Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CONNECTICUT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1998

Pharmacy access to syringes among injecting drug users: follow-up findings from Hartford, Connecticut.

OBJECTIVE: To break the link between drug use and the human immunodeficiency virus (HIV), in 1992 the state of Connecticut rescinded a 14-year ban on pharmacy sales of syringes without a physician's prescription. In 1993, the Center for Disease Control and Prevention (CDC) evaluated the impact of the new legislation on access to syringes among injecting drug users (IDUs) and found an initial pattern of expanded access. However, it also found that some pharmacies, after negative experiences with IDU customers, reverted to requiring a prescription. This chapter reports findings from a four-year follow-up study of current IDU access to over-the-counter (OTC) pharmacy syringes in Hartford, Connecticut. METHODS: Through structured interviews, brief telephone interviews, and mailed surveys, data on nonprescription syringe sale practices were collected on 27 pharmacies, including 18 of the 21 pharmacies in Hartford and none from pharmacies in contiguous towns, during June and July 1997. Interview data on pharmacy syringe purchase from two sample of IDUs, a group of out-of-treatment injectors recruited through street outreach, and a sample of users of the Hartford Needle Exchange Program, also are reported. RESULTS: The study found that, while market trends as well as negative experiences have further limited pharmacy availability of nonprescription syringes, pharmacies remain an important source of sterile syringes for IDUs. However, the distribution of access in not even; in some areas of the city it is much easier to purchase nonprescription syringes than in other. All of the seven pharmacies located on the north end of Hartford reported that they had a policy of selling OTC syringes, whereas only six (54.5%) of the II pharmacies located on the south end have such a policy. Overt racial discrimination was not found to be a barrier to OTC access to syringes. CONCLUSIONS: To further decrease acquired immunodeficiency syndrome (AIDS) risk among IDUs, there is a need for public education to counter empirically unsupported stereotypes about IDUs that diminish their access to health care and AIDS prevention resources and services. In states or cities where pharmacy sale of nonprescription syringes is illegal, policy makers should examine the benefits of removing existing barriers to sterile syringe acquisition. In cases in which pharmacy sale of nonprescription syringes is legal, local health departments should implement educational programs to inform pharmacy staff and management about the critically important role low-cost (or cost-free), sterile syringe access can play in HIV prevention.

Centers for Disease Control and Prevention, U.S.↗
PubMed1998

Factors inhibiting use of the pneumococcal polysaccharide vaccine: a survey of Connecticut physicians.

BACKGROUND: The pneumococcal polysaccharide vaccine (PPV) is effective in preventing invasive pneumococcal disease, but remains underutilized. Prior surveys of physicians revealed concern regarding the safety and efficacy of the vaccine, but there has been little information published in the last 10 years that sheds light on why the vaccine remains underutilized. Although there is currently emphasis on providing PPV to hospitalized patients, there is even less known about what factors prevent PPV use in the hospital setting and chronic care setting. We performed a survey of physicians in Connecticut to determine what factors prevent utilization of the vaccine in three patient care settings. METHODS: A survey of internists and family practitioners in Connecticut that ascertained their frequency of utilization of PPV and what factors inhibited utilization of PPV. RESULTS: Three hundred ninety-seven responses are included in the analysis. Forgetting to administer the vaccine (59% of respondents) and patient refusal (55% of respondents) were the factors most frequently noted as being important in preventing vaccination in the outpatient setting. In the inpatient and chronic care settings, difficulty in determining the patient's vaccine status was also noted. Concerns regarding the efficacy or safety of the vaccine did not seem to be important. The factor that correlated most closely with the respondents' reported frequency of vaccine use was forgetting to vaccinate. CONCLUSIONS: Physicians, although accepting the efficacy of PPV, are inhibited from its more frequent use by several factors.

Adolescent↗
PubMed1998

A comparison of the nutritional status and food security of drug-using and non-drug-using Hispanic women in Hartford, Connecticut.

This study compared food insecurity, nutritional status (as measured through anthropometry and dietary intake), and food preparation patterns of low-income Puerto Rican female out-of-treatment drug users with that of low-income Puerto Rican women who reported no drug use. A convenience sample of 41 drug users was compared with 41 age-matched non-drug-users from inner-city Hartford, Connecticut. A culturally appropriate food frequency questionnaire was administered and anthropometric measurements were taken. The findings suggest a high degree of poverty among all study participants, but in particular among drug users. Drug users were more likely than the controls to be food insecure (P < 0.05) and to be exposed to increasingly severe food sufficiency problems. The daily frequency of consumption of vegetables was lower (P = 0.03) for drug users than non-drug-users. Conversely, the frequency of consumption for sweets/desserts was significantly higher for drug users than the controls (P = 0.0001). Drug users, who were classified as food insecure were less likely to consume vegetables (P = 0.004) and fish (P = 0.03) than were controls who were food insecure. When comparing drug users with controls, the former group reported consuming fewer meals during a usual week than the latter group (P < 0.0001). Drug users were more likely to fry foods (P = 0.02) while the controls were more likely to bake (P = 0.005), boil (P = 0.02), and steam (P = 0.002) foods. All anthropometric measurements, except for height, were significantly lower for drug users. The results show that drug users generally maintain poorer nutritional status than non-drug-users. Nutrition interventions as part of drug treatment are needed.

Adolescent↗
PubMedDate not supplied

Technical, scale, and size efficiency in nursing home care: a nonparametric analysis of Connecticut homes.

Maindiratta (1990) questioned the usefulness of the concept of scale efficiency in production as the most productive scale size (MPSS) usually requires altering the scale of output produced. If the decision making unit (DMU) is required to deliver a specific output bundle, then altering output along with the input scale to reach the MPSS is not a valid recommendation. He proposed a measure of the size efficiency of a DMU. In this paper, we apply Data Envelopment Analysis (DEA) to examine the levels of technical, scale, and size efficiency of individual nursing homes providing health care to the elderly. The data used relate to the operations of 140 nursing homes from Connecticut, USA during the year 1982-83. Maindiratta's model is input-oriented. By contrast, our study is output-oriented and we appropriately reformulate Maindiratta's model. The findings show that in several cases size efficiency is less than unity. This suggests that the most efficient production of output would require restructuring of the nursing home under investigation as more than one small unit. We also compare the efficiency levels of 'for-profit' homes with those of 'not-for-profit' homes.

Aged↗
PubMed1982

Referral patterns of childhood brain tumors in the state of Connecticut.

Data from the Connecticut Tumor Registry (1968-1979) were analyzed to determined whether referral patterns influenced survival rates in children with brain tumors. Two-hundred-seventy-eight children with brain tumors were identified. Less that one-third of the children received all their treatment at university cancer centers. An actuarial analysis of survival rates revealed that children with medulloblastomas treated solely at university cancer centers had projected five-year survival rates of 7.4%. Children with medulloblastomas treated solely at community hospitals had projected five-year survival rates of 29%. Children with brainstem gliomas treated at university cancer centers had projected five-year survival rates of 40% whereas of those children treated at community hospitals only one patient was alive at 13 months. No major differences in survival were identified among children with other tumor types. These data suggest that children with certain types of brain tumors may fare better when treated at university cancer centers.

Adolescent↗
PubMed1984

The reach to recovery program. An evaluation of the attitudes of Connecticut surgeons.

Because the Reach to Recovery Program is under-utilized in Connecticut, the authors sent a 19-part questionnaire to all board-certified general surgeons in the state to evaluate their attitudes toward the Program. Most of the surgeons who responded were pleased with the Program and believed that it saved them time, and was of help to their patients. Twenty percent of the surgeons were unaware of various aspects of the Reach to Recovery Program. Historical and current aspects of the Program are presented. Suggestions are made regarding increasing the scope of the Program to address the needs of women who are to be treated with radiation therapy or who have had a mastectomy and are about to receive adjuvant chemotherapy.

Attitude of Health Personnel↗
PubMed1988

Patterns of invasive melanoma in the Connecticut Tumor Registry. Is the long-term increase real?

The decades-long increase in incidence rates for melanoma has been ascribed to artifactual changes in case ascertainment rather than to true changes in disease risk. In this study, population-based incidence data for invasive cutaneous malignant melanoma from the Connecticut Tumor Registry were categorized into seven age groups and four time periods to examine the pattern of change over four decades. Analyses of age, period, and cohort variables focused on the curvature components, which are estimable functions. Statistical modeling demonstrated the following: (1) incidence rates have increased by birth cohort in both sexes with no requirement for a period variable, regardless of whether data are examined by 10-year, 5-year, or 1-year intervals of diagnosis; (2) this pattern in incidence rates differed from the patterns of change in the two indices of case ascertainment, the proportion of cases confirmed microscopically and the proportion of cases in localized stage, both of which exhibited changes by period of diagnosis rather than by birth cohort; and (3) adjustment for these two indices caused a downward bend in the cohort curve for females but not for males. The results suggested that much of the observed increase for this tumor was real.

Adolescent↗
PubMed1990

Epidemiology of oral cancer in Connecticut, 1935 to 1985.

All cases of oral cancer (N = 9708) recorded by the Connecticut Tumor Registry from 1935 to 1985 were analyzed for time-trend patterns within 10-year age-groups. Crude, age-specific, age-adjusted incidence rates and birth cohort analyses were calculated. The average annual age-adjusted incidence rate was 12.9/100,000 for men and 2.9/100,000 for women (1970 US standard million population). The male age-adjusted incidence rate decreased 33% from the late 1930s to the early 1980s. The female age-adjusted incidence rate exhibited a threefold steady increase over this same time period. The male/female ratio for oral cancer incidence declined dramatically from 10.4 to 2.7 for the age-adjusted rate, nearly a fourfold decrease during the 51- year period. Birth cohort analyses for women indicated a marked increase in oral cancer incidence for the birth cohort of 1900, which was sustained in the birth cohorts that followed. Birth cohort analyses for men revealed a decline in oral cancer incidence for birth cohorts born after 1910. The highest incidence rates were found in the urban counties and the lowest in the rural areas.

Adult↗
PubMed1990

Intraoral squamous cell carcinoma. Epidemiologic patterns in Connecticut from 1935 to 1985.

There were 6181 cases of invasive intraoral squamous cell carcinoma accessioned by the Connecticut State Tumor Registry from 1935 to 1985. Cases were analyzed for age, sex, lesion site, and histologic differentiation. Crude, age-specific, and age-adjusted incidence rates plus birth cohort analyses were also calculated. It was found that incidence rates for both men and women increased over the 51-year period of study. For men, age-adjusted incidence rates (1970 United States standard) increased from 4.9/100,000 in 1935 to 1939 to 8.5/100,000 in 1980 to 1985; for women, rates increased from 0.5/100,000 to 3.3/100,000 for the same period. The male-to-female ratio for intraoral squamous cell carcinoma declined dramatically from 9.8 to 2.6 during the 51-year study period primarily because of the steep rate of increased incidence in women relative to that seen in men. The peak age of intraoral squamous cell carcinoma was the seventh decade. Age-specific analysis showed that the older the age group, the higher the incidence for both sexes. During recent years, there was evidence of slightly increased incidence in men younger than 40. The tongue was the most common site for intraoral squamous cell carcinoma, followed closely by the floor of the mouth. Moderately differentiated tumors were most common (54.3% of the total), followed by both well-differentiated cases (29.1%) and those that were poorly differentiated (16.6%).

Adult↗
PubMed1991

Time trends in malignant melanoma of the upper limb in Connecticut.

Time trends in the incidence of malignant melanoma of the anatomic subsites of the upper limb in Connecticut from 1935 to 1984 were examined. Among males, the incidence of melanoma of the hand was stable, in sharp contrast to the 15-fold to 16-fold increase in the upper arm and forearm. Among females, the 3-fold increase in melanoma of the hand was substantially less than the 12-fold to 14-fold increase in the upper arm and forearm. However, melanoma of the dorsal surface of the hand in females increased sevenfold. These results are in partial agreement with the hypothesis that the hand would be relatively resistant to increased melanoma incidence because it has continually been a sun-exposed site over the decades. The results contradict the hypothesis that the rise in incidence would be greater in the upper arm (a usually unexposed site that has received increasing exposure due to changes in recreation and dress habits) than in the forearm (a site of intermediate exposure).

Arm↗
PubMed1992

Incidence and mortality of carcinoids of the colon. Data from the Connecticut Tumor Registry.

The aims of this study were to calculate the true incidence of colonic carcinoids in Connecticut from 1976 to 1986 and to determine the outcome of patients with these lesions. Fifty-four patients with carcinoids of the colon were identified (23 male and 31 female patients). Their average age was 64.1 +/- 2.1 years, with a range of 12 to 83 years. The age-adjusted incidence was 0.31 cases/100,000 population/year. Forty-eight percent of the carcinoids were located in the cecum; 16%, ascending colon; 6%, transverse colon; 11%, descending colon; 13%, sigmoid colon; and 6%, not assigned. Follow-up information was available in all cases. The crude 2-year survival rate was 63%, whereas the 5-year survival rate was 37%. Only one of six (16.6%) lesions that were 2 cm or smaller metastasized, whereas 23 of 31 lesions larger than 2 cm metastasized (74%). Six patients have survived an average of 43.5 months after local excision of their carcinoids. Fourteen patients died of their carcinoids. Metachronous gastrointestinal malignant neoplasms developed in six patients. These results suggest that, when found at an early stage, carcinoids of the colon (2 cm or smaller) can be treated by local excision. The vast majority of colonic carcinoids, however, are discovered at an advanced stage and should be treated aggressively with standard colonic resection. In addition, surveillance of the entire gastrointestinal tract should be initiated in these patients because of a high rate of other gastrointestinal malignant neoplasms.

Adolescent↗
PubMed1992

Three participatory exercises on empowerment used in health and safety training of trainers course in Connecticut.

In a training-of-trainers course on health and safety sponsored by the Connecticut Council on Occupational Safety and Health and the Division of Worker Education, Workers' Compensation Commission, various participatory exercises have been utilized to train workers who are then expected to train their co-workers. Three of the exercises, including hazard recognition, tackling apathy, and strategies for change are described.

Connecticut↗
PubMed2006

Obtaining smoking histories for population-based studies on multiple primary cancers: Connecticut, 2002.

Because of the absence of data on smoking history for patients in cancer registries, large population-based studies have been unable to directly assess the role of smoking in the risk of multiple primary cancers. In a random sample of 618 adults diagnosed with invasive cancer in 2002 and reported to the population-based Connecticut (CT) cancer registry, however, search of hospital records identified smoking history (current, former, never- or nonsmoker) for 83.3%. Number of cigarettes per day was known for 71.3% of 289 current or former smokers, while duration of quitting was found for 92.3% of 194 former smokers. Smoking status was strongly associated with current heavy alcohol use. Hospital records appear to be a promising resource for population-based studies on smoking histories in relation to risk of multiple primaries, although completeness of information needs to be improved in CT and assessments are needed in other cancer registries.

Adult↗
PubMed1994

Time trends in the incidence of renal carcinoma: analysis of Connecticut Tumor Registry data, 1935-1989.

Recent trends in the incidence of renal cancer, stratified by histology, have not been reported. This study utilized data from the Connecticut Tumor Registry (CTR), the oldest population-based cancer registry in the United States, to establish time trends in the incidence of adenocarcinoma and transitional cell carcinoma of the kidney and urinary tract. All 10,209 incident cases of renal cancer reported to the CTR between 1935 and 1989 were analyzed. Regression modelling was employed to determine the effects of age, period, and birth cohort on incidence rates, and to project future trends. The incidence rate of adenocarcinoma increased in females from 0.7/100,000 in 1935-39, to 4.2/100,000 in 1985-89; and in males, from 1.6/100,000 in 1935-39, to 9.6/100,000 in 1985-89. The reported incidence of transitional cell carcinoma increased in males from 0.5/100,000 in 1950-54 to 2.8/100,000 in 1985-89, and in females from 0.2/100,000 to 1.1/100,000 over the same period. Regression modelling revealed that both net and recent drift, the sum of period and cohort slopes, were positive for adenocarcinoma in both sexes, largely due to a positive cohort effect. While the net drift for transitional cell carcinoma was positive, recent drift was negative in both sexes due primarily to a negative cohort effect. Incidence rates of adenocarcinoma are likely to rise in the immediate future, with the rate of rise in females possibly exceeding that in males. Incidence rates of transitional cell carcinoma will stabilize.

Adult↗
PubMed2005

Predictors of disease severity in children with asthma in Hartford, Connecticut.

Childhood asthma is a major public health problem in the United States, particularly among minority populations. The aim of our study was to examine the relationship among ethnicity, allergen sensitization, spirometric measures, and asthma severity in children with mild to severe asthma who received their medical care in Hartford, Connecticut. Four hundred thirty-eight children aged 4-18 years who were enrolled in an asthma care program (Easy Breathing) in Hartford and who were referred for spirometry and allergy skin testing participated in this cross-sectional study. Risk factors for increased asthma severity as defined by National Asthma Education and Prevention Program (NAEPP) guidelines were determined using multinomial logistic regression. Of 438 children, 383 (87.4%) had mild to moderate asthma, and 292 (66.7%) had at least one positive skin test to allergens. Forced expiratory volume in 1 sec/forced vital capacity (FEV1/FVC) was significantly decreased in children with severe vs. mild asthma (80.7 vs. 87.3, respectively). In a multivariate analysis, predictors of severe asthma included African-American ethnicity (odds ratio (OR)=3.70, 95% confidence interval (CI)=1.10-12.42), Puerto Rican ethnicity (OR=3.55, 95% CI=1.18-10.67), sensitization to cockroach allergen (OR=4.34, 95% CI=1.73-10.86), and decreased FEV1/FVC (OR for every 1% decrease in FEV1/FVC=1.06, 95% CI=1.02-1.11). In conclusion, among children with asthma in Hartford and its surrounding communities, predictors of disease severity included African-American ethnicity, Puerto Rican ethnicity, sensitization to cockroach allergen, and decreased FEV1/FVC. Our findings suggest that FEV1/FVC is a useful indicator of asthma severity in children.

Adolescent↗
PubMed1995

Declining use of radiotherapy for invasive cervical cancer in Connecticut: 1983-1990.

Data on the use of radiotherapy (i.e., external irradiation and/or intracavitary radioactive implants) in the first course of treatment were examined for all 1286 invasive cervical cancer cases diagnosed between 1983 and 1990 among Connecticut residents. These data, from a population-based cancer registry, reflect actual treatment practices in the geographic area under study. Use of radiotherapy declined from 62% in 1983 to 43% in 1990 (trend test P < 0.001); for "local"-stage cancers, the decline was from 50% in 1983 to 27% in 1990 (P < 0.001). Surveys are needed on physicians' attitudes and decisions regarding alternative treatments for cervical cancer.

Age Factors↗
PubMed2000

Prevalence and correlates of smokeless tobacco use in a sample of Connecticut students.

We examined the prevalence of smokeless tobacco use, and its relationship to other risky behaviors in Connecticut school children in grades four through 12 (n=31,861). Less than one per cent of students in grades 4-8, and four per cent of those in grades 9-12, used smokeless tobacco. Eighty-two percent of all users were white males. Among high school males, the prevalences of risk-taking behaviors and feelings of stress and depression were significantly higher among users than non-users. Among high school males, the highest prevalences of risky behaviors and stress indicators were reported by joint users of cigarettes and smokeless tobacco.

Adolescent↗
PubMed1995

The accuracy of prostate cancer staging in a population-based tumor registry and its impact on the black-white stage difference (Connecticut, United States).

Stage at diagnosis of prostate cancer is a major determinant of survival. Among Blacks, prostate cancer is diagnosed at a later stage of disease than among Whites. This study examined the accuracy of routine coding of prostate cancer stage in the Connecticut (United States) Tumor Registry (CTR) and its effect on the Black/White stage difference. Medical records were collected for 115 Black and 136 White men with prostate cancer diagnosed between 1987 and 1990. Stage at diagnosis was determined by a panel of two of the study members and compared with the stage in the CTR file. According to the panel, 32 percent of Blacks, but only 15 percent of Whites, were diagnosed with distant stage disease. Fifty-eight cases (26 percent of Whites and 20 percent of Blacks) were staged incorrectly by the CTR. Two-fifths of the errors were due to incomplete medical records at the CTR and three-fifths were due to CTR coding or data management errors. The more accurate staging did not have an appreciable impact on the Black/White stage difference. Further work is needed to characterize the accuracy of routinely coded cancer registry stage data for different cancer sites, to devise ways of improving accuracy, and to determine the impact of staging inaccuracies on research that utilizes these data.

Aged↗