: 1987 Volume: 77 Issue: 1 Pages: 79-81 Abstract: National Surveys of Family Growth data showed that as of 1982, most lactating women who were sexually active used a contraceptive method; barrier methods were most frequently used. Black women and women of higher parity and lower educational level were more likely to be sexually active and not using a method. Handle: RePEc:aph:ajpbhl:1987:77:1:79-81_2 Template-Type: ReDIF-Article 1.0 Title: Feasibility of large-scale cholesterol screening: Experience with a portable capillary-blood testing device Journal: American Journal of Public Health Author-Name: Greenland, P. Author-Name: Levenkron, J.C. Author-Name: Radley, M.G. Author-Name: Baggs, J.G. Author-Name: Manchester, R.A. Author-Name: Bowley, N.L. Year: 1987 Volume: 77 Issue: 1 Pages: 73-75 Abstract: We conducted a voluntary cholesterol screening in a medical/occupational setting using the Eastman Kodak Ektachem (desk top) blood analyzer. In 10 hours, five technicians performed a finger-stick puncture on 1,081 screenees, 17.7 percent of whom were classified as moderate-to-high risk. The cost per screenee was under $3; cost per moderate-to-high risk case was under $16. Turn-around time from check-in to report of result was under one hour. This project suggests the feasibility and acceptability of large-scale cholesterol blood screening. Handle: RePEc:aph:ajpbhl:1987:77:1:73-75_6 Template-Type: ReDIF-Article 1.0 Title: Evaluation of public health preschool child development screening. The process and outcomes of a community program Journal: American Journal of Public Health Author-Name: Cadman, D. Author-Name: Chambers, L.W. Author-Name: Walter, S.D. Author-Name: Ferguson, R. Author-Name: Johnston, N. Author-Name: McNamee, J. Year: 1987 Volume: 77 Issue: 1 Pages: 45-51 Abstract: We conducted a randomized controlled trial of a public health and education screening program aimed at all 4,797 four to five year old children registering for kindergarten in three school districts of southern Ontario, Canada. Children received either the Denver Developmental Screening Test (DDST) with a community health intervention program for positive screenees; the DDST with no intervention for positive screenees; or no screening test. The intervention program consisted of referral to the child's physician for assessment; a review conference between the child's teacher and the school health nurse; parent counseling; and monitoring of the child in school by the school health nurse. At the end of the third school year, no differences were found between positive screenees in the community health intervention group and the 'no intervention' groups using individual academic achievement, cognitive, and developmental tests. Parents' reports revealed no differences between groups in children's mental, social, and behavioral well-being. However, parents of intervention program children had more worry about their child's school progress suggesting a potentially harmful labeling effect. In comparison to a random sample of children with normal DDST results, or a random sample of children who had randomly not been screened, the children with positive preschool DDSTs had substantially more school problems three years after screening. Handle: RePEc:aph:ajpbhl:1987:77:1:45-51_9 Template-Type: ReDIF-Article 1.0 Title: Seasonal affective disorder: A review of the syndrome and its public health implications Journal: American Journal of Public Health Author-Name: Jacobsen, F.M. Author-Name: Wehr, T.A. Author-Name: Sack, D.A. Author-Name: James, S.P. Author-Name: Rosenthal, N.E. Year: 1987 Volume: 77 Issue: 1 Pages: 57-60 Abstract: Seasonal affective disorder (SAD) is a disturbance of mood and behavior which resembles some seasonal changes seen in lower mammals. Like these animal seasonal changes, SAD is thought to be related to decreased sunlight during winter months. [SAD has been successfully treated with exposure to bright artificial light of higher intensity than is usually present in the home or workplace. Many people not suffering from SAD may nonetheless have seasonal changes which could be helped by environmental light supplementation. Lighting standards in the home and workplace should be re-evaluated on the basis of new knowledge of the psychobiological effects of light]. We review the literature on SAD and discuss its public health implications in the context of a typical case presentation. Handle: RePEc:aph:ajpbhl:1987:77:1:57-60_9 Template-Type: ReDIF-Article 1.0 Title: Homelessness. Journal: American Journal of Public Health Author-Name: Regna, J. Year: 1987 Volume: 77 Issue: 2 Pages: 239-240 Handle: RePEc:aph:ajpbhl:1987:77:2:239-240_1 Template-Type: ReDIF-Article 1.0 Title: Economic development, political-economic system and PQL. Journal: American Journal of Public Health Author-Name: Kwon, I.W. Year: 1987 Volume: 77 Issue: 2 Pages: 242-243 Handle: RePEc:aph:ajpbhl:1987:77:2:242-243_7 Template-Type: ReDIF-Article 1.0 Title: Physical quality of life and the political-economic system. Journal: American Journal of Public Health Author-Name: Zilberg, Y. Year: 1987 Volume: 77 Issue: 2 Pages: 240 Handle: RePEc:aph:ajpbhl:1987:77:2:240_1 Template-Type: ReDIF-Article 1.0 Title: Stocks of variola virus. Journal: American Journal of Public Health Author-Name: Henderson, D.A. Year: 1987 Volume: 77 Issue: 2 Pages: 238-239 Handle: RePEc:aph:ajpbhl:1987:77:2:238-239_4 Template-Type: ReDIF-Article 1.0 Title: Policy and p-values. Journal: American Journal of Public Health Author-Name: Thompson, W.D. Year: 1987 Volume: 77 Issue: 2 Pages: 238 Handle: RePEc:aph:ajpbhl:1987:77:2:238_3 Template-Type: ReDIF-Article 1.0 Title: HTLV III/LAV screening and blood banking. Journal: American Journal of Public Health Author-Name: Stankaitis, J.A. Author-Name: Bigos, J.P. Year: 1987 Volume: 77 Issue: 2 Pages: 239 Handle: RePEc:aph:ajpbhl:1987:77:2:239_6 Template-Type: ReDIF-Article 1.0 Title: Body mass indices and body adiposity. Journal: American Journal of Public Health Author-Name: Dayal, H.H. Year: 1987 Volume: 77 Issue: 2 Pages: 240-241 Handle: RePEc:aph:ajpbhl:1987:77:2:240-241_5 Template-Type: ReDIF-Article 1.0 Title: Cesarean rate increases in 1985. Journal: American Journal of Public Health Author-Name: Placek, P.J. Author-Name: Taffel, S.M. Author-Name: Moien, M. Year: 1987 Volume: 77 Issue: 2 Pages: 241-242 Handle: RePEc:aph:ajpbhl:1987:77:2:241-242_3 Template-Type: ReDIF-Article 1.0 Title: Statistical criteria in the interpretation of epidemiologic data Journal: American Journal of Public Health Author-Name: Thompson, W.D. Year: 1987 Volume: 77 Issue: 2 Pages: 191-194 Handle: RePEc:aph:ajpbhl:1987:77:2:191-194_6 Template-Type: ReDIF-Article 1.0 Title: Relationship of participation in food assistance programs to the nutritional quality of diets Journal: American Journal of Public Health Author-Name: Emmons, L. Year: 1987 Volume: 77 Issue: 7 Pages: 856-858 Abstract: This study describes the participation of 76 low-income families in six food assistance programs, and analyzes their diets using 24-hour recalls collected weekly during one month. Larger families participated in more food assistance programs than smaller families but did not have diets with higher nutrient content. Although 71 per cent of the families participated in more than the Food Stamp Program (FSP), many did not consume nutrients supposedly available with the FSP alone. Handle: RePEc:aph:ajpbhl:1987:77:7:856-858_9 Template-Type: ReDIF-Article 1.0 Title: Stop smoking advice by physicians: A feasible approach? Journal: American Journal of Public Health Author-Name: Folsom, A.R. Author-Name: Grimm Jr., R.H. Year: 1987 Volume: 77 Issue: 7 Pages: 849-850 Abstract: To understand the effect of brief stop smoking advice by physicians, we conducted a randomized clinical trial in 258 smokers. After three months, 8.8 per cent of the intervention group and 6.8 per cent of the control group had become nonsmokers. The intervention group also reported significantly more attempts to quit and/or cut down. At follow-up, only 60 per cent recalled receiving a smoking message and only 85 per cent of these perceived it as a message to quit. Handle: RePEc:aph:ajpbhl:1987:77:7:849-850_5 Template-Type: ReDIF-Article 1.0 Title: Nuclear free zones Journal: American Journal of Public Health Author-Name: Christoffel, T. Year: 1987 Volume: 77 Issue: 7 Pages: 869-873 Handle: RePEc:aph:ajpbhl:1987:77:7:869-873_1 Template-Type: ReDIF-Article 1.0 Title: Selecting presumably radiogenic cancers for compensation. Journal: American Journal of Public Health Author-Name: Johnson, C.J. Year: 1987 Volume: 77 Issue: 1 Pages: 93-94 Handle: RePEc:aph:ajpbhl:1987:77:1:93-94_6 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of premenstrual symptoms Journal: American Journal of Public Health Author-Name: Boyle, C.A. Author-Name: Berkowitz, G.S. Author-Name: Kelsey, J.L. Year: 1987 Volume: 77 Issue: 3 Pages: 349-350 Abstract: We examined the prevalence of selected premenstrual symptoms among 520 Connecticut women in relation to demographic, reproductive, contraceptive, and medical characteristics. The prevalence ranged from 39 per cent for breast swelling to 81 per cent for premenstrual weight gain. Socioeconomic status, race, history of benign breast disease, bra cup size, and history of abortions were some of the factors associated with premenstrual symptoms. Handle: RePEc:aph:ajpbhl:1987:77:3:349-350_4 Template-Type: ReDIF-Article 1.0 Title: Elective foot surgery: Relative roles of doctors of podiatric medicine and orthopedic surgeons Journal: American Journal of Public Health Author-Name: Weiner, J.P. Author-Name: Steinwachs, D.M. Author-Name: Frank, R.G. Author-Name: Schwartz, K.J. Year: 1987 Volume: 77 Issue: 8 Pages: 987-992 Abstract: We examined the roles of Doctors of Podiatric Medicine (DPMs) and orthopedic surgeons in the provision of foot surgery by analyzing the 1982 computerized claims of over 1.1 million federal employees, retirees, and family members. We found that DPMs provided over 60 per cent of all elective insured foot surgery. Without being able to adjust for the severity of the patient's underlying condition or the appropriateness and outcome of the surgery, the average per procedure charge submitted by an orthopedist was 17 per cent higher than that of a DPM; orthopedists were five times as likely to perform a procedure on an inpatient basis, and admitted patients to a hospital had longer stays; DPMs perform a greater number of procedures per episode, but their overall charges during the average foot surgery episode were 30 per cent lower, primarily because of their lower hospitalization rates. The possible impact of recent changes in health care delivery on the DPM/orthopedist practice comparison are discussed as are several questions regarding the quality and need of the care provided by these two groups. Handle: RePEc:aph:ajpbhl:1987:77:8:987-992_9 Template-Type: ReDIF-Article 1.0 Title: The initial effects of the prospective payment system on nursing home patients Journal: American Journal of Public Health Author-Name: Lewis, M.A. Author-Name: Leake, B. Author-Name: Leal-Sotelo, M. Author-Name: Clark, V. Year: 1987 Volume: 77 Issue: 7 Pages: 819-821 Abstract: We examined the discharge outcomes and admission characteristics of patients admitted to Southern California skilled nursing facilities (SNFs) for the first time following an episode of hospitalization in 1980, 1982-83 (all pre-prospective payment system), and all admissions during July through September 1984 (post-prospective payment). The proportion of patients covered by Medicare on admission was 18 per cent in 1980, 36 per cent in 1982-83, and 57 per cent in 1984. For patients discharged within 30-60 days to SNFs, in all three time periods more Medicare than non-Medicare patients were bed-bound, had indwelling catheters, and were comatose. There were only modest case-mix differences between the groups and no changes over time in discharge outcomes, including the proportion dying in the SNF, or being returned to a hospital. The time-related changes that were found preceded the implementation of the diagnosis related group (DRG) based prospective payment system. Handle: RePEc:aph:ajpbhl:1987:77:7:819-821_5 Template-Type: ReDIF-Article 1.0 Title: A methodology for identifying workers exposed to asbestos since 1940 Journal: American Journal of Public Health Author-Name: Stanbury, M. Author-Name: Rosenman, K.D. Year: 1987 Volume: 77 Issue: 7 Pages: 854-855 Abstract: This paper describes a method to identify individual workplaces and to determine the number of employees at those workplaces who have had substantial exposure to asbestos. A total of 486,400 individuals are estimated to have had substantial exposure to asbeston in New Jersey since the start of World War II, including 102,700 individuals from 16 manufacturing plants, 376,200 from eight shipyards, and 7,500 insulators. Handle: RePEc:aph:ajpbhl:1987:77:7:854-855_2 Template-Type: ReDIF-Article 1.0 Title: Patterns of physicians' use of medical resources in ambulatory settings Journal: American Journal of Public Health Author-Name: Hartley, R.M. Author-Name: Charlton, J.R. Author-Name: Harris, C.M. Author-Name: Jarman, B. Year: 1987 Volume: 77 Issue: 5 Pages: 565-567 Abstract: We studied British general practitioners' use of ambulatory resources to determine whether the quantities of different resources used were related to each other, and whether these quantities were associated with their personal characteristics. Rates of laboratory requests, referrals for specialty opinion, prescriptions, and visits per patient per year were examined for 21 physicians in seven practices over one year. Physicians who more frequently saw their patients referred and prescribed for them more often and ordered more tests, once the number of years they had practiced was taken into account. Doctors who ordered more tests referred their patients more frequently, regardless of how often they saw them. Doctors longer in practice saw and prescribed for their patients more frequently. Resource use was not related to other personal characteristics we studied. Greater frequency of patient-physician contact appears to increase costs not only through use of more professional time but also through greater use of other ambulatory resources. Attention to the use of only one type of resource may result in a distorted picture of how physicians care for their patients and the costs that such care incurs. Handle: RePEc:aph:ajpbhl:1987:77:5:565-567_5 Template-Type: ReDIF-Article 1.0 Title: Survey of injury prevention knowledge among low-income families Journal: American Journal of Public Health Author-Name: Baldwin, S. Author-Name: Fisher, L. Author-Name: Simon, J. Year: 1987 Volume: 77 Issue: 8 Pages: 1014 Handle: RePEc:aph:ajpbhl:1987:77:8:1014_3 Template-Type: ReDIF-Article 1.0 Title: Rubella in the workplace: The need for employee immunization Journal: American Journal of Public Health Author-Name: Goodman, A.K. Author-Name: Friedman, S.M. Author-Name: Beatrice, S.T. Author-Name: Bart, S.W. Year: 1987 Volume: 77 Issue: 6 Pages: 725-726 Abstract: From 1983 to 1985, the New York City Department of Health investigated five workplace outbreaks of rubella. Approximately 40 per cent of the 265 cases were detected among women of child-bearing age (15-44 years). Data are reviewed from the 1983 Financial District outbreak to illustrate the continued susceptibility of young adults, the missed opportunities for rubella immunization, and the danger of congenital infection. A comprehensive rubella immunization program is required to protect pregnant women and eliminate congenital rubella. As one important component of this effort, employee health physicians are urged to assess the immune status of women of child-bearing age and to vaccinate all susceptibles who are not pregnant. Handle: RePEc:aph:ajpbhl:1987:77:6:725-726_3 Template-Type: ReDIF-Article 1.0 Title: Nicotine yield and measures of cigarette smoke exposure in a large population: Are lower-yield cigarettes safer? Journal: American Journal of Public Health Author-Name: Maron, D.J. Author-Name: Fortmann, S.P. Year: 1987 Volume: 77 Issue: 5 Pages: 546-549 Abstract: We examined the relationship of machine-estimated nicotine yield by cigarette brand with the level of cigarette consumption and two biochemical measures of smoke exposure (expired-air carbon monoxide and plasma thiocyanate) in a large, population-based sample of smokers (N = 713). The lower the nicotine yield of the cigarette, the greater the number of cigarettes smoked per day. Prior to adjusting for number of cigarettes smoked per day, nicotine yield was not related to the actual measures of smoke exposure. Smokers of ultralow-yield cigarettes had laboratory tests of smoke exposure which were not significantly different from those of smokers of higher-yield brands. Only after adjustment for number of cigarettes smoked per day did nicotine yield become significantly related to expired-air carbon monoxide and to plasma thiocyanate. In multivariate analysis, the number of cigarettes smoked per day accounted for 28 per cent and 22 per cent of the variance in observed expired-air carbon monoxide and plasma thiocyanate levels, respectively, whereas nicotine yield accounted for only 1 per cent and 2 per cent of the variance, respectively. The relative lack of an effect of nicotine yield on the biochemical measure appears to be due to the fact that smokers of lower nicotine brands smoked more cigarettes per day, thereby compensating for reduced delivery of smoke products. Our data do not support the concept that ultralow-yield cigarettes are less hazardous than others. Machine estimates suggesting low nicotine yield underrepresent actual human consumption of harmful cigarette constituents. Handle: RePEc:aph:ajpbhl:1987:77:5:546-549_8 Template-Type: ReDIF-Article 1.0 Title: Alcohol use and depression symptoms among employed men and women Journal: American Journal of Public Health Author-Name: Parker, D.A. Author-Name: Parker, E.S. Author-Name: Harford, T.C. Author-Name: Farmer, G.C. Year: 1987 Volume: 77 Issue: 6 Pages: 704-707 Abstract: A representative sample of 1,367 employed men and women in Detroit responded to questions about drinking practices and symptoms of depression. After controlling for age, education, family income, marital status, medication use, fathers' drinking, and other variables, increased quantity of alcohol consumed per drinking occasion was associated with increased depression symptoms in the sober state among men and women. Depression symptoms may be one of a group of not fully identified drug after-effect disorders involving psychological functioning. Handle: RePEc:aph:ajpbhl:1987:77:6:704-707_3 Template-Type: ReDIF-Article 1.0 Title: Risk factors for endemic giardiasis Journal: American Journal of Public Health Author-Name: Chute, C.G. Author-Name: Smith, R.P. Author-Name: Baron, J.A. Year: 1987 Volume: 77 Issue: 5 Pages: 585-587 Abstract: In a mail survey, 171 Hitchcock Clinic patients with giardiasis were compared with an age- and sex-matched control group of 684 clinic patients with respect to potential risk factors. Households with shallow well or surface water sources had an odds ratio (OR) for giardiasis of 2.1 (95% confidence interval (95%CI) 1.3-3.2) compared with households with drilled well or municipal water supply. Other observed risks include family member in day care program (OR 2.2, 95%CI 1.3-3.7) and family member with diagnosed giardiasis (OR 17, 95%CI 7.4-37). Previously reported risks such as travel out of country (OR 3.2, 95%CI 1.5-7.2) and camping (OR 1.7, 95%CI 0.9-3.2) were also observed. Virtually no giardiasis risk was observed associated with report of dog or barnyard animal proximity. Control for confounding and adjustment for recall and non-response bias does not materially alter the risk estimates. We suggest that shallow well or surface household water source is an important and previously unrecognized giardiasis risk factor. Handle: RePEc:aph:ajpbhl:1987:77:5:585-587_4 Template-Type: ReDIF-Article 1.0 Title: Mental illness and primary care. Journal: American Journal of Public Health Author-Name: Shepherd, M. Year: 1987 Volume: 77 Issue: 1 Pages: 12-13 Handle: RePEc:aph:ajpbhl:1987:77:1:12-13_0 Template-Type: ReDIF-Article 1.0 Title: Prevention of tap water scald burns: Evaluation of a multi-media injury control program Journal: American Journal of Public Health Author-Name: Katcher, M.L. Year: 1987 Volume: 77 Issue: 9 Pages: 1195-1197 Abstract: A prospective study was designed to evaluate a mass media injury prevention program reaching two million people to determine its impact on risk awareness of hot tap water burns and injury-prevention behavior. Liquid-crystal thermometers for testing hot water temperature were offered at no cost; 140,000 were requested. Pre- and post-program general population random surveys (N = 337 and 318, respectively) found increased awareness of the danger of hot tap water, from 72 per cent to 89 per cent, but no increase in testing or lowering of water heater temperatures. A third random sample survey (N = 325) among thermometer requesters found a higher rate of testing (difference 58.1 per cent, 95 per cent CL 55.3 per cent, 60.9 per cent) than in the general population. Of those who tested, 43 per cent reported temperatures in the dangerous range of 54.4°C (130°F) or greater; 52 per cent of this group lowered their water heater thermostat. These findings indicate that: more than 25 per cent of the public is unaware of the potential danger of hot tap water; a safety education program which increases awareness will not necessarily result in injury-control behavior; and most people motivated to request a free thermometer will test their hot water temperature and lower it if necessary. As a result of this effort, thermostats of an estimated 20,000 water heaters were lowered from dangerously high levels. Handle: RePEc:aph:ajpbhl:1987:77:9:1195-1197_9 Template-Type: ReDIF-Article 1.0 Title: Cancer mortality among Mexican Americans and other Whites in Texas, 1969-80 Journal: American Journal of Public Health Author-Name: Martin, J. Author-Name: Suarez, L. Year: 1987 Volume: 77 Issue: 7 Pages: 851-853 Abstract: Cancer mortality in Texas 1969-80 was 25 per cent lower among Mexican American males compared to other Whites; among females, rates were only 4 per cent lower. Reduced mortality was primarily a result of lower rates for cancers of the most common sites: lung, colon, breast and prostate. However, for cancers of the stomach, liver, and gallbladder, Mexican Americans had higher rates than other Whites. Female Mexican Americans were also at a higher mortality risk for cervical cancer. Implications are discussed. Handle: RePEc:aph:ajpbhl:1987:77:7:851-853_9 Template-Type: ReDIF-Article 1.0 Title: Spontaneous cigarette brand switching: Consequences for nicotine and carbon monoxide exposure Journal: American Journal of Public Health Author-Name: Lynch, C.J. Author-Name: Benowitz, N.L. Year: 1987 Volume: 77 Issue: 9 Pages: 1191-1194 Abstract: A group of smokers who had participated in smoking-related studies three to six years earlier were re-studied to assess changes in their smoking practices. Individuals who smoked the same brands of cigarettes showed no change in plasma cotinine (reflecting exposure to nicotine) or expired carbon monoxide (CO) concentration. Those who switched to cigarettes of lower nicotine yield (average decrease 38 per cent) showed reduced plasma cotinine concentrations, due primarily to smoking fewer cigarettes per day. The intake of nicotine per cigarette was not different. Subjects who smoked cigarettes of higher yield (102 per cent increase) had higher cotinine and CO levels, due to greater intake per cigarette. Handle: RePEc:aph:ajpbhl:1987:77:9:1191-1194_6 Template-Type: ReDIF-Article 1.0 Title: Hispanic/Latino--what's in a name? Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1987 Volume: 77 Issue: 1 Pages: 15-17 Handle: RePEc:aph:ajpbhl:1987:77:1:15-17_5 Template-Type: ReDIF-Article 1.0 Title: Mortality rates among opioid addicts in a longitudinal study Journal: American Journal of Public Health Author-Name: Joe, G.W. Author-Name: Simpson, D.D. Year: 1987 Volume: 77 Issue: 3 Pages: 347-348 Abstract: Mortality rates and survival curves were estimated for a sample of opioid addicts who had survived to an initial six-year follow-up interview. A total of 52 of the 555 addicts died between the six-year and 12-year follow-up interviews, which corresponds to an average of 13.8 deaths/1,000 person years. This rate is 6.9 times greater than the general population, adjusting for age. Approximately 29 per cent of the deaths were due to violence and 48 per cent to drugs. Handle: RePEc:aph:ajpbhl:1987:77:3:347-348_2 Template-Type: ReDIF-Article 1.0 Title: Trends in the United States cesarean section rate and reasons for the 1980-85 rise Journal: American Journal of Public Health Author-Name: Taffel, S.M. Author-Name: Placek, P.J. Author-Name: Liss, T. Year: 1987 Volume: 77 Issue: 8 Pages: 955-959 Abstract: The rate of cesarean section delivery in the United States rose from 4.5 per 100 deliveries in 1965 to 22.7 in 1985, and in 1985 an estimated 851,000 live births were cesarean deliveries, according to data from the National Hospital Discharge Survey. This increase has been observed for all ages, and within all regions of the country. The rate for teenagers and mothers aged 20 to 29 was five to six times as high in 1985 as in 1965, and four times as high for mothers aged 30 years and older. Repeat cesareans account for an increasing share of all cesarean deliveries; in 1985 one in three cesareans were repeats. The increase in the cesarean rate of 6.2 percentage points between 1980 and 1985 (from 16.5 to 22.7) was partitioned according to five complications of delivery recorded on hospital discharge records: previous cesarean delivery, breech presentation, dystocia, fetal distress, and all other complications. Nearly half (48 per cent) of the increase was associated with prevous cesarean delivery, 29 per cent with dystocia, 16 per cent with fetal distress, 5 per cent with breech presentation, and 2 per cent with all other complications. Handle: RePEc:aph:ajpbhl:1987:77:8:955-959_4 Template-Type: ReDIF-Article 1.0 Title: The epidemiology of end-stage renal disease: The six-year south-central Los Angeles experience, 1980-85 Journal: American Journal of Public Health Author-Name: Ferguson, R. Author-Name: Grim, C.E. Author-Name: Opgenorth, T.J. Year: 1987 Volume: 77 Issue: 7 Pages: 864-865 Abstract: Using the End-Stage Renal Disease Medical Information System and 1980 census information, the crude cumulative incidence among Blacks, Hispanics, and Whites in south central Los Angeles was determined to be 160.1, 49.28, and 55.3 per 100,000 respectively. Sex-specific rates were slightly greater in males. Among Blacks, nephrosclerosis and diabetes represented 41.5 and 30.2 per cent of the cases respectively and increased during the period 1980-85. Handle: RePEc:aph:ajpbhl:1987:77:7:864-865_6 Template-Type: ReDIF-Article 1.0 Title: Worksite smoking cessation using nicotine resin gum (Nicorette®) Journal: American Journal of Public Health Author-Name: Plank, S.J. Year: 1987 Volume: 77 Issue: 8 Pages: 1013-1014 Abstract: A worksite smoking cessation program using Nicorette, with or without self-help manuals, has not been reported previously. The gum is usually recommended only as an adjunct to a structured program or with individual counseling and support from a physician. Because of the cost in time and money, however, those options were not feasible for Shasta County. The relatively low-cost alternative described here was designed as an employee benefit which would pay for itself; it was not a research project. Interpreted with the corresponding limitations in mind, this report may be useful to other publich health practitioners. The Shasta County Public Health Department now offers nicotine poliacrilex gum with counseling among its clinic services and as an adjunct to the smoking cessation programs provided locally by the American Lung Association and the American Cancer Society. Handle: RePEc:aph:ajpbhl:1987:77:8:1013-1014_9 Template-Type: ReDIF-Article 1.0 Title: Investigation of occupational cancer clusters: Theory and practice Journal: American Journal of Public Health Author-Name: Schulte, P.A. Author-Name: Ehrenberg, R.L. Author-Name: Singal, M. Year: 1987 Volume: 77 Issue: 1 Pages: 52-56 Abstract: Local and federal government agencies are often asked to investigate apparent clusters of cancer in communities or workplaces. Often these investigations cannot utilize the methods that have been developed for evaluation of disease clusters because the clusters are too small, and the populations to be studied and the periods of time to be covered are determined in an a posteriori manner. Still, government investigators are called upon to render an official opinion of the apparent clusters. Application of a theoretical approach to cluster analysis must give way to a more pragmatic approach. A review of 61 investigations of apparent clusters conducted by the National Institute of Occupational Safety and Health (NIOSH) during the period 1978-84 showed that most of the clusters contained five or fewer cases and had no plausible occupational etiology. Despite the few clusters that were identified, these investigations generally provided a service to workers and employers who were concerned about occupational cancer. Handle: RePEc:aph:ajpbhl:1987:77:1:52-56_2 Template-Type: ReDIF-Article 1.0 Title: Cigarette smoking and changes in smoking among a cohort of Michigan adults, 1980-82 Journal: American Journal of Public Health Author-Name: Kirscht, J.P. Author-Name: Brock, B.M. Author-Name: Hawthorne, V.M. Year: 1987 Volume: 77 Issue: 4 Pages: 501-502 Abstract: Factors related to cigarette smoking and to changes over two years were investigated in a sample of Michigan adults. Smoking was associated with age, sex, education, occupation, and beliefs regarding its health effects. Cessation was predicted by amount smoked at baseline, desire to stop, and belief concerning difficulty stopping. Starting smoking was associated with time off cigarettes (negatively), age, belief about health effects, sex, and education. Heavy smoking and maintenance of cessation are major problems. Handle: RePEc:aph:ajpbhl:1987:77:4:501-502_2 Template-Type: ReDIF-Article 1.0 Title: The effect of physician terminology preference on coronary heart disease mortality: An artifact uncovered by the 9th revision ICD Journal: American Journal of Public Health Author-Name: Sorlie, P.D. Author-Name: Gold, E.B. Year: 1987 Volume: 77 Issue: 2 Pages: 148-152 Abstract: We dual coded 2,268 deaths due to heart disease occurring in Maryland, using the 8th and 9th revisions of the International Classification of Diseases (ICDA-8, Adapted for Use in the United States, and ICD-9). Certifier preference was for generalized cardiovascular terms rather than terms specific to the heart, resulting in an artifactual change in chronic ischemic heart disease death (IHD) rates in Maryland between 1978 and 1979 because the 8th and 9th ICD revisions classified these terms differently. Medical examiners were more likely to use these generalized cardiovascular terms as were physicians who went to certain medical schools in the state. The physician's terminology preference was associated with the sex and race of the decedent and was related to aspects of the patient's medical care. The ICD should be modified in the 10th revision to allow for the separate classification of generalized cardiovascular terminology within the ischemic heart disease category. Handle: RePEc:aph:ajpbhl:1987:77:2:148-152_7 Template-Type: ReDIF-Article 1.0 Title: Exposure to aerial malathion application and the occurrence of congenital anomalies and low birthweight Journal: American Journal of Public Health Author-Name: Grether, J.K. Author-Name: Harris, J.A. Author-Name: Neutra, R. Author-Name: Kizer, K.W. Year: 1987 Volume: 77 Issue: 8 Pages: 1009-1010 Abstract: The association between exposure to low dose malathion, after its aerial application to 13,000 square miles in the San Francisco Bay area, and the occurrence of birth defects and low birthweight was examined using newborn hospital discharge data and vital records. No biological plausible pattern of association was found. Limitation in the data and analysis are discussed. Handle: RePEc:aph:ajpbhl:1987:77:8:1009-1010_4 Template-Type: ReDIF-Article 1.0 Title: Smoking during pregnancy, 1967-80 Journal: American Journal of Public Health Author-Name: Kleinman, J.C. Author-Name: Kopstein, A. Year: 1987 Volume: 77 Issue: 7 Pages: 823-825 Abstract: Data from two national samples of live births to married mothers (the 1967 and 1980 National Natality Surveys) were used to document changes in smoking during pregnancy. Smoking among married teenagers remained essentially constant between 1967 and 1980. For married mothers age 20 and over, the prevalence of smoking during pregnancy decreased from 40 to 25 per cent among Whites and 33 to 23 per cent among Blacks. There were striking differences in the magnitude of the decrease by educational attainment. Among the White married mothers age 20 and over, the prevalence of smoking during pregnancy decreased from 48 to 43 per cent for those with less than 12 years education and from 34 to 11 per cent for those with 16 or more years education. Handle: RePEc:aph:ajpbhl:1987:77:7:823-825_5 Template-Type: ReDIF-Article 1.0 Title: Beyond the confidence interval Journal: American Journal of Public Health Author-Name: Poole, C. Year: 1987 Volume: 77 Issue: 2 Pages: 195-199 Handle: RePEc:aph:ajpbhl:1987:77:2:195-199_9 Template-Type: ReDIF-Article 1.0 Title: Nonpowder firearm injuries: Whose job is it to protect children? Journal: American Journal of Public Health Author-Name: Christoffel, T. Author-Name: Christoffel, K. Year: 1987 Volume: 77 Issue: 6 Pages: 735-738 Handle: RePEc:aph:ajpbhl:1987:77:6:735-738_2 Template-Type: ReDIF-Article 1.0 Title: Reliability of reporting nosocomial infections in the discharge abstract and implications for receipt of revenues under prospective reimbursement Journal: American Journal of Public Health Author-Name: Massanari, R.M. Author-Name: Wilkerson, K. Author-Name: Streed, S.A. Author-Name: Hierholzer Jr., W.J. Year: 1987 Volume: 77 Issue: 5 Pages: 561-564 Abstract: Proper reporting of discharge diagnoses, including complications of medical care, is essential for maximum recovery of revenues under the prospective reimbursement system. To evaluate the effectiveness of abstracting techniques in identifying nosocomial infections at discharge, discharge abstracts of patients with nosocomial infections were reviewed during September through November of 1984. Patients with nosocomial infections were identified using modified Centers for Disease Control (CDC) definitions and trained surveillance technicians. Records which did not include the diagnosis of nosocomial infections in the discharge abstract were identified, and potential lost revenues were estimated. We identified 631 infections in 498 patients. On average, only 57 per cent of the infections were properly recorded and coded in the discharge abstract. Of the additional monies which might be anticipated by the health care institution to assist in the cost of care of adverse events, approximately one-third would have been lost due to errors in coding in the discharge abstract. Although these lost revenues are substantial, they constitute but a small proportion of the potential costs to the institution when patients acquire nosocomial infections. Handle: RePEc:aph:ajpbhl:1987:77:5:561-564_8 Template-Type: ReDIF-Article 1.0 Title: On the comparison of effects Journal: American Journal of Public Health Author-Name: Thompson, W.D. Year: 1987 Volume: 77 Issue: 4 Pages: 491-492 Handle: RePEc:aph:ajpbhl:1987:77:4:491-492_1 Template-Type: ReDIF-Article 1.0 Title: Impact of growing numbers of the very old on Medicaid expenditures for nursing homes: A multi-state, population-based analysis Journal: American Journal of Public Health Author-Name: Ray, W.A. Author-Name: Federspiel, C.F. Author-Name: Baugh, D.K. Author-Name: Dodds, S. Year: 1987 Volume: 77 Issue: 6 Pages: 699-703 Abstract: We utilized Medicaid data from five states which account for 39 per cent of Medicaid expenditures to study the impact of the near-trembling of persons age 85 and older (the very old) projected to occur by the year 2012 upon Medicaid nursing home expenditures. We found a one-year prevalence of Medicaid-covered nursing home residence of 20 per 100 among the very old. If this rate continues, with no changes in current levels of Medicaid nursing home payments, and if population forecasts are accurate, increasing numbers of the very old will generate an additional $6.3 billion (1982 dollars) annually of Medicaid nursing home payments by 2012: an increase of 280 per cent from 1982 levels. The stress this trend will place upon societal ability to check growth in public expenditures for medical care while maintaining basic services for other low income populations will be an important force shaping public health policy in the next 25 years. Handle: RePEc:aph:ajpbhl:1987:77:6:699-703_3 Template-Type: ReDIF-Article 1.0 Title: Drowning in childhood and adolescence: A population-based study Journal: American Journal of Public Health Author-Name: Wintemute, G.J. Author-Name: Kraus, J.F. Author-Name: Teret, S.P. Author-Name: Wright, M. Year: 1987 Volume: 77 Issue: 7 Pages: 830-832 Abstract: We present the results of a residence-based study of drownings among Sacramento County, California children and adolescents ages 0-19 years for the years 1974-84. Children ages 1-3 had the highest drowning rates. The majority of drownings in this group, and one-third of all drownings in the study, occurred in residential swimming pools. Males ages 15-19 had a high drowning rate as well; at least 38 per cent of drownings in that age group were alcohol-associated. The implications for preventive efforts are discussed. Handle: RePEc:aph:ajpbhl:1987:77:7:830-832_3 Template-Type: ReDIF-Article 1.0 Title: The validity of health risk appraisal instruments for assessing coronary heart disease risk Journal: American Journal of Public Health Author-Name: Smith, K.W. Author-Name: McKinlay, S.M. Author-Name: Thorington, B.D. Year: 1987 Volume: 77 Issue: 4 Pages: 419-424 Abstract: This study evaluated the validity of the scoring systems employed by 41 health risk assessment instruments (HRAs) with respect to the probability of death due to coronary artery disease. Validity was assessed by comparing predictions of mortality risk produced by each HRA to estimates from the Framingham Heart Study and the Risk Factor Update Project. Correlations with both epidemiologic estimates indicated that instruments employing logistic regression or the Geller/Gesner methodology had the highest validity coefficients, while validity was lowest for self-administered general health status and lifestyle questionnaires. However, most instruments using the Geller/Gesner technique appear to systematically overestimate the probability of CHD mortality. For HRAs based on additive risk scales, validity was often attenuated by the crude categorization of some risk factors and by the omission of the effects of age from the scoring system. Handle: RePEc:aph:ajpbhl:1987:77:4:419-424_6 Template-Type: ReDIF-Article 1.0 Title: Public health and chronic mental illness Journal: American Journal of Public Health Author-Name: Westermeyer, J. Year: 1987 Volume: 77 Issue: 6 Pages: 667-668 Handle: RePEc:aph:ajpbhl:1987:77:6:667-668_9 Template-Type: ReDIF-Article 1.0 Title: Shigellosis outbreak associated with swimming Journal: American Journal of Public Health Author-Name: Makintubee, S. Author-Name: Mallonee, J. Author-Name: Istre, G.R. Year: 1987 Volume: 77 Issue: 2 Pages: 166-168 Abstract: In June 1982, an outbreak of gastrointestinal illness caused by Shigella sonnei occurred among residents of two counties in Oklahoma. A case-control study of cases and age and sex-matched controls showed an association with attendance at a southern Oklahoma lake (14/17 cases vs 3/17 controls, matched pair odds ratio [OR] 9/0, confidence interval [CI] 2.4-infinity). A survey of 85 persons who had visited the lake area showed that persons who had swum were more likely to have been ill with a gastrointestinal illness (50 per cent) than persons who had not swum (0 per cent); among those who had swum, illness was more frequent among those who reported having water in their mouths while swimming (62 per cent) than those who did not (19 per cent) (OR = 6.9, 95% CI = 2.2-21.5). No further primary lake-associated cases had onset of symptoms beyond two days of closing the reservoir. Swimming should be considered as a potential source of enteric infections. Handle: RePEc:aph:ajpbhl:1987:77:2:166-168_1 Template-Type: ReDIF-Article 1.0 Title: Putting the brakes on lawbreaking: State bans on radar detectors Journal: American Journal of Public Health Author-Name: Christoffel, T. Year: 1987 Volume: 77 Issue: 4 Pages: 507-511 Handle: RePEc:aph:ajpbhl:1987:77:4:507-511_7 Template-Type: ReDIF-Article 1.0 Title: Depressive symptomatology in Northern Mexico adults Journal: American Journal of Public Health Author-Name: Vega, W.A. Author-Name: Kolody, B. Author-Name: Hough, R.L. Author-Name: Figueroa, G. Year: 1987 Volume: 77 Issue: 9 Pages: 1215-1218 Abstract: A cross-sectional field survey of 991 people in Tijuana, Mexico, a border city experiencing unbridled population growth, was designed to measure levels of depressive symptoms and identify correlates using the Center for Epidemiological Studies Depression measure (CES-D). Bivariate and multivariate analyses of the data indicate that similar variables are highly associated with depressive symptoms in the US and Mexico: low socioeconomic status, female gender, disrupted marital status, unemployment, and poor health. Risk-for-caseness is 19.1 per cent for males and 33.0 per cent for females. Handle: RePEc:aph:ajpbhl:1987:77:9:1215-1218_8 Template-Type: ReDIF-Article 1.0 Title: Circumcision as a risk factor for urethritis in racial groups Journal: American Journal of Public Health Author-Name: Smith, G.L. Author-Name: Greenup, R. Author-Name: Takafuji, E.T. Year: 1987 Volume: 77 Issue: 4 Pages: 452-454 Abstract: A retrospective population-based case-control study of sexually transmitted urethritis was conducted at a large military base over a 21-month period. During the study, 9,514 patients were seen for sexually transmitted disease. The analysis was restricted to active duty males and showed that Blacks had 14.8 times the incidence rate of gonoccocal urethritis (GCU) and 4.7 times the rate of nongonococcal urethritis (NGU) compared to Whites. There were slightly fewer cases of NGU than GCU. A case-control study of active duty soldiers showed that both Black and White circumcised subjects were 1.65 times as likely to have NGU as uncircumcised subjects (95% CI: 1.37-2.00). However, circumcision was not associated with an increased incidence of GCU. Handle: RePEc:aph:ajpbhl:1987:77:4:452-454_4 Template-Type: ReDIF-Article 1.0 Title: Mass media and smoking cessation: A critical review Journal: American Journal of Public Health Author-Name: Flay, B.R. Year: 1987 Volume: 77 Issue: 2 Pages: 153-160 Abstract: Evaluations of 40 mass media programs/campaigns designed to influence cigarette smoking were reviewed. Information/motivation programs/campaigns generally produced changes in awareness, knowledge, and attitudes. Extensive national champaigns also produced meaningful behavioral change. Programs/campaigns designed to promote some specific smoking-related action produced mixed results, depending in large part on the type of promotion involved. Mass media cessation clinics were found to be effective, with media plus social support being more effective than viewing plus printed material, and either combination being more effective than viewing alone. It was concluded that mass media health promotion programs can be more effective than many academics may have thought, but that the knowledge necessary to ensure such success is seriously lacking. Research studies, rather than simple evaluations, are needed to improve our knowledge base and build a science of mass media health promotion. Handle: RePEc:aph:ajpbhl:1987:77:2:153-160_0 Template-Type: ReDIF-Article 1.0 Title: Continuance of elderly on home-delivered meals programs Journal: American Journal of Public Health Author-Name: Frongillo Jr., E.A. Author-Name: Williamson, D.F. Author-Name: Roe, D.A. Author-Name: Scholes, J.E. Year: 1987 Volume: 77 Issue: 9 Pages: 1176-1179 Abstract: Data from 2,002 elderly receiving home-delivered meals in 23 counties of New York State in 1984-85 were analyzed using a baseline survey and a six-month follow-up survey. Survival analysis estimated that 37.4 per cent of the clients left the program by the follow-up. The initial drop-out rate was estimated to be 14.2 per cent per month; by six months the rate fell to 3.3 per cent. Whites left the program at a rate 2.6 times (95% CI = 1.9, 3.8) that of minorities. Recent discharge from hospital was associated with the highest relative probability of program discontinuance (2.7, 95% CI = 2.2, 3.4), followed by having cancer (2.1, 95% CI = 1.6, 2.8), and having a non-hip fracture (2.0, 95% CI = 1.3, 2.9). Many of those with cancer died, while those recently discharged and those with non-hip fractures were more likely to leave the program because they were again able to cook for themselves. Handle: RePEc:aph:ajpbhl:1987:77:9:1176-1179_9 Template-Type: ReDIF-Article 1.0 Title: The prevalence of overweight and obesity in Britain, Canada, and United States Journal: American Journal of Public Health Author-Name: Millar, W.J. Author-Name: Stephens, T. Year: 1987 Volume: 77 Issue: 1 Pages: 38-41 Abstract: Three nations carried out large surveys of their non-institutionalized populations during the period 1976-81, with essentially similar techniques for measuring height and weight. Using criteria previously published for the British survey, we analyzed the Canadian and United States data and compared the prevalence of excessive weight for aged 20-64 in the three countries. Overweight was defined as a Quetelet index value of 25.1-30, and obesity as a value exceeding 30. Compared to their Canadian and British counterparts, American men are more likely to be overweight or obese, especially at the lower age levels. The proportion of excessively heavy men reaches a plateau around age 50 in all three countries, possibly indicative of a survivor phenomenon. Among women, the US has the highest proportion of excessively heavy individuals at all ages except 20-24; this difference is especially marked at ages 45-54. Unlike men, there is no evidence that the proportion of overweight or obese women reaches a plateau by age 64. Handle: RePEc:aph:ajpbhl:1987:77:1:38-41_3 Template-Type: ReDIF-Article 1.0 Title: Changes in patient characteristics and surgical outcomes for coronary artery bypass surgery 1972-82 Journal: American Journal of Public Health Author-Name: Rosenfeld, K. Author-Name: Luft, H.S. Author-Name: Garnick, D.W. Author-Name: McPhee, S.J. Year: 1987 Volume: 77 Issue: 4 Pages: 498-500 Abstract: Data from a national sample of hospitals were used to explore reasons for improved in-hospital survival rate for coronary artery bypass graft (CABG) surgery between 1972 and 1982. Increases in annual volumes of surgery explain a large fraction of the decline in death rates. The residual can be attributed to improved techniques, experience, and other factors, even though more operations were done on older patients and women in 1982 than 1972. Handle: RePEc:aph:ajpbhl:1987:77:4:498-500_4 Template-Type: ReDIF-Article 1.0 Title: Hepatitis B infection in a day school for mentally retarded students: Transmission from students to staff Journal: American Journal of Public Health Author-Name: Remis, R.S. Author-Name: Rossignol, M.A. Author-Name: Kane, M.A. Year: 1987 Volume: 77 Issue: 9 Pages: 1183-1186 Abstract: We carried out a seroepidemiologic study to evaluate the transmission of hepatitis B virus (HBV) from students to staff in a day school for mentally retarded students. Of 505 students tested, 37 (7.3 per cent) had HBsAg; 74 per cent of HBsAg-positive sera tested were HBeAg-positive. Of 162 staff members tested, 21 (13.0 per cent) were HBV marker positive and two (1.2 per cent) had HBsAg; specialized educators and teachers showed the highest HBV marker prevalence (22.2 per cent and 21.3 per cent, respectively). The prevalence of HBV markers among staff was independently associated with classroom contact with a HBsAg-positive student, duration of employment at the school, and previous work with mentally retarded individuals. The incidence of HBV infection among teaching staff with regular classroom contact, estimated by logistic regression analysis, was 2.6 per cent per year. This observation indicates that teaching staff in schools for mentally retarded students with direct classroom contact may carry an occupational risk of HBV infection. Handle: RePEc:aph:ajpbhl:1987:77:9:1183-1186_0 Template-Type: ReDIF-Article 1.0 Title: Advances in psychiatric epidemiology: Rates and risks for major depression Journal: American Journal of Public Health Author-Name: Weissman, M.M. Year: 1987 Volume: 77 Issue: 4 Pages: 445-451 Abstract: Over the last decade there has been a marked increase in information on the epidemiology of psychiatric disorders, particularly major depression, in adults living in the community and in families. The ability to conduct large epidemiologic studies of psychiatric disorders is due to improvements in diagnostic precision and reliability in psychiatry and to the development of systematic methods for collecting information on signs and symptoms to make diagnoses. Results from a recently completed epidemiologic survey of psychiatric disorders in five urban communities in the United States and from several large-scale family genetic studies suggest that major depression is a highly prevalent disorder. It occurs in adults and children, and there is evidence for an increased rate in younger people. The average age of first onset is in young adulthood. Most depressions are untreated. The firm risk factors for major depression include being female; young (born after World War II); separated/divorced or in an unhappy marriage; and having a family history of major depression. There is a two-to-three increased risk for major depression if there is a family history of the disorder. The relevance of these findings to clinical practice and public health is discussed. Handle: RePEc:aph:ajpbhl:1987:77:4:445-451_7 Template-Type: ReDIF-Article 1.0 Title: Marriage to a smoker and lung cancer risk Journal: American Journal of Public Health Author-Name: Humble, C.G. Author-Name: Samet, J.M. Author-Name: Pathak, D.R. Year: 1987 Volume: 77 Issue: 5 Pages: 598-602 Abstract: As part of a population-based case-control study of lung cancer in New Mexico, we have collected data on spouses' tobacco smoking habits and on-the-job exposure to asbestos. The present analyses include 609 cases and 781 controls with known passive and personal smoking status, of whom 28 were lifelong nonsmokers with lung cancer. While no effect of spouse cigarette smoking was found among current or former smokers, never smokers married to smokers had about a two-fold increased risk of lung cancer. Lung cancer risk in never smokers also increased with duration of exposure to a smoking spouse, but not with increasing number of cigarettes smoked per day by the spouse. Our findings are consistent with previous reports of elevated risk for lung cancer among never smokers living with a spouse who smokes cigarettes. Handle: RePEc:aph:ajpbhl:1987:77:5:598-602_5 Template-Type: ReDIF-Article 1.0 Title: The impact of a parental notification law on adolescent abortion decision-making Journal: American Journal of Public Health Author-Name: Blum, R.W. Author-Name: Resnick, M.D. Author-Name: Stark, T.A. Year: 1987 Volume: 77 Issue: 5 Pages: 619-620 Abstract: In 1984, we investigated the impact of a parental notification statute with judicial bypass procedures in Minnesota. Subjects were interviewed on the day of their abortion at four Minnesota and two Wisconsin clinics. Relatively few were aware of the statute in Minnesota. Parental notification rates were similar in Minnesota and Wisconsin, which has no parental notification statute. Handle: RePEc:aph:ajpbhl:1987:77:5:619-620_2 Template-Type: ReDIF-Article 1.0 Title: Training physicians for community-oriented primary care in Latin America: Model programs in Mexico, Nicaragua, and Costa Rica Journal: American Journal of Public Health Author-Name: Braveman, P.A. Author-Name: Mora, F. Year: 1987 Volume: 77 Issue: 4 Pages: 485-490 Abstract: Under the rubrics of preventive and social medicine, public health, and family and community medicine, medical educators in Latin America have developed programs to train physicians for community-oriented health care (COPC). The historical background for such programs in Latin America is reviewed. Three relevant examples of programs in Mexico, Nicaragua, and Costa Rica are highlighted, drawing on the author's direct experience with and in these faculties. The paper addresses the relation between these programs and national and regional trends in education and services. Handle: RePEc:aph:ajpbhl:1987:77:4:485-490_3 Template-Type: ReDIF-Article 1.0 Title: An outbreak of Brucella melitensis infection by airborne transmission among laboratory workers Journal: American Journal of Public Health Author-Name: Olle-Goig, J.E. Author-Name: Canela-Soler, J. Year: 1987 Volume: 77 Issue: 3 Pages: 335-338 Abstract: An outbreak of acute brucellosis infection was detected among the employees of a biologicals manufacturing laboratory located in Girona, Spain. The first cases appeared six weeks after a vaccine with attenuated Brucella melitensis, Rev-1 had been produced for one week. A clinical and epidemiologic investigation conducted among the 164 employees found 22 patients with clinical symptoms and positive serology, and six patients detected by serology only (attack rate: 17.1 per cent). Blood cultures were obtained from two patients and Brucella melitensis was isolated. Employees working in areas with open windows above the laboratory air extracting system had an attack rate of 39.5 per cent, substantially higher than those working in other locations. When vaccine was manufactured again, an electric oven reaching 300°C had been installed in the air extracting system just before its exit to the exterior. Appropriate culture medium plates were exposed to the laboratory air before and after passing through the oven. Brucellae were isolated from the plates exposed to the air before passing through the oven but not after doing so. Handle: RePEc:aph:ajpbhl:1987:77:3:335-338_3 Template-Type: ReDIF-Article 1.0 Title: Formaldehyde-related health complaints of residents living in mobile and conventional homes Journal: American Journal of Public Health Author-Name: Ritchie, I.M. Author-Name: Lehnen, R.G. Year: 1987 Volume: 77 Issue: 3 Pages: 323-328 Abstract: This paper explores the dose-response relation between formaldehyde (HCHO) concentration and reported health complaints (eye irritation, nose/throat irritation, headaches and skin rash) of nearly 2,000 residents living in 397 mobile and 494 conventional homes. The study analyzes the effects of HCHO concentration, age and sex of respondent, and smoking behavior on each of the four health effects. The results demonstrate a positive dose-response relation between HCHO concentration and reported health complaints, with reported health complaints demonstrated at HCHO concentrations of 0.1 ppm and above. Concentrations of 0.4 ppm in manufactured homes as targeted by the Department of Housing and Urban Development (HUD), may not be adequate to protect occupants from discomfort and from acute effects of HCHO exposure. Handle: RePEc:aph:ajpbhl:1987:77:3:323-328_7 Template-Type: ReDIF-Article 1.0 Title: The economic costs of Alzheimer's disease Journal: American Journal of Public Health Author-Name: Hay, J.W. Author-Name: Ernst, R.L. Year: 1987 Volume: 77 Issue: 9 Pages: 1169-1175 Abstract: This paper estimates the economic costs of Alzheimer's Disease to individuals and to society, based on review of published Alzheimer's Disease-related research. The analysis is derived from epidemiological projections and cost information for the United States population in 1983. Estimated costs include both direct medical care and social support costs, as well as indirect costs, such as support services provided by family or volunteers, and the value of lost economic productivity in Alzheimer's Disease patients. Mid-range estimates of net annual expected costs for an Alzheimer's Disease patient, excluding the value of lost productivity, are $18,517 in the first year and $17,643 in subsequent years, with direct medical and social services comprising about half of these costs. Under base case assumptions, the total cost of disease per patient in 1983, was $48,544 to $493,277, depending upon patient's age at disease onset. The estimated present value of total net costs to society for all persons first diagnosed with Alzheimer's Disease in 1983 was $27.9-31.2 billion. Development of a public or private insurance market for the economic burdens of Alzheimer's Disease would fill some of the gaps in the current US system of financing long-term chronic disease care. Handle: RePEc:aph:ajpbhl:1987:77:9:1169-1175_7 Template-Type: ReDIF-Article 1.0 Title: Reproductive mortality in the United States: Recent trends and methodologic considerations Journal: American Journal of Public Health Author-Name: Rosenberg, M.J. Author-Name: Rosenthal, S.M. Year: 1987 Volume: 77 Issue: 7 Pages: 833-836 Abstract: Between 1975 and 1982, the annual number of deaths attributable to pregnancy and childbirth, induced abortion, and contraception in the United States declined from 1.083 to 751. The mortality rates for each of these components decreased by 35, 89, and 35 per cent, respectively, and the overall reproductive mortality rate dropped by 35 per cent. The death rate due to pregnancy and childbirth is 25 times greater than that due to induced abortion and eight times more than that to contraceptive-associated mortality. In 1982 nearly 30 million women used contraceptives, while slightly fewer than four million women were pregnant to term. The decrease in contraceptive-associated mortality between 1975 and 1982 probably reflects a combination of safer contraceptives, fewer women using contraceptive methods that may not be safest for them, and an increasing number of sterilizations, which remove women from the group at highest risk of contraceptive-related mortality. Maternal mortality appears to be slowing its rate of decline, while induced abortion mortality has been very low since the legalization of abortion. Handle: RePEc:aph:ajpbhl:1987:77:7:833-836_1 Template-Type: ReDIF-Article 1.0 Title: Trends in routine screening examinations Journal: American Journal of Public Health Author-Name: Dawson, D.A. Author-Name: Hendershot, G.E. Author-Name: Bloom, B. Year: 1987 Volume: 77 Issue: 8 Pages: 1004-1005 Abstract: Data from the 1973 and 1982 National Health Interview Surveys reveal increased use of routine medical examinations between the two survey dates. The proportion of adults age 40 or older who ever had a glaucoma test increased by 50 per cent. Other large increases were in the proportion of adults age 40 or older who ever had an electrocardiogram and in the proportions of women age 17 or older who ever had breast examinations or Pap smears. Handle: RePEc:aph:ajpbhl:1987:77:8:1004-1005_7 Template-Type: ReDIF-Article 1.0 Title: Physicians and CPR training in high-risk family members Journal: American Journal of Public Health Author-Name: Goldberg, R.J. Year: 1987 Volume: 77 Issue: 6 Pages: 671-672 Handle: RePEc:aph:ajpbhl:1987:77:6:671-672_5 Template-Type: ReDIF-Article 1.0 Title: Thinness and mortality Journal: American Journal of Public Health Author-Name: Sidney, S. Author-Name: Friedman, G.D. Author-Name: Siegelaub, A.B. Year: 1987 Volume: 77 Issue: 3 Pages: 317-322 Abstract: The relationship of thinness to mortality was examined in White adult members of the Kaiser Permanente Medical Care Program who had at least three multiphasic health checkups between 1964 and 1972, with mortality follow-up through 1980. A detailed comparison was performed of the mortality patterns of 'thin' (decile 1 of Quetelet's index) and 'average' weight (deciles 4 and 5) cohort members who were age 40-79 years and free of illness at the beginning of follow-up. Thin male (relative risk 1.6, 95 per cent confidence limits 1.0, 2.6) and female (R.R. 2.1, 95 per cent C.L. 1.1, 3.9) current cigarette smokers were at increased risk of mortality compared with average weight smokers. Unmeasured differences between thin and average weight smokers with respect to quantity of cigarettes smoked may have contributed to the apparent association of thinness with mortality in smokers. Thinness was not associated with increased mortality in never smokers and ex-smokers (R.R. 1.0 in men and women). As association of long-term weight loss with mortality was present in thin and average weight men and in thin women. Handle: RePEc:aph:ajpbhl:1987:77:3:317-322_8 Template-Type: ReDIF-Article 1.0 Title: Parturition: Places and priorities Journal: American Journal of Public Health Author-Name: Pearse, W.H. Year: 1987 Volume: 77 Issue: 8 Pages: 923-924 Handle: RePEc:aph:ajpbhl:1987:77:8:923-924_4 Template-Type: ReDIF-Article 1.0 Title: Initial effects of the New York State auto safety belt law Journal: American Journal of Public Health Author-Name: Latimer, E.A. Author-Name: Lave, L.B. Year: 1987 Volume: 77 Issue: 2 Pages: 183-186 Abstract: New York State began enforcing a mandatory autombile safety belt use law on January 1, 1985. We present a proliminary analysis of its effect on fatalities and injuries. Applying a Poisson statistical model to pre- and post-law belt usage rates together with counts of fatalities and injuries in 12 metropolitan areas, we estimate the first six months' application of the law averted 220 fatal, 1,500 severe, 4,600 moderate, and 2,600 light injuries across the state. The Poisson approach gives estimates of injuries averted considerably greater than simple year to year comparsions, indicating that media announcements have understated the efficacy of requring safety belt usage. Handle: RePEc:aph:ajpbhl:1987:77:2:183-186_5 Template-Type: ReDIF-Article 1.0 Title: What are the odds that smoking will kill you? Journal: American Journal of Public Health Author-Name: Mattson, M.E. Author-Name: Pollack, E.S. Author-Name: Cullen, J.W. Year: 1987 Volume: 77 Issue: 4 Pages: 425-431 Abstract: We calculated the long-term risks of death from smoking for individuals of various ages and smoking status in terms of the excess mortality contributed by smoking, over and above the baseline mortality from the same diseases caused by factors other than smoking using standard life table procedures. Since mortality data for specific smoking categories were available only from prospective studies in the late 1950s, we scaled these to the 1982 mortality levels. We assumed, for lung cancer, that the death rates for nonsmokers have not changed and, for other smoking-related diseases, that the risks of death for smokers relative to those for nonsmokers have not changed since the 1950s. Probabilities that result from alternative assumptions were also investigated and are presented. As many as one-third of heavy smokers age 35 will die before age 85 of diseases caused by their smoking. The probabilities of death from smoking when compared with other causes may be persuasive as public education tools. Their effective use for this purpose is affected not only by the deficiencies in the public's factual knowledge of the magnitude of the risks from smoking, but also by numerous apparent misconceptions relating to the interpretation of risk information. Risk data should be presented to the public in a manner that clarifies these misconceptions and facilitates their understanding of the overwhelming risk imposed by smoking. Handle: RePEc:aph:ajpbhl:1987:77:4:425-431_4 Template-Type: ReDIF-Article 1.0 Title: Now is the time to prevent AIDS Journal: American Journal of Public Health Author-Name: Drotman, D.P. Year: 1987 Volume: 77 Issue: 2 Pages: 143 Abstract: AIDS will be with us for years, unfortunately. How soon we take definitive action may well influence the course of this public health problem for many decades to come. Our actions should be balanced between those steps that will provide us with future guidance and those that by current consensus will benefit our communities. We cannot wait any longer. Handle: RePEc:aph:ajpbhl:1987:77:2:143_6 Template-Type: ReDIF-Article 1.0 Title: Expenditure effects of changes in Medicaid benefit coverage: An alcohol and substance abuse example Journal: American Journal of Public Health Author-Name: Reutzel, T.J. Author-Name: Becker, F.W. Author-Name: Sanders, B.K. Year: 1987 Volume: 77 Issue: 4 Pages: 503-504 Abstract: An evaluation of the effect on total health care costs of a Medicaid demonstration project to provide coverage for alcoholism and substance abuse was conducted in Illinois in 1985. A pre/post-treatment analysis of expenditures for a subgroup of demonstration clients suggests that the addition of the alcohol and drug benefit did not result in higher total expenditures. [An important policy implication is that, when medical services substitute for one another, costs savings (increases) will not necessarily be realized when benefit packages are cut (expanded)]. Handle: RePEc:aph:ajpbhl:1987:77:4:503-504_8 Template-Type: ReDIF-Article 1.0 Title: Induced abortion trends in South Australia, 1970-84 Journal: American Journal of Public Health Author-Name: Hart, G. Author-Name: Macharper, T. Year: 1987 Volume: 77 Issue: 2 Pages: 200-202 Abstract: Following legislative amendments extending the grounds for abortion in South Australia the abortion rate rose from 6.0/1000 in 1970, to 9.9/1000 in 1971, to 13.2/1000 in 1984. However, rates differ widely by marital status among young women, the age pattern varies markedly for different marital status groups, and trends over time differ for different age/marital status groups. Collection of detailed age and marital status data on every live birth and abortion is recommended in order to provide the most informative analysis of abortion trends. Handle: RePEc:aph:ajpbhl:1987:77:2:200-202_2 Template-Type: ReDIF-Article 1.0 Title: Randomized trial of brief individual treatment for smoking using nicotine chewing gum in a workplace setting Journal: American Journal of Public Health Author-Name: Sutton, S. Author-Name: Hallett, R. Year: 1987 Volume: 77 Issue: 9 Pages: 1210-1211 Abstract: In a controlled trial of brief treatment for smoking using nicotine chewing gum in a workplace setting, 270 of 334 cigarette smokers who expressed interest were invited to take part in the program, which consisted of two individual consultations; 172 attended. The remaining 64 smokers constituted a no-intervention control group. Using a criterion of sustained one-year abstinence with biochemical validation, success rates were 12 per cent among participants, 1 per cent among those who were invited but did not attend, and 2 per cent in the control group. Handle: RePEc:aph:ajpbhl:1987:77:9:1210-1211_3 Template-Type: ReDIF-Article 1.0 Title: Coronary risk factors and clinical gallbladder disease: An approach to the prevention of gallstones? Journal: American Journal of Public Health Author-Name: Diehl, A.K. Author-Name: Haffner, S.M. Author-Name: Hazuda, H.P. Author-Name: Stern, M.O. Year: 1987 Volume: 77 Issue: 7 Pages: 841-845 Abstract: We examined the relationship of 'coronary' risk factors to clinical gallbladder disease prevalence in a cross-sectional survey. Persons with hypercholesterolemia, hypertriglyceridemia, or low high-density-lipoprotein cholesterol levels had elevated risks for clinical gallbladder disease. Smokers of 20 pack-years or more and infrequent users of alcohol had increased risks, as did persons with hypertension or diabetes mellitus. After adjusting for age, body mass index, ethnicity, and the coronary variables, relationships persisted for diabetes in women (OR = 0.3). The proportion of gallbladder disease related to all coronary risk factors was estimated to be 52 per cent. Handle: RePEc:aph:ajpbhl:1987:77:7:841-845_0 Template-Type: ReDIF-Article 1.0 Title: How problematic are nosocomial infections in the DRG reimbursement system? Journal: American Journal of Public Health Author-Name: DeWitt, T.G. Year: 1987 Volume: 77 Issue: 5 Pages: 542-543 Handle: RePEc:aph:ajpbhl:1987:77:5:542-543_8 Template-Type: ReDIF-Article 1.0 Title: Effects of age misstatement on the utility of age-dependent anthropometric indicators of nutritional status in rural Bangladesh Journal: American Journal of Public Health Author-Name: Bairagi, R. Author-Name: Edmonston, B. Author-Name: Khan, A.D. Year: 1987 Volume: 77 Issue: 3 Pages: 280-282 Abstract: We report the effects of age error on use of weight-for-age and height-for-age for assessing and screening malnutrition, and for identifying factors of malnutrition in 679 children aged 22-59 months in Companiganj, in rural Bangladesh. Overreporting and random error in age and correlation of age error with each of the anthropometric indices are observed. As a result, the proportion of children having less than or equal to 60 per cent of median weight-for-age is overestimated by five percentage points and the proportion having less than 80 per cent of median height-for-age is overestimated by six points. Loss in sensitivity (proportion of malnourished children correctly identified) for the above cutoff points is 20 per cent for weight-for-age and 28 per cent for height-for-age, compared to the situation in the absence of age error. Although mother's education is not a significant determinant of weight-for-age and height-for-age, age error makes mother's education appear artifactually significant in the analysis of variance. Handle: RePEc:aph:ajpbhl:1987:77:3:280-282_0 Template-Type: ReDIF-Article 1.0 Title: Community-based education of the health professions in Latin America and the US Journal: American Journal of Public Health Author-Name: Koch-Weser, D. Year: 1987 Volume: 77 Issue: 4 Pages: 412 Handle: RePEc:aph:ajpbhl:1987:77:4:412_7 Template-Type: ReDIF-Article 1.0 Title: Confidence intervals exclude nothing Journal: American Journal of Public Health Author-Name: Poole, C. Year: 1987 Volume: 77 Issue: 4 Pages: 492-493 Handle: RePEc:aph:ajpbhl:1987:77:4:492-493_7 Template-Type: ReDIF-Article 1.0 Title: Television and health education: Stay tuned Journal: American Journal of Public Health Author-Name: Warner, K.E. Year: 1987 Volume: 77 Issue: 2 Pages: 140-142 Handle: RePEc:aph:ajpbhl:1987:77:2:140-142_7 Template-Type: ReDIF-Article 1.0 Title: Factors affecting breastfeeding among women of Mexican origin or descent in Los Angeles Journal: American Journal of Public Health Author-Name: Scrimshaw, S.C.M. Author-Name: Engle, P.L. Author-Name: Arnold, L. Author-Name: Haynes, K. Year: 1987 Volume: 77 Issue: 4 Pages: 467-470 Abstract: Data on breastfeeding intentions and behavior were collected in prenatal and postpartum interviews as part of a study on first birth among 518 women of Mexican origin or descent in two Los Angeles hospitals. The prenatal intentions of 82 per cent of the women to breastfeed were maintained postpartum in one hospital but dropped sharply in the other. A greater number of hours a day with the baby in the hospital and earlier initiation of breastfeeding were associated with the hospital where prenatal breastfeeding intentions were more likely to be carried out. The intention to work postpartum was associated both with the decision not to breastfeed at all and with shorter intended duration of breastfeeding. Handle: RePEc:aph:ajpbhl:1987:77:4:467-470_3 Template-Type: ReDIF-Article 1.0 Title: Latino terminology: conceptual bases for standardized terminology. Journal: American Journal of Public Health Author-Name: Hayes-Bautista, D.E. Author-Name: Chapa, J. Year: 1987 Volume: 77 Issue: 1 Pages: 61-68 Abstract: Conceptually, the only element that all Latin American countries share is not language, race, or culture, but political: the presence of United States foreign policy as pronounced in the Monroe Doctrine in 1823. The political relation between the US and Latin America has colored US domestic policy toward its populations of Latin American origin. From the beginning of US-Latin American relations, there has been a constant confusion of race for national origin, compounded by the adoption of euphemistic terms such as "Spanish surname." The term "Latino", derived from "Latin American," is offered as the term that best reflects both the diverse national origins and the nearly unitary treatment of Latinos in the US. The term Latino is operationalized to include all persons of Latin American origin or descent, irrespective of language, race, or culture. Specifically excluded are individuals of Spanish national origin outside the Western Hemisphere. When a synthetic sample has been derived, the term should be modified to reflect the basis upon which the sample was derived, e.g., "Latino (Spanish surname)." When working with Latinos from a specific national origin, that should be noted, e.g., "Mexican origin Latinos." Handle: RePEc:aph:ajpbhl:1987:77:1:61-68_2 Template-Type: ReDIF-Article 1.0 Title: The impact of crime on home care services Journal: American Journal of Public Health Author-Name: Snow, D.A. Author-Name: Kleinman, L.S. Year: 1987 Volume: 77 Issue: 2 Pages: 209-210 Abstract: A telephone survey of 49 Veterans Administration Home Care Programs found 32 programs reporting dangerous areas in their territories. Twelve excluded patients based on safety of area of residence. Programs in the eastern United States and in cities with higher rates of crime were more likely to have paired visits, escorted visits, or to exclude patients. Programs providing paired or escorted visits were less likely to exclude patients, suggesting that such policies maximize access to home care. Handle: RePEc:aph:ajpbhl:1987:77:2:209-210_5 Template-Type: ReDIF-Article 1.0 Title: Seroepidemiologic study of giardiasis patients and high-risk groups in a midwestern city in the United States Journal: American Journal of Public Health Author-Name: Sullivan, R. Author-Name: Linneman Jr., C.C. Author-Name: Clark, C.S. Author-Name: Walzer, P.D. Year: 1987 Volume: 77 Issue: 8 Pages: 960-963 Abstract: Serum antibodies to Giardia lamblia were measured in giardiasis patients, in groups at high risk for intestinal parasite infection, and in controls by an indirect fluorescent antibody (IFA) technique. Symptomatic patients had the highest antibody titers, and antibodies remained present for up to 18 months in persons with chronic infection. Indochinese refugees and male homosexuals with the acquired immunodeficiency syndrome (AIDS) and pre-AIDS had higher mean antibody levels than did healthy controls, whereas sewer and highly maintenance workers had levels similar to those of controls. Serum antibodies to Entamoeba histolytica measured by an indirect hemagglutination antibody technique were detected in only a few Indochinese refugees. We conclude that serology is a promising tool in G. lamblia epidemiology and that further population studies would be of interest. Handle: RePEc:aph:ajpbhl:1987:77:8:960-963_0 Template-Type: ReDIF-Article 1.0 Title: Legal control measures for AIDS: Reporting requirements, surveillance, quarantine, and regulation of public meeting places Journal: American Journal of Public Health Author-Name: Gostin, L. Author-Name: Curran, W.J. Year: 1987 Volume: 77 Issue: 2 Pages: 214-218 Abstract: Public policy makers can be virtually assured of judicial and political support for compulsory public health measures to control the spread of AIDS which are carefully based upon the current state of scientific understanding. Such measures would not be required 'to resort to close distinctions or to maintain a precise scientific uniformity', no matter how much this is desirable. What policy makers may not do - even under the judiciary's 'minimum rationality' review - is to base their measures on 'vague, undifferentiated fears... of some portion of the community' or on 'irrational prejudice', Worse, public health regulators may not succumb to 'a bare... desire to harm a politically unpopular group'. Even stricter scrutiny will be applied to public health measures which affect liberty, autonomy, or privacy of human beings. These measures should not be promulgated without searching examination as to public health need, specificity of the targeted population, and adherence to the principle of the least restrictive alternative. Handle: RePEc:aph:ajpbhl:1987:77:2:214-218_5 Template-Type: ReDIF-Article 1.0 Title: Dental health of recent immigrant children in the newcomer schools, San Francisco Journal: American Journal of Public Health Author-Name: Pollick, H.F. Author-Name: Rice, A.J. Author-Name: Echenberg, D. Year: 1987 Volume: 77 Issue: 6 Pages: 731-732 Abstract: Dental screenings of 1,012 recent immigrant elementary school children in San Francisco showed 77 per cent of children needed dental treatment on first screening, compared to 25 per cent in the 1979-80 National Institute of Dental Research (NIDR) survey for the western United States. The prevalence of dental caries in primary teeth of the immigrant six and seven year-olds was twice that of their US counterparts. Non-refugee immigrants had more serious dental needs but used dental services less often than children with refugee status. Handle: RePEc:aph:ajpbhl:1987:77:6:731-732_8 Template-Type: ReDIF-Article 1.0 Title: Campylobacter infections: The emerging national pattern Journal: American Journal of Public Health Author-Name: Tauxe, R.V. Author-Name: Pegues, D.A. Author-Name: Hargrett-Bean, N. Year: 1987 Volume: 77 Issue: 9 Pages: 1219-1221 Abstract: In the United States, 8,837 Campylobacter isolates and eight outbreaks of Campylobacter infections were reported in 1984, a national isolation rate of 4.9/100,000. C. jejuni represented 99 per cent of reported isolates. Age-specific incidence was highest among infants (11/100,000), and young adults (8/100,000); infants in the second month of life were at highest risk. An unexplained nationwide November peak, not observed in previous years, occurred in all age groups and suggests there is an homogeneous nationwide source for this infection. Handle: RePEc:aph:ajpbhl:1987:77:9:1219-1221_2 Template-Type: ReDIF-Article 1.0 Title: Projected changes in breast cancer incidence due to the trend toward delayed childbearing Journal: American Journal of Public Health Author-Name: White, E. Year: 1987 Volume: 77 Issue: 4 Pages: 495-497 Abstract: Because there has been a recent trend toward delay of childbearing in the United States, women in the birth cohort of 1945-49 will have an estimated 5 per cent greater incidence of breast cancer, and those in the cohort of 1950-54 an estimated 9 per cent greater incidence compared with the cohort of 1935-39, which had the distribution of age at first birth most favorable for breast cancer risk. Handle: RePEc:aph:ajpbhl:1987:77:4:495-497_1 Template-Type: ReDIF-Article 1.0 Title: The impact of neuroleptic medication on tardive dyskinesia: A meta-analysis of published studies Journal: American Journal of Public Health Author-Name: Morgenstern, H. Author-Name: Glazer, W.M. Author-Name: Niedzwiecki, D. Author-Name: Nourjah, P. Year: 1987 Volume: 77 Issue: 6 Pages: 717-724 Abstract: To quantify the impact of chronic exposure to neuroleptic medication on the occurrence of tardive dyskinesia (TD), we conducted a meta-analysis of data collected from 21 studies published between 1966 and 1985. The observed prevalence of dyskinesia was greater among exposed subjects in all 21 studies; we estimate that, on the average, the occurrence rate was 2.9 times greater in exposed persons than would be expected if they had been unexposed. We estimate that 65 per cent of exposed cases and 51 per cent of all cases in these investigations were caused by long-term neuroleptic exposure. Among adult United States residents in 1980, we estimate that there were approximately 193,000 neuroleptic-induced TD cases of which about 60 per cent occurred in outpatients. We also observed substantial heterogeneity of effects (rate ratio) across studies, however, partially explained, by changes and differences in the rate of dyskinesia, by differences in the frequency of certain effect modifiers, and by differences in diagnostic methods. Methodologic limitations of the studies and their possible effects on our results are discussed. Handle: RePEc:aph:ajpbhl:1987:77:6:717-724_5 Template-Type: ReDIF-Article 1.0 Title: The impact of diabetes education and peer support upon weight and glycemic control of elderly persons with noninsulin dependent diabetes mellitus (NIDDM) Journal: American Journal of Public Health Author-Name: Wilson, W. Author-Name: Pratt, C. Year: 1987 Volume: 77 Issue: 5 Pages: 634-635 Abstract: We assessed diabetes education and peer support interventions as facilitators of weight loss and glycemic control in a community sample of 79 elderly persons with noninsulin-dependent diabetes mellitus (NIDDM). Different groups received: education only, education and peer support, and no treatment. Peer support was higher in groups where it was actively facilitated. Weight loss and reduction in level of glycemic control occurred within groups receiving both diabetes education and peer support. Handle: RePEc:aph:ajpbhl:1987:77:5:634-635_1 Template-Type: ReDIF-Article 1.0 Title: Smoking among Mexican Americans: A three-generation study Journal: American Journal of Public Health Author-Name: Markides, K.S. Author-Name: Coreil, J. Author-Name: Ray, L.A. Year: 1987 Volume: 77 Issue: 6 Pages: 708-711 Abstract: Smoking behavior was investigated with data from a three-generation study of Mexican Americans in San Antonio, Texas. Rates of smoking among the men were found to be higher than rates for other White men obtained in previous studies, while rates for women were slightly lower than those reported for other White women. However, the percentage of light smokers was considerably higher among Mexican Americans than among other groups. There was no evidence that acculturation was a consistent predictor of greater likelihood of smoking. However, there was evidence that the smoking behavior of younger Mexican Americans, particularly the women, was associated with the smoking behavior of their parents. Handle: RePEc:aph:ajpbhl:1987:77:6:708-711_3 Template-Type: ReDIF-Article 1.0 Title: Head injury with and without hospital admission: Comparisons of incidence and short-term disability Journal: American Journal of Public Health Author-Name: Fife, D. Year: 1987 Volume: 77 Issue: 7 Pages: 810-812 Abstract: All persons with head injuries (skull fracture or injury to the cranial contents resulting in a physician visit or at least one day of disability), regardless of treatment or hospital admission status, were identified from National Health Interview Survey data for the years 1977-81. Among those who reported such head injuries within the two weeks prior to interview, only 16 per cent were admittted to hospitals. Children, members of low-income families, and those injured at home, school, or in a recreational setting were less likely to be admitted to hospital than others. Among those who sustained a head injury in the previous three months and had some disability from that injury during the two weeks prior to interview, those not admitted to hospital included one-half of those with three to seven days of bed disability and one-third of those with more than seven days of bed disability; and they accounted for one-half of all disability days. These findings indicate that hospital-based head injury incidence data are incomplete and may contain substantial biases. Handle: RePEc:aph:ajpbhl:1987:77:7:810-812_9 Template-Type: ReDIF-Article 1.0 Title: Trends in esophageal cancer mortality among US Blacks and Whites Journal: American Journal of Public Health Author-Name: Blot, W.J. Author-Name: Fraumeni Jr., J.F. Year: 1987 Volume: 77 Issue: 3 Pages: 296-298 Abstract: National age-adjusted rates of mortality from esophageal cancer have increased among Blacks in the United States, while remaining nearly unchanged among Whites. By 1980, esophageal cancer had become one of the leading causes of cancer death among Blacks, with the excess among males under age 55 exceeding six-fold. Inferences about the causes of esophageal cancer cannot be made from this descriptive survey, but the rising trend raises etiologic hypotheses about environmental exposures (e.g., alcohol, tobacco, nutrition) that may differentially affect Blacks. Handle: RePEc:aph:ajpbhl:1987:77:3:296-298_1 Template-Type: ReDIF-Article 1.0 Title: AIDS-related competence of California's primary care physicians Journal: American Journal of Public Health Author-Name: Lewis, C.E. Author-Name: Freeman, H.E. Author-Name: Corey, C.R. Year: 1987 Volume: 77 Issue: 7 Pages: 795-799 Abstract: We conducted a telephone survey of a random sample of primary care physicians practicing throughout the State of California to determine their AIDS-related experiences and competencies. Interviews were completed early in 1986 with 1,000 family and general practitioners and internists, 60 per cent of those eligible. Data on practice experiences reflect the increased incidence of AIDS (acquired immunodeficiency syndrome) in Los Angeles and San Francisco. The proportion of practitioners in rural areas who evaluated possible cases (17 per cent), and counseled patients at risk (50 per cent) indicated the generalized nature of the problem. Compared to similar data obtained in 1984, levels of competency in diagnosing and counseling persons with AIDS-related disorders increased in Los Angeles. However, on a statewide basis, a majority of those interviewed lack the AIDS-related knowledge and skills required to carry out their roles in dealing with AIDS. Competency was associated with physicians' personal and professional characteristics and their level of discomfort in dealing with homosexuals. Handle: RePEc:aph:ajpbhl:1987:77:7:795-799_5 Template-Type: ReDIF-Article 1.0 Title: Prisoners as medical patients Journal: American Journal of Public Health Author-Name: Krupp, L.B. Author-Name: Gelberg, E.A. Author-Name: Wormser, G.P. Year: 1987 Volume: 77 Issue: 7 Pages: 859-860 Abstract: Nonpsychiatric and nonobstetrical principal diagnoses of 527 prison inmates discharged in 1981 from one referral hospital were reviewed. Male prisoners had the following diagnoses more frequently than an age-matched and sex-matched sample of the general population: lymphadenopathy, viral hepatitis, foreign body insertion into the gastrointestinal tract, dental caries, and pulmonary tuberculosis. Some differences may be due to lifestyles preceding incarceration, others may result from conditions of the prison environment. Handle: RePEc:aph:ajpbhl:1987:77:7:859-860_6 Template-Type: ReDIF-Article 1.0 Title: Adolescent depression, alcohol and drug abuse Journal: American Journal of Public Health Author-Name: Deykin, E.Y. Author-Name: Levy, J.C. Author-Name: Wells, V. Year: 1987 Volume: 77 Issue: 2 Pages: 178-182 Abstract: The Diagnostic Interview Schedule was employed to ascertain the prevalence of major depressive disorder (MDD), alcohol and substance abuse in a sample of 424 college students aged 16 to 19 years. Applying DSM III criteria, the prevalence of MDD was 6.8 per cent; of alcohol abuse, 8.2 per cent; and of substance abuse 9.4 per cent. Alcohol abuse was associated with MDD, but not with other psychiatric diagnoses. Substance abuse was associated both with MDD and with other psychiatric diagnoses as well. The onset of MDD almost always preceded alcohol or substance abuse suggesting the possibility of self-medication as a factor in the development of alcohol or substance abuse. Handle: RePEc:aph:ajpbhl:1987:77:2:178-182_0 Template-Type: ReDIF-Article 1.0 Title: WIC prenatal participation and its relation to pregnancy outcomes in Missouri: A second look Journal: American Journal of Public Health Author-Name: Stockbauer, J.W. Year: 1987 Volume: 77 Issue: 7 Pages: 813-818 Abstract: We studied the association of WIC prenatal suplementation with pregnancy outcome using Missouri WIC participants who delivered in 1982 linked with their offspring's birth/fetal death certificates. A 93 per cent match rate resulted in a final study population of 9,411 pregnancies. A control population of like number was acquired by matching on key demographic characteristics. The majority of the results generally confirm the results of a 1980 Missouri study; WIC participation was associated with decreases in low birth weight (7.8 vs 9.2 per cent), prematurity (9.7 vs 12.0 per cent) and inadequate prenatal care (30.5 vs 31.7 per cent), and an increase in mean gestational age (39.9 vs 39.6 weeks). Low birth weight rates were lower for infants of WIC participants in each of the risk categories reviewed. As noted in the 1980 study, duration of WIC of at least seven months was needed before improvements in birth weight outcomes measures were noted. Handle: RePEc:aph:ajpbhl:1987:77:7:813-818_9 Template-Type: ReDIF-Article 1.0 Title: The public health impact of Alzheimer's disease Journal: American Journal of Public Health Author-Name: Weiler, P.G. Year: 1987 Volume: 77 Issue: 9 Pages: 1157-1158 Handle: RePEc:aph:ajpbhl:1987:77:9:1157-1158_0 Template-Type: ReDIF-Article 1.0 Title: Mortality differentials among persons born in Cuba, Mexico, and Puerto Rico residing in the United States, 1979-81 Journal: American Journal of Public Health Author-Name: Rosenwaike, I. Year: 1987 Volume: 77 Issue: 5 Pages: 603-606 Abstract: This paper examines the mortality experience in 1979-81 of three first generation Hispanic subpopulations in the United States, as defined by area of birth (Cuba, Mexico, Puerto Rico). Numerators were derived from National Center for Health Statistics (NCHS) mortality tapes, which included codes for selected places of birth appearing on the death certificate. Denominators were based on decennial census data for these migrant populations from the 1980 census. Generally, mortality is relatively high among Cuban-born, Mexican-born and Puerto Rican-born adolescents and young adults, particularly males, largely due to violent deaths. Aged migrants, despite their disadvantaged socioeconomic status, exhibit relatively low death rates from heart disease and cancer. Handle: RePEc:aph:ajpbhl:1987:77:5:603-606_8 Template-Type: ReDIF-Article 1.0 Title: Standardized terminology for hispanic populations. Journal: American Journal of Public Health Author-Name: Treviño, F.M. Year: 1987 Volume: 77 Issue: 1 Pages: 69-72 Handle: RePEc:aph:ajpbhl:1987:77:1:69-72_1 Template-Type: ReDIF-Article 1.0 Title: HMO membership, copayment, and initiation of care for cancer: A study of working adults Journal: American Journal of Public Health Author-Name: Greenwald, H.P. Year: 1987 Volume: 77 Issue: 4 Pages: 461-466 Abstract: This study compares diagnosis and commencement of treatment of cancer among persons with fully financed fee-for-service coverage, persons with copaid fee-for-service coverage, and persons in an HMO (health maintenance organization). A total of 242 subjects actively employed at the time of their diagnosis were interviewed, typically within six months of beginning cancer treatment. After sex, age, income, education, residence (urban vs rural), and disease site and stage had been controlled, those who made copayments were found to have waited an average of 1.25 months longer (95 per cent confidence limit (cl) ± .88) between initial suspicion of illness and obtaining a definitive diagnosis than those with full insurance coverage. Time from diagnosis until the beginning of treatment averaged .83 months longer (95 per cent cl ± .41) for HMO members than those in fee-for-service. These relations were strongest in income categories equal to or exceeding $20,000 per year. Handle: RePEc:aph:ajpbhl:1987:77:4:461-466_9 Template-Type: ReDIF-Article 1.0 Title: Increasing influenza vaccination among high-risk elderly: A randomized controlled trial of a mail cue in an HMO setting Journal: American Journal of Public Health Author-Name: Mullooly, J.P. Year: 1987 Volume: 77 Issue: 5 Pages: 626-627 Abstract: A randomized controlled trial demonstrated that a single mailed influenza vaccination cue increased the vaccination rate among elderly HMO members with high-risk chronic conditions (n = 2217) from 30 per cent to 39 per cent during the fall and winter of 1984/85. Handle: RePEc:aph:ajpbhl:1987:77:5:626-627_6 Template-Type: ReDIF-Article 1.0 Title: Virchow, the heroic model in medicine: health policy by accolade. Journal: American Journal of Public Health Author-Name: Silver, G.A. Year: 1987 Volume: 77 Issue: 1 Pages: 82-88 Handle: RePEc:aph:ajpbhl:1987:77:1:82-88_0 Template-Type: ReDIF-Article 1.0 Title: Appraising health risk appraisal Journal: American Journal of Public Health Author-Name: Schoenbach, V.J. Year: 1987 Volume: 77 Issue: 4 Pages: 409-411 Handle: RePEc:aph:ajpbhl:1987:77:4:409-411_9 Template-Type: ReDIF-Article 1.0 Title: On changing Indian eligibility for health care Journal: American Journal of Public Health Author-Name: Bashshur, R. Author-Name: Steeler, W. Author-Name: Murphy, T. Year: 1987 Volume: 77 Issue: 6 Pages: 690-693 Abstract: We analyzed the ramifications and potential effects of a pending regulation that restricts Indian eligibility for health care. The most serious implication is a dwindling of support for Indian health care while the health of Indians continues to lag behind that of all other groups in the United States. Empirical analysis in one service area of the Indian Health Service (IHS) in Oklahoma reveals Indians of lower blood quantum to be younger, lower utilizers of expensive medical services, especially hospitals. The sudden loss of health care benefits from IHS will be detrimental not only to this population and to an ever increasing number of Indians in the future but also to the local service units in the Indian Health Service. Handle: RePEc:aph:ajpbhl:1987:77:6:690-693_4 Template-Type: ReDIF-Article 1.0 Title: Changes in drug behavior from the middle to the late twenties: Initiation, persistence, and cessation of use Journal: American Journal of Public Health Author-Name: Raveis, V.H. Author-Name: Kandel, D.B. Year: 1987 Volume: 77 Issue: 5 Pages: 607-611 Abstract: Patterns of initiation, persistence, and cessation of use of licit, illicit, and prescribed drugs are presented for a longitudinal cohort from their middle to the late twenties. The cohort is representative of adolescents formerly enrolled in public secondary high schools in New York State. No additional initiation of cigarettes, alcohol, and illicit drugs occurred in the four-year follow-up interval, except for cocaine and pills. The largest proportional increase of new users occurred for prescribed psychoactive drugs. Alcohol showed the most persistence of use, followed by cigarettes and marijuana. As the cohort ages, those who continue to use illicit drugs actively do so at lower levels of intensity than at younger ages. For each drug class, the persistence of use is strongly related to earlier intensity of involvement. By age 29, men have accumulated almost twice as many months of use of illicit drugs as women. Handle: RePEc:aph:ajpbhl:1987:77:5:607-611_7 Template-Type: ReDIF-Article 1.0 Title: AIDS screening, confidentiality, and the duty to warn Journal: American Journal of Public Health Author-Name: Gostin, L. Author-Name: Curren, W.J. Year: 1987 Volume: 77 Issue: 3 Pages: 361-365 Abstract: Testing for the presence of HIV antibodies can provide a clear focus for public education and counseling as a foundation for behavior change. The cost-free and timely availability of professional testing for persons vulnerable to HIV is an essential part of the public health strategy to impede the spread of the infection. In order to protect the privacy of high-risk groups and be fair to clinicians, statutory confidentiality protection with specific exceptions for foreseeable harm to others would be an important adjunct to this strategy. It is conceivable that some individuals would alter their behavior in response to a mandatory screening program. The price for such a speculative public health benefit would be the invasion of privacy and financial cost entailed in the widescale collection of sensitive information, and the subsequent loss of trust and cooperation of persons vulnerable to HIV. Handle: RePEc:aph:ajpbhl:1987:77:3:361-365_2 Template-Type: ReDIF-Article 1.0 Title: Incidence and costs of incidental appendectomy as a preventive measure Journal: American Journal of Public Health Author-Name: Sugimoto, T. Author-Name: Edwards, D. Year: 1987 Volume: 77 Issue: 4 Pages: 471-475 Abstract: Statewide hospital discharge data in South Carolina for the period 1979-81 were used to evaluate the effectiveness of the incidental appendectomy performed as a preventive measure. The occurrence of incidental appendectomy exceeded that of appendicitis treated by appendectomy, with population-based rates of 1.13/1,000 and 0.97/1,000 person-years, respectively. Over 64 per cent of appendicitis cases occurred in persons under 25 years of age while 74 per cent of incidental appendectomies occurred in persons age 25 and over. Extrapolating to the nation, the data suggest that 254,250 incidental appendectomies might prevent 3,382 future cases of hospitalized appendicitis. The cost of the prevented cases is estimated as $6,764,000. The cost of the incidental appendectomies would be $20,340,000 if as many as 10 per cent of surgeons' fees were separately charged and twice as much if twice as many were so charged. Information on charges for incidental appendectomies is not readily available. Handle: RePEc:aph:ajpbhl:1987:77:4:471-475_9 Template-Type: ReDIF-Article 1.0 Title: Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985 Journal: American Journal of Public Health Author-Name: Lui, K.-J. Author-Name: Kendal, A.P. Year: 1987 Volume: 77 Issue: 6 Pages: 712-716 Abstract: Baseline levels of mortality in the United States in the absence of influenza epidemics were estimated using cyclical regression models applied to national vital statistics from October 1972 to May 1985. Models were developed by age and by region. Results from 1983 to 1985 are preliminary. More mortality than predicted by the theoretical baseline occurred during nine influenza seasons. Epidemics with high morbidity in children and young adults occurred in 1976/77 and 1987/79. Regional differences in the impact of influenza occurred occasionally. Total influenza-associated excess mortality in six epidemics from the winters of 1972/73 to 1980/81 was about 200,000. About 80-90 per cent of excess mortality occurred in persons over 64 years old. Handle: RePEc:aph:ajpbhl:1987:77:6:712-716_4 Template-Type: ReDIF-Article 1.0 Title: Ambulatory surgery utilization by age level Journal: American Journal of Public Health Author-Name: Lagoe, R.J. Author-Name: Bice, S.E. Author-Name: Abulencia, P.B. Year: 1987 Volume: 77 Issue: 1 Pages: 33-37 Abstract: We compared ambulatory and inpatient surgery utilization by age level for procedures known to be frequently performed on an ambulatory basis. Our scope of data was the Crouse Irving Memorial Hospital in Syracuse, New York during 1984. The hospital operates one of the largest freestanding ambulatory surgery programs in the United States. The study included 8,348 ambulatory procedures, 42 percent of all operations performed under the aegis of the institution. At the aggregate, the inpatient surgery included a somewhat lower proportion of young adults and a higher proportion of individuals aged 65 and over than did outpatient surgery. For specific procedures, however, age distributions differed. Ambulatory procedures included lower percentages of elderly than did inpatient utilization for inguinal hernia repair, carpal tunnel release, destruction of larynx lesions, hernia repairs, destruction of skin lesions, and other operations, while ambulatory utilization for lens procedures included higher percentages of elderly patients than did inpatient utilization. Physician practice patterns also appeared to influence the setting of certain procedures. The study data suggest that persons involved in health planning should evaluate ambulatory surgery use on an age and procedure-specific basis, and utilization review should evaluate procedures on a case-by-case basis. Handle: RePEc:aph:ajpbhl:1987:77:1:33-37_9 Template-Type: ReDIF-Article 1.0 Title: An epizootic of rabies in Maryland; 1982-84 Journal: American Journal of Public Health Author-Name: Beck, A.M. Author-Name: Felser, S.R. Author-Name: Glickman, L.T. Year: 1987 Volume: 77 Issue: 1 Pages: 42-44 Abstract: The number of reported rabid raccoons increased by 617 percent in Maryland from 1982 to 1984. The percent of raccoons that tested positive for rabies increased from 7.9 percent in 1982 to 57 percent in 1984. During this period of time, more than 74 percent of human exposures to rabid animals involved raccoons. Reports of animal bites of humans, however, showed only a 2.6 percent increase. The raccoon rabies epizootic has had significant public health impact in terms of human postexposure prophylaxis and rabies control programs. Handle: RePEc:aph:ajpbhl:1987:77:1:42-44_1 Template-Type: ReDIF-Article 1.0 Title: Accuracy of fetal death reports: Comparison with data from an independent stillbirth assessment program Journal: American Journal of Public Health Author-Name: Greb, A.E. Author-Name: Pauli, R.M. Author-Name: Kirby, R.S. Year: 1987 Volume: 77 Issue: 9 Pages: 1202-1206 Abstract: We evaluated the completeness and accuracy of reporting on Wisconsin fetal death report forms (FDF) through case by case comparison with data from the Wisconsin Stillbirth Service Project (WiSSP), which uses extensive protocols for etiologic investigation of stillborns. Fetal deaths are underreported: no FDF was submitted for 17.8 per cent of fetal deaths evaluated through the WiSSP. For those for whom FDF were submitted, fetal anomalies were often unrecognized or unreported: only 60 per cent of stillborns identified by the WiSSP as having fetal anomalies had any indication of the presence of such anomalies on FDF. When causes of death were classified into fetal, placental/cord, maternal/environmental, and unknown, comparison of reported underlying cause of death revealed marked inaccuracies on FDF. Placental/cord causes reported on FDF often could not be documented subsequently while, in contrast, fetal causes of death were underreported. Few accurate fetal diagnoses were present on FDF. Even among common lethal malformations misdiagnosis occurred frequently. Handle: RePEc:aph:ajpbhl:1987:77:9:1202-1206_1 Template-Type: ReDIF-Article 1.0 Title: Leisure time physical activity assessment of American adults through an analysis of time diaries collected in 1981 Journal: American Journal of Public Health Author-Name: Brooks, C.M. Year: 1987 Volume: 77 Issue: 4 Pages: 455-460 Abstract: One of the 1990 Health Objectives established by the U.S. Department of Health and Human Services is for 60 per cent of adults 18-65 years of age to be participated regularly in vigorous physical exercise. Unfortunately, no valid and practical measurement system is available that will allow assessment of leisure time physical activity participation of large populations. Consequently, not only is it difficult to assess progress toward the 1990 goal, an accurate baseline from which to measure potential progress does not exist. This paper presents a time diary technique for measuring aggregate population physical activity participation and utilizes actual time diaries collected from adults by the Institute for Social Research in 1981 to arrive at a possible baseline. The results indicated that time diaries are a viable method for assessing aggregate physical activity behavior of large populations. American Adults were quite sedentary in 1981. Over a period of one week, 31% undertook no leisure time physical activity. Only 14 per cent expended more than 1600 kcals/week in leisure time physical activity, and 10 per cent met the DHHS physical activity requirements. Handle: RePEc:aph:ajpbhl:1987:77:4:455-460_0 Template-Type: ReDIF-Article 1.0 Title: Mortality after bereavement: A prospective study of 95,647 widowed persons Journal: American Journal of Public Health Author-Name: Kaprio, J. Author-Name: Koskenvuo, M. Author-Name: Rita, H. Year: 1987 Volume: 77 Issue: 3 Pages: 283-287 Abstract: The mortality of 95,647 persons, widowed during 1972-76 and identified by linking the Finnish Population Register and cause-of-death files, was followed up to the end of 1976. A total of 7,635 deaths during 225,251 person-years of experience were observed. Cause-specific standardized mortality ratios by time after bereavement were computed. The highest relative mortality risk was found immediately after bereavement. For all natural causes, mortality during the first week was over two-fold compared to expected rates. The relative risk was larger for ischemic heart disease (RR = 2.3 for men, and RR = 3.5 for women), an effect found in all age groups. Among men under age 65, excess mortality from IHD was also observed during later years of widowhood. For violent causes, exclusive of accidents simultaneously affecting both spouses, mortality was over two-fold during the first month. Mortality from suicides was greater than expected during the first years of widowhood. While the greatest excess mortality after bereavement seems to be due principally to the acute effects of becoming widowed, there also seems to be some excess mortality in younger persons widowed for a longer time. Handle: RePEc:aph:ajpbhl:1987:77:3:283-287_6 Template-Type: ReDIF-Article 1.0 Title: CPR training for patients' families: Do physicians recommend it? Journal: American Journal of Public Health Author-Name: Mandel, L.P. Author-Name: Cobb, L.A. Author-Name: Weaver, W.D. Year: 1987 Volume: 77 Issue: 6 Pages: 727-728 Abstract: All Seattle-area cardiologists and 25 per cent of selected other physicians were queried by mail to determine whether they recommended CPR (cardiopulmonary resuscitation) training for families of their patients. Two-thirds reported that they advocated training for some patients' families, but only 52 per cent of cardiologists and 37 per cent of the others did so for families of at least half of the patients considered at risk. Physicians who had performed out-of-hospital CPR or had received advanced or recent training were more likely to recommend instruction. Handle: RePEc:aph:ajpbhl:1987:77:6:727-728_1 Template-Type: ReDIF-Article 1.0 Title: The impact of AIDS on gay male sexual behavior patterns in New York City Journal: American Journal of Public Health Author-Name: Martin, J.L. Year: 1987 Volume: 77 Issue: 5 Pages: 578-581 Abstract: A sample of 745 gay men, ages 20 to 65, were interviewed in 1985 as part of an effort to determine the impact of the AIDS (acquired immunodeficiency syndrome) epidemic on the non-ill but at-risk community. Measured in terms of the number of different sexual partners, sexual activity was reported to have declined by 78 per cent since hearing about AIDS. The frequency of sexual episodes involving the exchange of body fluids and mucous membrane contact declined by 70 per cent, and condom use during anal intercourse increased from 1.5 to 20 per cent. Abstinence from gay sex did not change over time. Handle: RePEc:aph:ajpbhl:1987:77:5:578-581_3 Template-Type: ReDIF-Article 1.0 Title: The cost-effectiveness of three smoking cessation programs Journal: American Journal of Public Health Author-Name: Altman, D.G. Author-Name: Flora, J.A. Author-Name: Fortmann, S.P. Author-Name: Farquhar, J.W. Year: 1987 Volume: 77 Issue: 2 Pages: 162-165 Abstract: This study analyzed the cost-effectiveness and distribution of costs by program stage of three smoking cessation programs: 1) a smoking cessation class; 2) an incentive-based quit smoking contest; and 3) a self-help quit smoking kit. The self-help program had the lowest total cost, lowest per cent quit rate, lowest time requirement for participants, and was the most cost-effective. The most effective program, the smoking cessation class, required the most time from participants, had the highest total cost, and was the least cost-effective. The smoking contest was in-between the other two programs in total costs, per cent quit rate, and cost-effectiveness; it required the same time commitment from participants as the self-help program. These findings are interpreted within the context of comminity-based intervention in which the argument is made that cost-effectiveness is only one of several factors that should determine the selection of smoking cessation programs. Handle: RePEc:aph:ajpbhl:1987:77:2:162-165_0 Template-Type: ReDIF-Article 1.0 Title: The relation of body weight to length of stay and charges for hospital services for patients undergoing elective surgery: A study of two procedures Journal: American Journal of Public Health Author-Name: Epstein, A.M. Author-Name: Read, J.L. Author-Name: Hoefer, M. Year: 1987 Volume: 77 Issue: 8 Pages: 993-997 Abstract: We studied the relation of body weight to lengths of stay and total charges for all patients hospitalized at the Brigham and Women's Hospital for total knee replacement and total hip replacement during a 12-month period. Patients with moderate obesity (actual body weight 141-170 per cent of ideal) had lengths of stay and total charges similar to normal weight patients (body weight 100-110 per cent ideal). However, patients who were extremely overweight (body weight ≥188 per cent ideal) had mean lengths of stay 35 per cent longer (28.9 days vs 21.5) and total charges 30 per cent higher ($25,692 vs $19,576) than patients with normal weight. Those who were extremely underweight (body weight ≥75 per cent ideal) had mean lengths of stay 40 per cent longer (30.1 days vs 21.5) and total charges 35 per cent higher ($26,447 vs $19,576). Handle: RePEc:aph:ajpbhl:1987:77:8:993-997_3 Template-Type: ReDIF-Article 1.0 Title: Contraceptive and fertility behavior of family planning clinic dropouts: A Maryland study Journal: American Journal of Public Health Author-Name: Chow, L.P. Author-Name: Rider, R.V. Author-Name: Su, S.I.H. Author-Name: Hou, W.I. Year: 1987 Volume: 77 Issue: 8 Pages: 975-978 Abstract: A study to examine the acceptance of an drop-out from family planning clinic services in Maryland was undertaken during 1984-85 by interviewing a random sample of 1,020 women who came to the clinics as 'new clients' during 1980 through 1982 when they were 20 through 39 years of age. This article examines the contraceptive and fertility behavior after their last clinic visits. The results showed that most of these women were 'protected' from pregnancy risk considerably beyond their last clinic visit. However, the analysis also revealed that in spite of the reported high contraceptive use rate, unplanned pregnancies occurred after the client's last clinic visit, suggesting that contraceptive use was either inconsistent or ineffective. These findings suggest that instead of allocating a large proportion of resources to follow-up acceptors to bring the 'drop-outs' back to the clinics, a more effective program strategy would be to systematically and effectively educate and counsel the clients during their clinic attendance, especially during their first clinic visit. Handle: RePEc:aph:ajpbhl:1987:77:8:975-978_4 Template-Type: ReDIF-Article 1.0 Title: Primary liver cancer mortality and incidence in Texas Mexican Americans, 1969-80 Journal: American Journal of Public Health Author-Name: Suarez, L. Author-Name: Martin, J. Year: 1987 Volume: 77 Issue: 5 Pages: 631-633 Abstract: During the years 1969-80, primary liver cancer mortality rates for Mexican American males were 2.2 times higher than for other Whites; Mexican American females had rates 2.8 times higher than other White females. Age-specific mortality rates showed even higher risks for older Mexican Americans exceeding both other White and Black rates three to four-fold. Incidence data for El Paso County (Texas) confirmed the increased risk for Mexican American males (risk ratio = 2.3) and females (risk ratio = 13.7). Cirrhosis mortality was also higher in Texas Mexican Americans but risk ratios were not as large as seen for primary liver cancer. Handle: RePEc:aph:ajpbhl:1987:77:5:631-633_2 Template-Type: ReDIF-Article 1.0 Title: 'When it rains it pours': Endemic goiter, iodized salt, and David Murray Cowie, MD Journal: American Journal of Public Health Author-Name: Markel, H. Year: 1987 Volume: 77 Issue: 2 Pages: 219-229 Handle: RePEc:aph:ajpbhl:1987:77:2:219-229_3 Template-Type: ReDIF-Article 1.0 Title: Shelters for battered women and their children: An under-recognized source of communicable disease transmission Journal: American Journal of Public Health Author-Name: Gross, T.P. Author-Name: Rosenberg, M.L. Year: 1987 Volume: 77 Issue: 9 Pages: 1198-1201 Abstract: A survey of 73 full-time government-funded shelters for battered women and their children from five geographic regions in 15 states provided information on communicable disease problems and control measures (focusing on diarrheal illness). Outbreaks of diarrheal illness involving more than 10 persons were reported by 12 per cent (9/73) of shelter directors. Less than half reported screening potential residents for communicable diseases before admitting them, and the majority reported that most of their staff are trained in basics of first aid, principles of hygiene, and experienced in day care work. More than half of the staff in the majority of shelters are counselors, but only 5 per cent (4/73) of shelters have health care workers. Less than one-fourth of the shelters have areas designated for diapering infants and less than half of the shelter directors knew of specified health regulations applying to their shelter. For most shelters, limitations on staff size, training, and funding may restrict the types of disease control measures they can apply. However, basic hygienic practices, such as strict handwashing and identification and cohorting of sick clients, may be effective in disease prevention. Handle: RePEc:aph:ajpbhl:1987:77:9:1198-1201_9 Template-Type: ReDIF-Article 1.0 Title: Prevalence of hepatitis B serologic markers in community hospital personnel Journal: American Journal of Public Health Author-Name: McLean, A.A. Author-Name: Monahan, G.R. Author-Name: Finkelstein, D.M. Year: 1987 Volume: 77 Issue: 8 Pages: 998-999 Abstract: The seroprevalence of hepatitis B markers among predominantly high-risk staff members and personnel of 31 community hospitals located throughout the United States was 8.4 per cent (≥5 per cent in 25 hospitals and ≥10 per cent in 13 hospitals). Only two hospitals had seroprevalence rates ≤3 per cent. The institutional seroprevalence ranged from 0 per cent to 16.7 per cent, with a median of 8.2 per cent. Although there are limitations to this survey, the results suggest that the well established increased risk of contracting HBV infection among certain groups of health-care workers in urban teaching medical centers may also hold true for personnel in similar occupational and professional categories in community hospitals. Handle: RePEc:aph:ajpbhl:1987:77:8:998-999_3 Template-Type: ReDIF-Article 1.0 Title: The epidemiologic surveillance of medical care Journal: American Journal of Public Health Author-Name: Caper, P. Year: 1987 Volume: 77 Issue: 6 Pages: 669-670 Handle: RePEc:aph:ajpbhl:1987:77:6:669-670_9 Template-Type: ReDIF-Article 1.0 Title: Childbearing among young Latino women in the United States Journal: American Journal of Public Health Author-Name: Darabi, K.F. Author-Name: Ortiz, V. Year: 1987 Volume: 77 Issue: 1 Pages: 25-28 Abstract: We analyzed 1979 and 1982 data from the Youth Cohort of the National Longitudinal Surveys (NLS) of Labor Market Experience to compare rates of early childbearing among White, Black, Mexican-origin and Puerto Rican women up to age 21. Latino young women fall in between the extremely low rate of the Whites and the extremely high rate of the Blacks. Mexican and Puerto Rican young women have similar proportions of premarital first births, but the marital first birth rate for young Mexicans is twice that of the Puerto Ricans. The bulk of Mexican first births, like births to Whites, occur within marriage, while Puerto Rican first births are similar to those of Blacks, the majority being out-of-wedlock. These racial/ethnic differences in premarital first birth rates do not change greatly when socioeconomic status, and birthplace of respondents and respondents' parents are controlled. Handle: RePEc:aph:ajpbhl:1987:77:1:25-28_3 Template-Type: ReDIF-Article 1.0 Title: Do authors check their references? A survey of accuracy of references in three public health journals Journal: American Journal of Public Health Author-Name: Eichorn, P. Author-Name: Yankauer, A. Year: 1987 Volume: 77 Issue: 8 Pages: 1011-1012 Abstract: We verified a random sample of 50 references in the May 1986 issue of each of three public health journals. Thirty-one per cent of the 150 references had citation errors, one out of 10 being a major error (reference not locatable). Thirty per cent of the references differed from authors' use of them with half being a major error (cited paper not related to author's contention). Handle: RePEc:aph:ajpbhl:1987:77:8:1011-1012_6 Template-Type: ReDIF-Article 1.0 Title: A framework for preventing AIDS Journal: American Journal of Public Health Author-Name: Darrow, W.W. Year: 1987 Volume: 77 Issue: 7 Pages: 778-779 Handle: RePEc:aph:ajpbhl:1987:77:7:778-779_3 Template-Type: ReDIF-Article 1.0 Title: Clustering of disease. Journal: American Journal of Public Health Author-Name: Rothman, K.J. Year: 1987 Volume: 77 Issue: 1 Pages: 13-15 Handle: RePEc:aph:ajpbhl:1987:77:1:13-15_2 Template-Type: ReDIF-Article 1.0 Title: Smoking intervention: The expanding role of the physician Journal: American Journal of Public Health Author-Name: Ockene, J.K. Year: 1987 Volume: 77 Issue: 7 Pages: 782-783 Handle: RePEc:aph:ajpbhl:1987:77:7:782-783_3 Template-Type: ReDIF-Article 1.0 Title: Risk of fatherhood among black teenage males Journal: American Journal of Public Health Author-Name: Rivara, F.P. Author-Name: Sweeney, P.J. Author-Name: Henderson, B.F. Year: 1987 Volume: 77 Issue: 2 Pages: 203-205 Abstract: Among a group of 67 Black teenage fathers and 77 controls, the risk of repeat fatherhood at an average 20 months follow-up was 21.2 conceptions per 100 person years compared to a rate of 9.0 conceptions per 100 person years among teenage males not previously fathers. Repeat fathers came from families in which there were role models for teenage parenthood. The results suggest that teenage fathers should be included in teenage pregnancy prevention and follow-up programs. Handle: RePEc:aph:ajpbhl:1987:77:2:203-205_9 Template-Type: ReDIF-Article 1.0 Title: Elective cancer education: How effective from the public health viewpoint? Journal: American Journal of Public Health Author-Name: Gray, C.H. Author-Name: Colome, J.S. Author-Name: Curry-Daly, J.R. Year: 1987 Volume: 77 Issue: 9 Pages: 1207-1209 Abstract: An elective cancer education course at a public university attracted twice as many women as men. Course information was disseminated to an average of eight people by each student. The course seemed reasonably effective in stimulating positive behavioral changes. According to self-report, dietary fat was reduced by 47 per cent of women and 49 per cent of men. Fiber intake was increased by 48 per cent of women and 36 per cent of men. Breast self-examination was initiated by 36 per cent of previous non-performers; and testicular self-examination, by 23 per cent. Handle: RePEc:aph:ajpbhl:1987:77:9:1207-1209_8 Template-Type: ReDIF-Article 1.0 Title: A comparison of estrogen and progesterone receptors in Black and White breast cancer patients Journal: American Journal of Public Health Author-Name: Beverly, L.N. Author-Name: Flanders, W.D. Author-Name: Go, R.C.P. Author-Name: Soong, S.-J. Year: 1987 Volume: 77 Issue: 3 Pages: 351-353 Abstract: After standardization for age and menopausal status, the prevalence of estrogen receptor positivity among 88 White breast cancer patients was about .72 compared with a prevalence of about .54 among Black patients. The prevalence of progesterone receptor positivity was also higher among White than among Black patients, although the magnitude of the difference was smaller. These differences were unchanged after adjustment for tumor size and nodal and distant metastases in addition to age and menopausal status. Handle: RePEc:aph:ajpbhl:1987:77:3:351-353_8 Template-Type: ReDIF-Article 1.0 Title: The role of public opinion polling in health legislation Journal: American Journal of Public Health Author-Name: Perlstadt, H. Author-Name: Holmes, R.E. Year: 1987 Volume: 77 Issue: 5 Pages: 612-614 Abstract: Two public opinion polls, in Los Angeles and Michigan, on smoking in public places contradicted findings from other major surveys. Both were commissioned by the tobacco interests during consideration of non-smoking legislation to measure opinion and influence the outcome. Analysis reveals the two polls to be remarkably similar and in violation of basic principles of survey research. Response categories lacked objective or parallel phrasing, response lists were not rotated, and the ordering of items appeared prejudicial. Both polls were effectively countered and the legislation passed. Handle: RePEc:aph:ajpbhl:1987:77:5:612-614_8 Template-Type: ReDIF-Article 1.0 Title: Factors associated with low birthweight in an inner-city population: The role of financial problems Journal: American Journal of Public Health Author-Name: Binsacca, D.B. Author-Name: Ellis, J. Author-Name: Martin, D.G. Author-Name: Petitti, D.B. Year: 1987 Volume: 77 Issue: 4 Pages: 505-506 Abstract: A case-control study of low birthweight among residents of high risk areas of Alameda County was conducted in 1983. The relation of 13 variables to low birthweight was assessed using a multiple logistic regression analysis. A six-fold increase in the risk of low birthweight was found in association with financial problems during the current pregnancy, controlling for differences in race, certain poor health habits, complications of pregnancy, and several other factors between cases and controls. Handle: RePEc:aph:ajpbhl:1987:77:4:505-506_4 Template-Type: ReDIF-Article 1.0 Title: Incidence, severity, and outcomes of brain injuries involving bicycles Journal: American Journal of Public Health Author-Name: Kraus, J.F. Author-Name: Fife, D. Author-Name: Conroy, C. Year: 1987 Volume: 77 Issue: 1 Pages: 76-78 Abstract: We performed a population-based study on bicycle-related brain injuries in San Diego, California, residents during 1981. Incidence rates among males were three times higher than for females and were highest at ages 10-14 years for males. Only one-third of bicycle-related brain injuries involved collision with a motor vehicle, and this proportion was independent of age or gender. Brain injuries from motor-vehicle collisions were more severe than those resulting from other causes. Over half the brain-injured bicyclists aged 15 and older who were blood alcohol tested were legally intoxicated. Handle: RePEc:aph:ajpbhl:1987:77:1:76-78_5 Template-Type: ReDIF-Article 1.0 Title: Cigarette use among Hispanic and non-Hispanic White school children, Albuquerque, New Mexico Journal: American Journal of Public Health Author-Name: Greenberg, M.A. Author-Name: Wiggins, C.L. Author-Name: Kutvirt, D.M. Author-Name: Samet, J.M. Year: 1987 Volume: 77 Issue: 5 Pages: 621-622 Abstract: We conducted a survey of cigarette usage among Hispanic and non-Hispanic White school children in Albuquerque, New Mexico. The distributions of current, experimental, and never smokers were similar in the two groups. Among smokers, the average weekly cigarette consumption was 19 for Hispanic White males, 14 for non-Hispanic White males, 16 for non-Hispanic White females, and nine for Hispanic White females. Educational programs are needed to maintain the low-risk status of Southwestern Hispanics for cigarette-related diseases. Handle: RePEc:aph:ajpbhl:1987:77:5:621-622_6 Template-Type: ReDIF-Article 1.0 Title: Dental caries in permanent teeth in children of migrant farm workers Journal: American Journal of Public Health Author-Name: Call, R.L. Author-Name: Entwistle, B. Author-Name: Swanson, T. Year: 1987 Volume: 77 Issue: 8 Pages: 1002-1003 Abstract: A 1984 study of dental disease in 534 children (aged 6-15) of migrant farm workers in Colorado found that the prevalence of disease for this population continues to exceed the national and regional average. The mean DMFS was 3.56 with only 23 per cent caries free compared to a regional non-migrant DMFS mean of 2.50 with 44.7 per cent caries free. Results indicate that the children of migrant farm workers should remain a priority in preventive and restorative dental care programs. Handle: RePEc:aph:ajpbhl:1987:77:8:1002-1003_1 Template-Type: ReDIF-Article 1.0 Title: Less hazardous smoking and the pursuit of satisfaction Journal: American Journal of Public Health Author-Name: Kozlowski, L.T. Year: 1987 Volume: 77 Issue: 5 Pages: 539-541 Handle: RePEc:aph:ajpbhl:1987:77:5:539-541_7 Template-Type: ReDIF-Article 1.0 Title: The quality of cause-of-death statistics Journal: American Journal of Public Health Author-Name: Sirken, M.G. Author-Name: Rosenberg, H.M. Author-Name: Chevarley, F.M. Author-Name: Curtin, L.R. Year: 1987 Volume: 77 Issue: 2 Pages: 137-139 Handle: RePEc:aph:ajpbhl:1987:77:2:137-139_0 Template-Type: ReDIF-Article 1.0 Title: Body size, fatness, and leanness of Mexican American children in Brownsville, Texas: Changes between 1972 and 1983 Journal: American Journal of Public Health Author-Name: Malina, R.M. Author-Name: Zavaleta, A.N. Author-Name: Little, B.B. Year: 1987 Volume: 77 Issue: 5 Pages: 573-577 Abstract: Changes in the height, weight, body mass index, triceps skinfold, and arm and estimated midarm muscle circumferences in lower socioeconomic Mexican American children, 6 through 17 years of age, from Brownsville, Texas, were documented on the basis of surveys done in 1972 and 1983. With the exception of height in youths ages 14-17, all parameters show gains at most ages, and in particular an increase in fatness. Brownsville Mexican American youth are similar in height, weight, and the body mass index to Mexican American youth in other areas of Texas. These trends confirm the large proportion of relatively short but heavy children among Mexican Americans. Handle: RePEc:aph:ajpbhl:1987:77:5:573-577_1 Template-Type: ReDIF-Article 1.0 Title: The evolution of maternal birthing position Journal: American Journal of Public Health Author-Name: Dundes, L. Year: 1987 Volume: 77 Issue: 5 Pages: 636-641 Handle: RePEc:aph:ajpbhl:1987:77:5:636-641_9 Template-Type: ReDIF-Article 1.0 Title: Associations between smoking and body weight in the US population: Analysis of NHANES II Journal: American Journal of Public Health Author-Name: Albanes, D. Author-Name: Jones, Y. Author-Name: Micozzi, M.S. Author-Name: Mattson, M.E. Year: 1987 Volume: 77 Issue: 4 Pages: 439-444 Abstract: Recent recommendations for increases in desirable body weights are based upon studies which did not consider the potential confounding effect of cigarette consumption on body weight. We investigated the relation between tobacco use and several anthropometric measurements in 12,103 men and women 19-74 years of age in the United States examined between 1976 and 1980 during the Second National Health and Nutrition Examination Survey (NHANES II). Cigarette smokers weighed less (mean ± standard error = 69.8 ± 0.2 kg) and were leaner (body mass index (weight (kg)/height (m)2) = 24.6 ± 0.1) than nonsmokers (72.5 ± 0.2 kg and 25.7 ± 0.1, respectively), controlling for age and sex. Body leanness increased with the duration (but not intensity) of smoking. Ex-smokers were not heavier or fatter than nonsmokers, and these groups experienced similar weight gain after age 25 (approximately 6 kg in men, 9 kg in women), while current smokers gained substantially less weight (3.5 kg in men, 5.4 kg in women). Compared to nonsmokers, former and current smokers were also slightly taller. Most of these associations were evident in both sexes and all ages evaluated, and were not explained by differences in caloric intake, physical activity, illness, or socioeconomic status. Our findings suggest that the increased mortality observed among lean individuals in previous studies may have been due to smoking rather than leanness per se, and as a result, currently accepted desirable body weights may be overestimated. Handle: RePEc:aph:ajpbhl:1987:77:4:439-444_0 Template-Type: ReDIF-Article 1.0 Title: Health-related outcomes of war in Nicaragua Journal: American Journal of Public Health Author-Name: Garfield, R.M. Author-Name: Frieden, T. Author-Name: Vermund, S.H. Year: 1987 Volume: 77 Issue: 5 Pages: 615-618 Abstract: Since 1983, war in Nicaragua has slowed improvements in health which had developed rapidly from 1979-82. The rate of war-related deaths among Nicaraguans now exceeds that of the United States citizens in either the Vietnam War of World War II. Forty-two of the 84 documented war-related casualties among Nicaraguans health workers have been deaths. This high case fatality rate reflects the targeting of health workers by contra troops. The number of staff and services of the public medical system decreased by approximately 10 per cent from 1983 to 1985. Population movements, the establishment of new settlements, and war-related destruction of the primary health infrastructure are associated with recent epidemics of malaria, dengue, measles, and leishmaniasis. The estimated rate of infant mortality in Nicaragua, which had declined from 120 per 1,000 in 1978 to 76/1,000 live births in 1983, has since shown no further decline. Internationally mandated protections enjoyed by civilians and health workers during times of war do not appear to operate in this so-called 'low intensity' conflict. Further declines in infant mortality, prevention of epidemics, and improvement in other health indicators will likely await the cessation of military hostilities. Handle: RePEc:aph:ajpbhl:1987:77:5:615-618_4 Template-Type: ReDIF-Article 1.0 Title: Lead exposure in a firing range Journal: American Journal of Public Health Author-Name: Novotny, T. Author-Name: Cook, M. Author-Name: Hughes, J. Author-Name: Lee, S.A. Year: 1987 Volume: 77 Issue: 9 Pages: 1225-1226 Abstract: We report lead exposure in four employees of a privately owned shooting range, one of whom had neurological toxicity due to lead. Increasing time worked at the range was associated with elevation of blood lead. This incident emphasizes the risk of airborne lead exposure to employees of firing ranges. Handle: RePEc:aph:ajpbhl:1987:77:9:1225-1226_1 Template-Type: ReDIF-Article 1.0 Title: Alcohol consumption among pregnant smokers: Effects of a smoking cessation intervention program Journal: American Journal of Public Health Author-Name: Fox, N.L. Author-Name: Sexton, M.J. Author-Name: Hebel, J.R. Year: 1987 Volume: 77 Issue: 2 Pages: 211-213 Abstract: This study describes patterns of alcohol consumption among pregnant women who participated in a randomized clinical trial of smoking cessation intervention. Data on alcohol habits were obtained prospectively prior to the 18th week of gestation and during the 8th month of pregnancy. Average alcohol intake for both groups was reduced primarily prior to registration for prenatal care. The smoking cessation intervention reduced smoking during pregnancy but had no effect on alcohol intake. Handle: RePEc:aph:ajpbhl:1987:77:2:211-213_8 Template-Type: ReDIF-Article 1.0 Title: DTP and SIDS: When data differ Journal: American Journal of Public Health Author-Name: Mortimer Jr., E.A. Year: 1987 Volume: 77 Issue: 8 Pages: 925-926 Handle: RePEc:aph:ajpbhl:1987:77:8:925-926_4 Template-Type: ReDIF-Article 1.0 Title: The accuracy of health risk appraisal in predicting mortality Journal: American Journal of Public Health Author-Name: Foxman, B. Author-Name: Edington, D.W. Year: 1987 Volume: 77 Issue: 8 Pages: 971-974 Abstract: In order to determine the accuracy of the Centers for Disease Control/Health Risk Appraisal (CDC/HRA) program, the authors compared observed to predicted mortality for the 3,135 persons followed from 1959-79 as part of the Tecumseh Community Health Study. The analysis was limited to smokers and never-smokers aged 25-60 whose 1959 questionnaires included at least the minimal variables for prediction using the CDC/HRA (age, sex, race, height, weight, and smoking habits). For men and women overall and in each age group, the observed proportion dying over 20 years of follow-up increased as the difference between 1959 age and risk age increased. CDC/HRA predicted 10-year risks of mortality appeared to improve upon age-sex-race predicted risks of mortality when compared to the observed proportion dying over 10 years and when predictors were used in a logistic regression model with vital status after 10 years as the dependent variable. Thus, CDC/HRA may be an appropriate methd for identifying high-risk populations for health interventions. Handle: RePEc:aph:ajpbhl:1987:77:8:971-974_0 Template-Type: ReDIF-Article 1.0 Title: Dentists' consulting behavior and associated knowledge levels Journal: American Journal of Public Health Author-Name: Sadowsky, D. Author-Name: Kunzel, C. Year: 1987 Volume: 77 Issue: 8 Pages: 1000-1001 Abstract: Telephone interviews with stratified random samples of urban and rural general practitioners (GPU, n = 120; GPR, n = 97) and oral surgeons (OS, n = 105) in New York State indicated that requests for expertise, additional data, confirmation of patient's medical status, or medico-legal issues were frequent motives for requesting a consult. Those who consulted more frequently had lower mean knowledge scores than those who consulted less frequently, suggesting that the quality of patient care is potentially improved via the consulting process. Handle: RePEc:aph:ajpbhl:1987:77:8:1000-1001_7 Template-Type: ReDIF-Article 1.0 Title: Tuberculosis risk among migrant farm workers on the Delmarva peninsula Journal: American Journal of Public Health Author-Name: Jacobson, M.L. Author-Name: Mercer, M.A. Author-Name: Miller, L.K. Author-Name: Simpson, T.W. Year: 1987 Volume: 77 Issue: 1 Pages: 29-32 Abstract: A survey was conducted to ascertain the risk of tuberculosis (TB) among migrant farm workers on the Delmarva peninsula. Relevant histories were obtained from 842 migrants: a total of 709 skin tests were completed, and 239 sputum specimens were examined for acid-fast bacilli (AFB) and culture. No cases of infectious tuberculosis were ascertained by history or AFB examination. One sputum culture was positive for M. tuberculosis and 13 were positive for various species of nontuberculous mycobacteria. Thirty-seven percent of migrants tested had significant skin test reactions of 10 mm or more. Reaction rates for men were 41 percent and for women 25 percent. Age specific rates ranged from 14 percent in children aged 5-14 to 54 percent for ages 45-54. Rates for the principal national/ethnic groups were Haitians 55 percent, Mexicans 36 percent, US Blacks 29 percent and US-born Latinos 20 percent. Based on these results and other information currently available, it is recommended that current Centers for Disease Control (CDC) recommendations for TB prophylaxis continue to be applied for migrant workers, but that mass screening by skin testing in camp populations not be emphasized. Other recommendations focus on: case findings of active disease, improving continuity and follow-up, increasing coordination among involved agencies, and actively supporting improved economic and living conditions for migrant farm workers. Handle: RePEc:aph:ajpbhl:1987:77:1:29-32_7 Template-Type: ReDIF-Article 1.0 Title: Prevalence of dental caries and periodontal disease in Mexican American children aged 5 to 17 years: Results from Southwestern HHANES, 1982-83 Journal: American Journal of Public Health Author-Name: Ismail, A.L. Author-Name: Burt, B.A. Author-Name: Brunelle, J.A. Year: 1987 Volume: 77 Issue: 8 Pages: 967-970 Abstract: This paper describes the estimated prevalence of dental caries and periodontal disease in 2,550 children, 5 through 17 years of age, who resided in five southwestern states of the United States and were examined in the Hispanic Health and Nutrition Examination Survey (HHANES) of 1982-84 of the National Center for Health Statistics. Dental caries in the Mexican American children was predominantly a disease of occlusal surfaces of molars; few smooth surfaces of posterior and anterior teeth were affected by caries. This intra-oral distribution of dental caries strongly supports the use of fissure sealants as a preventive procedure. Filled tooth surfaces contributed about 66 per cent of the total DMFS (decayed, missing, filled surfaces) scores. The analysis also shows that about 50 per cent of the 17 year old Mexican Americans had five or more filled or decayed teeth. Mild gingivitis was prevalent (76.9 per cent) in the Mexican American children. Handle: RePEc:aph:ajpbhl:1987:77:8:967-970_1 Template-Type: ReDIF-Article 1.0 Title: Adjusted hospital death rates: A potential screen for quality of medical care Journal: American Journal of Public Health Author-Name: Dubois, R.W. Author-Name: Brook, R.H. Author-Name: Rogers, W.H. Year: 1987 Volume: 77 Issue: 9 Pages: 1162-1167 Abstract: Increased economic pressure on hospitals has accelerated the need to develop a screening tool for identifying hospitals that potentially provide poor quality care. Based upon data from 93 hospitals and 205,000 admissions, we used a multiple regression model to adjust the hospitals crude death rate. The adjustment process used age, origin of patient from the emergency department or nursing home, and a hospital case mix index based on DRGs (diagnostic related groups). Before adjustment, hospital death rates ranged from 0.3 to 5.8 per 100 admissions. After adjustment, hospital death ratios ranged from 0.36 to 1.36 per 100 (actual death rate divided by predicted death rate). Eleven hospitals (12 per cent) were identified where the actual death rate exceeded the predicted death rate by more than two standard deviations. In nine hospitals (10 per cent), the predicted death rate exceeded the actual death rate by a similar statistical margin. The 11 hospitals with higher than predicted death rates may provide inadequate quality of care or have uniquely ill patient populations. The adjusted death rate model needs to be validated and generalized before it can be used routinely to screen hospitals. However, the remaining large differences in observed versus predicted death rates lead us to believe that important differences in hospital performance may exist. Handle: RePEc:aph:ajpbhl:1987:77:9:1162-1167_0 Template-Type: ReDIF-Article 1.0 Title: Measles outbreak in a vaccinated school population: Epidemiology, chains of transmission and the role of vaccine failures Journal: American Journal of Public Health Author-Name: Nkowane, B.M. Author-Name: Bart, S.W. Author-Name: Orenstein, W.A. Author-Name: Baltier, M. Year: 1987 Volume: 77 Issue: 4 Pages: 434-438 Abstract: An outbreak of measles occurred in a high school with a documented vaccination level of 98 per cent. Nineteen (70 per cent) of the cases were students who had histories of measles vaccination at 12 months of age or older and are therefore considered vaccine failures. Persons who were unimmunized or immunized at less than 12 months of age had substantially higher attack rates compared to those immunized on or after 12 months of age. Vaccine failures among apparently adequately vaccinated individuals were sources of infection for at least 48 per cent of the cases in the outbreak. There was no evidence to suggest that waning immunity was a contributing factor among the vaccine failures. Close contact with cases of measles in the high school, source or provider of vaccine, sharing common activities or classes with cases, and verification of the vaccination history were not significant risk factors in the outbreak. The outbreak subsided spontaneously after four generations of illness in the school and demonstrates that when measles is introduced in a highly vaccinated population, vaccine failures may play some role in transmission but that such transmission is not usually sustained. Handle: RePEc:aph:ajpbhl:1987:77:4:434-438_3 Template-Type: ReDIF-Article 1.0 Title: Frame categories in weight-height tables. Journal: American Journal of Public Health Author-Name: Rookus, M.A. Author-Name: Burema, J. Year: 1987 Volume: 77 Issue: 1 Pages: 94 Handle: RePEc:aph:ajpbhl:1987:77:1:94_9 Template-Type: ReDIF-Article 1.0 Title: Hospitalizations for AIDS, United States, 1984-85 Journal: American Journal of Public Health Author-Name: Graves, E.J. Author-Name: Moien, M. Year: 1987 Volume: 77 Issue: 6 Pages: 729-730 Abstract: Data from the National Hospital Discharge Survey on hospitalizations for acquired immunodeficiency sydrome (AIDS) were analyzed for 1984-85. During 1984, an estimated 10,000 discharges from short-stay hospitals had a diagnosis of AIDS. In 1985, this figure more than doubled to 23,000. Ninety-seven percent of all AIDS discharges were male and 85 per cent were between the ages of 25 and 44. Hospitalizations for AIDS accounted for 510,000 days of hospital care and lasted an average of 15.6 days each. Handle: RePEc:aph:ajpbhl:1987:77:6:729-730_9 Template-Type: ReDIF-Article 1.0 Title: Degree of public support for household hazardous waste control alternatives Journal: American Journal of Public Health Author-Name: Tuthill, R.W. Author-Name: Stanek III, E.J. Author-Name: Willis, C. Author-Name: Moore, G.S. Year: 1987 Volume: 77 Issue: 3 Pages: 304-306 Abstract: This paper reports information from Massachusetts on attitudes of householders toward alternative approaches and economic solutions to household hazardous waste (HHW) generation and disposal. Residents appear to be aware of the nature of the HHW problem and clearly support action to address the problem. The majority support a law fining householders for the improper disposal of HHW, endorse paying a sales tax on domestic hazardous products to finance safe disposal, and appear willing to drive up to five miles to dispose of HHW twice yearly. Handle: RePEc:aph:ajpbhl:1987:77:3:304-306_3 Template-Type: ReDIF-Article 1.0 Title: Spousal veto over family planning services Journal: American Journal of Public Health Author-Name: Cook, R.J. Author-Name: Maine, D. Year: 1987 Volume: 77 Issue: 3 Pages: 339-344 Abstract: In many countries a spouse, usually the husband, can veto a partner's use of family planning services. Where spousal veto acts as a barrier to family planning services it represents a serious threat to the lives and health of women and children. Removal of spousal authorization requirements has been shown to increase the use of family planning services. The Family Guidance Association of Ethiopia, for example, removed their requirement in 1982 and clinic utilization increased by 26 per cent within a few months. Courts of several countries have held that spousal veto practices violate principles of personal privacy and autonomy and the right to health care. The effect of such judgments has been to reinforce rights to sexual nondiscrimination found, for example, in national constitutions and the Convention on the Elimination of All Forms of Discrimination against Women. This article discusses the nature and application of spousal veto practices, explains how such requirements can violate certain human rights, and explores possible remedies to this problem, including ministerial, legislative, and judicial initiatives. Handle: RePEc:aph:ajpbhl:1987:77:3:339-344_5 Template-Type: ReDIF-Article 1.0 Title: Sudden death in sleep of Laotian-Hmong refugees in Thailand: A case-control study Journal: American Journal of Public Health Author-Name: Munger, R.G. Year: 1987 Volume: 77 Issue: 9 Pages: 1187-1190 Abstract: A syndrome of sudden and unexpected death during sleep occurs among adult Southeast Asian refugees in the United States. Surveillance for sudden deaths was conducted among Laotian-Hmong refugees in the Ban Vinai refugee camp in northeastern Thailand to determine if a similar cause of death occurs there. Sixteen sudden and unexpected deaths associated with sleep were found that were similar to the sudden deaths noted among Southeast Asian refugees in the United States. A case-control study in Ban Vinai revealed associations between sudden death in sleep and membership in the Green-Hmong subgroup, a family history of sudden death, and previous non-fatal sleep disturbances. Sudden and unexpected death during sleep of young adults is a regional phenomenon within Asia and occurs in populations that are culturally and genetically distinct. Migrants from affected populations in Asia carry with them the susceptibility to sudden death in sleep. Handle: RePEc:aph:ajpbhl:1987:77:9:1187-1190_4 Template-Type: ReDIF-Article 1.0 Title: Neonatal mortality in Missouri home births, 1978-84 Journal: American Journal of Public Health Author-Name: Schramm, W.F. Author-Name: Barnes, D.E. Author-Name: Bakewell, J.M. Year: 1987 Volume: 77 Issue: 8 Pages: 930-935 Abstract: A study was conducted of 4,054 Missouri home births occurring from 1978 through 1984. Of the 3,645 births whose planning status was identified, 3,067 (84 per cent) were planned to be at home. Neonatal mortality was elevated for both planned (17 observed deaths vs 8.59 expected deaths) and unplanned home births (45 observed vs 33.19 expected) compared with physician-attended hospital births. Nearly all of the mortality excess for planned home births occurred in association with lesser trained attendants (12 observed vs 4.42 expected), while for unplanned home births the excess was entirely among infants weighing 1500 grams or more (19 observed vs 3.50 expected). For planned home births attended by physicians, certified nurse-midwives, or Missouri Midwife Association recognized midwives, there was little difference between observed and expected deaths (5 observed vs 3.92 expected). There also was little difference in deaths for unplanned home births weighing less than 1500 grams (26 observed vs 29.69 expected) compared with hospital births. The study provides evidence of the importance of having skilled attendants present at planned home births. Handle: RePEc:aph:ajpbhl:1987:77:8:930-935_2 Template-Type: ReDIF-Article 1.0 Title: Training bar personnel to prevent drunken driving: A field evaluation Journal: American Journal of Public Health Author-Name: Russ, N.W. Author-Name: Geller, E.S. Year: 1987 Volume: 77 Issue: 8 Pages: 952-954 Abstract: The potential of a server intervention program to decrease the likelihood that a bar patron will leave a bar intoxicated was evaluated. Research assistants posing as regular patrons ('pseudopatrons') visited two bars where about half of the servers had received server intervention training. Pseudopatrons set the occasion for server intervention to occur by drinking six alcoholic beverages in two hours. The blood-alcohol concentration (BAC) of the pseudopatrons was measured after they left the bar. Results revealed that trained servers initiated more server interventions than did untrained personnel. Moreover, pseudopatrons served by trained personnel reached substantially lower BACs than those served by untrained servers. These results suggest that, if implemented on a large scale, server intervention programs have the potential of reducing drunken driving by helping to decrease the exit BACs of bar patrons. Handle: RePEc:aph:ajpbhl:1987:77:8:952-954_3 Template-Type: ReDIF-Article 1.0 Title: Intestinal parasites in pet store puppies in Atlanta Journal: American Journal of Public Health Author-Name: Stehr-Green, J.K. Author-Name: Murray, G. Author-Name: Schantz, P.M. Author-Name: Wahlquist, S.P. Year: 1987 Volume: 77 Issue: 3 Pages: 345-346 Abstract: We examined 143 pups from 14 Atlanta area pet stores for intestinal parasites and reviewed deworming practices and information given to customers. Seventy-four (52 per cent) of the pups had at least one parasite including Giardia sp. (34 per cent), Toxocara canis (12 per cent), and Isospora sp. (9 per cent). Eighty-eight per cent received some form of anthelminthic treatment while at the store. Only six (43 per cent) of the stores routinely informed clients of the need to continue deworming procedures once the pup left the store. Handle: RePEc:aph:ajpbhl:1987:77:3:345-346_9 Template-Type: ReDIF-Article 1.0 Title: Progress toward meeting the 1990 nutrition objectives for the nation: Nutrition services and data collection in state/territorial health agencies Journal: American Journal of Public Health Author-Name: Kaufman, M. Author-Name: Heimendinger, J. Author-Name: Foerster, S. Author-Name: Carroll, M.A. Year: 1987 Volume: 77 Issue: 3 Pages: 299-303 Abstract: Promoting health, preventing disease, objectives for the Nation, specifies nutrition as a priority area for improving the health of Americans by 1990. Eleven of the 15 nutrition objectives target adults or the public while four address pregnant and lactating women, infants, and children. To determine progress by states toward achieving the nutrition objectives, the Association of State and Territorial Public Health Nutrition Directors conducted a survey in 1985 to which 54 state and territorial nutrition directors responded. Three-fourths of the nutrition personnel focused efforts on maternal and child populations, and were supported largely by frederal funds from the Special Supplemental Food Program for Women, Infants, and Children (WIC) and the Maternal and Child Health Block Grant. Only 15 percent were funded by state and local sources. Whilst most agencies reported using nutrition consultation in adult health programs, only 25 percent paid for these personnel. Data to monitor progress were commonly available for only five of the 15 objectives. Achievement of the nutrition objectives by states will require a more comprehensive approach to nutrition programming with increased allocation of appropriate resources and expansion of health data systems. Handle: RePEc:aph:ajpbhl:1987:77:3:299-303_7 Template-Type: ReDIF-Article 1.0 Title: Maternal marijuana use and neonatal outcome: Uncertainty posed by self-reports Journal: American Journal of Public Health Author-Name: Hingson, R. Author-Name: Zuckerman, B. Author-Name: Amaro, H. Author-Name: Frank, D.A. Author-Name: Kayne, H. Author-Name: Sorenson, J.R. Author-Name: Mitchell, J. Author-Name: Parker, S. Author-Name: Morelock, S. Author-Name: Timperi, R. Year: 1986 Volume: 76 Issue: 6 Pages: 667-669 Abstract: To assess the validity of self-reported marijuana use during pregnancy, this study randomly allocated pregnant women into a group who were told their urine would be tested for marijuana, alcohol, and other drugs and another group not so tested. Women told they would be tested reported more marijuana use during pregnancy than did untested women. Moreover, urine assays identified more women who used marijuana during pregnancy than were willing to admit it in the interview even after being told their urine would be tested. No differences in reported drinking or cigarette smoking during pregnancy were found between tested and untested women. Handle: RePEc:aph:ajpbhl:1986:76:6:667-669_4 Template-Type: ReDIF-Article 1.0 Title: Control of day care shigellosis: A trial of convalescent day care in isolation Journal: American Journal of Public Health Author-Name: Tauxe, R.V. Author-Name: Johnson, K.E. Author-Name: Boase, J.C. Author-Name: Helgerson, S.D. Author-Name: Blake, P.A. Year: 1986 Volume: 76 Issue: 6 Pages: 627-630 Abstract: Simultaneous outbreaks of S. sonnei infections occurred in September 1983 at two day care centers in Seattle, Washington. At both centers, there were high rates of diarrheal illness in the children (22/80 and 11/23, respectively), in staff members, and in family members of the ill children. The smaller center was temporarily closed, but the larger one remained open. Convalescent children and staff whose diarrhea had resolved and who were receiving appropriate antimicrobials were allowed to return to the larger center before negative cultures were obtained and were separated in an isolation room. No culture-proven cases of shigellosis occurred at either center in the following two months. Plasmid profile determinations suggested the Shigella were not transmitted from the center that remained open to the community. Estimated need for alternate child care requirements at the closed center were 100-fold greater than at the center with the isolation room. Caring for convalenscent children in isolation at day care centers while they receive antimicrobial therapy may be a useful strategy for controlling day care shigellosis. Handle: RePEc:aph:ajpbhl:1986:76:6:627-630_4 Template-Type: ReDIF-Article 1.0 Title: Source of admission and cost: Public hospitals face financial risk Journal: American Journal of Public Health Author-Name: Munoz, E. Author-Name: Soldano, R. Author-Name: Laughlin, A. Author-Name: Margolis, I.B. Author-Name: Wise, L. Year: 1986 Volume: 76 Issue: 6 Pages: 696-697 Abstract: We studied all admissions to the 11 acute care hospitals of the New York City Health and Hospitals Corporation (April 1983-September 1984) matching emergency room (ER) admitted diagnostic related group (DRG) subgroups in each hospital with at least five non-ER admitted patients (N = 222,961). Mean cost per ER patient ($8,385) was greater than non-ER mean cost per patient ($4,386) for Medicare and non-Medicare. Our data suggest that public hospitals with a high proportion of ER admissions may be at a financial disadvantage under DRG reimbursement. Handle: RePEc:aph:ajpbhl:1986:76:6:696-697_1 Template-Type: ReDIF-Article 1.0 Title: Survey of city/county public health agencies to determine the development, use, and effect of program performance standards Journal: American Journal of Public Health Author-Name: Axnick, N.W. Author-Name: Katz, M. Author-Name: Schiffer, C. Author-Name: Johnson, W. Author-Name: Cross, F. Year: 1986 Volume: 76 Issue: 6 Pages: 692-694 Abstract: For over 80 per cent of a national sample of local health agencies in the United States, minimum program standards are specified by the state, by law, regulation, or some other policy method. The performance standards that are used are a mix of state and local standards, with one-third of the agencies reporting that the Model Standards were used in developing their own standards. Handle: RePEc:aph:ajpbhl:1986:76:6:692-694_0 Template-Type: ReDIF-Article 1.0 Title: Influenza A in nursing homes. Journal: American Journal of Public Health Author-Name: Heun, E.M. Author-Name: Vogt, R.L. Author-Name: Birkhead, G.S. Year: 1986 Volume: 76 Issue: 12 Pages: 1460-1461 Handle: RePEc:aph:ajpbhl:1986:76:12:1460-1461_5 Template-Type: ReDIF-Article 1.0 Title: Occupational lead poisoning in Ohio: Surveillance using workers' compensation data Journal: American Journal of Public Health Author-Name: Seligman, P.J. Author-Name: Halperin, W.E. Author-Name: Mullan, R.J. Author-Name: Frazier, T.M. Year: 1986 Volume: 76 Issue: 11 Pages: 1299-1302 Abstract: To determine the utility of workers' compensation (WC) data in a system for the surveillance of occupational lead poisoning, we reviewed workers' compensation claims for lead poisoning in Ohio. For the period 1979 through 1983, 92 (81 per cent) of the 114 claims attributed to lead met our case definition of lead poisoning. The likelihood that a company had a case of lead poisoning was strongly correlated with the number of claims against the company. Thirty companies accounted for the 92 cases; two companies accounted for 49 per cent of these. Inspection by the Occupational Safety and Health Administration (OSHA) occurred at 14 of these companies, all of which were cited for violations of the OSHA lead standard. Comparison of the Standard Industrial Classification (SIC) codes for the 14 companies inspected by OSHA with the 15 companies not inspected by OSHA revealed that OSHA inspected battery manufacturers, non-ferrous foundries, secondary smelters, and primary lead smelters, but not bridge painters, manufacturers of electronic components, mechanical power transmission equipment, pumps, and paints, nor a sheriff's office where firing range slugs were remelted to make new bullets. Neither the number of cases of lead poisoning at a company nor the size of a company was related to the likelihood of being inspected by OSHA. Claims for WC appear to be a useful adjunct to an occupational lead poisoning surveillance system; their usefulness should be compared to that of other systems such as laboratory reports of elevated blood lead levels in adults. Handle: RePEc:aph:ajpbhl:1986:76:11:1299-1302_0 Template-Type: ReDIF-Article 1.0 Title: Geographic variation in the onset of decline of ischemic heart disease mortality in the United States Journal: American Journal of Public Health Author-Name: Wing, S. Author-Name: Hayes, C. Author-Name: Heiss, G. Author-Name: John, E. Author-Name: Knowles, M. Author-Name: Riggan, W. Author-Name: Tyroler, H.A. Year: 1986 Volume: 76 Issue: 12 Pages: 1404-1408 Abstract: This report examines geographic variation in the onset of the decline of ischemic heart disease (IHD) mortality in white males aged 35-74 during the period 1968-78. Using a quadratic regression model, State Economic Areas (SEAs) were classified as experiencing onset of the decline in 1968 or earlier, 1969-72, or 1973 or later. In the United States as a whole, approximately one-third of SEAs experienced a late onset of the decline (after 1968). Metropolitan SEAs were in advance of non-metropolitan, and the Northeast and Pacific states showed earlier onset than the South and midsections of the country. The acceleration of the national decline after 1972 appears to be due to declines in areas in which rates had been increasing or in plateau until that time. Evidence about geographic variation in the onset of decline may provide clues about social and environmental factors responsible for the decline. Handle: RePEc:aph:ajpbhl:1986:76:12:1404-1408_8 Template-Type: ReDIF-Article 1.0 Title: Hospitalized burn injuries in Massachusetts: An assessment of incidence and product involvement Journal: American Journal of Public Health Author-Name: Rossignol, A.M. Author-Name: Boyle, C.M. Author-Name: Locke, J.A. Author-Name: Burke, J.F. Year: 1986 Volume: 76 Issue: 11 Pages: 1341-1343 Abstract: We assessed the frequency of hospitalized burn injuries in Massachusetts, and product involvement in causing burns, by reviewing the hospital inpatient records and emergency room logbooks for 240 of New England's 256 acute-care hospitals. Children less than two years of age, males, and Blacks experienced higher burns rates than did older individuals, females, or Whites. Products frequently associated with burn injuries included those involved in food preparation and consumption, flammable liquids, and clothing. Handle: RePEc:aph:ajpbhl:1986:76:11:1341-1343_7 Template-Type: ReDIF-Article 1.0 Title: Acceptance of hepatitis B vaccine among hospital workers: A follow-up Journal: American Journal of Public Health Author-Name: Fulton, J.P. Author-Name: Bodenheimer Jr., H.C. Author-Name: Kramer, P.D. Year: 1986 Volume: 76 Issue: 11 Pages: 1339-1340 Abstract: We reported earlier on 1,500 hospital employees whose desire for hepatitis B vaccine was assessed. We followed 229 of these subjects to measure the effect of a voluntary educational intervention on desire for vaccine. Acceptance of vaccine declined in 37 per cent of subjects and increased in 13 per cent. One of the extraneous influences on demand for vaccine may have been high-profile media coverage of the AIDS (acquired immune deficiency syndrome) epidemic. Handle: RePEc:aph:ajpbhl:1986:76:11:1339-1340_6 Template-Type: ReDIF-Article 1.0 Title: Impact and cost of public health nurse telephone follow-up of school dental referrals Journal: American Journal of Public Health Author-Name: Oda, D.S. Author-Name: Fine, J.I. Author-Name: Heilbron, D.C. Year: 1986 Volume: 76 Issue: 11 Pages: 1348-1349 Abstract: The effect and cost of nursing follow-up services on school dental screening outcomes were investigated. Experimental and control groups were randomly assigned. A positive difference in dental visit rate occurred for all nurses, with the overall detist visit-no-visit, experimental-control odds ratio being 1.64 (95% CL = 1.15, 2.35). The service averaged 27.7 minutes and $8.92 per family contacted, suggesting that nursing follow-up increased dental care utilization after screening at low cost in this population. Handle: RePEc:aph:ajpbhl:1986:76:11:1348-1349_4 Template-Type: ReDIF-Article 1.0 Title: Chemical industry accidents, liability, and community right to know Journal: American Journal of Public Health Author-Name: Baram, M.S. Year: 1986 Volume: 76 Issue: 5 Pages: 568-572 Abstract: The communication of hazard information is now recognized as a vital feature of the new self-help efforts being made by workers and community residents to prevent industrial risks and avoid harem. Legislation at state and federal levels, regulatory actions, and common law doctrines now impose on industry the duty to warn of hazards, and also provide persons at risk with the right-to-know hazard information. Thus, hazard communication is more than a theory or moral imperative; it is now rooted in explicit and enforceable legal doctrines. Moreover, hazard communication is not an isolated development: it has broad implications for corporate management. The duty to warn imposed on industry carries with it two concomitant duties for industrial officials: the duty to identify hazards through reasonable efforts and the use of expertise so that the duty to warn will be meaningful; and the duty to act diligently to control or reduce the hazards, once they have been identified, so that the duty to warn will not be dispositive on the matter of corporate responsibility. Thus, three corporate functions for risk management are inextricably linked. Exercise of their rights under these doctrines, and of other authority for the right to know by persons who perceive they may be at risk provides the continuing pressure on industry and agencies to comply with these duties, and assures corporate accountability in carrying out the duties to identify, warn and act. Thus, powerful tools are now available for use in the new self-help era of occupational and environmental protection. Handle: RePEc:aph:ajpbhl:1986:76:5:568-572_6 Template-Type: ReDIF-Article 1.0 Title: Social class and Black-White differences in breast cancer survival Journal: American Journal of Public Health Author-Name: Bassett, M.T. Author-Name: Krieger, N. Year: 1986 Volume: 76 Issue: 12 Pages: 1400-1403 Abstract: In the United States, Blacks have poorer survival rates than Whites for breast cancer. The root of this difference - social or genetic - is unclear. Utilizing the Western Washington Cancer Surveillance System and 1980 Census block group data, we examined social class and race as predictors of breast cancer survival in 1,506 women during their first 11 years following diagnosis (251 Blacks, 1,255 Whites). In a Cox regression model, after adjustment for Black-White differences in age, stage, and histology, Black mortality was 1.35 times that of Whites (95%CI = 1.05-1.72). Following additional adjustment for social class, as measured by a variety of block group characteristics, Black mortality was only 1.10 times that of Whites (95%CI = 0.83-1.46). In both Blacks and Whites, poorer social class was a powerful determinant of shortened survival. These results indicate that the observed breast cancer survival differences between Black and White women today in the US today is substantially due to the poorer social class standing of Blacks. Handle: RePEc:aph:ajpbhl:1986:76:12:1400-1403_1 Template-Type: ReDIF-Article 1.0 Title: Adolescents and AIDS: A survey of knowledge, attitudes and beliefs about AIDS in San Francisco Journal: American Journal of Public Health Author-Name: DiClemente, R.J. Author-Name: Zorn, J. Author-Name: Temoshok, L. Year: 1986 Volume: 76 Issue: 12 Pages: 1443-1445 Abstract: To assess adolescents' knowledge, attitudes, and beliefs about AIDS in San Francisco, data were obtained from 1,326 adolescents. There was marked variability in knowledge across informational items, particularly about the precautionary measures to be taken during sexual intercourse which may reduce the risk of infection. We conclude that development and implementation of school health education programs on AIDS and other sexually transmitted diseases are needed in this population. Handle: RePEc:aph:ajpbhl:1986:76:12:1443-1445_3 Template-Type: ReDIF-Article 1.0 Title: Smoking behavior and attitudes toward smoking among hospital nurses Journal: American Journal of Public Health Author-Name: Becker, D.M. Author-Name: Myers, A.H. Author-Name: Sacci, M. Author-Name: Weida, S. Author-Name: Swank, R. Author-Name: Levine, D.M. Author-Name: Pearson, T.A. Year: 1986 Volume: 76 Issue: 12 Pages: 1449-1451 Abstract: We examined smoking prevalence, smoking behavior, and attitudes toward smoking in hospitals in 1,380 respondents among 1,719 registered nurses in a large urban teaching hospital. In this group, current prevalence of smoking in hospital nurses (22 per cent) was less than women in the general population (29 per cent). Smoking nurses were more likely than nonsmokers to hold attitudes which potentially reduce their efficacy in helping patients to stop smoking. Handle: RePEc:aph:ajpbhl:1986:76:12:1449-1451_5 Template-Type: ReDIF-Article 1.0 Title: Drugs and stillbirth Journal: American Journal of Public Health Author-Name: Porter, J.B. Author-Name: Hunter-Mitchell, J. Author-Name: Jick, H. Author-Name: Walker, A.M. Year: 1986 Volume: 76 Issue: 12 Pages: 1428-1431 Abstract: In a case-control study spanning five years' experience at Group Health Cooperative of Puget Sound, we could demonstrate no plausible association between the use of spermicides, oral contraceptives, Bendectin, or antibiotics prior to conception and the occurrence of 73 nontraumatic stillbirths. Handle: RePEc:aph:ajpbhl:1986:76:12:1428-1431_2 Template-Type: ReDIF-Article 1.0 Title: A comparative study of hospital fetal death records and Washington State fetal death certificates Journal: American Journal of Public Health Author-Name: Harter, L. Author-Name: Starzyk, P. Author-Name: Frost, F. Year: 1986 Volume: 76 Issue: 11 Pages: 1333-1334 Abstract: Hospital fetal death records were compared with Washington State fetal death certificates to ascertain the completeness of reporting. Washington State law requires reporting of all fetal deaths of 20 or more weeks gestation. For 16 hospitals reporting 603 fetal deaths, an additional 49 fetal deaths were identified in the mother's charts. The study documents underreporting, especially in the gestational ages closest to the 20-week age limitation where 71 per cent of the 48 unreported cases were 20 to 27 weeks gestation. Handle: RePEc:aph:ajpbhl:1986:76:11:1333-1334_5 Template-Type: ReDIF-Article 1.0 Title: Blacks in the Coronary Artery Surgery Study (CASS): Race and clinical decision making Journal: American Journal of Public Health Author-Name: Maynard, C. Author-Name: Fisher, L.D. Author-Name: Passamani, E.R. Author-Name: Pullum, T. Year: 1986 Volume: 76 Issue: 12 Pages: 1446-1448 Abstract: For patients enrolled in the Coronary Artery Surgery Study (CASS), surgery was recommended for 46.5 per cent of Blacks and 59.4 per cent of Whites, despite similar clinical and angiographic characteristics. Of those recommended, 80.5 per cent of Blacks and 90.4 per cent of Whites had bypass surgery. These differences were most apparent for Black laborers. Overall, only 38.0 per cent of Blacks had coronary artery bypass surgery, whereas 58.4 per cent of Whites received surgery. Handle: RePEc:aph:ajpbhl:1986:76:12:1446-1448_1 Template-Type: ReDIF-Article 1.0 Title: Asbestos disease screening by non-specialists: Results of an evaluation Journal: American Journal of Public Health Author-Name: Zoloth, S. Author-Name: Michaels, D. Author-Name: Lacher, M. Author-Name: Nagin, D. Author-Name: Drucker, E. Year: 1986 Volume: 76 Issue: 12 Pages: 1392-1395 Abstract: We performed a medical audit of an asbestos disease screening program offered to New York City sheet metal workers by a corporate medical service. The screening program purported to evaluates the health status of workers exposed to asbestos in the past and present during construction and renovation of commercial buildings. Using current Occupational Safety and Health Administration (OSHA) regulations as a benchmark, medical records for more than 800 workers who took the examination between 1982-83 were reviewed; x-ray interpretations of the staff radiologist were compared with the interpretations of specialists in occupational lung diseases. The audit found inadequate record-keeping procedures, a lack of a comprehensive occupational history, poor notification and absence of any form of health education. Further, there was an extreme lack of concordance between the staff radiologist and the specialist readers in the interpretation of x-rays (kappa = .14 for pleural disease and .26 for asbestosis). To an increasing extent, occupational clinical services are being provided by corporate medical groups; such groups may not be familiar with occupational health problems. Handle: RePEc:aph:ajpbhl:1986:76:12:1392-1395_9 Template-Type: ReDIF-Article 1.0 Title: Children's seatbelt usage: Evidence from the National Health Interview Survey Journal: American Journal of Public Health Author-Name: Haaga, J. Year: 1986 Volume: 76 Issue: 12 Pages: 1425-1427 Abstract: Data from the 1981 Child Health Supplement to the National Health Interview Survey were used to examine relationships between family and child characteristics and regular use of seatbelts or child restraints. Only for a third of children less than seven years old was regular seatbelt use reported. They were more likely to be used for infants and younger children than for older children; for a given child's age, older mothers were more likely to report seatbelt use by their children. Hispanics and Blacks reported lower rates of seatbelt use than White non-Hispanics, and usage rates were higher when mothers had more education. In a multivariate analysis, the effects of race, ethnicity, family income, urban residence, and child's age remained. A positive association with reported seatbelt use was found for such health-promoting behaviors as breastfeeding and abstinence from smoking during pregnancy. Handle: RePEc:aph:ajpbhl:1986:76:12:1425-1427_4 Template-Type: ReDIF-Article 1.0 Title: Condom usage by i.v. drug users. Journal: American Journal of Public Health Author-Name: Mackintosh, D. Author-Name: Mundey, L. Author-Name: Fischer, G. Author-Name: Morgan, E. Year: 1986 Volume: 76 Issue: 12 Pages: 1460 Handle: RePEc:aph:ajpbhl:1986:76:12:1460_2 Template-Type: ReDIF-Article 1.0 Title: Decline in the incidence of carcinoma in situ of the cervix Journal: American Journal of Public Health Author-Name: Chow, W.-H. Author-Name: Greenberg, R.S. Author-Name: Liff, J.M. Year: 1986 Volume: 76 Issue: 11 Pages: 1322-1324 Abstract: Temporal trends in the incidence of carcinoma in situ of the uterine cervix were evaluated in metropolitan Atlanta between 1975 and 1983. The average annual age-adjusted incidence rates per 100,000 women decreased from 61.5 in 1975-77 to 40.1 in 1981-83 for Whites and from 118.3 to 51.8 for Blacks during the same time periods. The relative declines were uniform across all age groups and exceeded the corresponding reductions in the incidence of invasive cervical carcinoma. Handle: RePEc:aph:ajpbhl:1986:76:11:1322-1324_8 Template-Type: ReDIF-Article 1.0 Title: Asbestos examinations for construction workers: A workable alternative Journal: American Journal of Public Health Author-Name: Whorton, M.D. Year: 1986 Volume: 76 Issue: 12 Pages: 1388-1389 Handle: RePEc:aph:ajpbhl:1986:76:12:1388-1389_6 Template-Type: ReDIF-Article 1.0 Title: Ethnic differences in preterm and very preterm delivery Journal: American Journal of Public Health Author-Name: Shiono, P.H. Author-Name: Klebanoff, M.A. Year: 1986 Volume: 76 Issue: 11 Pages: 1317-1321 Abstract: Ethnic differences in preterm (<37 weeks) and very preterm (<33 weeks) delivery were evaluated in a prospective cohort of 28,330 women. Blacks had the highest rate of preterm and very preterm delivery, followed by Mexican-Americans, Asians, and Whites. Adjustment for maternal age, education, marital status, employment, parity, number of previous spontaneous or induced abortions, smoking and drinking during pregnancy, infant sex, and gestational age at initiation of prenatal care resulted in the following odds ratios for preterm delivery: 1.79 (1.55-2.08) for Blacks, 1.40 (1.19-1.63) for Mexican-Americans, 1.40 (1.16-1.69) for Asians, and 1.00 for Whites. The corresponding odds ratios for very preterm delivery were 2.35 (1.72-3.22) for Blacks, 1.31 (0.88-1.94) for Mexican-Americans, 1.10 (0.67-1.83) for Asians, and 1.00 for Whites. Exclusion of cases of premature rupture of membranes, placenta previa, and abruptio placenta did not explain the large ethnic differences. Although Whites and Mexican-Americans had similar birthweight distributions, Mexican-Americans had an increased risk for preterm delivery. Fifty-five per cent of low birthweight babies in Kaiser were preterm and this fraction did not vary substantially by ethnic group. Handle: RePEc:aph:ajpbhl:1986:76:11:1317-1321_0 Template-Type: ReDIF-Article 1.0 Title: The nonprofit sector's response to the AIDS epidemic: Community-based services in San Francisco Journal: American Journal of Public Health Author-Name: Arno, P.S. Year: 1986 Volume: 76 Issue: 11 Pages: 1325-1330 Abstract: Community-based organizations in San Francisco have played a key role in providing social support services and public health information to those affected by acquired immune deficiency syndrome (AIDS). These services have helped minimize the economic impact of the epidemic by reducing the level and expense of hospitalization of AIDS patients. During fiscal year 1984-85, the three largest community-based groups in San Francisco provided more than 80,000 hours of social support and counseling services, responded to over 30,000 telephone inquiries and letters, and distributed nearly 250,000 pieces of literature. Home-based hospice care was provided to 165 AIDS patients at an average cost per day of $94 per patient. Community-based organizations require a significant level of funding from government and private sources. Local government in San Francisco has provided 62 per cent of the revenues for these groups. At the same time, they are not viable without a steady stream of volunteer labor. More than 130,000 hours were donated this past year. There are intrinsic limits to the current dependency on unpaid labor and contributions made by private charity and local government which will eventually require increased support and intervention at the state and federal levels. Handle: RePEc:aph:ajpbhl:1986:76:11:1325-1330_9 Template-Type: ReDIF-Article 1.0 Title: Advice about weight gain during pregnancy and actual weight gain Journal: American Journal of Public Health Author-Name: Taffel, S.M. Author-Name: Keppel, K.G. Year: 1986 Volume: 76 Issue: 12 Pages: 1396-1399 Abstract: In the 1980 National Natality Survey, married mothers were asked whether their doctors had suggested a weight gain limit during pregnancy and, if so, what limit was suggested. Current obstetric recommendations call for 22-27 pound weight gain. Previous research indicates that gaining less than 16 pounds greatly increases the likelihood of a poor pregnancy outcome. Reported advice varied by mother's race, education, parity, and prepregnancy weight. Mothers given no advice or advised to gain less than 22 pounds were far more likely than others to have an inadequate gain. The findings suggest that many more women should be told that it is appropriate to gain at least 22 pounds. Handle: RePEc:aph:ajpbhl:1986:76:12:1396-1399_0 Template-Type: ReDIF-Article 1.0 Title: Weight gain during pregnancy Journal: American Journal of Public Health Author-Name: Chez, R.A. Year: 1986 Volume: 76 Issue: 12 Pages: 1390-1391 Handle: RePEc:aph:ajpbhl:1986:76:12:1390-1391_8 Template-Type: ReDIF-Article 1.0 Title: Flies and Campylobacter. Journal: American Journal of Public Health Author-Name: Ruble, R. Year: 1986 Volume: 76 Issue: 12 Pages: 1457 Handle: RePEc:aph:ajpbhl:1986:76:12:1457_7 Template-Type: ReDIF-Article 1.0 Title: The relationship of family income to the incidence, external causes, and outcomes of serious brain injury, San Diego County, California Journal: American Journal of Public Health Author-Name: Kraus, J.F. Author-Name: Fife, D. Author-Name: Ramstein, K. Author-Name: Conroy, C. Author-Name: Cox, P. Year: 1986 Volume: 76 Issue: 11 Pages: 1345-1347 Abstract: Among residents of San Diego County, California the incidence and external causes of serious brain injury were related to the median family income of the census tract of residency. Low income tracts had high incidence rates - a finding not changed by adjustment for age and race/ethnicity. For those injured, the type of emergency transport, time from injury to treatment, and outcome of treatment were not related to the median income of the census tract of residency. Handle: RePEc:aph:ajpbhl:1986:76:11:1345-1347_7 Template-Type: ReDIF-Article 1.0 Title: Occupationally related illness reported to a Regional Poison Control Center Journal: American Journal of Public Health Author-Name: Blanc, P.D. Author-Name: Olson, K.R. Year: 1986 Volume: 76 Issue: 11 Pages: 1303-1307 Abstract: The San Francisco Bay Area Regional Poison Control Center studied 189 cases of toxic workplace exposure occurring over a six-month period in the belief that Regional Poison Control Center reporting could be a useful surveillance measure for occupational disease. Dermatitis was a relatively uncommon occurrence, but systemic complaints were frequent, a pattern differing from that seen in standard occupational surveillance programs. As compared to chemically caused illness detected through a statewide physician reporting program in California, increases in proportional frequencies of certain industrial chemical causes were observed. A matching strategy utilizing the physician reporting system identified only 15.9 per cent of poison control center cases that appear to have been otherwise detected through established surveillance. A nationwide system of Regional Poison Control Centers already exists with a computerized data base in place. This study indicates that these centers could be utilized as a supplementary system for acute occupational illness related to chemical exposures. Handle: RePEc:aph:ajpbhl:1986:76:11:1303-1307_3 Template-Type: ReDIF-Article 1.0 Title: The effects of race, residence, and prenatal care on the relationship of maternal age to neonatal mortality Journal: American Journal of Public Health Author-Name: Geronimus, A.T. Year: 1986 Volume: 76 Issue: 12 Pages: 1416-1421 Abstract: This population-based study explores whether excessive neonatal mortality rates (NMRs) among infants with teenage mothers are attributable to young maternal age or to a translation of environmental disadvantage into reproductive disadvantage. First births from the 1976-79 linked birth and infant death registers for three states are analyzed. The data set is sufficiently large (305,907 births) to measure maternal age in fine gradations while including several control variables in logit analyses. The associations of racial identification and prenatal care with low birthweight, short gestation, and neonatal mortality overshadow and confound the association between teenage and poor outcome. At every maternal age, higher NMRs are observed for Blacks compared to Whites. The hypothesis that excessive neonatal mortality among Blacks is due to the greater frequency of teenage childbearing among Blacks is refuted. Indeed, unlike White, Black primiparae above age 23 experience higher NMRs than most Black or White teenagers. These results suggest that teenage maternity is not the primary causal agent of all of the problems with which it is associated. Handle: RePEc:aph:ajpbhl:1986:76:12:1416-1421_7 Template-Type: ReDIF-Article 1.0 Title: Notifying workers at risk: The politics of the right-to-know Journal: American Journal of Public Health Author-Name: Bayer, R. Year: 1986 Volume: 76 Issue: 11 Pages: 1352-1356 Abstract: Holding that workers exposed to toxic substances in the workplace have a right to know about the extent to which they may have been put at risk, Bayer describes the history of the political controversy over whether the National Institute of Occupational Safety and Health (NIOSH) ought to provide individual notification to workers found through its retrospective cohort mortality studies to be at increased risk for disease. He comments that both advocates and opponents of notification have focused their arguments on the potential clinical consequences, even though the issue actually entails questions about the distribution of the burdens of uncertainty among powerful interests. Handle: RePEc:aph:ajpbhl:1986:76:11:1352-1356_6 Template-Type: ReDIF-Article 1.0 Title: Abortion and the Supreme Court: Why legislative motive matters Journal: American Journal of Public Health Author-Name: Glantz, L.H. Year: 1986 Volume: 76 Issue: 12 Pages: 1452-1455 Abstract: Glantz reviews the 1986 Supreme Court decision, Thornburgh v. American College of Obstetricians and Gynecologists, that struck down Pennsylvania's Abortion Control Act. The Justices found fault (5-4) with the statute's provisions relating to informed consent, reporting of abortion statistics, and post-viability abortions. Glantz notes that the Court for the first time used "antiabortion" to characterize a piece of legislation. In Glantz's view, Thornburgh was meant to reaffirm Roe v. Wade and to signal the states that future abortion-related laws will be strictly scrutinized for legislative intent as well as for constitutionality. A good faith desire to protect maternal health is the only justification the Court will recognize for regulating abortion. Glantz concludes that the majority of the Justices, anticipating changes in Court personnel, intended to re-affirm the right to make personal decisions without inappropriate state interference. Handle: RePEc:aph:ajpbhl:1986:76:12:1452-1455_6 Template-Type: ReDIF-Article 1.0 Title: Evaluation of pharmacists' compliance with the poison prevention packaging act Journal: American Journal of Public Health Author-Name: Dole, E.J. Author-Name: Czajka, P.A. Author-Name: Rivara, F.P. Year: 1986 Volume: 76 Issue: 11 Pages: 1335-1336 Abstract: Sixty pharmacies in Memphis, Tennessee were given two prescriptions at seven-day intervals to determine whether the medicine would be dispensed in child-resistant containers (CRCs) as required by federal law. One prescription included the statement 'dispense in child-resistant container'. Without such a statement, 77 per cent of the pharmacies dispensed the drug in a CRC; the prescription with the reminder elicited a compliance rate of 75 per cent. Factors such as cost of the prescription and time required to fill the prescription had no discernible effect on local pharmacy practice to dispense the prescription in a CRC. Handle: RePEc:aph:ajpbhl:1986:76:11:1335-1336_9 Template-Type: ReDIF-Article 1.0 Title: Student views on nuclear war. Journal: American Journal of Public Health Author-Name: Theuer, C. Author-Name: Kaplan, H. Author-Name: Lewis, T. Author-Name: Hellings, C. Author-Name: Kiefer, C. Author-Name: Hulley, S.B. Year: 1986 Volume: 76 Issue: 12 Pages: 1461 Handle: RePEc:aph:ajpbhl:1986:76:12:1461_9 Template-Type: ReDIF-Article 1.0 Title: A survey of aspirin use and Reye's syndrome awareness among parents Journal: American Journal of Public Health Author-Name: Morris, L.A. Author-Name: Klimberg, R. Year: 1986 Volume: 76 Issue: 12 Pages: 1422-1424 Abstract: A national telephone survey of 1,155 parents of children 19 years of age and younger solicited patterns of medication use during episodes of childhood flu and chicken pox. During the previous two years, 6 per cent of the parents whose children had chicken pox and 16 per cent of parents whose children had flu administered aspirin. Approximately 12 per cent of the total sample said they would give their child aspirin if their child were to get the flu or chicken pox today. About half (53 per cent) were aware of the contraindication against aspirin use and 40 per cent could spontaneously recall the name Reye's Syndrome (RS). When measured by a recognition test, 84 per cent of the sample said they had heard of RS. People who continued to believe that aspirin was an appropriate medication were more likely to have treated older children. The RS contraindication for aspirin should be emphasized for teenagers in future public informational programs. Handle: RePEc:aph:ajpbhl:1986:76:12:1422-1424_4 Template-Type: ReDIF-Article 1.0 Title: BCG vaccination among Manitoba Indians. Journal: American Journal of Public Health Author-Name: Comstock, G.W. Year: 1986 Volume: 76 Issue: 12 Pages: 1459 Handle: RePEc:aph:ajpbhl:1986:76:12:1459_7 Template-Type: ReDIF-Article 1.0 Title: A computer network for the surveillance of communicable diseases: The French experiment Journal: American Journal of Public Health Author-Name: Valleron, A.-J. Author-Name: Bouvet, E. Author-Name: Garnerin, P. Author-Name: Ménarès, J. Author-Name: Heard, I. Author-Name: Letrait, S. Author-Name: Lefaucheux, J. Year: 1986 Volume: 76 Issue: 11 Pages: 1289-1292 Abstract: The description and first results of the French Communicable diseases Network are reported. The network, initiated in November 1984, currently includes the National Department of Health, the local health offices and various clinical, biological, and epidemiological partners. Surveillance of influenza, viral hepatitis, acute urethritis, measles, and mumps is based upon reports from sentinel general practitioners throughout France who are equipped with terminals and can communicate their data on a 24-hour basis. The network distributes electronic bulletins summarizing the surveillance data, the regional statistics concerning other diseases, and epidemiological and administrative news. Electronic mail is used for data validation and enhances communication between the parties of the network. Handle: RePEc:aph:ajpbhl:1986:76:11:1289-1292_9 Template-Type: ReDIF-Article 1.0 Title: A randomized controlled trial of low carbohydrate and low fat/high fiber diets for weight loss Journal: American Journal of Public Health Author-Name: Baron, J.A. Author-Name: Schori, A. Author-Name: Crow, B. Author-Name: Carter, R. Author-Name: Mann, J.I. Year: 1986 Volume: 76 Issue: 11 Pages: 1293-1296 Abstract: Among 135 overweight subjects, we conducted a three-month randomized controlled trial of two sets of dietary advice, each providing approximately 1,000 calories per day but differing in fiber, carbohydrate, and fat content. Information on weight and eating habits, as well as measures of lipoprotein and glucose metabolism were obtained at entry and one and three months later. We found that dieters given low carbohydrate/low fiber dietary advice tended to lose more weight than those given a higher carbohydrate/higher fiber regimen (5.0 vs 3.7 kg on average at three months). This pattern was particularly marked among women, and among participants who were under age 40 or of lower social class. There were no differences between the diet groups in the proportion complaining of hunger but, in general, members of the low carbohydrate group complained of more problems in dieting. There were only minor differences in the serum lipoprotein patterns during the diet period. In view of these results, we believe previous claims of the benefits of fiber for weight loss may have been overstated. Handle: RePEc:aph:ajpbhl:1986:76:11:1293-1296_1 Template-Type: ReDIF-Article 1.0 Title: The relation between overweight and subjective health according to age, social class, slimming behavior and smoking habits in Dutch adults Journal: American Journal of Public Health Author-Name: Seidell, J.C. Author-Name: Bakx, K.C. Author-Name: Deurenberg, P. Author-Name: Burema, J. Author-Name: Hautvast, J.G. Author-Name: Huygen, F.J. Year: 1986 Volume: 76 Issue: 12 Pages: 1410-1415 Abstract: Subjective health status was assessed in relation to overweight by administering a list of 51 health complaints to adult men and women who were either chronically overweight as defined by Body Mass Index (BMI) or not overweight, in a continuous morbidity registration in four general practices during the period 1967-83. Respnses were received from 455 men (182 overweight) and 790 women (386 overweight), ages 26-66 years. Response rate (71 per cent) and age distribution (mean age 48) were similar in overweight and non-overweight groups of both sexes. BMI was correlated with the total number of complaints in women (r = 0.15) but not in men (r = 0.07). Multiple regression analysis revealed, however, that age was an effect modifier in this relation, there being a negative association between BMI and subjective health in younger men and a positive association in older men, whereas in women the association between BMI and subjective health was much more pronounced at younger ages than at older ages. In addition, current smoking habits and social class (in men and women) and reported slimming behavior (in women) had an independent relation to the total number of health complaints. BMI was also related to specific complaints and groups of complaints, particularly in women. Handle: RePEc:aph:ajpbhl:1986:76:12:1410-1415_4 Template-Type: ReDIF-Article 1.0 Title: Trends in the hospitalization for acute childhood asthma, 1970-84 Journal: American Journal of Public Health Author-Name: Halfon, N. Author-Name: Newachek, P.W. Year: 1986 Volume: 76 Issue: 11 Pages: 1308-1311 Abstract: Data from the 1970 through 1984 National Hospital Discharge Surveys indicate that the rate of hospitalization for children under 15 years old with asthma has increased at least 145 per cent while the average length of stay for children with asthma decreased by 26 per cent from 5 days in 1970 to 3.6 days in 1984. Over an analogous period (1970 to 1980), data from the National Health Interview Survey indicate that the prevalence of childhood asthma has increased by approximately 28 per cent for children 6 to 16 years of age. Several potential explanations for the hospital trend are discussed, including changes in the disease classification and information system, criteria for admission, organizational factors, changes in therapy, and changes in morbidity. Handle: RePEc:aph:ajpbhl:1986:76:11:1308-1311_7 Template-Type: ReDIF-Article 1.0 Title: In-home pregnancy tests. Journal: American Journal of Public Health Author-Name: Clark, J.D. Year: 1986 Volume: 76 Issue: 12 Pages: 1461 Handle: RePEc:aph:ajpbhl:1986:76:12:1461_2 Template-Type: ReDIF-Article 1.0 Title: The delivery and uptake of nicotine from an aerosol rod Journal: American Journal of Public Health Author-Name: Sepkovic, D.W. Author-Name: Colosimo, S.G. Author-Name: Axelrad, C.M. Author-Name: Adams, J.D. Author-Name: Haley, N.J. Year: 1986 Volume: 76 Issue: 11 Pages: 1343-1344 Abstract: Nicotine aerosol rods were assessed for their possible usefulness as substitutes for cigarettes. Under standard FTC conditions, the per puff delivery of the aerosol rod averaged 0.3 μg nicotine/puff after 10 puffs and 6.4 μg nicotine/puff after 60 puffs. After puffing on the rods, no nicotine was detected in the plasma or urine of seven subjects. Handle: RePEc:aph:ajpbhl:1986:76:11:1343-1344_5 Template-Type: ReDIF-Article 1.0 Title: Seat belt use laws and occupant crash protection in the United States Journal: American Journal of Public Health Author-Name: Williams, A.F. Author-Name: Lund, A.K. Year: 1986 Volume: 76 Issue: 12 Pages: 1438-1442 Abstract: Current federal rule-making requires restraints such as air bags or automatic seat belts in new cars starting with model year 1987 unless states with two-thirds of the United States population enact seat belt use laws meeting certain criteria. Belt use laws have been enacted by 26 states and the District of Columbia as of July 1, 1986. The first laws to go into effect increased use from less than 20 per cent to 50-70 per cent in the first month; in most cases rates subsequently dropped to below 50 per cent. Texas has been an exception to this trend because it has had much tougher enforcement of its seat belt law than other states. This pattern is similar to the experience of Canadian provinces that passed laws in the mid-1970s; enforcement/publicity programs in Canada have produced belt use rates that are currently greater than 60 per cent. An enforcement program in Elmira, New York also increased use rates sharply. New York, which had the first and one of the strongest and most successful laws so far, had an estimated fatality reduction of 9 per cent during the first nine months of the law. It is likely that a 10 per cent reduction in fatalities is the maximum that can be expected from belt use laws without special enforcement efforts. Provision of automatic restraints in combination with belt use laws would greatly increase crash protection. Handle: RePEc:aph:ajpbhl:1986:76:12:1438-1442_8 Template-Type: ReDIF-Article 1.0 Title: Birthweight and gestational age: Mothers' estimates compared with state and hospital records Journal: American Journal of Public Health Author-Name: Little, R.E. Year: 1986 Volume: 76 Issue: 11 Pages: 1350-1351 Abstract: Birthweight and gestational age estimates made by research subjects were compared with values obtained from birth certificates and hospital records. Ninety-one per cent of mothers' estimates of their infant's birthweight and 88 per cent of their estimates of infant gestational age agreed with the delivery record. When the same mothers estimated their own and their husband's birthweight, only 44 per cent were in agreement with birth certificate values; however, 78 per cent were in agreement with the pounds portion of the weight. Agreement of mothers' estimates of her own and her husband's gestational age with birth certificates was no better than chance. Handle: RePEc:aph:ajpbhl:1986:76:11:1350-1351_3 Template-Type: ReDIF-Article 1.0 Title: Exercise as a risk factor for infertility with ovulatory dysfunction Journal: American Journal of Public Health Author-Name: Green, B.B. Author-Name: Daling, J.R. Author-Name: Weiss, N.S. Author-Name: Liff, J.M. Author-Name: Koepsell, T. Year: 1986 Volume: 76 Issue: 12 Pages: 1432-1436 Abstract: To examine the relation of regular vigorous exercise to ovulatory infertility, we interviewed 346 infertile women, in whom there was evidence of ovulatory failure, regarding their exercise patterns during the year preceding their unsuccessful effort to conceive. Their responses were compared with similar exercise histories in women who had successfully conceived at the time the infertile women started trying to become pregnant. Vigorous exercise for an hour or more per day was reported more commonly in nulligravid cases (n = 187) than by their primiparous controls. The difference was particularly great in the subgroup of cases without additional evidence of tubal dysfunction (relative risk = 6.2%, 90% confidence interval = 1.0 - 39.8). This association was not seen among infertile women who had previously been pregnant. Vigorous exercise for an average of less than one hour per day was not associated with either primary or secondary infertility. Handle: RePEc:aph:ajpbhl:1986:76:12:1432-1436_5 Template-Type: ReDIF-Article 1.0 Title: Level of response in epidemiologic studies using the card-back system to contact subjects Journal: American Journal of Public Health Author-Name: Mueller, B.A. Author-Name: McTiernan, A. Author-Name: Daling, J.R. Year: 1986 Volume: 76 Issue: 11 Pages: 1331-1332 Abstract: Response levels obtained from two methods of patient contact to obtain subject consent for participation in epidemiologic studies were compared. When a signed, return card was required prior to further contact, 70 to 83 per cent of patients consented to participate, compared with consistently higher levels (89 to 93 per cent) obtained with telephone contact. These data suggest that the likelihood of obtaining the high response level required in epidemiologic studies is increased by methods that do not rely on a return card. Handle: RePEc:aph:ajpbhl:1986:76:11:1331-1332_9 Template-Type: ReDIF-Article 1.0 Title: Client transfers in long-term care: Five years' experience Journal: American Journal of Public Health Author-Name: Stark, A.J. Author-Name: Gutman, G.M. Year: 1986 Volume: 76 Issue: 11 Pages: 1312-1316 Abstract: This paper reports the home-facility and level of care changes, discharges, and deaths over a five-year period for 1,653 clients newly admitted in 1978 to a long-term care program in British Columbia, Canada. Five years after admission, of clients initially admitted to care at home (N = 1241), 34.3 per cent were still in the program (14.5 per cent unchanged; 6.7 per cent at home but at a higher level of care, and 11.7 per cent in facilities). Of the remainder, 38.9 per cent had died and 26.8 per cent had been discharged. Findings for those initially admitted to care in facilities (N = 412) are remarkably similar. After five years, 28.4 per cent of these clients were still in the program; 39.3 per cent had died. Moves from facility to home care were few (2.4 per cent). Despite their advanced age at admission (X̄ = 74.7, S.D. 14.6), one-third were still in the program five years later, some with status virtually unchanged. Handle: RePEc:aph:ajpbhl:1986:76:11:1312-1316_8 Template-Type: ReDIF-Article 1.0 Title: Pack size, reported cigarette smoking rates, and public health Journal: American Journal of Public Health Author-Name: Kozlowski, L.T. Year: 1986 Volume: 76 Issue: 11 Pages: 1337-1338 Abstract: The relation between packs containing 25 or 20 cigarettes each and self-reports of daily cigarette intake was examined in surveys of smoking habits from the United States and Canada. More Canadian than US smokers report smoking 25 cigarettes per day (19.3 per cent vs 2.1 per cent). As market share of packs of 25 increases across six regions in North America, reports of smoking 25 cigarettes per day increase. Even if smoke exposure remains constant, smoking statistics are likely to be influenced by pack size. Handle: RePEc:aph:ajpbhl:1986:76:11:1337-1338_4 Template-Type: ReDIF-Article 1.0 Title: Geocoding NY State Cancer Registry. Journal: American Journal of Public Health Author-Name: Howe, H.L. Year: 1986 Volume: 76 Issue: 12 Pages: 1459-1460 Handle: RePEc:aph:ajpbhl:1986:76:12:1459-1460_1 Template-Type: ReDIF-Article 1.0 Title: Do the sisters of childbearing teenagers have increased rates of childbearing? Journal: American Journal of Public Health Author-Name: Friede, A. Author-Name: Hogue, C.J.R. Author-Name: Doyle, L.L. Author-Name: Hammerslough, C.R. Author-Name: Sniezek, J.E. Author-Name: Arrighi, H. Year: 1986 Volume: 76 Issue: 10 Pages: 1221-1224 Abstract: In 1983, 89,000 children were born to United States women aged ≤ 16. To reduce teenage fertility rates, public health workers will need to identify teenagers at elevated risk for childbearing. We tested the hypothesis that the sisters of childbearing teenagers may form such a group. We performed an historical cohort study of 3,767 teenagers aged 12-16 years who were enrolled in Arkansas Aid to Families with Dependent Children (AFDC), 1978-81; they had 247 pregnancies. Multivariable log-linear hazard models were used to control and study age, race, number of AFDC-eligibles per household, and county urbanization and family planning services. Teenagers whose sisters bore children had elevated rate ratios (RR) for childbearing (RR = 1.8; 95% Confidence Limits [CL] = 1.2-2.6), as did Blacks (RR = 3.1; 95% CL = 2.0-4.8), and members of households with more than nine AFDC-eligibles (RR = 1.7; 95% CL = 1.1-2.6). Because they may have elevated childbearing rates, and would be easy to contact, the sisters of pregnant teenagers could form an important target population for family planning efforts. Handle: RePEc:aph:ajpbhl:1986:76:10:1221-1224_3 Template-Type: ReDIF-Article 1.0 Title: Newborn screening for hemoglobinopathies: The benefit beyond the target Journal: American Journal of Public Health Author-Name: Grover, R. Author-Name: Newman, S. Author-Name: Wethers, D. Author-Name: Anyane-Yeboa, K. Author-Name: Pass, K. Year: 1986 Volume: 76 Issue: 10 Pages: 1236-1237 Abstract: As a result of New York State's Newborn Screening Program 4,565 neonates with trait hemoglobinopathies were identified and 3,200 families were notified of the results of testing their infants in New York City in 1982. Of the 1,531 families (2,190 parents) tested and counseled, 22 parents were diagnosed with sickle cell disease and 39 couples were found to be at-risk for having a child with sickle cell disease. Amniocentesis was performed in 14 of the 28 at-risk pregnant women and three of the four affected pregnancies were terminated. Handle: RePEc:aph:ajpbhl:1986:76:10:1236-1237_9 Template-Type: ReDIF-Article 1.0 Title: Affirmative action at work: A survey of graduates of the University of California, San Diego, Medical School Journal: American Journal of Public Health Author-Name: Penn, N.E. Author-Name: Russell, P.J. Author-Name: Simon, H.J. Author-Name: Jacob, T.C. Author-Name: Stafford, C. Author-Name: Castro, E. Author-Name: Cisneros, J. Author-Name: Bush, M. Year: 1986 Volume: 76 Issue: 9 Pages: 1144-1146 Abstract: Reported here are the results of a mail survey of 113 graduates from the University of California, San Diego, School of Medicine. Fifty-seven had been admitted with assistance of the Special Admissions Subcommittee (SAS) and 56 had been admitted through the traditional Recruitment and Admissions Committee mechanisms. SAS graduates see more patients daily, and practive more often in primary care specialties in rural and inner-city areas, providing medical care for ethnic minorities from lower socioeconomic strata. Handle: RePEc:aph:ajpbhl:1986:76:9:1144-1146_6 Template-Type: ReDIF-Article 1.0 Title: Amebic infections in asymptomatic homosexual men, lack of evidence of invasive disease Journal: American Journal of Public Health Author-Name: Sorvillo, F.J. Author-Name: Strassburg, M.A. Author-Name: Seidel, J. Author-Name: Visvesvara, G.S. Author-Name: Mori, K. Author-Name: Todd, A. Author-Name: Portigal, L. Author-Name: Finn, M. Author-Name: Agee, B.A. Year: 1986 Volume: 76 Issue: 9 Pages: 1137-1139 Abstract: A survey for enteric infections in 140 asymptomatic homosexual men who attended a community clinic revealed a high prevalence of infection with Entamoeba histolytica (27.1 per cent) and Giardia lamblia (15.7 per cent). In contrast, the prevalence of elevated indirect hemagglutination (IHA) titers (≥ 1:128), which indicate invasive amebiasis, was low (5.7 per cent). Our findings suggest that only a limited amount of invasive amebic disease is occurring in this group of homosexual men. Handle: RePEc:aph:ajpbhl:1986:76:9:1137-1139_7 Template-Type: ReDIF-Article 1.0 Title: Financial cost as an obstacle to hypertension therapy Journal: American Journal of Public Health Author-Name: Shulman, N.B. Author-Name: Martinez, B. Author-Name: Brogan, D. Author-Name: Carr, A.A. Author-Name: Miles, C.G. Year: 1986 Volume: 76 Issue: 9 Pages: 1105-1108 Abstract: A home health interview, including blood pressure measurements, was conducted on 4,688 adults representing the noninstitutionalized population of Georgia. Subjects with diastolic blood pressure ≥ 90 mm Hg or on antihypertensive medication were considered hypertensive. The prevalence of uncontrolled moderate or severe hypertension (diastolic ≥ 105 mm Hg) was 1.9 per cent. With the exception of White women, all race-sex groups with uncontrolled moderate or severe hypertension reported substantially lower per capita income than their mild or controlled hypertensive counterparts. A larger percentage of the uncontrolled moderate to severe hypertensives on medication, as compared to their mild or controlled counterparts, reported economic barriers to pharmacologic and medical care on cost of medicines (36 per cent vs 22 per cent); refills (36 per cent vs 16 per cent); and office visits (26 per cent vs 16 per cent). Black women reported these barriers more than Whites. These findings suggest that costs of antihypertensive care may be an obstacle in blood pressure control for certain population subgroups. Handle: RePEc:aph:ajpbhl:1986:76:9:1105-1108_4 Template-Type: ReDIF-Article 1.0 Title: Non-physician providers. Journal: American Journal of Public Health Author-Name: Cawley, J.F. Author-Name: Combs, G.E. Author-Name: Curry, R.H. Year: 1986 Volume: 76 Issue: 11 Pages: 1360 Handle: RePEc:aph:ajpbhl:1986:76:11:1360_1 Template-Type: ReDIF-Article 1.0 Title: Smoking and lung cancer in New Mexico. Journal: American Journal of Public Health Author-Name: Humble, C.G. Author-Name: Samet, J.M. Year: 1986 Volume: 76 Issue: 11 Pages: 1361 Handle: RePEc:aph:ajpbhl:1986:76:11:1361_6 Template-Type: ReDIF-Article 1.0 Title: Further comments on 'State trends in infant mortality'. Journal: American Journal of Public Health Author-Name: Kleinman, J.C. Year: 1986 Volume: 76 Issue: 11 Pages: 1361-1362 Handle: RePEc:aph:ajpbhl:1986:76:11:1361-1362_2 Template-Type: ReDIF-Article 1.0 Title: Reducing the great American waistline. Journal: American Journal of Public Health Author-Name: Dwyer, J. Year: 1986 Volume: 76 Issue: 11 Pages: 1287-1288 Handle: RePEc:aph:ajpbhl:1986:76:11:1287-1288_9 Template-Type: ReDIF-Article 1.0 Title: Varicella-zoster dilemma: common sense in medical education. Journal: American Journal of Public Health Author-Name: Murray, D.L. Author-Name: Cleveland, R.P. Author-Name: Keefe, C. Year: 1986 Volume: 76 Issue: 11 Pages: 1362-1363 Handle: RePEc:aph:ajpbhl:1986:76:11:1362-1363_2 Template-Type: ReDIF-Article 1.0 Title: The French connection. Journal: American Journal of Public Health Author-Name: Graitcer, P.L. Author-Name: Thacker, S.B. Year: 1986 Volume: 76 Issue: 11 Pages: 1285-1286 Handle: RePEc:aph:ajpbhl:1986:76:11:1285-1286_6 Template-Type: ReDIF-Article 1.0 Title: Physician ratings of appropriate indications for six medical and surgical procedures Journal: American Journal of Public Health Author-Name: Park, R.E. Author-Name: Fink, A. Author-Name: Brook, R.H. Author-Name: Chassin, M.R. Author-Name: Kahn, K.L. Author-Name: Merrick, N.J. Author-Name: Kosecoff, J. Author-Name: Solomon, D.H. Year: 1986 Volume: 76 Issue: 7 Pages: 766-772 Abstract: We convened three panels of physicians to rate the appropriateness of a large number of indications for performing a total of six medical and surgical procedures. The panels followed a modified Delphi process. Panelists separately assigned initial ratings, then met in Santa Monica, California where they received reports showing their initial ratings and the distribution of the other panelists' ratings. They discussed the indications and revised the indications lists, then individually assigned final ratings. There was generally better agreement on the final ratings than on the initial ratings. Based on reasonable criteria for agreement and disagreement, and excluding one outlying procedure, the panelists agreed on ratings for 42 to 56 per cent of the indications, and disagreed on 11 to 29 per cent. Handle: RePEc:aph:ajpbhl:1986:76:7:766-772_6 Template-Type: ReDIF-Article 1.0 Title: Geographic variation of female lung cancer in China. Journal: American Journal of Public Health Author-Name: Xu, Z.Y. Author-Name: Blot, W.J. Author-Name: Fraumeni Jr., J.F. Year: 1986 Volume: 76 Issue: 10 Pages: 1249-1250 Handle: RePEc:aph:ajpbhl:1986:76:10:1249-1250_5 Template-Type: ReDIF-Article 1.0 Title: Delivery type and neonatal mortality among 10,749 breeches Journal: American Journal of Public Health Author-Name: Fortney, J.A. Author-Name: Higgins, J.E. Author-Name: Kennedy, K.I. Author-Name: Laufe, L.E. Author-Name: Wilkens, L. Year: 1986 Volume: 76 Issue: 8 Pages: 980-985 Abstract: Data on 10,749 breech presentations were analyzed for the effect of delivery type on neonatal mortality. Most of the data are from developing countries, and most of the hospitals have higher mortality than is found in Europe or the United States. The simultaneous effect of type of hospital where the delivery occurred, type of breech, birthweight, and parity were examined. The benefit of cesarean delivery was greater for nulliparae than multiparae, greater for footlings than for frank or complete breeches, and greater for larger babies than smaller ones. This last finding probably reflects the quality of neonatal care in developing country hospitals rather than the value of cesarean section. Maternal mortality and morbidity was higher among women delivered abdominally than among those delivered vaginally. Handle: RePEc:aph:ajpbhl:1986:76:8:980-985_0 Template-Type: ReDIF-Article 1.0 Title: When people and governments ignore disaster warnings. Journal: American Journal of Public Health Author-Name: Bader, M. Year: 1986 Volume: 76 Issue: 10 Pages: 1249 Handle: RePEc:aph:ajpbhl:1986:76:10:1249_2 Template-Type: ReDIF-Article 1.0 Title: The practices of general and subspecialty internists in counseling about smoking and exercise Journal: American Journal of Public Health Author-Name: Wells, K.B. Author-Name: Lewis, C.E. Author-Name: Leake, B. Author-Name: Schleiter, M.K. Author-Name: Brook, R.H. Year: 1986 Volume: 76 Issue: 8 Pages: 1009-1013 Abstract: We compared the practices of subspecialists and general internists in counseling about smoking and exercise, using data from a study of recent graduates of United States training programs in internal medicine. Information on the characteristics of physicians and their clinical practices was obtained from self-report questionnaires. The internists most likely to counsel smokers regardless of the presence or absence of diseases associated with smoking are cardiologists, pulmonary specialists, nephrologists, and generalists trained in a primary care residency funded by the Robert Wood Johnson Foundation or Health Resources Administration. Most internists practice tertiary prevention by counseling a high percentage of smokers with heart or lung disease. Rheumatologists counsel a higher percentage of all patients with poor exercise habits but a lower percentage of such patients with heart disease than do other internists. The differences in counseling related to training are not explained by different levels of involvement as a primary care physician. Rather, these differences appear to reflect training and subspecialty-specific priorities for counseling. Handle: RePEc:aph:ajpbhl:1986:76:8:1009-1013_6 Template-Type: ReDIF-Article 1.0 Title: Stress factors in children. Journal: American Journal of Public Health Author-Name: Jessop, D.J. Year: 1986 Volume: 76 Issue: 10 Pages: 1252 Handle: RePEc:aph:ajpbhl:1986:76:10:1252_3 Template-Type: ReDIF-Article 1.0 Title: New Mexico's premarital rubella test program. Journal: American Journal of Public Health Author-Name: Sewell, C.M. Author-Name: Hull, H.F. Author-Name: Montes, J. Author-Name: Ortiz, A. Year: 1986 Volume: 76 Issue: 10 Pages: 1250-1251 Handle: RePEc:aph:ajpbhl:1986:76:10:1250-1251_1 Template-Type: ReDIF-Article 1.0 Title: Is the Oklahoma child restraint law effective? Journal: American Journal of Public Health Author-Name: Muller, A. Year: 1986 Volume: 76 Issue: 10 Pages: 1251-1252 Handle: RePEc:aph:ajpbhl:1986:76:10:1251-1252_9 Template-Type: ReDIF-Article 1.0 Title: Characteristics of women with recurrent spontaneous abortions and women with favorable reproductive histories Journal: American Journal of Public Health Author-Name: Strobino, B. Author-Name: Fox, H.E. Author-Name: Kline, J. Author-Name: Stein, Z. Author-Name: Susser, M. Author-Name: Warburton, D. Year: 1986 Volume: 76 Issue: 8 Pages: 986-91 Abstract: Women with a history of recurrent spontaneous abortions (repeaters) are compared with women who have had live births and no spontaneous abortions (multiparae) and women who have had live births and only one spontaneous abortion (sporadics) to identify characteristics of the women and their abortuses that might predict subsequent fetal loss. A number of risk factors for recurrent spontaneous abortion have been identified: the loss of a chromosomally normal conception, loss after the first trimester of pregnancy, a delay in conceiving prior to the study pregnancy, a diagnosis of cervical incompetence, and a history of very low birthweight deliveries. The odds ratios associated with being a repeater vary from 1.4 to 5.6 depending on the number of characteristics present. Handle: RePEc:aph:ajpbhl:1986:76:8:986-91_3 Template-Type: ReDIF-Article 1.0 Title: Child safety seat Co-op in New Hampshire. Journal: American Journal of Public Health Author-Name: Chamberlin, A.N. Year: 1986 Volume: 76 Issue: 10 Pages: 1251 Handle: RePEc:aph:ajpbhl:1986:76:10:1251_9 Template-Type: ReDIF-Article 1.0 Title: Risk of postmenopausal hip fracture in Mexican American women Journal: American Journal of Public Health Author-Name: Bauer, R.L. Author-Name: Diehl, A.K. Author-Name: Barton, S.A. Author-Name: Brender, J. Author-Name: Deyo, R.A. Year: 1986 Volume: 76 Issue: 8 Pages: 1020-1021 Abstract: To assess the risk of hip fracture in Mexican Americans, the ethnicity of 80 women aged 50 years and over admitted with hip fractures to a Texas hospital was compared with that of age-matched women hospitalized for other reasons. The risk of fracture for Mexican Americans was only 35 per cent that of Whites (95% CI = 19 per cent, 65 per cent). This finding was confirmed in a chart survey performed in a second hospital population. These results suggest that Mexican American women may receive less potential benefit from preventive measures for hip fracture than Whites. Handle: RePEc:aph:ajpbhl:1986:76:8:1020-1021_4 Template-Type: ReDIF-Article 1.0 Title: Immediate public health concerns and actions in volcanic eruptions: Lessons from the Mount St. Helens eruptions, May 18-October 18, 1980 Journal: American Journal of Public Health Author-Name: Bernstein, R.S. Author-Name: Baxter, P.J. Author-Name: Falk, H. Author-Name: Ing, R. Author-Name: Foster, L. Author-Name: Frost, F. Year: 1986 Volume: 76 Issue: S3 Pages: 25-37 Abstract: A comprehensive epidemiological evaluation of mortality and short-term morbidity associated with explosive volcanic activity was carried out by the Centers for Disease Control in collaboration with affected state and local health departments, clinicians, and private institutions. Following the May 18, 1980 eruption of Mount St. Helens, a series of public health actions were rapidly instituted to develop accurate information about volcanic hazards and to recommend methods for prevention or control of adverse affects on safety and health. These public health actions included: establishing a system of active surveillance of cause-specific emergency room (ER) visits and hospital admissions in affected and unaffected communities for comparison; assessing the causes of death and factors associated with survival or death among persons located near the crater; analyzing the mineralogy and toxicology of sedimented ash and the airborne concentration of resuspended dusts; investigating reported excesses of ash-related adverse respiratory effects by epidemiological methods such as cross-sectional and case-control studies; and controlling rumors and disseminating accurate, timely information about volcanic hazards and recommended preventive or control measures by means of press briefings and health bulletins. Surveillance and observational studies indicated that: excesses in morbidity were limited to transient increases in ER visits and hospital admissions for traumatic injuries and respiratory problems (but not for communicable disease or mental health problems) which were associated in time, place, and person with exposures to volcanic ash; excessive mortality due to suffocation (76 per cent), thermal injuries (12 per cent), or trauma (12 per cent) by ash and other volcanic hazards was directly proportional to the degree of environmental damage-that is, it was more pronounced among those persons (48/65, or about 74 per cent) who, at the time of the eruption, were residing, camping, or sightseeing (despite restrictions) or working (with permission) closer to the crater in areas affected by the explosive blast, pyroclastic and mud flows, and heavy ashfall; and de novo appearance of ash-related asthma was not observed, but transient excesses in adverse respiratory effects occurred in two high-risk groups - hypersusceptibles (with preexisting asthma or chronic bronchitis) and heavily exposed workers. Laboratory and field studies indicated that: volcanic ash had mild to moderate fibrogenic potential, consisting of >90 per cent (by count) respirable size particles which contained 4-7 per cent (by weight) crystalline free silica (SiO2); importantly, community exposures to resuspended ash only transiently exceeded health limits normally applied to entire working lifetime exposures to free silica; and there were no excessive exposures to toxic metals, fibrous minerals, organic chemicals, radon, or toxic gases of volcanic origin in community water supplies or air. Recommended preventive measures include: avoidance of areas of predicted hazards during premonitory and ongoing volcanic activity and use of respiratory protection and wetting methods to control unavoidable exposures to ash. In densely populated countries with relatively frequent explosive volcanic activity, resources for epidemiological surveillance and investigation are needed following widespread environmental damage, mass evacuation, refugee resettlement, and disruption of routine public health services. Handle: RePEc:aph:ajpbhl:1986:76:S3:25-37_2 Template-Type: ReDIF-Article 1.0 Title: Acute myocardial infarction among Navajo Indians, 1976-83 Journal: American Journal of Public Health Author-Name: Coulehan, J.L. Author-Name: Lerner, G. Author-Name: Helzlsouer, K. Author-Name: Welty, T.K. Author-Name: McLaughlin, J. Year: 1986 Volume: 76 Issue: 4 Pages: 412-414 Abstract: We found that from 1976 through 1983 the incidence of acute myocardial infarction (AMI) diagnosed among Navajo Indians remained low (0.5 per 1,000 persons age 30 years or more), although the incidence in women appears to be climbing. Navajo AMI patients are more likely to be hypertensive and diabetic than age- and sex-matched patients with gallbladder disease. Twenty-four per cent die within one month of AMI. Handle: RePEc:aph:ajpbhl:1986:76:4:412-414_8 Template-Type: ReDIF-Article 1.0 Title: Epidemic Campylobacteriosis associated with a community water supply Journal: American Journal of Public Health Author-Name: Sacks, J.J. Author-Name: Lieb, S. Author-Name: Baldy, L.M. Author-Name: Berta, S. Author-Name: Patton, C.M. Author-Name: White, M.C. Author-Name: Bigler, W.J. Author-Name: Witte, J.J. Year: 1986 Volume: 76 Issue: 4 Pages: 424-428 Abstract: In May 1983, an estimated 865 cases of epidemic gastrointestinal disease occurred in Greenville, Florida. Surveillance of pharmacy sales of antidiarrheal medicines suggested that the outbreak was confined to Greenville and its immediate vicinity. Surveys demonstrated that the gastrointestinal illness attack rates inside and outside the city limits were 56 per cent (72/128) and 9 per cent (7/77), respectively (relative risk (RR) = 6.2); consumption of city water was associated with illness (RR = 12); and as water consumption increased, the attack rate also increased (p < 0.001). Four adults were hospitalized and one outbreak-related case of Guillain-Barre' syndrome was identified. Campylobacter jejuni was isolated from specimens from 11 ill persons; serologic studies showed the development of Campylobacter-specific antibodies. Fecal coliforms were found in water samples, but Campylobacter was not recovered from water. The city water plant, a deep well system, had numerous deficiencies including an unlicensed operator, a failure of chlorination, and open-top treatment towers. Birds were observed perching on the open-top treatment tower. Of 38 birds trapped seven weeks later, 37 per cent harbored C. jejuni; however, plasmid and serotyping studies showed that strains were not the same as the common strain from ill persons. This outbreak suggests that water systems that are unprotected from contact with birds may become contaminated and a source of outbreaks of human campylobacteriosis. Handle: RePEc:aph:ajpbhl:1986:76:4:424-428_2 Template-Type: ReDIF-Article 1.0 Title: Tuberculosis in employees at a Vermont furniture plant Journal: American Journal of Public Health Author-Name: Spitalny, K.C. Author-Name: O'Grady, R.V. Author-Name: Vogt, R.L. Author-Name: Witherell, L.E. Author-Name: Hoshino, D. Year: 1986 Volume: 76 Issue: 4 Pages: 462-463 Abstract: In a case-contact investigation of a patient (A) with smear- and culture-positive pulmonary tuberculosis, we found that co-workers in one room of a furniture factory had a higher prevalence of significant reactions to 5 Tu PPD tuberculin than other furniture factory workers. One co-worker also had active pulmonary tuberculosis. It was concluded that Patient A probably transmitted mycobacteria in a well-ventilated, spacious work setting; and that Patient A's disease and the subsequent outbreak could have been prevented. Handle: RePEc:aph:ajpbhl:1986:76:4:462-463_1 Template-Type: ReDIF-Article 1.0 Title: Height and weight of Southeast Asian preschool children in Northern California Journal: American Journal of Public Health Author-Name: Dewey, K.G. Author-Name: Daniels, J. Author-Name: Teo, K.S. Author-Name: Hassel, E. Author-Name: Otow, J. Year: 1986 Volume: 76 Issue: 7 Pages: 806-808 Abstract: Anthropometric data were obtained from 526 South-east Asian preschool children during 1980-84. Length of time in the United States averaged 21.8 months. Mean weights and heights were substantially below the National Center for Health Statistics (NCHS) 50th percentile. Although 39 per cent of children were below the 5th percentile of height for age, only 7 per cent were below the 5th percentile of weight for height. Rates of weight and height gain were similar to reference values, indicating adequate growth after arrival in the US. Handle: RePEc:aph:ajpbhl:1986:76:7:806-808_3 Template-Type: ReDIF-Article 1.0 Title: The development of a multidisciplinary plan for evaluation of the long-term health effects of the Mount St. Helens eruptions Journal: American Journal of Public Health Author-Name: Buist, A.S. Author-Name: Martin, T.R. Author-Name: Shore, J.H. Author-Name: Butler, J. Author-Name: Lybarger, J.A. Year: 1986 Volume: 76 Issue: S3 Pages: 39-44 Handle: RePEc:aph:ajpbhl:1986:76:S3:39-44_5 Template-Type: ReDIF-Article 1.0 Title: Self-rated health as a predictor of hospital admission and nursing home placement in elderly public housing tenants Journal: American Journal of Public Health Author-Name: Weinberger, M. Author-Name: Darnell, J.C. Author-Name: Tierney, W.M. Author-Name: Martz, B.L. Author-Name: Hiner, S.L. Author-Name: Barker, J. Author-Name: Neill, P.J. Year: 1986 Volume: 76 Issue: 4 Pages: 457-459 Abstract: We assessed the validity of self-rated health in a one-year prospective study of 155 elderly public housing tenants. Compared to studies of elderly community residents, tenants had poorer self-rated health, and higher hospital admission and nursing home placement rates. Poor self-rated health was a risk factor for both outcomes. We conclude that self-rated health may be useful in identifying persons at increased risk for hospital admission and nursing home placement. Handle: RePEc:aph:ajpbhl:1986:76:4:457-459_1 Template-Type: ReDIF-Article 1.0 Title: Outpatient surgery: are we satisfied? Journal: American Journal of Public Health Author-Name: Muller, C. Year: 1986 Volume: 76 Issue: 9 Pages: 1086-1087 Handle: RePEc:aph:ajpbhl:1986:76:9:1086-1087_1 Template-Type: ReDIF-Article 1.0 Title: On homelessness and the American way. Journal: American Journal of Public Health Author-Name: Jonas, S. Year: 1986 Volume: 76 Issue: 9 Pages: 1084-1086 Handle: RePEc:aph:ajpbhl:1986:76:9:1084-1086_6 Template-Type: ReDIF-Article 1.0 Title: Trends in fatality rates in bituminous coal mines, 1970-85. Journal: American Journal of Public Health Author-Name: Weeks, J.L. Year: 1986 Volume: 76 Issue: 9 Pages: 1151-1152 Handle: RePEc:aph:ajpbhl:1986:76:9:1151-1152_4 Template-Type: ReDIF-Article 1.0 Title: Occupational hazard and health surveillance. Journal: American Journal of Public Health Author-Name: Sundin, D.S. Author-Name: Pedersen, D.H. Author-Name: Frazier, T.M. Year: 1986 Volume: 76 Issue: 9 Pages: 1083-1084 Handle: RePEc:aph:ajpbhl:1986:76:9:1083-1084_6 Template-Type: ReDIF-Article 1.0 Title: Mental health and social characteristics of the homeless: A survey of mission users Journal: American Journal of Public Health Author-Name: Fischer, P.J. Author-Name: Shapiro, S. Author-Name: Breakey, W.R. Author-Name: Anthony, J.C. Author-Name: Kramer, M. Year: 1986 Volume: 76 Issue: 5 Pages: 519-524 Abstract: Selected mental health and social characteristics of 51 homeless persons drawn as a probability sample from missions are compared to those of 1,338 men aged 18-64 years living in households from the NIMH Epidemiologic Catchment Area survey conducted in Eastern Baltimore. Differences between the two groups were small with respect to age, race, education, and military service but the differences in mental health status, utilization patterns, and social dysfunction were large. About one-third of the homeless scored high on the General Health Questionnaire which measures distress. A similar proportion had a current psychiatric disorder as ascertained by the Diagnostic Interview Schedule (DIS), with the homeless exhibiting higher prevalence rates in every DIS/DSM III diagnostic category compared to domiciled men. Homeless persons reported higher rates of hospitalization than household men for both mental (33 per cent vs 5 per cent) and physical (20 per cent vs 10 per cent) problems but a lower proportion received ambulatory care (41 per cent vs 50 per cent). Social dysfunction among the homeless was indicated by fewer social contacts and higher rates of arrests as adults than domiciled men (58 per cent vs 24 per cent), including multiple arrests (38 per cent vs 9 per cent) and felony convictions (16 per cent vs 5 per cent). Implications of these findings are discussed in terms of research and health policy. Handle: RePEc:aph:ajpbhl:1986:76:5:519-524_5 Template-Type: ReDIF-Article 1.0 Title: The effect of passive smoking on children's pulmonary function in Shanghai Journal: American Journal of Public Health Author-Name: Chen, Y. Author-Name: Li, W.-X. Year: 1986 Volume: 76 Issue: 5 Pages: 515-518 Abstract: We report the findings of a cross-sectional study of the relationship between passive smoking and pulmonary function of children in Shanghai, People's Republic of China. The 571 study subjects included 303 males and 268 females, ranging in age from 8 to 16 years, from a primary school and a secondary school at Xu-Hui District. Lung function tests were performed at the schools, and questionnaires were completed by parents. The father's cigarette smoking status during child's lifetime was linearly related to a decrease in the per cent predicted values of FEV1.0, MMEF and FEF(62.5-87.5%) in total subjects; in school-girls, father's smoking status accounted for 0.5 per cent, 1.2 per cent, and 1.6 per cent of the total variation, respectively; the trend was less marked in boys. Other environmental factors considered in this study, i.e., educational level of the father, the use of coal or gas for cooking, the presence of patients with chronic respiratory diseases in the family, etc., did not seem to have any important role on the children's pulmonary function. Handle: RePEc:aph:ajpbhl:1986:76:5:515-518_8 Template-Type: ReDIF-Article 1.0 Title: An outbreak of influenza A in a nursing home Journal: American Journal of Public Health Author-Name: Horman, J.T. Author-Name: Stetler, H.C. Author-Name: Israel, E. Author-Name: Sorley, D. Author-Name: Schipper, M.T. Author-Name: Joseph, J.M. Year: 1986 Volume: 76 Issue: 5 Pages: 501-504 Abstract: An outbreak of influenza A occurred in an elderly population in a Maryland nursing home between December 8, 1980 and January 13, 1981 and involved 76 of the 170 residents. Throat swabs from two of 10 acutely ill residents yielded influenza A virus similar to the A/Taiwan/1/79 strain. Fourfold or greater increases in the titer of complement-fixing (CF) or hemagglutination-inhibiting (HI) antibodies were detected in paired sera from four of five ill residents and from none of four well residents. One hundred (62.9 per cent) of 159 residents with known vaccination histories had been vaccinated with trivalent influenza virus vaccine in October and November 1980. Crude illness attack rates and mortality rates were similar in vaccinees and nonvaccinees. Various risk factors and hypotheses were examined in an attempt to explain the apparent lack of vaccine efficacy. Handle: RePEc:aph:ajpbhl:1986:76:5:501-504_3 Template-Type: ReDIF-Article 1.0 Title: IUD use and subsequent tubal ectopic pregnancy Journal: American Journal of Public Health Author-Name: Chow, W.-H. Author-Name: Daling, J.R. Author-Name: Weiss, N.S. Author-Name: Moore, D.E. Author-Name: Soderstrom, R.M. Author-Name: Metch, B.J. Year: 1986 Volume: 76 Issue: 5 Pages: 536-539 Abstract: As part of a case-control study of tubal ectopic pregnancy (TEP), we sought to evaluate the possible etiologic role of use of an intrauterine device (IUD) prior to conception. We interviewed 155 women who had a tubal ectopic pregnancy treated at one of five Seattle, Washington hospitals between 1975-79 regardiing their reproductive, contraceptive, and medical histories; 456 women who delivered a baby in King County during the same period were identified from vital records and interviewed as controls. An elevated risk of TEP was detected among former users of the Dalkon Shield (adjusted OR = 2.5; 95% CI = 1.3-4.7). Women who had used other IUDs did not have an excess risk of TEP. Handle: RePEc:aph:ajpbhl:1986:76:5:536-539_9 Template-Type: ReDIF-Article 1.0 Title: Nurse practitioner and physician assistant practices in three HMOs: Implications for future US health manpower needs Journal: American Journal of Public Health Author-Name: Weiner, J.P. Author-Name: Steinwachs, D.M. Author-Name: Williamson, J.W. Year: 1986 Volume: 76 Issue: 5 Pages: 507-511 Abstract: This study empirically examines the practices of non-physician providers (NPPs) within three large competitive health maintenance organizations (HMOs), as well as the physicians' and NPPs' views regarding the ideal role of NPPs. These roles are compared with NPP delegation patterns incorporated in the modeling methodology developed by the Graduate Medical Education National Advisory Committee (GMENAC). GMENAC recommended relatively high levels of delegation by physicians to NPPs. One of the HMO sites made use of NPPs at rates even higher than GMENAC's national ideals, while the rates of the other two were lower. The normative ideals for pediatric NPPs developed at each HMO were consistently higher than their actual roles. Concerns with acceptance and the role of NPPs are clearly no longer issues. Instead, the limits on NPP involvement appear to relate to considerations of costs, availability, and the increasing numbers of physicians competing for similar opportunities. Handle: RePEc:aph:ajpbhl:1986:76:5:507-511_9 Template-Type: ReDIF-Article 1.0 Title: Cesarean section and breech presentations. Journal: American Journal of Public Health Author-Name: Ryan Jr., G.M. Year: 1986 Volume: 76 Issue: 8 Pages: 962 Handle: RePEc:aph:ajpbhl:1986:76:8:962_1 Template-Type: ReDIF-Article 1.0 Title: Litigating for the public's health. Journal: American Journal of Public Health Author-Name: Teret, S.P. Year: 1986 Volume: 76 Issue: 8 Pages: 1027-1029 Handle: RePEc:aph:ajpbhl:1986:76:8:1027-1029_6 Template-Type: ReDIF-Article 1.0 Title: Wastewater recycling and reuse. Journal: American Journal of Public Health Author-Name: Straub, C.P. Year: 1986 Volume: 76 Issue: 8 Pages: 960-962 Handle: RePEc:aph:ajpbhl:1986:76:8:960-962_9 Template-Type: ReDIF-Article 1.0 Title: Significance tests represent consensus and standard practice. Journal: American Journal of Public Health Author-Name: Walker, A.M. Year: 1986 Volume: 76 Issue: 8 Pages: 1033-1034 Handle: RePEc:aph:ajpbhl:1986:76:8:1033-1034_9 Template-Type: ReDIF-Article 1.0 Title: On residential status of New York City homicide victims. Journal: American Journal of Public Health Author-Name: Durkin, M. Year: 1986 Volume: 76 Issue: 8 Pages: 1034 Handle: RePEc:aph:ajpbhl:1986:76:8:1034_0 Template-Type: ReDIF-Article 1.0 Title: Banning worksite smoking. Journal: American Journal of Public Health Author-Name: Fielding, J.E. Year: 1986 Volume: 76 Issue: 8 Pages: 957-959 Handle: RePEc:aph:ajpbhl:1986:76:8:957-959_0 Template-Type: ReDIF-Article 1.0 Title: Differences noted in quit smoking manuals. Journal: American Journal of Public Health Author-Name: Buxton, T. Year: 1986 Volume: 76 Issue: 8 Pages: 1034-1035 Handle: RePEc:aph:ajpbhl:1986:76:8:1034-1035_5 Template-Type: ReDIF-Article 1.0 Title: The effects of infant feeding on rotavirus-induced gastroenteritis: A prospective study Journal: American Journal of Public Health Author-Name: Duffy, L.C. Author-Name: Byers, T.E. Author-Name: Riepenhoff-Talty, M. Author-Name: La Scolea, L.J. Author-Name: Zielezny, M. Author-Name: Ogra, P.L. Year: 1986 Volume: 76 Issue: 3 Pages: 259-263 Abstract: The relationship between feeding method and risk of rotavirus infection was studied by following a cohort of 197 infants from low income households through the winter diarrhea season of 1983-84. Fecal specimens were systematically collected and tested for the presence of rotavirus particles by electron microscopy, confirmed by ELISA. The attack rates of rotavirus gastroenteritis were similar for breast-fed and bottle-fed infants (20 per cent, 17 per cent, respectively); however, the clinical course of rotavirus gastroenteritis was quite different. Infants who were breast-fed had illnesses which were characterized by milder symptoms of shorter duration. Of the 10 breast-fed infants who acquired rotavirus gastroenteritis, nine (90 per cent) were classified as mild illnesses while of the 25 bottle-fed infants who acquired rotavirus gastroenteritis, only nine (36 per cent) were classified as having mild illnesses. These data suggest that factors associated with breast-feeding, although not affecting rotavirus infection rates, may moderate the clinical course of rotavirus gastroenteritis. Handle: RePEc:aph:ajpbhl:1986:76:3:259-263_7 Template-Type: ReDIF-Article 1.0 Title: The impact of the Mississippi improved Child Health Project on prenatal care and low birthweight Journal: American Journal of Public Health Author-Name: Strobino, D.M. Author-Name: Chase, G.A. Author-Name: Kim, Y.J. Author-Name: Crawley, B.E. Author-Name: Salim, J.H. Author-Name: Baruffi, G. Year: 1986 Volume: 76 Issue: 3 Pages: 274-278 Abstract: A quasi-experimental, nonequivalent control group design was used to evaluate the Improved Child Health Projects in northwest Mississippi (ICHP1 and ICHP2). Control counties were selected for each project that on average were similar to ICHP counties on racial composition, median family income in 1970 and 1980, and number of births in 1978-79. The study population comprised all resident births in the ICHP and control counties during a pre-ICHP period (1975-78) and the ICHP period (1979-81). The percentage of women with adequate prenatal care rose between the two periods for all counties; the rise was greater for the study than for the control counties for ICHP1; the reverse was found for ICHP2. For both projects, the low birthweight rate remained constant in the pre-ICHP and ICHP periods for the study and control counties. Adjustment for changes in the childbearing characteristics between the two periods did not alter these results. Community involvement in its development and coordination may explain ICHP1's impressive rise in the use of prenatal care. Handle: RePEc:aph:ajpbhl:1986:76:3:274-278_4 Template-Type: ReDIF-Article 1.0 Title: Cigarette smoking behavior among Rhode Island physicians, 1963-83 Journal: American Journal of Public Health Author-Name: Buechner, J.S. Author-Name: Perry, D.K. Author-Name: Scott, H.D. Author-Name: Freedman, B.E. Author-Name: Tierney, J.T. Author-Name: Waters, W.J. Year: 1986 Volume: 76 Issue: 3 Pages: 285-286 Abstract: A survey of practicing physicians in Rhode Island revealed a cigarette smoking rate of only 8.3 per cent in 1983. This represents a continuation of the consistent decrease seen in the percentage of physician smokers in each such survey since 1963. Under age 30, the rate was only 4.5 per cent. An exponential model suggests that the overall rate for Rhode Island physicians will be below 3 per cent by the year 2000. Handle: RePEc:aph:ajpbhl:1986:76:3:285-286_5 Template-Type: ReDIF-Article 1.0 Title: Associations of moderate and severe overweight with self-reported illness and medical care in Dutch adults Journal: American Journal of Public Health Author-Name: Seidell, J.C. Author-Name: de Groot, L.C.P.G.M. Author-Name: van Sonsbeek, J.L.A. Author-Name: Deurenberg, P. Author-Name: Hautvast, J.G. Year: 1986 Volume: 76 Issue: 3 Pages: 264-269 Abstract: Data on height, weight, illness, medical care consumption, and demographic variables for 19,126 Dutch adults aged 20 years or older were obtained from three annual Health Interview Surveys. Data on severely overweight (Body Mass Index 30.0-40.0 kg/m2) and moderately overweight (BMI 25.0-29.9 kg/m2) subjects were compared with those on non-overweight persons (BMI 20.0-24.9 kg/m2), taking into account effects of sex, age, and educational level. In men, severe overweight was associated with hypertension, especially in men under 50 years of age. In women, severe overweight was associated with hypertension, diabetes, varicose veins, asthma/bronchitis, and hemorrhoids. Increased utilization of medical care and medications were also associated with severe overweight. For moderately overweight subjects, these associations were less clear or absent. Handle: RePEc:aph:ajpbhl:1986:76:3:264-269_1 Template-Type: ReDIF-Article 1.0 Title: Multidimensional scaling and the information it conveys. Journal: American Journal of Public Health Author-Name: Bartolucci, A.A. Year: 1986 Volume: 76 Issue: 7 Pages: 747-748 Handle: RePEc:aph:ajpbhl:1986:76:7:747-748_5 Template-Type: ReDIF-Article 1.0 Title: Union-based surveillance of occupational hazards. Journal: American Journal of Public Health Author-Name: Sheikh, K. Year: 1986 Volume: 76 Issue: 7 Pages: 818-819 Handle: RePEc:aph:ajpbhl:1986:76:7:818-819_1 Template-Type: ReDIF-Article 1.0 Title: The American Journal of Public Health, 1911-85. Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1986 Volume: 76 Issue: 7 Pages: 809-815 Handle: RePEc:aph:ajpbhl:1986:76:7:809-815_8 Template-Type: ReDIF-Article 1.0 Title: Worksite smoking modification competitions: long-term vs short-term success. Journal: American Journal of Public Health Author-Name: Hessol, N.A. Year: 1986 Volume: 76 Issue: 7 Pages: 819-820 Handle: RePEc:aph:ajpbhl:1986:76:7:819-820_4 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: LaBoccetta, A.C. Year: 1986 Volume: 76 Issue: 6 Pages: 709-710 Handle: RePEc:aph:ajpbhl:1986:76:6:709-710_8 Template-Type: ReDIF-Article 1.0 Title: Salience of survey questionnaires: examining bias. Journal: American Journal of Public Health Author-Name: Carnrike Jr., C.L. Year: 1986 Volume: 76 Issue: 6 Pages: 710-711 Handle: RePEc:aph:ajpbhl:1986:76:6:710-711_5 Template-Type: ReDIF-Article 1.0 Title: Intervention of tobacco chewing and smoking habits. Journal: American Journal of Public Health Author-Name: Gupta, P.C. Author-Name: Mehta, C.R. Author-Name: Pindborg, J.J. Author-Name: Aghi, M.B. Author-Name: Mehta, F.S. Author-Name: Bhonsle, R.B. Author-Name: Murti, P.R. Year: 1986 Volume: 76 Issue: 6 Pages: 709 Handle: RePEc:aph:ajpbhl:1986:76:6:709_2 Template-Type: ReDIF-Article 1.0 Title: A health profile for use in Spain. Journal: American Journal of Public Health Author-Name: Antó, J.M. Author-Name: Alonso, J. Year: 1986 Volume: 76 Issue: 6 Pages: 711 Handle: RePEc:aph:ajpbhl:1986:76:6:711_4 Template-Type: ReDIF-Article 1.0 Title: Alcohol use and interpersonal violence: Alcohol detected in homicide victims Journal: American Journal of Public Health Author-Name: Goodman, R.A. Author-Name: Mercy, J.A. Author-Name: Loya, F. Author-Name: Rosenberg, M.L. Author-Name: Smith, J.C. Author-Name: Allen, N.H. Author-Name: Vargas, L. Author-Name: Kolts, R. Year: 1986 Volume: 76 Issue: 2 Pages: 144-149 Abstract: To characterize the relationship between alcohol use and homicide victimization, we used data from the Los Angeles City Police Department and the Los Angeles Medical Examiner's Office to study 4,950 victims of criminal homicides in Los Angeles in the period 1970-79. Alcohol was detected in the blood of 1.883 (46 per cent) of the 4,092 victims who were tested. In 30 per cent of those tested, the blood alcohol level was ≥100 mg/100 ml, the level of legal intoxication in most states. Blood alcohol was present most commonly in victims who were male, young, and Latino, categories where rates have been increasing at an alarming pace. Alcohol was also detected most commonly in victims killed during weekends, when homicides occurred in bars or restaurants, when homicides resulted from physical fights or verbal arguments, when victims were friends or acquaintances of offenders, and when homicides resulted from stabbings. The evidence for alcohol use by homicide victims focuses attention on the need for controlled epidemiologic studies of the role played by alcohol as a risk factor in homicide and on the importance of considering situational variables in developing approaches to homicide prevention. Handle: RePEc:aph:ajpbhl:1986:76:2:144-149_1 Template-Type: ReDIF-Article 1.0 Title: Lessons from the Visual Acuity Impairment Survey pilot study Journal: American Journal of Public Health Author-Name: Ederer, F. Author-Name: Krueger, D.E. Author-Name: Mowery, R.L. Author-Name: Connett, J. Author-Name: Wentworth, D. Year: 1986 Volume: 76 Issue: 2 Pages: 160-165 Abstract: The Visual Acuity Impairment Survey (VAIS) pilot study was carried out in three larger metropolitan areas of the United States to determine whether it would be feasible to conduct a large two-stage survey of the prevalence of visual acuity impairment and its causes. The study was conducted in conjunction with the Health Interview Survey (HIS), performed by the National Center for Health Statistics and the Census Bureau. In the first stage, a simple vision screening test was administered to 1,868 adults in their homes by specially trained Census Bureau interviewers. All those who failed the test, and a sample of those who passed it, were invited to a local clinic for a check on the accuracy of the screen and a detailed eye examination to establish the cause of the impairment. About 89 per cent of the HIS interviewees took the vision screening test in the home and agreed to have the results released, making it possible for the clinic to invite them for an examination. The principal obstacle for the success of the feasibility study was a low rate (less than 50 per cent) of participation in the clinic examination by the target population. Such low participation would leave the survey open to a serious question about its representativeness. The methods and findings of the pilot study are presented because the lessons may be of value to those attempting similar studies in the future. Suggestions are made for methodological modifications that may enhance the chances for success. Handle: RePEc:aph:ajpbhl:1986:76:2:160-165_6 Template-Type: ReDIF-Article 1.0 Title: Reproductive mortality in two developing countries Journal: American Journal of Public Health Author-Name: Fortney, J.A. Author-Name: Susanti, I. Author-Name: Gadalla, S. Author-Name: Saleh, S. Author-Name: Rogers, S.M. Author-Name: Potts, M. Year: 1986 Volume: 76 Issue: 2 Pages: 134-138 Abstract: Reproductive mortality includes mortality attributable to pregnancy, termination of pregnancy, childbirth and its sequelae, and contraception. Reproductive mortality has been estimated for the United Kingdom, the United States, and for states of the US. However, it has not previously been measured for developing countries, where maternal mortality often remains distressingly high. This paper reports on data from one governorate of Egypt, where reproductive mortality was 46 per 100,000 married women ages 15-49 (2.2 per cent of this was attributable to contraception), and one province of Indonesia, where reproductive mortality was 70 per 100,000 (of which 1.4 per cent was due to contraception). In both locations, complications of pregnancy and childbirth were a leading cause of death in the age group studied (the first cause in Indonesia, second in Egypt). Contraceptive prevalence was 24 per cent of married women ages 15-49 in Egypt and 48 per cent of this age group in Indonesia. Handle: RePEc:aph:ajpbhl:1986:76:2:134-138_7 Template-Type: ReDIF-Article 1.0 Title: Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in human milk: Effects of maternal factors and previous lactation Journal: American Journal of Public Health Author-Name: Rogan, W.J. Author-Name: Gladen, B.C. Author-Name: McKinney, J.D. Author-Name: Carreras, N. Author-Name: Hardy, P. Author-Name: Thullen, J. Author-Name: Tingelstad, J. Author-Name: Tully, M. Year: 1986 Volume: 76 Issue: 2 Pages: 172-177 Abstract: The authors measured polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in maternal serum, cord blood, placenta, and serial samples of breast milk from 868 women. Almost all samples of breast milk showed detectable levels of both chemicals. Overall, values for DDE in this study are within the range of those found previously, whereas those for PCBs are somewhat higher. Possible causes of variation in levels were investigated. For DDE, older women, Black women, cigarette smokers, and women who consumed sport fish during pregnancy had higher levels; only age and race showed large effects. For PCBs, older women, women who regularly drink alcohol, and primiparae had higher levels. In addition, both chemicals showed modest variation across occupational groupings. Causal exposure to a PCB spill did not result in chemical levels different from background. In general, women have higher levels in the first lactation and in the earlier samples of a given lactation, and levels decline both with time spent breast-feeding and with number of children nursed. These striking declines are presumably a measure of exposure to the child. Handle: RePEc:aph:ajpbhl:1986:76:2:172-177_5 Template-Type: ReDIF-Article 1.0 Title: FDA's comments on in-home pregnancy tests. Journal: American Journal of Public Health Author-Name: Johnson, W. Year: 1986 Volume: 76 Issue: 5 Pages: 588 Handle: RePEc:aph:ajpbhl:1986:76:5:588_0 Template-Type: ReDIF-Article 1.0 Title: Public health responsibilities, roles, and realities. Journal: American Journal of Public Health Author-Name: Walker Jr., B. Year: 1986 Volume: 76 Issue: 5 Pages: 555 Handle: RePEc:aph:ajpbhl:1986:76:5:555_8 Template-Type: ReDIF-Article 1.0 Title: A commentary on 'The oral health of older Americans'. Journal: American Journal of Public Health Author-Name: Friedman, J.S. Year: 1986 Volume: 76 Issue: 5 Pages: 589-590 Handle: RePEc:aph:ajpbhl:1986:76:5:589-590_2 Template-Type: ReDIF-Article 1.0 Title: Content, adequacy of sex education programs. Journal: American Journal of Public Health Author-Name: Luckhurst, D.G. Year: 1986 Volume: 76 Issue: 5 Pages: 589 Handle: RePEc:aph:ajpbhl:1986:76:5:589_9 Template-Type: ReDIF-Article 1.0 Title: 'Totally safe sex' or AIDS. Journal: American Journal of Public Health Author-Name: Feldman, D.A. Year: 1986 Volume: 76 Issue: 5 Pages: 588-589 Handle: RePEc:aph:ajpbhl:1986:76:5:588-589_7 Template-Type: ReDIF-Article 1.0 Title: Confidence intervals vs significance tests: quantitative interpretation. Journal: American Journal of Public Health Author-Name: Fleiss, J.L. Year: 1986 Volume: 76 Issue: 5 Pages: 587-588 Handle: RePEc:aph:ajpbhl:1986:76:5:587-588_8 Template-Type: ReDIF-Article 1.0 Title: The San Francisco experience with regulation of smoking in the workplace: the first twelve months. Journal: American Journal of Public Health Author-Name: Martin, M.J. Author-Name: Silverman, M.F. Year: 1986 Volume: 76 Issue: 5 Pages: 585-586 Handle: RePEc:aph:ajpbhl:1986:76:5:585-586_5 Template-Type: ReDIF-Article 1.0 Title: Underreporting of infant deaths: then and now. Journal: American Journal of Public Health Author-Name: Kleinman, J.C. Year: 1986 Volume: 76 Issue: 4 Pages: 365-366 Handle: RePEc:aph:ajpbhl:1986:76:4:365-366_0 Template-Type: ReDIF-Article 1.0 Title: Conjecture versus empirical data: a response to concerns raised about the National Preventive Dentistry Demonstration Program. 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: Graves, R.C. Year: 1986 Volume: 76 Issue: 4 Pages: 448-452 Handle: RePEc:aph:ajpbhl:1986:76:4:448-452_8 Template-Type: ReDIF-Article 1.0 Title: The fabric of public health. 1985 Presidential address. Journal: American Journal of Public Health Author-Name: Sidel, V.W. Year: 1986 Volume: 76 Issue: 4 Pages: 373-378 Handle: RePEc:aph:ajpbhl:1986:76:4:373-378_1 Template-Type: ReDIF-Article 1.0 Title: Different strokes, regarding the NPDDP. Journal: American Journal of Public Health Author-Name: Rebich Jr., T. Year: 1986 Volume: 76 Issue: 4 Pages: 453 Handle: RePEc:aph:ajpbhl:1986:76:4:453_4 Template-Type: ReDIF-Article 1.0 Title: Homelessness and community mental health. Journal: American Journal of Public Health Author-Name: Ossorio, E.D. Year: 1986 Volume: 76 Issue: 4 Pages: 464 Handle: RePEc:aph:ajpbhl:1986:76:4:464_3 Template-Type: ReDIF-Article 1.0 Title: 1985 DTP vaccine shortage: failure of a remedial vaccination program. Journal: American Journal of Public Health Author-Name: Weiss, B.D. Author-Name: Watkins, S.S. Author-Name: Gilles, H.C. Year: 1986 Volume: 76 Issue: 4 Pages: 464-465 Handle: RePEc:aph:ajpbhl:1986:76:4:464-465_4 Template-Type: ReDIF-Article 1.0 Title: Error effects of survey questionnaires on the public's assessments of health risks. Journal: American Journal of Public Health Author-Name: Sirken, M.G. Year: 1986 Volume: 76 Issue: 4 Pages: 367-368 Handle: RePEc:aph:ajpbhl:1986:76:4:367-368_0 Template-Type: ReDIF-Article 1.0 Title: Passage to Methuselah: some demographic consequences of continued progress against mortality. Journal: American Journal of Public Health Author-Name: Vaupel, J.W. Author-Name: Gowan, A.E. Year: 1986 Volume: 76 Issue: 4 Pages: 430-433 Abstract: How will progress against mortality affect the size and age composition of the United States population over the next century? To gain some insight into this question, three scenarios are examined: no future progress against mortality; steady reductions in mortality at all ages at a rate of 2 per cent per year; and a radical breakthrough in the year 2000 that cuts mortality in half. All three scenarios substantially shift the composition of the US population toward older ages, steady progress resulting in the most radical change. If mortality is reduced 2 per cent per year, by 2080 almost two-fifths of the population would be above age 65 and the number of centenarians would approach 19 million. The social, economic, and public health consequences of this new demography, although speculative and uncertain, are so important that detailed analysis and planning are warranted. Handle: RePEc:aph:ajpbhl:1986:76:4:430-433_9 Template-Type: ReDIF-Article 1.0 Title: Microbiological markers for swimming-associated infectious health hazards. Journal: American Journal of Public Health Author-Name: Mossel, D.A. Year: 1986 Volume: 76 Issue: 3 Pages: 297 Handle: RePEc:aph:ajpbhl:1986:76:3:297_5 Template-Type: ReDIF-Article 1.0 Title: Foodborne streptococcal pharyngitis. Journal: American Journal of Public Health Author-Name: Horan, J.M. Author-Name: Cournoyer, J.J. Year: 1986 Volume: 76 Issue: 3 Pages: 296-297 Handle: RePEc:aph:ajpbhl:1986:76:3:296-297_2 Template-Type: ReDIF-Article 1.0 Title: Do motorcycles 'wobble' in the USA too? Journal: American Journal of Public Health Author-Name: Björnstig, U. Year: 1986 Volume: 76 Issue: 3 Pages: 297 Handle: RePEc:aph:ajpbhl:1986:76:3:297_4 Template-Type: ReDIF-Article 1.0 Title: Snuff and neuromuscular performance. Journal: American Journal of Public Health Author-Name: Edwards, S.W. Author-Name: Glover, E.D. Year: 1986 Volume: 76 Issue: 2 Pages: 206 Handle: RePEc:aph:ajpbhl:1986:76:2:206_4 Template-Type: ReDIF-Article 1.0 Title: Subtle differences on abortion. Journal: American Journal of Public Health Author-Name: Vojtecky, M.A. Year: 1986 Volume: 76 Issue: 2 Pages: 205 Handle: RePEc:aph:ajpbhl:1986:76:2:205_7 Template-Type: ReDIF-Article 1.0 Title: Conducting smokeless tobacco cessation clinics. Journal: American Journal of Public Health Author-Name: Glover, E.D. Year: 1986 Volume: 76 Issue: 2 Pages: 207 Handle: RePEc:aph:ajpbhl:1986:76:2:207_3 Template-Type: ReDIF-Article 1.0 Title: Reproductive mortality in developing countries Journal: American Journal of Public Health Author-Name: Simmons, G.B. Year: 1986 Volume: 76 Issue: 2 Pages: 131-132 Handle: RePEc:aph:ajpbhl:1986:76:2:131-132_2 Template-Type: ReDIF-Article 1.0 Title: Constitutional protection of sexual privacy in the 1980s: What is big brother doing in the bedroom? Journal: American Journal of Public Health Author-Name: Wing, K.R. Year: 1986 Volume: 76 Issue: 2 Pages: 201-204 Abstract: In virtually all states, statutes define sodomy, 'crimes against nature,' and other sexually related activities as major felonies. Their existence has often been the object of ridicule and scorn. Read literally, these statutes impose severe criminal penalties on any homosexual activity, regardless of the setting, as well as a variety of sexual practices between heterosexuals, married or not. They are sometimes referred in the statutes only in the most Victorian terms, and sometimes listed in what would appear to be unnecessary detail. The language of some state statutes allows criminal courts almost limitless discretion to interpret what is feloniously 'unnatural' or 'unspeakable'. Handle: RePEc:aph:ajpbhl:1986:76:2:201-204_1 Template-Type: ReDIF-Article 1.0 Title: Trichinosis in Southeast Asian refugees in the United States Journal: American Journal of Public Health Author-Name: Stehr-Green, J.K. Author-Name: Schantz, P.M. Year: 1986 Volume: 76 Issue: 10 Pages: 1238-1239 Abstract: Between 1975 and 1984, the incidence of trichinosis in the United States (per million person years at risk) was 25 times greater for the Southeast Asian refugee population than for the general United States population. Cases in the southeast Asian refugees differed from those reported previously in the general population in geographic distribution and source of infected meat. Cambodians and Laotians accounted for over 90 percent of the cases in the Southeast Asian refugees, but comprised less than 50 percent of that total population. Handle: RePEc:aph:ajpbhl:1986:76:10:1238-1239_9 Template-Type: ReDIF-Article 1.0 Title: National and state trends in use of prenatal care, 1970-83 Journal: American Journal of Public Health Author-Name: Ingram, D.D. Author-Name: Makuc, D. Author-Name: Kleinman, J.C. Year: 1986 Volume: 76 Issue: 4 Pages: 415-423 Abstract: Using birth certificate data, national trends in prenatal care use are examined for White and Black mothers overall, as well as for 10 separate subgroups defined by marital status, maternal age, and educational attainment. The per cent of Black mothers with early prenatal care increased each year during the 1970s but the average annual percentage point increase for 1976-80 (1.2) was smaller than that for 1970-75 (2.3). Furthermore, the per cent of Black mothers with early care declined from 62.6 in 1980 to 61.4 in 1982 and remained at this lower level in 1983. Similar changes in trends were observed for all of the 10 Black subgroups despite substantial variation among the subgroups in the level of early prenatal care use. Analyses of state trends provide further evidence of a change in trend for Black mothers. For White mothers, average annual increases in the per cent with early care were similar for 1970-75 and 1976-80 (0.8 and 0.6 percentage points). In addition, the per cent with early care has remained stable since 1980. Handle: RePEc:aph:ajpbhl:1986:76:4:415-423_7 Template-Type: ReDIF-Article 1.0 Title: Primary prevention and coronary heart disease: The economic benefits of lowering serum cholesterol Journal: American Journal of Public Health Author-Name: Oster, G. Author-Name: Epstein, A.M. Year: 1986 Volume: 76 Issue: 6 Pages: 647-656 Abstract: We examined the expected economic benefits of cholesterol lowering for adult men with significant elevations of total serum cholesterol (above 260 mg/dl), incorporating estimates of direct benefits from anticipated reductions in lifetime expenditures for medical care, and estimates for indirect benefits related to extension of work-life secondary to reductions in morbidity and premature mortality. Our findings yield discounted lifetime direct benefits of a 15 per cent reduction in total serum cholesterol of $3 to $208 per person, and discounted lifetime indirect benefits of $1 to $8,946. Benefits increase with an individual's initial cholesterol level and decrease with the age at which an intervention is initiated. Econimic benefits increase approximately twofold in the presence of other coronary risk factors, such as cigarette smoking and hypertension. Results suggest that cholesterol-lowering interventions, no matter what their cost, are unlikely to result in substantial direct savings to the health care system. However, the indirect benefits of intervention are quite high for young and middle-aged adults, as well as for those with severe elevations of cholesterol or with additional coronary risk factors. Handle: RePEc:aph:ajpbhl:1986:76:6:647-656_5 Template-Type: ReDIF-Article 1.0 Title: Incidence and outcome of hospital-treated head injury in Rhode Island Journal: American Journal of Public Health Author-Name: Fife, D. Author-Name: Faich, G. Author-Name: Hollinshead, W. Author-Name: Boynton, W. Year: 1986 Volume: 76 Issue: 7 Pages: 773-778 Abstract: Hospital discharge summary data were used to identify and study all 2,870 Rhode Island residents hospitalized in-state with head injuries during 1979 and 1980. The overall hospitalized incidence rate was 152 per 100,000 of population per year with age and sex variations similar to those found in other studies. This is consistent with the observation that fatal injury rates in Rhode Island are only 75 per cent of the United States average. Hospitalized incidence rates of head injury of the census tracts in the lowest decile of median income were twice those for census tracts in the highest decile. Smaller increases were also observed with increasing population density. Length of hospital stay increased with age. Discharge to chronic care facilities plus in-hospital deaths increased 20-fold with increasing age. In each age group, in-hospital deaths and discharge to chronic care facilities were associated with long hospital stays. Handle: RePEc:aph:ajpbhl:1986:76:7:773-778_3 Template-Type: ReDIF-Article 1.0 Title: Childhood tuberculosis in North Carolina: A study of the opportunities for intervention in the transmission of tuberculosis to children Journal: American Journal of Public Health Author-Name: Nolan Jr., R.J. Year: 1986 Volume: 76 Issue: 1 Pages: 26-30 Abstract: New cases of tuberculosis in children continue to appear. A retrospective review of the medical records of a representative sample of such cases occurring from 1977 through 1981 was conducted to gain an understanding of why this preventable disease continues to occur in North Carolina children. Three percent of cases were detected by routine screening; 17 percent were diagnosed after the child's symptomatic presentation; and 80 percent after contact screening. However, 14 percent of cases detected by contact screening developed disease while receiving isoniazid prophylaxis for a positive tuberculin test; and 19 percent of cases detected by contact screening developed disease while under surveillance, but not recieving isoniazid prophylaxis, as tuberculin negative contacts of known infectious cases. Adherence to accepted recommendations for prophylaxis should reduce the childhood tuberculosis case rate. Handle: RePEc:aph:ajpbhl:1986:76:1:26-30_4 Template-Type: ReDIF-Article 1.0 Title: Trends in activity-limiting chronic conditions among children Journal: American Journal of Public Health Author-Name: Newacheck, P.W. Author-Name: Budetti, P.P. Author-Name: Halfon, N. Year: 1986 Volume: 76 Issue: 2 Pages: 178-184 Abstract: Data from the National Health Interview Survey indicate that the prevalence of activity-limiting chronic conditions among children under age 17 years doubled between 1960 and 1981, from 1.8 to 3.8 per cent. Approximately 40 per cent of the overall rise in prevalence occurred before 1970. Most of the increase in prevalence during this early period can be attributed to changes in questionnaire design and aging of the child population following the 'baby boom' years. The factors responsible for increases in reported cases of activity limitation following 1970 are more difficult to specify and evaluate. During this later period, the increase in prevalence was restricted to less severe levels of limitations. While prevalence levels rose for a variety of conditions during this period, respiratory conditions and mental and nervous system disorders demonstrated the largest changes. It appears that much of the increase in reported cases of activity limitations during the 1970s can be attributed to shifting perceptions on the part of parents, educators, and physicians. Handle: RePEc:aph:ajpbhl:1986:76:2:178-184_2 Template-Type: ReDIF-Article 1.0 Title: Sex and smoking differences in duodenal ulcer mortality Journal: American Journal of Public Health Author-Name: Kurata, J.H. Author-Name: Elashoff, J.D. Author-Name: Nogawa, A.N. Author-Name: Haile, B.M. Year: 1986 Volume: 76 Issue: 6 Pages: 700-702 Abstract: Data from the US Census Bureau and the National Center for Health Statistics suggest that differences in male and female smoking habits between 1920 and 1980 may have contributed to changes in duodenal ulcer mortality sex ratios. An attributable risk analysis suggests that between 43 per cent and 63 per cent of duodenal ulcer mortality for males results from smoking; the comparable figures for females being between 25 per cent and 50 per cent. Handle: RePEc:aph:ajpbhl:1986:76:6:700-702_0 Template-Type: ReDIF-Article 1.0 Title: The health care reform in Mexico: Before and after the 1985 earthquakes Journal: American Journal of Public Health Author-Name: Soberon, G. Author-Name: Frenk, J. Author-Name: Sepulveda, J. Year: 1986 Volume: 76 Issue: 6 Pages: 673-680 Abstract: The earthquakes that hit Mexico City in September 1985 caused considerable damage both to the population and to important medical facilities. The disaster took place while the country was undertaking a profound reform of its health care system. This reform had introduced a new principle for allocating and distributing the benefits of health care, namely, the principle of citizenship. Operationally, the reform includes an effort to decentralize the decision-making authority, to modernize the administration, to achieve greater coordination whithin the health sector and among sectors, and to extend coverage to the entire population through an ambitious primary care program. This paper examines the health context in which the reform was taking place when the September earthquakes hit. After presenting the damages caused by the quakes, the paper analyzes the characteristics of the immediate response by the health system. Since many facilities within the system were severely damaged, a series of options for reconstruction are posited. The main lession to be learned from the Mexican case is that cuts in health care programs are not the inevitable response to economic or natural crises. On the contrary, it is precisely when the majority of the population is undergoing difficulties that a universal and equitable health system becomes most necessary. Handle: RePEc:aph:ajpbhl:1986:76:6:673-680_1 Template-Type: ReDIF-Article 1.0 Title: Infectious diseases and field water supply and sanitation among migrant farm workers Journal: American Journal of Public Health Author-Name: Arbab, D.M. Author-Name: Weidner, B.L. Year: 1986 Volume: 76 Issue: 6 Pages: 694-695 Abstract: An audit for fecal-related symptoms was performed on clinic patient charts of 936 migrant farm workers without access to water and sanitation facilities in the work fields and on an urban poor population of 8,968 patients. Migrants displayed a clinic utilization rate for diarrhea 20 times higher than that for the urban poor; similar findings for other enteric disease symptoms were documented. The data suggest that a water and sanitation standard mandating facilities in the work field for farm workers would reduce the incidence of fecal-related disease. Handle: RePEc:aph:ajpbhl:1986:76:6:694-695_7 Template-Type: ReDIF-Article 1.0 Title: The decline in congenital rubella syndrome in Western Australia: An impact of the school girl vaccination program? Journal: American Journal of Public Health Author-Name: Stanley, F.J. Author-Name: Sim, M. Author-Name: Wilson, G. Author-Name: Worthington, S. Year: 1986 Volume: 76 Issue: 1 Pages: 35-37 Abstract: Rubella vaccination became available in 1970 in Australia. In Western Australia (WA), a school girl vaccination program was well established by 1971. Mothers under 26 years of age in 1983 would have been eligible for this program and they constitute 40 per cent of WA births. Data on Congenital Rubella Syndrome (CRS) cases were obtained for years of birth 1968-83 inclusive to ascertain if there had been an impact of the program on the CRS rate. Epidemics of rubella occurred in 1970-71, 1974, and 1979-80. The CRS rate has fallen steadily; it did not rise during the 1979-80 epidemic and was less than one in each year after 1977. All CRS cases born since 1974 were to mothers too old to have been eligible for the program. The data suggest that the vaccination program is effective cannot be proven until data become available on pregnancy terminations. Handle: RePEc:aph:ajpbhl:1986:76:1:35-37_2 Template-Type: ReDIF-Article 1.0 Title: Validation of hospital discharge diagnosis data for chronic obstructive pulmonary disease and other allied conditions Journal: American Journal of Public Health Author-Name: Mazumdar, S. Author-Name: Colbus, D.S. Author-Name: Townsend, M.C. Year: 1986 Volume: 76 Issue: 7 Pages: 803-805 Abstract: The assumption that discharge diagnoses of chronic obstructive pulmonary disease and other allied conditions accurately reflect patient medical records was tested using a sample of 553 hospital discharges from the Pittsburgh, Pennsylvania area. Three validation criteria were used in reviewing patient hospital records; 1) the presence of abnormal spirometry test results; 2) reference made to a previous diagnosis of one of the conditions; and 3) reports of respiratory symptoms consistent with these conditions. The findings were that 1 per cent of the 432 cases with a primary diagnosis in this disease category and 10 per cent of the 121 cases with a primary diagnosis of heart disease and a secondary diagnosis in this disease category were not supported by any of the selected criteria. Handle: RePEc:aph:ajpbhl:1986:76:7:803-805_4 Template-Type: ReDIF-Article 1.0 Title: State liquor laws as enablers for impaired driving and other impaired behaviors Journal: American Journal of Public Health Author-Name: Waller, J.A. Year: 1986 Volume: 76 Issue: 7 Pages: 787-792 Abstract: In theory, liquor control laws are meant to promote temperance. In most states, however, a purveyor of alcoholic beverages does not have to stop serving a customer until she/he appears 'intoxicated'; this means that many people continue to be served alcohol long after they have reached the legal limit for impaired driving,. 10 per cent blood alcohol concentration (BAC). Objective impairment and increased injury risk substantially precede clinical signs of intoxication. State liquor control laws should be changed to establish a maximum permissible number of drinks that may be served so that patrons are unlikely to exceed a maximum BAC (.10 per cent or .15 per cent) and to adopt a BAC of .10 per cent or .15 per cent as presumptive evidence that a patron has been served too much. Currently five states have a cutoff based at least in part on BAC, while the remaining states either have cutoffs based on appearance of intoxication or no cutoff at all. Handle: RePEc:aph:ajpbhl:1986:76:7:787-792_2 Template-Type: ReDIF-Article 1.0 Title: The effect of prescription eyewear on ocular exposure to ultraviolet radiation Journal: American Journal of Public Health Author-Name: Rosenthal, F.S. Author-Name: Bakalian, A.E. Author-Name: Taylor, H.R. Year: 1986 Volume: 76 Issue: 10 Pages: 1216-1220 Abstract: Several studies have suggested that ultraviolet radiation in sunlight may cause cataracts and other eye disease. We evaluated the effect of prescription eyewear in attenuating ocular exposure to ultraviolet radiation (UVR) in the sunlight portions of the ultraviolet spectrum (295-350 nm). Using natural sunlight as the source, the attenuation was measured with two ultraviolet detectors, one sensitive to only UVB (295-315 nm) and one sensitive to both UVA and UVB (295-350 nm). A random sample of spectacles, spectacle lenses, and contact lenses was examined. The average transmission, as measured with either detector, was highest for soft contact lenses, followed by glass spectacle lenses, untinted hard contact lenses, and plastic spectacle lenses. Measurements performed with mannikins wearing spectacles showed that an average of 6.6 percent of incident radiation reached the eye when the lenses were covered with black opaque tape. The amount of exposure was increased substantially when the spectacles were moved 0.6 cm away from the forehead. The results show that the protection against ultraviolet exposure provided by prescription eyewear is highly variable and depends largely on its composition, size, and wearing position. Handle: RePEc:aph:ajpbhl:1986:76:10:1216-1220_5 Template-Type: ReDIF-Article 1.0 Title: Epidemiology of hepatitis Binfection in institutionalized mentally retarded clients Journal: American Journal of Public Health Author-Name: Lohiya, S. Author-Name: Lohiya, G. Author-Name: Caires, S. Year: 1986 Volume: 76 Issue: 7 Pages: 799-802 Abstract: In 1,149 clients of an institution for the mentally retarded, the prevalences of hepatitis B surface antigen (HBsAg) and hepatitis B virus markers were 12 per cent and 66 per cent, respectively. HBsAg prevalence was higher in males, Down syndrome, ambulatory, and older clients, and those with longer institutionalization. Serum alanine aminotransferase levels were abnormal in 31 per cent of HBsAg positive and 10 per cent of HBsAg-negative clients. Handle: RePEc:aph:ajpbhl:1986:76:7:799-802_4 Template-Type: ReDIF-Article 1.0 Title: Patterns of smokeless tobacco use in a population of high school students Journal: American Journal of Public Health Author-Name: Marty, P.J. Author-Name: McDermott, R.J. Author-Name: Williams, T. Year: 1986 Volume: 76 Issue: 2 Pages: 190-192 Abstract: We assessed the prevalence of smokeless tobacco use by 901 high school students in two Arkansas communities, and identified factors associated with initiation and maintenance. Results showed that 36.7 per cent of males and 2.2 per cent of females currently used smokeless tobacco. Modal responses indicated that if smokeless tobacco was used at all, it was used with frequency on an almost daily basis. Health professionals need to monitor this phenomenon closely and take appropriate preventive actions. Handle: RePEc:aph:ajpbhl:1986:76:2:190-192_1 Template-Type: ReDIF-Article 1.0 Title: Variations in physicians' hospitalization practices: A population-based study in Manitoba, Canada Journal: American Journal of Public Health Author-Name: Roos, N.P. Author-Name: Flowerdew, G. Author-Name: Wajda, A. Author-Name: Tate, R.B. Year: 1986 Volume: 76 Issue: 1 Pages: 45-51 Abstract: This paper uses claims data from a universal health care system to describe physicians' hospitalization styles after adjusting for case-mix characteristics of their primary patients. Patients were uniquely assigned to that physician (general or family practitioners, internist, general surgeon, or obstetrical/gynecologist) seen most frequently over each two two-year periods (1972-74 and 1974-76). Four indices were developed including: 1) percentage of primary patients hospitalized; 2) mean number of readmissions for such patients; 3) mean length of stay; and 4) total days of hospitalization per primary care patient (a summary measure combining the first three). Rates of admission, not length of stay, were shown to be strongly related to this summary measure. Marked variations in the hospitalization indices were observed across physicians; these variations cannot be explained by the health or sociodemocraphic characteristics of a physician's patients. Rural physicians practicing in areas with high bed-to-population ratios and low occupancy rates were particularly high users of hospitals. The economic implications of different practice styles are shown to be large; physicians who were high users of hospitals serve 27 per cent of the patients but their patients consume 42 per cent of the hospital days. Handle: RePEc:aph:ajpbhl:1986:76:1:45-51_6 Template-Type: ReDIF-Article 1.0 Title: The contest for control: Regulating new and expanding health occupations Journal: American Journal of Public Health Author-Name: DeVries, R.G. Year: 1986 Volume: 76 Issue: 9 Pages: 1147-1150 Handle: RePEc:aph:ajpbhl:1986:76:9:1147-1150_0 Template-Type: ReDIF-Article 1.0 Title: Distributional change in physician manpower, United States, 1963-80 Journal: American Journal of Public Health Author-Name: McConnel, C.E. Author-Name: Tobias, L.A. Year: 1986 Volume: 76 Issue: 6 Pages: 638-642 Abstract: Using data from the American Medical Association's Physician Masterfiles (1963-80) and the GINI index of resource concentration as a global measure of changes in the pattern of locational choice, the expectation of a more uniform distribution of physicians is shown to have been met for all major categories of physicians except General Practitioners. Increases in the supply of Surgical Specialists, Medical Specialists, and Other Specialists were accompanied by increases in the index of dispersion across counties of 23.1 per cent, 17.9 per cent and 21 per cent, respectively. By 1980, Surgical Specialists were the most uniformly distributed of all physician groups. The distributional implications of location theory for physicians are addressed and evidence relevant to evaluating this economic theory of locational choice is presented. Handle: RePEc:aph:ajpbhl:1986:76:6:638-642_7 Template-Type: ReDIF-Article 1.0 Title: Group participation and survival among patients with end-stage renal disease Journal: American Journal of Public Health Author-Name: Friend, R. Author-Name: Singletary, Y. Author-Name: Mendell, N.R. Author-Name: Nurse, H. Year: 1986 Volume: 76 Issue: 6 Pages: 670-672 Abstract: All 126 End-Stage Renal Disease (ESRD) patients who entered dialysis between 1971 and 1981 at the Harlem Hospital Center, New York City, were separated into those who had participated in a patient support group and those who had not done so. Patients who engaged in the group activities survived considerably longer than non-participants. Family history of renal disease, psychiatric illness, blood urea nitrogen (BUN), and creatinine were also related to survival, but, education, religion, marital status, and age were not. When 13 psychosocial and physiological covariates were controlled for in a Cox proportional hazard analysis, the group participation effect remained substantial. Handle: RePEc:aph:ajpbhl:1986:76:6:670-672_9 Template-Type: ReDIF-Article 1.0 Title: Collisions with passenger cars and moose, Sweden Journal: American Journal of Public Health Author-Name: Bjornstig, U. Author-Name: Eriksson, A. Author-Name: Thorson, J. Author-Name: Bylund, P.-O. Year: 1986 Volume: 76 Issue: 4 Pages: 460-462 Abstract: The number of collisions between motor vehicles and moose is increasing in many countries. Collisions with large, high animals such as moose cause typical rear- and downward deformation of the windshield pillars and front roof, most pronounced for small passenger cars; the injury risk increases with the deformation of the car. A strengthening of the windshield pillars and front roof and the use of antilacerative windshields would reduce the injury risk to car occupants. Handle: RePEc:aph:ajpbhl:1986:76:4:460-462_8 Template-Type: ReDIF-Article 1.0 Title: Health care of poverty and nonpoverty children in Iowa Journal: American Journal of Public Health Author-Name: Levey, L.A. Author-Name: MacDowell, N.M. Author-Name: Levey, S. Year: 1986 Volume: 76 Issue: 8 Pages: 1000-1003 Abstract: Responses to a survey of 637 Iowa children under age six years from Aid to Families with Dependent Children (AFDC) households was conducted through telephone interviews with parents and compared to a second sample of children in 760 randomly sampled households. Utilization of health services for children in the AFDC sample was similar to that of nonpoverty children and superior to that of other poverty children. Irrespective of Medicaid coverage, poverty children's health care differed from that of nonpoverty children in the following ways: less well care from a private practice or pediatrician, seeing the same health professional at each well visit less often, receiving immunizations at the same place as source of well care, examination by a physician at the most recent well visit, sick care at the same place as well care. Handle: RePEc:aph:ajpbhl:1986:76:8:1000-1003_7 Template-Type: ReDIF-Article 1.0 Title: Contraceptive practices among female heroin addicts Journal: American Journal of Public Health Author-Name: Ralph, N. Author-Name: Spigner, C. Year: 1986 Volume: 76 Issue: 8 Pages: 1016-1017 Abstract: In a sample of 115 heroin-addicted women, 25.8 per cent reported any type of contraception compared to 48.5 per cent of a national sample. Matching for age, ethnic group, and income level, reported contraceptive rates for the heroin-addicted sample versus the national sample for the never married, married, and formerly married groups were 40.1 per cent versus 37.7 percent; 64.9 per cent versus 22.0 per cent; and 51.9 per cent versus 19.9 per cent, respectively. Handle: RePEc:aph:ajpbhl:1986:76:8:1016-1017_9 Template-Type: ReDIF-Article 1.0 Title: Lyme disease: Epidemiologic characteristics of an outbreak in Westchester County, NY Journal: American Journal of Public Health Author-Name: Williams, C. Author-Name: Curran, A.S. Author-Name: Chen Lee, A. Author-Name: Sousa, V.O. Year: 1986 Volume: 76 Issue: 1 Pages: 62-65 Handle: RePEc:aph:ajpbhl:1986:76:1:62-65_9 Template-Type: ReDIF-Article 1.0 Title: Changing trends of tobacco use in a teenage population in western Pennsylvania Journal: American Journal of Public Health Author-Name: Guggenheimer, J. Author-Name: Zullo, T.G. Author-Name: Kruper, D.C. Author-Name: Verbin, R.S. Year: 1986 Volume: 76 Issue: 2 Pages: 196-197 Abstract: Information on tobacco use was obtained from an anonymous questionnaire distributed to 609 8th, 9th, and 10th grade students in the Pittsburgh area. The data disclosed that 22 per cent of the girls and 11 per cent of the boys were smoking. However, 35 per cent of the young men reported using smokeless tobacco; snuff dipping ( 6 per cent), tobacco chewing (10 per cent), and snuff and/or tobacco chewing (19 per cent). Handle: RePEc:aph:ajpbhl:1986:76:2:196-197_2 Template-Type: ReDIF-Article 1.0 Title: Prevalence of hepatitis A virus antibody among Navajo school children Journal: American Journal of Public Health Author-Name: Williams, R. Year: 1986 Volume: 76 Issue: 3 Pages: 282-283 Abstract: Previous studies of the prevalence of immunity to hepatitis A (anti-HAV) in the United States have used urban settings or institutions for the mentally handicapped. In a rural setting among normal children, a serologic investigation of prevalence of anti-HAV was conducted in a boarding school adjacent to the Navajo reservation. The results show rates of anti-HAV that are the highest reported at the ages tested in any subpopulation in the United States, comparable only with those in developing countries. Handle: RePEc:aph:ajpbhl:1986:76:3:282-283_4 Template-Type: ReDIF-Article 1.0 Title: Introduction to the epidemiological aspects of explosive volcanism Journal: American Journal of Public Health Author-Name: Bernstein, R.S. Author-Name: Baxter, P.J. Author-Name: Buist, A.S. Year: 1986 Volume: 76 Issue: S3 Pages: 3-9 Handle: RePEc:aph:ajpbhl:1986:76:S3:3-9_9 Template-Type: ReDIF-Article 1.0 Title: Health risks associated with wastewater irrigation: An epidemiological study Journal: American Journal of Public Health Author-Name: Fattal, B. Author-Name: Wax, Y. Author-Name: Davies, M. Author-Name: Shuval, H.I. Year: 1986 Volume: 76 Issue: 8 Pages: 977-979 Abstract: An analysis of morbidity was made in 11 kibbutzim (cooperative agricultural settlements), with a total population of 3,040, that had switched from nonwastewater to wastewater sprinkler irrigation or vice versa. Generally, partially treated stabilization pond effluent of poor microbial quality was used for irrigation. Vegetables or salad crops were not irrigated with effluent. The results showed that a seasonal, twofold, excess risk of 'enteric' disease was found in the 0 to 4 year-old age group during the summer irrigation months in those years in which wastewater was used for irrigation, compared with the parallel summer months of nonwastewater years in the same kibbutz. On the year-round rates basis, little or no excess enteric disease was found in wastewater irrigating communities. Handle: RePEc:aph:ajpbhl:1986:76:8:977-979_6 Template-Type: ReDIF-Article 1.0 Title: Poisoning hospitalizations and deaths from solids and liquids among children and teenagers Journal: American Journal of Public Health Author-Name: Trinkoff, A.M. Author-Name: Baker, S.P. Year: 1986 Volume: 76 Issue: 6 Pages: 657-660 Abstract: Twenty-four deaths and 4,271 hospital admissions due to poisoning occurred in the 0-19 year age group in Maryland during 1979-82. Four-fifths of the deaths (83 per cent) and two-thirds of the admissions involved teenagers. Among teenagers, four out of five admissions and deaths were of suicidal or undetermined intent. Black males had the highest hospitalization rate among young children, and White females among teenagers. The most common poisons ingested by children aged 0-4 years were aspirin, solvents and petroleum products, tranquilizers, and iron compounds. Among teenagers, aspirin, tranquilizers, sedatives, and antidepressants were the most common substances ingested, with antidepressants and stimulants most common among the fatalities. Reducing the availability and toxicity of the most hazardous drugs is important if morbidity and mortality from poisoning are to be prevented. Handle: RePEc:aph:ajpbhl:1986:76:6:657-660_3 Template-Type: ReDIF-Article 1.0 Title: The prevalence of bulimia among college students Journal: American Journal of Public Health Author-Name: Zuckerman, D.M. Author-Name: Colby, A. Author-Name: Ware, N.C. Author-Name: Lazerson, J.S. Year: 1986 Volume: 76 Issue: 9 Pages: 1135-1137 Abstract: A survey was conducted to determine the prevalence of bulimia and bulimic symptoms in a nonclinical sample of 907 college freshmen and seniors. Using criteria based on the Diagnostic and Statistical Manual of Mental Disorders, 4 per cent of the women and 0.4 per cent of the men were classified as bulimic. Symptoms of bulimia, such as binge eating, purging behaviors, and extreme fear of gaining weight, were much more prevalent. (Am J Public Health 1986; 76:1135-1137). Handle: RePEc:aph:ajpbhl:1986:76:9:1135-1137_5 Template-Type: ReDIF-Article 1.0 Title: A community-based analysis of ambulatory surgery utilization Journal: American Journal of Public Health Author-Name: Lagoe, R.J. Author-Name: Milliren, J.W. Year: 1986 Volume: 76 Issue: 2 Pages: 150-153 Abstract: We conducted a study to determine the utilization level for ambulatory surgery and the proportions of specific procedures which could be performed in certain ambulatory settings in one community. Syracuse, New York, which has used this service extensively. It was estimated that, in 1983, 26.9 surgery cases per 1,000 population in Syracuse were performed in ambulatory settings. This level amounted to approximately 37 per cent of hospital-based surgery in the area. Analysis of surgery utilization in two hospital-integrated and freestanding ambulatory surgery facilities indicated that more than 95 per cent of myringotomies, tonsillectomies, and adenoidectomies as well as substantial proportions of carpal tunnel releases, lens extractions, sterilizations, circumcisions, and inguinal hernia repairs in these two facilities were performed in ambulatory settings. The availability of dedicated facilities and full-time staff produced higher utilization for these procedures in freestanding facilities. The utilization levels for individual procedures identified in the study can be employed in the planning of hospital-integrated and freestanding programs. Handle: RePEc:aph:ajpbhl:1986:76:2:150-153_1 Template-Type: ReDIF-Article 1.0 Title: Changes in Spanish surname cancer rates relative to other whites, Denver area, 1969-71 to 1979-81 Journal: American Journal of Public Health Author-Name: Savitz, D.A. Year: 1986 Volume: 76 Issue: 10 Pages: 1210-1215 Abstract: Cancer incidence rates for persons of Spanish surname and other Whites in the Denver, Colorado area were derived for two time periods, 1969-71 and 1979-81. The substantial deficits in total cancers for Spanish surname males and females relative to other Whites in 1969-71 diminished considerably for all age groups by 1979-81. The major determinants of this pattern were the rapidly rising Spanish surname rates for cancer of the colon and rectum, lung cancer, kidney cancer, female breast and uterine cancers, and male prostate, bladder, and hematopoietic cancers. There was a convergence of Spanish surname rates toward the other White rates for nearly all sites, regardless of whether other Whites showed increasing, decreasing, or stable rates. Notable exceptions occurred for cervical cancer, which dropped more slowly among persons of Spanish surname than among other Whites, and Spanish surname female stomach cancer rates which rose during the 1970s in contrast to a decrease among other Whites. The overall pattern is consistent with acculturation of persons of Spanish surname towards the majority's lifestyle, suggesting the value of more detailed studies of specific cancer determinants in the Spanish surname population. Handle: RePEc:aph:ajpbhl:1986:76:10:1210-1215_7 Template-Type: ReDIF-Article 1.0 Title: Identification of the physical and chemical characteristics of volcanic hazards Journal: American Journal of Public Health Author-Name: Olsen, K.B. Author-Name: Fruchter, J.S. Year: 1986 Volume: 76 Issue: S3 Pages: 45-52 Handle: RePEc:aph:ajpbhl:1986:76:S3:45-52_2 Template-Type: ReDIF-Article 1.0 Title: Transmission of Giardia lamblia from a day care center to the community Journal: American Journal of Public Health Author-Name: Polis, M.A. Author-Name: Tuazon, C.U. Author-Name: Alling, D.W. Author-Name: Talmanis, E. Year: 1986 Volume: 76 Issue: 9 Pages: 1142-1144 Abstract: An outbreak of giardiasis was investigated in one urban day care center; another day care center was selected as a control. In the study day care center, 35 per cent of the children were infected. Infection was spread to at least one household contact of 47 per cent of the infected children. The data suggest person-to-person transmission of giardiasis and the need for measures to prevent its dissemination. Early recognition and treatment of Giardia lamblia infections in children may be indicated. Handle: RePEc:aph:ajpbhl:1986:76:9:1142-1144_7 Template-Type: ReDIF-Article 1.0 Title: The prevalence and health impact of shiftwork Journal: American Journal of Public Health Author-Name: Gordon, N.P. Author-Name: Cleary, P.D. Author-Name: Parker, C.E. Author-Name: Czeisler, C.A. Year: 1986 Volume: 76 Issue: 10 Pages: 1225-1228 Abstract: Data from the National Center for Health Statistics National Survey of Personal Health Practices and Consequences were analyzed to determine the impact of variable shift schedules on health-related behaviors of persons in the United States labor force. Twenty-six percent of mean and 18 per cent of women in the US labor force reported working a variable shift in Spring 1980. As compared to men working non-variable work schedules, those working variable shifts exhibited higher rates of heavy drinking, job stress, and emotional problems. Female variable shift workers reported higher rates of sleeping pill, tranquilizer, and alcohol use, as well as lower social network scores, more job stress, and more emotional problems. Handle: RePEc:aph:ajpbhl:1986:76:10:1225-1228_6 Template-Type: ReDIF-Article 1.0 Title: Excess pneumonia and influenza associated hospitalization during influenza epidemics in the United States, 1970-78 Journal: American Journal of Public Health Author-Name: Barker, W.H. Year: 1986 Volume: 76 Issue: 7 Pages: 761-765 Abstract: In this study, excess rates of pneumonia and influenza (P&I) associated hospitalization during influenza A epidemics which occurred in the United States between 1970-78 were computed utilizing unpublished data from the National Hospital Discharge Survey (NHDS). Excesses occurred at rates of 35, 93, and 370 per 100,000 persons per epidemic for age groups 15-44, 45-64, and 65+ years. There was no evidence of a persisting excess or a compensatory decline in P&I hospitalization during post-epidemic months. An average excess of $300 million was computed. The study quantifies a major impact of epidemic influenza upon health and health services, much of which may be preventable, and illustrates an important use of unpublished data contained in the NHDS. Handle: RePEc:aph:ajpbhl:1986:76:7:761-765_6 Template-Type: ReDIF-Article 1.0 Title: Lead poisoning: More than a medical problem Journal: American Journal of Public Health Author-Name: Schneider, D.J. Author-Name: Lavenhar, M.A. Year: 1986 Volume: 76 Issue: 3 Pages: 242-244 Abstract: Medical records of 236 Newark, New Jersey children hospitalized and chelated for lead poisoning in 1977 through 1980 were reviewed to determine whether or not any discernible progress had been made in eradicating the disease since 1972. Results show that the number of treated asymptomatic children, ages 1-6, began to rise after 1976 and was higher in 1980 than in 1972 when the Newark Lead Poisoning Prevention and Control Program first began. Although mean and peak blood lead levels have decreased over the nine-year period since 1972, signaling a lessening of disease severity, the increase in numbers and rates indicates that childhood lead poisoning still exists as an environmental and social problem. Handle: RePEc:aph:ajpbhl:1986:76:3:242-244_0 Template-Type: ReDIF-Article 1.0 Title: Economic development, political-economic system, and the physical quality of life Journal: American Journal of Public Health Author-Name: Cereseto, S. Author-Name: Waitzkin, H. Year: 1986 Volume: 76 Issue: 6 Pages: 661-666 Abstract: This study compared capitalist and socialist countries in measures of the physical quality of life (PQL), taking into account the level of economic development. The World Bank was the principal source of statistical data for 123 countries (97 per cent of the world's population). PQL variables included: 1) indicators of health, health services, and nutrition (infant mortality rate, child death rate, life expectancy, population per physician, population per nursing person, and daily per capita calorie supply); 2) measures of education (adult literacy rate, enrollment in secondary education, and enrollment in higher education); and 3) a composite PQL index. Capitalist countries fell across the entire range of economic development (measured by gross national product per capita), while the socialist countries appeared at the low-income, lower-middle-income, and upper-middle-income levels. All PQL measures improved as economic development increased. In 28 of 30 comparisons between countries at similar levels of economic development, socialist countries showed more favorable PQL outcomes. Handle: RePEc:aph:ajpbhl:1986:76:6:661-666_9 Template-Type: ReDIF-Article 1.0 Title: Evaluation of mental effects of disaster, Mount St. Helens eruption Journal: American Journal of Public Health Author-Name: Shore, J.H. Author-Name: Tatum, E.L. Author-Name: Vollmer, W.M. Year: 1986 Volume: 76 Issue: S3 Pages: 76-83 Abstract: This psychiatric epidemiology study following the Mount St. Helens volcanic disaster revealed a significant morbidity for psychiatric disorders. The increased prevalence showed a dose response pattern in three population groups. The findings are reported as relative and attributable risk for the two exposed populations as compared to a control group. Patterns of significant risk are presented for sex, age, and for victims with pre-existing physical illness. The research utilized a new criteria-based interview schedule for the identification of psychiatric disorders. The methodology is reviewed in the context of the controversies and assumptions within the field of behavioral response to disaster stress. There are important implications for public health planning and intervention. Handle: RePEc:aph:ajpbhl:1986:76:S3:76-83_5 Template-Type: ReDIF-Article 1.0 Title: Comparison of complication rates in first trimester abortions performed by physician assistants and physicians Journal: American Journal of Public Health Author-Name: Freedman, M.A. Author-Name: Jillson, D.A. Author-Name: Coffin, R.R. Author-Name: Novick, L.F. Year: 1986 Volume: 76 Issue: 5 Pages: 550-554 Abstract: The outcomes of 2,458 first trimester abortions performed in a freestanding clinic in Vermont were studied. Procedures were performed by physician assistants and by physicians. Demographic information, medical history, and data relevant to the abortion were recorded. Both immediate and delayed (up to four weeks post-abortion) complications were noted. Direct follow-up four weeks after the procedure by clinic visit, letter, or telephone contact was achieved for 96 per cent of all patients. An overall rate of 29.1 complications per 1,000 procedures was observed, with a rate of 27.4 for abortions performed by physician assistants and 30.8 for physicians. The incidence of immediate complications was 6.1 per 1,000 procedures; delayed complication incidence was 23.2 per 1,000 procedures. Overall complication rates varied according to operative procedure used. Handle: RePEc:aph:ajpbhl:1986:76:5:550-554_5 Template-Type: ReDIF-Article 1.0 Title: Reporting the results of epidemiologic studies Journal: American Journal of Public Health Author-Name: Walker, A.M. Year: 1986 Volume: 76 Issue: 5 Pages: 556-558 Handle: RePEc:aph:ajpbhl:1986:76:5:556-558_0 Template-Type: ReDIF-Article 1.0 Title: Relationship between body mass indices and measures of body adiposity Journal: American Journal of Public Health Author-Name: Revicki, D.A. Author-Name: Israel, R.G. Year: 1986 Volume: 76 Issue: 8 Pages: 992-994 Abstract: We examined the relationship between various body mass indices (BMIs), skinfold measures, and laboratory measures of body fat in 474 males aged 20-70 years. Evaluations included height, weight, skinfold thickness, and hydrostatic measurements of adiposity. The weight-height ratio (W/H), Quetelet index (W/H3), Khosla-Lowe index (W/H2), and Benn index [W/H(P)] were calculated. The correlations among the various BMIs were high, ranging from 0.91 to 0.99, and all were strongly correlated with weight (rs = 0.81-0.98), while only W/H2 (r = -.03) and W/H(P) (r = -.01) were not correlated with height. The W/H2 and W/H(P) had the strongest correlation with hydrostatic and skinfold measurements, although all the BMIs were significantly correlated with these measurements. Results suggest that the Benn index and the Quetelet index are equally valid estimates of body fat in respect to their relationship with hydrostatic measures. Handle: RePEc:aph:ajpbhl:1986:76:8:992-994_7 Template-Type: ReDIF-Article 1.0 Title: Compensation for occupational disease with multiple causes: The case of coal miners' respiratory diseases Journal: American Journal of Public Health Author-Name: Weeks, J.L. Author-Name: Wagner, G.R. Year: 1986 Volume: 76 Issue: 1 Pages: 58-61 Abstract: Many diseases associated with occupational exposures are clinically indistinguishable from diseases with non-occupational causes. Given this, how are fair decisions made about eligibility for compensation? This problem is discussed in relation to the federal black lung program. Conflicting definitions of terms - coal workers' pneumoconiosis as defined by the medical profession, pneumoconiosis as defined by the United States Congress, and the popular term, black lung - are important considerations in this discussion. Each is embedded in different logical interpretations of the causes of occupational disease and of disability. Alternative views are presented and critically discussed. Handle: RePEc:aph:ajpbhl:1986:76:1:58-61_8 Template-Type: ReDIF-Article 1.0 Title: Prevalence of antibody to LAV/HTLV-III among homosexual men in Seattle Journal: American Journal of Public Health Author-Name: Collier, A.C. Author-Name: Barnes, R.C. Author-Name: Handsfield, H.H. Year: 1986 Volume: 76 Issue: 5 Pages: 564-565 Abstract: The prevalence of antibody to LAV/HTLV-III among homosexual men attending a community clinic and a sexually transmitted disease clinic in Seattle, Washington in early 1985 was 42 per cent and 32 per cent, respectively. Seropositivity was apparently not related to age or number of sexual partners. The high prevalence of LAV/HTLV-III seropositivity in an area where overt AIDS (acquired immune deficiency syndrome) is still relatively uncommon suggests that public health measures to prevent acquisition and transmission of LAV/HTLV-III should be a high priority even in areas with low incidences of AIDS. Handle: RePEc:aph:ajpbhl:1986:76:5:564-565_9 Template-Type: ReDIF-Article 1.0 Title: An analysis of the costs of ambulatory and inpatient care Journal: American Journal of Public Health Author-Name: Ancona-Berk, V.A. Author-Name: Chalmers, T.C. Year: 1986 Volume: 76 Issue: 9 Pages: 1102-1104 Abstract: Savings resulting from the substitution of ambulatory for inpatient care have been widely reported. This study examined the hypothesis that these savings may result from a reduction of services provided to the ambulatory patient and/or from an incomplete evaluation of these services, when the market value of relatives' support services is not included. Cataract extraction was chosen as an example. Sixty-two medical records of patients admitted to Mount Sinai for cataract extraction in the first six months of 1980 were reviewed, and the cost of their stay was estimated. This cost was then compared to five simulations of home care costs. The simulations differed among themselves primarily as to the experience and training of the person providing nursing services - from an RN to an untrained relative. The quantity and type of service provided in patients were assumed to be provided to ambulatory patients in all five stimulations. The results of the comparison of hospital costs to home costs were that, in the case of post-cataract extraction, home care is less costly than hospital care either if fewer services are provided to home patients or if the cost of some services assumed by relatives is not calculated. Handle: RePEc:aph:ajpbhl:1986:76:9:1102-1104_1 Template-Type: ReDIF-Article 1.0 Title: Health effects of volcanoes: An approach to evaluating the health effects of an environmental hazard Journal: American Journal of Public Health Author-Name: Buist, A.S. Author-Name: Bernstein, R.S. Year: 1986 Volume: 76 Issue: S3 Pages: 1-2 Handle: RePEc:aph:ajpbhl:1986:76:S3:1-2_3 Template-Type: ReDIF-Article 1.0 Title: Reducing the destructive impact of alcohol: The search for acceptable strategies continues Journal: American Journal of Public Health Author-Name: Healey, J.M. Year: 1986 Volume: 76 Issue: 7 Pages: 749-750 Handle: RePEc:aph:ajpbhl:1986:76:7:749-750_7 Template-Type: ReDIF-Article 1.0 Title: Some issues raised on Q fever study. Journal: American Journal of Public Health Author-Name: Robinson, R.A. Year: 1986 Volume: 76 Issue: 1 Pages: 88-89 Handle: RePEc:aph:ajpbhl:1986:76:1:88-89_6 Template-Type: ReDIF-Article 1.0 Title: Evaluation of physical health effects due to volcanic hazards. The use of experimental systems to estimate the pulmonary toxicity of volcanic ash Journal: American Journal of Public Health Author-Name: Martin, T.R. Author-Name: Wehner, A.P. Author-Name: Butler, J. Year: 1986 Volume: 76 Issue: S3 Pages: 59-65 Handle: RePEc:aph:ajpbhl:1986:76:S3:59-65_6 Template-Type: ReDIF-Article 1.0 Title: The role of poultry and meats in the etiology of Campylobacter jejuni/coli enteritis Journal: American Journal of Public Health Author-Name: Harris, N.V. Author-Name: Weiss, N.S. Author-Name: Nolan, C.M. Year: 1986 Volume: 76 Issue: 4 Pages: 407-411 Abstract: To determine the role of meats as possible sources of infection leading to Campylobacter jejuni/coli (CJC) enteritis, 218 cases and 526 controls were selected from the King County Group Health Cooperative (GHC) population from April 1982 through September 1983. All subjects were interviewed regarding food consumption one week prior to case onset. Consumption of chicken and cornish game hen were both associated with more than a doubling of the risk of CJC enteritis: for chicken (relative risk = 2.4, 95% CI = 1.6-3.6), and for game hen, (RR = 3.3, 95% CI = 1.1-9.8). The consumption of raw or rare chicken was even more strongly associated (RR = 7.6, 95% CI = 2.1-27.6). Strains of CJC bearing R factors for tetracycline were equally as likely as tetracycline-susceptible strains to have been acquired from chicken and game hens. Processed turkey sandwich meats (RR = 1.7, 95% CI = 1.0-2.9) raw or rare fish (RR = 4.0, 95% CI = 1.1-14.5) and shellfish (RR = 1.5, 95% CI = 1.1-2.1) were the only other meats reported to have been eaten significantly (p < .05) more often by cases than by controls. These data along with the results of bacteriologic sampling of meats from King County retail food markets during the same period suggest that ingestion of contaminated chicken is a primary source of CJC enteritis, contributing to approximately half of the cases. Handle: RePEc:aph:ajpbhl:1986:76:4:407-411_9 Template-Type: ReDIF-Article 1.0 Title: Trends in ischemic heart disease mortality in Italy, 1968-78 Journal: American Journal of Public Health Author-Name: La Vecchia, C. Author-Name: Decarli, A. Year: 1986 Volume: 76 Issue: 4 Pages: 454-456 Abstract: In Italy during the period 1968-78, female heart disease mortality decreased in all age groups up to age 79, with an average annual rate of decline in the 35-74 age-standardized rate of over 0.7 per cent. In males, age-specific death rates in some age groups were stable or increased moderately, but in middle-aged (50 to 59) males there was a consistent increase so that the rise in the 35-74 age standardized male death rate was approximately 1 per cent per year. Handle: RePEc:aph:ajpbhl:1986:76:4:454-456_0 Template-Type: ReDIF-Article 1.0 Title: The place of child-spacing as a factor in infant mortality: A recursive model Journal: American Journal of Public Health Author-Name: Park, C.B. Year: 1986 Volume: 76 Issue: 8 Pages: 995-999 Abstract: This study investigates the role of a preceding birth interval in infant mortality by considering a causal ordering of seven variables. Data are from the 1974 World Fertily Survey for Korea and cover the survival of 6,161 index children. A two-stage logit model was used. The analysis suggests that infant mortality is directly influenced by the preceding birth interval which, in turn, is influenced by five other explanatory variables: maternal age, birth order, immediately preceding infant's death, education of mother, and place of residence. Maternal age and prior infant death also exert direct effects on mortality. In terms of relative risk, prior infant death has the strongest effect of all the explanatory variables. A longer birth interval increases the odds of an infant's survival by 25 per cent, whereas the death of a preceding child decreases the odds by 45 per cent. However, infant deaths in Korea occur infrequently in comparison with short birth intervals. Thus, the two factors present comparable attributable risks in unadjusted measurements. The first-stage causal structure affecting a birth interval is more complicated than the second-stage structure affecting infant mortality. Handle: RePEc:aph:ajpbhl:1986:76:8:995-999_5 Template-Type: ReDIF-Article 1.0 Title: The severity of breast cancer at diagnosis: A comparison of age and extent of disease in black and white women Journal: American Journal of Public Health Author-Name: Satariano, W.A. Author-Name: Belle, S.H. Author-Name: Swanson, G.M. Year: 1986 Volume: 76 Issue: 7 Pages: 779-782 Abstract: A comparison was made of the incidence rates of localized, regional, and remote breast cancer between Black and White women by age at diagnosis. The analysis is based on 17,361 cases of breast cancer, newly diagnosed between 1973 and 1982, in Black and White female residents of the Detroit metropolitan area. Cases with breast cancer classified as local, regional or remote were drawn from the Metropolitan Detroit Cancer Surveillance System of the Division of Epidemiology at the Michigan Cancer Foundation, a participant in the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute. The findings indicate that older women, particularly Black women, are at elevated risk for being diagnosed with the most advanced form of breast cancer. Handle: RePEc:aph:ajpbhl:1986:76:7:779-782_0 Template-Type: ReDIF-Article 1.0 Title: Accuracy of consumer performed in-home tests for early pregnancy detection Journal: American Journal of Public Health Author-Name: Doshi, M.L. Year: 1986 Volume: 76 Issue: 5 Pages: 512-514 Abstract: We investigated the accuracy of the in-home pregnancy test in early pregnancy detection. A total of 109 women volunteered to perform their own pregnancy test using one of three brands. Kit accuracy ranged from 45.7 per cent to 89.1 per cent (95 per cent confidence interval), differing from the 97.4 per cent average of manufacturer claims. Sensitivity was calculated at 56 per cent, while specificity was 83 per cent. Predictive value of a negative result was 56 per cent and the predictive value of a positive test was 83 per cent. Handle: RePEc:aph:ajpbhl:1986:76:5:512-514_6 Template-Type: ReDIF-Article 1.0 Title: Planning for community physician services prior to deinstitutionalization of mentally retarded persons Journal: American Journal of Public Health Author-Name: Minihan, P.M. Year: 1986 Volume: 76 Issue: 10 Pages: 1202-1206 Abstract: This study assessed the need for physician services among a group of institutionalized mentally retarded individuals in anticipation of their transfer to community residential facilities and subsequent management of their care by community-based physicians. The clients' personal physicians in the institution identified every chronic condition which required physician services, and recommended the kind of physician and frequency of visits for the management of each condition. Key informants reviewed these estimates and determined if there were sufficient physicians in their communities to provide this care. Thirty-two percent of the conditions but only 8 percent of the clients could be managed by a primary care physician. The most frequently required specialties were neurology, orthopedics, and ophthalmology. While primary care services and many of the necessary specialty services were available in the community to meet the needs of these individuals, several specialties essential to the medical care of this group were not available. These included orthopedics for the multiply-handicapped, neurology including behavioral neurology, and psychiatry. Deinstitutionalization policies which rely solely upon community physician services will lead to inadequate medical care in the community for some mentally retarded individuals. In these situations, alternative approaches to care must be developed. Handle: RePEc:aph:ajpbhl:1986:76:10:1202-1206_1 Template-Type: ReDIF-Article 1.0 Title: Identification and classification of carcinogens: Procedures of the chemical substances threshold limit value committee, ACGIH Journal: American Journal of Public Health Author-Name: Spirtas, R. Author-Name: Steinberg, M. Author-Name: Wands, R.C. Author-Name: Weisburger, E.K. Year: 1986 Volume: 76 Issue: 10 Pages: 1232-1235 Abstract: The Chemical Substances Threshold Limit Value Committee of the American Conference of Governmental Industrial Hygienists has refined its procedures for evaluating carcinogens. Types of epidemiologic and toxicologic evidence used are reviewed and a discussion is presented on how the Committee evaluates data on carcinogenicity. Although it has not been conclusively determined whether biological thresholds exist for all types of carcinogens, the Committee will continue to develop guidelines for permissible exposures to carcinogens. The Committee will continue to use the safety factor approach to setting Threshold Limit Values for carcinogens, despite its shortcomings. A compilation has been developed for lists of substances considered to be carcinogenic by several scientific groups. The Committee will use this information to help to identify and classify carcinogens for its evaluation. Handle: RePEc:aph:ajpbhl:1986:76:10:1232-1235_4 Template-Type: ReDIF-Article 1.0 Title: Parental consent for abortion: Impact of the Massachusetts law Journal: American Journal of Public Health Author-Name: Cartoof, V.G. Author-Name: Klerman, L.V. Year: 1986 Volume: 76 Issue: 4 Pages: 397-400 Abstract: This study assessed the impact of Massachusetts' parental consent law, which requires unmarried women under age 18 to obtain parental or judicial consent before having an abortion. Data were analyzed on monthly totals of abortions and births to Massachusetts minors prior to and following the April 1981 implementation of the law. Findings indicate that half as many minors obtained abortions in the state during the 20 months after the law went into effect as had done so previously. More than 1,800 minors residing in Massachusetts traveled to five surrounding states during these 20 months to avoid the statute's mandates. This group accounts for the reduction in in-state abortions. A small number of minors (50 to 100) bore children rather than aborting during 1982, perhaps because of the law. Findings suggest that this state's parental consent law had little effect on adolescent's pregnancy-resolution behavior. Handle: RePEc:aph:ajpbhl:1986:76:4:397-400_4 Template-Type: ReDIF-Article 1.0 Title: Psychosocial and behavioral factors differentiating past drinkers and life-long abstainers Journal: American Journal of Public Health Author-Name: Eward, A.M. Author-Name: Wolfe, R. Author-Name: Moll, P. Author-Name: Harburg, E. Year: 1986 Volume: 76 Issue: 1 Pages: 68-70 Abstract: Studies of the health effects associated with alcohol consumption often use a single non-drinker category as a referrent. In this community study (N = 1,672) from Tecumseh, Michigan, past drinkers (N = 191) and life-long abstainers (N = 215) differed substantially for certain behavioral and psychosocial factors. In addition, 65 per cent of the male and 36 per cent of the female non-drinkers were past drinkers. Our findings suggest that a single non-drinking category might lead to ambiguous inferences across studies. Handle: RePEc:aph:ajpbhl:1986:76:1:68-70_3 Template-Type: ReDIF-Article 1.0 Title: Evidence of a reversal of the breastfeeding decline in Peninsular Malaysia Journal: American Journal of Public Health Author-Name: Haaga, J.G. Year: 1986 Volume: 76 Issue: 3 Pages: 245-251 Abstract: Data from the Malaysian Family Life Survey show an increase in the percentage of infants breastfed, at least initially, from 75 per cent in 1970-74 to 79 per cent in 1975-77. Contrary to what would be expected if Malaysia were following the trends observed in the United States and Western Europe, the increase has occurred among poor and uneducated women as well as among the more fortunate. The increase was especially marked for infants born in hospitals and private clinics, which had very low rates of breastfeeding in the early 1970s. The change may be due partly to a shift in the practices and recommendations of health professionals. Trends in infant feeding practices in Malaysia during the whole period 1950-77 are reviewed. Reasons for thinking the increase in the mid-1970s an artifact of the survey are presented and provisionally rejected. The implications of these findings for child health policy in Malaysia and for theories of infant feeding trends in developing countries are discussed. Handle: RePEc:aph:ajpbhl:1986:76:3:245-251_1 Template-Type: ReDIF-Article 1.0 Title: Screening for coinfection with Cryptosporidium and Giardia in Oregon public health clinic patients Journal: American Journal of Public Health Author-Name: Skeels, M.R. Author-Name: Sokolow, R. Author-Name: Hubbard, C.V. Author-Name: Foster, L.R. Year: 1986 Volume: 76 Issue: 3 Pages: 270-273 Abstract: During 1984, we screened 1,710 local public health clinic patients for Giardia and Cryptosporidium. Six patients (0.35 per cent) were positive for Cryptosporidium, and 214 (12.5 per cent) were positive for Giardia. One patient was positive for both parasites. In contrast to other reported studies, no evidence was found for an association between the two parasites (odds ratio = 1.39, 95 percent CI 0.16, 11.8). The apparent prevalence of Cryptosporidium in our study population was lower than has been reported previously. More laboratory screening could contribute to a better understanding of the distribution of Cryptosporidium and its role in human diarrheal disease, especially in immunocompetent patients. Handle: RePEc:aph:ajpbhl:1986:76:3:270-273_8 Template-Type: ReDIF-Article 1.0 Title: Willingness to pay and accept risks to cure chronic disease Journal: American Journal of Public Health Author-Name: Thompson, M.S. Year: 1986 Volume: 76 Issue: 4 Pages: 392-396 Abstract: Measurements of disease burden focus most often on economic outputs-neglecting effects on quality of life. More comprehensive quantification is based on what people would pay or risk to avoid illness. Many, however, find it difficult to respond thoughtfully to hypothetical questions about what they would pay or risk. With response rates frequently under 50 per cent, the practicality of these methods has been of concern. In this study, specially trained interviewers asked 247 subjects with rheumatoid arthritis how much of their income they would pay and how large a mortal risk they would accept to achieve a hypothetical cure. Ninety-eight per cent of the subjects estimated their maximum acceptable risk (MAR) at an average 27 per cent chance of immediate death. Eighty-four per cent gave plausible responses to the willingness-to-pay (WTP) questions, with a mean WTP of 22 per cent of household income. The aspect of disease most strongly associated with WTP was impairment in activities of daily living; measured pain was most associated with MAR. The response rates achieved indicate the overall feasibility of these methods; the associations of WTP and MAR with other variables suggest systematic consideration of personal circumstances. Handle: RePEc:aph:ajpbhl:1986:76:4:392-396_9 Template-Type: ReDIF-Article 1.0 Title: Ischemic heart disease mortality of firemen and policemen Journal: American Journal of Public Health Author-Name: Sardinas, A. Author-Name: Miller, J.W. Author-Name: Hansen, H. Year: 1986 Volume: 76 Issue: 9 Pages: 1140-1141 Abstract: Ischemic heart disease (IHD) mortality of Connecticut firemen and policemen is studied for the years 1960-78, using death certificate data. The mortality of these two occupations is expected to be greater than that of other workers. Standardized Mortality Odds Ratios for firemen and policemen are greater than 1.00. Although some increased IHD risk for firemen and policemen is suggested, the exact role of occupational risk factors remains to be determined. Handle: RePEc:aph:ajpbhl:1986:76:9:1140-1141_9 Template-Type: ReDIF-Article 1.0 Title: Alternative paths to long-term care: Nursing home, geriatric day hospital, senior center, and domiciliary care options Journal: American Journal of Public Health Author-Name: Sherwood, S. Author-Name: Morris, J.N. Author-Name: Ruchlin, H.S. Year: 1986 Volume: 76 Issue: 1 Pages: 38-44 Abstract: This paper examines certain quality of life outcomes, as well as comparative costs of care, for selected types of persons entering three very distinct types of alternative service programs that address the long-term care needs of vulnerable elderly persons: nursing homes (NH), geriatric day hospitals (GDH), and senior center (SC) programs. For selected outcomes, based on secondary analysis of the data gathered in another study, it was possible to add to the comparison samples of similar types of persons entering small foster-type domiciliary care homes (DC). From pools of persons entering these programs, six separate sets of comparison samples who were similar at baseline were constructed (GDH-SC, NH-SC, NH-GDH, NH-DC, SC-DC, GDH-DC). Only analyses pertaining to institutionalization and costs were conducted for the last three sets of comparison groups. Except for the issue of institutionalization, quality of life impact analysis showed only a few more post-test differences than would be expected by chance (although the few post-test differences that were observed in each case favored less restrictive settings). This more general similarity of outcome is indeed provocative, suggesting that in many ways the applicants adapted similarly to these quite distinct programs. Cost analyses found that nursing home and geriatric day hospital care, the two most restrictive settings, were also the two most expensive interventions. Handle: RePEc:aph:ajpbhl:1986:76:1:38-44_5 Template-Type: ReDIF-Article 1.0 Title: Drugs, lifestyle, and health: A longitudinal study of urban black youth Journal: American Journal of Public Health Author-Name: Brunswick, A. Author-Name: Messeri, P. Year: 1986 Volume: 76 Issue: 1 Pages: 52-57 Abstract: The association of drug use with indicators of health status was studied in a sample of urban Black youth interviewed first in adolescence and then six to seven years later in young adulthood. Seven substances, with interaction terms as appropriate, were tested against a psychophysical health scale and also against a more inclusive general health scale. Both measures of health outcomes yielded similar findings. Earlier inhalants use and, under certain conditions, methadone were linked to health change in males. Heroin had a delayed relationship to females' health. Additionally, methadone was associated with poorer health among young Black women who also were heavily alcohol drinkers. The observed relationships between drug use and health persisted after introducing controls for associated lifestyle factors. Handle: RePEc:aph:ajpbhl:1986:76:1:52-57_6 Template-Type: ReDIF-Article 1.0 Title: Preparing for disaster Journal: American Journal of Public Health Author-Name: Merchant, J.A. Year: 1986 Volume: 76 Issue: 3 Pages: 233-235 Abstract: The cataclysmic eruption of Mount St. Helens on May 18, 1980 resulted in displacement of one and one-half cubic kilometers of mountain covering over 100 square miles of the 'blast zone' with volcanic debris destroying all in its path and claiming the lives of at least 63 people who were voluntarily or mistakenly caught within the 'blast zone'. For several reasons, the relatively few individuals killed in this disaster must be considered fortunate. The Mount St. Helens eruption also provided a major test for federal, state, and community disaster plans. For those of us involved in the immediate public health response, Mount St. Helens provided some important lessons in organizing a disaster team, in documenting the impact on the public's health, and in preparing for future disasters.The Biological Effects of Volcanic Ash (BEVA) monograph that is the subject of the supplement to this issue of the Journal provides a planning model for future volcanic eruptions and other major disasters. It should be viewed in its broadest context. Handle: RePEc:aph:ajpbhl:1986:76:3:233-235_4 Template-Type: ReDIF-Article 1.0 Title: Characteristics of hazardous material spills from reporting systems in California Journal: American Journal of Public Health Author-Name: Shaw, G.M. Author-Name: Windham, G.C. Author-Name: Leonard, A. Author-Name: Neutra, R.R. Year: 1986 Volume: 76 Issue: 5 Pages: 540-543 Abstract: Data on hazardous material releases that occurred between January 1, 1982 and September 30, 1983 in California were obtained from the California Highway Patrol (CHP) and the US Department of Transportation (DOT). The majority of incidents involved highway transport of hazardous materials, although some information was available on air, rail, and stationary facility releases. Vehicle accidents and failure of or damage to the container were the most frequent causes of releases. Proportionately more hazardous materials incidents occurred in early summer than at other times of the year, during weekdays, and daytime hours. The largest proportions of incidents involved the chemical categories of corrosives and fuels. Reported exposures and injuries to response personnel and other people at the scene were relatively few; no fatalities were reported. Few incidents were reported in both data sources, suggesting that the examination of only one data source would yield a gross underestimate of the total number of hazardous materials incidents in California. The lack of available denominator data limits the interpretation of the findings. Handle: RePEc:aph:ajpbhl:1986:76:5:540-543_1 Template-Type: ReDIF-Article 1.0 Title: Preventive health measures in volcanic eruptions Journal: American Journal of Public Health Author-Name: Baxter, P.J. Author-Name: Bernstein, R.S. Author-Name: Buist, A.S. Year: 1986 Volume: 76 Issue: S3 Pages: 84-90 Abstract: Medical treatment has only a small role in severe volcanic eruptions and so preventive measures are paramount if injuries and loss of life are to be reduced. The health team must be incorporated in emergency planning and response at the earliest stage. Guidance on the interpretation of geological information about a volcano and the appropriate health measures that should be adopted before and after an eruption are summarized for the benefit of health workers. Handle: RePEc:aph:ajpbhl:1986:76:S3:84-90_7 Template-Type: ReDIF-Article 1.0 Title: Your money or your life: 'Dumping' uninsured patients from hospital emergency wards Journal: American Journal of Public Health Author-Name: Annas, G.J. Year: 1986 Volume: 76 Issue: 1 Pages: 74-77 Abstract: Annas argues that current public policy that emphasizes cost containment over quality of care and equity of access is an effort to transform medical care from a social good to an economic good. This trend threatens to erode the community ethic of providing emergency care to all regardless of ability to pay. The author cites statistics and cases that reveal a trend by hospitals to deny emergency care or to transfer medically unstable patients for economic reasons. Courts have upheld the right to emergency treatment and physicians, who determine what is an emergency, are urged to oppose hospital policies that compromise patient care and to reaffirm their ethical stance. The author concludes that state regulations should define emergency broadly, develop "emergency transfer protocols," and provide for sanctions against institutions and personnel that violate them. Handle: RePEc:aph:ajpbhl:1986:76:1:74-77_4 Template-Type: ReDIF-Article 1.0 Title: Trends in tobacco use on television Journal: American Journal of Public Health Author-Name: Cruz, J. Author-Name: Wallack, L. Year: 1986 Volume: 76 Issue: 6 Pages: 698-699 Abstract: A two-week composite sample of prime time television programming from fall 1984 was analyzed for portrayals of alcohol and tobacco. Earlier studies note that smoking acts have progressively declined, suggesting smoking is no longer as frequent on prime time television. The current study notes higher levels of smoking. This could be an indication that smoking is returning, and/or related to recent programming changes featuring more dramas on prime time television. Handle: RePEc:aph:ajpbhl:1986:76:6:698-699_4 Template-Type: ReDIF-Article 1.0 Title: Bicycle helmet use by children: Knowledge and behavior of physicians Journal: American Journal of Public Health Author-Name: Weiss, B.D. Author-Name: Duncan, B. Year: 1986 Volume: 76 Issue: 8 Pages: 1022-1023 Abstract: A survey of pediatricians and family physicians in Tucson, Arizona revealed that the majority knew that bicycle accidents are an important cause of childhood mortality and were aware that head trauma causes most bicycle-related deaths. Ninety-two per cent knew that children rarely use bicycle helmets and most believed this was due to inadequate parental awareness of the importance of helmets. Despite this, many physicians never include bicycle safety in patient education provided during well-child care. Handle: RePEc:aph:ajpbhl:1986:76:8:1022-1023_0 Template-Type: ReDIF-Article 1.0 Title: Lobbying for international health: The link between good ideas and funded programs: Bread for the world and the Agency for International Development Journal: American Journal of Public Health Author-Name: Quinley, J.C. Author-Name: Baker, T.D. Year: 1986 Volume: 76 Issue: 7 Pages: 793-796 Abstract: Historically, the Agency for International Development (AID) health budget has been closely tied to overall development spending. A large increase in the international health appropriations in 1984 broke this pattern. Investigation shows that active grass roots organizing and congressional lobbying are the most likely responsible factors in the increase. Maintenance and expansion of this success will require increased recognition of and participation in these activities by individuals and organizations involved in international health. Handle: RePEc:aph:ajpbhl:1986:76:7:793-796_4 Template-Type: ReDIF-Article 1.0 Title: Oral rehydration in China Journal: American Journal of Public Health Author-Name: Taylor, C.E. Author-Name: Yu, X.Z. Year: 1986 Volume: 76 Issue: 2 Pages: 187-189 Abstract: Oral rehydration with salt and sugar solution for diarrhea seems to have been widely used in China for more than 20 years. Surveys in five rural counties in widely distributed provinces have revealed that over 90 per cent of barefoot doctors and county doctors have been using a simple salt and sugar solution. Thirty-four per cent of mothers also said they used the oral solution. By contrast, most urban hospitals, especially teaching hospitals, continued to rely on intravenous (I-V) fluids. It had been previously observed that China has had high morbidity but low mortality from diarrheal diseases. Part of the explanation undoubtedly is the relatively good nutritional status of children and the widespread use of liquid traditional medicines. The finding that barefoot doctors have been using oral rehydration also may help explain the low mortality. Handle: RePEc:aph:ajpbhl:1986:76:2:187-189_1 Template-Type: ReDIF-Article 1.0 Title: Retreiving benefit from adversity Journal: American Journal of Public Health Author-Name: Wegman, M.E. Year: 1986 Volume: 76 Issue: 6 Pages: 621-622 Handle: RePEc:aph:ajpbhl:1986:76:6:621-622_6 Template-Type: ReDIF-Article 1.0 Title: Child restraint laws: An analysis of gaps in coverage Journal: American Journal of Public Health Author-Name: Teret, S.P. Author-Name: Jones, A.S. Author-Name: Williams, A.F. Author-Name: Wells, J.K. Year: 1986 Volume: 76 Issue: 1 Pages: 31-34 Abstract: The limiting effects of exemptions to the coverage of child restraint laws were estimated by determining the extent to which laws would have applied to child motor vehicle occupants, ages 0-5 years, killed before the laws were passed (1976-80). The 50 state laws would have exempted about 39 per cent of child motor vehicle occupants less than 6 years of age killed in the years immediately preceding enactment of the laws. Of those children killed in pre-law years who were within the age limits set by the subsequent state laws, about 21 per cent would not have been covered. The gaps in the laws are unnecessary, and proper amendments based on these data can save lives. Handle: RePEc:aph:ajpbhl:1986:76:1:31-34_0 Template-Type: ReDIF-Article 1.0 Title: Early subsequent pregnancy among economically disadvantaged teenage mothers Journal: American Journal of Public Health Author-Name: Polit, D.F. Author-Name: Kahn, J.R. Year: 1986 Volume: 76 Issue: 2 Pages: 167-171 Abstract: This study investigated the antecedents and short-term consequences of an early subsequent pregnancy in a sample of economically disadvantaged teenage mothers. Data were gathered over a two-year period from a sample of 675 young mothers living in eight United States cities. Within two years of the initial inverview, when half the sample was still pregnant with the index pregnancy, nearly half of the sample experienced a second- or higher-order pregnancy. Characteristics of the young women at entry into the study were relatively poor predictors of which teenagers would conceive again by the final interview. An early repeat pregnancy was associated with a number of negative short-term consequences in the areas of education, employment, and welfare-dependency, even after background characteristics were statistically controlled. Handle: RePEc:aph:ajpbhl:1986:76:2:167-171_9 Template-Type: ReDIF-Article 1.0 Title: A case-control study to evaluate the effectiveness of mass neonatal BCG vaccination among Canadian Indians Journal: American Journal of Public Health Author-Name: Young, T.K. Author-Name: Hershfield, E.S. Year: 1986 Volume: 76 Issue: 7 Pages: 783-786 Abstract: This paper reports a case-control study to assess the protective effect of BCG (bacille Calmette-Guerin) vaccination among Indian infants in Manitoba, Canada. A record of past BCG vaccination was found in 49 per cent of the tuberculosis cases, compared to 77 per cent of the controls, yielding a relative risk of 0.30. Stratified analysis, controlling for age, increased the relative risk to 0.39 (95% confidence interval 0.22 - 0.69). The preventive fraction was 44 per cent. Non-differential misclassification of exposure status could have occurred; if this was adjusted for, the relative risk would be reduced. If only bacteriologically confirmed cases were analyzed, the age-adjusted relative risk was 0.27. The protective effect of BCG vaccination in the newborn among Manitoba Indians is therefore at least 60 per cent. The implications for health policy in this population are further discussed. Handle: RePEc:aph:ajpbhl:1986:76:7:783-786_3 Template-Type: ReDIF-Article 1.0 Title: Occupational and worksite norms and attitudes about smoking cessation Journal: American Journal of Public Health Author-Name: Sorensen, G. Author-Name: Pechacek, T. Author-Name: Pallonen, U. Year: 1986 Volume: 76 Issue: 5 Pages: 544-549 Abstract: The relationship of worksite and occupational norms about smoking to workers' attitudes toward smoking cessation was studied in a defined population. From smokers identified in a self-administered questionnaire circulated to all employees of 10 worksites in suburban Minneapolis, 447 smokers were randomly selected and interviewed. Attitudes and social norms about smoking cessation were compared by occupation and worksite using analysis of covariance, controlling for age, sex, and education. Similarly, the relationships of social norms to attitudes were examined using multiple regression analysis. Interest in quitting smoking, confidence in the ability to quit, and coworker support of prior quit attempts were equally pervasive among workers from blue collar and white collar occupations. Yet substantial differences between worksites in attitudes and norms about smoking cessation suggest the importance of the unique social milieu of individual worksites. Of particular importance is the impact of coworkers discouragement of prior quit attempts, which varied across worksites and was directly related to confidence in the ability to quit and the desire to seek formal help in future quit attempts. These findings point to the relevance of intervention programs aimed at changing worksite norms about smoking and smoking cessation. Handle: RePEc:aph:ajpbhl:1986:76:5:544-549_1 Template-Type: ReDIF-Article 1.0 Title: The benefits of evaluating close associates of child tuberculin reactors from a high prevalence group Journal: American Journal of Public Health Author-Name: Sullam, P.M. Author-Name: Slutkin, G. Author-Name: Hopewell, P.C. Year: 1986 Volume: 76 Issue: 9 Pages: 1109-1111 Abstract: To determine the efficacy of evaluating persons (associates) in close contact to children with significant tuberculin reactions, we prospectively evaluated 831 associates of 297 children younger than eight years who had significant (≥10 mm) tuberculin reactions. Eighty-seven per cent of the index reactors were foreign-born, as were 84 per cent of the associates. All associates were evaluated by tuberculin skin testing: chest roentgenograms and sputum cultures were obtained if indicated. Four hundred sixty-one (55 per cent) of the associates had significant tuberculin reactions, and 15 had current tuberculosis. However, only three of these cases were newly discovered (total case rate: 1.81/100, new case rate: 0.36/100). Two of the three new cases were detected in the associates of children younger than three years of age. In addition, 338 candidates for isoniazid (INH) preventive therapy were found. We conclude that although the yield of new cases was low, the evaluation of associates did provide a convenient, high yield method of identifying candidates for INH preventive therapy. Moreover, it served as a useful mechanism for monitoring the adequacy of other case-finding activities. Handle: RePEc:aph:ajpbhl:1986:76:9:1109-1111_9 Template-Type: ReDIF-Article 1.0 Title: Tuberculin reactivity in United States and foreign-born Latinos: Results of a community-based screening program Journal: American Journal of Public Health Author-Name: Perez-Stable, E.J. Author-Name: Slutkin, G. Author-Name: Paz, E.A. Author-Name: Hopewell, P.C. Year: 1986 Volume: 76 Issue: 6 Pages: 643-646 Abstract: Because of the concern that we were underestimating the prevalence of tuberculosis within the Latino community in San Francisco, we undertook a community-based screening program directed largely towards recent immigrants. Of 1,871 intermediate-strength (5 TU) tuberculin tests applied and read, 37 per cent of the reactions were ≥10 mm. Significant reactions were found in 53 per cent of foreign-born persons compared to 7 per cent of those born in the United States. Persons older than 20 years of age were more likely to have significant reactions compared to younger Latinos. Among the foreign-born, the frequency of significant reactions was not influenced by the length of stay in the US or a history of BCG (bacille Calmette-Guerain) vaccination. Two foreign-born children were found to have current tuberculosis. The prevalence of tuberculin reactors among US-born Latino children was 3 per cent, which suggests that undetected transmission of tuberculosis may be occurring. We conclude that Latino immigrants should be systematically screened for tuberculosis. Handle: RePEc:aph:ajpbhl:1986:76:6:643-646_3 Template-Type: ReDIF-Article 1.0 Title: Newborn screening: A potpourri of policies Journal: American Journal of Public Health Author-Name: Townes, P.L. Year: 1986 Volume: 76 Issue: 10 Pages: 1191-1192 Handle: RePEc:aph:ajpbhl:1986:76:10:1191-1192_3 Template-Type: ReDIF-Article 1.0 Title: A study of homicides in Manhattan, 1981 Journal: American Journal of Public Health Author-Name: Tardiff, K. Author-Name: Gross, E.M. Author-Name: Messner, S.F. Year: 1986 Volume: 76 Issue: 2 Pages: 139-143 Abstract: There were 573 persons murdered in Manhattan (New York) during 1981 for an overall rate of 40.5 per 100,000 population. The male, young, and Black or Latino populations were at higher risk of being homicide victims. For male victims, the homicides were the result of disputes in 37.6 per cent of the cases, drug-related activities in 37.6 per cent, and robbery and other criminal activities in 24.8 per cent of cases. For female victims, homicides resulted from disputes in 62.2 per cent of cases, drug-related activities in 13.8 per cent, and robberies in 20.0 per cent of cases. The observed proportion of homicides related to drug and other criminal activities was higher than has been reported previously in the United States. The role of alcohol continued to be important in homicides related to disputes. The authors stress the importance of differentiating drug-related homicides from those associated with other criminal activities. Handle: RePEc:aph:ajpbhl:1986:76:2:139-143_8 Template-Type: ReDIF-Article 1.0 Title: Evaluation of physical health effects due to volcanic hazards: Human studies Journal: American Journal of Public Health Author-Name: Buist, A.S. Author-Name: Bernstein, R.S. Author-Name: Johnson, L.R. Author-Name: Vollmer, W.M. Year: 1986 Volume: 76 Issue: S3 Pages: 66-75 Handle: RePEc:aph:ajpbhl:1986:76:S3:66-75_7 Template-Type: ReDIF-Article 1.0 Title: Parasitic infections in a New York City hospital: Trends from 1971 to 1984 Journal: American Journal of Public Health Author-Name: Vermund, S.H. Author-Name: LaFleur, F. Author-Name: MacLeod, S. Year: 1986 Volume: 76 Issue: 8 Pages: 1024-1026 Abstract: We report the frequency of parasitic infections 1971-84 in a major New York City Medical Center whose catchment area includes many immigrants from Dominican Republic. Infection with 7,803 parasites was documented in 41,958 laboratory specimens. Trends were toward fewer total specimens being sent and fewer still being positive, although a rise in G. lamblia, E. histolytica, and Cryptosporidium is apparent in recent years. Parasitology laboratories should provide similar data to alert clinicians to the parasites prevalent locally. Handle: RePEc:aph:ajpbhl:1986:76:8:1024-1026_8 Template-Type: ReDIF-Article 1.0 Title: Physician house call services for medically needy, inner-city residents Journal: American Journal of Public Health Author-Name: Reuler, J.B. Author-Name: Bax, M.J. Author-Name: Sampson, J.H. Year: 1986 Volume: 76 Issue: 9 Pages: 1131-1134 Abstract: To increase access to services, a non-profit, voluntary health agency was developed to provide on-site services to residents of hotels and night shelters in the Skid Road area of Portland, Oregon. From a hotel-based clinic site, volunteer physicians, nurses, and medical students make house calls. During the first 18 months, 1,184 evaluations were made, and 21 hotels and two shelters visited. Volunteers were well accepted by residents and served as members of case management terms. The additional benefits of such a program vis-a-vis extension of local government's mission and student education are discussed. Handle: RePEc:aph:ajpbhl:1986:76:9:1131-1134_5 Template-Type: ReDIF-Article 1.0 Title: Evaluation of smoking prohibition policy in a health maintenance organization Journal: American Journal of Public Health Author-Name: Rosenstock, I.M. Author-Name: Stergachis, A. Author-Name: Heaney, C. Year: 1986 Volume: 76 Issue: 8 Pages: 1014-1015 Abstract: Four months after Group Health Cooperative of Puget Sound adopted a policy prohibiting smoking in its 35 facilities, we assessed attitudes and behavior of a sample of 447 employees. Results indicated that 85 per cent of employees approved of the decision to go smoke-free, the rate of reported smoking decreased, and a large proportion of non-smokers believed that their own and co-workers' work performance had improved. Suggestions for successful implementation of future programs are provided. Handle: RePEc:aph:ajpbhl:1986:76:8:1014-1015_3 Template-Type: ReDIF-Article 1.0 Title: Public hospitals in the changing health system. Journal: American Journal of Public Health Author-Name: Boufford, J.I. Year: 1986 Volume: 76 Issue: 1 Pages: 12-13 Handle: RePEc:aph:ajpbhl:1986:76:1:12-13_5 Template-Type: ReDIF-Article 1.0 Title: Comparison of occupation and industry information form death certificates and interviews Journal: American Journal of Public Health Author-Name: Schumacher, M.C. Year: 1986 Volume: 76 Issue: 6 Pages: 635-637 Abstract: Information on occupation and industry obtained via an interview prior to death was compared to occupation and industry on the death certificate of 184 colon cancer patients in Utah. The data were coded blindly using a five-digit code. Overall, agreement in the five-digit codes were found for 63 per cent. The industry codes agreed for 67 per cent of the individuals, and the occupation was identical for 68 per cent. Agreement by subjective evaluation of the two data sources, disregarding the five-digit codes, was 73 per cent. There were no differences in agreement of the five-digit codes by age, sex, and county of residence. The number of years worked at the job given by interview was related to agreement. Misclassification occurred in a random manner. It is concluded that the use of death certificates to study the association of occupation and disease is most appropriate for pilot studies. Handle: RePEc:aph:ajpbhl:1986:76:6:635-637_5 Template-Type: ReDIF-Article 1.0 Title: Evaluation of physical health effects due to volcanic hazards: Crystalline silica in Mount St. Helens volcanic ash Journal: American Journal of Public Health Author-Name: Dollberg, D.D. Author-Name: Bolyard, M.L. Author-Name: Smith, D.L. Year: 1986 Volume: 76 Issue: S3 Pages: 53-58 Abstract: This investigation has shown that crystalline silica has been identified as being present in the Mount St. Helens volcanic ash at levels of 3 to 7 per cent by weight. This identification has been established using X-ray powder diffraction, infrared spectrophotometry, visible spectrophotometry, electron microscopy, and Laser Raman spectrophotometry. Quantitative analysis by IR, XRD, and visible spectrophotometry requires a preliminary phosphoric acid digestion of the ash sample to remove the plagioclase silicate material which interferes with the determination by these methods. Electron microscopic analysis as well as Laser Raman spectrophotometric analysis of the untreated ash confirms the presence of silica and at levels found by the XRD analysis of the treated samples. An interlaboratory study of volcanic ash samples by 15 laboratories confirms the presence and levels of crystalline silica. Although several problems with applying the digestion procedure were observed in this hastily organized study, all laboratories employing the digestion procedure reported the presence of crystalline silica. These results unequivocally put to rest the question of the presence of silica in the volcanic ash from eruptions of Mount St. Helens in 1980. Shortly after Mount St. Helens erupted in 1980, a number of laboratories began to investigate the effects of volcanic ash in a variety of experimental systems in attempts to predict effects that might occur in the lungs of humans exposed to volcanic ash. The published results are remarkably consistent, despite the use of non-uniform ash samples and variability in the experimental approaches used. The data indicate that volcanic ash, even in high concentrations, causes little toxicity to lung cells in vitro and in vivo, as compared with effects of free crystalline silica, which is known to be highly fibrogenic. Volcanic ash does not appear to be entirely inert, however, possibly because of low concentrations of free crystalline silica in the ash. The published experimental studies suggest that inhaled volcanic ash is not likely to be harmful to the lungs of healthy humans, but the potential effects of volcanic ash in patients with pre-existing lung diseases are more difficult to ascertain from these studies. Handle: RePEc:aph:ajpbhl:1986:76:S3:53-58_8 Template-Type: ReDIF-Article 1.0 Title: Community-oriented primary care: An examination of the US experience Journal: American Journal of Public Health Author-Name: Nutting, P.A. Author-Name: Connor, E.M. Year: 1986 Volume: 76 Issue: 3 Pages: 279-281 Abstract: Community-oriented primary care (COPC) represents a specific variation on the general primary care model. Seven case studies from vastly different health care settings were examined and this report describes the diversity of expression of the principles of COPC observed. The results suggest that COPC is not limited to publicly funded programs, but can find expression in the private sector as well. The organization of financing and the lack of feasible quantitative tools hinder the full development of the model. Handle: RePEc:aph:ajpbhl:1986:76:3:279-281_9 Template-Type: ReDIF-Article 1.0 Title: Etiology of developmental disabilities in Soweto, South Africa Journal: American Journal of Public Health Author-Name: Rubin, I.L. Author-Name: Davis, M. Year: 1986 Volume: 76 Issue: 9 Pages: 1112-1114 Abstract: A retrospective review was undertaken of the records of 725 children who attended the neurodevelopmental clinic at the Baragwanath Hospital in Sowetio, South Africa. Most children presented at an early age (<2-6 years). The etiological factors were prenatal, 4 per cent; perinatal, 41 per cent; postnatal, 21 per cent. Seventy-one per cent of the perinatal factors were a result of birth related problems in full-term infants; only 22 per cen of this group were represented by premature and low birthweight infants, contrasting sharply with data from industrialized centers. Almost a third of the postnatal causes were a result of acute intracranial infections. Another 13 per cent were a result of the metabolic consequences of acute gastroenteritis. Thus a high proportion of problems were preventable through provision of adequate nutrition, mass immunization campaigns, and adequate primary health care services including antenatal and obstetric management. Handle: RePEc:aph:ajpbhl:1986:76:9:1112-1114_5 Template-Type: ReDIF-Article 1.0 Title: A cluster of injuries at a water slide in Washington State Journal: American Journal of Public Health Author-Name: Paulozzi, L.J. Author-Name: McKnight, B. Author-Name: Marks, S.D. Year: 1986 Volume: 76 Issue: 3 Pages: 284-285 Abstract: Interviews were conducted with 46 people injured on a newly opened water slide in Washington State during the summer of 1983, and on 46 age-matched controls. The injuries included nine concussions and eight spinal fractures. The odds ratio associated with being 10 per cent over ideal body weight, adjusted for age and sex, was 1.6 (95% C.I. 1.1-2.5). Three of eight people with spinal fractures were riding with another person between their legs, compared with two of 38 other injured riders (OR = 10.8, 95% C.I. 1.8-63.5). Handle: RePEc:aph:ajpbhl:1986:76:3:284-285_6 Template-Type: ReDIF-Article 1.0 Title: Did low birthweight among US Blacks really increase? Journal: American Journal of Public Health Author-Name: David, R.J. Year: 1986 Volume: 76 Issue: 4 Pages: 380-384 Abstract: The low birthweight (LBW) rate among reported United States non-White births increased 32 per cent from 1950 to 1967. States with large increments in non-White LBW rates over the period 1950-67 ('rising LBW states') were compared to states with more stable LBW rates. Paradoxically, states with the most deterioration in LBW rates had the most improvement in LBW risk factors (low income, mothers under age 20 or over age 35, birth order over four). In 1950, at least 9.7 per cent of non-White births in rising LBW states went unreported, and underreporting was biased, with out-of-hospital LBW births who die young least likely to be reported. From 1950 to 1967, non-White out-of-hospital births for the US declined from 42 per cent to 7 per cent, and yearly values for per cent of non-White births in hospital and LBW rates were highly correlated (r = .98). These data suggest that the observed rise in non-White LBW rates from 1950 to 1967 was due in large part to systematic underreporting of LBW births among non-White out-of-hospital deliveries in the 1950s. This underreporting essentially ceased when hospital delivery for non-Whites became nearly universal in the late 1950s and 1960s. Handle: RePEc:aph:ajpbhl:1986:76:4:380-384_5 Template-Type: ReDIF-Article 1.0 Title: Risk factors for drug use among adolescents: Concurrent and longitudinal analyses Journal: American Journal of Public Health Author-Name: Newcomb, M.D. Author-Name: Maddahian, E. Author-Name: Bentler, P.M. Year: 1986 Volume: 76 Issue: 5 Pages: 525-531 Abstract: We examined the concurrent and longitudinal associations between risk factors and substance use for a sample of high school students. Ten risk factors were defined that assessed numerous important personal and social areas of life. These factors were found to be associated with ever using, frequency of use, and heavy use of cigarettes, alcohol, cannabis, and hard drugs. Few effects were noted for nonprescription medication. No sex differences were evident for number of risk factors. Finally, the number of different risk factors was predictive of increases in use of all types of substances over a one-year period, after controlling for initial level of use. Handle: RePEc:aph:ajpbhl:1986:76:5:525-531_1 Template-Type: ReDIF-Article 1.0 Title: Characteristics of sheltered homeless families Journal: American Journal of Public Health Author-Name: Bassuk, E.L. Author-Name: Rubin, L. Author-Name: Lauriat, A.S. Year: 1986 Volume: 76 Issue: 9 Pages: 1097-1101 Abstract: To describe the characteristics of homeless families, we interviewed 80 homeless mothers and 151 children living in 14 family shelters in Massachusetts (two-thirds of the shelters in the state). Ninety-four per cent of the families were headed by women, 91 per cent were on AFDC (aid to families with dependent children), with twice as many as the state average having been on AFDC for at least two years; most had long histories of residential instability. Although 60 per cent had completed high school, only a third had worked for longer than one month. One-third of the mothers reported having been abused during their childhood, and two-thirds had experienced a major family disruption. At the time of the interview, almost two-thirds either lacked or had minimal supportive relationships and one-fourth of these named their child as the major support. Eighteen mothers were involved with the Department of Social Services because of probable child abuse or neglect. Seventy-one per cent of the mothers had personality disorders. In contrast to many adult homeless individuals, however, deinstitutionalized persons or those suffering from psychoses were not overrepresented. About 50 percent of the homeless children were found to have developmental lags, anxiety, depression, and learning difficulties, and about half required further psychiatric evaluation. Two-thirds described housing and social welfare agencies as not helpful. Given the many serious problems of the mothers and the difficulties already manifested by their children, comprehensive psychosocial and economic interventions must be made to interrupt a cycle of extreme instability and family breakdown. Handle: RePEc:aph:ajpbhl:1986:76:9:1097-1101_2 Template-Type: ReDIF-Article 1.0 Title: Two simple methods of spatial analysis and their applications in location-oriented health services research Journal: American Journal of Public Health Author-Name: Khan, A.A. Year: 1986 Volume: 76 Issue: 10 Pages: 1207-1209 Abstract: This paper illustrates the usefulness of cartographic and centrographic methods in examining the locational characteristics of health care resources, such as specialist physicians' offices. Cartographic analysis involving map comparisons not only describes the nature of particular spatial patterns, but it also suggests relevant hypotheses on the basis of observed locational relationships among the mapped phenomena. Centrographic analysis generally substantiates the findings of simple map analysis by providing certain objective quantitative measures regarding the basic characteristics of a point distribution; additionally, it generates a graphic summary, the Standard Deviational Ellipse (SDE), which offers a convenient means for direct comparison of multiple spatial patterns. The essentially complementary nature of the two methods is highlighted, and it is concluded that they are most useful when used in conjunction with one another. Handle: RePEc:aph:ajpbhl:1986:76:10:1207-1209_9 Template-Type: ReDIF-Article 1.0 Title: Removal of lead paint from old housing: The need for a new approach Journal: American Journal of Public Health Author-Name: Chisolm Jr., J.J. Year: 1986 Volume: 76 Issue: 3 Pages: 236-237 Abstract: It has been nearly a century since peeling lead-based paint was recognized in Queensland, Australia as a major source of severe lead poisoning in children. By 1904, Gibson had launched a vigorous campaign in Queensland against the use of lead paints in any situation where children could be exposed to them. Although the first case of childhood plumbism due to paint in the United States was reported in 1914, it is only during the past 20 years that plumbism due to lead paint has been recognized as a widespread public health problem in the United States. Handle: RePEc:aph:ajpbhl:1986:76:3:236-237_0 Template-Type: ReDIF-Article 1.0 Title: Nutrient intake and supplementation in the United States (NHANES II) Journal: American Journal of Public Health Author-Name: Koplan, J.P. Author-Name: Annest, J.L. Author-Name: Layde, P.M. Author-Name: Rubin, G.L. Year: 1986 Volume: 76 Issue: 3 Pages: 287-289 Abstract: Data from the second United States Health and Nutrition Examination Survey (NHANES II) suggest that almost 35 per cent of the US population 18 to 74 years of age takes vitamin/mineral supplements regularly. Both higher nutrient intake and use of vitamin supplementation are associated with older ages, higher income, higher education level, and White race. Accounting for differences associated with sex, age, race, income, and education, persons with higher nutrient intakes remain more likely to take vitamin supplements. Handle: RePEc:aph:ajpbhl:1986:76:3:287-289_4 Template-Type: ReDIF-Article 1.0 Title: State trends in infant mortality, 1968-83 Journal: American Journal of Public Health Author-Name: Kleinman, J.C. Year: 1986 Volume: 76 Issue: 6 Pages: 681-687 Abstract: This paper presents an analysis of state trends in infant mortality rates (IMRs) for 1968-83. In order to take into account the large random error component associated with state IMRs, weighted least squares estimates are used to fit long-linear models to these trends. Using simulated data, these estimates are shown to be nearly unbiased and to provide valid significance tests. However, the power to detect changes in trend is rather limited, especially in small states. Using these methods, separate analyses of White IMRs in 49 states and non-White IMRs in 30 states were completed. Nine states are identified which had infant mortality trends less favorable than the national experience and 1981-83 rates more than 5 per cent above the national average. Handle: RePEc:aph:ajpbhl:1986:76:6:681-687_0 Template-Type: ReDIF-Article 1.0 Title: Volcanic activity: A review for health professionals Journal: American Journal of Public Health Author-Name: Newhall, C.G. Author-Name: Fruchter, J.S. Year: 1986 Volume: 76 Issue: S3 Pages: 10-24 Abstract: Volcanoes erupt magma (molten rock containing variable amounts of solid crystals, dissolved volatiles, and gas bubbles) along with pulverized pre-existing rock (ripped from the walls of the vent and conduit). The resulting volcanic rocks vary in their physical and chemical characteristics, e.g., degree of fragmentation, sizes and shapes of fragments, minerals present, ratio of crystals to glass, and major and trace element composition. Variability in the properties of magma, and in the relative roles of magmatic volatiles and groundwater in driving an eruption, determine to a great extent the type of an eruption; variability in the type of an eruption in turn influences the physical characteristics and distribution of the eruption products. The principal volcanic hazards are: ash and larger fragments that rain down from explosion cloud (airfall tephra and ballistic fragments); flows of hot ash, blocks, and gases down the slopes of a volcano (pyroclastic flows); 'mudflows' (debris flows); lava flows; and concentrations of volcanic gases in topographic depressions. Progress in volcanology is bringing improved long- and short-range forecasts of volcanic activity, and thus more options for mitigation of hazards. Collaboration between health professionals and volcanologists helps to mitigate health hazards of volcanic activity. Handle: RePEc:aph:ajpbhl:1986:76:S3:10-24_0 Template-Type: ReDIF-Article 1.0 Title: Community health services for mentally retarded adults Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1986 Volume: 76 Issue: 10 Pages: 1187-1189 Handle: RePEc:aph:ajpbhl:1986:76:10:1187-1189_7 Template-Type: ReDIF-Article 1.0 Title: Firearms and youth suicide Journal: American Journal of Public Health Author-Name: Boyd, J.H. Author-Name: Moscicki, E.K. Year: 1986 Volume: 76 Issue: 10 Pages: 1240-1242 Abstract: The firearm suicide rate for persons aged 10 to 24 has increased from 2.3 per 100,000 in 1933 to 5.5 per 100,000 in 1982. Over the same period, the suicide rate for this age group by all methods other than firearms has only risen from 2.5 to 3.3. The most dramatic rise in the firearm suicide rate has occurred primarily since 1970, notably among males aged 15 to 24. During the 1960s and 1970s there was a substantial increase in the number of civilian firearms in the United States. Handle: RePEc:aph:ajpbhl:1986:76:10:1240-1242_6 Template-Type: ReDIF-Article 1.0 Title: Referral patterns to and from inpatient psychiatric services: A social network approach Journal: American Journal of Public Health Author-Name: Nakao, K. Author-Name: Milazzo-Sayre, L.J. Author-Name: Rosenstein, M.J. Author-Name: Manderscheid, R.W. Year: 1986 Volume: 76 Issue: 7 Pages: 755-760 Abstract: Interorganizational linkages have assumed more import for mental health service systems during the past three decades because of increased levels of complexity in service delivery patterns. This analysis examines these linkages from a relational perspective, with network of patient referral patterns as the basic unit. Multdimensional scaling is employed to discern patterns of interorganizational linkages in national patient referral data collected by the National Institute of Mental Health in 1975 and 1980 for patient samples from inpatient psychiatric services of state and county mental hospitals, private psychiatric hospitals, and public and nonpublic general hospitals. The multidimensional scaling techniques distinguish two structural characteristics of the interorganizational linkages of psychiatric inpatient services - public vs private services, and drift over time in referral patterns. Public and private inpatient psychiatric services are differentiated principally in terms of degree of interaction with legal agencies and private practice psychiatrists. Chronological change in referral patterns is characterized principally by changes in the degree of interaction with other inpatient or outpatient psychiatric services. Methodologically and theoretically, the techniques and findings described can enhance our understanding of interorganizational linkages and dynamics. Handle: RePEc:aph:ajpbhl:1986:76:7:755-760_7 Template-Type: ReDIF-Article 1.0 Title: Influenza and nursing homes Journal: American Journal of Public Health Author-Name: Barker, W.H. Year: 1986 Volume: 76 Issue: 5 Pages: 491-492 Handle: RePEc:aph:ajpbhl:1986:76:5:491-492_4 Template-Type: ReDIF-Article 1.0 Title: Breastfeeding trends Journal: American Journal of Public Health Author-Name: Brown, R.E. Year: 1986 Volume: 76 Issue: 3 Pages: 238-240 Handle: RePEc:aph:ajpbhl:1986:76:3:238-240_6 Template-Type: ReDIF-Article 1.0 Title: War or peace: Smallpox and the use and abuse of public health Journal: American Journal of Public Health Author-Name: Sidel, V.W. Year: 1986 Volume: 76 Issue: 10 Pages: 1189-1190 Handle: RePEc:aph:ajpbhl:1986:76:10:1189-1190_3 Template-Type: ReDIF-Article 1.0 Title: The day care center diarrhea dilemma Journal: American Journal of Public Health Author-Name: Pickering, L.K. Year: 1986 Volume: 76 Issue: 6 Pages: 623-624 Handle: RePEc:aph:ajpbhl:1986:76:6:623-624_0 Template-Type: ReDIF-Article 1.0 Title: Are public hospitals in New York City inferior to voluntary, nonprofit hospitals? A study of JCAH hospital surveys Journal: American Journal of Public Health Author-Name: Hyman, H. Year: 1986 Volume: 76 Issue: 1 Pages: 18-22 Abstract: All 60 non-profit, acute-care hospitals in New York City were grouped into three classes: publicly supported hospitals (HHCs), voluntary hospitals under 400 beds (CHs), and voluntary hospitals over 400 beds (SHs). 11 functional areas listed in Joint Commission on Accreditation of Hospitals 1980-82 surveys were analyzed to compare recommendations for improving cited deficiencies. The survey findings showed that HHCs had a mean of 37.8 recommendations per hospital compared to 42.7 for CHs and 46.9 for SHs. The 11 functions were aggregated into three major components: safety, support, and direct medical services. CHs had fewer safety mean recommendations per hospital (18.7) than SHs (22.2), but on support and direct medical service components HHCs had fewer recommendations on nine of eleven functions compared to the other hospitals. Based on these data, HHCs do not appear inferior to either class of voluntary hospitals. Handle: RePEc:aph:ajpbhl:1986:76:1:18-22_4 Template-Type: ReDIF-Article 1.0 Title: Accidental firearm fatalities in North Carolina, 1976-80 Journal: American Journal of Public Health Author-Name: Morrow, P.L. Author-Name: Hudson, P. Year: 1986 Volume: 76 Issue: 9 Pages: 1120-1123 Abstract: All accidental gunshot fatalities in North Carolina were reviewed for the years 1976-80. There were 210 cases, of which 94 were self-inflicted and 116 were inflicted by others. Young white males predominated as victims, 31 per cent under the age of 15. Sixty-five per cent of the accidents occurred in the home and 18 per cent occurred in rural, 'hunting' locations. Forty-one per cent of the cases involved shotguns, 39 per cent involved handguns, and 16 per cent, rifles. Sixteen per cent of the accidents involved children playing with guns and 14 per cent involved dropped or mishandled weapons. During the same period, there were 2,553 suicides and 2,509 homicides by firearm. Gunshot fatalizes are an important American public health problem. Handle: RePEc:aph:ajpbhl:1986:76:9:1120-1123_2 Template-Type: ReDIF-Article 1.0 Title: Nuclear weapons testing fallout: Proving causation for exposure injury Journal: American Journal of Public Health Author-Name: Christoffel, T. Author-Name: Swartzman, D. Year: 1986 Volume: 76 Issue: 3 Pages: 290-292 Abstract: If the courts are to succeed as a forum for dealing with harm caused by toxic exposures, it will have to be through the development of a respectable body of case law. The decision in Allen v. United States makes an important early contribution to the case-by-case development of such a body of law. Should this indeed signal a trend, Allen's attention to statistical association suggests more sophisticated input from epidemiologists and statisticians than allowed under the all-win or all-lose approaches. Handle: RePEc:aph:ajpbhl:1986:76:3:290-292_0 Template-Type: ReDIF-Article 1.0 Title: Tobacco habits Journal: American Journal of Public Health Author-Name: Rothman, K.J. Year: 1986 Volume: 76 Issue: 2 Pages: 133 Handle: RePEc:aph:ajpbhl:1986:76:2:133_4 Template-Type: ReDIF-Article 1.0 Title: Significance tests have a role in epidemiologic research: Reactions to A.M. Walker Journal: American Journal of Public Health Author-Name: Fleiss, J.L. Year: 1986 Volume: 76 Issue: 5 Pages: 559-560 Handle: RePEc:aph:ajpbhl:1986:76:5:559-560_0 Template-Type: ReDIF-Article 1.0 Title: Occupational health surveillance: A means to identify work-related risks Journal: American Journal of Public Health Author-Name: Froines, J.R. Author-Name: Dellenbaugh, C.A. Author-Name: Wegman, D.H. Year: 1986 Volume: 76 Issue: 9 Pages: 1089-1096 Abstract: The lack of successful disease surveillance methods has resulted in few reliable estimates of workplace-related disease. Hazard surveillance - the ongoing assessment of chemical use and worker exposure to the chemicals - is presented as a way to supplement occupational disease surveillance. Existing OSHA (Occupational Safety and Health Administration) and NIOSH (National Institute for Occupational Health) data systems are adapted to this function to characterize the distribution and type of hazardous industry in Los Angeles County. A new method is developed for ranking potentially hazardous industries in the county using actual exposure measurements from federal OSHA compliance inspections. The strengths of the different systems are presented along with considerations of industrial employment and types of specific chemical exposures. Applications for information from hazard surveillance are discussed in terms of intervention, monitoring exposure control, planning, research, and as a complement to disease surveillance. Handle: RePEc:aph:ajpbhl:1986:76:9:1089-1096_4 Template-Type: ReDIF-Article 1.0 Title: Acceptance of hepatitis B vaccine among hospital workers Journal: American Journal of Public Health Author-Name: Bodenheimer Jr., H.C. Author-Name: Fulton, J.P. Author-Name: Kramer, P.D. Year: 1986 Volume: 76 Issue: 3 Pages: 252-255 Abstract: Data on sociodemographic status, health beliefs, knowledge of hepatitis B, experience with prior vaccinations, health locus of control, and desire to receive hepatitis B vaccine were assessed in 1,500 hospital employees. Twenty per cent of the variance of the decision to accept vaccine could be explained; beliefs about the safety and efficacy of vaccine influenced acceptance most. Beliefs concerning the likelihood of contracting hepatitis B and the chance of becoming severely ill were less important determinants of vaccine acceptance. Additional factors studied, including knowledge, experience with vaccinations, and sociodemographic status, were important independent determinants of health beliefs. We conclude that the beliefs of health care providers, particularly regarding the safety and efficacy of hepatitis B vaccine, have a major impact on their decision to accept or reject vaccine. Health education interventions may be most effective when addressing beliefs about vaccine safety and efficacy. Handle: RePEc:aph:ajpbhl:1986:76:3:252-255_9 Template-Type: ReDIF-Article 1.0 Title: A survey of campylobacter and other bacterial contaminants of pre-market chicken and retail poultry and meats, King County, Washington Journal: American Journal of Public Health Author-Name: Harris, N.V. Author-Name: Thompson, D. Author-Name: Martin, D.C. Author-Name: Nolan, C.M. Year: 1986 Volume: 76 Issue: 4 Pages: 401-406 Abstract: As part of a larger study to determine the flow of Campylobacter and Salmonella from food animals to humans during 1982-83, 1,936 swabs were collected for bacteriologic study from pre-market chickens, retail poultry, and other retail meats as well as from equipment and work surfaces used to process such foods. Of the 297 samples collected in a poultry processing plant, 56.6 per cent were positive for Campylobacter jejuni/coli (CJC), as were 23.1 per cent of the 862 retail chicken, and 17.2 per cent of the 29 retail game hen samples. CJC was found infrequently in retail turkey, pork, and beef samples. Contamination of retail and pre-market chicken with CJC appeared to increase as the week progressed, and in pre-market chicken, later in the day. Less than 5 per cent of the retail samples of poultry, beef, and pork were found to contain Yersinia or Salmonella. However, Salmonella was cultured from 14.8 per cent of the swabs taken from the processing plant with 68 per cent of 44 Salmonellas being isolated concurrently with CJC. Tetracycline resistance which was plasmid-mediated was the most common antibiotic resistance observed, and was carried by 23.8 per cent of all CJC isolates. Overall, 38.8 per cent of all CJC isolates were resistant to ampicillin, erythromycin, streptomycin, or tetracycline, either singly or in combination. Handle: RePEc:aph:ajpbhl:1986:76:4:401-406_6 Template-Type: ReDIF-Article 1.0 Title: The epidemiology of milk-borne scarlet fever: The case of Edwardian Brighton Journal: American Journal of Public Health Author-Name: Eyler, J.M. Year: 1986 Volume: 76 Issue: 5 Pages: 573-584 Handle: RePEc:aph:ajpbhl:1986:76:5:573-584_8 Template-Type: ReDIF-Article 1.0 Title: How many nurse practitioners are enough? Journal: American Journal of Public Health Author-Name: Henry, O.M. Year: 1986 Volume: 76 Issue: 5 Pages: 493 Handle: RePEc:aph:ajpbhl:1986:76:5:493_8 Template-Type: ReDIF-Article 1.0 Title: An analysis of the costs of infertility treatment Journal: American Journal of Public Health Author-Name: Cooper, G.S. Year: 1986 Volume: 76 Issue: 8 Pages: 1018-1019 Abstract: For 597 couples receiving care at an infertility clinic in Nova Scotia, the average cost of diagnosis and treatment per successful pregnancy is $10,700. This is compared to the costs of alternatives to infertility treatment. Adoption costs generally range from $3,000 to $10,000, and surrogate mother arrangements are much higher (around $20,000). This study demonstrates the feasibility and value of a systematic analysis of the costs of infertility. Handle: RePEc:aph:ajpbhl:1986:76:8:1018-1019_8 Template-Type: ReDIF-Article 1.0 Title: The impact of 'Bottle Bill' legislation on the incidence of lacerations in childhood Journal: American Journal of Public Health Author-Name: Baker, M.D. Author-Name: Moore, S.E. Author-Name: Wise, P.H. Year: 1986 Volume: 76 Issue: 10 Pages: 1243-1244 Abstract: We studied the effect of legislation requiring deposits for beverage containers on the incidence of lacerations in urban children. Records of emergency room visits for lacerations and fractures were reviewed for three years pre-legislation (1980-82) and the immediate post-legislation period (1983). The incidence of total sutured lacerations did not change substantially after the legislation, but glass-related lacerations fell by 60 percent, due to a reduced incidence in lacerations occurring outside of the home. Handle: RePEc:aph:ajpbhl:1986:76:10:1243-1244_1 Template-Type: ReDIF-Article 1.0 Title: Health hazards associated with windsurfing on polluted water Journal: American Journal of Public Health Author-Name: Dewailly, E. Author-Name: Poirier, C. Author-Name: Meyer, F.M. Year: 1986 Volume: 76 Issue: 6 Pages: 690-691 Abstract: We documented the risks associated with windsurfing on sewage polluted water. Seventy-nine windsurfers and 41 controls were studied over a nine-day period for occurrence of symptoms of gastroenteritis, otitis, conjunctivitis, and skin infection. Relative risks were 2.9 for occurrence of one or more of these symptoms and 5.5 for symptoms of gastroenteritis. Relative risk increased with the reported number of falls into the water. Handle: RePEc:aph:ajpbhl:1986:76:6:690-691_6 Template-Type: ReDIF-Article 1.0 Title: Cervical cancer in immigrant Caribbean women Journal: American Journal of Public Health Author-Name: Fruchter, R.G. Author-Name: Remy, J.C. Author-Name: Burnett, W.S. Author-Name: Boyce, J.G. Year: 1986 Volume: 76 Issue: 7 Pages: 797-798 Abstract: At a public hospital serving the low-income community in Brooklyn, New York, invasive cervical cancer (ICC) was diagnosed in more advanced stages in Haitian and English-speaking Caribbean immigrants than in US-born Black women. In Brooklyn as a whole, only Haitians had more advanced ICC. Fewer Haitians had preinvasive cancer or ICC detected by a Pap test. Data are consistent with less frequent screening among low-income immigrants. Handle: RePEc:aph:ajpbhl:1986:76:7:797-798_7 Template-Type: ReDIF-Article 1.0 Title: Social medicine vs professional dominance: the German experience Journal: American Journal of Public Health Author-Name: Light, D.W. Author-Name: Liebfried, S. Author-Name: Tennstedt, F. Year: 1986 Volume: 76 Issue: 1 Pages: 78-83 Abstract: This article describes the efforts by German workers' groups and pioneering social physicians to design health care services oriented to prevention and cost-effective treatment. Jews played a key role in developing these prototypes of today's health maintenance organizations (HMOs) and preferred provider organizations (PPOs). The growing success of these services threatened private practitioners in a number of ways. They formed a trade union and took militant action. Stage by stage, the profession asserted its dominance, culminating in an alliance with the National Socialists and Hitler to take over these services and to purge them of socialist and Jewish physicians. Medical societies assisted Hitler in his policies of 'purification', and the health care delivery systems shifted from being local, patient-centered, and focused on curing illness. After World War II, these changes were not reversed as part of denazification, and 40 years later, social medicine has yet to recover. Handle: RePEc:aph:ajpbhl:1986:76:1:78-83_4 Template-Type: ReDIF-Article 1.0 Title: Confronting the immunization problem: Proposals for compensation reform Journal: American Journal of Public Health Author-Name: Mariner, W.K. Author-Name: Clark, M.E. Year: 1986 Volume: 76 Issue: 6 Pages: 703-708 Abstract: Pharmaceutical companies in the U.S. are withdrawing from the development and production of vaccines for both economic and legal reasons, most notably because of the expense attributable to insuring and defending against liability for infrequent but inevitable injuries that result from nondefective as well as defective vaccines. The authors discuss difficulties that arise with the current system of tort liability and argue that a no-fault compensation program is warranted. They propose a set of criteria for establishing an equitable and efficient program at the federal level. Handle: RePEc:aph:ajpbhl:1986:76:6:703-708_7 Template-Type: ReDIF-Article 1.0 Title: Profiles of physician practice and patient severity of illness Journal: American Journal of Public Health Author-Name: Horn, S.D. Author-Name: Horn, R.A. Author-Name: Moses, H. Year: 1986 Volume: 76 Issue: 5 Pages: 532-535 Abstract: We report on a study that examined physician practice profiles using two methods of patient classification: the Severity of Illness Index and diagnosis-related groups (DRGs). When used together with conventional management information and DRGs, the Severity of Illness Index permitted useful comparisons to be made among physicians; differences in both case-mix and severity could be estimated. In 37 per cent of the physicians studied, we found differences of more than $10,000 in the apparent impact of a physician on the hospital's financial position, depending on whether one controlled for severity or not. The extent to which these differences in impact could be due to quality of care differences is an area for future research. However, the findings that 37 per cent of the physicians in the study may be wrongly identified as over- or under-utilizers suggest long-term public health consequences of preparing physician profiles based on unadjusted DRGs. Handle: RePEc:aph:ajpbhl:1986:76:5:532-535_0 Template-Type: ReDIF-Article 1.0 Title: Smallpox and biological warfare: The case for abandoning vaccination of military personnel Journal: American Journal of Public Health Author-Name: Capps, L. Author-Name: Vermund, S.H. Author-Name: Johnsen, C. Year: 1986 Volume: 76 Issue: 10 Pages: 1229-1231 Abstract: Smallpox was officially declared eradicated from the world in 1980. Earlier, in 1972, over 50 nations signed the Biological Weapons Convention renouncing this entire category of weapons. Despite this international agreement, both the United States and the Soviet Union continue to vaccinate their military troops against smallpox, thus implying that each fears the other might still use it in biological warfare. Vaccination is not a harmless procedure, and vaccinia infections continue to be reported in troops and their contacts. Negotiating an end to the vaccination of troops would be a final step in ending the fear of smallpox. Handle: RePEc:aph:ajpbhl:1986:76:10:1229-1231_5 Template-Type: ReDIF-Article 1.0 Title: Increasing incidence of toxic shock syndrome in the 1970s Journal: American Journal of Public Health Author-Name: Linnemann Jr., C.C. Author-Name: Knarr, D. Year: 1986 Volume: 76 Issue: 5 Pages: 566-567 Abstract: To determine if there was a true increase in the incidence of toxic shock syndrome (TSS) or just increasing recognition of an old problem, we reviewed 2,145 charts of patients between the ages of 10 and 30 years with discharge diagnoses compatible with signs and symptoms of TSS. No cases were identified in 1970 and 1975, but eight cases were found in 1979 and 1980. The data suggest that an increase of TSS in this age group occurred in the late 1970s. Handle: RePEc:aph:ajpbhl:1986:76:5:566-567_4 Template-Type: ReDIF-Article 1.0 Title: Longitudinal patterns of cigarette smoking and smokeless tobacco use in youth: The Bogalusa heart study Journal: American Journal of Public Health Author-Name: MaxD. Hunter, S. Author-Name: Croft, J.B. Author-Name: Burke, G.L. Year: 1986 Volume: 76 Issue: 2 Pages: 193-195 Abstract: Tobacco use was studied during 1977-76 (n=2880) and 1981-82 (n=2158) in a total biracial community of children, ages 8-17 years, in Bogalusa, Louisiana. White males were the early adopters of tobacco products in both surveys. Cigarette smoking decreased in all race and gender groups while smokeless tobacco use increased in White males. Studies which find a decline in male adolescent smoking should investigate a possible concurrent increase in smokeless tobacco. Handle: RePEc:aph:ajpbhl:1986:76:2:193-195_2 Template-Type: ReDIF-Article 1.0 Title: Seizures in public places in New York City Journal: American Journal of Public Health Author-Name: Neugebauer, R. Author-Name: Oppenheimer, G. Author-Name: Susser, M. Year: 1986 Volume: 76 Issue: 9 Pages: 1115-1119 Abstract: The frequency of police aid to persons experiencing seizures in public in New York City in 1977 was examined as an index of uncontrolled seizure disorders, and as a pointer to variations in seizure frequencies by age, sex, and ethnicity. The overall rate of assistance to persons with public seizures was 5.4 per 10,000 person years. For Blacks the rate was more than double than for Whites and 'Hispanics' (10, 4.7, and 4 per 10,000 person years, respectively). Males were assisted about 2.5 times more often than females (8.2 vs 3.3 per 10,000 person years). Among Black males, young adults and those of late middle age had the most pronounced excess over White males of the same ages (26.1 and 23.1 vs 7.8 and 4.0, respectively, per 10,000 person years). These variations underscore an unmet need for medical care for seizures that is especially marked in particular ethnic, sex, and age groups. Handle: RePEc:aph:ajpbhl:1986:76:9:1115-1119_1 Template-Type: ReDIF-Article 1.0 Title: Some properties of saliva cotinine measurements in indicating exposure to tobacco smoking Journal: American Journal of Public Health Author-Name: Di Giusto, E. Author-Name: Eckhard, I. Year: 1986 Volume: 76 Issue: 10 Pages: 1245-1246 Abstract: The studies reported herein were designed to investigate some properties of saliva cotinine measurements in indicating exposure to tobacco smoke. Such measurements were found to be minimally affected by saliva flow rate or time since smoking as well as being sensitive to a low level of exposure to tobacco smoke. Results supported the view that the saliva cotinine assay is the most useful currently available method for objectively measuring exposure to tobacco smoke. Handle: RePEc:aph:ajpbhl:1986:76:10:1245-1246_7 Template-Type: ReDIF-Article 1.0 Title: Health status and access to health services among the urban homeless Journal: American Journal of Public Health Author-Name: Robertson, M.J. Author-Name: Cousineau, M.R. Year: 1986 Volume: 76 Issue: 5 Pages: 561-563 Abstract: Self-reported health status and access to care were reported for 238 homeless adults in Los Angeles. One-third reported their health as fair or poor; women reported more health problems than men. Half (53 per cent) of the samples reported no regular source of care, and most (81 per cent) were without health insurance. Lack of financial resources and health insurance were reported as important barriers to care. Handle: RePEc:aph:ajpbhl:1986:76:5:561-563_0 Template-Type: ReDIF-Article 1.0 Title: A worksite smoking modification competition: Potential for public health impact Journal: American Journal of Public Health Author-Name: Klesges, R.C. Author-Name: Vasey, M.M. Author-Name: Glasgow, R.E. Year: 1986 Volume: 76 Issue: 2 Pages: 198-200 Abstract: We evaluated the effectiveness of a worksite smoking cessation/reduction program both with and without formal competition for monetary prizes in five worksites (n=107). A greater percentage of eligible smokers participated in the competition (88 per cent) than the non-competition (53 per cent) condition. Treatment outcome among participants was generally equivalent across conditions, but at a six-month follow-up, nonabstinent subjects in the competition condition had lower levels of carbon monoxide than subjects in the non-competition condition. On a worksite-wide basis, a higher percentage of employees quit smoking in the competition condition (16 per cent) compared to the non-competition (7 per cent). Handle: RePEc:aph:ajpbhl:1986:76:2:198-200_9 Template-Type: ReDIF-Article 1.0 Title: Bias resulting from using the card-back system to contact patients in an epidemiologic study Journal: American Journal of Public Health Author-Name: McTiernan, A. Author-Name: Weiss, N.S. Author-Name: Daling, J.R. Year: 1986 Volume: 76 Issue: 1 Pages: 71-73 Abstract: In a case control study of thyroid cancer in women in western Washington, the card-back system was used to contact patients. Demographic characteristics and reproductive history of 124 cases who returned a card and 35 who did not were compared, and were found to differ with respect to various reproductive and demographic factors. Relative risk estimates for various thyroid cancer risk factors were calculated two ways: including as cases only those who returned a card, and including all cases; these estimates differed for some risk factors. The results suggest that the use of the card-back system may result in a low level of response which can lead to biased study results. Handle: RePEc:aph:ajpbhl:1986:76:1:71-73_2 Template-Type: ReDIF-Article 1.0 Title: The persistence of publich health problems: SF, STD, and AIDS Journal: American Journal of Public Health Author-Name: Yankauer, A. Year: 1986 Volume: 76 Issue: 5 Pages: 494-495 Handle: RePEc:aph:ajpbhl:1986:76:5:494-495_3 Template-Type: ReDIF-Article 1.0 Title: The cumulative risk of tuberculin skin test conversion for five years of hospital employment Journal: American Journal of Public Health Author-Name: Ktsanes, V.K. Author-Name: Williams, W.L. Author-Name: Boudreaux, V.V. Year: 1986 Volume: 76 Issue: 1 Pages: 65-67 Abstract: We studied tuberculin skin test conversions in a cohort of 550 new employees followed for five years after assignment to adult inpatient services at Charity Hospital at New Orleans, LA. There were 17 known conversions, an overall five-year cumulative probability of converting of 5.2 per cent. Proportional hazards regression analysis found that race and type of job (nursing vs other) were independent explanatory variables. To examine further the job effect, we compared the conversion curves for Blacks in nursing and Blacks in other jobs and found those in nursing to have higher rates. Handle: RePEc:aph:ajpbhl:1986:76:1:65-67_8 Template-Type: ReDIF-Article 1.0 Title: Modern contraceptive practice in rural Appalachia Journal: American Journal of Public Health Author-Name: Gairola, G.A. Author-Name: Hochstrasser, D.L. Author-Name: Garkovich, L.E. Year: 1986 Volume: 76 Issue: 8 Pages: 1004-1008 Abstract: This paper examines contraceptive practice in a traditionally high fertility and economically disadvantaged rural county of central Appalachia. A key consideration is the extent to which the modernization of birth control observed nationally has diffused to and been adopted within this rural area. Data from the community study indicate that professional family planning services are, in fact, widely available and easily accessible to the vast majority of county residents. Interviews with a random sample of 407 currently married women of childbearing age, 15-45 years, revealed that 87 per cent of contraceptors were using either sterilization, the pill, or the IUD, with sterilization used by close to half of all couples practicing family planning. Moreover, this widespread use of modern contraceptives and sterilization was found among all educational and income groups. Handle: RePEc:aph:ajpbhl:1986:76:8:1004-1008_1 Template-Type: ReDIF-Article 1.0 Title: Comments on 'state trends in infant mortality' Journal: American Journal of Public Health Author-Name: Zemach, R. Year: 1986 Volume: 76 Issue: 6 Pages: 688 Handle: RePEc:aph:ajpbhl:1986:76:6:688_0 Template-Type: ReDIF-Article 1.0 Title: Pregnancy outcomes among Spanish-surname women in California Journal: American Journal of Public Health Author-Name: Williams, R.L. Author-Name: Binkin, N.J. Author-Name: Clingman, E.J. Year: 1986 Volume: 76 Issue: 4 Pages: 387-391 Abstract: We compared pregnancy outcomes among United States-born and Mexican-born women having Spanish surnames with US-born Whites and Blacks using California's 1981 matched birth-death cohort file. Maternal risk characteristics between US-born Black women and US-born women with Spanish surnames were similar. In contrast, Latino women, regardless of national origin, delivered small proportions of low weight infants as compared to Blacks. Birthweight-specific mortality rates during the fetal and neonatal periods for the offspring of Mexican-born Spanish surname women were generally higher than those for other ethnic groups. Our findings are consistent with the underreporting of postneonatal deaths among Mexican-born Latinos, yet suggest that their relatively low reported infant mortality rates compared to Blacks can be explained by a more favorable birthweight distribution. Handle: RePEc:aph:ajpbhl:1986:76:4:387-391_0 Template-Type: ReDIF-Article 1.0 Title: The relationship between vitamin C intake, general health practices, and mortality in Alameda County, California Journal: American Journal of Public Health Author-Name: Enstrom, J.E. Author-Name: Kanim, L.E. Author-Name: Breslow, L. Year: 1986 Volume: 76 Issue: 9 Pages: 1124-1130 Abstract: To evaluate the relationship between vitamin C intake and mortality, a prospective follow-up study was carried out among 3,119 noninstitutionalized adult residents of Alameda County, California who had completed a detailed lifestyle questionnaire around the beginning of 1974. During 10 years follow-up, 276 deaths have been identified. The questionnaire information and mortality data indicate that this sample is fairly representative of the county population and similar to the United States population. There is no important relation between the estimated 1974 vitamin C intake at levels above and below 250 mg per day and subsequent mortality from cancer, circulatory disease, all other causes, or all causes combined. However, there is an inverse relation between combinations of several health habits and total mortality. The health habits include never smoking cigarettes, regular physical activity, moderate or no use of alcohol, 7-8 hours of sleep per day, and maintaining proper weight. The conclusions with regard to vitamin C are limited by the crudeness with which the dietary intake has been estimated and changes in intake over time. Nevertheless, these results are not consistent with any substantial relation between vitamin C intake and subsequent mortality. Handle: RePEc:aph:ajpbhl:1986:76:9:1124-1130_0 Template-Type: ReDIF-Article 1.0 Title: How much tuberculosis in children must we accept? Journal: American Journal of Public Health Author-Name: Bloch, A.B. Author-Name: Snider Jr., D.E. Year: 1986 Volume: 76 Issue: 1 Pages: 14-15 Abstract: The closing of the sanatoria and the mainstreaming of tuberculosis patients into society has also led to the illusion that the disease has disappeared. It is possible for tuberculosis patients to blend invisibly into society and avoid the stigma of the disease. Most Americans are in racial, ethnic, and socioeconomic strata that are less commonly afflicted, and they are thus unaware of the continued occurrence of tuberculosis. In view of these factors, maintaining commitment to tuberculosis control efforts can be difficult. Perhaps calling public attention to the problem of tuberculosis in children will help public health officials to obtain commitment for tuberculosis control efforts. Each case of tuberculosis in a child is a failure of the public health establishment to convince society that control of tuberculosis in children is a feasible goal deserving support. Handle: RePEc:aph:ajpbhl:1986:76:1:14-15_4 Template-Type: ReDIF-Article 1.0 Title: Health problems encountered by three levels of providers in a remote setting Journal: American Journal of Public Health Author-Name: Dunn, E.V. Author-Name: Higgins, C.A. Year: 1986 Volume: 76 Issue: 2 Pages: 154-159 Abstract: A study conducted in the Sioux Lookout Health Zone in northwestern Ontario, Canada analyzed the diagnoses and managements for 139,618 patient visits to three levels of practitioners: physicians, nurse practitioners, and minimally trained health aides. There were major differences between providers in their diagnostic and management patterns. Some of these differences were the result of administrative police (e.g., physician and nurses do preventive medicine) but even when adjustment had been made for these differences there was still considerable variation. The minimally trained practitioners made many more signs and symptoms diagnoses and asked for help more frequently. The nurses did much of the preventive measures and made more diagnoses in the supplementary diagnostic class. Physicians diagnosed medically sophisticated conditions more frequently. The physicians did considerable reassuring, suggesting that many cases referred to them were adequately handled. They were also more likely to order investigations. Handle: RePEc:aph:ajpbhl:1986:76:2:154-159_0