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PubMed2002

Bioterrorism-related anthrax surveillance, Connecticut, September-December, 2001.

On November 19, 2001, a case of inhalational anthrax was identified in a 94-year-old Connecticut woman, who later died. We conducted intensive surveillance for additional anthrax cases, which included collecting data from hospitals, emergency departments, private practitioners, death certificates, postal facilities, veterinarians, and the state medical examiner. No additional cases of anthrax were identified. The absence of additional anthrax cases argued against an intentional environmental release of Bacillus anthracis in Connecticut and suggested that, if the source of anthrax had been cross-contaminated mail, the risk for anthrax in this setting was very low. This surveillance system provides a model that can be adapted for use in similar emergency settings.

Absenteeism↗
PubMed2003

Isolated case of bioterrorism-related inhalational anthrax, New York City, 2001.

On October 31, 2001, in New York City, a 61-year-old female hospital employee who had acquired inhalational anthrax died after a 6-day illness. To determine sources of exposure and identify additional persons at risk, the New York City Department of Health, Centers for Disease Control and Prevention, and law enforcement authorities conducted an extensive investigation, which included interviewing contacts, examining personal effects, summarizing patient's use of mass transit, conducting active case finding and surveillance near her residence and at her workplace, and collecting samples from co-workers and the environment. We cultured all specimens for Bacillus anthracis. We found no additional cases of cutaneous or inhalational anthrax. The route of exposure remains unknown. All environmental samples were negative for B. anthracis. This first case of inhalational anthrax during the 2001 outbreak with no apparent direct link to contaminated mail emphasizes the need for close coordination between public health and law enforcement agencies during bioterrorism-related investigations.

Anthrax↗
PubMed2003

Bioterrorism-related inhalational anthrax in an elderly woman, Connecticut, 2001.

On November 20, 2001, inhalational anthrax was confirmed in an elderly woman from rural Connecticut. To determine her exposure source, we conducted an extensive epidemiologic, environmental, and laboratory investigation. Molecular subtyping showed that her isolate was indistinguishable from isolates associated with intentionally contaminated letters. No samples from her home or community yielded Bacillus anthracis, and she received no first-class letters from facilities known to have processed intentionally contaminated letters. Environmental sampling in the regional Connecticut postal facility yielded B. anthracis spores from 4 (31%) of 13 sorting machines. One extensively contaminated machine primarily processes bulk mail. A second machine that does final sorting of bulk mail for her zip code yielded B. anthracis on the column of bins for her carrier route. The evidence suggests she was exposed through a cross-contaminated bulk mail letter. Such cross-contamination of letters and postal facilities has implications for managing the response to future B. anthracis-contaminated mailings.

Aged↗
PubMed2005

Osler and the infected letter.

The spread of infectious agents through the mail has concerned public health officials for 5 centuries. The dissemination of anthrax spores in the US mail in 2001 was a recent example. In 1901, two medical journals reported outbreaks of smallpox presumably introduced by letters contaminated with variola viruses. The stability and infectivity of the smallpox virus are reviewed from both a historical (anecdotal) perspective and modern virologic studies. Bubonic plague was the contagious disease that led to quarantines as early as the 14th century in port cities in southern Europe. Later, smallpox, cholera, typhus, and yellow fever were recognized as also warranting quarantine measures. Initially, attempts were made to decontaminate all goods imported from pestilential areas, particularly mail. Disinfection of mail was largely abandoned in the early 20th century with newer knowledge about the spread and stability of these 5 infectious agents.

Correspondence as Topic↗
PubMed2002

Response rate, speed, and completeness: a comparison of Internet-based and mail surveys.

Because of their speed and accessibility, the use of on-line research tools has grown considerably in recent years. The present study compared two ways of delivering surveys: Internet-based and mail delivery methods. Although Internet-based and mail surveys achieved a similar response rate, Internet-based surveys may be more effective than mail surveys in a setting such as when the target population has both e-mail and Internet access.

Data Collection↗
PubMed2000

Investigating moral intensity with the World-Wide Web: a look at participant reactions and a comparison of methods.

This paper reports the results of a vignette- and questionnaire-based research project over the World-Wide Web investigating the influence of moral intensity (MI) on decision making in a business context. A qualitative analysis of the feedback in terms of e-mail communications was used to provide insights into the reactions and responses of participants to both the research method and the topic of research. Implications are discussed, and some methodological recommendations are derived. Second, analysis of the quantitative results of the Web-based questionnaire administration indicated that three of the six MI components were particularly important determinants of several outcome variables. This pattern of results essentially replicated findings yielded by a previous mail administration of the survey, even though a smaller amount of variation in the outcome variables was accounted for. Neither occupational background nor the region of origin of participants measurably influenced the results.

Commerce↗
PubMedDate not supplied

Effects of a self-determination theory-based mail-mediated intervention on adults' exercise behavior.

PURPOSE: To examine the effect of a mail-mediated intervention, based on self-determination theory, on adults'exercise behavior. METHODS: The study was a randomized control trial conducted over a 2-month period. Of the initial 185 volunteer participants, 126 (68.1%) completed questionnaires at baseline, 1 month, and 2 months. Participants in intervention-only and intervention-plus-booster groups received a mail-delivered packet containing strategies designed to promote perceptions of autonomy, competence, and relatedness regarding exercise. Those in a control group received an American Heart Association physical-activity facts packet. After 1 month, those in the intervention-plus-booster group received a booster postcard, reiterating the main points of the initial intervention packet. Exercise behavior was the primary outcome variable. Perceptions of autonomy, competence, and relatedness were evaluated as mediating variables. RESULTS: Separate 3 (group) x 3 (time) repeated measures analyses of variance conducted for men and women revealed that for women, all three groups significantly increased exercise levels over the 2-month period. No significant interactions were found regarding the influence of the intervention on the mediating variables. A process evaluation indicated a lack of compliance regarding completing intervention-packet worksheets. DISCUSSION: Findings suggested that more intensive interventions and greater fidelity of treatment may be needed to evidence change in exercise behavior.

Adult↗
PubMedDate not supplied

Do we need a "virtual" program infrastructure for worksite and population health promotion efforts?

As the demand for Worksite Health Promotion heats up, it is becoming clear that the traditional models of programming that work well in worksites with large number of employees will not meet the needs of small and medium size employer organizations. Additionally, the large number of individuals who are served by health plans are also likely to require different types of Health Promotion interventions. In presenting the concept of a "virtual" set of interventions that form a "program infrastructure" this article seeks to bridge the gap between large employer programming strategies and small employer and health plan settings. A set of eleven interventions are described and recommended technical specifications are presented.

Health Promotion↗
PubMed1992

Role of psychosocial risk factors in work-related low-back pain.

The experience of low-back pain and its psychosocial associates were directly compared among sufferers drawn from three populations, a blue-collar working group, a white-collar working group, and a patient group. Sufferers drawn from the patient population revealed the expected psychological disturbance. There was no evidence of such involvement for sufferers still at work. Disability resulting from low-back pain was positively linearly related to severity of pain for sufferers drawn from working groups, irrespective of psychological disturbance. For patients, on the other hand, the presence of psychological disturbance modified the relationship between severity and disability such that no simple linear relationship existed between the two variables. Work dissatisfaction was not found to be related to the presence of, and did not account for disability resulting from, low-back pain in working subjects.

Adult↗
PubMed1977

Age and sex as determinants of the relative aerobic strain of nonmotorized mail delivery.

The relative aerobic strain (RAS) of nonmotorized mail delivery was assessed in 54 Finnish mail carriers who represented both sexes, the entire workage range and both downtown and suburban delivery districts. The mean RAS of the entire delivery time was 55% of the maximal oxygen uptake (ml/kg-min). It was higher for women than for men, and higher for suburban than for downtown delivery. The RAS tended to increase systematically with age after the age of 50. The work strain of mail carriers of over 50 years of age, especially of older women carriers in suburban areas, was concluded to be high enough to lead to possible excessive strain on the workers.

Adult↗
PubMed2004

Prospective study of the relationship between musculoskeletal and psychological complaints and electromyographic activity during isometric muscular contractions in a working population.

OBJECTIVES: This study focused on determining whether musculoskeletal and psychological complaints reported monthly over a 4-month period predicted muscular activity during and immediately after standardized worktasks and whether muscular activity during and immediately after these tasks predicted changes in complaint severity in the following 12 months. METHODS: Surface electromyography (EMG) was recorded bilaterally from the upper trapezius, middle deltoid, and forearm extensor muscles of 45 postal workers (30 women) during sustained submaximal (25% of peak force) isometric contractions (wrist extension and shoulder abduction). Self-reported health complaints were recorded monthly. Musculoskeletal and psychological complaint-severity indices (MSI and PI, respectively) were computed from complaint-severity scores (intensity score x duration score). The history of complaints over the previous 4 months was included in adjusted regression models to predict muscular activity during and immediately after submaximal contractions. Muscular activity was included in adjusted models to predict changes in the complaint severity over the subsequent 12-month period. RESULTS: A higher MSI predicted a lower EMG level in the trapezius muscle during submaximal contractions (P<0.014), whereas the PI did not predict the level of EMG in any of the muscles studied (P > 0.194). The EMG activity did not predict changes in the complaint severity over the subsequent 12 months. CONCLUSIONS: These findings may support the hypotheses of pain adaptation or the dysfunction of synergistic muscular control in relation to musculoskeletal complaints. However, the findings did not indicate that increased or decreased muscular activity is a risk factor for heightened levels of complaints in the subsequent 12 months.

Adult↗
PubMed1981

Fallibility of postal questionnaire follow-up for detection of hypothyroidism after iodine-131 therapy.

Four hundred and twelve patients who received radioactive iodine for thyrotoxicosis were followed up for periods from one to three years by postal questionnaire. Hypothyroidism was detected in only three instances, and, despite intensive efforts to trace subjects, 41% of them were lost to follow-up because of either failure to participate or change of address over three years. It is apparent that a postal questionnaire is an unsatisfactory method for following up a Melbourne inner-suburban population over a prolonged period.

False Negative Reactions↗
PubMedDate not supplied

Randomized trial of 2 interventions to increase older women's exercise.

OBJECTIVE: To test 2 interventions to increase older women's physical activity. METHODS: A randomized 2-way factorial experimental design compared the effects of 2 limited-contact interventions, motivational sessions and periodic prompts, among 190 women. Experimental participants received a 3-encounter motivational intervention. Those randomized to prompts received weekly telephone or mail-delivered cues. RESULTS: The prompting intervention consistently increased exercise and physical activity scores. The motivational intervention did not affect outcome scores. CONCLUSIONS: Prompting is a low-cost strategy for increasing exercise and physical activity among older women. Future research should examine alternative modes for prompt delivery.

Aged↗