Early detection of developmental dysplasia of the hip in The Netherlands: the validity of a standardized assessment protocol in infants
This study evaluated the validity of the traditionally recommended screening protocol for developmental dysplasia of the hip in infants. Study children (n = 1968) underwent a standardized screening examination. The incidence of developmental dysplasia of the hip was 3.7%. The sensitivity of the test...
Gespeichert in:
Veröffentlicht in: | American journal of public health (1971) 1998-02, Vol.88 (2), p.285-288 |
---|---|
Hauptverfasser: | , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 288 |
---|---|
container_issue | 2 |
container_start_page | 285 |
container_title | American journal of public health (1971) |
container_volume | 88 |
creator | Boere-Boonekamp, M M Kerkhoff, T H Schuil, P B Zielhuis, G A |
description | This study evaluated the validity of the traditionally recommended screening protocol for developmental dysplasia of the hip in infants.
Study children (n = 1968) underwent a standardized screening examination.
The incidence of developmental dysplasia of the hip was 3.7%. The sensitivity of the test protocol was 86%, the specificity was 82%, and the predictive values of positive and negative tests were 16% and 99%, respectively.
The validity of the screening protocol for developmental dysplasia of the hip is disappointingly low. The yield of adding an ultrasonographic examination to current screening activities needs further study. |
doi_str_mv | 10.2105/AJPH.88.2.285 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1508179</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>18875799</sourcerecordid><originalsourceid>FETCH-LOGICAL-c531t-35e0df070e4ef75ce6475a15a080a45fdb5ce985523b2c05c639e43a6c147513</originalsourceid><addsrcrecordid>eNqFkk2P0zAQhiMEWsrCkSNShBC3FDuOY5sD0mq1sKAVcOjdmjqTjSs3DrZbVP4AfxuHrcrHZU8ez_vonQ9NUTynZFlTwt9cfPp6vZRyWS9ryR8UC8obWhHSyIfFghBFcszax8WTGDeEUKo4PSvOVKMoqZtF8fMKgjuUHSY0yfqx9H3-7NH5aYtjAld2hzg5iBZmKQ1YDnYq7ViucvgZcyI4GLv49re2B2c7mw4zC2VMWYHQ2R_YlRAjxjibllPwyRvvZhs79jCm-LR41IOL-Oz4nher91ery-vq5suHj5cXN5XhjKaKcSRdTwTBBnvBDbaN4EA5EEmg4X23zjklOa_ZujaEm5YpbBi0hmaQsvPi3Z3ttFtvsTO5mwBOT8FuIRy0B6v_VUY76Fu_15QTSYXKBq-PBsF_22FMemujQZd3gH4XtVCCqJbfD3LBWtYIcS9IpRRcqNnx5X_gxu_CmLel69ye4pyxDFV3kAk-xoD9aTZK9Hwver4XLaWudb6XzL_4eyEn-nggWX911CEacH2A0dh4wnLhvNb2zxCDvR2-24A6bsG5bEo1bKbhVO8XbbPXaQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>215095533</pqid></control><display><type>article</type><title>Early detection of developmental dysplasia of the hip in The Netherlands: the validity of a standardized assessment protocol in infants</title><source>MEDLINE</source><source>PAIS Index</source><source>Business Source Complete</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>EBSCOhost Education Source</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Boere-Boonekamp, M M ; Kerkhoff, T H ; Schuil, P B ; Zielhuis, G A</creator><creatorcontrib>Boere-Boonekamp, M M ; Kerkhoff, T H ; Schuil, P B ; Zielhuis, G A</creatorcontrib><description>This study evaluated the validity of the traditionally recommended screening protocol for developmental dysplasia of the hip in infants.
Study children (n = 1968) underwent a standardized screening examination.
The incidence of developmental dysplasia of the hip was 3.7%. The sensitivity of the test protocol was 86%, the specificity was 82%, and the predictive values of positive and negative tests were 16% and 99%, respectively.
The validity of the screening protocol for developmental dysplasia of the hip is disappointingly low. The yield of adding an ultrasonographic examination to current screening activities needs further study.</description><identifier>ISSN: 0090-0036</identifier><identifier>EISSN: 1541-0048</identifier><identifier>DOI: 10.2105/AJPH.88.2.285</identifier><identifier>PMID: 9491024</identifier><identifier>CODEN: AJPEAG</identifier><language>eng</language><publisher>Washington, DC: Am Public Health Assoc</publisher><subject>Age ; Assessment ; Babies ; Biological and medical sciences ; Children & youth ; Diagnostic tests ; Diseases of the osteoarticular system ; Dysplasia ; Families & family life ; Female ; Hip dislocation ; Hip Dislocation, Congenital - diagnosis ; Hip Dislocation, Congenital - diagnostic imaging ; Hip joint ; Hips ; Humans ; Infant ; Infant, Newborn ; Male ; Medical disorders ; Medical referrals ; Medical sciences ; Medical screening ; Miscellaneous. Osteoarticular involvement in other diseases ; Neonatal Screening ; Netherlands ; Orthopedics ; Parents & parenting ; Predictive Value of Tests ; Prospective Studies ; Public health ; Sensitivity and Specificity ; Standardization ; Surgeons ; Ultrasonic imaging ; Ultrasonography ; Validity</subject><ispartof>American journal of public health (1971), 1998-02, Vol.88 (2), p.285-288</ispartof><rights>1998 INIST-CNRS</rights><rights>Copyright American Public Health Association Feb 1998</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c531t-35e0df070e4ef75ce6475a15a080a45fdb5ce985523b2c05c639e43a6c147513</citedby><cites>FETCH-LOGICAL-c531t-35e0df070e4ef75ce6475a15a080a45fdb5ce985523b2c05c639e43a6c147513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508179/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508179/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27866,27924,27925,31000,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2157516$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9491024$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boere-Boonekamp, M M</creatorcontrib><creatorcontrib>Kerkhoff, T H</creatorcontrib><creatorcontrib>Schuil, P B</creatorcontrib><creatorcontrib>Zielhuis, G A</creatorcontrib><title>Early detection of developmental dysplasia of the hip in The Netherlands: the validity of a standardized assessment protocol in infants</title><title>American journal of public health (1971)</title><addtitle>Am J Public Health</addtitle><description>This study evaluated the validity of the traditionally recommended screening protocol for developmental dysplasia of the hip in infants.
Study children (n = 1968) underwent a standardized screening examination.
The incidence of developmental dysplasia of the hip was 3.7%. The sensitivity of the test protocol was 86%, the specificity was 82%, and the predictive values of positive and negative tests were 16% and 99%, respectively.
The validity of the screening protocol for developmental dysplasia of the hip is disappointingly low. The yield of adding an ultrasonographic examination to current screening activities needs further study.</description><subject>Age</subject><subject>Assessment</subject><subject>Babies</subject><subject>Biological and medical sciences</subject><subject>Children & youth</subject><subject>Diagnostic tests</subject><subject>Diseases of the osteoarticular system</subject><subject>Dysplasia</subject><subject>Families & family life</subject><subject>Female</subject><subject>Hip dislocation</subject><subject>Hip Dislocation, Congenital - diagnosis</subject><subject>Hip Dislocation, Congenital - diagnostic imaging</subject><subject>Hip joint</subject><subject>Hips</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical disorders</subject><subject>Medical referrals</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Miscellaneous. Osteoarticular involvement in other diseases</subject><subject>Neonatal Screening</subject><subject>Netherlands</subject><subject>Orthopedics</subject><subject>Parents & parenting</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Public health</subject><subject>Sensitivity and Specificity</subject><subject>Standardization</subject><subject>Surgeons</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography</subject><subject>Validity</subject><issn>0090-0036</issn><issn>1541-0048</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7TQ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkk2P0zAQhiMEWsrCkSNShBC3FDuOY5sD0mq1sKAVcOjdmjqTjSs3DrZbVP4AfxuHrcrHZU8ez_vonQ9NUTynZFlTwt9cfPp6vZRyWS9ryR8UC8obWhHSyIfFghBFcszax8WTGDeEUKo4PSvOVKMoqZtF8fMKgjuUHSY0yfqx9H3-7NH5aYtjAld2hzg5iBZmKQ1YDnYq7ViucvgZcyI4GLv49re2B2c7mw4zC2VMWYHQ2R_YlRAjxjibllPwyRvvZhs79jCm-LR41IOL-Oz4nher91ery-vq5suHj5cXN5XhjKaKcSRdTwTBBnvBDbaN4EA5EEmg4X23zjklOa_ZujaEm5YpbBi0hmaQsvPi3Z3ttFtvsTO5mwBOT8FuIRy0B6v_VUY76Fu_15QTSYXKBq-PBsF_22FMemujQZd3gH4XtVCCqJbfD3LBWtYIcS9IpRRcqNnx5X_gxu_CmLel69ye4pyxDFV3kAk-xoD9aTZK9Hwver4XLaWudb6XzL_4eyEn-nggWX911CEacH2A0dh4wnLhvNb2zxCDvR2-24A6bsG5bEo1bKbhVO8XbbPXaQ</recordid><startdate>19980201</startdate><enddate>19980201</enddate><creator>Boere-Boonekamp, M M</creator><creator>Kerkhoff, T H</creator><creator>Schuil, P B</creator><creator>Zielhuis, G A</creator><general>Am Public Health Assoc</general><general>American Public Health Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>0U~</scope><scope>1-H</scope><scope>3V.</scope><scope>7RV</scope><scope>7TQ</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88A</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>88J</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DHY</scope><scope>DON</scope><scope>DPSOV</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K60</scope><scope>K6~</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>KC-</scope><scope>L.-</scope><scope>L.0</scope><scope>LK8</scope><scope>M0C</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2L</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M2R</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PATMY</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>PYCSY</scope><scope>Q9U</scope><scope>S0X</scope><scope>7TS</scope><scope>7QJ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19980201</creationdate><title>Early detection of developmental dysplasia of the hip in The Netherlands: the validity of a standardized assessment protocol in infants</title><author>Boere-Boonekamp, M M ; Kerkhoff, T H ; Schuil, P B ; Zielhuis, G A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c531t-35e0df070e4ef75ce6475a15a080a45fdb5ce985523b2c05c639e43a6c147513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Age</topic><topic>Assessment</topic><topic>Babies</topic><topic>Biological and medical sciences</topic><topic>Children & youth</topic><topic>Diagnostic tests</topic><topic>Diseases of the osteoarticular system</topic><topic>Dysplasia</topic><topic>Families & family life</topic><topic>Female</topic><topic>Hip dislocation</topic><topic>Hip Dislocation, Congenital - diagnosis</topic><topic>Hip Dislocation, Congenital - diagnostic imaging</topic><topic>Hip joint</topic><topic>Hips</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical disorders</topic><topic>Medical referrals</topic><topic>Medical sciences</topic><topic>Medical screening</topic><topic>Miscellaneous. Osteoarticular involvement in other diseases</topic><topic>Neonatal Screening</topic><topic>Netherlands</topic><topic>Orthopedics</topic><topic>Parents & parenting</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Public health</topic><topic>Sensitivity and Specificity</topic><topic>Standardization</topic><topic>Surgeons</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography</topic><topic>Validity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boere-Boonekamp, M M</creatorcontrib><creatorcontrib>Kerkhoff, T H</creatorcontrib><creatorcontrib>Schuil, P B</creatorcontrib><creatorcontrib>Zielhuis, G A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>Global News & ABI/Inform Professional</collection><collection>Trade PRO</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>PAIS Index</collection><collection>ABI/INFORM Collection</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Global (Alumni Edition)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Business Premium Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>Politics Collection</collection><collection>ProQuest Central Korea</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>ABI/INFORM Global (Corporate)</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Politics Collection</collection><collection>ABI/INFORM Professional Advanced</collection><collection>ABI/INFORM Professional Standard</collection><collection>ProQuest Biological Science Collection</collection><collection>ABI/INFORM Global</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Political Science Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Social Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Environmental Science Database</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>Environmental Science Collection</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>Physical Education Index</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of public health (1971)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boere-Boonekamp, M M</au><au>Kerkhoff, T H</au><au>Schuil, P B</au><au>Zielhuis, G A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early detection of developmental dysplasia of the hip in The Netherlands: the validity of a standardized assessment protocol in infants</atitle><jtitle>American journal of public health (1971)</jtitle><addtitle>Am J Public Health</addtitle><date>1998-02-01</date><risdate>1998</risdate><volume>88</volume><issue>2</issue><spage>285</spage><epage>288</epage><pages>285-288</pages><issn>0090-0036</issn><eissn>1541-0048</eissn><coden>AJPEAG</coden><abstract>This study evaluated the validity of the traditionally recommended screening protocol for developmental dysplasia of the hip in infants.
Study children (n = 1968) underwent a standardized screening examination.
The incidence of developmental dysplasia of the hip was 3.7%. The sensitivity of the test protocol was 86%, the specificity was 82%, and the predictive values of positive and negative tests were 16% and 99%, respectively.
The validity of the screening protocol for developmental dysplasia of the hip is disappointingly low. The yield of adding an ultrasonographic examination to current screening activities needs further study.</abstract><cop>Washington, DC</cop><pub>Am Public Health Assoc</pub><pmid>9491024</pmid><doi>10.2105/AJPH.88.2.285</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0090-0036 |
ispartof | American journal of public health (1971), 1998-02, Vol.88 (2), p.285-288 |
issn | 0090-0036 1541-0048 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1508179 |
source | MEDLINE; PAIS Index; Business Source Complete; Applied Social Sciences Index & Abstracts (ASSIA); EBSCOhost Education Source; PubMed Central; Alma/SFX Local Collection |
subjects | Age Assessment Babies Biological and medical sciences Children & youth Diagnostic tests Diseases of the osteoarticular system Dysplasia Families & family life Female Hip dislocation Hip Dislocation, Congenital - diagnosis Hip Dislocation, Congenital - diagnostic imaging Hip joint Hips Humans Infant Infant, Newborn Male Medical disorders Medical referrals Medical sciences Medical screening Miscellaneous. Osteoarticular involvement in other diseases Neonatal Screening Netherlands Orthopedics Parents & parenting Predictive Value of Tests Prospective Studies Public health Sensitivity and Specificity Standardization Surgeons Ultrasonic imaging Ultrasonography Validity |
title | Early detection of developmental dysplasia of the hip in The Netherlands: the validity of a standardized assessment protocol in infants |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T12%3A46%3A28IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Early%20detection%20of%20developmental%20dysplasia%20of%20the%20hip%20in%20The%20Netherlands:%20the%20validity%20of%20a%20standardized%20assessment%20protocol%20in%20infants&rft.jtitle=American%20journal%20of%20public%20health%20(1971)&rft.au=Boere-Boonekamp,%20M%20M&rft.date=1998-02-01&rft.volume=88&rft.issue=2&rft.spage=285&rft.epage=288&rft.pages=285-288&rft.issn=0090-0036&rft.eissn=1541-0048&rft.coden=AJPEAG&rft_id=info:doi/10.2105/AJPH.88.2.285&rft_dat=%3Cproquest_pubme%3E18875799%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=215095533&rft_id=info:pmid/9491024&rfr_iscdi=true |