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PubMed1978

An investigation of the use of asbestos cement pipe for public water supply and the incidence of gastrointestinal cancer in Connecticut, 1935-1973.

The age adjusted sex specific incidence data for stomach, colon, and rectal cancer for Connecticut townships for the period 1935 to 1973 were used to investigate whether asbestos cement pipe usage for domestic drinking water is associated with gastrointestinal cancer. The townships were grouped according to the Assessment of Exposure (AOE) and Risk Factor (RF) for asbestos. These are composite indices of asbestos exposure including factors relating to the age of the pipe, the ability of water to leach asbestos from the pipe, and the length of pipes used by the population. No association was noted between these asbestos risk scores and gastrointestinal tumor incidence.

Asbestos↗
PubMed1980

Thyroid cancer in Connecticut, 1935-1975: an analysis by cell type.

Incidence data from the Connecticut Tumor Registry for the years 1935-1975 were examined for changing patterns in the rates of thyroid cancer and its four major cell types. Both males and females exhibited a 5-fold increase in age-adjusted thyroid cancer rates over the 41 years, with a nearly constant female:male ratio of 3:1. Papillary and follicular carcinomas were the cell types responsible for the upward trend. Birth cohort analysis revealed cohort effects, especially for females with papillary carcinoma. Age-specific incidence curves for the cohorts born after 1910 showed progressive increases in slope until the 1960 cohort, when the slope decreased. This pattern coincides with the widespread use of radiation therapy for benign conditions of the head and neck among children and adolescents from the early 1920s to the late 1950s. Fitting a logistic model to these data produced relative risks for successive birth cohorts which were consistent with the effects of radiation exposure.

Adenocarcinoma↗
PubMed1983

Coffee drinking and bladder cancer in Connecticut.

The association between coffee consumption and bladder cancer is investigated in a population-based case-control study carried out in Connecticut during 1978-1979. Measures of coffee consumption employed include total weekly cups, years of consumption, and more than seven cups per week, in addition to use frequencies of specific coffee types. After adjustment for age and cigarette smoking, a significant elevation in risk for consuming more than seven cups weekly was found for males (odds ratio = 1.5) but not for females (odds ratio = 1.0); there was also some evidence of a dose-response relationship in males. Among nonsmokers of both sexes combined, the odds ratio for more than seven cups per week was 1.9. Male smokers showed age- and smoking-adjusted odds ratios for coffee similar to those of male nonsmokers. Female smokers had a decreased risk for bladder cancer associated with increased coffee consumption which reflects the substantially lowered risk among older (65 years and over) smoking women who may constitute a selected resistant group; odds ratios among younger female smokers were close to 1.0. Males also showed elevated risks associated with consumption of regular (non-decaffeinated) and ground (noninstant) coffees. No relationship with duration of consumption was found.

Adult↗
PubMed1986

The relationship of cancer incidence to terrestrial radiation and population density in Connecticut, 1935-1974.

The relationship of cancer incidence to terrestrial radiation and population density was investigated. Cancer incidence was obtained using 40 years of age-standardized data from the Connecticut Tumor Registry, and environmental radiation was estimated using data from an airborne gamma radiation survey of the entire state. These variables were examined ecologically, using the 169 towns of the state as the analytic units in a weighted regression analysis. The study design involves a large population base in a state having relatively high terrestrial radiation exposure levels overall and reasonable variation in exposure between towns. For all cancer combined, only one of the eight sex-specific analyses by decade yielded a significant radiation regression coefficient, and this was negative. In the sex- and site-specific analyses, almost all the coefficients for radiation were not significantly different from zero. In contrast, significant positive relationships of cancer incidence with population density were found for all cancer, for cancer of the lung for both sexes, for stomach, colonic, and prostatic cancer for males, and for lymphomas, thyroid, breast, and ovarian cancer for females. Both the radiation and population density relationships were adjusted for socioeconomic status. Socioeconomic status was significantly negatively associated with stomach and lung cancer in males and with cervical cancer in females; it was also positively associated with lymphomas and breast cancer in females. A power calculation revealed that, despite the relatively large size of this study, there was only a small probability of detecting a radiation effect of the strength anticipated from previous estimates.

Air Pollution, Radioactive↗
PubMed1986

Occupational risk factors for laryngeal carcinoma: Connecticut, 1975-1980.

A case-control study of possible occupational risk factors for laryngeal carcinoma in white males in the New Haven, Connecticut, area included 92 cases diagnosed between 1975 and 1980 and 181 hospital controls individually matched to the cases on age, year and hospital of admission, county of residence, smoking status (current vs. ex-smoker), and type of tobacco used at the time of admission. Only cases and controls who were alive at the time of the study were included. With the effects of tobacco and alcohol controlled in a conditional linear logistic model, elevated odds ratios were found for men who had ever worked in rubber products manufacturing or transportation equipment manufacturing other than shipbuilding, and for men who had ever been machinists, bartenders, farmers, masons, or metal grinders. However, only one occupation, machinists, had a statistically significant odds ratio (2.5, 95% confidence interval = 1.2-5.2) in these multivariate analyses. Asbestos and nickel were not found to be risk factors for laryngeal carcinoma. Amount of tobacco smoked and alcohol consumed were positively associated with risk for laryngeal cancer.

Aged↗
PubMed1990

Self-evaluated health and mortality among the elderly in New Haven, Connecticut, and Iowa and Washington counties, Iowa, 1982-1986.

The ability of global self-evaluations of health to predict survival in follow-up studies is tested in two samples of elderly, noninstitutionalized adults. Data from the Yale Health and Aging Project, New Haven, Connecticut (n = 2,812), and the 65+ Rural Health Study, Iowa and Washington counties, Iowa (n = 3,673), were used to investigate the association between 1982 self-evaluated global health status (excellent, good, fair, poor) and survivorship from 1982 to 1986. Despite extensive controls for physical health status in the form of measures of disabilities and chronic conditions, sociodemographic characteristics, and health risk behaviors at the beginning of the follow-up period, and the use of analytic techniques which take into account the stratified sample design of the New Haven data, poor self-perceptions of health significantly increase the risk of mortality. Adjusted odds ratios for the extreme categories ("poor" as compared with "excellent") for New Haven men and women were 5.33 (95% confidence interval (CI) 1.93-14.75) and 2.99 (95% CI 1.30-6.91), respectively; for Iowa men and women they were 4.84 (95% CI 2.22-10.57) and 3.16 (95% CI 1.49-6.71). Respondents reporting "fair" and "good" health also show elevated risks of mortality in dose-response fashion. Self-perceptions of health status appear to be a factor of unique prospective significance in mortality studies.

Activities of Daily Living↗
PubMed2002

Antipsychotic prescribing practices in Connecticut's public mental health system: rates of changing medications and prescribing styles.

We characterized prescribing in Connecticut's State public mental health system to assess the feasibility of implementing an evidence-based medication algorithm. Medication records for a random sample of outpatients with diagnoses of schizophrenia spectrum disorders showed prescribing patterns similar to the entire United States. The base rate of changing antipsychotic medications was moderate. Over half of patients received decanoate medications, polypharmacy was nontrivial, and there was variability in prescribing patterns across physicians. Caucasian patients were more likely to receive an atypical antipsychotic and less likely to have a decanoate medication, and Latino patients were less likely to change medications. Because the base rate of changing medications was moderate and a considerable proportion of patients were prescribed newer antipsychotic medications, introducing a research-derived medication algorithm with newer atypical antipsychotics as first line agents may fit well with current practice. Further, implementing such an algorithm may reduce racial and ethnic disparities in prescribing patterns.

Adult↗
PubMed1987

Adenoid cystic carcinoma of the breast. Data from the Connecticut Tumor Registry and a review of the literature.

The case records of the Connecticut Tumor Registry were reviewed from 1952-1982. There were 37 cases of adenoid cystic carcinoma of the breast (ACC) from a total of 40,350 invasive breast tumors. Patient survival, complications, and pathologic sections were reviewed. Only 14 of 27 surgical pathology slides available for review could be confirmed histologically as ACC. All patients were white females with a mean age of 64 years. The tumor remained localized to the breast in all cases. Nine patients had either radical or modified radical mastectomy, four patients had either simple mastectomy or lumpectomy, and one patient refused treatment. There was no evidence of axillary node involvement, metastases, or local recurrence after excision. At the time of follow-up, nine patients were alive and disease free and four died of disease unrelated to their breast cancer. The one patient who died of breast cancer had a radical mastectomy and survived 11.7 years after diagnosis. It is concluded that ACC has a favorable biologic behavior characterized by a prolonged clinical course and good prognosis. Simple mastectomy is all that is required as initial treatment, and a chest x-ray and thorough physical examination looking for local recurrence is all that is needed for follow-up.

Aged↗
PubMed1994

Cohort-specific risks of developing breast cancer to age 85 in Connecticut.

Previous estimates of the lifetime risk of developing breast cancer have used cross-sectional estimates of incidence. Cross-sectional rates, however, yield a biased picture of cohort risks when rates are unstable, as breast cancer trends have been. We developed cohort life tables for Connecticut women born from 1888-1892 to 1948-1952 to generate more specific estimates of breast cancer risk to age 85. Multiple decrement life tables were produced for each birth cohort. We included as cases only the first reports of breast cancer in women with no earlier malignancy. Our results indicate that widely circulated lifetime risks of 1 in 9 may be inflated slightly owing to changing incidence. We estimate that of those women 40-44 years old in 1992, 1 woman in 10 will develop breast cancer by age 85. For women born between 1928 and 1932, 1 in 13 will be diagnosed with breast cancer by age 85. The results are insensitive to mortality trends in the past. Errors in the estimates are more likely to arise from changes in incidence and mortality in the future.

Adult↗
PubMed1976

United States foreign medical graduates in Connecticut: how they compare with foreign medical graduates.

This study contrasts the graduate training and subsequent careers of a cohort of United States-born foreign medical graduates (USFMGs) and foreign medical graduates (FMGs) who were in training positions in Connecticut in 1964 and who were located in 1971. The data suggest that although USFMGs were foreign-educated, they had certain advantages--both cultural and administrative--in hospital training positions which helped them to pursue different career alternatives than FMGs. However, the data further suggest that they retained characteristics of their foreign training which continued to differentiate them from United States medical graduates (USMGs).

Age Factors↗
PubMed1987

Case mix of public patients in skilled nursing facilities in Connecticut.

The case mix of publicly funded residents in 73 skilled nursing facilities (SNFs) in two Connecticut counties was examined. Data collected in 1980-1981 for utilization review by a professional standards review organization were used for the analysis. The findings indicate that considerable variation exists in case mix across the SNFs. Medicaid per diem rates, which are based on historic costs, have a low and negative correlation with case mix. Case mix indices are significantly higher for rural facilities, with a for-profit type of ownership, and with less than 75% of the bed days devoted to Medicaid residents.

Connecticut↗
PubMed2002

Antibodies to granulocytic ehrlichiae in cattle from Connecticut.

Enzyme-linked immunosorbent assays (ELISA) with a purified recombinant 44-kDa protein and indirect fluorescent antibody (IFA) staining methods incorporating whole-cell antigens of the human granulocytic ehrlichiosis (HGE) agent were used to detect antibodies to Ehrlichia phagocytophila genogroup organisms in cattle sera. The cattle lived in tick-infested areas of Connecticut, USA and were healthy at the times blood samples were collected in 1990, 1999 and 2000. Of the 339 serum samples analysed, 40 (12%) and 15 (4%) were positive by ELISA and IFA, respectively. Western immunoblots of a subset of sera verified antibody reactivity of six serum samples, positive by ELISA with titres of 640-2,560, to a protein with a molecular mass of c. 44 kDa. Although seroprevalence rates were low, cattle were exposed to the HGE agent at different sites and should be monitored for anaemia, leukopenia or thrombocytopenia, especially if there is evidence of unexplained decreased milk production. Different serological testing methods should be used to detect immunoglobulins.

Animals↗
PubMed2005

Connecticut's new comprehensive and universal early childhood health assessment form.

Health assessments are required for entrance into child care, Head Start, and preschool programs. However, state and federal screening and documentation mandates vary, and programs create their own forms for keeping required data on file. Inconsistent recording formats present challenges for primary care providers who must document each child's health status and for program administrators who wish to collect data across groups of children. This article describes how the passage of new legislation in Connecticut establishing a statewide prekindergarten program presented the opportunity to develop a comprehensive early childhood health form for all early childhood programs, which promotes children's access to health services and coordination of care among health care professionals, early childhood providers, and families.

Child Day Care Centers↗
PubMed2001

West Nile virus serosurvey and assessment of personal prevention efforts in an area with intense epizootic activity: Connecticut, 2000.

West Nile virus (WNV) can cause large outbreaks of febrile illness and severe neurologic disease. This study estimates the seroprevalence of WNV infection and assesses risk perception and practices regarding potential exposures to mosquitoes of persons in an area with intense epizootics in 1999 and 2000. A serosurvey of persons aged > or = 12 years was conducted in southwestern Connecticut during October 10-15, 2000, using household-based stratified cluster sampling. Participants completed a questionnaire regarding concern for and personal measures taken with respect to WNV and provided a blood sample for WNV testing. Seven hundred thirty persons from 645 households participated. No person tested positive for WNV (95% CI: 0-0.5%). Overall, 44% of persons used mosquito repellent, 56% practiced > or = two personal precautions to avoid mosquitoes, and 61% of households did > or = two mosquito-source reduction activities. In multivariate analyses, using mosquito repellent was associated with age < 50 years, using English as the primary language in the home, being worried about WNV, being a little worried about pesticides, and finding mosquitoes frequently in the home (P<0.05). Females (OR = 2.0; CI = 1.2-2.9) and persons very worried about WNV (OR = 3.8; CI = 2.2-6.5) were more likely to practice > or = two personal precautions. Taking > or = two mosquito source reductions was associated with persons with English as the primary language (OR = 2.0; CI = 1.1-3.5) and finding a dead bird on the property (OR = 1.8; CI = 1.1-2.8). An intense epizootic can occur in an area without having a high risk for infection to humans. A better understanding of why certain people do not take personal protective measures, especially among those aged > or = 50 years and those whose primary language is not English, might be needed if educational campaigns are to prevent future WNV outbreaks.

Adolescent↗
PubMed1962

Zinc-65 levels in oysters in the Thames River (Connecticut).

Levels of zinc-65 in oysters from selected sites in the Thames River (Connecticut) have been determined for a 12-month period. The highest levels of radioactivity were in oysters from a bed situated opposite the United States submarine base in March 1961 (1637 micro-microcuries per kilogram of moist tissue). None of the samples assayed showed sufficient amounts of radioactivity to represent a health hazard.

Animals↗
PubMed1980

Seroepidemiology of clinical isolates of Klebsiella in Connecticut.

The distribution of capsular serotypes of 200 clinical isolates of Klebsiella pneumoniae and Klebsiella oxytoca from four Connecticut hospitals was determined. Serotyping was done by an indirect fluorescent-antibody technique. Hospitals included three community hospitals from the Hartford area and one university hospital in New Haven. During the test period, epidemiological surveillance did not detect any nosocomial epidemic involving Klebsiella species. Ninety-two percent of the isolates were typable. Of the 72 possible serotypes, 62 were represented among these strains. Forty-two percent of the typable strains were distributed among 10 serotypes. The predominant serotypes were types 31, 22, and 18 representing 19% of the typable strains (8, 6, and 5%, respectively). No one particular serotype was associated exclusively with a specific site of infection.

Blood↗
PubMed1990

Canine ehrlichiosis in Connecticut.

The first case of canine ehrlichiosis in Connecticut is reported. A female Brittany spaniel from Milford presented with lethargy, anorexia, fever, petechiae, splenomegaly, thrombocytopenia, anemia, elevated serum alkaline phosphatase, lymphopenia, and hypoalbuminemia. Serologic analysis revealed antibodies to Ehrlichia canis (titer, 1:2,560). This documents a more northern geographic distribution in the United States for this infectious agent than had previously been suspected.

Animals↗
PubMed1991

Spotted fever group rickettsiae or Borrelia burgdorferi in Ixodes cookei (Ixodidae) in Connecticut.

Immatures and females of Ixodes cookei, a hard-bodied tick, were collected from woodchucks and other mammals in the northeastern United States and examined for spotted fever group rickettsiae and Borrelia burgdorferi. Of the 93 nymphs analyzed by a hemolymph test, 4 (4.3%) harbored rickettsiae. Six (15%) of 40 females were also infected. All infected ticks were collected from woodchucks in Connecticut. Indirect fluorescent antibody staining of midgut tissues from 128 nymphs revealed B. burgdorferi in two (1.6%) ticks, whereas larval and female ticks were negative. Further consideration should be given to I. cookei as a possible vector of spotted fever group rickettsiae or spirochetes that cause Lyme borreliosis.

Animals↗