Trends in Pediatric Dental Care Use.

This article explores trends in 3 areas of dental services use for children less than 21 years of age. First, it examines the change in access to prevention, diagnostic, and treatment services over time among Medicaid-enrolled children and how access to care is affected by state-level factors. Second, it evaluates trends and health care costs associated with the treatment of oral health conditions in the operating room of pediatric hospitals. Third, it examines the trends in use of emergency departments for dental needs among children in the United States.

Honorary and ghost authorship in high impact biomedical journals: a cross sectional survey.

OBJECTIVES: To assess the prevalence of honorary and ghost authors in six leading general medical journals in 2008 and compare this with the prevalence reported by authors of articles published in 1996. DESIGN: Cross sectional survey using a web based questionnaire. SETTING: International survey of journal authors. PARTICIPANTS: Sample of corresponding authors of 896 research articles, review articles, and editorial/opinion articles published in six general medical journals with high impact factors in 2008: Annals of Internal Medicine, JAMA, Lancet, Nature Medicine, New England Journal of Medicine, and PLoS Medicine. MAIN OUTCOME MEASURES: Self reported compliance with International Committee of Medical Journal Editors (ICMJE) criteria for authorship for all authors on the selected articles. RESULTS: A total of 630/896 (70.3%) corresponding authors responded to the survey. The prevalence of articles with honorary authorship or ghost authorship, or both, was 21.0% (95% CI 18.0% to 24.3%), a decrease from 29.2% reported in 1996 (P = 0.004). Based on 545 responses on honorary authorship, 96 articles (17.6% (95% CI 14.6% to 21.0%)) had honorary authors (range by journal 12.2% to 29.3%), a non-significant change from 1996 (19.3%; P = 0.439). Based on 622 responses on ghost authorship, 49 articles (7.9% (6.0% to 10.3%)) had ghost authors (range by journal 2.1% to 11.0%), a significant decline from 1996 (11.5%; P = 0.023). The prevalence of honorary authorship was 25.0% in original research reports, 15.0% in reviews, and 11.2% in editorials, whereas the prevalence of ghost authorship was 11.9% in research articles, 6.0% in reviews, and 5.3% in editorials. CONCLUSIONS: Evidence of honorary and ghost authorship in 21% of articles published in major medical journals in 2008 suggests that increased efforts by scientific journals, individual authors, and academic institutions are essential to promote responsibility, accountability, and transparency in authorship, and to maintain integrity in scientific publication.

Tobacco-reporting validity in an epidemiological drug-use survey.

We compared responses to questions about tobacco use and passive exposure to smoking with biological tests for cotinine in order to estimate tobacco-reporting validity in an epidemiological survey on drug use. Respondents identified via multistage sampling (n=627) completed household surveys that were administered using an Audio Computer-Assisted Self-Interview (ACASI) procedure. Following the survey, respondents were asked to participate in drug testing. Saliva (oral fluid) was used to screen for the presence of cotinine, a major metabolite of tobacco. Hair, urine, and oral fluid testing were used to detect the presence of illicit drugs such as amphetamines, cocaine, heroin, and marijuana. While underreporting of tobacco was relatively rare, estimates from this recent study suggest that it may be increasing over time. Even after adjusting for passive exposure, self-report sensitivity estimates were still well below the 90% level suggested in prior reviews. Underreporting of marijuana and race/ethnicity showed a strong association with underreporting of tobacco use, suggesting that factors associated with the underreporting of illicit substance use parallel those associated with the underreporting of tobacco use.

Effects on alcohol use and anxiety of the September 11, 2001, attacks and chronic work stressors: a longitudinal cohort study.

OBJECTIVES: We hypothesized that chronic stressors associated with an everyday social role (work) would interact with a traumatic macrosocial stressor (the terrorist attacks of September 11, 2001) in predicting mental health status (during the fall of 2001). METHODS: We used mail surveys returned as part of wave 3 of a workplace cohort study, both before and after September 11, 2001, to assess decision latitude, sexual harassment, generalized workplace abuse, psychological distress, and alcohol use. We also used regression analyses to assess the main effect of September 11 and interactions between September 11 and stressors, after control for baseline mental health. RESULTS: The main effect of September 11 on elevated alcohol use was significant for women but not for men. For women, work stressors significantly interacted with experiencing the events of September 11 to affect alcohol use and anxiety outcomes. CONCLUSIONS: Women experiencing chronic work stressors were most vulnerable to elevated psychological distress and alcohol use after September 11, 2001.

Drug test feasibility in a general population household survey.

Drug testing was used as an adjunct to a general population household drug use survey administered via audio computer assisted self-interview. Participants, ages 18-40 years residing in Chicago, were recruited to participate in three different biological tests (hair, oral fluid, and urine) presented in random order subsequent to completing an interview. Subjects had the option of participating in zero to three different tests. We examined participation/refusal in tests, reaction to testing requests, as well as variables associated with participation and reaction. Subjects were randomly assigned to a low (US$ 10 per test) or high (US$ 20 per test) incentive condition. Over 90% of the sample participated in at least one test, usually the oral fluid test. Associations between refusal status and two variables, socioeconomic status (SES) and presence of children in the household, provided partial support for the notion that drug test participation parallels the survey response process in general. Incentive level did not directly increase drug test participation. Reporting of recent illicit drug use was associated with participation in only one procedure, hair testing. Type of test offered and individual differences in willingness to be drug tested were important predictors of drug test refusal and subject reaction to testing requests. Compared with urine and hair testing, oral fluid testing had lower refusal rates and was generally more acceptable to respondents in a general population survey. The findings support the feasibility of incorporating multiple drug tests with modest incentives into general population household surveys on drug abuse.

The utility of drug testing in epidemiological research: results from a general population survey.

AIMS: To assess the utility of biological testing in a general population survey for estimating prevalence and evaluating self-report data quality. DESIGN: An audio computer-assisted interview was administered to subjects from June 2001 to January 2002. Immediately following the interview, subjects were requested to participate in hair, oral fluid and urine testing. SETTING: Subjects were from randomly selected households in the City of Chicago using multi-stage sampling methods. Interviews were conducted in subjects' homes. PARTICIPANTS: The data represent 627 randomly selected adult participants, ages 18-40 years. MEASUREMENTS: Prevalance, kappa, conditioned kappa, sensitivity, specificity, under-reporting, 'mixed model' and logistic regression. FINDINGS: Higher rates of marijuana use were generated from survey reports than from drug testing. Drug testing generated higher prevalence rates than survey reports for recent use of cocaine and heroin. Under-reporting of recent drug use was apparent for all three substances. Sensitivity was particularly low for cocaine and heroin. Race was related to under-reporting, with African Americans less likely to report marijuana use despite a positive test result. CONCLUSIONS: The utility of drug testing for surveys depends on the type of substance examined as well as on the type of test employed. Multiple tests have more utility than a single test. Drug testing is useful for identifying the levels and sources of under-reporting in a survey and provides a basis for adjusting prevalence estimates based on self-reports.

A contextual profile of club drug use among adults in Chicago.

AIMS: To better understand the prevalence, correlates, risk factors and context of club drug use among US adults in the City of Chicago. DESIGN: An Audio Computer-Assisted Self Interview was administered to a household probability sample of adults, aged 18-40 years, from June 2001 to January 2002. SETTING: Subjects were drawn from randomly selected households using a multi-stage area probability design. PARTICIPANTS: The data represent 627 randomly selected adult participants. MEASUREMENT: Weighted prevalence estimates with design-effect adjusted confidence intervals of life-time, past 12 month and past 30 day use of any club drug and of specific club drugs; prevalence of rave attendance, other drug use, motivation for use among club drug users; chi2 tests of significance, logistic regression and adjusted odds ratios. FINDINGS: Overall club drug prevalence rates were nearly twice those obtained for MDMA alone. Club drug users were more likely to use multiple illicit substances and to report having been in treatment for substance use. A majority of life-time club drug users never attended a rave although rave attendees were more likely to report frequent use of MDMA. Use was associated with gender, race and sexual orientation. CONCLUSIONS: Prevention research should be informed by further population-based research on club drug use. Research should not focus exclusively on rave attendees, as they are only a subset of club drug users. Research is needed on neurological and behavioral sequelae across different types of club drugs, gender differences in the impact of sexual orientation on club drug risk and on the effects of personality characteristics such as sensation seeking on club drug use behavior.