Accelerator mass spectrometry.
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Isotopes↗
Biomedical subjects
D E Nelson
Publications and source records attributed to D E Nelson.
Physical abuse among high school students. Prevalence and correlation with other health behaviors.
OBJECTIVE: To better understand the epidemiology of physical abuse among adolescents. DESIGN: School-based survey of students in grades 9 through 12. SETTING: Twenty-five schools throughout Oregon in 1993. MAIN OUTCOME MEASURES: Prevalence of ever being physically abused, prevalence of most recent occurrence of physical abuse, and correlation of physical abuse with high-risk health behaviors. RESULTS: Of the 1957 respondents, 31.5% reported having ever been physically abused, with female subjects (34.6%) more likely than male subjects (28.0%) to have ever been abused. Overall, 3.7% of students had been physically abused in the past week, 7.8% in the past month, and 16.3% in the past year. Based on multivariate models, students physically abused in the past year were more likely than students who had never been physically abused to engage in a variety of high-risk behaviors; these included weapon carrying (odds ratio, 1.9), suicidal ideation (odds ratio, 2.1), cigarette smoking (odds ratio, 1.8), cocaine use (odds ratio, 3.2), or multiple sexual partners (odds ratio, 1.9). CONCLUSIONS: Physical abuse, an important problem among high school students, is correlated with many high-risk behaviors. Using consistent definitions, periodic surveys of children about physical abuse and other types of violent behavior are needed to provide better estimates of the extent of these problems.
Adolescent↗
Effects of peroxidative stress and age on the concentration of a deoxyguanosine-malondialdehyde adduct in rat DNA.
The effect of age and peroxidative stress on the concentration of a deoxyguanosine malondialdehyde adduct (dG-MDA) in rat tissues was investigated. Vitamin E deficiency had no effect on the dG-MDA content of liver DNA in rats fed a diet containing 10% corn oil. When 2% cod liver oil was added to this diet, the dG-MDA content of liver DNA doubled in the positive controls fed a high level of vitamin E (100 ppm dl-alpha-tocopherol), and there was a further increase when vitamin E was deleted. Neither iron nitrilotriacetate administration nor choline deficiency had any effect on the dG-MDA content of liver DNA. Carbon tetrachloride had a lowering effect. The failure of iron or carbon tetrachloride administration and of vitamin E deficiency to increase liver dG-MDA is consistent with their failure in previous experiments to affect the urinary excretion of dG-MDA. In contrast, these forms of peroxidative stress produce large increments in the urinary excretion of MDA adducts with lysine, reflecting increased formation and degradation of MDA-modified proteins. DNA appears to be protected from modification by MDA produced at extranuclear sites. The frequency of dG-MDA in different tissues of 4-month-old rats varied markedly: brain >> liver > kidneys and testes. Higher concentrations of dG-MDA were found in the liver and kidneys, but not the testes, of 25-month-old rats. The determinants of the concentration of dG-MDA in DNA merit further investigation.
Aging↗
Dependence in activities of daily living as a risk factor for fall injury events among older people living in the community.
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Accidental Falls↗
Trends in cigarette smoking among US adolescents, 1974 through 1991.
OBJECTIVES: The purpose of this study was to determine national trends in adolescent cigarette smoking prevalence. METHODS: We conducted trend analyses based on 1974 through 1991 current smoking prevalence data among persons aged 12 through 19 years from the National Household Surveys on Drug Abuse, High School Seniors Surveys, and National Health Interview Surveys. RESULTS: Overall smoking prevalence declined much more rapidly from 1974 through 1980 (1.9 percentage points annually among younger adolescents; the range among surveys of older adolescents was 0.2 to 2.0 percentage points annually) than from 1985 through 1991 (0 to 0.5 percentage points annually among all adolescents). Since 1980, smoking has generally declined at a slightly faster rate among older female adolescents than among male adolescents. Smoking among Black adolescents of all ages declined in nearly every survey population during each study period (range among surveys: 1974-1985 = 1.0 to 2.9 percentage points; 1985-1991 = 0.7 to 1.5 percentage points annually); for White adolescents, only minimal declines in smoking have occurred since 1985. CONCLUSIONS: Since 1974, major changes in adolescent smoking patterns have occurred, especially among Blacks. The overall slowing rate of decline in smoking prevalence since 1985 may indicate success of increased tobacco advertising and promotional activities targeted at adolescents or inadequate antitobacco education efforts.
Adolescent↗
Trends in cigarette smoking and physicians' advice to quit smoking among people with diabetes in the U.S.
OBJECTIVE: This study describes changes in the distribution of cigarette smoking and in physicians' advice to quit smoking among the U.S. population with and without diabetes from the mid-1970s to 1990. RESEARCH DESIGN AND METHODS: Data on self-reported smoking status, physicians' advice to quit smoking, history of diabetes, and demographic characteristics were obtained from the 1974, 1985, and 1990 National Health Interview Surveys. We examined the age-adjusted prevalence of smoking and physicians' advice to quit smoking by race, sex, and educational level among individuals with diabetes and those without diabetes. RESULTS: The prevalence of smoking decreased 9.8 percentage points from 1974 to 1990 among individuals with diabetes (from 35.6 to 25.8%, P < 0.01) and 11.7 percentage points among those without diabetes (from 37.3 to 25.6%, P < 0.01). For all years, younger individuals, men, and people with less than a high school education were more likely to smoke, regardless of diabetes status. Among individuals who had ever smoked, those with diabetes were more likely to have received advice to quit than those without diabetes; from 1974 to 1990, the percentage advised to quit smoking by a physician increased from 35.1 to 58.4% for smokers with diabetes and from 26.8 to 46.0% for smokers without diabetes. CONCLUSIONS: Despite decreases in smoking prevalence over time, people with diabetes are still as likely to smoke as those without diabetes. More than 40% of smokers with diabetes currently report never having received advice from a physician to quit smoking. Health care providers should increase their efforts to reduce smoking among people with diabetes.
Adolescent↗
Outcome-based management and public health: the Oregon Benchmarks experience.
Oregon is taking major steps toward monitoring health and nonhealth issues through the use of an outcome-based management approach called Benchmarks. Developed through a lengthy statewide consensus-building process, there are currently 272 goals, or Benchmarks, for the years 1995, 2000, and 2010, of which 54 are health related. Major effects on both the state and the local health departments include enhanced assessment activities, increased health planning, and improved collaboration both among health agencies and with other governmental and nongovernmental organizations.
Benchmarking↗
Surveillance for smoking-attributable mortality and years of potential life lost, by state--United States, 1990.
PROBLEM/CONDITION: Mortality and years of potential life lost attributable to cigarette smoking. REPORTING PERIOD COVERED: 1990. DESCRIPTION OF SYSTEM: Mortality and years of potential life lost were estimated for each state by using the Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) software. These estimates were based on attributable risk formulas for smoking-related causes of death. Estimates of smoking prevalence were obtained from the Behavioral Risk Factor Surveillance System and the U.S. Bureau of the Census, and mortality data were obtained from CDC. RESULTS: The median estimate for the number of smoking-attributable deaths among states was 5,619 (range: 402 [Alaska] to 42,574 [California]). Within each state, the number of smoking-attributable deaths among males was approximately twice as high as among females. Utah had the lowest mortality rate (218.0 per 100,000 population) and the lowest percentage of all deaths attributable to cigarette smoking (13.4%). Nevada had the highest mortality rate (478.1 per 100,000 population) and the highest percentage of deaths from smoking (24.0%). The number of years of potential life lost ranged from 6,720 (Alaska) to 498,297 (California). INTERPRETATION: The number of deaths attributable to cigarette smoking in 1990 remained high. Efforts are needed to control tobacco use in all states. ACTIONS TAKEN: SAMMEC data are used in many states to assist policymakers in strengthening tobacco control efforts.
Adult↗
Trends in cigarette smoking among US physicians and nurses.
OBJECTIVE: To determine trends in cigarette smoking prevalence among physicians, registered nurses, and licensed practical nurses since 1974. DESIGN: Analyses of data on smoking prevalence among persons 20 years of age and older using combined National Health Interview Survey data sets from 1974, 1976, and 1977; 1978, 1979, and 1980; 1983 and 1985; 1987 and 1988; and 1990 and 1991. MAIN OUTCOME MEASURES: Prevalence of cigarette smoking and average annual change in smoking prevalence. RESULTS: Based on the data for 1990 and 1991, there were an estimated 18,000 physicians, 322,000 registered nurses, and 128,000 licensed practical nurses who smoked cigarettes in the United States. Compared with 1974, 1976, and 1977, by 1990 and 1991 cigarette smoking prevalence had declined from 18.8% to 3.3% among physicians (average annual decline of 1.15 percentage points); from 31.7% to 18.3% among registered nurses (average annual decline of 0.88 percentage point); and from 37.1% to 27.2% among licensed practical nurses (average annual decline of 0.62 percentage point). CONCLUSION: Since 1974, cigarette smoking has declined most rapidly among physicians, at an intermediate rate among registered nurses, and at a lower rate among licensed practical nurses. Because of their important roles as exemplars and health educators, persons in these occupations should not smoke.
Health Behavior↗
Smoking and injuries: an overview.
BACKGROUND: Although the disease consequences of cigarette smoking are well documented, smoking may also be associated with increased risk of injury. Our purpose is to provide an overview of this potential association. METHODS: We conducted a literature review. RESULTS: Cigarettes are the leading cause of death from fire and the second leading cause of fire-related injury. Studies estimate that compared with nonsmokers, smokers appear 1.5 times more likely to have a motor vehicle crash, 1.4-2.5 times more likely to be injured at work, and 2.0 times more likely to suffer other unintentional injuries. A variety of reasons may explain an association between cigarette smoking and injuries; these include (a) direct toxicity; (b) distractibility; (c) smoking-associated medical conditions; and (d) confounding factors, including personality or behavioral characteristics. CONCLUSIONS: Smoking may be an independent risk factor for thermal, motor vehicle, occupational, and other unintentional injuries. Nonsmokers may be at increased risk of injury from the presence of smokers in their environments, e.g., from fires. Societal benefits from decreased smoking prevalence are likely to include reduction of both fatal and nonfatal injuries.
Accidents, Occupational↗
Epidemic Clostridium difficile-associated diarrhea: role of second- and third-generation cephalosporins.
OBJECTIVE: To better define the role of multiple risk factors for cytotoxic Clostridium difficile-associated diarrhea. DESIGN: Case-control study. SETTING: A Veterans Affairs Medical Center. PATIENTS: Thirty-three case patients with C difficile-associated diarrhea. Two control groups were used: one group consisted of 32 patients from the same ward as the case patients, and one group consisted of 34 patients with nosocomial diarrhea and negative C difficile toxin assays. INTERVENTION: None. RESULTS: Multivariate analyses revealed that exposure to second- or third-generation cephalosporins was the most important independent risk factor, even after controlling for other antimicrobial use (odds ratio [OR] = 8.3, 95% confidence interval [CI95] = 1.4 to 48.9 compared to ward controls; OR = 9.6, CI95 = 2.1 to 44.1 compared with diarrhea controls). Persons exposed to two or more antimicrobials simultaneously were at substantially elevated risk (OR = 18.7, CI95 = 4.1 to 85.8 compared with ward controls; OR = 21.5, CI95 = 3.2 to 141.9 compared with diarrhea controls). CONCLUSION: Physicians should consider carefully the appropriateness of second- and third-generation cephalosporin use and combination antimicrobial therapy, especially during nosocomial C difficile-associated diarrhea outbreaks (Infect Control Hosp Epidemiol 1994;15:88-94).
Case-Control Studies↗
Using the youth risk behavior survey to estimate prevalence of sexual abuse among Oregon high school students.
To estimate the extent of childhood sexual abuse, questions were added to the 1993 Oregon Youth Risk Behavior Survey of students in grades 9-12. Twenty-five high schools throughout Oregon participated in the survey. Among the 2,332 students who answered sexual abuse questions, 20.9% had ever been sexually abused; females (33.1%) were much more likely to have ever been abused than were males (8.1%). Females (10.3%) also were more likely than males (3.4%) to have been sexually abused within the past year. High school students sexually abused in the past year engaged in many high risk health behaviors such as weapon carrying, substance abuse, seriously considering suicide in the past year, and sexual activity when compared with students who had never been sexually abused. Further educational efforts with teachers, health care providers, parents, and child care providers, as well as development and use of school curricula, are needed to reduce sexual abuse.
Adolescent↗
Correspondence re: B. Wagner. "The 'cause of death' is dying." Editorial. Mod Pathol 6:237, 1993.
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Cause of Death↗
Cigarette smoking prevalence by occupation in the United States. A comparison between 1978 to 1980 and 1987 to 1990.
We analyzed data from 1987 to 1990 National Health Interview Surveys and compared them with 1978 to 1980 National Health Interview Surveys data to determine changes in cigarette smoking prevalence by occupation. During this period, cigarette smoking prevalence declined from 31.7% to 24.2% among white-collar workers, from 43.7% to 39.2% among blue-collar workers, and from 37.2% to 34.5% among service workers. For occupational groups, the largest significant declines in smoking prevalence occurred among male sales workers (10.5 percentage points), female and male managers and administrators (9.9 and 8.7 percentage points), female professional and technical workers (8.0 percentage points), and male transportation equipment operatives (7.5 percentage points). Analyses of 1987 to 1990 detailed occupation codes revealed that roofers (57.8%) and crane and tower operators (57.6%) had the highest prevalences of cigarette smoking, whereas physicians (5.4%) and clergy (6.5%) had the lowest smoking prevalences. Since 1978 to 1980, the differences in smoking prevalence by occupation have widened, providing further evidence that smoking has moved from a relatively common behavior practiced by most segment of society to one that has become more concentrated among selected subpopulations. Health professionals need to play an important role in encouraging smoking cessation among workers and in advising management and labor about the benefits of strong work-site smoking policies.
Female↗
Horseback riding injuries among children and young adults.
BACKGROUND: Horseback riding injuries are responsible for an estimated 2300 hospital admissions annually among persons younger than 25 years of age in the United States, but injury rates, patterns of injury, and risk factors for this population have not been well studied. METHODS: Study participants were selected from a list provided by a national mail-order company that sells riding equipment. A total of 557 persons younger than 25 years of age who rode horses at least six times a year completed survey questionnaires. RESULTS: Among the study participants, 34 (6.1%) had been hospitalized at least once because of a riding injury and 153 (27.5%) had been treated by a physician within the previous 2 years for such an injury. The overall injury rate was 0.6 per 1000 riding hours. Among those injured, sprains or strains (41.8%), lacerations or bruises (40.0%), and fractures or dislocations (33.3%) were the most common types of injury. A total of 27.5% of those injured sustained concussions or other head injuries. Riding 15 to 24 hours per month (odds ratio [OR] = 2.04), being female (OR = 1.81), and riding English style (OR = 1.77) were the characteristics most strongly correlated with injury. CONCLUSIONS: Horseback riding injuries among participants in this study tended to be serious. Family physicians should inform their patients who ride horses about the risks associated with equestrian activities and should emphasize helmet use.
Adolescent↗
Sensitivity of multiple-cause mortality data for surveillance of deaths associated with head or neck injuries.
PROBLEM/CONDITION: Multiple-cause mortality data was assessed as a source of information for surveillance of deaths associated with head or neck injuries. REPORTING PERIOD COVERED: 1985-1986 DESCRIPTION OF SYSTEM: Data on causes of death were abstracted from death certificates in New Mexico and coded according to criteria of the International Classification of Diseases, Ninth Revision (ICD-9). Deaths with an external cause-of-death (E) code as the underlying cause of death and one or more head or neck injury nature-of-condition (N) codes as contributing causes of death were considered head or neck injury deaths. These data were compared with data for head or neck injury deaths obtained from computerized records from the New Mexico Office of the Medical Investigator (OMI). Data for alcohol or drug use were abstracted from both systems. RESULTS: Of the 699 head or neck injury deaths coded by the New Mexico OMI system in 1985-1986, 536 were identified as head or neck injury deaths in multiple-cause mortality data (sensitivity = 76.7%). Firearms were the leading cause of head or neck injury deaths, followed by motor vehicles. Multiple-cause mortality data contained alcohol codes for only 3.7% of OMI records with blood alcohol concentrations > or = 0.10 mg/dL and contained drug codes for none of the OMI records with positive toxicology tests for drugs. INTERPRETATION: The sensitivity of multiple-cause mortality data was relatively high for surveillance of head and neck injury deaths.(ABSTRACT TRUNCATED AT 250 WORDS)
Accidental Falls↗
Analysis of an osmotically regulated pathogenesis-related osmotin gene promoter.
Osmotin is a small (24 kDa), basic, pathogenesis-related protein, that accumulates during adaptation of tobacco (Nicotiana tabacum) cells to osmotic stress. There are more than 10 inducers that activate the osmotin gene in various plant tissues. The osmotin promoter contains several sequences bearing a high degree of similarity to ABRE, as-1 and E-8 cis element sequences. Gel retardation studies indicated the presence of at least two regions in the osmotin promoter that show specific interactions with nuclear factors isolated from cultured cells or leaves. The abundance of these binding factors increased in response to salt, ABA and ethylene. Nuclear factors protected a 35 bp sequence of the promoter from DNase I digestion. Different 5' deletions of the osmotin promoter cloned into a promoter-less GUSNOS plasmid (pBI 201) were used in transient expression studies with a Biolistic gun. The transient expression studies revealed the presence of three distinct regions in the osmotin promoter. The promoter sequence from -108 to -248 bp is absolutely required for reporter gene activity, followed by a long stretch (up to -1052) of enhancer-like sequence and then a sequence upstream of -1052, which appears to contain negative elements. The responses to ABA, ethylene, salt, desiccation and wounding appear to be associated with the -248 bp sequence of the promoter. This region also contains a putative ABRE (CACTGTG) core element. Activation of the osmotin gene by various inducers is discussed in view of antifungal activity of the osmotin protein.
Abscisic Acid↗
Cost savings associated with increased safety belt use in Iowa, 1987-1988.
Although safety belt use increases after passage of a safety belt law, the statewide direct and indirect cost savings associated with increased safety belt use after a belt use law has been enacted is not known. We analyzed a subset of data from the Iowa Safety Restraint Assessment consisting of 997 injured motor vehicle occupants treated at any of 11 Iowa hospitals from throughout the state between November 1987 and March 1988. We found that injuries were more serious and that more deaths and cases of permanent disability occurred among persons who did not wear safety belts. Failure to use safety belts was independently associated with higher payments to hospitals by health care insurers and individuals in nearly all age, sex, and vehicle speed categories. Lifetime direct and indirect cost savings associated with Iowa's safety belt law for persons injured in one year were estimated to be $69.5 million.
Adolescent↗