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At least 343 records · Page 19Linked to original sources
PubMed1972

Vibrio parahaemolyticus gastroenteritis in Maryland: laboratory aspects.

Vibrio parahaemolyticus was the etiological agent in three food-related epidemics of gastroenteritis in Maryland, during August 1971. These outbreaks involved crab food products. Fifteen isolates of V. parahaemolyticus were made which included 11 from patients and 4 from foods. Serotype 04:K11 was the cause of the outbreaks. It was recovered from patients in each outbreak and gave a positive Kanagawa reaction, an indication of enteropathogenicity. Other patient isolates included types 03:K30, 03:K33, and an untypable isolate, all of which were Kanagawa negative. Food isolates included serotypes 03:K30, 02:K28, and two untypable isolates, all of which were Kanagawa negative. The outbreaks reported in this paper constitute the first confirmed foodborne epidemics due to V. parahaemolyticus in the United States. Methods for the isolation and identification of V. parahaemolyticus are presented, including a procedure for the simple conversion of conventional laboratory media into suitable culture media for this halophilic organism.

Bacteriological Techniques↗
PubMed1996

Teaching safety: evaluation of a children's village in Maryland.

OBJECTIVES: The purpose of this study was to evaluate Children's Village, a life safety education facility for children. SETTING: The study took place in Washington County, Maryland, a rural county. METHODS: Eight elementary schools with 20 second grade classrooms (410 students aged 7 and 8) were selected to participate. Using a quasiexperimental design, tests were administered to two cohorts of children before (pretest) and after (post-test) they attended the Children's Village during 1993-4. Parent and teacher surveys were also completed after the program. RESULTS: Among children who attended in December 1993-January 1994, there was a significant improvement in average test scores between the pretest (58% correct) and post-test (78%). Among children who attended in April 1994, there also was a significant improvement in test scores between pretest (74%) and post-test (85%). Among parents, 70% reported that their child learned a great deal at Children's Village and 33% reported having made changes in their home as a result. The parent survey also revealed that 25% of children and 35% of adults did not always wear their seat belts, and 74% of children did not always wear bicycle helmets. Teachers' responses to the program were generally positive. CONCLUSIONS: Children's Village brought together an extensive network of community leaders, parents, and teachers dedicated to safety education of children. The curriculum had a positive impact on children's knowledge and, to a lesser extent, on parents' safety practices. Program impact could be enhanced by more emphasis on automobile restraints and helmets (behaviors that parents reported were not consistently practiced) and by expanding the village services to parents as well as children. Others considering creating similar programs need to identify community leaders willing to commit the time, effort, and resources required to develop and sustain such programs.

Accident Prevention↗
PubMed1993

Angioplasty, bypass surgery, and amputation for lower extremity peripheral arterial disease in Maryland: a closer look.

Tunis and colleagues attempted to assess the effect of peripheral angioplasty in a large population with descriptive epidemiologic methods. Their study suffered from a vague statement of purpose, inappropriate and inadequate outcome measures, undetermined differences in prevalence of peripheral vascular disease and prevalence of risk factors for bypass/amputation in 1989 versus 1979, no differentiation between levels of amputation or between primary and secondary amputation, lack of a unique ICD-9-CM code indicating angioplasty for peripheral vascular disease of the lower extremities, lack of unique patient identifiers, a mistaken perception of the adoption of angioplasty as "widespread" in Maryland, and the assumption of uniform coding accuracy throughout the period of study. We conclude that the study design of Tunis et al was inadequate to determine the beneficial effects of angioplasty or bypass surgery in the treatment of peripheral vascular disease. Moreover, the conclusion by Coffman (2) that "invasive procedures are indicated only for the severely ischemic limb" is completely unsupported by the study data. Physicians should not attempt to apply the results of the study by Tunis et al to individual case situations. It should be further appreciated that the study findings do not provide an adequate basis for policy-making decisions. It is clear that important clinical questions concerning the roles of angioplasty, bypass, and amputation should be answered with more definitive studies.

Algorithms↗
PubMedDate not supplied

Stroke-associated deaths in Washington county, Maryland, with special reference to water hardness.

Deaths associated with strokes from 1963 to 1975 among 36,860 adult residents of Washington County, Maryland, were studied in relation to the hardness of drinking water at home, assessed on the basis of 1,569 water samples taken during this period. There was no satisfactory evidence that water hardness was related to stroke mortality. Age was a strongly related factor. There was little or no association with sex, marital status, socio-economic status as reflected by education or housing, smoking history, or frequency of church attendance.

Adult↗
PubMed1989

Respiratory risk factors and mortality: longitudinal studies in Washington County, Maryland.

Risk factors for temporal changes in chronic respiratory disease mortality were evaluated from two studies conducted in Washington County, Maryland. The first examined the mortality of a private census population (greater than 35,000 whites) enumerated in 1963 over two subsequent time periods by age, sex, and initial smoking status. The second examined the 10-yr mortality of a subset of the 1963 census (884 men who had undergone spirometry). We observed a fall in age-adjusted mortality from all causes and from arteriosclerotic heart disease (ASHD), but an increase in COPD mortality. However, the increase in these chronic pulmonary deaths is essentially confined to persons who were smoking cigarettes at the beginning of the study period. Furthermore, while smokers showed an increased mortality risk for all causes, the excess mortality risk did not fall uniformly across cigarette smokers. It is a major observation of this study that all-cause and cardiovascular (as well as pulmonary) mortality are significantly more often found among subjects with ventilatory impairment (independent of smoking status). Reasons for the association of ASHD mortality with impaired forced expiration are discussed. Thus, men at increased risk for three (ASHD, lung cancer, COPD) of the five leading causes of death (three of eight for women) may be identified by spirometry. Perhaps it is time that this test was more generally applied.

Adult↗
PubMed1989

Prevalence estimates of pathological gambling in New Jersey and Maryland.

This survey of the gambling behavior of 1,750 adults in New Jersey and Maryland confirmed findings in New York State. The substantial differences between problem and pathological gamblers in the general population and those entering treatment programs have serious implications for prevention, outreach, and treatment efforts.

Adult↗
PubMed2001

Variations in utilization and cost of inpatient psychiatric services among adults in Maryland.

The author examined variations in the clinical characteristics, costs, utilization, and discharge patterns of adult inpatients who were hospitalized for psychiatric disorders in Maryland state general hospitals in 1998. Administrative discharge data on all 30,121 adult psychiatric patients in the state in 1998 were used to calculate descriptive statistics on elderly (age 65 years and over) and nonelderly (age 19 to 64 years) patients. The most common reasons for hospitalization were substance-related disorders, which affected 25 percent of the patients, and major depressive disorders, which affected 24.6 percent of the patients. After the effects of Medicare's prospective payment system were disregarded, the average cost of treating elderly persons for depression was calculated to be around 80 percent higher than national estimates.

Adult↗
PubMed1991

Evaluation of a Maryland fiscal incentive plan for placing state hospital patients in nursing homes.

In Maryland a six-month fiscal incentive to promote nursing homes' acceptance of chronic patients discharged from state psychiatric hospitals was evaluated after one year. During the fiscal year of the incentive program, such placements (N = 182) increased an average of 38 percent from previous years. Of 163 patients whose placements were evaluated, 22 were returned to the state hospital during the six-month period that the incentive was in place. Ten of the 22 were returned within 30 days of placement. Contrary to expectation, the return rate did not rise after the incentive was discontinued; four patients were returned during the second six months of the study period. Most returns during the first six months were due to patients' physical and verbal threats. The results supported the use of short-term fiscal incentives and emphasized the importance of intensive supportive interventions with chronic mentally ill patients early in the nursing home placement.

Aged↗
PubMed1992

A system for patients' rights advocacy in state psychiatric inpatient facilities in Maryland.

A patients' rights advocacy system was developed in 1986 by the Maryland Department of Health and Mental Hygiene to serve patients hospitalized in 12 state facilities. The system includes a four-level appeal program that attempts to resolve grievances through mediation between patients and state staff and a legal assistance program operated by attorneys under state contract. Data from fiscal year 1990 indicate that issues related to treatment, to seclusion and restraint, and to admission, discharge, and transfer generated the most complaints. The majority of complaints were resolved without legal intervention at the first stage of the appeal program, usually in a meeting between a rights adviser, the patient, and the patient's primary physician.

Commitment of Persons with Psychiatric Disorders↗
PubMed2006

Understanding and informing policy implementation: a case study of the domestic violence provisions of the Maryland Gun Violence Act.

The Maryland Gun Violence Act, enacted into law in 1996, explicitly authorized courts to order batterers to surrender their firearms through civil protective orders. It also vested law enforcement with the explicit authority to remove guns when responding to a domestic violence complaint. In order to assess how these laws were implemented, we designed a case study and collected data from in-depth, key informant interviews, court observations, and relevant documents. We present findings from this study and recommend how to increase the likelihood that policies designed to separate batterers and guns are implemented in a way that will result in greater protections for victims of domestic violence.

Criminal Law↗
PubMed1996

Nasopharyngeal radium irradiation: the Washington County, Maryland, study.

Although there have been many studies of cancer risk associated with a variety of x-ray treatments for benign conditions of the head and neck, little is known about the possible long-term health consequences of nasopharyngeal radium irradiation. This treatment results in minimal radiation exposure to the thyroid gland, which is the focus of much of the research regarding other head and neck irradiation. With nasopharyngeal radiation, on the other hand, exposure to the pituitary gland and the nasopharynx in the area immediately adjacent to the application site may have been substantial. In 1975 a follow-up study was undertaken in Washington County, Maryland, of 2925 persons who were treated at the Health Department's Clinic for the Prevention of Deafness in Children between 1943 and 1960. Of these, 904 persons had been treated with nasopharyngeal radium. After an average of 24 years of follow-up, an excess risk from brain cancer was suggested on the basis of three cases of cancer occurring in the treated group and none occurring in those who were not treated. This finding could have resulted by chance. Other results were consistent with a potential pituitary effect of radiation, but interpretation is limited by the absence of clinical and laboratory data. The history of the study is reported along with an overview of study methods and results.

Adult↗
PubMed1996

A follow-up study of childhood nasopharyngeal radium irradiation in Washington County, Maryland.

In 1978 an epidemiologic study exploring the health consequences of nasopharyngeal radium irradiation among individuals treated for adenoid enlargement in Washington County, Maryland, found an excess risk of brain tumors and a deficit of female breast cancers. The study population included all persons first seen at the Washington County Clinic for the Prevention of Deafness in Children from 1940 to January 1, 1960. We will continue the follow-up of irradiated and nonirradiated patients to (1) assess the risk of brain tumors and other neoplasms of the head and neck developing during a 40-year period, (2) assess hormone-related disorders resulting from irradiation of the pituitary gland, and (3) compare cancer incidence and mortality rates among exposed and nonexposed groups. Of the 2135 persons eligible for this study, 93.5% have been traced, and 90% have replied to a mailed questionnaire that elicits information on demographic characteristics, reproductive and medical history, infertility, and other sources of radiation exposure. Information on cancer incidence and mortality is being obtained from the Washington County Cancer Registry and death certificate files from Washington County and the Social Security Administration. Statistical methods to be used in the data analysis include standardized mortality ratios, standardized cancer incidence ratios, and Kaplan-Meier survival analysis.

Brain Neoplasms↗
PubMed2003

Adolescent pregnancy and homicide: findings from the Maryland Office of the Chief Medical Examiner, 1994-1998.

Homicide has remained the third leading cause of death among girls aged 10 to 19 for more than a decade. Recent research indicates that pregnant or postpartum teens are three times more likely to be victims of homicide compared to their nonpregnant counterparts. These findings portray a compelling picture that leads the authors to investigate the relationship between homicide and pregnancy among teens in Maryland. The purpose of this study is to compare women whose deaths had been evaluated by the medical examiner and who had evidence of pregnancy to women without evidence of pregnancy, with a particular focus on adolescents; 329 (17.7%) adults and 66 (32.7%) adolescents were victims of homicide. Adolescent homicide victims were 3.7 (1.2 to 11.8) times more likely to be pregnant compared to adult homicide victims. The rate of homicide was nearly double in all women who were pregnant. Further research is necessary to evaluate factors associated with these risks so that the future generation and society are protected.

Adolescent↗
PubMed2000

Uses of process evaluation in the Maryland WIC 5-a-day promotion program.

Using a crossover design, the authors conducted a 6-month intervention program aimed at increasing fruit and vegetable consumption among women served by the Women, Infants, and Children program in Baltimore City and six Maryland counties. The theoretical framework for the interventions was the Transtheoretical Model of Change. At 2 months postintervention, mean daily consumption had increased significantly more in intervention participants than in control participants. Extensive process evaluation data were collected to assess the quantity and quality of program services delivered. These included participant nutrition session evaluation forms and attendance logs, focus groups of attenders and nonattenders of sessions, information about peer educators, and postintervention surveys. Many lessons were learned about program delivery, factors affecting attendance, and the obstacles to dietary change. Strategies to increase participants' consumption of fruits and vegetables were modified based on these lessons and the process evaluations.

Adolescent↗
PubMed2006

Disparities in colon cancer presentation and in-hospital mortality in Maryland: a ten-year review.

BACKGROUND: Much attention has focused on in-hospital treatment disparities in colon cancer outcomes. Little is known about the effect of prehospital factors on outcomes. We hypothesized that racial and socioeconomic disparities exist in the presentation of colon cancer and that these disparities affect in-hospital outcomes. METHODS: Ten-year data on colon cancer patients were obtained from the Maryland Hospital Discharge Database. Life-threatening symptoms at presentation served as a proxy for delay in diagnosis. Patients with the primary diagnosis of colon cancer treated with surgical resection were included. Outcomes of interest were obstruction, hemorrhage, perforation, and in-hospital mortality. RESULTS: A total of 14,291 patients had primary colon cancer, and 13,031 underwent resection. Among this group, 52% were male, 22% were African American (AA), and mean age of AA was 66.0 years versus non-AA mean age of 70.5 years (P < .001). Overall, 27.6% of patients presented with life-threatening symptoms. In-hospital mortality rate was 3.8%. Symptomatic patients had a 2-fold higher rate of in-hospital mortality (odds ratio [OR], 6.06 vs. 2.89, P < .001). Multivariate analysis demonstrated that AA were more likely to have life-threatening symptoms at presentation independent of socioeconomic status (SES) (OR, 1.36). In addition, AA had a higher in-hospital mortality, both overall (OR, 1.39) and in the higher SES (OR, 1.81). CONCLUSIONS: Racial disparities exist in the rate of presentation with life-threatening symptoms that may be a proxy for a delay in diagnosis. These findings were independent of SES, implying that factors beyond health care access may account for poorer outcomes among AA.

Black or African American↗
PubMed2001

Cohort studies of health effects among people exposed to estuarine waters: North Carolina, Virginia, and Maryland.

A variety of human symptoms have been associated with exposure to the dinoflagellate Pfiesteria and have been grouped together into a syndrome termed "possible estuary-associated syndrome." Prospective cohort studies of health effects associated with exposure to estuarine waters that may contain Pfiesteria spp. and related organisms are in progress in North Carolina, Virginia, and Maryland. The three studies recruited cohorts of 118-238 subjects who work or engaged in recreation in estuary waters. Baseline health and neuropsychological evaluations are conducted, and study subjects are followed prospectively for 2-5 years with periodic assessments of health and performance on a battery of neuropsychological tests. Health symptoms and estuary water exposure are recorded by telephone interviews or diaries every 1-2 weeks. Water quality information, including measurements of Pfiesteria spp., is collected in the areas where the subjects are working. Because it is not possible to measure individual exposure to Pfiesteria or a toxin produced by this organism, these studies examine surrogate exposure measures (e.g., time spent in estuary waters, in a fish kill area, or in waters where Pfiesteria DNA was detected by molecular amplification). Preliminary analyses of the first 2 years (1998-2000) of data indicate that none of the three ongoing cohorts have detected adverse health effects. However, there have not been any reported fish kills associated with Pfiesteria since the studies began, so it is possible that none of the study subjects have been exposed to toxin-producing Pfiesteria spp.

Animals↗
PubMed2002

Analysis of aggregate exposure to chlorpyrifos in the NHEXAS-Maryland investigation.

As part of the National Human Exposure Assessment Survey (NHEXAS) in Maryland, we collected indoor air, carpet dust, exterior soil, and duplicate diet samples from a stratified random sample of 80 individuals to evaluate aggregate daily exposure, contributions of specific pathways of exposure, and temporal variation in exposure to chlorpyrifos. We collected samples from each participant in up to six equally spaced sampling cycles over a year and analyzed them for chlorpyrifos. We used chlorpyrifos concentrations in each medium and self-reported rates of time spent inside at home, time and frequency of contact with carpet, frequency of contact with soil, and weights of the duplicate diet samples to derive exposure to chlorpyrifos from each medium as well as average daily aggregate exposure (nanograms per day). The mean aggregate daily exposure to chlorpyrifos of 36 measurements obtained from 31 people was 1,390 ng/day (SD, 2,770 ng/day). Exposure from inhalation of indoor air accounted for 84.7% of aggregate daily exposure to chlorpyrifos on average. Chlorpyrifos concentrations in indoor air and carpet dust and the corresponding exposure rates were significantly correlated. Repeated short-term measurements of chlorpyrifos in carpet dust from individual residences were strongly correlated over time (reliability coefficient, R = 0.90), whereas the short-term measurements of chlorpyrifos in indoor air (R = 0.55) and solid food (R = 0.03) had moderate to weak reliability. Exposure to chlorpyrifos through those media and in aggregate based on direct measurements reported in this study can be used to understand better the accuracy of pesticide safety assessments.

Activities of Daily Living↗
PubMed1991

Epizootiology and distribution of transmissible sarcoma in Maryland softshell clams, Mya arenaria, 1984-1988.

Seasonal and geographic studies of transmissible sarcoma in Maryland softshell clams, Mya arenaria, were carried out from 1984 to 1988. Three major epizootics occurred in our sampling location during this time, resulting in prevalences as high as 90%, with comparable mortalities in other high prevalence areas. The disease invaded populations of large adult clams first, later spreading to the small juvenile clam populations. An apparent 2-year cycle was noted with varying seasonal effects. Affected sites tended to be in the main stem of Chesapeake Bay north of Tangier Sound, primarily in the areas where the major harvesting occurs. Several sites, mostly in upstream locations, were consistently free of disease. The epizootiological study supports the interpretation that the disease is infectious exclusively to this species. Regression analysis between sarcoma prevalence and contaminant levels in clam tissues showed a significant correlation (p = 0.0001) between chlordane levels and this disease. No correlations were found with other contaminants that were analyzed.

Animals↗