ConnecticutPeromyscus: A genus of the subfamily SIGMODONTINAE consisting of 49 species. Two of these are widely used in medical research. They are P. leucopus, or the white-footed mouse, and P. maniculatus, or the deer mouse.Raccoons: Carnivores of the genus Procyon of the family PROCYONIDAE. Two subgenera and seven species are currently recognized. They range from southern Canada to Panama and are found in several of the Caribbean Islands.Ticks: Blood-sucking acarid parasites of the order Ixodida comprising two families: the softbacked ticks (ARGASIDAE) and hardbacked ticks (IXODIDAE). Ticks are larger than their relatives, the MITES. They penetrate the skin of their host by means of highly specialized, hooked mouth parts and feed on its blood. Ticks attack all groups of terrestrial vertebrates. In humans they are responsible for many TICK-BORNE DISEASES, including the transmission of ROCKY MOUNTAIN SPOTTED FEVER; TULAREMIA; BABESIOSIS; AFRICAN SWINE FEVER; and RELAPSING FEVER. (From Barnes, Invertebrate Zoology, 5th ed, pp543-44)Lyme Disease: An infectious disease caused by a spirochete, BORRELIA BURGDORFERI, which is transmitted chiefly by Ixodes dammini (see IXODES) and pacificus ticks in the United States and Ixodes ricinis (see IXODES) in Europe. It is a disease with early and late cutaneous manifestations plus involvement of the nervous system, heart, eye, and joints in variable combinations. The disease was formerly known as Lyme arthritis and first discovered at Old Lyme, Connecticut.Babesiosis: A group of tick-borne diseases of mammals including ZOONOSES in humans. They are caused by protozoa of the genus BABESIA, which parasitize erythrocytes, producing hemolysis. In the U.S., the organism's natural host is mice and transmission is by the deer tick IXODES SCAPULARIS.Rhode IslandArthropod Vectors: Arthropods, other than insects and arachnids, which transmit infective organisms from one host to another or from an inanimate reservoir to an animate host.Encephalitis Virus, Eastern Equine: A species of ALPHAVIRUS causing encephalomyelitis in Equidae and humans. The virus ranges along the Atlantic seaboard of the United States and Canada and as far south as the Caribbean, Mexico, and parts of Central and South America. Infections in horses show a mortality of up to 90 percent and in humans as high as 80 percent in epidemics.Encephalomyelitis, Eastern Equine: A form of arboviral encephalitis (primarily affecting equines) endemic to eastern regions of North America. The causative organism (ENCEPHALOMYELITIS VIRUS, EASTERN EQUINE) may be transmitted to humans via the bite of AEDES mosquitoes. Clinical manifestations include the acute onset of fever, HEADACHE, altered mentation, and SEIZURES followed by coma. The condition is fatal in up to 50% of cases. Recovery may be marked by residual neurologic deficits and EPILEPSY. (From Joynt, Clinical Neurology, 1996, Ch26, pp9-10)Ehrlichiosis: A tick-borne disease characterized by FEVER; HEADACHE; myalgias; ANOREXIA; and occasionally RASH. It is caused by several bacterial species and can produce disease in DOGS; CATTLE; SHEEP; GOATS; HORSES; and humans. The primary species causing human disease are EHRLICHIA CHAFFEENSIS; ANAPLASMA PHAGOCYTOPHILUM; and Ehrlichia ewingii.MassachusettsArachnid Vectors: Members of the class Arachnida, especially SPIDERS; SCORPIONS; MITES; and TICKS; which transmit infective organisms from one host to another or from an inanimate reservoir to an animate host.Babesia: A genus of tick-borne protozoan parasites that infests the red blood cells of mammals, including humans. There are many recognized species, and the distribution is world-wide.
Plymouth Congregational Church (New Haven, Connecticut)Peromyscus: The genus Peromyscus contains the animal species commonly referred to as deer mice. This genus of New World mice is only distantly related to the common house mouse and laboratory mouse, Mus musculus.Raccoon eyes: Raccoon eye/eyes (also known in the United Kingdom and Ireland as panda eyes, though that term commonly refers to excess or smeared dark make-up around the eyes or to dark rings around the eyes) or periorbital ecchymosis is a sign of basal skull fracture or subgaleal hematoma, a craniotomy that ruptured the meninges, or (rarely) certain cancers.EMT Prehospital Care (4th Edition) Bilateral hemorrhage occurs when damage at the time of a facial fracture tears the meninges and causes the venous sinuses to bleed into the arachnoid villi and the cranial sinuses.Ticks of domestic animals: Ticks of domestic animals directly cause poor health and loss of production to their hosts by many parasitic mechanisms. Ticks also transmit numerous kinds of viruses, bacteria, and protozoa between domestic animals.Lyme disease microbiology: Lyme disease, or borreliosis, is caused by spirochetal bacteria from the genus Borrelia, which has at least 37 known species, 12 of which are Lyme related, and an unknown number of genomic strains. Borrelia species known to cause Lyme disease are collectively known as Borrelia burgdorferi sensu lato.BabesiosisMiss Rhode IslandBiological agentEhrlichiosis ewingii infectionMassachusetts Tobacco Cessation and Prevention Program: The Massachusetts Tobacco Cessation and Prevention Program (MTCP) is an anti-tobacco program run by the Massachusetts Department of Public Health with the goal of decreasing tobacco prevalence in the state of Massachusetts. MTCP has four main components: preventing youth smoking, assisting current smokers with quitting, protecting against second hand smoke, and eliminating tobacco related disparities.Babesia divergens: Babesia divergens is an intraerythrocytic protozoan parasite, transmitted by the tick Ixodes ricinus. It is the main agent of bovine babesiosis, or "redwater fever", in Europe.
(1/828) Indoor, outdoor, and regional summer and winter concentrations of PM10, PM2.5, SO4(2)-, H+, NH4+, NO3-, NH3, and nitrous acid in homes with and without kerosene space heaters.
Twenty-four-hour samples of PM10 (mass of particles with aerodynamic diameter < or = 10 microm), PM2.5, (mass of particles with aerodynamic diameter < or = 2.5 microm), particle strong acidity (H+), sulfate (SO42-), nitrate (NO3-), ammonia (NH3), nitrous acid (HONO), and sulfur dioxide were collected inside and outside of 281 homes during winter and summer periods. Measurements were also conducted during summer periods at a regional site. A total of 58 homes of nonsmokers were sampled during the summer periods and 223 homes were sampled during the winter periods. Seventy-four of the homes sampled during the winter reported the use of a kerosene heater. All homes sampled in the summer were located in southwest Virginia. All but 20 homes sampled in the winter were also located in southwest Virginia; the remainder of the homes were located in Connecticut. For homes without tobacco combustion, the regional air monitoring site (Vinton, VA) appeared to provide a reasonable estimate of concentrations of PM2.5 and SO42- during summer months outside and inside homes within the region, even when a substantial number of the homes used air conditioning. Average indoor/outdoor ratios for PM2.5 and SO42- during the summer period were 1.03 +/- 0.71 and 0.74 +/- 0.53, respectively. The indoor/outdoor mean ratio for sulfate suggests that on average approximately 75% of the fine aerosol indoors during the summer is associated with outdoor sources. Kerosene heater use during the winter months, in the absence of tobacco combustion, results in substantial increases in indoor concentrations of PM2.5, SO42-, and possibly H+, as compared to homes without kerosene heaters. During their use, we estimated that kerosene heaters added, on average, approximately 40 microg/m3 of PM2.5 and 15 microg/m3 of SO42- to background residential levels of 18 and 2 microg/m3, respectively. Results from using sulfuric acid-doped Teflon (E.I. Du Pont de Nemours & Co., Wilmington, DE) filters in homes with kerosene heaters suggest that acid particle concentrations may be substantially higher than those measured because of acid neutralization by ammonia. During the summer and winter periods indoor concentrations of ammonia are an order of magnitude higher indoors than outdoors and appear to result in lower indoor acid particle concentrations. Nitrous acid levels are higher indoors than outdoors during both winter and summer and are substantially higher in homes with unvented combustion sources. (+info)
(2/828) Differences in physician compensation for cardiovascular services by age, sex, and race.
The purpose was to determine whether physicians receive substantially less compensation from patient groups (women, older patients, and nonwhite patients) that are reported to have low rates of utilization of cardiovascular services. Over an 18-month period we collected information on payments to physicians by 3,194 consecutive patients who underwent stress testing an 833 consecutive patients who underwent percutaneous coronary angioplasty at the Yale University Cardiology Practice. Although the charges for procedures were not related to patient characteristics, there were large and significant differences in payment to physicians based on age, sex, and race. For example, physicians who performed percutaneous transluminal coronary angioplasty received at least $2,500 from, or on behalf of, 72% of the patients 40 to 64 years old, 22% of the patients 65 to 74 years old, and 3% of the patients 75 years and older (P < 0.001); from 49% of the men and 28% of the women (P < 0.001); and 42% of the whites and 31% of the nonwhites (P < 0.001). Similar differences were observed for stress testing. These associations were largely explained by differences in insurance status. (+info)
(3/828) Physicians' perceptions of managed care.
We wished to determine physicians' views and knowledge of managed care, particularly their beliefs about the provisions of managed care contracts in terms of legality and ethics. A questionnaire was sent to the 315 physicians of the medical staff of Norwalk Hospital in Connecticut regarding managed care and managed care contracts. Sixty-six responses were received within a 45-day period (20.9% return). Although only 1 of 11 contract provisions presented in one section of the questionnaire was illegal in Connecticut, a majority of physicians believed 7 of the 11 were illegal. On average, 50% of physicians polled thought each of the provisions was illegal, and a varying majority of physicians (53% to 95.4%) felt the various provisions were unethical. The majority of respondents (84.8% to 92.4%) believed that nondisclosure provisions were unethical. Ninety-seven percent thought managed care interferes with quality of care, and 72.7% of physicians felt that the managed care industry should be held legally responsible for ensuring quality of care. However, 92.4% of physicians considered themselves to be ethically responsible for ensuring quality of care. Physicians have a poor understanding of the legal aspects of managed care contracts but feel strongly that many provisions of these contracts are unethical. Physicians also believe that managed care is causing medicine to be practiced in a manner that is contrary to patients' interests and that legal recourse is needed to prevent this. (+info)
(4/828) A population-based study of environmental hazards in the homes of older persons.
OBJECTIVES: This study sought to estimate the population-based prevalence of environmental hazards in the homes of older persons and to determine whether the prevalence of these hazards differs by housing type or by level of disability in terms of activities of daily living (ADLs). METHODS: An environmental assessment was completed in the homes of 1000 persons 72 years and older. Weighted prevalence rates were calculated for each of the potential hazards and subsequently compared among subgroups of participants characterized by housing type and level of ADL disability. RESULTS: Overall, the prevalence of most environmental hazards was high. Two or more hazards were found in 59% of bathrooms and in 23% to 42% of the other rooms. Nearly all homes had at least 2 potential hazards. Although age-restricted housing was less hazardous than community housing, older persons who were disabled were no less likely to be exposed to environmental hazards than older persons who were nondisabled. CONCLUSIONS: Environmental hazards are common in the homes of community-living older persons. (+info)
(5/828) Smoking, physical activity, and active life expectancy.
The effect of smoking and physical activity on active and disabled life expectancy was estimated using data from the Established Populations for Epidemiologic Studies of the Elderly (EPESE). Population-based samples of persons aged > or = 65 years from the East Boston, Massachusetts, New Haven, Connecticut, and Iowa sites of the EPESE were assessed at baseline between 1981 and 1983 and followed for mortality and disability over six annual follow-ups. A total of 8,604 persons without disability at baseline were classified as "ever" or "never" smokers and doing "low," "moderate," or "high" level physical activity. Active and disabled life expectancies were estimated using a Markov chain model. Compared with smokers, men and women nonsmokers survived 1.6-3.9 and 1.6-3.6 years longer, respectively, depending on level of physical activity. When smokers were disabled and close to death, most nonsmokers were still nondisabled. Physical activity, from low to moderate to high, was significantly associated with more years of life expectancy in both smokers (9.5, 10.5, 12.9 years in men and 11.1, 12.6, 15.3 years in women at age 65) and nonsmokers (11.0, 14.4, 16.2 years in men and 12.7, 16.2, 18.4 years in women at age 65). Higher physical activity was associated with fewer years of disability prior to death. These findings provide strong and explicit evidence that refraining from smoking and doing regular physical activity predict a long and healthy life. (+info)
(6/828) Aging successfully until death in old age: opportunities for increasing active life expectancy.
The purpose of this study was to estimate the prevalence of having no disability in the year prior to death in very old age and to examine factors associated with this outcome. Participants were men and women aged 65 years and older who were followed prospectively between 1981 and 1991 from three communities: New Haven, Connecticut; Iowa and Washington counties, Iowa; and East Boston, Massachusetts. Persons who died in late old age with known disability status within 15 months of death (n = 1,097) were studied for predictors of dying without disability at the last follow-up interview prior to death. The probability of a nondisabled 65-year-old man's surviving to age 80 and then being nondisabled prior to death was 26% and, for a 65-year-old woman, the probability of surviving to age 85 and being nondisabled before death was 18%. Physical activity was a key factor predicting nondisability before death. There was nearly a twofold increased likelihood of dying without disability among the most physically active group compared with sedentary adults (adjusted odds ratio = 1.86, 95% confidence interval 1.24-2.79). These findings provide encouraging evidence that disability prior to death is not an inevitable part of a long life but may be prevented by moderate physical activity. (+info)
(7/828) Weight loss counseling by health care providers.
OBJECTIVES: This study explores the pattern of weight loss counseling by health care providers in Connecticut and the associated weight loss efforts by patients. METHODS: Data from the 1994 Connecticut Behavioral Risk Factor Surveillance System survey were analyzed to determine (1) the frequency of weight management counseling by health care providers of overweight adults with and without additional cardiovascular risk factors and (2) the current weight loss practices of overweight subjects. RESULTS: Only 29% of all overweight respondents and fewer than half with additional cardiovascular risk factors, reported that they had been counseled to lose weight. CONCLUSIONS: The findings suggest a need for more counseling of overweight persons, especially those with cardiovascular disease risk factors. (+info)
(8/828) Evaluating the impact of a street barrier on urban crime.
OBJECTIVES: Violence is a major urban public health problem in the United States. The impact of a physical barrier placed across a street in a public housing project to prevent street violence and drug activity was evaluated. METHODS: Hartford Police Department data on violent and drug related crime incidence within the housing project containing the barrier were analyzed by use of a computerized geographic information system. RESULTS: Violent crime decreased 33% on the intervention street during the 15 month period after erection of the barrier, compared with the 15 month period before erection of the barrier, but there was no change in drug related crime. On adjoining streets and surrounding blocks, violent crime decreased 30%-50% but drug related crimes roughly doubled. A non-adjacent area of the housing project and the entire city experienced 26% and 15% decreases in violent crimes, and 414% and 25% increases in drug crimes, respectively. CONCLUSIONS: The barrier decreased violent crime but displaced drug crimes to surrounding areas of the housing project. These results have important implications for other cities that have erected or are considering erecting similar barriers. (+info)