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PubMed1997

Effects of administrative license revocation on employment.

This study addresses the impact of administrative license revocation (ALR) on the employment and income of first and multiple drunk-driving (DUI) offenders. It also inquires into the impact of alcohol-related crashes on the employment of other persons involved in such crashes (i.e. innocent drivers, passengers and pedestrians). Questionnaires were completed by 579 first-time offenders and 233 multiple offenders at alcohol education schools and treatment programs in four counties in four states, which represented varying ALR laws: Chester County, PA (without ALR); Anne Arundel County, MD (ALR with immediate hardship license available); Marin County, CA (30-day hard license suspension); and New Castle County, DE (90-day hard license suspension). Completed crash 'victim' surveys were returned by 146 crash victims from Pennsylvania, California and Delaware. The study found that ALR does not have a major impact on the DUI offender's job and income. Alcohol-involved crashes can have a great impact on seriously injured victims, but the proportion of DUI crashes producing serious injury is quite low. Most DUI is crash-free, and most crashes do not involve injury. The vast bulk of the impact of DUI events falls on the offenders rather than innocent victims.

Alcohol Drinking↗
PubMed1996

Spinal cord injury and bladder recovery.

OBJECTIVE: To investigate whether spinothalamic tract preservation and posterior column sparing are predictors of neurogenic recovery of bladder function after spinal cord injury (SCI). DESIGNS AND PARTICIPANTS: In a retrospective review, the initial perianal pinprick sensation (S4.5 dermatomes) and position sense of the great toes were examined and correlated with bladder function at 1 year after SCI in 19 consecutive spinal cord injured patients (age 18 to 68 years), Frankel A-D, with spinal injury (level C-4-T-12). All patients were admitted to the Regional Spinal Cord Injury Center of Delaware Valley (RSCIDDV) within 72 hours of injury between July 1990 and June 1991 and were available for a 1-year follow-up evaluation. MAIN OUTCOME MEASURES: The correlation of initial perianal pinprick and great toe position sensation with bladder management approximately 1 year after SCI. RESULTS: During the initial 72 hours, 10 of the 19 patients had positive perianal pinprick sensation and 9 did not feel the pin. Eight patients had positive great toe position sense, and 11 had no proprioception. At the 1-year follow-up visit, 7 of the 10 patients with initial preserved perianal pinprick were voiding volitionally, whereas none of the 9 patients who did not have pinprick voided volitionally at 1-year after SCI. Six of the 8 with initial preserved great toe position sense were voiding volitionally at 1 year, but only 1 of the original 11 without initial toe position sense was voiding volitionally. CONCLUSIONS: Both perianal pinprick sensation and toe position sense are sensitive in predicting return of bladder function. Although both tests have positive predictive value, their negative predictive values are much more noteworthy. A patient without initial position sense of the great toes will likely not regain volitional voiding, whereas a patient without initial perianal pinprick sensation will definitely not regain volitional voiding.

Adolescent↗
PubMed2000

Lipoprotein (a) and the risk of ischemic stroke in young women.

BACKGROUND AND PURPOSE: lipoprotein (a) (lp (a)) is a lipid-containing particle similar to LDL which has been found in atherosclerotic plaque. The role of lp (a) in ischemic stroke remains controversial, but some studies suggest lp (a) is particularly important as a risk factor for stroke in young adults. We investigated the role of lp (a) as a risk factor for stroke in young women enrolled in the Stroke Prevention in Young Women Study. METHODS: subjects were participants in a population-based, case-control study of risk factors for ischemic stroke in young women. Cases were derived from surveillance of 59 regional hospitals in the central Maryland, Washington DC, Pennsylvania and Delaware area. Lp (a) was measured in 110 cases and 216 age-matched controls. Demographics, risk factors, and stroke subtype were determined by interview and review of medical records. RESULTS: lp (a) values were higher in blacks than whites, but within racial groups, the distribution of lp (a) values was similar between cases and controls. After adjustment for age, race, hypertension, diabetes, cigarette smoking, coronary artery disease, total cholesterol and HDL cholesterol, the odds ratio for an association of lp (a) and stroke was 1.36 (95% CI 0.80-2.29). There was no dose-response relationship between lp (a) quintile and stroke risk. Among stroke subtypes, only lacunar stroke patients had significantly elevated lp (a) values compared to controls. CONCLUSIONS: we found no association of lp (a) with stroke in a population of young women with ischemic stroke. Small numbers of patients limit conclusions regarding risk in ischemic stroke subtypes, but we could not confirm previous suggestions of an association of lp (a) with atherosclerotic stroke in young adults.

Adolescent↗
PubMed2000

Physical activity and reduced risk of ovarian cancer.

OBJECTIVE: To examine the relation between leisure-time physical activity and ovarian cancer. METHODS: We used data from a population based case-control study. Cases (n = 767) were women 20-69 years of age in whom epithelial ovarian cancer was diagnosed during 1994-1998 and who resided in a defined region of Pennsylvania, New Jersey, or Delaware. Controls (n = 1367) were ascertained by using random-digit dialing and Health Care Financing Administration files and were frequency-matched to cases for age and county of residence. Information on lifetime leisure-time physical activity was obtained during in-person interviews. RESULTS: Leisure-time physical activity was significantly associated with reduced occurrence of ovarian cancer (P =.01). After adjustment for age, parity, oral contraceptive use, tubal ligation, family history of ovarian cancer, race, and body mass index, women with the highest level of activity had an odds ratio of 0.73 (95% CI 0.56, 0.94) for ovarian cancer compared with women with the lowest level of activity. When the relation was analyzed by various recalled time periods during life, the odds ratios for the highest versus the lowest category of activity at ages 14-17, 18-21, 22-29, 30-39, 40-49, and >50 years ranged from 0.64-0.78. CONCLUSION: Leisure-time physical activity is associated with reduced occurrence of epithelial ovarian cancer.

Adolescent↗
PubMed1994

Specific transfer of 3H from D-[3-3H]gluconic acid into L-tartaric acid in vitaceous plants.

Transfer of 3H from D-gluconic acid, specifically labelled with 3H at C-2 or C-3 and 14C at C-1, C-2, or C-3, 4, to L(+)-tartaric acid was examined in leaves and berries of Vitis labrusca cv Delaware and in leaves of Parthenocissus quinquefolia. 3H located at C-3 of D-gluconic acid was highly conserved in this transfer, yielding a 3H/14C ratio between 3.3 and 14 in the light and between 11 and 22 in the dark. These experiments strongly suggest that a portion of the 3H present in L(+)-tartaric acid may have been transferred from D-gluconic acid to L(+)-tartaric acid, possibly via NADP[3H] through a redox process involving reduction of L-xylo-2-hexulosonate (2-keto-L-idonate). Both [3H]-tartaric acid and [14C]tartaric acid synthesized in grape leaves from D-[3-3H, 2-14C]gluconic acid, or [3-3H, 3,4-14C]gluconic acid were characterized as L(+)-chiral form exclusively, the naturally occurring from of tartaric acid.

Fruit↗
PubMed1996

Adverse effect of donor vasopressor support on immediate and one-year kidney allograft function.

BACKGROUND: This purpose of this study was to determine if there was a significant difference between the rates of acute tubular necrosis (ATN) and long-term graft survival in renal allografts procured from donors requiring inotropic support (DRIS) and those from donors not requiring inotropic support. METHODS: Eighty-two consecutive cadaveric renal transplant patients were prospectively followed in our local procurement area, the Delaware Valley Transplant Program. Forty-eight patients received organs from DRIS (> 10 mcg/kg per minute of dopamine, dobutamine, epinephrine, and norepinephrine alone or in combination), and 34 did not. RESULTS: Allografts from the non-DRIS group had an immediate function rate of 82.4% and a 1-year function rate of 91.2%. In comparison, the DRIS grafts had an immediate function rate of 58.3% and a 1-year function rate of 72.9%. These differences were statistically significant. The mean serum creatinine in the non-DRIS group was 1.46 +/- 0.58 mg/dl, whereas in the DRIS cohort it was 1.89 +/- 0.93 mg/dl. CONCLUSIONS: Kidneys transplanted from DRIS had significantly (1) poorer immediate function, (2) worse 1-year survival rates, and (3) higher serum creatinine at 1 year. We conclude that recipients receiving organs from donors requiring inotropic support are at a higher risk of developing ATN after surgery and experience reduced 1-year function.

Adolescent↗
PubMed2000

Concentrations of suspended particulate organic carbon in the tidal Yorkshire Ouse River and Humber Estuary.

Data are presented for particulate organic carbon (POC) and particulate nitrogen (PN) concentrations in the Humber Estuary and tidal River Ouse Estuary. The POC data were derived from approximately monthly surveys and are consistent with data reported for suspended particulate matter (SPM) in the non-tidal River Ouse (the freshwater river) and with SPM, or bed sediments, in estuarine ecosystems such as the Mississippi, Delaware, San Francisco Bay, Tolo Harbour, the Vellar Estuary and Cochin Backwater, as well as the Loire, Gironde, Ems and Tamar Estuaries. Relative to the dry weight of SPM, the Humber-averaged organic carbon and nitrogen percentages during the year February 1995-March 1996 were 2.6 +/- 0.6% (mean and S.D.) and 0.21 +/- 0.04%, respectively. The ratio of Humber-averaged POC to Humber-averaged PN was 13 +/- 3. Higher POC levels were observed near the Humber's mouth and in the adjacent coastal zone during 'bloom' conditions, and in the upper estuarine reaches during large, winter and springtime freshwater inflows. At these times of high runoff, the POC content of SPM increased progressively up-estuary from the coastal zone to the tidal River Ouse. When inflows became very low, during late spring to early autumn of 1995, both the freshwater-saltwater interface (FSI) and the strengthening turbidity maximum (TM) moved further up-estuary and the POC content of SPM in the upper reaches of the Ouse became lower compared with that immediately down-estuary. This led to a poorly defined POC maximum near the confluence of the Humber, Ouse and Trent, before POC eventually decreased again towards the coastal zone. The lower POC contents in the upper estuarine reaches of the tidal Ouse may have been partly due to POC respiration by heterotrophic bacteria attached to SPM within the TM, consistent with the severe oxygen depletion observed there during high turbidity, summertime spring tides.

Carbon↗
PubMed2001

Partitioning of copper onto suspended particulate matter in river waters.

Suspended particles and river water from the Susquehanna River, White Clay Creek and the Delaware River were collected to experimentally study the partitioning of copper. The effects of many factors that may influence the partitioning coefficient (Kd) including pH, total suspended solids (TSS), total copper concentration ([Cu]T), dissolved organic matter (DOM), particulate organic matter (POM), hardness, and ionic strength were investigated by performing batch adsorption experiments. The results implied that organic matter binding sites in both the aqueous and solid phases play the most important role in controlling copper partitioning. Other major factors governing the partitioning are pH and TSS. Kd increases with pH in the pH range 3-8. TSS increases caused decreases in Kd values, which may be attributed to the decrease in the quantity of available binding sites caused by interparticle interactions, rather than by the redistribution of organic matter between solid and solution phases with the variation of TSS. Kd decreases slightly when total Cu concentration increases; however, Kd can be considered to be independent of Cu concentration when TSS is high. The effects of calcium competition and ionic strength on partitioning are small.

Binding Sites↗
PubMed1996

Chlordane contamination in selected estuarine and coastal marine finfish and shellfish of New Jersey, USA.

Analysis of chlordane contamination in selected finfish and shellfish species from estuarine and coastal marine waters of New Jersey, USA, indicates consistently highest organochlorine pesticide levels in samples from the north and northeast regions of the state. Gas chromatographic analysis of tissue samples from four finfish species (American eel, Anguilla rostrata; bluefish, Pomatomus saltatrix; striped bass, Morone saxatilis; and weakfish, Cynoscion regalis) and one shellfish species (blue crab, Callinectes sapidus) collected at 28 stations throughout the state during the 1986-1987 sampling period and 42 stations during the 1988-1991 sampling period revealed chlordane concentrations ranging from 5 to 2150 ppb wet weight (wet wt). Highest mean concentrations of chlordane (300 ppb wet wt) occurred in American eel from the Camden region, with secondary maxima (100 ppb wet wt) observed in the northeast region. Lower mean concentrations of chlordane (< 100 ppb wet wt) were recorded in tissue samples of other species collected elsewhere in the state. In general, the lowest levels of chlordane contamination (mean < 50 ppb wet wt) were found in samples from the south coast and Delaware regions. A major conclusion of this study is that some commercially and recreationally important finfish and shellfish species in New Jersey waters, especially those which are lipid-rich, have continued to accumulate chlordane from the environment long after restrictive regulations were first placed on its use in the US. The greatest impact of chlordane contamination is nearby metropolitan centers of the state (i.e., New York, Newark, Camden), although the total concentrations of chlordane in tissue samples from these areas are currently far less than the US Food and Drug Administration action level of 300 ppb wet wt.

Journal Article↗
PubMed2003

"Love thy neighbour"-it's good for your health: a study of racial homogeneity, mortality and social cohesion in the United States.

This paper explores the idea that in societies that experience racial tension, increasing racial heterogeneity will be associated with poorer health outcomes, and this effect will be observable in the health of both the minority and the majority group. Here, the association between mortality and racial homogeneity in the United States is examined. The level of racial homogeneity, indexed by the proportion of blacks in each state of the 50 states in the US, was examined in relation to all-cause mortality, adjusted for age and disaggregated by race and sex. The level of poverty in each state was controlled for in ordinary least squares regression models. The level of racial homogeneity was significantly associated with age adjusted mortality rates for both blacks and whites, accounting for around 30% of the variance in mortality rates in the total population and the white population. Every 1% increase in the percentage of the state population who were black was associated with an increase in the total mortality rate of 5.06 per 100000 and an increase in the white mortality rate of 3.58 per 100000. Based on the data, this suggests, for example, that racial heterogeneity in Mississippi accounts for around 14% of the white mortality rate and in New York and Delaware it accounts for around 7%. These results appear to support the social cohesion thesis that in societies that are intolerant, mortality rates will increase as the proportion of racial or ethnic minorities increase in population. Limitations and explanations for the findings are discussed.

Black or African American↗
PubMed2003

Differences in stages of change of smoking behavior among current smokers of four Asian American subgroups.

This study assessed the impact of demographics and acculturation on stages of change in smoking behavior among Asian current smokers (Koreans, Chinese, Vietnamese, and Cambodians) who live in the Delaware Valley region. Three stages (precontemplation, contemplation, and preparation) that applied to current smokers in Prochaska's Transtheoretical Model were measured, with a small modification. A cross-sectional self-report survey was conducted by utilizing a stratified cluster proportional sampling technique. Recruited were 1374 Asian Americans from 26 randomly selected community organization clusters and 1174 completed the survey (83%). Data were analyzed using the Pearson chi(2) test of significance. Education was negatively associated with stages of smoking behavior change. Time living in the United States showed a statistically significant positive correlation. Individuals older than 21 years appeared more seriously inclined to quit (be in the preparation stage) than those below age 21. Among the four subgroups, Cambodians (91%) were more likely to fall in either contemplation or preparation, while Chinese had the highest rate in precontemplation stage. Men were more likely than women to be in the preparation stage. Immigration status was not a significant predictor of stages.

Adolescent↗
PubMed2001

Sensation seeking needs among 8th and 11th graders: characteristics associated with cigarette and marijuana use.

This cross-sectional school-based study explored the relationship between adolescent use of cigarettes and marijuana and the sensation seeking personality factors of (1) Disinhibition and (2) Thrill and Adventure Seeking. The study population included a representative sample of both male and female 8th and 11th graders in the state of Delaware. Analytic methods utilized included correlational analysis and multivariate logistic regression. In the multivariate logistic regression models, the Disinhibition personality factor accounted for cigarette and marijuana using behaviors with odds ratios ranging between 2 and 3. Thrill and Adventure Seeking was not a significant explanatory variable in any of the final multivariate models. Potential confounders (age, gender and race) were considered in all analyses. Of all the two-way interactions assessed, none was significant. The findings from this study utilizing a large general community sample indicate that sensation seeking needs are a potential risk factor for adolescent substance use.

Adolescent↗
PubMed2001

Staff beliefs about addiction treatment.

In 1999, the National Institute on Drug Abuse established a researcher/provider partnership designed to test the effectiveness of research-based innovations in community-based treatment settings and facilitate the transfer of those innovations throughout the national treatment system. As a preliminary step in developing their local Clinical Trials Network, researchers and treatment providers within the Delaware Valley Node surveyed 317 staff members concerning their beliefs about addiction treatment. More than 80% of respondents supported increased use of research-based innovations, 12-step/traditional approaches, and spirituality in addiction treatment, while only 39% and 34%, respectively, endorsed the increased use of naltrexone and methadone maintenance. Also, 35% of respondents indicated that confrontation should be used more, and 46% agreed with discharging noncompliant patients. Individuals with more formal training tended to be less supportive of confrontation and more supportive of the increased use of medications. Implications for the clinical trials and technology transfer are discussed.

Alcoholics Anonymous↗
PubMed2003

Findings from long-term monitoring studies at MSW landfill facilities with leachate recirculation.

This paper presents findings from long-term monitoring studies performed at full-scale municipal solid waste landfill facilities with leachate recirculation. Data from two facilities at a landfill site in Delaware, USA were evaluated as part of this study: (1) Area A/B landfill cells; and (2) two test cells (one with leachate recirculation and one control cell). Data from Area A/B were compared with proposed waste stability criteria for leachate quality, landfill gas production, and landfill settlement. Data from the test cells were directly compared with each other. Overall, the trends at Area A/B pointed to the positive effects (i.e., more rapid waste degradation) that may be realized through increasing moisture availability in a landfill relative to the reported behavior of more traditionally operated (i.e., drier) landfills. Some significant behavioral differences between the two test cells were evident, including dissimilarities in total landfill gas production quantity and the extent of waste degradation observed in recovered time capsules. Differences in leachate quality were not as dramatic as anticipated, probably because the efficiency of the leachate recirculation system at distributing leachate throughout the waste body in the recirculation cell was low.

Environmental Monitoring↗
PubMed1999

Transfusion after coronary artery bypass surgery: the impact of heparin-bonded circuits.

OBJECTIVE: To identify the impact of heparin bonded (Carmeda) circuits on the need for transfusion of packed red blood cells (PRBC) after CABG independent of the influence of patient, procedural, and surgical experience variables. METHODS: A prospective, randomized trial examined the impact of heparin-bonded circuits in 210 patients undergoing coronary artery bypass surgery at Medical Center of Delaware (Christiana Care Health Services). Patients were randomized to either non-bonded circuits or heparin-bonded (Carmeda) circuits. There were no significant differences in patient characteristics between the treatment and control group. A multivariate analysis was performed to identify the independent predictors of both the need for transfusion (logistic) and number of units of PRBC transfused (OLS). RESULTS: The only significant (P < 0.05) independent predictors of need for transfusion were gender (odds ratio (OR) = 0.35 for males), use of anticoagulants prior to surgery (OR = 2.09), cross-clamp time (OR = 1.03 for each extra minute), and use of heparin-bonded circuits (OR = 0.50 for patients in the heparin-bonded; Carmeda, circuit group). The only significant independent predictors of number of PRBCs were anticoagulants prior to surgery, cross-clamp time, catheterization procedure on the same day, body surface area, and use of heparin-bonded circuits. Other patient demographic variables, comorbidities, and surgical variables were not significant independent predictors of the need for transfusion or the number of units transfused. CONCLUSIONS: Several factors influence the probability of transfusion that patients face following coronary artery bypass surgery. The probability of transfusion is 50% less and the number of PRBCs transfused are 1.42 units less when heparin-bonded (Carmeda) circuits are used, adjusted for patient demographics, comorbidities, or surgical variables.

Anticoagulants↗
PubMed2003

AFLP analysis of a worldwide collection of Didymella bryoniae.

Didymella bryoniae (anamorph Phoma cucurbitacearum) is an ascomycete that causes gummy stem blight, a foliar disease that occurs on cucurbits in greenhouses and fields throughout the world. In a previous study using RAPD analysis, little genetic diversity was found among isolates of D. bryoniae from New York and South Carolina, USA. Here we report the use of amplified fragment length polymorphism (AFLP) analysis to assess the genetic variation within a worldwide collection of D. bryoniae, 102 field and greenhouse isolates from ten states in the USA (California, Delaware, Florida, Georgia, Indiana, Maryland, Michigan, Oklahoma, South Carolina, and Texas) and seven other countries (Australia, Canada, China, Greece, Israel, Sweden, and The Netherlands) were examined. Seven different AFLP primer-pair combinations generated 450 bands, of which 134 were polymorphic (30%). Using cluster analysis, two groups and a total of seven subgroups were delineated. Representative isolates varied in their virulence on muskmelon and watermelon seedlings, but the degree of virulence was not strongly associated with AFLP groupings. However, isolates from the northern USA grouped separately from isolates originating from the southern USA.

Ascomycota↗
PubMedDate not supplied

The effect of a quality improvement feedback loop on paramedic skills, charting, and behavior.

OBJECTIVE: A mechanism was initiated for conveying quality improvement (QI) results to paramedics as a means of improving chart documentation in difficult-to-correct areas. This study examines the impact of this QI feedback loop on charting, resuscitation rates from cardiac arrest, endotracheal intubation (ETI) success rates, and trauma scene times. DESIGN: Paramedic trip sheets were reviewed before and after the institution of the QI feedback loop in this interrupted time series design. SETTING: The New Castle County, Delaware, Paramedic Program. PARTICIPANTS: All New Castle County paramedics participated in the study. INTERVENTIONS: In January 1990, the medical director began to circulate a QI summary among the paramedics in an effort to improve performance and chart documentation. The summary focused on the management of respiratory distress or arrest, cardiac arrest, and major trauma. The success rate for ETI was compared with the rate of field resuscitation from cardiac arrest, the percentage of unjustified prolonged trauma scene times (longer than 10 minutes), and the percent compliance with minimum endotracheal intubation documentation (ETID) requirements from a six-month period before institution of the QI feedback mechanism with data obtained from a six-month period after the program had been operational for one year. RESULTS: Comparing results from before with after the initiation of the QI program, the ETI success rate was 273 of 295 (92.5%) before and 300 of 340 (88.2%) after (chi 2 = 3.04, p < .1, ns); field resuscitations totaled 26 of 187 (13.9%) before and 44 of 237 (18.6) after (chi 2 = 1.40, p < .25, ns); ETID rate was 249 of 295 (84.4%) before and 336 of 340 (98.8%) after (chi 2 = 44.24, p < .001), and unjustified prolonged trauma scene times were 69 of 278 (24.8%) before and seven of 501 (1.4%) after (chi 2 = 320.5, p < .001). CONCLUSION: The use of QI feedback had little effect on psychomotor skills as the ETI success rate or resuscitation rate, but had a dramatic effect on chart documentation, as evidenced by ETID rate, and behavior, as evidenced by the reduction in prolonged trauma scene times. The use of QI feedback is recommended as a means of correcting charting deficiencies or modifying behavior.

Clinical Competence↗
PubMed2001

Photoproduction of hydrated electron from constituents of natural waters.

The wavelength dependence for the photoproduction of the hydrated electron (e-(aq)) from various humic and fulvic acids and from natural waters was determined, employing a method that converts e-(aq) to a methyl radical that is detected fluorimetrically as the O-methylhydroxylamine of a stable nitroxide. Quantum yields for e-(aq) production from potassium ferrocyanide and N,N-dimethylaniline are in agreement with previously reported values. The quantum yields for production of e-(aq) from colored dissolved organic matter (CDOM) decrease precipitously with increasing wavelength with the rate of decline increasing in the order: humic acid < fulvic acid < natural water in the UV-B region. For Suwannee River fulvic acid, quantum yields ranged from 7.9 x 10(-6) at 366 nm to 1.9 x 10(-4) at 296 nm indicating that previously reported values for e-(aq) production from CDOM involving laser sources of irradiation are high due to experimental artifact. Apparent natural water quantum yields at 296 nm are higher than those for humic substances, ranging from 9.4 x 10(-5) to 3.7 x 10(-3) depending on location. The highly absorbing waters of the Delaware and Chesapeake Bays show insignificant production of e-(aq). These results indicate that the hydrated electron, through its reaction with dioxygen, is not a significant source of hydrogen peroxide in many natural waters and that humic substances may not be the principal source of e-(aq) production.

Absorption↗