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oai:open-archive.highwire.org:amjepid:135/3/2232015-05-11HighWireOUPamjepid:135:3
Measurements, Estimates, and Inferences in Reporting Epidemiologic Study Results
Savitz, David A.
EDITORIAL
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/223
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/2252015-05-11HighWireOUPamjepid:135:3
Parenteral and Sexual Transmission of Human Immunodeficiency Virus in Intravenous Drug Users: A Study of Seroconversion
Nicolosi, Alfredo
Correa Leite, Maria Lèa
Musicco, Massimo
Molinari, Silvia
Lazzarin, Adriano
for the Northern Italian Seronegative Drug Addicts (NISDA) Study,
ORIGINAL CONTRIBUTIONS
To evaluate the role of parenteral and sexual transmission of human immunodeficiency virus, we studied seronegative intravenous drug users recruited from 25 drug dependence treatment centers in northern Italy. All attending intravenous drug users were asked for their consent and screened for antibodies to human immunodeficiency virus; those who were seronegative were enrolled, interviewed about their habits, and invited to follow-up visits. Between 1987 and 1989, 1,195 seronegative intravenous drug users were enrolled, 635 were followed up (mean duration, 11.9 months), and 35 seroconversions were observed. The incidence rate ratios were 3.3 (95% confidence interval (Cl) 1.4–7.5) for subjects aged <20 years, 2.4 (95% Cl 1.2%4.7) for <2 years of intravenous drug use, 2.2 (95% Cl 0.9–5.5) for syringe sharing, and 1.0 for subjects with a sexual partner who had tested positive for human immunodeficiency virus. A case-control approach, using logistic regression and adjusting for sex, age, area, and prevalence, showed odds ratios of 13.2 (95% Cl 3.1–56.8) for frequent syringe sharing and 4.0 (95%; Cl 1.5–10.4) for sexual contacts with seropositive partners; frequent use of condoms was associated with a reduction in risk that did not reach statistical significance. Parenteral transmission is the most important route of infection with the human immunodeficiency virus among intravenous drug users, and sexual transmission plays a relevant, additive role. <it>Am J Epidemiol</it> 1992;135:225–33.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/225
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/2342015-05-11HighWireOUPamjepid:135:3
Passive Smoking and Canine Lung Cancer Risk
Reif, John S.
Dunn, Kari
Ogilvie, Gregory K.
Harris, Cheryl K.
ORIGINAL CONTRIBUTIONS
A case-control study was conducted to determine whether household exposure to environmental tobacco smoke is associated with an increased risk for lung cancer in pet dogs. Lung cancer cases and controls with other forms of cancer were obtained from two veterinary teaching hospitals during 1985–1987. Exposures assessed included the number of smokers in the household, the amount smoked, and the proportion of time spent indoors by the pet. A weak relation was found for exposure to a smoker in the home (odds ratio = 1.6, 95% confidence interval 0.7–3.7), after controlling for confounding in stratified analyses. Strong evidence for a further increase in risk associated with more than one smoker in the home was not found, nor was a significant trend observed for increasing number of packs of cigarettes smoked per day or an exposure index based on number of smokers in each household, packs smoked per day, and the proportion of time the dog spent within the home. However, skull shape appeared to exert effect modification; the risk was restricted to breeds with short and medium length noses (odds ratio = 2.4,95% confidence interval 0.7–7.8). Despite the inconclusive findings of the current study, epidemiologic studies in pet animals may add to our understanding of environmental tobacco smoke effects in human populations. <it>Am J Epidemiol</it> 1992;135:234–9.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/234
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/2402015-05-11HighWireOUPamjepid:135:3
Age Interacts with Heaviness of Smoking in Predicting Success in Cessation of Smoking
Coambs, Robert B.
Li, Selina
Kozlowski, Lynn T.
ORIGINAL CONTRIBUTIONS
There is conflicting evidence regarding the relation between heaviness of smoking and the likelihood of quitting smoking. We investigated this issue using the data set of the 1986 Adult Use of Tobacco Survey, a telephone survey of the smoking behavior of noninstitutionalized, civilian, US adults aged >16 years. Analyses were based on a subsample of 4,383 individuals who had made a serious attempt to stop smoking 1–10 years before the survey. Among younger smokers, the lighter smokers (<25 cigarettes/day) were the most likely to stop, whereas among older smokers, the heavier smokers (≥25 cigarettes/day) were the most likely to stop. These results indicate that age is an important factor in the relation between heaviness of smoking and success in quitting smoking. <it>Am J Epidemiol</it> 1992;135:240–6.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/240
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/2472015-05-11HighWireOUPamjepid:135:3
Risk Factors for Fibroadenoma: A Case-Control Study in Australia
Yu, He
Rohan, Thomas E.
Cook, Martin G.
Howe, Geoffrey R.
Miller, Anthony B.
ORIGINAL CONTRIBUTIONS
Risk factors for fibroadenoma were examined in a case-control study involving 117 fibroadenoma cases ascertained by a major private pathology laboratory in Adelaide, Australia, between January 1983 and October 1985. For each case a population control was randomly selected from the electoral roll in Adelaide and matched to the corresponding case by sex, age, and socioeconomic grading of area of residence. Another 189 women whose first biopsy for benign breast disease was examined in the same laboratory during the same time period as those of the cases, but did not show evidence of epithelial proliferation, were also included in the study as a biopsy control group. Risk of fibroadenoma was associated inversely with the Quetelet index, but there was no evidence of an association with age at menarche or menopausal status. The risk of fibroadenoma decreased with an increasing number of full-term pregnancies and was increased in association with use of oral contraceptives at an early age (under 20 years); however, these two associations were observed only when cases were compared with the population controls. Alcohol consumption and dietary fat intake were found not to be associated with altered risk of fibroadenoma, while in multivariate analyses, duration of cigarette smoking and daily vitamin C intake were both shown to have inverse associations with risk of fibroadenoma. Although fibroadenoma does share some risk factors with breast cancer, there is insufficient evidence to suggest that it represents a precursor state. <it>Am J Epidemiol</it> 1992;135:247–58.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/247
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/2592015-05-11HighWireOUPamjepid:135:3
Serum Cholesterol Concentration and Primary Malignant Brain Tumors: A Prospective Study
Smith, George Davey
Neaton, James D.
Ben-Shlomo, Yoav
Shipley, Martin
Wentworth, Deborah
ORIGINAL CONTRIBUTIONS
Case-control studies and a prospective study have suggested a positive relation between serum cholesterol and brain tumors. To examine this association further, mortality from malignant brain tumors among men who participated in the Multiple Risk Factor Intervention Trial (a prospective study, 1973–1986) who indicated they were not black were examined. No relation was seen between age-standardized mortality rates and baseline serum cholesterol. Excluding deaths occurring during the first 5 years or adjusting for median census tract income did not alter this finding. This suggests that no generalizabte relation between serum cholesterol and primary malignant brain tumors exists. An environmental factor associated with serum cholesterol in some, but not all populations, may explain the apparently contradictory results. <it>Am J Epidemiol</it> 1992;135:259–65.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/259
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Copyright (C) 1992, Oxford University Press
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Is Abdominal Body Fat Distribution a Major Explanation for the Sex Difference in the Incidence of Myocardial Infarction?: The Study of Men Born in 1913 and The Study of Women, Goteborg, Sweden
Larsson, Bo
Bengtsson, Calle
Björntorp, Per
Lapidus, Leif
Sjöstrom, Lars
Svardsudd, Kurt
Tlbblin, Gösta
Wedel, Hans
Welin, Lennart
Wilhelmsen, Lars
ORIGINAL CONTRIBUTIONS
The authors considered whether the difference in body fat distribution between men and women, measured as waist: hip ratio, might explain part of the sex difference in coronary heart disease incidence in prospective population studies of 1,462 women and 792 men. In these studies, conducted in Sweden, men were found to have about four times higher odds for coronary heart disease than women during a 12-year follow-up period (men, 1967 to 1979; women, 1968–1969 to 1980–1981). Controlling for differences in blood pressure, serum cholesterol, smoking, and body mass index only marginally altered the magnitude of the mate-female difference. When waisthip ratio, which predicted coronary heart disease rates in both sexes, was also considered, the sex difference in coronary heart disease risk was significantly reduced and virtually disappeared (odds ratios = 1.0–1.1; nonsignificant). The findings suggest that body fat distribution or a factor highly correlated with waistihip ratio (genetic, hormonal, or behavioral) may help to explain the sex differences in coronary heart disease. <it>Am J Epidemiol</it> 1992;135:266–73.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/266
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/2742015-05-11HighWireOUPamjepid:135:3
Is Gallstone Disease caused by Obesity or by Dieting?
Thijs, Carel
Knipschild, Paul
Leffers, Pieter
ORIGINAL CONTRIBUTIONS
The effects of dieting and obesity on the risk of acute gallstone disease were evaluated in a case-control study in Maastricht, The Netherlands, during 1983–1986. The study comprised 151 cases with acutely symptomatic gallstone disease and 451 population controls. The effects of dieting and obesity as measured by body mass index (weight (kg)/height (m)2) were disentangled in a multivariate logistic regression analysis. Both dieting and body mass index were positively associated with the rate of gallstone disease. The association with dieting largely disappeared when initial body mass index was controlled for (rate ratio = 1.4, 95% confidence interval 0.8–2.4). Conversely, controlling for dieting did not affect the association between body mass index and gallstone disease. Analysis by risk period (year 1 and 2–5, 6–10, and 11–15 years prior to interview) did not show consistent risk period-specific effects when initial body mass index was controlled for. The authors conclude that dieting does not account for the association between obesity and gallstone disease. In obese persons, dieting does not increase the risk of acute gallstone disease over the long term. <it>Am J Epidemiol</it> 1992:135:274–80.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/274
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/2812015-05-11HighWireOUPamjepid:135:3
Hospitalizations Involving Gastroenteritis in the United States, 1985: The Special Burden of the Disease among the Elderly
Gangarosa, Raymond E.
Glass, Roger I.
Lew, Judy F.
Boring, John R.
ORIGINAL CONTRIBUTIONS
While diarrheal disease is a well-recognized problem in children, its impact in the elderly has not been adequately assessed. Among the 4.06 million hospitalizations in 1985 in the McDonnell-Douglas Health Information System database, 98,185 hospitalizations, including 1,130 deaths, had gastroenteritis recorded as a discharge diagnosis. The authors analyzed the 87,181 hospitalizations and 514 deaths for which gastroenteritis was one of the top three diagnoses. Gastroenteritis was among the top three diagnoses in 9% of all hospitalizations of children 1–4 years of age, compared with 1.5– of hospitalizations throughout adulthood (≥20 years). Only 0.05% of hospitalizations involving gastroenteritis were fatal for children younger than 5 years, compared with 3% in individuals 80 years or older. While children aged less than 5 years and adults aged 60 years or more each comprised one-fourth of hospitalizations involving gastroenteritis, the older group represented 85% of diarrheal deaths. Age was the most important risk factor for death subsequent to a hospitalization involving gastroenteritis (odds ratio = 52.6, 95% confidence interval 37.0–76.9 for age ≥70 years vs. <5 years). Gastroenteritis is a large, underemphasized public health problem among the elderly, among whom its case-fatality ratio is higher than in children. <it>Am J Epidemiol</it> 1992;135:281–90.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/281
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/2912015-05-11HighWireOUPamjepid:135:3
The Association between the Use of Urinary Catheters and Morbidity and Mortality among Elderly Patients in Nursing Homes
Kunln, Calvin M.
Douthitt, Suzanne
Dancing, Judith
Anderson, Judith
Moeschberger, Melvin
ORIGINAL CONTRIBUTIONS
To determine whether the use of urinary catheters in elderly patients in nursing homes has an independent effect on morbidity and mortality, the authors conducted a 1 -year prospective study among 1,540 patients in a stratified random sample of nursing homes. Patient mortality was assessed at 1 year in relation to the presence or absence of a catheter at entry to the study, acquisition of a catheter, and the proportion of nursing home days spent catheterized during the study year. The independent association of catheter use with mortality was assessed by logistic regression analysis adjusted for age, activities of daily living, mental status, skin condition (decubitus ulcers), and 20 medical diagnoses. The effect of catneterization on hospitalization, use of systemic antimicrobial drugs, and mortality was also examined by matched pairs analysis. At entry, 10.5% of patients had catheters, and they tended to remain catheterized during most of the study year. An additional 10% were catheterized during the year. The following factors were found to have a significant independent association with mortality: urinary catheters, age, mental status or activities of daily living, cancer, cardiac disease, diabetes, and skin condition. There was a stepwise increase in mortality with duration of catneterization. Patients who were catheterized for 76% or more of their days in the nursing home were three times more likely to die within a year. The number of hospttalizations, duration of hospitalization, and use of antimicrobial drugs were all three times greater among catheterized patients. <it>Am J Epidemiol</it> 1992;135:291–301.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/291
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/3022015-05-11HighWireOUPamjepid:135:3
Job Stress and Adverse Outcome of Pregnancy: A Causal Link or Recall Bias?
Brandt, Lars P. A.
Nielsen, Claus V.
ORIGINAL CONTRIBUTIONS
A case-base study in a population of 214,108 commercial and clerical female workers in Denmark during the period 1983–1985 investigated whether increasing job stress, defined as increasing job demands and decreasing job control, increased the risk of an adverse outcome of pregnancy. Information on the cohort, the outcome of 24,362 pregnancies, was obtained by linkage with nationwide health registers. Six case groups were selected: 1) 2,248 spontaneous abortions, 2) 209 stillbirths or deaths within the first year of life, 3) 661 infants with congenital malformations, 3) 593 preterm deliveries, 4) 587 infants with term low birth weights, 5) 988 infants with light-for-date birth weights, and 6) a random sample of 2,252 pregnancies that constituted the reference group. Information on exposure was obtained by mailed questionnaire. When dichotomized scales on data concerning job demand and control were used, there was an increased relative risk of spontaneous abortion (odds ratio = 1.28, 95% confidence interval (Cl) 1.05–1.57) and term low birth weight (odds ratio = 1.46, 95% Cl 1.05–2.04) for women experiencing high job stress. For the other case groups, the odds ratios were as follows: congenital malformation, 1.23 (95% Cl 0.93–1.63); preterm delivery, 1.03 (95% Cl 0.77–1.39); light-for-date birth weight, 1.08 (95% Cl 0.83–1.40); and stillbirth/death within the first year of life, 1.42 (95% Cl 0.90–2.24). No substantial response bias was found. When occupational titles were used as an exposure matrix, no increased risk was found, except for term low birth weight. Recall bias is one possible explanation. Thus, the results must be interpreted with caution. <it>Am J Epidemiol</it> 1992;135:302–11.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/302
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/3122015-05-11HighWireOUPamjepid:135:3
Self-reported Health Status of Vietnam Veterans in Relation to Perceived Exposure to Herbicides and Combat
Decouflé, Pierre
Holmgreen, Patricia
Boyie, Coleen A.
Stroup, Nancy E.
ORIGINAL CONTRIBUTIONS
The authors examined how the setf-reported hearth of 7,924 US Army Vietnam veterans in 1985–1986 related to the men's perceived exposure to herbicides and combat in Vietnam. The results showed strong, positive associations between the extent of reported herbicide exposure (classified as a four-level ordinal index) and all 21 health outcomes studied, with clear “dose-response” relations in most instances. In contrast, only chloracne and psychological symptoms, including a symptom pattern consistent with posttraumatic stress disorder, were found to be strongly related to the amount of reported combat exposure (classified as a four-level ordinal index). The multiple herbicide/outcome associations seem implausible because of their nonspecific-ity and because of collateral biologic evidence suggesting the absence of widespread exposure to dtoxin-containing herbicides among US Army combat units. These associations may have resulted from long-term stress reactions that produced somatjzation, hypochondriasis, and increased utilization of medical care among some Vietnam veterans. The available data suggest, however, that the association between reported combat exposure and psychological symptoms consistent with posttraumatic stress disorder may be causal. <it>Am J Epidemiol</it> 1992;135:312–23.
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/312
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Copyright (C) 1992, Oxford University Press
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RE: "VASECTOMY AND THE RISK OF PROSTATE CANCER"
Peterson, Dan E.
Remington, Patrick L.
Anderson, Henry A.
LETTERS TO THE EDITOR
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/324
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/3252015-05-11HighWireOUPamjepid:135:3
RE: "A COMPENDIUM OF PUBLIC HEALTH DATA SOURCES"
Sørensen, Henrik Toft
LETTERS TO THE EDITOR
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/325
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/326-a2015-05-11HighWireOUPamjepid:135:3
RE: "TOBACCO USE AND PROSTATE CANCER: 26-YEAR FOLLOW-UP OF US VETERANS"
Mills, Paul K.
Beeson, W. Lawrence
LETTERS TO THE EDITOR
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/326-a
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/3262015-05-11HighWireOUPamjepid:135:3
THE AUTHOR REPLIES
Gable, Carol Brignoli
LETTERS TO THE EDITOR
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/326
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/3272015-05-11HighWireOUPamjepid:135:3
RE: "TOBACCO USE AND PROSTATE CANCER: 26-YEAR FOLLOW-UP OF US VETERANS"
Mantel, Nathan
LETTERS TO THE EDITOR
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/327
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/328-a2015-05-11HighWireOUPamjepid:135:3
RE: "MATHEMATICAL MODELING AND ATTEMPTS TO ELIMINATE MEASLES: A TRIBUTE TO THE LATE PROFESSOR GEORGE MACDONALD"
Cárdenas-Ayala, Victor M.
LETTERS TO THE EDITOR
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/328-a
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/3282015-05-11HighWireOUPamjepid:135:3
THE AUTHORS REPLY
Hsing, Ann W.
McLaughlin, Joseph K.
Hrubec, Zdenek
Blot, William J.
LETTERS TO THE EDITOR
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/328
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Copyright (C) 1992, Oxford University Press
oai:open-archive.highwire.org:amjepid:135/3/3292015-05-11HighWireOUPamjepid:135:3
THE AUTHORS REPLY
Thacker, Stephen B.
Millar, J. Donald
LETTERS TO THE EDITOR
Oxford University Press
1992-02-01 00:00:00.0
TEXT
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http://aje.oxfordjournals.org/cgi/content/short/135/3/329
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Copyright (C) 1992, Oxford University Press