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PubMed1996

People with AIDS as residents: preparedness and acceptance by Connecticut long-term care facilities.

The management of AIDS has become an issue of chronic care as well as acute treatment. As the number of people with AIDS increases, the demand for ongoing care and support, both informal and formal, is expected to increase. The present study is based on a survey of all licensed nursing homes in the state of Connecticut with respect to prevailing attitudes toward the admission of residents with AIDS, and the level of staff, resident and procedural preparedness that exists. Both positive attitudes among the various LTC constituent groups as well as the level of preparation in a number of areas are correlated with the admission of residents with AIDS. Implications are discussed and recommendations are offered for policy development.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Childhood injuries in Connecticut's Medicaid managed care program.

This study describes childhood injuries and injury-related care using encounter data from a Medicaid managed care program. Enrollment and encounter data for federal fiscal year 2000 were used to identify children who received treatment for an injury, to identify risk factors, and to describe injury-related care. Twenty percent of children were treated for an injury. Preschool-age children and adolescents, males, whites, and residents of nonurban areas were at greatest risk. Sixty percent of injured children received emergency care or were hospitalized. Length of hospital stay for treatment of injuries was 33 percent longer than admissions for other conditions. E-codes were rarely reported. One of five children in Connecticut's Medicaid managed care program was treated for an injury in a one-year period. Medicaid managed care data can be used to determine the percentage of children who experience injuries, to identify risk factors, and to describe injury-related care.

Adolescent↗
PubMed2001

Poverty, comorbidity, and survival of colorectal cancer patients diagnosed in Connecticut.

Studies have reported reduced survival rates for colorectal cancer patients in lower socioeconomic status categories, but this finding could be due (at least in part) to higher comorbidity. This study involved 1,219 patients diagnosed with invasive colorectal cancer in 1992 who were reported to the population-based Connecticut Tumor Registry and followed to their death or through the end of 1997. Risk of death was elevated for patients living in census tracts in the highest quintile for poverty rate, independent of comorbidity (as recorded in a hospital discharge database), age, and stage at diagnosis. Patients living in census tracts with a poverty rate of 20 percent or higher had the highest risk of death. The explanation for these findings requires further study, in order to reduce socioeconomic status disparities in survival rates.

Aged↗
PubMed1985

Household production of alcoholic beverages in early eighteenth-century Connecticut.

In light of the recent controversy concerning the applicability of the household economy model to early American history, this study examines the case of alcoholic beverages produced in the households of early-eighteenth-century Connecticut. All probate inventories from Hartford, New London and Fairfield counties for 1700, 1710, 1720, 1730 and 1740 (a total of 274 inventories) were examined with a checklist of items (e.g., hops, malt, cider presses and stills) crucial to the production of alcoholic beverages during that period. The presence of these beverages themselves was also noted. Of the inventories read, 133 (49%) suggested that beverage making took place in the household. The three counties sampled showed surprisingly little deviation in the percentages of inventories suggesting alcohol production and in the preferences for specific types of drinks. Of all inventories bearing references to alcohol production, beer brewing was indicated in 83% and cider in only 55%--despite the traditional opinion of cider's predominance. The independence of cider entries from the seasonal bias of the inventories was also demonstrated. These findings, insofar as they show the pervasiveness of alcohol production within the households inventoried, thus argue strongly for the validity of the household economy model. Some implications of this model for alcohol studies are also discussed.

Alcoholic Beverages↗
PubMed2001

Hemolytic-Uremic Syndrome and Escherichia coli O121 at a Lake in Connecticut, 1999.

OBJECTIVE: Non-O157 Shiga toxin-producing Escherichia coli (STEC) have emerged as an important public health problem. Outbreaks attributed to non-O157 STEC rarely are reported. In 1999, follow-up of routine surveillance reports of children with hemolytic- uremic syndrome (HUS) identified a small cluster of 3 cases of HUS, all of whom had spent overlapping time in a Connecticut lake community in the week before onset of symptoms. We conducted an investigation to determine the magnitude and source of the outbreak and to determine risk factors associated with the transmission of illness. METHODS: We conducted a cohort study and an environmental investigation. The study population included all people who were at the lake in a defined geographic area during July 16-25, 1999. This time and area were chosen on the basis of interviews with the 3 HUS case-patients. A case was defined as diarrhea (>/=3 loose stools/d for >/=3 days) in a person who was at the lake during July 16-25, 1999. Stool samples were requested from any lake resident with diarrheal illness. Stools were cultured for Salmonella, Shigella, Campylobacter, and E coli O157. Broth cultures of stools were tested for Shiga toxin. Case-patients were asked to submit a serum specimen for antibody testing to lipopolysaccharides of selected STEC. Environmental samples from sediment, drinking water, lake water, and ice were obtained and cultured for E coli and tested for Shiga toxin. An environmental evaluation of the lake was conducted to identify any septic, water supply system, or other environmental condition that could be related to the outbreak. RESULTS: Information was obtained for 436 people from 165 (78%) households. Eleven (2.5%) people had illnesses that met the case definition, including the 3 children with HUS. The attack rate was highest among those who were younger than 10 years and who swam in the lake on July 17 or 18 (12%; relative risk [RR]: 7.3). Illness was associated with swimming (RR = 8.3) and with swallowing water while swimming (RR = 7.0) on these days. No person who swam only after July 18 developed illness. Clinical characteristics of case-patients included fever (27%), bloody diarrhea (27%), and severe abdominal cramping (73%). Only the 3 children with HUS required hospitalization. No bacterial pathogen was isolated from the stool of any case-patient. Among lake residents outside the study area, E coli O121:H19 was obtained from a Shiga toxin-producing isolate from a toddler who swam in the lake. Serum was obtained from 7 of 11 case-patients. Six of 7 case-patients had E coli O121 antibody titers that ranged from 1:320 to >1:20 480. E coli indicative of fecal contamination was identified from sediment and water samples taken from a storm drain that emptied into the beach area and from a stream bed located between 2 houses, but no Shiga toxin-producing strain was identified. CONCLUSIONS: Our findings are consistent with a transient local beach contamination in mid-July, probably with E coli O121:H19, which seems to be able to cause severe illness. Without HUS surveillance, this outbreak may have gone undetected by public health officials. This outbreak might have been detected sooner if Shiga toxin screening had been conducted routinely in HUS cases. Laboratory testing that relies solely on the inability of an isolate to ferment sorbitol will miss non-O157 STEC, such as E coli O121. Serologic testing can be used as an adjunct in the diagnosis of STEC infections. Lake-specific recommendations included education, frequent water sampling, and alternative means for toddlers to use lake facilities.

Adolescent↗
PubMed2001

Management of tick bites and early Lyme disease: a survey of Connecticut physicians.

Practice guidelines have been published for the treatment of Lyme disease (LD). These guidelines have been challenged as inadequate. Two common LD management problems are antibiotic prophylaxis of deer tick bites (deer ticks may carry Borrelia burgdorferi, the spirochete that causes LD) and antibiotic treatment of erythema migrans, the pathognomonic rash of LD. A 1-page questionnaire was sent to a 13% (573/4300) sample of Connecticut physicians to define how they treat deer tick bites and erythema migrans. Questionnaires were returned by 320 (56%) of 573 physicians. Questionnaires were analyzed for the 267 physicians who saw patients with LD. Seventy (26%) of the 267 surveyed physicians prescribed antibiotic prophylaxis for patients with tick bites. B burgdorferi serology was ordered by 31% of physicians for patients with tick bites. Most surveyed physicians treated erythema migrans with doxycycline or amoxicillin for a mean of 21 days. Serology was ordered by 49% of physicians for patients with erythema migrans. Most physicians did not use prophylaxis for patients with deer tick bites. In addition, most of the physicians surveyed followed established guidelines for treating patients with erythema migrans. However, many of the physicians surveyed do serologic testing for patients with tick bites and/or erythema migrans. Serologic testing for these patients is usually not necessary.

Amoxicillin↗
PubMed2006

Acculturation, socioeconomic status, obesity and lifestyle factors among low-income Puerto Rican women in Connecticut, U.S., 1998-1999.

OBJECTIVES: To examine the associations of socioeconomic status and acculturation with obesity and lifestyle characteristics that may be risk factors for diabetes and cardiovascular disease among low-income Puerto Rican women. METHODS: This cross-sectional study was conducted between 1998 and 1999 by interviewing a convenience sample of 200 low-income Puerto Rican female caretakers of young children in Hartford, Connecticut, United States of America. Various recruitment methods were used to ensure adequate representation of the target community. The associations of obesity (body mass index > or = 30.0) and lifestyle factors (physical activity, cigarette smoking, alcohol consumption, food intake) with socioeconomic status (education, employment, car ownership), acculturation, age, and marital status were examined with Spearman rho, chi-squared, and Mann-Whitney U tests and logistic regression analyses. RESULTS: Mean age was 29 years. Obesity (40%), physical inactivity (47%), and cigarette smoking (32%) were common. Less acculturated participants were 57% less likely to smoke and 54% less likely to be obese than their more acculturated counterparts. Lower socioeconomic status (not finishing high school or not owning a car) was associated with a higher likelihood of obesity, but unemployed (vs. employed) women were less likely to be obese (P < 0.05). Women who did not own a car consumed meat, eggs and fish less often than those who owned a car. Smokers were more likely to have an unhealthy food intake pattern than nonsmokers. CONCLUSIONS: The associations of acculturation and socioeconomic status with some lifestyle characteristics suggest the need for culturally appropriate programs to promote healthy lifestyle behaviors in this low-income community.

Acculturation↗
PubMed2006

West Nile virus from female and male mosquitoes (Diptera: Culicidae) in subterranean, ground, and canopy habitats in Connecticut.

In total, 93,532 female mosquitoes (Diptera: Culicidae) were captured in traps placed in subterranean (catch basin), ground (approximately 1.5 m above ground), and canopy (approximately 7.0 m above ground) habitats in Stamford and Stratford, CT, during 2003-2005. Culex pipiens L. was the most abundant (64.8%) of the 31 species identified. Significantly greater numbers of Cx. pipiens were captured in canopy-placed mosquito magnet experimental traps, and significantly greater numbers were collected in catch basin-placed (Centers for Disease Control) CDC traps than in CDC traps placed elsewhere. Culex restuans Theobald was captured in significantly greater numbers in traps placed in catch basins. Aedes vexans (Meigen), Aedes cinereus Meigen, and Aedes cantator (Coquillett) were significantly more abundant in ground traps. In total, 429 isolations of West Nile virus (WNV) were made from seven species of mosquitoes from late June through the end of October during 2003 through 2005. Three hundred ninety-eight (92.8%) isolates were from Cx. pipiens. Others were from Cx. restuans (n = 16), Culex salinarius Coquillett (n = 5), Ae. vexans (n = 4), Ae. cantator (n = 3), Aedes triseriatus (Say) (n = 2), and Ae. cinereus (n = 1). Multiple isolates from Cx. pipiens were made each week, primarily during the later part of July through the end of September. Weekly minimum infection rates (MIRs) were lower in 2004 (highest weekly MIR = 7.1) when no human cases were reported in Connecticut in comparison with 2003 and 2005 (highest weekly MIR = 83.9) when human cases were documented. Frequencies of infected pools were significantly higher in Cx. pipiens captured in traps in the canopy and significantly higher in catch basin placed traps than in traps at ground level. The physiological age structure of Cx. pipiens captured in the canopy was significantly different from that of Cx. pipiens collected in catch basins. Invariably, Cx. pipiens captured in the canopy were nulliparous or parous with ovaries in Christophers' stage 2, whereas 58.7% of the females captured in catch basins possessed ovaries filled with mature oocytes in Christophers' stage 5. Our results suggest that females in the canopy are seeking hosts, and after digestion of the bloodmeal and development of mature oocytes, they descend to catch basins for shelter and deposition of eggs. WNV was isolated from three, one, and two pools of male Cx. pipiens captured in catch basin-, ground-, and canopy-placed traps, respectively, and from six nulliparous Cx. pipiens females collected in the canopy. Weekly MIR ranged from 1.2 to 31.1 per 1,000 male specimens. These data show that mosquitoes become infected by means other than by blood feeding, possibly by transovarial transmission. The placement of traps in tree canopies and in catch basins can be used to augment current practices of placement of traps near the ground for surveillance of mosquitoes infected with WNV and for studies of the ecology of WNV.

Aedes↗
PubMed1980

The impact of non-physician health directors on full-time public health coverage in Connecticut.

Seven years after passing a 1971 law enabling individuals without MD degrees but trained in public health to become local directors of health, the proportion of Connecticut towns covered by full-time directors had risen from 14 per cent to 38 per cent and the proportion of the population covered had risen from 46 per cent to 63 per cent. The directors of health without MD degrees were satisfied with their positions and believed they had developed good relationships with physicians, the community, and government.

Connecticut↗
PubMed1989

Cigarette and smokeless tobacco use among Connecticut adolescents.

Despite data that the rate of boys' cigarette use has declined nationwide, boys' total tobacco use may actually have remained high because of their substantial use of smokeless tobacco. We surveyed anonymously a random sample of entire classes of grade 7-12 boys and girls from 59 Connecticut towns concerning tobacco use. Despite girls' higher daily cigarette use, boys' total daily tobacco use was higher than that of girls in grades 7-9, and only slightly lower in grades 10-12.

Adolescent↗
PubMed1989

Nulliparity, decade of first birth, and breast cancer in Connecticut cohorts, 1855 to 1945: an ecological study.

Risk of breast cancer increases with age at first birth, and is lower in women who bear their first children while young than in nulliparous women. While previous studies have investigated risk of breast cancer in birth cohorts by examining partial aspects of cohort childbearing, the present ecological study assesses total cohort childbearing risk in Connecticut women born between 1855 and 1945. In each cohort, the proportion of women nulliparous and first bearing children in their twenties, thirties, and forties are weighted by relative risks associated with these events as ascertained in previous studies. Summed cohort childbearing risks are compared to the incidence of breast cancer in women 40 years of age and older in the same cohorts. Changes in decade of first birth and nulliparity do not explain the changes in breast cancer incidence observed: while cohort childbearing risk has declined over the period examined, breast cancer incidence has increased in the same cohorts. Alternative explanations for cohort increases in breast cancer incidence are reviewed.

Breast Neoplasms↗
PubMed1995

Estimating mortality in the Hispanic population of Connecticut, 1990 to 1991.

Among all deaths to Connecticut residents (1990/91), 1260 were acceptable Spanish-surname matches (using father's surname for females), of which only 793 (62.9%) were identified as Hispanic origin on the death certificate. Certificates also identified 127 non-Spanish-surnamed Hispanics. With death rates for non-Hispanics used as the standard, the standardized mortality ratio for Hispanics based on the 920 (793 plus 127) deaths identified by the Hispanic-origin item was lower (by 33% in males and 36% in females) than that based on all 1387 (1260 plus 127) Hispanics. Spanish-surname matching should improve estimation of mortality rates in some Hispanic populations.

Adolescent↗
PubMed1997

Predisposing factors for individuals' Lyme disease prevention practices: Connecticut, Maine, and Montana.

OBJECTIVES: This study examined factors that predispose individuals to protect against Lyme disease. METHODS: Knowledge, attitude, and practice questions concerning Lyme disease prevention were included in the Behavioral Risk Factor Surveillance surveys in Connecticut, Maine, and Montana. A total of 4246 persons were interviewed. RESULTS: Perceived risk of acquiring Lyme disease, knowing anyone with Lyme disease, knowledge about Lyme disease, and believing Lyme disease to be a common problem were significantly associated with prevention practices. CONCLUSIONS: Predisposing factors differ substantially between states and appear related to disease incidence. Personal risk, knowing someone with Lyme disease, and cognizance about Lyme disease and acting on this information are consistent with social learning theories.

Adult↗
PubMed2004

Predictors of help seeking among Connecticut adults after September 11, 2001.

OBJECTIVES: We conducted a population-based telephone survey in an attempt to determine correlates of formal and informal help seeking after September 11, 2001. METHODS: Between October 15 and December 31, 2001, 1774 Connecticut Behavioral Risk Factor Surveillance System respondents were asked questions directly related to their experiences of September 11. RESULTS: Multivariate logistic regression analyses showed that receipt of formal help was predicted by sleep problems, close association with a victim, reports of increased smoking or drinking, and receipt of informal help. Age, gender, reports of 1 or more problems, and formal help seeking predicted receipt of informal help. CONCLUSIONS: Public health planning and bioterrorism preparedness should include programs addressing increased smoking and drinking, sleep problems, and bereavement in the wake of disasters.

Adult↗
PubMedDate not supplied

West Nile virus surveillance in Connecticut in 2000: an intense epizootic without high risk for severe human disease.

In 1999, Connecticut was one of three states in which West Nile (WN) virus actively circulated prior to its recognition. In 2000, prospective surveillance was established, including monitoring bird deaths, testing dead crows, trapping and testing mosquitoes, testing horses and hospitalized humans with neurologic illness, and conducting a human seroprevalence survey. WN virus was first detected in a dead crow found on July 5 in Fairfield County. Ultimately, 1,095 dead crows, 14 mosquito pools, 7 horses, and one mildly symptomatic person were documented with WN virus infection. None of 86 hospitalized persons with neurologic illness (meningitis, encephalitis, Guillain-Barré-like syndrome) and no person in the seroprevalence survey were infected. Spraying in response to positive surveillance findings was minimal. An intense epizootic of WN virus can occur without having an outbreak of severe human disease in the absence of emergency adult mosquito management.

Animals↗
PubMed2002

Anthrax postexposure prophylaxis in postal workers, Connecticut, 2001.

After inhalational anthrax was diagnosed in a Connecticut woman on November 20, 2001, postexposure prophylaxis was recommended for postal workers at the regional mail facility serving the patient's area. Although environmental testing at the facility yielded negative results, subsequent testing confirmed the presence of Bacillus anthracis. We distributed questionnaires to 100 randomly selected postal workers within 20 days of initial prophylaxis. Ninety-four workers obtained antibiotics, 68 of whom started postexposure prophylaxis, and of these, 21 discontinued. Postal workers who never started or stopped taking prophylaxis cited as reasons disbelief regarding anthrax exposure, problems with adverse events, and initial reports of negative cultures. Postal workers with adverse events reported predominant symptoms of gastrointestinal distress and headache. The influence of these concerns on adherence suggests that communication about risks of acquiring anthrax, education about adverse events, and careful management of adverse events are essential elements in increasing adherence.

Adolescent↗
PubMed1977

Host feeding patterns of Connecticut mosquitoes (Diptera: Culicidae).

Blood-engorged Coquillettidia perturbans, Psorophora ferox, Culex, Culiseta, and Aedes mosquitoes were collected principally by sweep net from salt marsh and woodland habitats in Connecticut. Of the 570 mosquitoes tested, precipitin tests identified the origins of 517 blood meals and revealed distinct host feeding patterns. Aedes mosquitoes fed chiefly on mammals; A. abserratus, A. cantator, and A. vexans showed selectivity for cattle and (or) horses. A. cantator also obtained blood from avian hosts and, in some instances, showed mixed passerine-mammal blood meals. These findings increase the vector potential of this salt marsh mosquito for eastern equine encephalomyelitis virus. Feedings on deer by A. abserratus suggest potential involvement of this mosquito in the transmission of certain subtypes of California encephalitis. Culex-pipiens, C. restuans, Culiseta melanura, and Cs. morsitans dyari acquired blood almost exclusively from passeriform birds.

Aedes↗
PubMed1981

Human cases of furuncular, traumatic, and nasal myiasis in Connecticut.

Case histories are reported for four persons who had furuncular, traumatic, and nasal myiasis in Connecticut during 1980. Third-stage Sarcophaga sp. and Musca domestica larvae were removed from sores or wounds, a 2nd-stage Cuterebra sp. larva was dislodged from cutaneous tissue, and 3rd-stage larvae of Phaenicia sericata were extracted from nasal membranes. Human exposure to these facultative or obligate dipteran parasites occurred at residences in urban and suburban settings, including a convalescent home and a hospital. Infestations were asymptomatic in three cases, and following removal of larvae, each person recovered without further complications.

Adult↗