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PubMed1995

Blood lead levels among children--Rhode Island, 1993-1995.

Since January 1993, screening of children aged < 6 years for elevated blood lead levels (BLLs) has been mandatory in Rhode Island. Erythrocyte protoporphyrin was eliminated as a method of lead screening in February 1993; since then, all children in the state have been screened for lead poisoning by testing capillary or venous blood samples for lead. From March 1993 through February 1995, results of blood lead tests of 56,379 children aged < 6 years were reported to Rhode Island's lead surveillance system. This report summarizes an analysis of these data by the Rhode Island Department of Health (RIDH) to better characterize the burden of childhood lead poisoning in the state.

Child, Preschool↗
PubMed1982

Incidence of death during jogging in Rhode Island from 1975 through 1980.

In the six years from 1975 through 1980, a total of 12 men died during jogging in the state of Rhode Island. The cause of death in 11 was coronary heart disease (CHD). One man died of an acute gastrointestinal hemorrhage. The prevalence of jogging in the Rhode Island population was determined using a random-digit telephone survey. Among men aged 30 through 64 years, 7.4% +/- 2.6% (mean +/- SEE) reported jogging at least twice a week. The incidence of death during jogging for men of this age group was one death per year for every 7,620 joggers, or approximately one death per 396,000 man-hours of jogging. This rate is seven times the estimated death rate from CHD during more sedentary activities in Rhode Island and suggests that exercise contributes to sudden death in susceptible persons. The occurrence of only one death per 7,620 joggers per year demonstrates that the risk of exercise is small and suggests that the routine exercise testing of healthy subjects before exercise training in not justified.

Adolescent↗
PubMed1993

Growth rate and egg production of Creole and Rhode Island red x Creole fowls.

In Guyana 3 experiments were conducted using 1,440 chicks and 640 pullets and the same number of hens in a randomised block design to determine the growth rate, egg production, and egg fertility and hatchability of 1/2 Creole x 1/2 Rhode Island Red (CR) and 3/4 Rhode Island Red x 1/4 Creole (CRR) fowls compared with the parental strains of Creole (C) and Rhode Island Red (R) fowls. The growth rate of CR and CRR was higher than C, but lower (P < 0.05) than R. Total egg production per hen housed during the pullet year was 59.5, 106.8, 130.7 and 171.8 for C, CR, CRR and R respectively and they were all significantly (P < 0.05) different. There were no significant (P > 0.05) differences between the 4 strains for fertility and hatchability percentages of the eggs which averaged 87.8 and 88.9 respectively. The level of production was comparatively high and mortality low enough for the crossbreds to be recommended for small holder poultry development, although the feed cost of production would be higher for CRR than for CR.

Animals↗
PubMed2002

Neonatologists' opinions regarding resuscitation of extremely premature infants in Connecticut and Rhode Island.

OBJECTIVE: To characterize the range of opinions among neonatologists in Connecticut and Rhode Island regarding the gestational age at which they would support parental resuscitation or nonresuscitation requests for infants born at 21-27 weeks. METHODS: Anonymous questionnaire mailed to 70 Connecticut and Rhode Island neonatologists detailing specific resuscitation scenarios and hypothetical guidelines regarding management of premature infants. RESULTS: Response rate was 69%. Nine percent of neonatologists would never reject a parental resuscitation request. Ninety-one percent would reject a resuscitation request at 21 weeks, 67% at 22 weeks, and 11% at 23 weeks. Fifty-three percent would refuse a nonresuscitation request at 24 weeks, 96% at 25 weeks, and 100% at 26 weeks. CONCLUSIONS: The majority of neonatologists would not resuscitate infants born at < or = 22 weeks and would resuscitate infants born at > or = 25 weeks gestational age despite parental wishes to the contrary.

Adult↗
PubMed1995

Associations between diet and health behavior: results from the 1992 Rhode Island Behavioral Risk Factor Survey.

The 1992 Rhode Island Behavioral Risk Factor Surveillance System was used to assess self-reported health behaviors of consumers of finfish and raw shellfish. We hypothesized that consumers of finfish, foods considered to be healthy, were more likely than nonconsumers of finfish to partake in health-promoting behaviors. Similarly, we postulated that consumers of raw molluscan shellfish, foods linked to an elevated risk of acquiring various illnesses, were more likely than nonconsumers of raw-shellfish to partake in risk-taking behaviors. Finfish eaters were significantly more likely than abstainers to report recent exercise, efforts to lose weight, periodic monitoring of serum cholesterol, and not currently being smokers. Raw shellfish eaters were significantly more likely than abstainers to report recent acute and chronic alcohol consumption. The results suggest that inquiry into dietary patterns may be an avenue for exploring other health behaviors.

Adolescent↗
PubMed1996

The licensed physicians of Rhode Island in the year 1895.

A brief demographic profile of the 466 physicians applying for licensure in Rhode Island in the year 1895, is presented here. The typical Rhode Island physician of a century ago was a New England-born 39-year-old white male general practitioner who had little undergraduate education, received his medical diploma from an allopathic medical school within 180 miles of his place of birth, typically a small town, had little or no supervised hospital training, professed to no specialty and established his office, often sharing space with his practitioner-father, within the same community in which he was born.

Adult↗
PubMed1986

Incidence and outcome of hospital-treated head injury in Rhode Island.

Hospital discharge summary data were used to identify and study all 2,870 Rhode Island residents hospitalized in-state with head injuries during 1979 and 1980. The overall hospitalized incidence rate was 152 per 100,000 of population per year with age and sex variations similar to those found in other studies. This is consistent with the observation that fatal injury rates in Rhode Island are only 75 per cent of the United States average. Hospitalized incidence rates of head injury for the census tracts in the lowest decile of median income were twice those for census tracts in the highest decile. Smaller increases were also observed with increasing population density. Length of hospital stay increased with age. Discharge to chronic care facilities plus in-hospital deaths increased 20-fold with increasing age. In each age group, in-hospital deaths and discharge to chronic care facilities were associated with long hospital stays.

Accidents, Traffic↗
PubMed1984

Utilization and charges for terminal cancer patients in Rhode Island.

A population-based sample of 2,104 terminal cancer patients who died in Rhode Island during 1980-1981 was created by merging death certificates, the claims of Medicare and non-Medicare health insurance beneficiaries served by Blue Cross and Blue Shield of Rhode Island, and records of the state's only hospice. The data collected included utilization and charges for services rendered by hospitals, nursing homes, home health agencies, physicians, and outpatient clinics. Regression analysis of charges during the last month and six months revealed significant differences for age and hospice: Six-month charges were found to be inversely related to age (+151 for each year of age), and the charges for the last month of care for decedents who received hospice care were 43.5% lower than the charges for conventional care.

Aged↗
PubMedDate not supplied

Comprehensive medical care among HIV-positive incarcerated women: the Rhode Island experience.

Our objective was to characterize the clinical presentation of human immunodeficiency virus (HIV) infection among incarcerated women in a program that provides HIV testing and primary care to all state prisoners in Rhode Island. A retrospective medical chart review on all HIV-seropositive women who were incarcerated between 1989 and 1994 and had at least two medical visits with an HIV medical care provider was used. At the Rhode Island Adult Correctional Institution (ACI), under mandatory testing laws between 1989 and 1994, 28% (172 of 623) of all women were identified with HIV infection. Of the 172 women who tested seropositive in prison, 110 were included in the study. Of the 110 women followed, 84% reported injection drug use (IDU) as their primary risk factor, and 30% reported both IDU and sex work. The median CD4 count was 596/mm3, with 60% having a CD4 count >500 cells/mm3. The most common medical conditions were vaginal candidiasis, oral candidiasis, and bronchitis. Antiretroviral therapy was well accepted and followed community standards. Continuity of medical care after release was facilitated by the same physician caring for the patient in the community setting, with 83% of women following up for HIV care after release. The medical conditions noted reflect that these women are early in the course of their HIV disease when they are initially diagnosed. This comprehensive program in Rhode Island's state prison plays a central role in the diagnosis of HIV-seropositive women and provides counseling, primary medical and gynecological care, and linkage to community resources after release.

Adult↗
PubMed2006

A success story: HIV prevention for injection drug users in Rhode Island.

BACKGROUND: New HIV diagnoses related to injection drug use (IDU) have declined in the United States. Access to clean syringes and decreasing HIV transmission among injection drug users have been HIV prevention priorities of the Rhode Island (RI) HIV community. To examine trends in IDU-related new HIV diagnoses in RI, we performed a retrospective analysis of new HIV diagnoses according to HIV risk factor from 1990-2003. RESULTS: There has been an 80% absolute reduction in IDU-related new HIV diagnoses in RI coincident with IDU-specific prevention efforts. CONCLUSION: There has been a greater decline in IDU-related new HIV diagnoses in Rhode Island compared to national data reported by the Centers for Disease Control and Prevention. We hypothesize that this dramatic decline in Rhode Island is related to extensive HIV prevention efforts targeting IDUs. Further research is needed to examine the impact of specific HIV prevention interventions for injection drug users.

Causality↗
PubMed2006

Surveillance and assessment of workplace assault injuries: analysis of Rhode Island workers' compensation claims 1998-2002.

OBJECTIVE: To analyze workplace assault by rate, injury severity, and trends using Rhode Island workers' compensation claim data. METHOD: A total of 6402 workers' compensation assault claims from Rhode Island for the period of 1998 through 2002 was analyzed. Data from the U.S. Department of Labor was used to derive estimates of injury rates. RESULTS: An average rate of 27.7 assaults per 10,000 workers was found and varied only marginally across years. Females filed 75% of all assault claims, though injuries to males resulted in longer periods of indemnification. The total cost of workplace assaults was 7,025,997 dollars, averaging 1097 dollars per claim, and average indemnification duration was 16.8 days per claim. While the assault rate was relatively stable, a notable decline in both cost and indemnification periods over time was discovered. CONCLUSION: The assault rate found was among the highest reported to date, demonstrating that workplace violence remains a significant threat to employee safety. While a decline in incident severity was discovered over time, many outcomes were still serious. Preventive interventions to reduce incidents of workplace assaults among groups at the highest risk should be given highest priority.

Adult↗
PubMed1992

Motor vehicle fatalities in Rhode Island (FY1990-1991): a report on driver impairment.

Autopsy specimens from 52 fatally injured drivers in Rhode Island were analyzed for the presence of alcohol and other drugs of abuse, including, among others, cocaine, opiates, cannabinoids (THC), and phencyclidine (PCP). The ages of the drivers ranged from 16 to 87 years; 41 were male and 11 female. Based on this sample, 65% of Rhode Island driver fatalities involve drugs. The most common drug, alcohol was found in 59% of the cases. Drugs other than alcohol were detected in 19% of the cases, 13% had illicit drugs found in combination with alcohol, and 6% had illicit drugs only.

Accidents, Traffic↗
PubMed1993

Occurrence and distribution in Rhode Island of Hunterellus hookeri (Hymenoptera: Encyrtidae), a wasp parasitoid of Ixodes dammini.

The wasp Hunterellus hookeri Howard parasitizes several species of ixodid ticks including Ixodes dammini Spielman, Clifford, Piesman & Corwin, the vector of Lyme disease spirochetes, Borrelia burgdorferi, in the northeastern United States. We detected the occurrence and evaluated the distribution of this wasp parasitoid in populations of I. dammini in Rhode Island. There has been no intentional introduction of a tick parasitoid recorded anywhere in Rhode Island; yet, we found this wasp at one of the six study sites (Prudence Island), where it parasitized 21 (n = 243) and 17% (n = 284) of nymphal I. dammini collected during 1988 and 1989, respectively. The proportion of nymphs parasitized was greatest during May (46%) and was less in June (18%), July (18%), and August (11%). In Rhode Island, the wasp was only found parasitizing ticks at the site with the highest (by a factor of 2) tick population, confirming similar observations in Massachusetts and New York. It is suggested that establishment as well as the distribution of H. hookeri depends upon a super abundant deer tick population. The usefulness of this parasitoid as a biological control agent is yet unknown.

Animals↗
PubMed1998

The Rhode Island Hearing Assessment Program: experience with statewide hearing screening (1993-1996)

OBJECTIVE: The objective of this study was to evaluate key outcomes of a universal hearing screen/rescreen program for all births with transient evoked otoacoustic emissions in all 8 maternity hospitals in the state of Rhode Island over a 4-year period. STUDY DESIGN: This was a retrospective analysis of the hearing screen/rescreen refer data collected prospectively for 53,121 survivors born in Rhode Island between January 1, 1993, and December 31, 1996. Primary outcomes included the first-stage refer rates, rescreen compliance, diagnostic referral rates, identification rates, and the age of amplification. RESULTS: During this 4-year time period 11 infants were identified with permanent hearing loss, resulting in an impairment rate of 2 per 1000. The mean age of hearing loss confirmation decreased from 8.7 months to 3.5 months, and the age at amplification declined from 13.3 months to 5.7 months. CONCLUSION: We conclude that time and experience are important factors in the development and refinement of a universal hearing screen program. Hearing screen outcome data collected over a 4-year period in Rhode Island reveal a steady improvement in the percent of infants completing the 2-stage screen process, the stage 1 and stage 2 refer rates, compliance with rescreen and diagnostic testing, and significant improvement in the age of identification and age of amplification.

Age Factors↗
PubMed2005

Lead poisoning associated with use of litargirio--Rhode Island, 2003.

Lead can damage the neurologic, hematologic, and renal systems. Deteriorated leaded paint in older housing remains the most common source of lead exposure for children in the United States; however, other lead sources increasingly are recognized, particularly among certain racial/ethnic populations. In 2003, the Rhode Island Department of Health (RIDOH) recognized litargirio (also known as litharge or lead monoxide), a yellow or peach-colored powder used as an antiperspirant/deodorant and a folk remedy in the Hispanic community, as a potential source of lead exposure for Hispanic children. This report summarizes a case investigation of elevated blood lead levels (BLLs > or =10 microg/dL) associated with litargirio use among two siblings in Rhode Island, the public health action taken, and a survey of parents/guardians in three pediatric clinics in Providence, Rhode Island, to assess litargirio use. Findings underscore the importance of follow-up of elevated BLLs and thorough investigation to identify all lead sources.

Child↗
PubMed1998

Co-infection with Mycobacterium tuberculosis and HIV in high risk clinical care setting in Rhode Island.

We assessed the extent to which co-infection with HIV and Mycobacterium tuberculosis (Mtb) was diagnosed at several high risk clinical care sites from 1992 to 1994 to determine whether surveillance for co-infection was performed. Information on PPD skin testing, HIV status, and HIV risk exposures was extracted from records at HIV clinics in Rhode Island and a large database (HIV sites) and from records at the state TB clinic and the Rhode Island Health Department (TB sites). At the HIV sites, 34 of 1,408 HIV infected subjects were newly diagnosed with Mtb infection in the study period. At the TB sites, 16 of 1,389 subjects with newly diagnosed Mtb infection or disease were identified as HIV infected. Eighty per cent of the records reviewed for this study were incomplete. Hispanic subjects were at higher risk of being identified as co-infected at the HIV sites. At the TB sites, US-born subjects were at higher risk of being identified as co-infected Recommendations for high risk individuals include yearly tuberculosis skin testing. Adherence to these guidelines in selected high-risk clinical care sites in Rhode Island was substandard during the study period; the importance of Mtb screening was demonstrated in this study. Identification of groups that are at higher risk of having HIV and Mtb co-infection identified may enable health care providers to improve testing and prevention of tuberculosis at high risk clinical care settings.

AIDS-Related Opportunistic Infections↗
PubMed1999

Obstacles to needle exchange participation in Rhode Island.

OBJECTIVE: This study explores obstacles to participation in needle exchange programs (NEPs) among injection drug users (IDUs) in the state of Rhode Island, U.S.A. METHODS: A written questionnaire was administered at two Rhode Island drug detoxification sites in 1998. RESULTS: 488 self-administered surveys were completed, 226 (46.3%) respondents had injected drugs in the past 6 months. 62.1% reported sharing syringes in the past 6 months, and each syringe was used a mean of 10.7 times. Major obstacles to NEP participation were a lack of awareness of the program (25.6%), inconvenient location or hours (15.9%), and fear of identification and/or police harassment (12.2%). Non-white race was a significant predictor of being unaware of the NEP (p = .01) and not participating in the NEP (p = .03). 13.1% of IDUs who used the NEP were referred to the detoxification program by the NEP. Among all IDUs surveyed, 51.0% had participated in a NEP. CONCLUSIONS: NEPs are important in reducing the spread of bloodborne pathogens among IDUs and are effective referral sources for drug treatment. Surveys of IDUs at sites other than NEPs, such as detoxification facilities, can identify obstacles to the use of NEPs.

Acquired Immunodeficiency Syndrome↗
PubMed1981

Surgeons and surgery in Rhode Island, 1970 and 1977.

In the 1970s the likelihood of an oversupply of physicians in the United States began to be recognized by health-manpower analysts. The number of surgeons available to meet the population's needs was of particular concern. Using data from 1970 on four representative geographic areas, including Rhode Island, investigators in the Study on Surgical Services for the United States (SOSSUS) found operative workloads of surgeons to be light by any standard; they recommended several actions to limit the number of physicians performing operations. I repeated the 1970 SOSSUS analysis of Rhode Island, using data from this state for 1977. Comparison of the results for 1970 and 1977 indicated that, at least in this state, little or no progress had been made in reducing the excess of surgical manpower. As of 1977, the SOSSUS recommendations were having no demonstrable impact in Rhode Island. The number of surgeons was continuing to increase without apparent need, as judged by operative workloads.

General Surgery↗