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the home care industry: strategies for survival in an era of dwindling resources.the home care component of our long-term care system is increasingly being recognized as the preferred alternative to institutional care for the frail elderly and disabled. dwindling resources, both human and financial, are likely to have a deleterious effect on home care. findings from a 1987-88 survey of paraprofessional home care workers of the frail elderly in new york city are used to draw implications for the home care industry. the scope of problems inherent in the industry imply that cha ...199210186811
evaluation of "hope for a million kids immunization event: "process, outcome, and costs.this study evaluates the hope for a million kids immunization event in east harlem, new york, in 1996. the methodology: (1) documented planning and implementation processes. (2) analyzed numbers of children reached through the outreach initiative and those actually immunized due to the event. (3) assessed associated costs. the event reached and educated 120,000 children through door-to-door canvassing. substantially fewer children, 562, registered at the health and human services fair, and 211 c ...199810186766
supplemental security income for the aged, blind and disabled (ssi) program demonstration project; treatment of cash received and conserved to pay for medical or social services--ssa. notice.the commissioner of social security will conduct a demonstration project to test how certain altered resources counting rules might apply in the ssi program. the ssi program is authorized by title xvi of the social security act (the act). the rules which will be tested are those that apply to the treatment of cash received and conserved to pay for medical or social services. cash which is received for the purposes of payment for medical or social services is not counted as income to the benefici ...199810185853
court denies motion to compel discovery where documents are "predecisional" or "deliberative.". 199110183549
caring for survivors of torture in an urban, municipal hospital.survivors of torture can present with multiple health consequences, both physical and psychological, which can persist even years after the abuse. the authors developed a multidisciplinary program in the primary care medical clinic of an urban municipal hospital in new york city serving an ethnically diverse population to provide multidisciplinary care to survivors of torture and their families.199810181462
gnyha to sue hhs over fraud probe. 199810178317
the emotionally competent leader.aristotle once challenged man "to be angry with the right person, to the right degree, at the right time, for the right purpose, and in the right way" (the nicomachean ethics). daniel goleman, ph.d., a journalist for the new york times, expands on this statement in his new book, "emotional intelligence." he defines emotional intelligence as the ability to rein in emotional impulses, to read another's innermost feelings and to handle relationships and conflict smoothly. this new model of intellig ...199810177113
a slant on cloning.human cloning may be the most difficult moral dilemma posed by science since splitting of the atom. but recent stories in the new york times suggest the ethical debate is all but over. now, along comes dr. seed.199810176715
application and feasibility of video telecommunications in home healthcare.the capital area consortium on aging and disability (cacad) of albany, ny, partnered with nynex and the james a. eddy memorial geriatric center ("the eddy"), a non-profit provider of services to the aged and disabled, to conduct a trial to investigate the use of video conferencing as a platform for providing health care services to the home. the trial, which took place from june to september of 1994 at the eddy in troy, new york had three goals: determine what quality of video is needed to provi ...199710176387
the role of human resources in supporting reengineering.to ensure the successful reengineering of a large, complex, unionized, urban teaching hospital, communication, education, and employee participation are key aspects. human resources-designed training supports the transition in concert with reengineering management, organizational development, labor relations, and external consultants. education improves patient care and raises employee self-esteem as new teams focus together on excellence.199610162817
inpatient treatment patterns of human immunodeficiency virus-associated pneumocystis carinii pneumonia in new york state medicare patients.hospital charts were reviewed to ascertain the frequency with which patients with human immunodeficiency virus (hiv)-associated pneumocystis carinii pneumonia (pcp) were being managed in accordance with current guidelines or recommendations in new york state for the calendar year 1993. comparisons were made between hospitals that are designated by the new york state department of health as comprehensive treatment centers--designated acquired immunodeficiency syndrome (aids) centers--and all othe ...199610156543
the small group consensus process for changing physician practices: influenza vaccination.to evaluate the effectiveness of a small group consensus process in enhancing compliance with guidelines for influenza vaccination among older hmo members.199510151093
interdisciplinary, functional approach to quality review.dramatic changes in the standards of the joint commission on accreditation of healthcare organizations, as part of its "agenda for change," pose new challenges for health care managers. the goal of the "agenda for change" is to focus accreditation on the actual performance of important functions while continuously stimulating improvement in the organization's performance and outcomes of care. in 1994, seven important functions--improvement of performance, leadership, management of information, a ...199510143968
the effect of characteristics of human service workers on subsequent morale and turnover.the authors examine the relationship of sociopsychological characteristics of human services workers to their subsequent morale and continuance on the job. eighty-two intensive case managers (half of them social workers) who had caseloads of clients with severe mental disorders were invited to participate in a four-wave panel study. explored are the relationships between 16 predictors (general background, prior work experience and training, and social psychological variables) and worker outcomes ...199510143141
n.y. hospital stops clinical trials. 199510139830
full-text document storage and retrieval in a clinical information system.the overall design of the cis at cpmc is heavily influenced by the decision support component. the type of automated decision support being implemented dictates the need for highly structured or coded data. the value of decision support systems has been well documented. the current reliance on free-text documents is natural and a rewarding first step to a more valuable mix of coded and free text. while the health care provider might find the textual comments of the various reports extremely usef ...199310139111
parents with severe mental illness and their children: the need for human services integration.this article presents the findings and recommendations of a statewide interagency task force on parents with mental illness who have young children. based on testimony from consumers, providers, and advocates, the task force concluded that this is a substantial and neglected public policy issue requiring an intergovernmental, services integration approach. recommendations were made in the areas of services, policies and procedures, and service coordination.199410138012
madness in fine print. 199410137484
communities that are making a difference. heart, body and soul, east baltimore, md; orleans county human services council, medina, ny. 199410134899
measuring the monday blues: validation of a job satisfaction scale for the human services. 199410134784
hospitals adopt intensive programs for diabetic patients to avoid high inpatient costs.just over a year ago, a 24-year-old man walked into a free health screening at palmyra medical centers in albany, ga., complaining of weight loss, unending thirst and frequent urination. a quick blood test revealed the man was diabetic, with an alarming hemoglobin a1c level of 20.1. after six months of intervention, the man's hemoglobin dropped to an excellent rating of 7.1 and his physician is now ready to take him off insulin, said layne cox, program manager of the diabetes treatment center at ...199410134694
ruling could mean millions for hospitals. 199410132726
a study of provider perceptions of individuals with dual disorders.human service workers devote a great deal of time in preparing to serve clients. the majority of this preparation is focused in one direction, with exposure to a limited type of client. the growing population of individuals with dual disorders of mental illness and substance abuse challenges this tradition in training, in that these clients pose unique, multiple, and overlapping characteristics, symptomatology, and behaviors requiring a synthesis of training approaches. based on survey data coll ...199410131893
notes of a slow learner. homelessness in the past decade. 199310129107
'to make a difference'. the lincoln collective.the lincoln collective was born in 1970 as a grassroots effort of health and community workers to start the kind of nonhierarchical community-oriented program described in this article. the idea of two residents who were already at lincoln hospital, the notion was given official approval because of the influx of young, american-trained physicians and nurses it would bring. but, as the experiment was advertised by word of mouth to members of the student health organization, the medical committee ...199310129104
at-home options. enhancing care for aids patients.mark is a 45-year-old man with advanced aids. his care partner, gary, has a full-time job in the design industry. a home care aide visits mark five days a week for 10 hours at a time to provide personal care while gary is at work. a visiting nurse sees mark weekly and has taught gary how to prepare mark's ganciclovir infusion. every six weeks mark meets with a nutritionist, who evaluates his dietary status and advises gary on purchasing high-calorie foods for mark. in may gary must attend a conf ...199310125243
hhs judge lowers boom on hospital that curbed hiv-positive pharmacist. 199210117584
multiple listing for organ transplantation: autonomy unbounded.recently, debate about the distribution of scarce organs for transplantation has focused on whether patients should have the right to place themselves on waiting lists at several transplant centers, thereby gaining an advantage over other potential recipients. this article explores the social and ethical issues raised by multiple listing, contrasting policies adopted at the national level with those implemented in new york state. it concludes by examining the implications of the debate for broad ...199210117351
the economic returns from investments in physical and mental health: a case study of migrant farmworkers in rural new york.spiraling costs of medical care services and limited federal and state resources necessitate discriminating and cost-effective strategies for financing health care to indigent populations. thus, while the selection among intervention strategies is aided by information on both the cost and benefits of program alternatives, data on the latter aspect is more difficult to obtain. human capital research provides a mechanism for assessing one of the multifarious aspects of the benefits of medical serv ...199110116393
the boundaries of business: commentaries from the experts.the world leadership survey, which began a worldwide dialogue on a set of important issues facing managers in the 1990s, continues with commentaries from four recognized experts, each of whom addresses the survey results from a different perspective. kenichi ohmae, chairman of mckinsey and company in tokyo, addresses "the perils of protectionism." ohmae argues that the old definitions of national boundaries and corporate interests reflect obsolete economic theories. the real test of national wel ...199110112918
assessing environmental exposure to pcbs among mohawks at akwesasne through the use of geostatistical methods.the mohawk nation at akwesasne is a native american community located along the st. lawrence river in new york state, ontario, and quebec. one component of a multiphase human health study was to assess the impact of different pathways of human exposure resulting from the off-site migration of polychlorinated biphenyl (pcb) contamination in this area. this paper illustrates how mapped residential information and environmental sampling data can be united to assist in exposure assessment for epidem ...199910092433
mortality in male and female capacitor workers exposed to polychlorinated biphenyls.a mortality study was conducted in workers with at least 90 days' exposure to polychlorinated biphenyls (pcbs) between 1946 and 1977. vital status was established for 98.7% of the 7075 workers studied. in hourly male workers, the mortality from all cancers was significantly below expected (standardized mortality ratio [smr] = 81; 95% confidence interval [ci], = 68 to 97) and comparable to expected (smr = 110; 95% ci, 93 to 129) in hourly female workers. no significant elevations in mortality for ...199910091139
statistical analysis of the age-adjusted incidence rates of human neoplasias: changes in time and space from early 1960's to mid 1980's with special reference to the steroid criminal hypothesis of carcinogenesis.our earlier reports indicated that the changes of age-adjusted incidence rates (aairs) of any 2 tumors in time and space, as investigated by the sequential regression analysis, showed a good fitness to the equilibrium model under the control of the law of mass action. the purpose of this study is to investigate the problem of whether or not the changes of aairs of individual tumors in time and space show a similar fitness to the equilibrium model of the law of mass action. the cancer risk data s ...199910085420
cyclospora: an enigma worth unraveling.in part, cyclospora cayetanensis owes its recognition as an emerging pathogen to the increased use of staining methods for detecting enteric parasites such as cryptosporidium. first reported in patients in new guinea in 1977 but thought to be a coccidian parasite of the genus isospora, c. cayetanensis received little attention until it was again described in 1985 in new york and peru. in the early 1990s, human infection associated with waterborne transmission of c. cayetanensis was suspected; fo ...199910081671
chronic liver disease in central harlem: the role of alcohol and viral hepatitis.for reasons not yet determined, chronic liver disease (cld) has been a leading cause of excess morbidity and mortality in central harlem. we conducted a case series and case-control analysis of demographic, clinical, epidemiological, and alcohol-intake-related information from patients with cld and age- and sex-matched hospitalized control patients. patients' sera were tested for markers of viral hepatitis. the presumed etiology of cld among case-patients was as follows: both alcohol abuse and h ...199910051493
a study of adult t-cell leukemia/lymphoma incidence in central brooklyn.adult t-cell leukemia/lymphoma (atl), a rare outcome of infection with human t-lymphotropic virus (htlv-i), is endemic in central brooklyn, which has a large caribbean migrant population. previous studies have suggested that htlv-i prevalence in central brooklyn may be similar to that recorded in the caribbean islands. we established a pilot 1-year surveillance program to identify cases of atl in 7 of 10 hospitals serving the residents of 18 zip codes of central brooklyn with a combined populati ...199910048963
human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature.human immunodeficiency virus (hiv)-associated pericardial effusion is common. we present its clinical features, cause, and prognosis on the basis of a review of 40 cases at a single public hospital.199910047635
association between exercise and hiv disease progression in a cohort of homosexual men.to study the relationship between exercise and human immunodeficiency virus (hiv) disease progression.199910037557
serologic testing for human granulocytic ehrlichiosis at a national referral center.an indirect immunofluorescence assay (ifa) was used to identify patients with antibodies reactive to the human granulocytic ehrlichiosis (hge) agent. serum samples collected from clinically ill individuals were submitted to the centers for disease control and prevention by physicians via state health departments from throughout the united states and tested against a panel of ehrlichial and rickettsial pathogens. antibodies reactive to the hge agent were detected in 142 (8.9%) of 1,602 individual ...19999986812
polychlorinated biphenyls, cytochrome p4501a1 polymorphism, and postmenopausal breast cancer risk.in experimental systems, polychlorinated biphenyls (pcbs) induce cytochrome p4501a1 (cyp1a1), which is involved in metabolism of steroid hormones and polycyclic aromatic hydrocarbons in humans. a genetic polymorphism coding for a valine to isoleucine substitution in exon 7 has been associated with lung cancer risk in japanese populations. in a previous study, we found no association between cyp1a1 genotype and breast cancer risk. however, we were interested in determining whether genotype would ...19999950238
economic losses from repetitive strain injuries.lost employment income and inability to perform household activities can have a devastating impact on the individual suffering from repetitive strain injury.19999950017
recurrent major depressive disorder among human immunodeficiency virus (hiv)-positive and hiv-negative intravenous drug users: findings of a 3-year longitudinal study.a longitudinal study was conducted to investigate the association between human immunodeficiency virus (hiv) infection, history of major depressive disorder (mdd), and persistent or recurrent mdd among intravenous drug users. psychiatric disorders were assessed in a sample of hiv-positive (hiv+) and hiv-negative (hiv-) intravenous drug users every 6 months for 3 years. results indicated that hiv status and baseline mdd independently predicted persistent or recurrent episodes of mdd after gender, ...19999924874
decrease in aids-related mortality in a state correctional system--new york, 1995-1998.the new york state department of correctional services (nysdocs) administers one of the largest prison systems in the united states, with a population of approximately 70,000 inmates; in 1995, blinded seroprevalence studies indicated that an estimated 9500 inmates were infected with human immunodeficiency virus (hiv). this report summarizes an analysis of death records of inmates, which indicate a substantial reduction in the acquired immunodeficiency syndrome (aids)-related deaths from 1995 thr ...19999921729
is there really a heterosexual aids epidemic in the united states? findings from a multisite validation study, 1992-1995. mode of transmission validation study group.the objective of this study was to verify the mode of exposure to the human immunodeficiency virus (hiv) among cases who obtained acquired immunodeficiency syndrome (aids) through heterosexual contact and to determine the proportion of cases initially reported with no risk but whose exposure may have been heterosexual. adults aged > or = 13 years with aids, diagnosed from 1992 through 1995 with heterosexual risk or no risk at six us study sites (alabama, california, florida, new jersey, new york ...19999883796
multistate outbreak of listeriosis--united states, 1998.since early august 1998, 40 illnesses caused by a single strain of listeria monocytogenes (lm) have been identified in 10 states: ohio (13 cases); new york; tennessee, massachusetts, and west virginia (three each); michigan (two); and connecticut, oregon, vermont, and georgia (one each). dates of illness onset or lm isolation ranged from august 2 through december 2. all lm isolates from these cases are serotype 4b and share an unusual pattern when subtyped either by pulsed-field gel electrophore ...19989883769
rabies surveillance in the united states during 1997.in 1997, 49 states, the district of columbia, and puerto rico reported 8,509 cases of rabies in nonhuman animals and 4 cases in human beings to the centers for disease control and prevention. nearly 93% (7,899) were wild animals, whereas 7% (610) were domestic species. the total number of reported cases increased 19.4% from that of 1996 (7,128 cases). increases were apparent in each of the major species groups, with the exception of cattle. the relative contributions of these groups to the total ...19989861958
comparative epidemiology of cancers of the testis, lung, bladder and stomach with special reference to the possible implication of environmental hormones in the recent risk changes of the 4 neoplasia types.the purpose of this study is to extract common features of an environmental hormone-oriented neoplasia by comparatively investigating the epidemiological characteristics of testicular cancer in denmark with those of other cancers, of which the age-adjusted incidence rates (aairs) underwent remarkable increase or decrease in the time range of early 1960's to mid 1980's. practically, the log-transformed (log) aairs and the corresponding log asirs (age-specific incidence rates) were used in paralle ...19989850740
human immunodeficiency virus-associated nephropathy in the bronx: low prevalence in a predominantly hispanic population.reports of human immunodeficiency virus-associated nephropathy (hivan) occurring in hispanics, females and heterosexuals are scarce. we reviewed 858 charts from our total hiv population to determine the prevalence and epidemiology of hivan at our center, and to evaluate the renal and patient survival among individual groups, according to race, sex and hiv risk factor. the prevalence of hivan was low (1.9%), relative to other centers (4-13%). although hispanics accounted for 56% of the hiv popula ...19989845826
arthur purdy stout (1885-1967), a pioneer of surgical pathology: a survey of his notes on the education of an "oncological" surgical pathologist.arthur purdy stout (1885-1967) started his medical career as a surgical intern and house surgeon at institutions that were to join the columbia-presbyterian medical center. with virtualy no formal training in pathology and little supervision, he was given the opportunity to work in a laboratory of surgical pathology. he focused his attention on neoplasms and tumor-like conditions, and authored human cancer in 1932. this book was organized according to topography of lesions and set a model for th ...19989845748
james ewing: cancer man.to a large extent, the progress in understanding, diagnosing and treating cancer is the story of individuals: james ewing was one of the giants. in spite of personal tragedy and infirmities he rose to become the leading tumor pathologist of his time and to head the nation's first cancer center in new york.19989845732
update: influenza activity--united states, 1998-99 season.in collaboration with the world health organization (who), its collaborating laboratories, and state and local health departments, cdc conducts surveillance to monitor influenza activity and to detect antigenic changes in the circulating strains of influenza viruses. this report summarizes influenza activity from october 4 through november 7, 1998; during this period, overall influenza activity in the united states was low. however, outbreaks of influenza a occurred in new york during october-no ...19989843358
female injecting drug users: human immunodeficiency virus risk behavior and intervention needs.injecting drug use and heterosexual contact are the major exposure categories for women acquiring human immunodeficiency virus (hiv). the purpose of this study was to explore the relationship of acquired immunodeficiency syndrome (aids) risk perception, perceived seriousness of hiv, drug use self-efficacy, sexual self-efficacy, and social support for hiv/aids risk behavior among female injecting drug users (idus). a random sample of 140 female idus was interviewed using a structured questionnair ...19989838760
geographic risk for lyme disease and human granulocytic ehrlichiosis in southern new york state.ixodes scapularis, the tick vector of lyme disease and human granulocytic ehrlichiosis (hge), is prevalent in much of southern new york state. the distribution of this species has increased, as have reported cases of both lyme disease and hge. the unreliability of case reports, however, demonstrates the need for tick and pathogen surveillance in order to accurately define areas of high risk. in this study, a total of 89,550 m2 at 34 study sites was drag sampled in 1995 and a total of 51,540 m2 a ...19989835546
rates of tuberculosis infection in healthcare workers providing services to hiv-infected populations. terry beirn community programs for clinical research on aids.to assess the prevalence of tuberculosis (tb) or a positive skin test in healthcare workers (hcws) providing services to human immunodeficiency virus (hiv)-infected individuals and to determine prospectively the incidence of new infections in this population.19989831938
human contact with bait containing vaccine for control of rabies in wildlife.to document the number of human contacts with bait containing liquid vaccinia-rabies glycoprotein (v-rg) vaccine, to evaluate factors that might affect human contact with bait-vaccine units, and to summarize adverse reactions in people after contact with vaccine.19989828931
clinical and laboratory spectrum of culture-proven human granulocytic ehrlichiosis: comparison with culture-negative cases.we describe the clinical and laboratory manifestations of human granulocytic ehrlichiosis (hge) in eight patients for whom cultures were positive for the hge agent and compare them with 15 patients for whom cultures were negative but who fulfilled a modified new york state surveillance definition for hge. polymerase chain reaction analysis was positive in 8 (100%) of 8 culture-positive cases vs. 3 (20%) of 15 culture-negative cases (p < .001), morulae were detected in 7 (100%) of 7 culture-posit ...19989827289
abbreviated regimens of zidovudine prophylaxis and perinatal transmission of the human immunodeficiency virus.the pediatric aids clinical trials group protocol 076 reported a reduction in the rate of perinatal transmission of the human immunodeficiency virus (hiv) from 25.5 percent to 8.3 percent with a three-part regimen of zidovudine given ante partum, intra partum, and to the newborn. we examined the effects of abbreviated zidovudine regimens on perinatal hiv transmission using data from the hiv polymerase-chain-reaction (pcr) testing service of the new york state department of health. pregnant women ...19989811915
increased transmission of vertical hepatitis c virus (hcv) infection to human immunodeficiency virus (hiv)-infected infants of hiv- and hcv-coinfected women.the transmission of perinatal hepatitis c virus (hcv) infection was studied retrospectively in 62 infants born to 54 hcv- and human immunodeficiency virus (hiv)-coinfected women enrolled in a prospective natural history study of hiv transmission. infant hcv infection was assessed by nested rna polymerase chain reaction. the overall rate of vertical hcv transmission was 16.4% (9/62). most hcv-infected children did not develop antibodies to hcv. the rate of hcv infection was higher among hiv-infec ...19989806033
human babesiosis in new york state: review of 139 hospitalized cases and analysis of prognostic factors.babesiosis infections are infrequent, occur in limited geographic locations, and range from asymptomatic infection to severe illness and death.19989801183
reliability of serum measurements of lignans and isoflavonoid phytoestrogens over a two-year period.we examined the distribution and long-term reliability of serum measurements of the two main human lignans, enterolactone and enterodiol, and the isoflavonoid phytoestrogens daidzein, genistein, equol, and o-desmethylangolensin in the new york university women's health study, a prospective cohort study of sex hormones and breast cancer. serum samples collected at three yearly visits in 30 premenopausal and 30 postmenopausal women who had not been diagnosed with cancer or cardiovascular disease w ...19989796633
coinfection of blacklegged ticks (acari: ixodidae) in dutchess county, new york, with the agents of lyme disease and human granulocytic ehrlichiosis.adult blacklegged ticks, ixodes scapularis say, collected from forested sites in dutchess county, ny, were tested for infection with the etiologic agents of lyme disease, borrelia burgdorferi johnson, schmid, hyde, steigerwalt & brenner, and human granulocytic ehrlichiosis (hge). rates of infection with the 2 pathogens were high and independent of one another, confirming prior findings and suggesting that a variety of hosts may be competent reservoirs of the hge agent.19989775627
supporting autonomy to motivate patients with diabetes for glucose control.we applied the self-determination theory of human motivation to examine whether patient perceptions of autonomy supportiveness (i.e., patient centeredness) from their diabetes care providers related to improved glucose control over a 12-month period.19989773724
hpv 16 and cigarette smoking as risk factors for high-grade cervical intra-epithelial neoplasia.although genital human papillomavirus (hpv) infection is well established as the etiologic agent for cervical intraepithelial neoplasia (cin), little is known about the cofactors involved in the development of high-grade lesions or the progression of low-grade to high-grade lesions. in our study of hpv-infected women with cin (163 cin i, 51 cin ii and 44 cin iii), women with cin ii or iii were compared with those with cin i for risk factors associated with high-grade lesions. after controlling f ...19989766558
epidemiologic features of equine leptospira interrogans of human significance.leptospirosis is a zoonotic bacterial disease caused by leptospira interrogans. there is a serologic evidence that horses are exposed to l. interrogans and, as a shedder of these organisms, can be a threat to humans. we examined risk factors associated with the risk of testing seropositive to three l. interrogans serovars (l. icterohaemorrhagiae, l. grippotyphosa, and l. canicola) in the horses of new york state, in order to understand the epidemiology of the disease and suggest strategies to co ...19989762736
mortality in hartford, connecticut: a comparison with the south bronx, new york.very high mortality rates have been reported in large inner-city areas such as the south bronx and harlem in new york city, but also may occur in smaller us urban areas. using published death rates for the south bronx as the standard, the standardized mortality ratio was slightly lower than 1.00 for hartford, connecticut (population 139,739 in 1990), but more than 1.00 for three impoverished hartford census tracts that contained public housing projects. compared with the south bronx, death rates ...19989762649
circulation patterns of genetically distinct group a and b strains of human respiratory syncytial virus in a community.human respiratory syncytial virus (hrsv) is classified into two major groups, a and b, each of which contains multiple variants. to characterize the molecular epidemiology of hrsv strains over time, sequencing studies of a variable region of the attachment protein gene from a single community in the united states during 5 successive years were performed. phylogenetic analysis revealed distinct clades (genotypes) that were further classified in subtypes based on > or = 96% nucleotide similarity. ...19989747732
congener-specific levels of dioxins and dibenzofurans in u.s. food and estimated daily dioxin toxic equivalent intake.food, especially meat, milk, and fish, is the immediate source of almost all polychlorinated dibenzo-p-dioxins (pcdds), dibenzofurans (pcdfs), and dioxinlike compounds in the general population. to estimate intake of these highly toxic compounds, we performed congener-specific dioxin analyses for the first time on u.s. food for 18 dairy meat, and fish samples from a supermarket in upstate new york. 2,3,7,8 tetrachlorodibenzo-p-dioxin (tcdd, "dioxin") toxic equivalents (teqs) on a wet weight basi ...19949738211
the network approach and interventions to prevent hiv among injection drug users.to review human immunodeficiency virus (hiv) risk reduction interventions among injecting drug users (idus) that have adopted a network approach.19989722819
methadone treatment protects against hiv infection: two decades of experience in the bronx, new york city.we undertook a study of the role of methadone maintenance in protecting injecting drug users (idus) from human immunodeficiency virus (hiv) infection from the earliest days of the hiv epidemic in new york city to the present. the historical context of the epidemic in the bronx is discussed.19989722816
efficacy of an ospa vaccine preparation for prevention of lyme disease in new york state.a multicenter, double-blinded, placebo-controlled study was done comparing a 30-microgram dose of a single protein recombinant ospa vaccine preparation with a saline placebo for efficacy in prevention of lyme disease in humans. the ospa vaccine (30-microgram dose) or saline placebo was given intramuscularly at day 0, 1 month later, and 12 months later. cases of possible lyme disease were evaluated clinically and using culture, polymerase chain reaction and immunoblot assays. safety data are bein ...20079717677
postexposure prophylaxis for human immunodeficiency virus: frequency of initiation and completion of newly recommended regimen.recent evidence demonstrating the efficacy of zidovudine, as well as experience with protease inhibitors, led to revision of recommendations for occupational exposures to human immunodeficiency virus-infected blood. at our hospital, this resulted in significant increases in rates of reported exposures and prophylaxis initiation. among 10 healthcare workers given three-drug, protease-inhibitor-containing regimens, five completed 4 weeks, two completed 4 weeks of two drugs, and three stopped due t ...19989702574
human immunodeficiency virus among trauma patients in new york city.to determine the hiv seroprevalence rates in relation to the demographic characteristics of victims, cause of death, and toxicology findings in a sample of victims of violence and accidents who presented to emergency departments before death.19989701297
hepatitis c virus infection in the mothers and infants cohort study.to estimate the hepatitis c virus (hcv) vertical transmission rate, the effect of potential risk factors, and the pattern of hcv antibody response and viremia in hcv-infected infants.19989685438
fish consumption and breast milk pcb concentrations among mohawk women at akwesasne.a study was conducted to determine the relation between the consumption of contaminated local fish and concentrations of total polychlorinated biphenyls (pcbs) and 68 pcb congeners in the milk of nursing mohawk women residing near three hazardous waste sites. from 1986 to 1992, 97 mohawk women were interviewed and donated at least 50 ml of breast milk. the comparison population consisted of 154 caucasians. after adjustment for potential confounders, mohawk mothers who gave birth in 1986-1989 had ...19989676698
the reawakening of national concern about silicosis.from west texas to west virginia, from california to new york, in industries from oil refining to coal mining and work settings from foundries to shipyards, the united states is experiencing an epidemic of silicosis, a preventable disease. silica sand has been linked to cancer, and the international agency for research on cancer has named silica as a probable human carcinogen. this article analyzes the reawakening of national concern about silicosis and the social, economic, and epidemiologic fa ...19989672567
rates of and risk factors for trichomoniasis among pregnant inmates in new york city.trichomonas vaginalis is a common pathogen that is associated with adverse pregnancy outcomes and may serve as a cofactor in human immunodeficiency virus (hiv) transmission.19989662764
cost-effectiveness of directly observed chemoprophylaxis of tuberculosis among drug users at high risk for tuberculosis.a methadone treatment program with on-site medical care in the bronx, new york.19989661818
statewide surveillance for ehrlichiosis--connecticut and new york, 1994-1997.in the united states, human monocytic ehrlichiosis (hme) and human granulocytic ehrlichiosis (hge) represent two clinically indistinguishable yet epidemiologically and etiologically distinct diseases caused by ehrlichia chaffeensis and a bacterium similar or identical to e. equi, respectively. infection with these emerging tickborne pathogens results in acute, influenza-like illnesses with fever, headache, malaise, and frequently leukopenia and/or thrombocytopenia. connecticut and new york have ...19989649234
relative abundance of organochlorine pesticides and polychlorinated biphenyls in adipose tissue and serum of women in long island, new york.some organochlorine pesticides (ocps) and pcbs are under investigation as possible risk factors for breast cancer because of their estrogenic properties and widespread presence in the environment. it is important to know whether adipose tissue used by some investigators and serum assays used by others can provide comparable information on body burden. concentrations of seven ocps or their breakdown products as well as 14 pcb congeners were measured in the adipose tissue and serum of 293 women en ...19989641493
organizational issues in conducting tuberculosis screening at a syringe exchange program.there has been a rise in tuberculosis (tb) cases in the united states and there is a potent link between human immunodeficiency virus (hiv) and tuberculosis. in new city it is estimated that 40% of the 200,000 injecting drug users are infected with hiv. in addition, the tuberculosis case rate is approximately four times the national average, and one third of these cases occurred in those persons infected with hiv. drug users have a high prevalence of latent tuberculous infection and are at high ...19989633035
performance-based physician reimbursement and influenza immunization rates in the elderly. the primary-care physicians of monroe county.to investigate the effect of performance-based financial incentives on the influenza immunization rate in primary care physicians' offices.19989631159
the death of a healthy volunteer in a human research project: implications for australian clinical research.a healthy 19-year-old united states college student volunteer in a clinical research program underwent a bronchoscopy and died as a result of acute lignocaine toxicity. the major contributing factor in the tragedy was that the research protocol failed to specify an upper dose limit for lignocaine spray, although previous versions of the protocol had done so. we look at the implications of this case for australian institutional ethics committees.19989612458
improved birth outcomes associated with enhanced medicaid prenatal care in drug-using women infected with the human immunodeficiency virus.to evaluate the effectiveness of an intervention designed to enhance medicaid prenatal care in improving birth outcomes of drug-using women infected with the human immunodeficiency virus (hiv).19989610991
variability of birth-weight distributions by sex and ethnicity: analysis using mixture models.birth weight is the most important proximate determinant of the level of infant mortality. however, the association between birth weight and infant mortality is not constant among populations. for example, the mortality of african american infants is lower at low birth weight but higher at high birth weight compared with european american infants. one possible explanation is that birth cohorts are heterogeneous even after controlling for birth weight, ethnicity, sex, and multiple births. the ana ...19989599943
lasting immunity to varicella in doctors study (l.i.v.i.d. study). 19989591824
long-term survival of children with human immunodeficiency virus infection in new york city: estimates from population-based surveillance data.the life expectancy of children with human immunodeficiency virus (hiv) infection acquired through mother-to-child transmission has important clinical and public health significance. several sources of population-based surveillance data from new york city, covering 1982 through the end of 1994, were combined to estimate long-term survival of hiv-infected children and age-specific prevalence. hiv incidence among newborns was estimated by applying expected transmission rates to seroprevalence surv ...19989583715
effect of hiv/aids versus other causes of death on premature mortality in new york city, 1983-1994.this study examined years of potential life lost (ypll) before age 65 years to assess the relative impact of human immunodeficiency virus (hiv)/acquired immunodeficiency syndrome (aids) versus other leading causes of death on premature mortality in new york city, new york, between 1983 and 1994. most causes of death showed substantial year-to-year variation in ypll, with the exception of hiv/aids. the ypll attributed to hiv/aids increased monotonically from 11,866 in 1983 to 167,317 in 1994, a n ...19989583714
correlation between skeletal calcium mass and muscle mass in man revisited: age, gender, and ethnicity. 19989569552
the high-risk sexual practices of crack-smoking sex workers recruited from the streets of three american cities. the multicenter crack cocaine and hiv infection study team.small ethnographic and clinic-based studies indicate that crack-smoking sex workers are at high risk for human immunodeficiency virus (hiv) and sexually transmitted diseases (std). study goals: to examine the prevalence of risky sexual behaviors and hiv and std in a large sample of street-recruited crack-smoking sex workers.19989564720
directly observed therapy in an inner city hospital.a directly observed therapy (dot) tuberculosis (tb) program in a large urban teaching hospital in the east harlem section of new york city.19989562124
variations in intensive care unit utilization for patients with human immunodeficiency virus-related pneumocystis carinii pneumonia: importance of hospital characteristics and geographic location.to determine whether intensive care unit (icu) use and outcomes for patients with human immunodeficiency virus (hiv)-related pneumocystis carinii pneumonia vary by hospital characteristics and geographic location.19989559603
from the centers for disease control and prevention. update: influenza activity--united states, 1997-98 season. 19989555740
human granulocytic ehrlichiosis in new york.human granulocytic ehrlichiosis (hge), a potentially fatal tick-borne disease, was first described in the upper midwest in 1994. following reports of suspected cases of ehrlichiosis from new york physicians, descriptive and case-control studies were conducted to characterize the epidemiology and risk factors for hge in new york residents.19989554683
influenza a outbreak on a cruise ship. 19989553278
cigarette smoking and cervical dysplasia among non-hispanic black women.this is the first case-control study to determine whether smoking is associated with cervical dysplasia, after adjustment for human papillomavirus (hpv) infection, among a group of non-hispanic black women. subjects were interviewed and asked questions about smoking and other risk factors for cervical cancer. hpv infection was determined by hybrid capture. thirty-two women with histologically confirmed incident dysplasia and 113 control women with normal cytologic smears were enrolled; all women ...19989544431
update: influenza activity--united states, 1997-98 season.in collaboration with the world health organization (who), its collaborating laboratories, and state and local health departments, cdc conducts surveillance to monitor influenza activity and to detect antigenic changes in the circulating strains of influenza viruses. this report summarizes influenza surveillance in the united states from september 28, 1997, through march 7, 1998, and presents reports of outbreaks in long-term care facilities (ltcfs) in three states and at a military base. the fi ...19989531023
detection of human granulocytic ehrlichiosis agent and borrelia burgdorferi in ticks by polymerase chain reaction.adult ixodid ticks were collected from westchester county, new york, and ipswich, massachusetts, to determine the presence of infection with a human granulocytic ehrlichiosis (hge) agent by using the polymerase chain reaction (pcr). the presence of borrelia burgdorferi in ticks collected from new york was also determined by pcr. of the 229 ticks from new york and 47 ticks from massachusetts, 9% (22/229) and 25% (12/47) of ticks contained hge agent, respectively. fifty-four percent (123/229) of t ...19989526861
health-care report cards and implications for anesthesia. 19989523827
respiratory isolation of tuberculosis patients using clinical guidelines and an automated clinical decision support system.to evaluate a clinical guideline and an automated computer protocol for detection and respiratory isolation of tuberculosis (tb) patients.19989510106
serologic evidence of infection with ehrlichia spp. in wild rodents (muridae: sigmodontinae) in the united states.rodent (muridae: sigmodontinae) blood and sera collected from 14 states were tested for seroreactivity to a cultured isolate of the human granulocytic ehrlichiosis (hge) agent by using an indirect immunofluorescence assay. of the 1,240 samples tested, 136 (11%) were found to be reactive at titers of > or = 32. rodents with hge agent-specific antibodies were found in new york (23% of 491 samples; geometric mean endpoint titer [gmt] = 441), connecticut (11% of 100 samples; gmt = 481), california ( ...19989508298
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