Assessing the health of migrant and seasonal farmworkers in New York State: statewide data 2003-2005.

OBJECTIVES: New York State data were used to document demographic characteristics and identify the top five most prevalent disease conditions among migrant and seasonal farmworkers and their families working in the state from 2003 to 2005. METHODS: Prevalence estimates were derived using enumeration and diagnosis data provided by New York State Department of Health contractors. The sample totals ranged from 6,500 to 8,000 migrant and seasonal farmworkers and their families. RESULTS: The majority of migrant and seasonal farmworkers were Hispanic with New York or Mexico the most frequently reported migrant home. Infections, muscular skeletal problems, respiratory disease, hypertension, and diabetes were the five most prevalent diseases identified. CONCLUSION: Migrant and seasonal farmworkers in New York State experienced health conditions common among agricultural workers. Additional research and surveillance are necessary for understanding and serving their health needs.

Comprehensive statewide approach to improve youth outcomes: experience of the New York State Youth Development Team.

Best practice research indicates a need for a policy shift toward positive youth development (YD) principles and strategies. The New York State Youth Development Team (YDT) is a public-private partnership of leading agencies whose holistic vision, "families, schools and communities partner to support the development of healthy, capable and caring youth," requires key stakeholders at all levels to address adverse youth health outcomes through effective partnerships. To transform the YDT vision into statewide practice requires committed actions (policy, funding, and training) at the state and community levels. Key lessons learned and experience-based recommendations that guide YD efforts in New York State can help state and local agencies move more to a positive YD approach that helps young people become healthy, caring, competent, and contributing adults, fully prepared to be parents, workers, leaders, entrepreneurs, and citizens of the future.

Purchasing online journal access for a hospital medical library: how to identify value in commercially available products.

BACKGROUND: Medical practice today requires evaluating large amounts of information which should be available at all times. This information is found most easily in a digital form. Some information has already been evaluated for validity (evidence based medicine sources) and some is in unevaluated form (paper and online journals). In order to improve access to digital information, the School of Clinical Medicine and Research at the University of the West Indies and Queen Elizabeth Hospital decided to enhance the library by offering online full text medical articles and evidence based medicine sources. The aim of this paper is to evaluate the relative value of online journal commercial products available for a small hospital and medical school library. METHODS: Three reference standards were chosen to represent the ideal list of core periodicals for a broad range of medical care: 2 Brandon/Hill selected lists of journals for the small medical library (BH and BH core) and the academic medical library core journal collection chosen for the Florida State University College of Medicine Medical Library. Six commercially available collections were compared to the reference standards and to the current paper journal subscription list as regards to number of journals matched and cost per journal matched. Ease of use and presence of secondary sources were also considered. RESULTS: The cost per journal matched ranged from US $3194 to $81. Because of their low subscription prices, the Biomedical Reference Collection and Proquest products were the most cost beneficial. However, they provided low coverage of the ideal lists (12-17% and 21-32% respectively) and contained significant embargoes on current editions, were not user friendly and contained no secondary sources. The Ovid Brandon/Hill Plus Collection overcame these difficulties but had a much higher cost-benefit range while providing higher coverage of the ideal lists (14-47%). CONCLUSION: After considering costs, benefits, ease of use, embargoes, presence of secondary sources (ACP Journal Club, DARE), the Ovid Brandon/Hill Plus Collection was the best choice for our hospital considering our budget. However, the option to individually select our own journal list from Ovid and pay per journal has a certain appeal as well.

A survey identified publication bias in the secondary literature.

OBJECTIVE: To investigate the existence of publication bias in the translation of evidence from the primary to the secondary literature, using the ACP Journal Club (ACPJC) as a representative of secondary literature and Medline as a representative of primary literature. METHODS: A cross-sectional survey of randomly selected randomized controlled trials of therapy published between 1994 and 2002 in English in Medline and all summaries of therapy trials published by ACPJC between the same dates. The main outcome measure was the rate of positive trials from among those trials aiming to find a difference between groups. RESULTS: 831 trials from Medline and 823 summaries of trials from ACPJC met the inclusion criteria and were included in the study. Compared to trials cataloged in Medline, ACPJC preferentially summarized trials with a positive outcome (P < .001). This bias remained after controlling for other selection biases seen in the ACPJC such as preferentially summarizing multicentered trials with large sample size, no active treatment control, blinding, and in certain disease fields (adjusted odds ratio 2.8, 95% confidence interval 2.02-3.93). CONCLUSION: The ACPJC preferentially summarizes trials with a positive outcome. Efforts should be made to reduce this bias.

Effect of interpregnancy interval on risk of spontaneous preterm birth in Emirati women, United Arab Emirates.

OBJECTIVE: To investigate whether a short interpregnancy interval is a risk factor for preterm birth in Emirati women, where there is a wide range of interpregnancy intervals and uniformity in potentially confounding factors. METHODS: A case-control design based on medical records was used. A case was defined as a healthy multiparous Emirati woman delivering a healthy singleton spontaneously before 37 weeks of gestation between 1997 and 2000, and a control was defined as the next eligible similar woman delivering after 37 weeks of gestation. Women were excluded if there was no information available about their most recent previous pregnancy or if it had resulted in a multiple or preterm birth. Data collected from charts and delivery room records were analysed using the STATA statistical package. All variables found to be valid, stable and significant by univariate analysis were included in multivariate logistic regression analysis. FINDINGS: There were 128 cases who met the eligibility criteria; 128 controls were selected. Short interpregnancy intervals were significantly associated with case status (P<0.05). The multivariate adjusted odds ratios for the 1st, 2nd, and 4th quartiles of interpregnancy interval compared with the lowest-risk 3rd quartile were 8.2, 5.4, and 2.0 (95% confidence intervals: 3.5-19.2, 2.4-12.6, and 0.9- 4.5 respectively). CONCLUSION: A short interpregnancy interval is a risk factor for spontaneous preterm birth in Emirati women. The magnitude of the risk and the risk gradient between exposure quartiles suggest that the risk factor is causal and that its modification would reduce the risk of preterm birth.