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At least 19 recordsLinked to original sources

Motorcycle trauma in the state of Illinois: analysis of the Illinois Department of Public Health Trauma Registry.

STUDY OBJECTIVE: To assess the current morbidity and mortality of motorcycle trauma in the state of Illinois and, specifically, to assess the incidence and cost of head injury to motorcycle crash patients according to their helmet use. DESIGN: Retrospective, cross-sectional examination of the Illinois Department of Public Health Trauma Registry, for which data are available from July 1, 1991, through December 31, 1992. Data are collected from all hospitals designated as Level I or Level II trauma centers in Illinois. PARTICIPANTS: All patients involved in motorcycle crashes and subsequently taken to a Level I or Level II trauma center in Illinois and entered into the trauma registry during the period studied. RESULTS: Head injury, spinal injury, helmet use, demographic data, hospital charges, days in ICU, and source of payment were selected as outcome measures. During the 18-month study period, 1,231 motorcycle trauma patients were entered into the trauma registry. Eighteen percent were helmeted and 56.0% were nonhelmeted. In 26.0% the helmet status at the time of the crash was unknown. Thirty percent of the helmeted patients sustained head injury and 4% sustained spinal or vertebral injury, compared with 51% and 8%, respectively, for nonhelmeted patients. Nonhelmeted patients were significantly more likely to sustain severe (Abbreviated Injury Score [AIS], 3 or more) or critical (AIS, 5 or more) head injury. Patients with these serious head injuries incurred almost three times the hospital charges and used a disproportionately larger share of ICU days than those with mild or no head injuries. There was a trend toward greater use of public funds or self-pay status (no insurance) for payment of hospital charges in nonhelmeted patients. CONCLUSION: Motorcycle helmet nonuse was associated with an increased incidence of serious head injury. Motorcycle trauma patients with severe or critical head injuries used a significantly greater proportion of ICU days and hospital charges than those with mild or no head injuries.

Accidents, Traffic↗

Children in Illinois with elevated blood lead levels, 1993-1998, and lead-related pediatric hospital admissions in Illinois, 1993-1997.

OBJECTIVE: This study uses screening and hospitalization data to describe the prevalence of childhood lead poisoning in Chicago and the rest of the state of Illinois. METHODS: The authors used aggregate data published by the Illinois Department of Public Health on blood lead testing of children ages 0-6 years and data on lead-related hospital admissions of children ages 0-6 years, drawn from an administrative dataset compiled as part of a state initiative. RESULTS: No clear time trends in the percentage of children with elevated blood lead levels (defined as >15 micrograms per deciliter [microg/dL] or >45 microg/dL) were evident in either Chicago or the rest of Illinois. The proportions of children with elevated blood lead levels in Chicago and in the rest of Illinois did not decline at the dramatic rate seen in the US as a whole during the 1990s. Over a five-year period, in-hospital charges of $7.7 million were generated for the care of lead-poisoned children ages 6-16 in Chicago alone. CONCLUSION: Surveillance data, analyzed at the appropriate geographic level, can be used to focus resources on high-risk areas and to evaluate prevention efforts.

Chicago↗

Case-control studies of cancer in Illinois farmers using data from the Illinois State Cancer Registry and the U.S. Census of Agriculture.

A series of case-control studies have been carried out to compare farmers reported to the Illinois State Cancer Registry (ISCR) with other males reported to the ISCR between 1986 and 1988. Data on the number of farms in each Illinois county producing given agricultural commodities were obtained from the United States Census of Agriculture and used as surrogate exposure indicators. Employment as a farmer was found to be associated with cancer of the eye [odds ratio (OR) = 6.49, 95% confidence interval (CI) = 1.78, 23.71], lip (OR = 4.42, 95% CI = 2.46, 7.94), prostate (OR = 1.15, 95% CI = 0.99, 1.35) and leukaemia (OR = 1.51, 95% CI = 1.01, 2.25). Wheat and soybean production were found to be positively associated with leukaemia. Hay and beef production were found to be positively associated with cancer of the prostate.

Aged↗

A model teacher education program in health occupations at the University of Illinois, Urbana-Champaign, Illinois, USA.

The Health Occupations Teacher Education Program at the University of Illinois, Urbana-Champaign, U.S.A. has been shown to be a viable and productive model for the preparation of health occupations teacher for both traditional and non-traditional educational settings. Since 1971 the undergraduate program has grown from twelve students to 30 students on-campus, with more than two hundred students in the extramural and part-time programs. Recruitment has been accomplished through professional association meetings, journals and personal contacts. More recently, persons have heard of the program through extramural classes and from students, graduates or University personnel who have become familiar with the program. Program development has been effected through the "capstone" concept, which allows for transfer of technical credit in one's specialty, capped by teacher education courses and concentrated courses to enhance one's expertise in the teaching role. Courses developed by the HOTEP faculty are based on perceived student needs, and were designed as both integrative and collaborative courses to be taken with other health care practitioners and teachers. Evaluation procedures have shown the health occupations teacher education program to be effective in preparing graduates for their predicted roles. The numbers of new students, kinds of health practitioners, and numbers of graduates have increased steadily. Implementation of courses into the Health Occupations Teacher Education Program curriculum has been gradual, so that the undergraduate core of courses is now considered to be nearly complete. Much curriculum planning has already been completed on the master's program, from which some students have already graduated. A doctoral program is also open to those ready for this level of preparation. More time and effort needs to be and will be expended on courses for the master's and doctoral level programs being developed. This health occupations teacher education has been a transportable model for similar programs begun at several other U.S. universities. Many requests have been received from health occupations teacher educators from other states wishing information on this program. Experience gained in this program shows that there is a need for more health occupations teachers in the State of Illinois (2). More requests are being received both at the program and individual levels. Graduates of the program have attested to the benefits of a multidisciplinary program in its effectiveness for preparation in the health care team concept. Student teaching, according to present students and graduates, is the single most effective experience in preparation for the future teaching setting. Since students are placed in a facility resembling as closely as possible the one in which they expect to be employed, there is a real identification with the school and students. The uniqueness of this program lies in its mix of students from the various health fields...

Health Occupations↗

A multiple sclerosis cluster associated with a small, north-central Illinois community.

The authors investigated a reported incidence cluster of multiple sclerosis (MS) cases in a small, north-central Illinois community to determine validity and statistical significance. DePue, Illinois--a small, north-central Illinois community--has previously been the site of significant environmental heavy-metal exposure from a zinc smelter. Significant contamination of soil and water with zinc and other metals has been documented in this community during the time period of interest. In the mid-1990s, several cases of MS were reported to the Illinois Department of Public Health within the geographic limits of this community. Available medical records from purported MS cases reported to the Illinois Department of Public Health were reviewed, and living individuals were seen and examined. Statistical analyses were conducted with clinically definite MS cases; onset dates were determined by first symptom, and expected incidence rates were determined from published epidemiologic studies. Nine new cases of clinically definite MS occurred among residents of DePue, Illinois, during the period between 1971 and 1990. Seven of the 8 living subjects included in the final analyses were examined by one author (RS). The computed incidence rate deriving from these cases within DePue Township, Illinois, represented a statistically significant excess of new MS cases over expected. During the period from 1971 through 1990, a significant excess of MS cases occurred within the population of DePue, Illinois. Significant exposure of this population to mitogenic trace metals, including zinc, was also documented during this time period.

Adolescent↗

Effect of a statewide neonatal resuscitation training program on Apgar scores among high-risk neonates in Illinois.

OBJECTIVE: The national Neonatal Resuscitation Program (NRP), started in 1987, provided training to hospital delivery room personnel to standardize knowledge and skills to reduce neonatal morbidity and mortality and increase successful resuscitation during the first few critical minutes after birth. The Apgar score continues to be used as the best established index of immediate postnatal health. The purpose of this study was to evaluate the impact of the NRP instruction in Illinois hospitals by examining Apgar scores among high-risk infants who are likely to benefit from the NRP. METHODS: A retrospective 3-time period cohort design was used (before the introduction of the NRP, 1985-1988; transition when NRP training occurred, 1989-1990; and after NRP training was completed at least once for some delivery room personnel in each Illinois hospital, 1991-1995). Illinois computerized birth certificate files on a selected group of 636 429 high-risk neonates provided information on Apgar scores and maternal characteristics. The American Academy of Pediatrics provided instructor lists to determine when NRP training started and when it was fully implemented in Illinois. Illinois Department of Public Health provided data to categorize hospitals into levels based on type and intensity of neonatal services (Level I, II, II+, III). High-risk neonates were defined as meeting 1 of the following criteria: maternal age <20 years old or >35 years old, birth weight <2500 g or >4000 g, presence of a maternal medical risk factor, and no prenatal care or prenatal care started after the first trimester. Several exclusion criteria were applied including the following: birth records with missing data, multiple birth or congenital anomaly, and hospital information that indicate no birth deliveries in 1 of the 11 study years or delivery outside of a hospital. One-minute and 5-minute Apgar scores were divided into categories for analysis (0-3, 4-6, 7-10). No change or a decrease in a low (0-6) 1-minute Apgar when compared with the 5-minute Apgar was a primary measure to evaluate effect of NRP resuscitation. Variables examined included the following: race/ethnicity, maternal age, level of education, presence of maternal medical risk factor, trimester started prenatal care, complications of labor and delivery, and a low birth weight. Analysis consisted of chi(2) tests, relative risk calculations, and logistic regression to reveal independent associations with no change in low 1-minute Apgar score or continued low (0-6) 5-minute Apgar. RESULTS: A total of 636 429 high-risk birth records was selected for detailed analyses out of 2 077 533 births in Illinois between 1985 and 1995 for 193 hospitals. The number of active NRP instructors in Illinois changed dramatically during the study period; for example, 1 to 6 between 1987 and 1988 to 1096 to 1242 between 1991 and 1995. The percentage of neonates reported to have low (<7) 1-minute Apgar score decreased in 1991 to 1995 overall and for each of 4 hospital levels. Overall and by hospital level, there was a statistically significant lower proportion of high-risk newborns who showed a decrease or no change in their 5-minute Apgar scores after the NRP instruction. After adjusting for several maternal characteristics, logistic regression analysis revealed that high-risk newborns with a low 1-minute Apgar were more likely to increase their 5-minute Apgar after the NRP instruction in 1991 to 1995. Additional analyses indicated that very low birth weight and low birth weight newborns benefited the most from NRP instruction. CONCLUSION: Although previous research has shown that the NRP instruction improves knowledge and skill among health care personnel in the delivery room, both short-term and long-term, there has been little evidence to demonstrate NRP impact on infant morbidity. Several strategies were used in this study to control for bias and to adjust for secular trends in decreased infant morbidity during the study period. This study demonstrated sufficient support for the hypothesis that a significant improvement occurred among neonates in their Apgar score after the NRP instruction in Illinois. Empirical support is provided for the clinical effectiveness of NRP instruction.

Apgar Score↗

Maternal and Paternal Risk Factors and Birth Outcomes among Asian and Pacific Islanders in Illinois.

PURPOSE. The pupose of this study was to compare maternal and paternal risk factors and the outcomes of Asian Pacific Islander (API) pregnancies with other racial/ethnic groups (Black, Hispanic, and White) in Illinois. METHODS. We examined computerized birth certificate files in Illinois to descriptively analyze birth outcomes and parental characteristics for births occurring between 1989 and 1993. Infant mortality tables were examined for birth cohorts born from 1989 to 1992. Rates among Illinois API groups were presented for the following: maternal and paternal socio-demographic factors; maternal medical risk factors, amount of prenatal care and type of method of delivery; newborn complications and various morbidity outcomes; and, early neonatal mortality. For comparison, simliar Illinois data are presented for Blacks and Whites and Hispanics. We statistically evaluated the significance in variability of rates. PRINCIPAL FINDINGS. APIs in Illinois experienced a lower infant mortality rate. API mothers were more likely to be married, beyond the teenage years, have more education and smoke less often during their pregnancy than any of the other racial/ethnic groups. In addition, API mothers were more likely to experience primiparity rather than high parity. We detected statistically signifacnt differences for maternal and paternal socio-demographic characteristics among the four populations (p<0.0001). Similarly we found statistically significant differences in risk factors during pregnancy and labor and delivery complications among four race/ethnic population (p<0.0001). CONCLUSIONS. Fetal, neonatal, post-natal and infant mortality rates were the lowest among APIs when compared to Hispanic, Black and White neonates. These differences were statistically signifacant. However, rates of inadequate prenatal care, labor and elivery complications, prematurity and low birth weight were not similarly lower among APIs. RELEVANCE TO ASIAN AND PACIFIC ISLANDER AMERICAN POPULATIONS. This paper provides a state-level examination of parental risk factors and birth outcomes among APIs. KEY WORDS. infant mortality rates; pregnancy outcomes; prenatal care; maternal risk factors; paternal risk factors; women; Illinois.

Journal Article↗

Cancer incidence and age at northern migration of African Americans in Illinois, 1986-1991.

We compared the proportional cancer incidence of Illinois-born African Americans with those who migrated to Illinois from southern US states as children and adults, and with African American residents of the south. Adult Illinois residents, born between 1913 and 1966, who were diagnosed with cancer from 1986 through 1991 were classified by both birthplace and the state and year their social security number was assigned to determine their migration status: native, early (as child) migrant or late (as adult) migrant. African Americans of Atlanta were used to represent southern homeland ratios. Only lung cancer in African American females showed a statistically significant trend among the four groups, with Illinois native having the highest ratio. Although no trend was identified, Illinois natives had statistically significantly different ratios than both migrant groups and the southern homeland for cancers of the oral cavity (males), colon (females) and leukemias (females). The data also suggested that US regional differences in cancer ratios among African Americans exist (cancers of the prostate and testis, and in females, cancers of the oral cavity, esophagus and kidney), and among those African Americans that migrate to the north from the south, some cancer ratios also change (in males, cancers of the stomach colon, bladder and myeloma and in females, rectal cancer). Further, evidence was found in some cancer sites for the effect of the timing of northern migration on cancer risk (cancer of the rectum (males), liver (both sexes), and in females, cancer of the breast, stomach and nervous system).

Adult↗

Status of Ixodes dammini (Acari: Ixodidae) in Illinois.

Ixodes dammini Spielman, Clifford, Piesman & Corwin was found for the first time in Illinois in November 1987, when two adult females were collected from two deer in Jo Daviess County in the northwestern corner of the state. In 1988, in a study of six state parks in northern Illinois, questing adults and nymphs were encountered in one park in Ogle County. During the firearm deer hunt in November 1988, adult female and male ticks were found in several counties, with a high rate of infestation (greater than 25%) in two counties (Ogle and Rock Island) along the Rock River, which flows from Wisconsin into the Mississippi River. Several cases in humans with no history of travel outside of the state have been reported, primarily from northern Illinois. We suspect that infiltration of infected ticks and wildlife from Wisconsin is resulting in the emergence of Lyme disease in Illinois. Because all the components necessary for the completion of the tick life cycle and for the transmission of Borrelia burgdorferi are available throughout much of the state, I. dammini and Lyme disease can spread and become established in large portions of Illinois.

Animals↗

Analysis of Hispanic motor vehicle trauma victims in Illinois, 1991-1992.

OBJECTIVE: 1) To develop a profile of Hispanic motor vehicle trauma victims in Illinois, 2) to ascertain whether differences exist between Hispanic and general-Illinois-population motor vehicle trauma victims, and 3) to identify potential target areas for future injury intervention programs. METHODS: A retrospective analysis of Illinois motor vehicle trauma patients admitted from July 1991 to June 1992 was made. Participants were motor vehicle trauma victims (drivers and passengers) who presented to one of 73 level I or level II trauma centers throughout Illinois and were entered into the Illinois Trauma Registry (ITR) from July 1, 1991, through June 30, 1992. RESULTS: Of the 12,299 motor vehicle trauma victims in the ITR, 771 (6.3%) were Hispanic, 8,979 (73.0%) were white, 1,115 (9.1%) were black, and 1,434 (11.6%) were other. When compared with the other racial groups, the group of Hispanic victims were younger (25.2 vs 33.2 years), had higher male predominance (72.8% vs 60.9%), and had the lowest rate of safety equipment/occupant restraint use (21.7% vs 34.7%). A high alcohol use rate (30.7%) and high mean serum ethanol levels (44 mmol/L; 0.2 mg%) were noted. When contrasted with other racial/ethnic groups, the Hispanic victims had lower Injury Severity Scale scores (p < 0.001), but mean hospital charges tended to be higher, with fewer alternative sources of payment (p < 0.001). CONCLUSION: Using age-adjusted data from the ITR, Hispanic motor vehicle trauma victim features differ significantly from those of other racial groups. Effective health maintenance and injury prevention strategies should address the basis for these differences.

Accident Prevention↗

Genotypic and phenotypic characterization of Borrelia burgdorferi isolated from ticks and small animals in Illinois.

We have characterized 33 isolates of Borrelia burgdorferi from northern Illinois (32 isolates) and Wisconsin (1 isolate) representing the largest series of midwestern isolates investigated to date. The techniques used for molecular analysis of strains included (i) genospecies typing with species-specific PCR primers, (ii) plasmid profiling by pulsed-field gel electrophoresis of total genomic DNA, (iii) large-restriction-fragment pattern (LRFP) analysis by pulsed-field gel electrophoresis of MluI-digested genomic DNA (J. Belfaiza, D. Postic, E. Bellenger, G. Baranton, and I. Saint Girons, J. Clin. Microbiol. 31:2873-2877, 1993), (iv) sodium dodecyl sulfate-polyacrylamide gel electrophoresis of total proteins, (v) microsequencing of high-performance liquid chromatography-purified peptides derived from proteins showing high levels of expression, (vi) amino acid composition analysis of proteins, and (vii) immunological analysis of proteins with a polyclonal antiserum of human origin. Five reference strains as well as two atypical tick isolates from California (DN127) and New York (25015) were included for comparison. All of the Illinois and Wisconsin isolates were typed as B. burgdorferi sensu stricto with genospecies-specific PCR primers. The isolates were found to be heterogeneous with regard to their plasmid and protein profiles. One isolate from Illinois possessed two large-molecular-size plasmids instead of the usual 49-kb plasmid. Fragment patterns resulting from MluI digestion of genomic DNA from the 33 isolates and strains DN127 and 25015 were separable into six distinct LRFPs, five of which have not previously been described. Strain 25015 and an isolate from Illinois (CT39) shared an unusual LRFP that is not typical of other B. burgdorferi sensu stricto strains, suggesting that they may represent a fifth species of B. burgdorferi sensu lato. Five of the 33 isolates and strains DN127 and 25015 showed high-level expression of proteins with molecular masses of approximately 22 kDa. Investigation of these proteins by microsequencing of individual peptides and total amino acid composition analysis indicated that the 22-kDa proteins expressed by the seven strains were polymorphic OspC proteins. By using a polyclonal serum of human origin, expression of OspC could be detected in all 33 Illinois and Wisconsin isolates.

Amino Acid Sequence↗

Evaluation of risk assessment questions used to target blood lead screening in Illinois.

OBJECTIVE: Beginning in 1995, Illinois law permitted targeted-as opposed to universal-blood lead screening in low-risk areas, which were defined by ZIP code characteristics. State guidelines recommended specific lead risk assessment questions to use when targeting screening. This study was designed to evaluate the sensitivity and specificity of Illinois lead risk assessment questions. DESIGN: Parents bringing their 9- or 10- or 12-month and 24-month-old children for health supervision visits at 13 pediatric practices and parents of children (aged 6 through 25 months and who needed a blood lead test) receiving care at 5 local health departments completed a lead risk assessment questionnaire concerning their child. Children had venous or capillary blood lead testing. Venous confirmation results of children with a capillary level >/=10 micrograms/dL were used in analyses. CHILDREN: There were 460 children with both blood and questionnaire data recruited at the pediatric practices (58% of eligible) and 285 children (51% of eligible) recruited at local health departments. Of the 745 children studied, 738 provided a ZIP code that allowed their residence to be categorized as in a low-risk (n = 456) or high-risk (n = 282) area. RESULTS: Sixteen children (3.5%) living in low-risk areas versus 34 children (12.1%) living in high-risk areas had a venous blood lead level (BLL) >/=10 micrograms/dL; 1.8% and 5.3%, respectively, had a venous BLL >/=15 micrograms/dL. For children living in low-risk areas, Illinois mandated risk assessment questions (concerning ever resided in home built before 1960, exposure to renovation, and exposure to adult with a job or hobby involving lead) had a combined sensitivity of.75 for levels >/=10 micrograms/dL and.88 for levels >/=15 micrograms/dL; specificity was.39 and.39, respectively. The sensitivity of these questions was similar among children from high-risk areas; specificity decreased to.27 and.28, for BLLs >/=10 micrograms/dL and >/=15 micrograms/dL, respectively. The combination of items requiring respondents to list house age (built before 1950 considered high risk) and indicate exposure to renovation had a sensitivity among children from low-risk areas of.62 for BLLs >/=10 micrograms/dL with specificity of.57; sensitivity and specificity among high-risk area children were.82 and.36, respectively. For this strategy, similar sensitivities and specificities for low and high-risk areas were found for BLLs >/=15 micrograms/dL. CONCLUSIONS: The Illinois lead risk assessment questions identified most children with an elevated BLL. Using these questions, the majority of Illinois children in low-risk areas will continue to need a blood lead test. This first example of a statewide screening strategy using ZIP code risk designation and risk assessment questions will need further refinement to limit numbers of children tested. In the interim, this strategy is a logical next step after universal screening.

Child, Preschool↗