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An essay is presented which discusses U.S. Boundary Survey Commissioner John Russell Bartlett's book "Personal Narrative of Explorations and Incidents in Texas, New Mexico, California, Sonora, and Chihuahua." Particular focus is given to utilizing Bartlett's book to examine the ethnological aspects of determining a U.S.-Mexico boundary following the Mexican-American War.

This article focuses on the emergence of the New York bookshop and publishing firm, the American Ethnological Society, as the commercial center of an intellectual enterprise. It stresses its relevance between the ethnological research and literary commerce and the American expansion in the southwest and Mexico. It outlines the partnership of John Russell Bartlett and Albert Gallatin in founding the bookshop. Moreover, the significance of the bookshop and the views of the founders are discussed.

Objective. This study assessed the long-term economic implications of a national program to vaccinate all adults treated at sexually transmitted disease (STD) clinics in a single year. Methods. A model was developed to track the long-term disease outcomes and costs among a hypothetical cohort of 2 million STD clinic clients accessing services in one year, using data from published sources and demonstration projects at STD clinics in San Diego (California), Illinois, and Denver (Colorado). The model estimated net economic benefits of a routine hepatitis B vaccination policy at STD clinics nationwide compared with no vaccination. Results. Without a vaccination program, an estimated 237,021 new hepatitis B virus (HBV) infections would occur over the lifetimes of the 2 million STD clinic clients seen in a single year. HBV-related medical costs and productivity losses would be $1.6 billion. In a national program for routine vaccination at STD clinics, 1 .3 million adults would be expected to receive at least one vaccine dose, and an estimated 45% of the new HBV infections expected without vaccination would be prevented. The vaccination program would cost $138 million, HBV infections occurring despite the program would cost $878 million, and clients' time and travel would cost $45 million. The net economic benefit (savings) of routine vaccination would be $526 million. If the indirect costs of lost productivity due to HBV infection are not considered, routine vaccination would have a net cost of $28 million. Conclusions. Estimates from this model suggest a national program for routine hepatitis B vaccination of adults at STD clinics would be a cost saving to society. [ABSTRACT FROM AUTHOR]

This article focuses on the revolution and aberrant form of the literary culture of the seventeenth century in the U.S. Criticism on several literary works discussed in the "Monthly Magazine and American Review," by Charles Brockden Brown is presented, including the "Parallel Between Hume, Robertson," in May of 1799, "Walstein's School of History," and the essay "The Difference Between History and Romance," from the August 1800 issue. The work of Brown centers on the line that history and romance have never before been properly distinguished, but are in fact opposed concepts. However, Brown quickly establishes a more stable ground for discussion, illustrating that "history" is a highly restricted category, consisting only of the "catalogue of natural appearances."

The article reports on the study conducted to determine the impact of hepatitis B vaccination service offered in an urban sexually transmitted disease (STD) clinic. The study was conducted among men who have sex with men and other clients that attend the main STD clinic in San Diego County, California. According to a report released by the Centers for Disease Control and Prevention, hepatitis B vaccination reduces the risk of acquiring STDs. The study concluded that the vaccination could be incorporated with STD clinic services.

Objectives. The Centers for Disease Control and Prevention recommend screening individuals at risk for hepatitis C virus (HCV) infection. However, few published data describe outcomes of individuals with antibody to HCV (anti-HCV) identified through screening programs. The purpose of this study was to assess rates of medical evaluation and HCV treatment, change in alcohol consumption, and barriers to medical care after testing anti-HCV positive through a public screening program. Methods. Anti-HCV positive individuals identified through San Diego sexually transmitted disease (STD) clinics and an HIV test site screening program were informed of positive test results, provided education and referral, and contacted by telephone three, six, and ≥12 months later. Results. From September 1, 1999, to December 31, 2001, 411 anti-HCV positive individuals were newly identified, of whom 286 (70%) could be contacted ≥ three months after receipt of test results (median length [range] of follow-up 14 [3-35] months). Of these 286, 156 (55%) reported having received a medical evaluation, of whom 19 (12%) began HCV treatment. Of 132 who reported drinking alcohol before diagnosis, 100 (76%) reported drinking less after diagnosis. Individuals with medical insurance at diagnosis were more likely than those without insurance to obtain a medical evaluation during follow-up (75 [68%] of 111 vs. 70 [45%] of 155; p<0.001). Among those who did not obtain an evaluation, the most commonly reported reason was lack of insurance. Conclusions. Only about half of newly identified anti-HCV positive individuals received a medical evaluation, although 76% reported drinking less alcohol. Identifying ways to improve medical access for those who are anti-HCV positive could improve the effectiveness of screening programs. [ABSTRACT FROM AUTHOR]

Background: Persons with repeat gonorrhea (GC) infection often participate in sexual networks that maintain and spread GC throughout the community. However, there are no established methods for collecting repeat GC surveillance data that are needed to monitor trends and risk factors for repeat infection. Goal: The goal of this study was to evaluate definitions and methods for establishing surveillance for repeat gonorrhea infection. Study Design: During a 7-year period (1995-2001), all reported GC cases in San Diego County, California, were reviewed to identify persons with ≥2 GC infections that occurred >30 but ≤365 days apart. Various matching criteria and definitions of repeat infection were evaluated. Results: Overall, 12,287 GC infections were reported; 509 persons accounted for 551 episodes of repeat infection and 9.7% of all GC infections. The mean annual repeat GC case rate was 2.8 per 100,000 population (range, 1.5-4.1) and repeat cases were 4.5% of total GC (range, 2.7-5.5%). Temporal trends in both repeat measures mirrored the overall county reported GC case rate. Young, inner-city males were more likely to have reported repeat GC infection. Conclusion: Simple, uniform repeat GC measures can be used to establish a surveillance system for monitoring trends, risk factors, and the impact of interventions directed toward preventing repeat GC infections. [ABSTRACT FROM AUTHOR]

Background: Little is known about the epidemiology of gonorrhea in the United States, except for basic demographics of reported cases. Knowing the proportion of reported gonorrhea cases identified through screening, the diagnostic test used, and patient behavioral risk factors might help to better explain changes in gonorrhea rates over time.Goal: The goal of this study was to implement and evaluate a gonorrhea sample survey surveillance methodology in San Diego, California.Study Design: Healthcare providers caring for a representative sample of all gonorrhea patients reported during August 16 through October 18, 2001 were interviewed by telephone about patient demographics, risk factors, and management.Results: The healthcare providers of 248 gonorrhea patients were contacted; data were obtained on 224 (90%) patients. Major reasons for testing included symptoms (68%), partner referral (14%), and screening (12%). Gonococcal culture, DNA probe tests, and nucleic acid amplification tests were used to diagnose 40%, 34%, and 21% of patients, respectively. At minimum, 36% of male gonorrhea patients were men who have sex with men (MSM); MSM with gonorrhea were rarely diagnosed with rectal or pharyngeal gonorrhea outside of sexually transmitted disease (STD) clinics. Estimated local resources required to conduct this survey were $12 per completed interview.Conclusion: Healthcare provider telephone interviews regarding recently reported gonorrhea patients are feasible and can provide important additional information to STD programs, which could be used to direct intervention strategies and monitor trends. Ultimately, a national sampling approach could be explored and incorporated into ongoing gonorrhea surveillance. [ABSTRACT FROM AUTHOR]

Focuses on the risk of sexually transmitted disease (STD) clinic clients for subsequent gonorrhea and chlamydia infections in the United States. Implications of identifying core transmitter groups for STD preventive programs; Promotion of client-centered risk reduction; Elements of STD-prevention case management.

Several trends in sexually transmitted diseases (STDs) have laid the foundation for a new paradigm for STD treatment and prevention that encompasses a community-wide, population-oriented approach. Public health STD programs, in partnership with a wide variety of community collaborators, will need to carry out the essential functions of public health-assessment, policy development, and assurance-by developing resources for community organizing and planning, enhanced information systems, and comprehensive training programs for professional staff and community partners. Community providers (particularly practicing clinicians and community and hospital clinics) will need to deliver primary prevention (community health promotion and clinical preventive services) and secondary prevention (screening and treatment) services while categorical STD clinics focus on providing care for high-risk, high-frequency STD transmitters who serve as the reservoir for much of a community's bacterial STDs. Managed care organizations and public health STD programs will need to formalize collaborative arrangements and capitalize on the strengths of each organization in order to have a population-level impact on STD transmission. [ABSTRACT FROM AUTHOR]

Studies the incidence of syphilis in San Diego County, California from 1983-1992. Link between syphilis epidemics and crack cocaine use, prostitution and partner notification limitations; Improvement of measures to control inner city drug/prostitution-related syphilis epidemics.

In 1983, the State Epidemiologists in 46 States completed a survey questionnaire describing the professional qualifications, training, and experience of State health department epidemiologists and the scope of participation by the State Epidemiologists and their staffs in public health programs. The survey identified 224 State health department epidemiologists (estimated U.S. ratio 1.1 per million population). A State health department epidemiologist was most often male (80 percent), frequently (57 percent) was a physician, had an average age of 41 years, and had worked as an epidemiologist for 9 years. Participation in public health programs (either by supervising or providing consultation) by the State Epidemiologists and their staffs focused mainly on general epidemiology and communicable disease programs; fewer than half had participated in programs relating to the health of women and children, chronic diseases, injuries, or in other programs directed towards preventing premature mortality. Recently, the State Epidemiologists have been trying to broaden their activities into these areas; however, the demands created by the acquired immunodeficiency syndrome (AIDS) will mostly likely slow this process. Based on the overall findings and collective experience, it was concluded that State health departments have too few epidemiologists to address the wide variety of important public health problems facing our communities. It was proposed that each State health department have at least four epidemiologists (including one or more physician epidemiologists) and at least one master's level biostatistician and that the epidemiologists-per-population ratio not be less than 1 per million. [ABSTRACT FROM AUTHOR]

Purpose: To determine the cause of an outbreak of chronic diarrhea and to define the clinical profile of the illness.Design: A case series of patients with chronic diarrhea and case-control and cohort studies to determine the vehicle and cause of the illness.Setting: Rural Henderson County, Illinois.Patients: Seventy-two patients who had onset of chronic diarrheal illness between May and August 1987. Controls were local residents and eating companions who did not have diarrheal illness. A cohort study included 80 truck drivers from a local firm.Methods and Measurements: Nonbloody diarrhea was characterized by extreme frequency (median, 12 stools/d), marked urgency, fecal incontinence, and weight loss (mean, 4.5 kg). The median incubation period was 10 days. Nine patients were hospitalized; none died. Diarrhea persisted in 87% of patients after 6 months. Antimicrobial therapy produced no clinical improvement. No bacterial, mycobacterial, viral, or parasitic agents known to be enteropathogenic were detected in stools or implicated water. Three of five small-bowel biopsies showed mild inflammatory changes. Mild inflammation was also seen in two of nine colonic biopsies. Case-control studies implicated a local restaurant (P = 0.0001, odds ratio = 19) and subsequently the untreated well water served in the restaurant (P = 0.04, odds ratio = 9.3) as the vehicle of transmission.Conclusions: This is the first outbreak of chronic diarrhea linked to drinking untreated water. The causative agent and pathophysiologic mechanism of the illness remain elusive. [ABSTRACT FROM AUTHOR]

Abstract: We report an outbreak of Salmonella typhimarium in the infant room of a day care center. Time between onset dates. clustering of eases in the room, lack of a common food exposure, lack of illness among other children and staff, and lack of community-wide infection suggested person-to-person or continuing-common-source transmission. Successful preventive measures included instruction of personnel in proper handwashing arid diaper-changing procedures and cohorting of infected anti non-infected children. This is the second description of a non-foodborne outbreak of salmonellosis in a day care center, and the first involving S. typhimurium. [ABSTRACT FROM AUTHOR]

Determines the acceptability of health department notification of sex and needle-sharing partners of persons infected with HIV in South Carolina. Concerns of several HIV-infected persons regarding the system of health department notification of HIV exposure; Prevalence of HIV infection in South Carolina since February 1986; Factors that contribute to high participation rate in initial testing and counseling and the high approval rates for notification of HIV exposure.

Comments on the general approaches to HIV and sexually transmitted (STD) diagnosed patients in the United States. Incidence of chlamydia and gonorrhea among HIV-infected patients; Risk factors of HIV; Absence of screening and preventive services for STD.

Abstract. The reported incidence of mumps has declined dramatically since licensure of the live attenuated mumps vaccine in the United States in 1967, particularly in young children. Because administration of the vaccine was not widely practiced during the first decade it was available, there is now a cohort of teenagers and young adults who are relatively underimmunized. Reported mumps cases in this cohort increased substantially during 1986 to 1987. Mumps outbreaks at three Illinois universities, from which 123 clinical cases were reported between September 1986 and May 1987, were investigated. Meningeal involvement was reported in 17% of case-patients, orchitis occurred in 19% of 64 men, 6% of patients were hospitalized, and direct health care costs were estimated at $264 per case and more than $32 000 for the three outbreaks combined. The risk of mumps illness was greater for students <20 years of age (relative risk [RR] = 2.1, 95% confidence interval [CI] = 1.4, 3.1); students residing in dormitories (RR = 2.7, 95% CI = 1.6, 4.6); and out-of-state students (RR = 1.8, 95% CI = 1.0, 3.0). Because the available data suggest that mumps in college-aged persons is due chiefly to a failure to vaccinate susceptible persons, colleges and universities should become one major focus of mumps prevention activities to reduce susceptibility in this high-risk population. [ABSTRACT FROM AUTHOR]

Short summary: Syphilis cases were reviewed to see if reported stages met the Centers for Disease Control and Prevention case definition. Classification was excellent for primary and secondary and good for late latent, but half of early latent and unknown duration were misclassified. New surveillance definitions are suggested, comments requested. Background: Uncertainty when staging latent syphilis should lead clinicians to call it late latent (requires more treatment) and disease investigators to call it early latent (priority for partner investigation). Accurate surveillance requires consistent case definitions. Objective: Assess validity of reported syphilis stages. Methods: Record reviews in 6 jurisdictions to determine if reported cases met the Centers for Disease Control and Prevention case definitions. Results: Nine hundred seventy-three records from 6 jurisdictions in 2002 showed excellent agreement for reported primary (94.0%) and secondary (95.4%), good agreement for late latent (80.2%), and poor agreement for early latent (48.4%) and unknown duration (49.7%). Unknown duration (age ≤35 and nontreponemal test titer ≥32) was often misinterpreted to mean ‘not known.’ Early latent (within the past year, documented: seroconversion, fourfold titer increase, symptoms, or contact with an independently documented early syphilis case) was often misinterpreted to include patients with risky behavior, young age, or high nontreponemal test titers. Conclusions: The unknown duration stage should be dropped. Surveillance of latent syphilis would be more consistent if cases were reported as having high or low titers on nontreponemal test. Alternative approaches are solicited from readers. [ABSTRACT FROM AUTHOR]