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PubMed1993

Accuracy of indexing coverage information as reported by serials sources.

This article reports on the accuracy of indexing service coverage information listed in three serials sources: Ulrich's International Periodicals Directory, SERLINE, and The Serials Directory. The titles studied were randomly selected journals that began publication in either 1981 or 1986. Aggregate results reveal that these serials sources perform at 92%, 97%, and 95% levels of accuracy respectively. When the results are analyzed by specific indexing services by year, the performance scores ranged from 80% to 100%. All three serials sources tend to underreport index coverage. The author advances five recommendations for improving index coverage accuracy and four specific proposals for future research. The results suggest that, for the immediate future, librarians should treat index coverage information reported in these three serials sources with some skepticism.

Abstracting and Indexing↗
PubMed1994

Vaccination coverage of 2-year-old children--United States, 1991-1992.

Protecting children against vaccine-preventable diseases is a national priority in public health. Because approximately 80% of childhood vaccine doses are recommended for administration during the first 2 years of life, vaccination coverage among children must be continuously monitored. National estimates of vaccination coverage were calculated annually from 1959 through 1985 but not for 1986-1990. Beginning in 1991, national estimates of vaccination coverage of preschool children have been available through the National Health Interview Survey (NHIS), a national survey of the civilian noninstitutionalized population conducted by CDC's National Center for Health Statistics. This report presents 1992 national estimates of vaccination coverage for 2-year-old children and describes changes from 1991 to 1992.

Child, Preschool↗
PubMed1993

The effect of providing health coverage to poor uninsured pregnant women in Massachusetts.

OBJECTIVES: There has been substantial policy interest in whether the provision of health coverage to poor uninsured pregnant women affects access to prenatal care and birth outcomes. We therefore examined whether the statewide provision of health coverage to uninsured low-income pregnant women affects access to prenatal care and infant birth outcomes. DESIGN: Natural experiment. PATIENTS: All in-hospital, single-gestation live births in 1984 (N = 57,257) and 1987 (N = 64,346). INTERVENTION: In 1985, Massachusetts instituted Healthy Start, a program providing health coverage to uninsured pregnant women with incomes below 185% of the federal poverty level. MAIN OUTCOME MEASURES: Rates of satisfactory prenatal care, care initiated before the third trimester, and adverse infant outcome for uninsured women and for two concurrent control groups, women with Medicaid, and women with private insurance. We calculated the difference in rates between the uninsured and each concurrent control. To assess the effect of the program, we examined the change in these interpayer differences in rates between 1984 and 1987. MAIN RESULTS: Between 1984 and 1987, the rate of satisfactory prenatal care declined from 96.4% to 93.8% for all women in Massachusetts (P < .001). There was no statewide change in the overall incidence of adverse birth outcome (6.6% in both years). In 1984, uninsured women were less likely than privately insured women to receive satisfactory prenatal care (90.5% and 98.1%, respectively; interpayer difference, -7.6%) and to initiate care before the third trimester (94.2% and 99.1%; interpayer difference, -4.9%), and were more likely to suffer an adverse birth outcome (7.1% and 5.8%; interpayer difference, 1.3%). Between 1984 and 1987, there were no statistically significant changes in the interpayer differences in rates for any of the outcome measures relative to either control group. CONCLUSIONS: Our findings suggest that access to prenatal care may have declined for all women in Massachusetts between 1984 and 1987. In the setting of this statewide decline in access, the expansion of health coverage to uninsured low-income pregnant women was not associated with an improvement in access to prenatal care or birth outcomes.

Female↗
PubMed1993

Gastrocnemius muscle flap coverage of exposed or infected knee prostheses.

A retrospective analysis was performed of 12 patients who required soft-tissue coverage of an exposed or infected total knee prosthesis between 1982 and 1989. All knees had skin closure with medial gastrocnemius muscle flaps. At a mean follow-up period of 41 months, all patients who were treated for infected prostheses with removal of the implant, intravenous antibiotics, and muscle flap closure had an excellent clinical result with complete skin coverage and no infection. Five of the six patients went on to successful reimplantation. Of the patients with an exposed prosthesis, five of six had an excellent outcome with retention of the prosthesis. Thus, 11 of 12 patients (92%) who had medial gastrocnemius flap coverage of an exposed or infected knee prosthesis had an excellent outcome, with ten of 12 patients (82%) retaining their prostheses or having a successful reimplantation. No medial gastrocnemius flap failed after standard primary or revision total knee arthroplasty. Gastrocnemius muscle flaps provide excellent soft-tissue coverage of exposed or infected knee prostheses and facilitate surgical care of this difficult problem.

Adolescent↗
PubMed1995

A comparison of a 30-cluster survey method used in India and a purposive method in the estimation of immunization coverages in Tamil Nadu.

A 30-cluster survey method that is employed for estimating immunization coverages by the Government of India (GOI) was compared with a Purposive method, to investigate whether the likely omission of SC/ST and backward classes in the former would lead to the reporting of higher coverages. The essential difference between the two methods is in the manner in which the first household is selected in the chosen first stage sampling units (villages). With the GOI method, it is often close to the village centre, whereas with the Purposive method it is always in the periphery or in a pocket consisting of SC/ST or backward classes. A concurrent comparison of the two methods in three districts in Tamil Nadu showed no real differences in the coverage with DPT and BCG vaccines. However, the coverage was consistently higher by the GOI method in the case of the Polio vaccine (by 1.5%, 3.1% and 5.3% in the 3 districts), and the Measles vaccine (by 4.8%, 13.3% and 13.9%); the average difference was 3.3% for Polio vaccine (p = 0.08) and 7.3% for Measles vaccine (p = 0.01).

Analysis of Variance↗
PubMed1996

Surgical advances in the coverage of exposed roots.

A review of the past year's literature on the coverage of exposed roots reveals that surgical advances have centered on the use of membranes for guided tissue regeneration as well as surgical ingenuity combining subepithelial connective tissue with previously described root coverage techniques. In this review, the articles are critiqued, and their clinical significance is discussed. Surgical correction of exposed roots has become a remarkably successful and predictable procedure with either connective tissue or guided tissue regeneration. In most cases, connective tissue grafting for root coverage should be preferred to guided tissue regeneration, and the use of epithelialized palatal tissue (free gingival graft) for root coverage is a dated procedure.

Connective Tissue↗
PubMedDate not supplied

[Vaccinal coverage for measles and pertussis: a study in 7 regions of Italy].

During the year 1993 a series of surveys aimed to estimate the immunization coverage against measles and pertussis have been carried out in seven Italian regions and two large towns (Milan and Naples). Mothers of children aged between 12 and 23 months, randomly selected from the list of newborns, by using the EPI cluster sampling, have been interviewed in order to determine the reasons for absent or incomplete vaccinations. The observed coverage for pertussis ranges between 8% in the Molise region and 71% in the town of Milan; coverage for measles ranges between 9% in the town of Naples and 52% in the region Lombardy. The most commonly reported reason for not-vaccinating for pertussis has been the negative advise given by the caring physician. Immunization against measles has often not been administered because of relative contraindications and the negative advise by the physicians. The coverage for the two non-compulsory vaccinations are low compared to compulsory vaccinations and to the immunization level reported for most European countries, pointing out that further health education is needed for improving the up-take of such voluntary vaccinations.

Adult↗
PubMed1996

The impact of the standards for pediatric immunization practices on vaccination coverage levels.

OBJECTIVE: To assess the impact on clinic-specific vaccination coverage of implementing the Standards for Pediatric Immunization Practices. DESIGN: A nonrandomized intervention trial conducted for 1 year. SETTING: Two public health clinics in Albuquerque, NM: 1 intervention site and 1 control site, each serving 1 of 4 city quadrants. PARTICIPANTS: All children enrolled in the 2 city public health clinics. INTERVENTIONS: Implementation of the Standards for Pediatric Immunization Practices. OUTCOME MEASURES: Assessment of up-to-date vaccination coverage levels prior to and at the conclusion of the project. The impact on the proportion of children who dropped out of vaccination services after receiving 1 dose by 3 months of age. RESULTS: At the intervention site, up-to-date coverage at 12 months of age rose from 57.5% to 80.4%, while levels at the control site decreased from 42.1% to 41.9%. Before the intervention, 24% of children at the intervention site who received the first dose of diphtheria and tetanus toxoids and pertussis vaccine (DTP 1) by 3 months of age failed to receive the third dose of DTP (DTP 3) by 12 months of age vs 5% after the intervention. At the control site, the proportion of children who received DTP 1 by 3 months of age, but not DTP 3 by 12 months of age, increased from 39% to 51%. CONCLUSION: Implementation of the Standards for Pediatric Immunization Practices in a public health clinic was associated with important increases in vaccination coverage levels and a reduction in the proportion of children who dropped out of vaccination services.

Child↗
PubMed1996

Pap test coverage in São Paulo municipality and characteristics of the women tested.

Interview data collected in March-September 1987 as part of an international multi-center study were used to assess Pap test coverage in the municipality of São Paulo and determine characteristics that made study subjects more likely or less likely to have been tested. The data analyzed came from interviews with 967 women. Information gathered during the interviews included demographic and socioeconomic data as well as information about use of health service facilities, use of oral contraceptives, breast self-examination, smoking, alcoholism, and prior Pap testing. The results showed that 666 (69%) of the women said they had received a Pap test in the past; 588 (61%) said they had one within three years of the interview; and 399 (41%) said they had one during the past year. Statistically significant relationships were found between Pap testing sometime in the past (and also Pap testing within the preceding three years) and age, education, marital status, use of oral contraceptives, breast self-examination, and consulting with a physician during the year preceding the interview. Adjustment for all the other statistically significant variables through multivariate analysis influenced but did not undo the statistical significance of each of these relationships. Overall, the results of this study point to levels of Pap test coverage exceeding those found by other São Paulo studies. One reason could have been this study's inclusion of Pap tests obtained at medical clinics that were not specifically accredited to give the test; another, which does not exclude the first, could have been a real increase in coverage resulting from increasing dissemination of messages in the 1980s stressing the importance of Pap testing. It is also noteworthy that 40% of the women interviewed said they had not had the test within the preceding three years. Characteristics associated with those not having had the test were youth (being 15-24 years old), being single, having low socioeconomic status, not having consulted a physician for a year, not having used oral contraceptives, and not having performed breast self-examination for a year. Knowing these characteristics could help implement measures to increase Pap test coverage of specific subgroups.

Adolescent↗
PubMed1997

National, state, and urban area vaccination coverage levels among children aged 19-35 months--United States, January-December 1995.

The National Immunization Survey (NIS) is an ongoing survey that provides national estimates of vaccination coverage among children aged 19-35 months based on data for the most recent 12 months for each of the 50 states and for 28 selected urban areas, including the District of Columbia. CDC implemented NIS in April 1994 to monitor current vaccination coverage levels as one element of the five-part Childhood Immunization Initiative (CII) (Table 1), a national strategy to attain high vaccination coverage among children during the first 2 years of life. This report presents NIS findings for 1995, which indicate that 1995 CII interim national coverage goals were achieved or exceeded for all routinely recommended childhood vaccines.

Child, Preschool↗
PubMed1997

Health insurance coverage and outcome following acute myocardial infarction. A community-wide perspective.

BACKGROUND: Several studies have suggested that type of medical insurance coverage is associated with hospital utilization rates and receipt of selected diagnostic or treatment approaches. To our knowledge no studies, however, have examined the relation between medical insurance coverage and short-term outcomes following acute myocardial infarction (AMI) from a multihospital, community-wide perspective. OBJECTIVE: To examine the association between medical insurance coverage and in-hospital case-fatality rates as well as length of hospital stay following AMI. METHODS: The study sample consisted of 3735 residents of the Worcester, Mass, metropolitan area hospitalized with validated AMI during 1986, 1988, 1990, 1991, and 1993 at all metropolitan Worcester hospitals. Data were obtained from the review of medical records. Patients were stratified into 5 medical insurance groups for purposes of analysis: private or commercial (n = 711), Medicaid (n = 101), Medicare (n = 1991), health maintenance organization (n = 741), and self-pay or other (n = 191). Crude and multivariable-adjusted analyses were used to examine the relation between medical insurance coverage and length of hospital stay and in-hospital case-fatality rates following AMI. RESULTS: In-hospital case-fatality rates during the period under study were 7.7%, 11.9%, 21.4%, 9.3%, and 10.0% in the 5 medical insurance groups, respectively. After adjusting for several factors that may affect in-hospital mortality, relative to the referent group of private or commercial insurance patients (odds ratio, 1.0), the multivariable-adjusted odds for dying during the acute hospitalization were 0.87 (95% confidence interval [CI], 0.56-1.36) for health maintenance organization patients, 1.22 (95% CI, 0.55-2.68) for Medical patients, 1.25 (95% CI, 0.85-1.84) for Medicare patients, and 1.21 (95% CI, 0.60-2.44) for self-pay or other patients. The mean length of hospitalization after excluding patients with a prolonged hospitalization was 10.1 days for private or commercial insurance patients, 9.4 days for health maintenance organization patients, 10.9 days for Medicaid patients, 11.1 days for Medicare patients, and 9.8 days for self-pay or other patients. No significant differences in the average duration of hospitalization were seen between the medical insurance groups after controlling for potential confounding variables. CONCLUSIONS: The results of this population-based study suggest that patient insurance status is not significantly associated with either length of hospital stay or short-term mortality following AMI. Other demographic and clinical prognostic factors appear to be more important predictors of short-term outcome in this patient population.

Adult↗
PubMed1997

Content analysis of coverage of alcohol control policy issues in black-oriented and mainstream newspapers in the U.S.

We conducted a content analysis of alcohol control policy issues in Black-oriented and mainstream newspapers in the United States from 1993 to 1995, using computerized content analysis methods. The specific purpose of our study was to compare differences in coverage of alcohol control policy issues in Black-oriented and mainstream newspapers. Fifteen Black-oriented and 12 mainstream newspapers were selected and analyzed. The number of policy paragraphs per year and the number of paragraphs in different policy thematic categories per year were examined. Regional differences in coverage of alcohol policy themes were examined for selected policies in mainstream newspapers. We found more similarities than differences in coverage of alcohol policy issues in Black-oriented and mainstream newspapers. Limiting the marketing/advertising and promotion of alcohol products was the most widely covered alcohol control policy issue over the three-year period in both Black-oriented media and mainstream newspapers. There were some important differences in coverage of alcohol policy issues. While economic alcohol policy issues were covered extensively in mainstream newspapers, these issues received far less attention in Black-oriented newspapers. Findings suggest that certain alcohol control policies may have less salience in African-American communities than in other communities.

Adult↗
PubMed1997

Status report on the Childhood Immunization Initiative: national, state, and urban area vaccination coverage levels among children aged 19-35 months--United States, 1996.

The Childhood Immunization Initiative (CII), a comprehensive response to under-vaccination among preschool-aged children, was initiated in the United States in 1993 (1). The CII established the goal of increasing vaccination coverage levels among children aged 2 years to > or = 90% by 1996 for the most critical doses of each vaccine routinely recommended for children (except hepatitis B vaccine, for which the objectives were to increase coverage to 70% by 1996 and 90% by 1998). This report presents final 1996 estimates of coverage with vaccines targeted by CII among children aged 19-35 months, which indicate that in 1996 all national vaccination coverage goals were exceeded for the routinely recommended vaccines.

Bacterial Proteins↗
PubMed1996

A clinical/statistical comparison between the subpedicle connective tissue graft method and the guided tissue regeneration technique in root coverage.

Subepithelial connective tissue grafts and guided tissue regeneration have been shown to be effective means to obtain root coverage. The purpose of this study is to compare statistically the results obtained with these techniques 1 year after the surgical procedures were performed. Thirty-six gingival recessions belonging to Class I and Class II of the Miller classification were treated: 18 cases with subepithelial connective tissue grafts (SCTG) and 18 cases with guided tissue regeneration (GTR). Each patient was randomly assigned to a group. At baseline, the group treated with subepithelial connective tissue grafts presented a mean recession of 4.88 mm, whereas the group treated with guided tissue regeneration presented a mean recession of 5.88 mm (P = .082). After 1 year, the mean root coverage was 77.08% in the SCTG group and 80.88% in the GTR group. The difference was not statistically significant (P > .05). The mean root coverage was 3.83 mm for the SCTG group and 4.61 mm for the GTR group. The mean gain in probing attachment level was 3.05 mm for the SCTG group and 5.55 mm for the GTR group. The difference was statistically significant (P = .01). In conclusion, the mean root coverage obtained was similar for the two groups, whereas the clinical attachment gain was greater in the GTR group. Therefore, it appears that the GTR technique is preferable when severe mucogingival defects are present and gain of clinical attachment level is mandatory.

Connective Tissue↗
PubMed1997

Demographic profile of health-care coverage in America in 1993.

This study examined the distribution of health-care insurance coverage by race/ethnicity using data on gender, age, income, and education to identify segments of the population with and without health-care insurance in 1993. Among all groups, whites were more likely to have health-care insurance coverage than blacks or Hispanics. The data also were cross-classified by type of insurance coverage, including private, Medicare, and Medicaid. Whites were more likely than minorities to have private coverage, whereas minorities, socially disadvantaged persons in all groups, and the elderly were more likely to be covered by Medicare and Medicaid.

Adolescent↗
PubMed1997

Immunisation coverage in Christchurch in a birth cohort. Christchurch Immunisation Coordination Committee.

AIM: To ascertain the immunisation status of a birth cohort of infants at 8 months of age. METHODS: Data on all children born in Christchurch in June, July and August 1995 were matched with immunisation benefit claim information for the 6-week, 3-month and 5-month immunisation events. Those not listed as receiving all three immunisations by the age of 8 months were traced to ascertain their immunisation status. RESULTS: Immunisation status was established for 933 (93.1%) of the cohort of 1002 infants. Of these, 95% had received all three immunisations that were scheduled up to 5 months of age. This represents a coverage of at least 88.2% of the entire cohort. It was probable that many of those not traced would also have been fully immunised. Using a conservative estimate of coverage among this group, we calculated that 93% of the entire cohort had been fully immunised by the age of 8 months. CONCLUSION: There was a high immunisation coverage rate in Christchurch. This is in contrast to a commonly held view that children in New Zealand have a poor immunisation record. There was no evidence of a significant anti-immunisation stance among Christchurch parents. Immunisation data relevant to specific, defined populations can identify individual children and groups of children who may require assistance beyond general practitioner recall to achieve appropriate immunisation. The tracking process also allowed for immunisation reminders to be personally delivered and included some facilitation for achieving further immunisation. We suggest that a pilot programme, using a centralised register based on birth data, feeding into existing immunisation delivery and recall systems, and using tracking methods similar to those used in our study, should be the next step in addressing immunisation coverage surveillance and immunisation coordination in Christchurch.

Birth Certificates↗
PubMed1998

National, state, and urban area vaccination coverage levels among children aged 19-35 months--United States, July 1996-June 1997.

The National Immunization Survey (NIS) is an ongoing survey that provides national estimates of vaccination coverage among children aged 19-35 months based on data for the most recent 12 months for each of the 50 states, the District of Columbia, and 27 other selected urban areas. CDC initiated the NIS in April 1994 to monitor vaccination coverage levels as part of the Childhood Immunization Initiative (CII), a national strategy to ensure high vaccination coverage of children during the first 2 years of life. This report presents NIS findings for July 1996-June 1997, which indicate that vaccination levels among U.S. children aged 19-35 months remain the highest ever recorded. This report also includes the first annualized estimates for varicella vaccine coverage.

Child, Preschool↗
PubMed1998

Vaccination coverage by race/ethnicity and poverty level among children aged 19-35 months--United States, 1997.

The goals of the Childhood Immunization Initiative (CII) for 1996 were to have > or =90% of children receive three or more doses of diphtheria and tetanus toxoids and pertussis vaccine/diphtheria and tetanus toxoids (DTP/DT), poliovirus vaccine, and Haemophilus influenzae type b vaccine (Hib) and one dose of measles-mumps-rubella vaccine, and for > or =70% of children to receive three or more doses of hepatitis B vaccine. The National Immunization Survey (NIS) was undertaken as part of the CII to monitor vaccination coverage levels for each state and for 28 urban areas. This report presents coverage estimates by race/ethnicity and poverty level for 1997 and compares coverage estimates for 1995 and 1997; the findings indicate improvements in vaccination coverage levels among children living below poverty level although these levels were lower than levels among children living at or above poverty level.

Child, Preschool↗