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At least 19 recordsLinked to original sources
PubMed1996

Screening for tuberculosis infection among secondary school students in Minneapolis-St. Paul: policy implications.

Three students in the St. Paul Public Schools were diagnosed with active tuberculosis (TB) in late 1991 and early 1992. To define the prevalence of TB infection in St. Paul and Minneapolis, we conducted school-based screening projects in the St. Paul and Minneapolis public schools during 1992 and 1993. In St. Paul, 7,596 (74.8%) students in grades six through 12 received Mantoux tests; 268 (3.5%) were reactive. Infection rates varied significantly by country of birth, with students born outside the United States more likely to be Mantoux reactors than U.S.-born students (RR = 20.2; 95% CI = 14.9-27.3; p < 0.001). In Minneapolis, 752 (47.2%) eighth-grade students received Mantoux tests; 23 (3.1%) were reactive. As in St. Paul, infection rates varied by country of birth; students born outside the United States were more likely to have reactive Mantoux tests than students born in this country (RR = 13.2; 95% CI = 5.6-31.4; p < 0.001). We conclude that routine TB screening of school students is not warranted in Minnesota, although school-based screening targeted at the highest risk students, particularly those born outside the United States, may be a beneficial prevention strategy.

Adolescent↗
PubMed1983

Hospitals and health maintenance organizations: an analysis of the Minneapolis-St. Paul experience.

Minneapolis-St. Paul is recognized as a prime example of health care competition. Policymakers and others have been asked to look to the Twin Cities as a model upon which to base new competitive initiatives in the health care sector. Yet little is known about the impact of Health Maintenance Organizations (HMOs) on other health care providers. This study examines the effects of the area's seven health maintenance organizations on the local hospital community. Three questions are addressed. First, is the situation in the Twin Cities unique? A comparison of case study findings and the available literature together with hospital data from similarly HMO-penetrated markets suggests that the Twin Cities' hospital market is indeed different. Second, what is the nature of hospital-HMO interaction? The flexibility of contracting apparently allows hospitals to affiliate successfully with an HMO under a variety of service and reimbursement agreements. Third, what effect has HMO activity had on community-wide utilization? While HMO enrollees clearly use fewer hospital days and the trend in the community is toward fewer days, attributing the change to HMOs is difficult. A large portion of the differences between HMO and community-wide utilization levels is attributable to differences in population.

Economic Competition↗
PubMed1994

Prenatal drug use in Minneapolis-St Paul, Minn. A 4-year trend.

OBJECTIVES: To determine the rates of maternal ingestion of cocaine, marijuana, and opiates in women from Minneapolis-St Paul, Minn, in 1993 and compare them with rates observed in 1989; and to compare outcomes of newborns born to those women with and without evidence of prenatal drug ingestion. STUDY DESIGN: The meconium from newborns of a representative cluster-based sample of women from Minneapolis-St Paul was analyzed for metabolites of cocaine, marijuana, and opiates. The newborns were consecutive births in four urban and suburban hospitals. Maternal demographic information and newborn outcome data were collected and matched to the meconium samples. The race, age, and socioeconomic status of the mothers whose newborns were screened were the same as the demographic characteristics of all women delivering babies in Minneapolis-St Paul in 1990 and 1991. SETTING: Metropolitan hospitals of Minneapolis-St Paul. MAIN RESULTS: Of the 1333 samples, 27 (2.0%) were cocaine positive, 35 (2.6%) were tetrahydrocannabinol positive, and 16 (1.2%) were opiate positive. There were 168 women (22.6%) reporting that they smoked. Detection of tetrahydrocannabinol and cocaine was more common in newborns of women of color, those receiving medical assistance, and those over age 23 years. Newborns with meconium samples positive for cocaine or tetrahydrocannabinol had slightly lower average birth weights but were no more likely to be premature or to require neonatal intensive care unit admission than newborns with no drugs detected in their meconium. Newborns of mothers who smoked throughout pregnancy had lower average birth weights and higher rates of prematurity and neonatal intensive care unit admissions. Standardized rates of cocaine detection in the four hospitals decreased from 4.0% in 1989 to 2.0% in 1993. CONCLUSIONS: Rates of perinatal cocaine detection have declined in the Twin Cities of Minneapolis-St Paul over the past 4 years. In this population, self-reported smoking was associated with more serious adverse outcomes of the newborns than was the detection of cocaine, marijuana, or opiates.

Adolescent↗
PubMed2002

The use of GIS for monitoring and predicting urban growth in east and west St Paul, Winnipeg, Manitoba, Canada.

Most urban growth in Canada occurs in the urban-rural fringe. The increasing dispersal of the Canadian urban population is due to centrifugal forces pulling urbanites past the suburbs into the surrounding exurban communities. Most Canadian urban centres are located on prime agricultural land. Exurban sprawl devours an inordinate amount of the better agricultural land. The growth around the city of Winnipeg is a case in point. Within Winnipeg's urban field are the rural municipalities of East and West St Paul. The objective of this study is to investigate the impact of urban growth on the agricultural land of these RMs as well as the rate of urban growth in both Municipalities based on database analysis using aerial photographs taken in 1960 and 1989 and Geographic Information System (GIS). East St Paul was found to have a higher rate of urbanization (from 10.14% to 43.75%) between 1960 and 1989 than West St Paul (from 7.36% to 23.57%). The growth prediction using Markov probability chain analysis showed that East St Paul will henceforth experience a reduced rate of increase than West St Paul. The rate of urbanization for both RMs is found to be comparable with areas surrounding other major cities such as Toronto. The largest increases in urban land use categories occurred in and around the existing exurban settlements. It was found that most urbanization take place on the most fertile soil.

Cities↗
PubMed1997

Comparison of medical care and one- and 12-month mortality of hospitalized patients with acute myocardial infarction in Minneapolis-St. Paul, Minnesota, United States of America and Göteborg, Sweden.

We compared medical care and mortality through 1-year of hospitalized acute myocardial infarction (AMI) patients in 2 large metropolitan areas in the United States and Sweden. All hospitalized AMI discharges (International Classification of Diseases, 9th revision [ICD9] codes 410) occurring among 30 to 74-year-old residents of the Minneapolis-St. Paul metropolitan area in 1990 and Göteborg, Sweden, in 1990 to 1991 were identified and their medical records examined. There were dramatic differences in medical care during the index hospitalization of AMI patients between Minneapolis-St. Paul and Göteborg. Use of thrombolytic therapy, coronary angioplasty, bypass surgery, calcium antagonists and lidocaine was more common in Minneapolis-St. Paul; beta blockers were more frequently used in Göteborg, and aspirin use was similar. Despite these large differences, neither 28-day nor 1-year mortality of hospitalized AMI patients differed significantly. The marked differences found in the early treatment of AMI between Minneapolis-St. Paul and Göteborg, combined with the negligible differences observed in short- and long-term mortality, raise questions about the most effective and efficient allocation of medical resources.

Adult↗
PubMedDate not supplied

The effects of school-based health clinics in St. Paul on school-wide birthrates.

School-based clinics in St. Paul have provided comprehensive health services, including reproductive health care, for almost two decades. This study examines the effects of those clinics on the birthrates in their respective schools, using a newly developed methodology with numerous advantages over previous methods for estimating student birthrates. Confidentially matching the names of female students from school records with the names of mothers on birth records at the Department of Health provided birthrates for each of the St. Paul public high schools with clinics for each year between 1971 and 1986. The results show that birthrates fluctuated dramatically from one year to the next, but school-wide birthrates were not significantly lower in the years immediately following the opening of a clinic than in the years preceding it.

Abortion, Legal↗
PubMed1997

Air pollution and hospital admissions for respiratory causes in Minneapolis-St. Paul and Birmingham.

We investigated the association between air pollution and hospital admissions for chronic obstructive pulmonary disease and pneumonia among the elderly in Minneapolis-St. Paul, MN, and Birmingham, AL, over the period January 1, 1986, to December 31, 1991. Pollutants included in our analyses were PM10 (particulate matter less than 10 microns in aerodynamic diameter), SO2, NO2, O3, and CO in Minneapolis-St. Paul, and PM10, O3, and CO in Birmingham. After adjusting for temperature, day of week, season, and temporal trends, we found little evidence of association between air pollution and hospital admissions for respiratory causes in Birmingham. In contrast, we found that air pollution was associated with hospital admissions for respiratory causes in Minneapolis-St. Paul. Among the individual pollutants, O3 was most strongly associated with admissions (estimated increase in hospital admissions associated with a 15-parts-per-billion increase in O3 on the previous day = 5.15%; 95% confidence interval = 2.36-7.94%), and this association was robust in the sense that it was little affected by the simultaneous consideration of other pollutants. PM10, SO2, and NO2 were also associated with hospital admissions, although none could be singled out as being more important than the others.

Aged↗
PubMed2000

Secular trends in dietary macronutrient intake in Minneapolis-St, Paul, Minnesota, 1980-1992.

Trends in dietary macronutrient intake were evaluated in population-based surveys conducted in adults aged 25-74 years in 1980-1982, 1985-1987, and 1990-1992 in the seven-county Minneapolis-St. Paul metropolitan area. A 24-hour dietary recall (n = 6,499) was completed by a random 50% sample. The authors obtained energy intake for each macronutrient (protein, carbohydrate, fat, saturated fat, monounsaturated fat, polyunsaturated fat, and alcohol). Tine trends for percentage of total energy were analyzed using a generalized linear mixed model. While energy intake remained stable over time, macronutrient composition changed substantially. In 1980-1982, the caloric distribution for men comprised 15.8% protein, 39.4% fat, 40.9% carbohydrate, and 3.9% alcohol; similar findings were observed in women (15.7% protein, 38.9% fat, 43% carbohydrate, and 2.4% alcohol). From 1980 to 1992, total fat intake decreased 4.7% in men and 4.9% in women (p < 0.001). The decline was greatest for monounsaturated fat, although saturated and polyunsaturated fat intake also fell. During this same period, carbohydrate intake increased 5.7% and 5.8% in men and women, respectively (p < 0.001). Alcohol intake decreased in men and women (p < 0.01), while protein intake remained stable. In summary, the Minneapolis-St. Paul metropolitan area diet shifted substantially during the 1980s toward more carbohydrate and lower fat and alcohol intake.

Adult↗
PubMedDate not supplied

PM10, ozone, and hospital admissions for the elderly in Minneapolis-St. Paul, Minnesota.

Several recent studies have reported associations between airborne particles and/or ozone and hospital admissions for respiratory disease. PM10 has rarely been used as the particle exposure measure, however. This study examined whether such an association could be seen in Minneapolis-St. Paul, Minnesota, which has daily monitoring data for PM10. Data on hospital admissions in persons aged 65 y and older were obtained from Medicare records for the years 1986 through 1989. Daily counts of admissions, by admit date, were computed for pneumonia (ICD9 480-487) and chronic obstructive pulmonary disease (COPD) (ICD9 490-496). Classification was by discharge diagnosis. Daily air pollution data from all monitoring stations for ozone and PM10 in Minneapolis-St. Paul were obtained, and the daily average for each pollutant was computed. An average of approximately six pneumonia admissions and two admissions for chronic obstructive pulmonary disease occurred each day. Poisson regression analysis was used to control for time trends, seasonal fluctuations, and weather. PM10 was a risk factor for pneumonia admissions (relative risk [RR] = 1.17, 95% confidence interval [CI] = 1.33-1.02) and COPD admissions (RR = 1.57, 95% CI = 2.06-1.20). Ozone was also associated with pneumonia admissions (RR = 1.15, 95% CI = 1.36-0.97). The relative risks are for an increase of 100 micrograms/m3 in daily PM10 and 50 ppb in daily ozone concentration. Several alternative methods for controlling for seasonal patterns and weather were used, including nonparametric regression techniques. The results were not sensitive to the methods. When days exceeding the National Ambient Air Quality Standard for either pollutant were excluded, the association remained for both pneumonia (RR = 1.18, 95% CI = 1.34-1.03 for PM10, and RR = 1.18, 95% CI = 1.41-0.99 for ozone) and COPD (RR = 1.54, 95% CI = 2.06-1.16 for PM10).

Aged↗
PubMed1982

Winter weather and cardiovascular mortality in Minneapolis-St. Paul.

A study of vital statistics data from five Minneapolis-St. Paul winters indicates cardiovascular mortality is influenced by winter temperatures and snow. Although air temperature was not statistically implicated in triggering cardiovascular mortality in four of the five study winters, during the winter of 1976-77, about 15 per cent of the variance in daily cardiovascular mortality could be attributed to fluctuations in the daily minimum air temperature. Snow influenced mortality on the day of occurrence as well as the two days following a snowfall. There appear to be some differences in the ability of winter weather to influence mortality from acute myocardial infarction (ICD 410) and old myocardial infarction (ICD 412). The variance in daily ICD 410 mortality attributable to the influence of snow is somewhat less than that in daily ICD 412 mortality. The greatest variance in daily ICD 412 mortality that could be ascribed to snow occurred during the winter of 1974-75, and was 13 per cent. It is likely that rain intermixed with snow may also trigger increased mortality from cardiovascular disease. A combination of rain and snow can produce dramatic increased in mortality from ICD 410. Study of mortality data from five winters indicates that snow is somewhat more important in triggering deaths from heart disease than is air temperature.

Cardiovascular Diseases↗
PubMed1988

Antimicrobial agent resistance in Neisseria gonorrhoeae in St. Paul Minnesota.

In a prospective survey of 283 Neisseria gonorrhoeae isolated in St. Paul, Minnesota, 5% were found to produce beta-lactamase, and 11% were resistant to penicillin by chromosomal mediation, thus indicating a hyperendemic level of resistance according to Centers for Disease Control guidelines. A significant level of chromosomal resistance (30%) was noted for tetracycline, and MICs for spectinomycin approached the upper limits of susceptibility for a large number of isolates. The need for uniformity in agar dilution test methodology is discussed, and the variability in antimicrobial agent interpretive breakpoint criteria is illustrated by comparing penicillin breakpoints published by the Centers for Disease Control with those of the National Committee for Clinical Laboratory Standards as applied to the study isolates.

Ceftriaxone↗
PubMedDate not supplied

Mutant allele frequencies in cats of Minneapolis-St. Paul.

Coat color phenotype frequencies were determined in the cat population of Minneapolis and St. Paul. Mutant allele frequencies are estimated to be p (O) = 0.287, q(a) = 0.742, q(d) = 0.635, q(l) = 0.507, p(S) = 0.288. q(tb) = 0.472, p(W) = 0.016, and q(cs) = 0.214. A substantial number of cats displaying the Siamese coat pattern were found. These cats have a long history in the population.

Alleles↗
PubMed1998

A community health assessment of a culturally diverse housing project in St. Paul.

A comprehensive community needs assessment was recently completed at Skyline Towers, a culturally diverse housing project in St. Paul. Eighty-one randomly selected residents were interviewed over a one-month period. This article outlines the process of conducting the assessment and describes the results from the health care and demographic sections of the survey. The assessment showed that two-thirds of the building residents were born outside the United States and that the Somali population in particular faces linguistic, financial, and cultural barriers that limit their access to health care.

Adult↗
PubMed1991

Change in survival from out-of-hospital cardiac arrest and its effect on coronary heart disease mortality, Minneapolis-St. Paul. The Minnesota Heart Survey.

Emergency medical services with advanced life support systems were implemented in the Minneapolis-St. Paul, Minnesota, area in the mid-1970s. To assess the impact of emergency medical services on coronary heart disease mortality, the authors reviewed ambulance records and hospital emergency room logs for possible out-of-hospital cardiac arrest cases in the period 1972-1982. Potential cases, and their survival to discharge, were validated by hospital record review and were checked against Minnesota death certificates for the year of cardiac arrest and the year following cardiac arrest. Age-adjusted rates of survival to 1 year after cardiac arrest (per 100,000 population) for survivors of out-of-hospital cardiac arrest aged 30-74 years increased significantly from 1972 to 1982 for men (1.8 vs. 11.7; p less than 0.00001) and for women (0.5 vs. 3.5; p less than 0.01). Coronary heart disease mortality rates declined in that period by 34.9% for men (from 527.5 per 100,000 to 343.3 per 100,000) and by 41.7% for women (from 168.6 per 100,000 to 98.3 per 100,000). The authors estimate that improved survival from out-of-hospital cardiac arrest contributed 5.4% (9.9 of 184.2) of the mortality decline for men and 4.3% (3.0 of 70.3) of the decline for women. This was a significant contribution to the decline in coronary heart disease mortality, but it explains only a small part of it.

Adult↗
PubMed2003

Ascaridoid nematodes and associated lesions in stomachs of subadult male northern fur seals (Callorhinus ursinus) on St. Paul Island, Alaska: (1987-1999).

Stomachs from subadult male northern fur seals (SAMs) (Callorhinus ursinus) (n = 5,950) from St. Paul Island, Alaska, were examined from 1987 to 1999 for lesions and parasites. On gross examination of these stomachs, parasite nodules were evident in 92% of the stomachs and active and healing ulcers were found in 14% and 10%, respectively. Prevalence of nematodes from 1987 to 1997 was 88% for 5,700 SAMs for which numbers of parasites were estimated but not identified to the genus level. All nematodes recovered from 250 SAMs examined in 1998 (n = 124; 99% infected) and in 1999 (n = 126; 91% infected) were identified and counted. Prevalences in 1998 and 1999 were 5% and 0% for Anisakis spp., 52% and 18% for Contracaecum spp., and 96% and 89% for Pseudoterranova spp., respectively.

Alaska↗
PubMed1992

Cholesterol screening by primary care pediatricians: a study of attitudes and practices in the Minneapolis-St Paul metropolitan area.

A telephone survey of the 197 board-certified pediatricians actively engaged in primary care in the Minneapolis-St Paul metropolitan area was conducted to assess their cholesterol screening practices and hypercholesterolemia management. The response rate was 95%. Nearly all the pediatricians (90%) do some cholesterol screening, with the majority (58%) screening only children with a strong family history of coronary heart disease. Though only 33% screen all their patients, 66% advocate universal pediatric screening. Most of the pediatricians indicated they would manage hypercholesterolemia patients themselves, nearly always with dietary means. Despite their strong support for screening, the pediatricians expressed skepticism about the significance of childhood cholesterol level as a predictor of adult cardiovascular disease and doubted their effectiveness in getting patients to adopt a cholesterol-reducing diet. Their definition of elevated total cholesterol level in childhood was consistent with published recommendations, but only 29% could define elevated low-density lipoprotein cholesterol level. The pediatricians expressed strong opposition to pediatric cholesterol screening in schools or in any setting other than clinics and hospitals.

Attitude of Health Personnel↗