Trends in stimulation and induction of labor 1989-1995

Between 1989 and 1995 the rates for stimulation and induction of labor rose every year, representing a 48 and 77 percent, respectively, total rise over the time period. In 1995 the rate of stimulation was 161 per 1,000 live births and of induction 160. Two percent, or 74,167, of the 3,899,589 births in 1995 had both procedures performed. While rates of stimulation decline with advancing maternal age, the induction rates tend to be higher for older women. Rates for both procedures increased between 1989 and 1995 for both black and white women in all age categories. Women whose pregnancies have extended beyond the expected gestation of 37 weeks consistently had much higher rates of both stimulation and induction. Rates for both procedures rose for doctors of medicine (MD's), doctors of osteopathy (DO's) and certified nurse-midwives (CNM's). DO's had the greatest increases in both stimulation and induction rates. Declines in the cesarean section rate were greater for births that were stimulated or induced than for those without either of these procedures. The rates for stimulated or induced vaginal birth after cesarean (VBAC) were double those of VBACs without such procedures.     

Trends in contraceptive use in the United States: 1982-1995

CONTEXT: Trends in contraceptive use have implications for shifts in pregnancy rates and birthrates and can inform clinical practice of changes in needs for contraceptive methods and services. METHODS: Information on current contraceptive use was collected from a representative sample of women of reproductive age in the 1995 National Survey of Family Growth (NSFG). This information is compared with similar data from 1982 and 1988 to examine trends in use, both overall and in social and demographic subgroups. RESULTS: The proportion of U.S. women using a contraceptive method rose from 56% in 1982 to 60% in 1988 and 64% in 1995. As in 1982 and 1988, female sterilization, the pill and the male condom were the most widely used methods in 1995. Between 1988 and 1995, the proportion of users relying on the pill decreased from 31% to 27%, while condom use rose from 15% to 20%. The largest decreases in pill use and the largest increases in condom use occurred among never-married women and among black women younger than 25. Reliance on the IUD dropped sharply among Hispanic women, while use of the diaphragm fell among college-educated white women. CONCLUSIONS: The decline in pill and diaphragm use and the increase in reliance on condoms suggest that concerns about HIV and other sexually transmitted diseases are changing patterns of method use among unmarried women.     

Trends in United States ovarian cancer mortality, 1979-1995

The authors have compared the results of scalp reductions with extenders with their earlier results of scalp reductions without extenders. The extenders seem to prevent "stretch-back" and provide 30 to 86% more effectiveness when a second reduction is performed 4 weeks later.     

A more diversified America: state and local population changes, 1990-1997

Recently, the U.S. Bureau of the Census released state and county population estimates with age, gender, race and Hispanic origin detail for 1990-1997. These estimates illustrate the changing demographics of the United States. The 1997 state population estimates show that both Texas and Georgia experienced notable population growth since 1990. Texas replaced New York as the second largest state; Georgia bumped North Carolina from the list of top 10 most populous states to become the state with the 10th largest population. In both Texas and Georgia, migration flows have contributed to the population change. Texas is one of the most popular "intended states of residence" for international migrants, many coming from Latin American countries. On the other hand, Georgia's growth has largely been influenced by "rustbelt" to "sunbelt" domestic migration. At the county level, the largest total population increases again occurred in western and southern states. Population estimates for Asian and Pacific Islanders show that this population remained concentrated in the West in 1997. Similarly, the Hispanic population is primarily concentrated in southwestern states. However, as the Asian and Pacific Islander and Hispanic populations continue to grow, there is spillover into other regions, primarily the larger metropolitan areas in the South, including Washington, DC, and Atlanta, GA. The population projections produced by the Census Bureau indicate that racial and ethnic diversity will continue to increase in the United States well into the next century.     

Radiation-induced cancers: state of the art in 1997

Scientists now have available a large amount of data dealing with radiation-induced neoplasms. These data went back to anecdotal observations which were made in the very first years of utilization of X-rays and radioactive elements. In fact, it is essentially the strict follow-up of the Japanese populations irradiated by the Hiroshima and Nagasaki bombing which allowed a more precise evaluation of the carcinogenicity of ionizing radiations. Further refinements came from therapeutical irradiations: it is now possible to study large cohorts of patients given well-known doses in well-defined volumes and followed for more than 20 years. Last but not least, a significant increase in the incidence and mortality of thyroid cancer has been detected in children contaminated by iodine radioisotopes after the Tchernobyl accident. Recently, some data suggested the emergence of "clusters" of leukemias close to some nuclear facilities, but this question remains highly polemical, both in France and in the UK. Other questions are still waiting for a precise answer; of course, the extrapolation of our available data to very low doses delivered at very low dose rates, but also the carcinogenic risk at high doses. For these "high" doses (about 30 to 70 Gy), a competition between mutagenesis and cell killing was expected, so that these dose levels were expected to be less carcinogenic than lower (a few sieverts) doses. Actually, recent data suggest that the carcinogenic risk goes on increasing up to relatively important doses. In addition, carcinogenic factors, such as tabacco, anticancer chemotherapy and individual susceptibility, are found more and more to be closely intricated with ionizing radiation in the genesis of a given cancer. Even if a number of questions are still pending, the already available data allow specialists, both in medicine and radioprotection, to edict strict rules which can be reasonably expected to have significantly reduced the risk of radiation-induced neoplasms in most situations.     

Trends in governmental and academic institutions affecting science.

Discusses (1) clarification of the roles of the various sectors and institutions involved in science, particularly the federal government, state governments, universities, and industry; (2) the strengthening of the individual institutions and sectors that compose scientific enterprise; and (3) the strengthening of the ties that bind these institutions. It is important for organization such as the American Psychological Association to help define institutional roles, reinforce interinstitutional linkages, and represent the interests of scientists when national goals are being set. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trends in alcohol consumption patterns among whites, blacks and Hispanics: 1984 and 1995

OBJECTIVE: To report national trends in alcohol consumption patterns among whites, blacks and Hispanics between 1984 and 1995, in relation to the recent decline in per capita consumption in the United States. METHOD: Data were obtained from two nationwide probability samples of U.S. households, the first conducted in 1984 and the second in 1995. The 1984 sample consisted of 1,777 whites, 1,947 blacks and 1,453 Hispanics; the 1995 sample consisted of 1,636 whites, 1,582 blacks and 1,585 Hispanics. On both occasions, interviews averaging 1 hour in length were conducted in respondents' homes by trained interviewers. RESULTS: Between 1984 and 1995, the rate of abstention remained stable among whites but increased among blacks and Hispanics. Frequent heavy drinking decreased among white men (from 20% to 12%), but remained stable among black (15% in both surveys) and Hispanic men (17% and 18%). Frequent heavy drinking decreased among white women (from 5% to 2%), but remained stable among black (5% in both surveys) and Hispanic women (2% and 3%). White men and women were two times more likely to be frequent heavy drinkers in 1984 than in 1995. CONCLUSIONS: The reduction in per capita consumption in the U.S. is differentially influencing white, black and Hispanic ethnic groups. The stability of rates of frequent heavy drinking places blacks and Hispanics at a higher risk for problem development than whites. This finding is, therefore, a concern to public health professionals and others interested in the prevention of alcohol-related problems among ethnic groups in the United States.     

The perinatal situation in France. Trends between 1981 and 1995

OBJECTIVES: Assess the main indicators of health status and medical practice at delivery and to determine the feasibility of a routine national survey. POPULATION AND METHOD: A survey conducted in 1995 concerned all live births and stillbirths occurring within one week. The sample included 13,147 women in metropolitan France. The results were compared with those of earlier national perinatal surveys. RESULTS: Since 1981, the perinatal situation in France has shown a rise in maternal age at delivery, development of prenatal care (particularly the number of visits), and an increase in the number of procedures at delivery, notably induction. The preterm delivery calculated for all births has remained unchanged: 5.6% in 1981 and 5.9% in 1995, but the proportion of infants weighing less than 2500 g has increased from 5.2% to 6.2%. CONCLUSION: The 1995 national perinatal survey in France, based on all births during one week and involving minimal data collection has provided a representative sample of births and information well adapted to surveillance of the main health and medical practice parameters. This type of survey should become routine and serve as a basic element for epidemiological surveillance.     

Comparison of influenza immunization rates for Oklahoma Medicare patients: 1995, 1996 and 1997

The Health Care Financing Administration has reported influenza immunization rates since 1994. The Department of Health and Human Services has set a minimum national target rate for the annual immunization of the elderly population at 60 percent, as published in Healthy People 2000. The Oklahoma Foundation for Medical Quality analyzed the Medicare claims data for Oklahoma for the 1995, 1996, and 1997 influenza seasons. Additionally, we reviewed the Behavioral Risk Factor Surveillance System influenza immunization data for 1995. Claims data for the 1997 influenza season show the immunization rate for the Medicare population of Oklahoma is 41.4 percent. The immunization rate for the African-American Medicare population was 22.3 percent for 1997, compared with 42.2 percent for the Caucasian population. The ten most populous counties in the state had a 9-percent higher rate of immunization than the other 67 counties. The Medicare population in Oklahoma is not receiving the influenza vaccination at the target rate. Especially underserved are the African-American and non-urban populations. There appear to be opportunities for improvement in the provision of the influenza vaccination for the Medicare population of Oklahoma.     

依照节能法规做好节能工作

本文介绍公司近年来的有效节能方法和公司节能前景。     

Improvement in mammography quality control: 1987-1995

PURPOSE: To assess possible changes in quality control (QC) practices at mammography sites in the United States. MATERIALS AND METHODS: Mammography site surveys were conducted in 1990, 1992, and 1995 through the Colorado Mammography Advocacy Project (CMAP). Data from mammography sites applying for American College of Radiology (ACR) accreditation were collected between August 1987 and August 1993 through the ACR Mammography Accreditation Program. Data from both of these surveys were analyzed to assess temporal changes in mammography QC practices in the United States between 1987 and 1995. RESULTS: CMAP results indicated statistically significant improvement in medical physicist QC practices between 1990 and 1992 and in technologist QC practices between 1990 and 1995. Improvements in radiologic technologist QC practices coincided with increases in radiologic technologist continuing education in mammography. ACR results indicated statistically significant improvement in technologist QC practices between 1988 and 1992. CONCLUSION: There have been substantial improvements in QC practices at mammography sites in the United States during the past decade.     

Listeriosis 1985-1995: microbiologic and epidemiologic aspects

Listeriosis is an emerging foodborne infection caused by L. monocytogenes (L. m.), mainly identified in industrialized countries. It is a severe disease (meningitis, septicaemia, abortion) which preferentially affects individuals whose immune system is perturbed (pregnant women, newborns, immunocompromized patients and the elderly). Epidemiology is characterized by a background of sporadic cases on which may be surimposed outbreaks. Progresses in microbiology during the last decade (detection and typing of L. m., better understanding of L.m. ecology...) and epidemiological investigations (increased use of case-control studies) demonstrated that all kind of foods, at each step of the food chain, can transmit the disease. In many respects, L.m. differs from most recognized foodborne pathogens: it is ubiquitously present in nature, resistant to various kind of environments, microaerophilic and psychrophilic. Its tenacity in industrial environment and its capability to survive in food over extended period of time under adverse conditions made this bacterium the hottest topic for industrials during the last decade.     

HMO market structure and performance: 1985-1995

This paper estimates the effect of market structure on hospital days and ambulatory visits in independent practice associations (IPAs) and group-model health maintenance organizations (HMOs) where market structure is measured by HMO penetration and the number of HMOs operating in a market. There was a steady decline in inpatient use in HMOs during the study period and a steady increase in use of ambulatory care. In multivariate analyses, inpatient use is significantly higher in IPAs, but there is no difference in ambulatory use. As HMO penetration increases and the number of HMOs increases, group-model HMOs have lower hospital use and greater ambulatory use. In contrast, use of both inpatient and ambulatory care decreases in IPAs but only at high levels of penetration and numbers of competitors.