Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ALABAMA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources

Professional personnel in health care among secondary school athletics in Alabama.

To ascertain the use of professional personnel in health care among secondary school athletics in Alabama, a survey was sent to all high schools in the state. Smaller schools (classified 1A) are located an average of 10.8 miles from the nearest medical facility, while for larger schools (classified 4A) the average is 3.2 miles. Overall, 55% have a team physician; primary care physicians represent 65.8% and orthopedists 13%. Only 40% of the team physicians conduct preseason physical examinations for the boys and 25% for the girls. Also, 65% of all the schools reported that a physician was not readily available for practice and games for boys' or girls' teams. Almost 90% of the 4A schools reported that a physician lives in the community, compared to 30% for the 1A schools. On this survey, a physician or athletic trainer outranked a medical facility or training room as being most important to their athletic program, suggesting that the greatest need in health care among high schools in Alabama is the presence of personnel trained in athletic injuries.

Adolescent↗

Survey of Alabama physicians' use of mammography, 1989.

In early 1989 we surveyed by questionnaire Alabama primary care physicians (N = 1800) concerning their attitudes toward and use of mammography. There were 681 respondents (37.8%). The majority (83%) recommend mammograms for their patients according to the American Cancer Society guidelines and obtain baseline studies in asymptomatic women between the ages of 35 and 40 years. It appears that the cost of mammograms is decreasing in Alabama; a screening study was available for $50 or less to 34% of responding physicians. Almost one half (48%) of the physician respondents believe that more than 50% of their patients have had at least one mammogram.

Adult↗

Guidelines for Regional Anesthesia in Obstetrics: potential impact on obstetric anesthesia services in rural Alabama.

When the American Society of Anesthesiologists published its Guidelines for Regional Anesthesia in Obstetrics, I did a survey to determine what impact a broadly implemented strict interpretation of those guidelines might have on obstetric anesthesia care in small rural Alabama hospitals. Thirty-six rural Alabama hospitals with fewer than 200 beds were included in the survey, with a response rate of 50%. Data included total deliveries, cesarean section rates, utilization rates of anesthesia services, personnel providing anesthesia care, and identification of physician personnel available during labor and cesarean section. Results showed that anesthesia care is provided for approximately 52% of births in the responding hospitals. Of these, approximately 60% of cesarean sections and 90% of vaginal deliveries are not routinely attended by anesthesiologists. If these data also reflect the nonrespondent hospitals, statewide access could be limited for approximately 6000 parturients annually. The Guidelines should be interpreted with caution. Rather than conform to related policies, interpretation should allow implementation consistent with the capabilities of the individual institutions, while ensuring quality anesthesia care for the parturients.

Alabama↗

Birth defects surveillance: Jefferson County, Alabama, and Uppsala County, Sweden.

Birth defects in live-born infants were documented for 2 years in Jefferson County, Alabama (USA)--1986 and 1987--and in Uppsala County, Sweden--1985 and 1986. A total of 27,561 live births (9,179 white male, 8,728 white female, 4,883 black male, and 4,771 black female infants) occurred in Jefferson County; 6,896 live births (3,535 male and 3,361 female) were recorded in Uppsala County. These newborns were studied to establish a database of birth defects for the two small geographic areas and to study similarities and differences. Rates of hip dislocation, heart malformations, and clubfoot were high in Swedish infants. Similar frequencies of spina bifida and polydactyly were noted in Alabama whites and Swedish infants. Regional registries offer a systematic approach to detection of clustering of specific birth defects, identification of families for further study, location of patients with unique needs, and enhanced coordination of health services, including genetic counseling.

Alabama↗

Clinical presentation and treatment of a Salmonella bredeney epidemic in Shelby County, Alabama.

BACKGROUND: Numerous residents of Shelby County, Alabama, were infected with Salmonella when a restaurant unknowingly served food tainted with the bacterium. Because of the similarity in symptoms caused by other gastrointestinal pathogens and the variability in time of presentation, an outbreak such as this could be confused with one of another pathogenic origin. The pathogen identified, Salmonella bredeney, is a particularly rare cause of food poisoning. It makes up only 0.1% of the Salmonella isolates identified by the Centers for Disease Control and Prevention (CDC) each year. METHODS: We analyzed patient presentations through chart review and combined this information with that obtained from the state laboratories in Montgomery and the Shelby County Health Department. RESULTS: Symptoms were mostly gastrointestinal and ranged greatly in severity. The total number of patients affected in this incident exceeded 170, making it the largest epidemic of its kind in the recent history of Alabama. CONCLUSIONS: The outbreak in Shelby County was caused by an exceedingly rare species of Salmonella. At this time, it is the only outbreak of S bredeney reported in MEDLINE-accessible literature since 1983.

Adult↗

Alabama coronary artery bypass grafting project: results from phase II of a statewide quality improvement initiative.

OBJECTIVE/BACKGROUND: This report describes the first round of results for Phase II of the Alabama CABG Project, a regional quality improvement initiative. METHODS: Charts submitted by all hospitals in Alabama performing CABG (ICD-9 codes 36.10-36.20) were reviewed by a Clinical Data Abstraction Center (CDAC) (preintervention 1999-2000; postintervention 2000-2001). Variables that described quality in Phase I were abstracted for Phase II and data describing the new variables of beta-blocker use and lipid management were collected. Data samples collected onsite by participating hospitals were used for rapid cycle improvement in Phase II. RESULTS: CDAC data (n = 1927 cases in 1999; n = 2001 cases in 2000) showed that improvements from Phase I in aspirin prescription, internal mammary artery use, and duration of intubation persisted in Phase II. During Phase II, use of beta-blockers before, during, or after CABG increased from 65% to 76% of patients (P < 0.05). Appropriate lipid management, an aggregate variable, occurred in 91% of patients before and 91% after the educational intervention. However, there were improvements in 3 of 5 subcategories for lipid management (documenting a lipid disorder [52%-57%], initiating drug therapy [45%-53%], and dietary counseling [74%-91%]; P < 0.05). CONCLUSIONS: In Phase II, this statewide process-oriented quality improvement program added two new measures of quality. Achievements of quality improvement from Phase I persisted in Phase II, and improvements were seen in the new variables of lipid management and perioperative use of beta-blockers.

Adrenergic beta-Antagonists↗

Why is the cesarean delivery rate so high in Alabama? An examination of risk factors, 1991-1993.

BACKGROUND: Cesarean delivery is now the most frequently performed major operative procedure for childbearing women in the United States. Many of these operations are reported to be unnecessary, and millions of dollars could be saved by reducing their frequency. METHODS: Method of delivery was added to the 1989 revision of the standard certificate of live birth. Alabama also added questions on the source of payment for delivery and the provider of prenatal care in 1991, which enabled an investigation of the risk factors for cesarean delivery that occurred in the state during this period. RESULTS: One of every four births in Alabama is by cesarean delivery. The risk of cesarean delivery is not random, and the risk factors include mother's race and age, coverage by private insurance, birthweight, setting where the mother received prenatal care, mother's educational attainment, live birth order, and complications of labor and delivery. CONCLUSION: With present concerns about health care reform and the costs of health care, a reduction in the cesarean delivery rate could result in significant cost savings.

Adult↗

Long-term molecular analysis of tuberculosis strains in alabama, a state characterized by a largely indigenous, low-risk population.

With a tuberculosis case detection rate of 5.9 per 100,000 population in 2001, Alabama ranked twelfth highest in the United States. However, cases among foreign-born and human immunodeficiency virus-infected individuals remain low in Alabama. To understand the endemic statewide disease pattern, tuberculosis strains were studied for clustering in a long-term population-based study from January 1994 to May 2000. IS6110 restriction fragment length polymorphism analysis was performed for 1,834 strains. Spoligotyping was used as a secondary typing method for the 37% of isolates displaying a restriction fragment length polymorphism pattern with <6 IS6110 copies. A total of 721 (41%) patients provided isolates that composed 114 clusters, each containing isolates from 2 to 136 patients, suggesting that recent transmission accounted for 35% of tuberculosis cases. Demographic, behavioral, and clinical characteristics of patients with clustered versus nonclustered isolates stratified by low-copy-number strains (<6 IS6110 copies) versus high-copy-number strains (> or =6 IS6110 copies) were evaluated. Younger age, black race, a history of alcohol abuse, and homelessness were predictors of clustering of low-copy-number, strains and younger age, urban residency, alcohol abuse, homelessness, noninjection drug use, and a history of incarceration and/or cavitary disease were predictors of clustering of high-copy-number strains. By identifying local characteristics of tuberculosis clustering through molecular fingerprinting, control programs can distribute their limited resources to impact the transmission of tuberculosis in high-risk populations and evaluate strain distribution across geographical areas.

Adult↗

Hypothermia deaths in Jefferson County, Alabama.

INTRODUCTION: Some reported characteristics associated with hypothermia mortality include older age, alcohol consumption, male sex, and black race. The purpose of this paper is to present the epidemiology of hypothermia deaths in Jefferson County, Alabama. METHODS: Autopsy reports maintained by the county coroner's office were abstracted for all cases with primary or underlying causes of death listed as "hypothermia" or "exposure to cold" between January 1983 and July 1999. RESULTS: Sixty three hypothermia deaths occurred in Jefferson County during the study period. The mean age among cases was 68 years, 63.9% were male and 70% were of black race. Rates of hypothermia death were highest among black males, followed by black females, particularly blacks aged 80 years or older. Deaths occurring indoors were more common among older persons and outdoor deaths more common among younger persons. Thirty per cent of decedents tested positive for alcohol, 75% of whom were found outdoors. Nine decedents tested positive for drugs or medications. Approximately 90% of decedents were identified as having one or more chronic medical conditions. Excluding alcoholics, 52% of decedents had one or more chronic medical conditions. CONCLUSIONS: Hypothermia in Jefferson County, Alabama is a cause of death primarily affecting two distinct groups of individuals, elderly persons who develop hypothermia inside a dwelling and middle aged males who develop hypothermia out of doors and have consumed alcohol.

Adolescent↗

Stroke in south Alabama: incidence and diagnostic features--a population based study.

This study has attempted to identify all persons from an area of southern Alabama who had a stroke in 1980 and were hospitalized. Data were gathered on disease onset, clinical course, laboratory results, history of risk factors, and outcome. The age-adjusted incidence rates for initial stroke were 109 per 100,000 for whites and 208 per 100,000 for blacks. Age-specific rates were higher in blacks than whites, and highest for black females. The distribution of cases by type of stroke was: atherothrombotic (6%), embolic (26%), lacunar (13%), infarction of unspecified origin (40%), parenchymatous hemorrhage (8%), subarachnoid hemorrhage (6%), and unidentified type (1%). Blacks had higher incidence rates for hemorrhages, and black females had the highest incidence rate for lacunar stroke. The overall stroke incidence rates in this series were not significantly higher than those from prior population studies, suggesting that southern Alabama is not part of the so-called "Stroke Belt" area of the southeastern United States.

Adult↗

Wyatt v. Stickney: assessing the impact in Alabama.

In 1971 U.S. District Judge Frank M. Johnson, Jr., ruled that patients involuntarily committed to Alabama mental institutions have a constitutional right to treatment. The following year he issued a court order containing 35 minimum constitutional standards for adequate treatment of the mentally ill and appointed human rights committees at the institutions to oversee their implementation. Focusing primarily on Bryce Hospital in Tuscaloosa, the author examines the extent to which compliance with the standards has been achieved, problems that have arisen in implementing the standards, and issues that still must be dealt with. He briefly discusses changes in the state's mental health system that preceded the filing of the case, and he emphasizes that those changes may have contributed significantly to the improvements that have occurred in mental health care in Alabama after Wyatt.

Alabama↗

Impact of Hurricane Ivan on pharmacies in Baldwin County, Alabama.

OBJECTIVE: To evaluate the impact of Hurricane Ivan, which made landfall east of Mobile, Alabama, on September 16, 2004, on pharmacies in the affected areas. DESIGN: Retrospective cross-sectional analysis. SETTING: Baldwin County, Alabama. INTERVENTIONS: Pharmacy community rapid-needs-assessment survey. PARTICIPANTS: 41 hospital and community (chain and independent) pharmacies. MAIN OUTCOME MEASURES: Posthurricane pharmacy hours of operations, prescription volumes, infrastructure damage, and prehurricane disaster planning. RESULTS: During the week of the hurricane, both chain and independent community pharmacies within the evacuation zone worked significantly fewer hours (46% and 49%, respectively) and dispensed significantly fewer prescriptions (37% and 52%) compared with the same week of the prior year. Overall, 40% of pharmacies depleted their supplies of certain medications (e.g., anxiolytics, antihypertensives). A total of 60% of the chain and independent pharmacies outside the evacuation zone closed because of loss of electricity, but pharmacies with a generator were significantly less likely to report having turned away patients. The proportion of pharmacies that had a disaster plan but turned away patients or rationed or ran out of medications was similar to that of pharmacies without a disaster plan. CONCLUSION: Although Hurricane Ivan primarily affected the operation of pharmacies within the evacuation zone, pharmacies in the surrounding area were also affected because of loss of power. Emergency management officials should evaluate the efficacy of specific guidelines outlined in disaster plans and identify ways to deliver essential medications to people in disaster-affected areas.

Alabama↗

Access to dental care in Alabama for children with special needs: parents' perspectives.

BACKGROUND: Access to dental care and delivery of quality dental health services are important for children with special needs. The authors surveyed parents of children with special needs in Alabama to determine their perceptions of access and barriers to dental care for their children. METHODS: The authors sent a questionnaire to 2,057 parents of children aged 3 to 13 years with special needs--cleft lip and/or palate; cerebral palsy, or CP; spina bifida; or epilepsy/seizure disorders--who were listed in a database provided by Children Rehabilitation Services of Alabama. The authors conducted univariate and multivariate analyses to calculate odds ratios and 95 percent confidence intervals. RESULTS: The overall response rate was 38 percent (N = 714). Eighty-five percent of respondents reported that their children had received some form of routine dental care. However, 35 percent of respondents reported they had had problems finding dentists willing to treat their children. Among those with problems, significant barriers to dental care included their children's having Medicaid insurance, poor oral health or CP, as well as a shortage of dentists with training in the care of children with special needs. CONCLUSIONS AND PRACTICE IMPLICATIONS: While the majority of respondents said their children had access to dental care, one-third said their children had problems receiving this care. Many of these problems can be ameliorated. Increasing providers' participation in the Medicaid program and improving their knowledge about, empathy for and training in the care of children with special needs is essential in improving access to dental care for this population.

Adolescent↗

Secret encounters: black men, bisexuality, and AIDS in Alabama.

Black men suffer the highest rates of HIV infection in Alabama. However, little is known about the HIV risks of this sector of the population, primarily because the current public health focus is on women and children. The dearth of research on HIV risk among black men in Alabama is addressed by drawing on focus group, elicitation, and key informant data from an ongoing epidemiologic study on AIDS in that state. These hypothesis-generating qualitative interviews were used to identify three high-risk scenarios: "sex for money or drugs"; "prison sex"; and "sneaky sex" by married or nominally heterosexual men. It was found that covert and unprotected sex among bisexually active black men was commonplace for reasons that included prostitution, habituation to same-sex relations during incarceration, and the desire to maintain a facade of heterosexuality in homophobic communities. It was concluded that bisexual activity is highly correlated with secrecy and unprotected sex. The risks of bisexuality among black men are exacerbated by incarceration, homophobia, drug use, and the prison and public health focus on surveillance rather than prevention.

Adult↗

Tick infestations of birds in coastal Georgia and Alabama.

Mist-netted birds were examined for ticks on Jekyll Island, Glynn Co., Georgia (32 bird species) in 1996-1998, and at Fort Morgan, Baldwin Co., Alabama (36 species) in 1998 during fall migration. Sixty-two (14.7%) of 423 birds from Jekyll Island and 22 (13.3%) of 165 birds from Fort Morgan were infested with ticks. The mean number of ticks per infested bird was 2.0 on Jekyll Island and 6.3 at Fort Morgan. Ten species of birds were infested with ticks on Jekyl1 Island where 87% of all ticks were recovered from 3 species: the common yellowthroat (Geothlypis trichas), gray catbird (Dumetella carolinensis), and northern waterthrush (Seiurus noveboracensis). Eight species of birds were infested with ticks at Fort Morgan where 83% of all ticks were recovered from 3 species: the brown thrasher (Toxostoma rufum), swamp sparrow (Melospiza georgiana), and common yellowthroat. Six species of ticks (Amblyomma americanum, Amblyomma maculatum, Haemaphysalis leporispalustris, Ixodes brunneus, Ixodes minor, and Ixodes scapularis) were recovered from the Georgia birds, whereas 3 species (A. maculatum, H. leporispalustris, and Ixodes dentatus) were recovered from the Alabama birds. Attempts to isolate Borrelia burgdorferi sensu stricto, the etiologic agent of Lyme borreliosis, from Ixodes spp. ticks recovered from birds were unsuccessful.

Alabama↗

Analysis of drug involvement in traffic fatalities in Alabama.

Toxicology studies were performed on a subset of highway fatalities in Alabama. Results of those tests were analyzed for the years 1980 through 1984. It was found that 63% of driver fatalities tested had some level of blood alcohol concentration. From a smaller subset of the fatalities, it was found that almost 17% tested positively for marijuana. More than 5% of fatalities had some level of drugs (either illicit or prescription) in their blood stream. A statistical significant association was found between diazepam (tranquilizer) and low alcohol blood concentration. Another important finding is that for Alabama, marijuana is a problem drug of young drivers.

Accidents, Traffic↗

Impact of the revision of DUI legislation in Alabama.

On May 19, 1980, a major revision in the Alabama DUI laws went into effect which gave judges greater discretion in sentencing. This revision resulted in an increase in the proportion of DUI convictions, a reduction in the number of DUI citations reduced to reckless driving, a reduction in the proportion of offenders acquitted and/or dismissed, an increase in the proportion of revocations, and an increase in court referrals to an educational program on the first offense. However, the 1980 revision was accompanied by a significant increase in the percentage of alcohol-related accidents. Consequently, the Alabama legislature revised the 1980 law on July 29, 1983, the revision taking effect immediately. The more stringent penalties in the new law apparently had a positive effect on all six alcohol-related measures cited above. Most importantly, the latest revision was accompanied by a significant decrease (2.80%) in the proportion of alcohol-related accidents.

Accidents, Traffic↗

Borrelia lonestari DNA in adult Amblyomma americanum ticks, Alabama.

Polymerase chain reaction analysis of 204 Amblyomma americanum and 28 A. maculatum ticks collected in August 1999 near the homes of patients with southern tick-associated rash illness and in control areas in Choctaw County, Alabama, showed Borrelia lonestari flagellin gene sequence from two adult A. americanum. The presence of B. lonestari in A. americanum ticks from Alabama suggests that this suspected pathogen may be widespread in the southeastern United States.

Alabama↗