Biomedical subjects
Publications and source records attributed to J W Collins.
Following anti-HIV bioassay-guided fractionation, four new prenylated benzophenones, vismiaphenones D-G (7-10), were isolated from extracts of leaves of Vismia cayennensis. The structures were elucidated by spectral analyses. Only vismiaphenone D (7) exhibited HIV-inhibitory activity in the NCI primary screen.
This study explored the relationship between ecologic risk factors and infant birthweight. A stratified analysis was performed on all African-American, Mexican-American, and white infants born in Chicago in 1990. One half of African-American mothers (n = 26,799) resided in communities with multiple ecologic risk factors, yet their very low birthweight rates were unaffected by the number of these factors. By contrast, only 5% of Mexican-American mothers (n = 9913) and 5% of white mothers (n = 13,596) lived in communities with multiple ecologic risk factors. Their very low birthweights were twice that of infants born to mothers who resided in communities with no ecologic risk factors. These results indicate that ecologic risk factors affect the very low birthweight rates of Mexican Americans and whites but not African Americans.
We performed a hospital-based case-control study of African-American mothers to explore the relation between a mother's perception of her own residential environment and very low birthweight. We administered a structured questionnaire to mothers of very-low-birthweight (<1,500 gm; N = 28) and critically ill non-low-birthweight (>2,500 gm; N = 52) infants. The groups had similar sociodemographic characteristics. The vast majority of participants were unmarried and had no private medical insurance. The odds ratios of very low birthweight fluctuated between 1.7 and 3.2 for African-American mothers who rated their neighborhoods (in terms of police protection, protection of property, personal safety, friendliness, delivery of municipal services, cleanliness, quietness, and schools) unfavorably. Additionally, the odds ratio of very low birthweight for mothers exposed to three or more stressful life events during pregnancy was 3.1 (95% confidence interval = 1.2-8.2). We conclude that African-American mothers' perception of their residential environment and frequency of stressful life events are associated with very low birthweight in their infants.
OBJECTIVES: To determine the relation of traditional sociodemographic characteristics to the small-for-gestational age rates of urban Mexican Americans. DESIGN: A cross-sectional study. METHODS: We performed a stratified analysis of 1982-1983 Illinois vital records and 1980 U.S. Census income data. The authors analyzed the 1982-1983 Illinois vital records and 1980 U.S. Census income data to determine whether maternal sociodemographic characteristics are associated with the small-for-gestational age (weight-for-gestational-length < 10th percentile) rates among Mexican Americans in Chicago. RESULTS: The small-for-gestational age rate was 2.1% for infants with U.S.-born mothers (N = 2,253) compared to 1.4% for infants with foreign-born mothers (N = 8,746); relative risk 1.5 (95% confidence interval 1.1-2.1). For the U.S.-born cohort, maternal education, marital status, parity, prenatal care, and community income were associated with small-for-gestational age rates. In contrast, with the exception of marital status, these commonly cited risk factors were not associated with the small-for-gestational age rates of infants with Mexican-born mothers. The U.S.-born:Mexico-born small-for-gestational age rate ratio fluctuated around 2 among mothers with a high-risk (maternal age < 20 years, < 12 years education, unmarried marital status) demographic profile. CONCLUSIONS: We conclude that traditional sociodemographic risk factors have different reproductive outcome consequences for U.S.-born and foreign-born Mexican-American mothers.
The authors used a transgenerational data set of Illinois vital records to ascertain the relation between parental birth weights and infant birth weight. The infant generation consisted of all African Americans and whites born in Illinois during 1989-1991. The parent generation included the mothers and fathers who were also born in Illinois between 1956 and 1975. In the infant cohort, the rate of low birth weight (LBW) (<2,500 g) was 11.7% for African Americans (n = 15,287) versus 5.0% for whites (n = 117,708) (relative risk (RR) = 2.3, 95% confidence interval (CI) 2.2-2.5). For African Americans, the LBW rate was 17.9% among those born to LBW mothers (n = 1,943) compared with 10.8% among those born to non-LBW mothers (n = 13,344) (RR = 1.8, 95% CI 1.6-1.9). For whites, the LBW rate was 8.5% among those born to LBW mothers (n = 2,174) compared with 4.8% among those born to non-LBW mothers (n = 115,534) (RR = 1.7, 95% CI 1.6-2.0). A weaker association was observed between paternal birth weight and infant birth weight. The authors conclude that parental birth weights are important risk factors for LBW in both African Americans and whites.
BACKGROUND: In the United States, the birth weights of infants of black women are lower than those of infants of white women. The extent to which the lower birth weights among blacks are related to social or genetic factors is unclear. METHODS: We used vital records for 1980 through 1995 from Illinois to determine the distribution of birth weights among infants born to three groups of women -- U.S.-born blacks, African-born blacks, and U.S.-born whites. RESULTS: The mean birth weight of 44,046 infants of U.S.-born white women was 3446 g, that of 3135 infants of African-born black women was 3333 g, and that of 43,322 infants of U.S.-born black women was 3089 g. The incidence of low birth weight (weight less than 2500 g) was 13.2 percent among infants of U.S.-born black women and 7.1 percent among infants of African-born black women, as compared with 4.3 percent among infants of U.S.-born white women (relative risks, 3.1 and 1.6, respectively). Among the women at lowest risk (those 20 to 39 years old, with 12 years of education for themselves and their spouses, early prenatal care, gravida 2 or 3, and no previous fetal loss), the rate of low birth weight in infants of African-born black women (3.6 percent) was closer to the rate in infants of U.S.-born white women (2.4 percent), and the rate in infants of U.S.-born black women remained high (7.5 percent). CONCLUSIONS: The birth-weight patterns of infants of African-born black women and U.S.-born white women are more closely related to one another than to the birth weights of infants of U.S.-born black women.
We used Illinois vital records and U.S. Census data to quantify the association of race and small-for-dates rates among women with 16 or more years of education. The small-for-dates rate for African-Americans was 2.8%, compared with 1.2% for whites [odds ratio (OR) = 2.5; 95% confidence interval (CI) = 1.8-3.4]. Adjustment for measures of socioeconomic status did not reduce the racial disparity (OR = 2.9; 95% CI = 1.4-4.5). We conclude that unidentified variables occurring with greater prevalence among African-Americans increase the risk of small-for-dates infants among college-educated African-American mothers.
OBJECTIVES: Illinois vital records for 1982/1983 and US census income data for 1980 were analyzed to ascertain the relationship of income incongruity, race, and very low birthweight. METHODS: Positive income incongruity was considered present when study infants resided in wealthier neighborhoods than non-Latino Whites at the same level of parental education attainment and marital status. RESULTS: The odds ratios of very low birthweight for African Americans (n = 44,266) and Whites (n = 27,139) who experienced positive income incongruity were 0.7 (95% confidence interval [CI] = 0.5, 0.9) and 0.6 (95% CI = 0.5, 0.9), respectively. CONCLUSIONS: Positive income incongruity is associated with lower race-specific rates of very low birthweight.
This study examines the extent to which the Adequacy of Prenatal Care Utilization Index explains the racial disparity in infant birthweight. A stratified analysis was performed on all African-American, Mexican-American, and non-Latino white singleton infants born in Chicago, Illinois between 1982 and 1983. This older cohort was chosen to avoid the confounding effect of cocaine associated with its increased local availability after 1985. The adequacy of prenatal care utilization varied by race and place of residence. However, in moderate-income areas (median family annual income of $20,001 to $30,000), the African-American birthweight disadvantage persisted among infants born to mothers who received adequate and adequate-plus prenatal care. Similarly, although race-specific term (gestational age > 37 weeks) low birthweight rates declined as prenatal care usage rose, the position of African Americans relative to Mexican Americans and whites was essentially unchanged. These findings indicate that maternal race or some factor closely related to it affects pregnancy outcome regardless of the adequacy of prenatal care utilization.
OBJECTIVE: We sought to determine whether black race is a risk factor for very low birthweight in a developed country other than the United States. DESIGN: A cross-sectional study was performed. SETTING: We analyzed a dataset of 1987-1990 birth records from three hospitals in East London, England. PARTICIPANTS: All live born African (N = 3,495), West Indian (N = 3,471), and European white (N = 20,313) singleton infants born to East London residents. MAIN OUTCOME MEASURES: For each ethnic group, we calculated the proportion of very low birthweight (< 1500g) and moderately low birthweight (1500-2499g) infants. RESULTS: The very low birthweight rate was 2.9% for infants of West Indian descent and 2.2% for infants of African descent vs. 1.3% for European whites; odds ratio (95% confidence interval) = 2.1(1.7-2.8) and 1.8(1.2-3.1), respectively. West Indian and white mothers were similar in terms of age, social support, and prenatal care. African mothers were older and had less social support. The West Indian:white and African:white differentials in very low birthweight rates persisted among low risk mothers; odds ratio (95% confidence interval) = 2.7(1.7-4.0) and 2.3(1.5-3.6), respectively. CONCLUSIONS: We conclude that black race is a risk factor for very low birthweight in the United Kingdom.
OBJECTIVES: To ascertain the extent to which residence in violent communities is an independent risk factor for adverse pregnancy outcomes among impoverished (census tract median family income < $10,000/year) African-American mothers. DESIGN: A cross-sectional study was performed. METHODS: We performed multivariate analyses on 1983 Illinois vital records, Chicago Police Department violent crime rates, and 1980 United States Census income data. RESULTS: African-American mothers who resided in the most violent communities had a low birth weight rate of 16% compared to 12% for infants (N = 315) with mothers who lived in the least violent communities; odds ratio = 1.5 (1.0-2.1). The proportion of small-for-gestational-age infants was substantially elevated in mothers who resided in the most violent communities compared to mothers who lived in the least violent communities: 7% vs. 3%; odds ratio = 2.6 (1.5-2.1). In multivariate logistic regression models that controlled for individual risk factors, the adjusted odds ratios for low birth weight and small-for-gestational-age infants among mothers who resided in the most (compared to the least) violent communities were 1.1 (0.9-1.2) and 1.5 (1.1-2.1), respectively. CONCLUSION: We conclude that a community's violent crime rate is associated with intrauterine growth retardation among infants born to African-American women.
The authors used 1982-1983 Illinois vital records and 1980 US Census income data to determine the contribution of maternal race to the risk of preterm (< 260 days), non-low birth weight (> 2,500 g) infants. This older cohort was chosen to avoid the confounding effect of cocaine associated with its increased local availability after 1985. In Chicago, the unadjusted preterm, non-low birth weight rate was 14% for African Americans (n = 43,059) compared with 9% for Mexican Americans (n = 10,397) and 7% for whites (n = 26,152) (odds ratio = 1.7, 95% confidence interval 1.6-1.8; odds ratio = 2.4, 95% confidence interval 2.3-2.5, respectively). In logistic models that included maternal sociodemographic and prenatal care variables, the adjusted odds ratio of preterm, non-low birth weight for. African Americans compared with Mexican Americans and whites was 1.6 (95% confidence interval 1.4-1.8) and 1.5 (95% confidence interval 1.2-1.7), respectively. The authors conclude that some factor closely linked to the African-American race, not underserved minority status per se, is a fundamental cause of preterm, non-low birth weight.
To better understand the methodological challenges faced by intervention research in health care, workshops reviewed two intervention studies to reduce back injuries among nursing home staff and two studies on the use of precautions to prevent occupational transmission of bloodborne pathogens. These studies adapted rigorous designs to real-world settings and made good use of multiple measures to detect effects and communicate this information to policy makers. The studies grappled with issues about implementation integrity and would benefit from better theory of administrative practices associated with a safety-conscious work environment.
Over the past 100 years, advances in nutrition, modern medicine, public health, and a multitude of public health improvements have increased the life expectancy of U.S. residents. The fact that Americans are living longer has resulted in extensive growth in our elderly population and a rapid employment growth that delivered about 2 million new jobs between 1980 and 1989 in the health care workforce. The Bureau of Labor Statistics Injury and Illness Data for nursing homes rose from 10.7 to 18.6 injuries or illnesses per 100 full-time workers between 1980 and 1992. The injury and illness rates among nursing home workers are partly due to the physical stress of providing round-the-clock assistance with the basic activities of daily living, such as getting in and out of a bed or chair, as well as bathing and toileting. The National Institute for Occupational Safety and Health (NIOSH) is conducting a series of research studies to identify strategies to reduce the risk of musculoskeletal injuries to workers in nursing homes. NIOSH has funded two laboratory evaluations of resident transferring methods and one field study in an actual nursing home. The purpose of this paper is to describe the key findings from past NIOSH research initiatives and to present an overview of future research.
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Although Hispanics are a poorly educated and medically underserved minority, the incidence of low birth weight (less than 2,500 g) Hispanic infants is similar to that of non-Hispanic whites. The authors used 1982-1983 Illinois vital records and 1980 US census income data to determine the contribution of maternal nativity and place of residence to this epidemiologic paradox. The proportion of low birth weight Hispanic (n = 22,892) infants ranged from 4.3% for Mexicans to 9.1% for Puerto Ricans. Maternal age, education, trimester of prenatal care initiation, and place of residence were associated with the prevalence of low birth weight infants among Puerto Rican but not foreign-born Mexican or Central-South American mothers. In very low-income (less than $10,000/year) census tracts, Mexican and other Hispanic infants with US-born mothers had low birth weight rates of 14 and 15%, respectively. In contrast, Mexican and other Hispanic infants with foreign-born mothers who resided in these areas had low birth weight rates of 3 and 7%, respectively. In a logistic model that included only impoverished infants, the adjusted odds ratio of low birth weight for those with US-born mothers equalled 6.3 (95 percent confidence interval 2.3-16.9). The authors conclude that urban poverty is negatively associated with Hispanic birth weight only when the mother is Puerto Rican or a US-born member of another subgroup.
OBJECTIVES: The purpose of the study was to determine the role of infant race as a determinant of the Black-White disparity in low birthweight (< 2500 g). METHODS: Univariate analysis and multivariate logistic regression were performed on Illinois vital records from 1982 and 1983 and on 1980 United States census income data. RESULTS: Fourteen percent of the infants born to Black mothers and White fathers were of low birthweight, compared with 9% of infants born to White mothers and Black fathers and 6% of a random sample of White infants. Both groups of biracial infants were more likely to have been born to unmarried mothers and to reside in very low-income (< $10,000 per year) census tracts than were White infants. When all confounding variables were entered into a logistic model, the adjusted odds ratio of low birthweight for biracial infants born to Black mothers and White fathers equaled 1.4. When biracial infants born to White mothers and Black fathers were compared with White infants, the adjusted odds ratio of low birthweight equaled 1.0. CONCLUSIONS: Paternal and consequent infant race does not affect the birthweight distribution of those born to White mothers and Black fathers. Unidentified factors closely related to maternal race underlie the Black-White disparity in infant birthweight.
To determine the extent to which disparities in risk status and access to tertiary care affect racial differences in neonatal mortality rates among normal birth weight infants, we conducted a vital records study concerning normal weight black (N = 44,399) and white (N = 48,146) singleton births in Chicago. Neonatal mortality rate among black infants was twice that among white infants (3.3 deaths per 1000 births vs 1.5 deaths per 1000 births); the unadjusted black relative risk equaled 2.2 (95% confidence interval, 1.7 to 2.9). Because prematurity, growth retardation, congenital anomalies, low Apgar scores at 5 minutes, teenage mothers, and poverty were more common among black infants, multivariate analyses were performed. The disparity in mortality rate was greatest between black and white infants with none of these risk factors; relative risk for black infants equaled 3.6 (95% confidence interval, 2.0 to 6.7). Approximately 30% of all deaths of black infants were attributable to birth in nontertiary hospitals. When the confounding variables, including hospital of birth, were put into a multivariate logistic-regression model, the adjusted relative risk estimate (odds ratio) for black infants equaled 1.5 (95% confidence interval, 1.1 to 2.0). Traditional risk factors fail to explain the racial disparity in neonatal mortality rate among normal birth weight infants. Level of perinatal care available, or some factor closely related to this level, is an important determinant of neonatal chance of survival for normal birth weight urban black infants.