TO MEET THESE WANTS. A HISTORY OF THE RHODE ISLAND HOSPITAL.
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Race, ethnicity, and access to health care, Rhode Island, 1990.
Differences in access to health care by race and ethnicity have been examined using data obtained from a statewide health interview survey conducted by Rhode Island Department of Health in 1990 (N = 6,536 individuals in 2,586 households), in which ethnic minorities were oversampled. Compared to White non-Hispanic (WNH) respondents, White Hispanics (WH) were more likely to lack a regular source of medical care at some time in the past twelve months (14.0% vs. 9.8%) and were much more likely to lack health insurance coverage (22.7% vs. 7.5%). Black respondents were more likely to lack regular source of care (10.4%) and health insurance coverage (17.4%). Asian respondents also had a high proportion without insurance (13.5%). Multivariate analysis has been employed to identify significant social, economic, and demographic determinants of inadequate access to care, including variables for race/ethnicity, age, sex, income, education, and employment status, and to quantify their independent contributions as predictors of level of access.
Black or African American↗
Guilty in Rhode Island. Conviction of hospital executives in Roger Williams case strengthens the argument that stronger oversight needed.
The conviction of two former Roger Williams Medical Center executives in Rhode Island is sure to keep up the heat for more vigorous oversight of hospitals. Robert Urciuoli and Frances Driscoll were both convicted of fraud. "It's not to say that directors should be running these organizations," says attorney Patrick Coffey, left. "But it is their function to hire qualified people (who) won't ever tarnish the reputation of their institution".
Chief Executive Officers, Hospital↗
Domestic violence incidents with children witnesses: findings from Rhode Island surveillance data.
In this study we analyze factors associated with children witnessing police-reported domestic violence (DV) and determine the age distribution of children witnessing. Rhode Island Department of Health surveillance data (1996-1998) from police forms were used to assess demographic characteristics of victims, characteristics of incidents, whether children were present, and children's ages. Victim gender, age, race/ethnicity, relationship to suspect, and whether the victim was assaulted were all strong predictors of children witnessing a DV incident. Almost half (48%) of the children who witnessed DV incidents were less than 6 years old. To reach these young children, prevention and intervention programs will need to target parents and caretakers of young children and/or pediatricians.
Adolescent↗
Breast biopsy rate and positivity in Rhode Island.
Breast biopsy is a common procedure for which few age-specific, population-based data are available. We identified all women who underwent breast biopsy in Rhode Island in 1989 by reviewing the specimen logs at each of 13 pathology laboratories. Among 425,000 women aged 15-97 years, 2685 underwent breast biopsy, for an overall rate of 6/1000. The rate increased with age, peaking among 45- to 54-year-olds and then declining in women over 75. Among those biopsied, 726 were diagnosed with breast cancer, for an overall biopsy positivity of 27%. In contrast to rate, positivity increased steadily with age. These results are within the range of estimates produced by smaller group studies.
Adolescent↗
Blizzard morbidity and mortality: Rhode Island, 1978.
The total number of outpatient visits to 10 hospital emergency rooms declined 64 per cent and emergency admissions 35 per cent immediately after the February 1978 blizzard in Rhode Island; both quickly returned to normal levels. Three days after the storm, admissions for myocardial infarction increased markedly. Total mortality and ischemic heart disease deaths showed a considerable increase for the five-day period following the blizzard. The physical and psychological stress of the blizzard probably precipitated cardiac deaths in susceptible individuals.
Disasters↗
Cesarean section and maternal mortality in Rhode Island. Incidence and risk factors, 1965-1975.
An 11-year study from January 1, 1965, through December 31, 1975, was undertaken to study maternal death associated with cesarean section in Rhode Island. The risk of maternal death associated with cesarean section and that for vaginal delivery was calculated, and it was found that the risk of death from cesarean section was 26 times greater than with vaginal delivery. The expanding indications for cesarean section, factors associated with excess risk of death from cesarean section, and suggestions to prevent such catastrophe are discussed.
Adult↗
Random amplified polymorphic DNA markers in crosses between inbred lines of Rhode Island red and White Leghorn chickens.
Reciprocal crosses and backcrosses were conducted between inbred Rhode Island Red and White Leghorn chickens differentiated for egg production and egg quality traits. Random amplified polymorphic DNA (RAPD) markers distinguishing inbred lines were detected. Twenty-two polymorphic bands were found from screening 120 single 10-mer random primers of which two were consistent with sex-linked markers. Of 90 pairwise two-point linkage analyses completed for the autosomal markers, four close linkages (8.2 cM to 14.9 cM) were significantly different from zero.
Animals↗
Occupational injury among Rhode Island adolescents: an analysis of workers' compensation claims, 1998 to 2002.
OBJECTIVES: We sought to examine occupational injuries sustained by adolescent workers during a 5-year period. METHODS: Workers' compensation claims from Rhode Island were used to assess injuries of 15- to 19-year-old employees (n = 8321) from 1998 to 2002. Baseline employee population estimates were derived using the Current Population Survey. RESULTS: The annual estimated adolescent claim rate was 6.6 per 100 workers (95% confidence interval = 6.1-7.1), with annual average costs of $614,182. Injury rates increased with employee age, hours worked, and for day and nightshift employees relative to evening shift workers. The highest proportion of claims by industry was in eating establishments, and the average indemnification duration was 13.0 days. CONCLUSIONS: Specific emphasis should be placed on increasing safety training and preventative interventions for teenagers in hazardous occupations and for those working longer hours.
Adolescent↗
Assessment of occupational eye injury risk and severity: an analysis of Rhode Island workers' compensation data 1998-2002.
BACKGROUND: Occupational eye injuries have been recognized as a serious health risk to workers and are in need of further investigation to develop effective interventions. METHODS: Rhode Island workers' compensation claims of ocular injury between 1998 through 2002 (n=8,877) were examined. The Current Population Survey was used to estimate occupational employment levels as a baseline for rate calculations. RESULTS: The estimated ocular injury claim rate was 32.9 per 10,000 workers (95% CI=32.3-33.6), with the cost of claims totaling $1,514,666 and averaging $171 per claim. The highest estimated claim rate of all occupations was found for construction laborers of 373.7 per 10,000 workers (95% CI=267.1-480.3). Relative to the durable manufacturing industry, the highest risk of injury resulting in disability indemnification was the wholesale trade industry (OR=2.18, 95% CI=1.19-4.01, P<0.05). CONCLUSIONS: Many of the eye injuries reported were likely preventable. Greater diligence, training, and safety precautions are needed to reduce the risk of eye injury to employees.
Accidents, Occupational↗
Control of West Nile virus, Rhode Island, 2003.
Thanks largely to systematic larviciding by the State's 39 municipalities, and aided by the public's destruction of "backyard" mosquito habitats and adoption of personal protective measures (clothing, repellant), Rhode Island minimized the potential human burden of WNV during the 2003 mosquito season (six serious WNV cases, one death, and no reports of WNV-tainted blood donations). The potential burden of WNV on domestic animals was also reduced through immunization. Nonetheless, the State's first WNV death reminds us of the danger this disease poses for the very young, for elders, and for people of all ages who are immune-compromised. Similarly, the widespread location of birds positive for WNV signifies the ubiquity of risk. All mosquitoes must be avoided. Based on its experience with WNV control over the past few years, the State will continue and enhance its surveillance and control efforts in 2004. Once again, systematic larviciding by municipalities and continuing public education through multiple channels will form the backbone of control, supported by active surveillance for the virus in the wild, in domestic animals, and in humans. For the latter effort, the vigilance of the health care community is of signal importance to the protection of the public. Every human case is investigated thoroughly, to establish as accurately as possible the time and place of exposure. DEM and HEALTH use this information to assess potential weaknesses in WNV control efforts, and to take corrective action, as necessary. Health care providers also play an essential role in public education, reminding patients (all patients, but especially the very young, elders, and the immune-compromised) to avoid mosquito bites. Discussing the avoidance of mosquito bites with patients who engage in regular outdoor activity is especially important. School physicians and the medical directors of nursing homes are well-positioned to keep mosquito control and avoidance on the agenda of their respective institutions. Together, we can control the burden of this disease among domestic animals and humans, if we continue to pursue mosquito control and personal protection aggressively. If we don't, the potential for tragedy is tremendous, as evidenced by the recent experience of other regions of the country.
Animals↗
Prevalence and incidence of HIV, hepatitis B virus, and hepatitis C virus infections among males in Rhode Island prisons.
OBJECTIVES: We evaluated prevalence and intraprison incidence of HIV, hepatitis B virus, and hepatitis C virus infections among male prison inmates. METHODS: We observed intake prevalence for 4269 sentenced inmates at the Rhode Island Adult Correctional Institute between 1998 and 2000 and incidence among 446 continuously incarcerated inmates (incarcerated for 12 months or more). RESULTS: HIV, hepatitis B virus, and hepatitis C virus prevalences were 1.8%, 20.2%, and 23.1%, respectively. Infections were significantly associated with injection drug use (odds ratio = 10.1, 7.9, and 32.4). Incidence per 100 person-years was 0 for HIV, 2.7 for HBV, and 0.4 for HCV. CONCLUSIONS: High infection prevalence among inmates represents a significant community health issue. General disease prevention efforts must include prevention within correctional facilities. The high observed intraprison incidence of HBV underscores the need to vaccinate prison populations.
Adult↗
Electrical wiring configurations and childhood leukemia in Rhode Island.
The study of the relationship between childhood leukemia and electric power line configurations in the greater Denver, Colorado, area by Wertheimer and Leeper (Am J Epidemiol 109:273-284, 1979) was repeated in Rhode Island, focusing on leukemia (age at onset, 0-20 years; year of onset, 1964-1978). The addresses of 119 leukemia patients and 240 controls were studied by mapping power lines within 50 yards (45.72 m) of each residence. The shortest distance between each power line and the point of the residence closest to it was found; the number and types of wires in each power line were noted. Exposure weights were assigned each type of wire using Wertheimer and Leeper's median field strength reading for each. Assuming that the strength of the field decreases with the square of the distance from its source, and that fields generated by different wires grouped in the same power line are simply additive, a summary value of relative exposure was calculated for each address. Quartile exposure values for controls were used to group patient exposures. Contrary to Wertheimer and Leeper's results, no relationship was found between leukemia and electric power line configurations.
Child↗
The North Cape oil spill: hydrocarbons in Rhode Island coastal waters and Point Judith Pond.
On 19 January 1996, the North Cape oil barge ran aground near Moonstone Beach, RI, and spilled over 2700 metric tons of No. 2 fuel oil during a severe winter storm. High winds and rough seas drove the oil into the water column, and the oil spread throughout Block Island Sound and into several coastal salt ponds. Over 50 water samples were collected from Point Judith Pond (PJP) and the southern coast of Rhode Island for four months after the spill and analyzed for polycyclic aromatic hydrocarbons (PAHs) and total petroleum hydrocarbons (TPHs). These analyses revealed that at least 60 km2 of coastal waters were impacted from the spill. Maximum concentrations of sigmaPAHs and TPHs were 115 and 3940 microg l(-1), respectively. The percentage of sigmaPAHs relative to the TPHs for all samples varied from 0.2 to 43%, showing that there was no clear relationship between sigmaPAHs and TPHs for the whole dataset and likely resulting from spatial and temporal partitioning over the course of the spill. However, within the dataset, there were stronger correlations for distinct samples collected at similar locations and times. In PJP, water column concentrations of individual PAHs decreased at rates of 0.08-0.24 day(-1) and lower-molecular weight PAHs were removed faster than higher-molecular weight PAHs.
Environmental Monitoring↗
Ground water input to coastal salt ponds of southern Rhode Island estimated using 226Ra as a tracer.
The naturally occurring radionuclide 226Ra (t1/2 = 1600 years) was used as a tracer to determine ground water input to Point Judith, Potter, Green Hill and Ninigret ponds in southern Rhode Island. Measurements of 226Ra activity were made in samples collected from salt ponds, pore waters, sediments, and local ground water wells during June-August, 1997. These results were combined with a simple box model to derive ground water input fluxes of 0.1-0.3 cm3 cm-2 d-1 (2-5 x 10(7) L d-1), which are comparable to previous estimates of ground water input to these ponds.
Environmental Monitoring↗
Prescribing syringes to prevent HIV: a survey of infectious disease and addiction medicine physicians in Rhode Island.
This article describes the assessment of physicians' attitudes and practices regarding prescribing syringes to injection drug users (IDUs). A brief, anonymous, self-administered questionnaire was sent to all Infectious Disease and Addiction Medicine specialists in Rhode Island. Of 49 eligible physicians, 39 responded (response rate 80%). Most (95%) indicated that there is a legitimate medical reason for IDUs to obtain sterile syringes. Many (71%) agreed that they would prescribe syringes to prevent disease in IDUs if it were clearly legal to do so. We can conclude that physician syringe prescription to IDUs may be an acceptable supplement to existing HIV prevention strategies.
Adult↗
Rhode Island's got the Blues. But the state's Blues plan isn't the only one drawing fire over its reserves, executive perks and compensation.
It's been a strained few months at Blue Cross and Blue Shield of Rhode Island. Outrage over corporate excess led to a flurry of reforms at the insurer, headed by Chairman Frank Montanaro, left, including banning loans to employees and dropping lavish perks. Other Blues have been catching flak for their burgeoning bottom lines, but executives say they need ample reserves since that's their only capital.
Administrative Personnel↗
Risk factors for syphilis among incarcerated women in Rhode Island.
Syphilis remains a significant problem in the United States. The prison environment is an ideal location to identify and treat syphilis. We undertook this study to describe the correlates and risk factors for syphilis among incarcerated women in Rhode Island. The study design was a review of all cases of syphilis identified through routine screening in the state prison and a case control study. Between 1992 and 1998, among 6,249 incarcerated women, 86 were found to have syphilis; of these, 29 were primary and secondary cases representing 49% of infectious cases of syphilis in women in the state. The prison environment offers a unique opportunity for the diagnosis and treatment of syphilis.
Adult↗