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Biomedical subjects

S B Thacker

Publications and source records attributed to S B Thacker.

118 records · Page 7Linked to original sources
PubMedDate not supplied

Survey of graduates of the Epidemic Intelligence Service as an approach to enhancing ethnic diversity among the nation's epidemiologists.

A survey was conducted to improve the recruitment, training, and retention of epidemiologists in the Epidemic Intelligence Service (EIS) Program of the Centers for Disease Control. The authors compared minority graduates of the program and nonminority graduates in several areas: reasons for application, degree of satisfaction, appropriateness of preparation for epidemiologic practice, and current professional activities. A closed-ended questionnaire was mailed to all 87 minority graduates from the program during the period 1970-88, and to 172 randomly selected nonminority graduates. Of 259 graduates surveyed, 234 or 90.3 percent returned the questionnaire--89.6 percent of minority graduates and 90.7 percent of nonminority graduates. Virtually all graduates were satisfied with their EIS experience (95.2 percent), have encouraged others to apply (96.1 percent), and are the most frequent sources of initial contact of prospective officers (38.2 percent). Most EIS graduates (71.2 percent) were still working in epidemiology. Compared with the nonminority graduates, the minority graduates were more likely to be women and to be single. Minority graduates were less likely than non minorities to hold academic appointments (44.2 percent versus 60.0 percent) and less likely to work in academic settings as their primary job (11.5 percent versus 18.7 percent). At the same time, minority graduates were more likely to have learned of the EIS Program from academic advisors (32.1 percent versus 19.4 percent). Graduates express high levels of satisfaction with the EIS Program and continue to practice epidemiology following graduation. Few differences between the minority and nonminority graduates were found. Because fewer minority graduates are in academic settings to serve as mentors or role models, alternative recruitment methods must be developed to sustain a high level of interest among minority groups in the EIS Program.

Career Choice↗
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Training and service in public health practice, 1951-90--CDC's Epidemic Intelligence Service.

The Epidemic Intelligence Service (EIS) was created at the Centers for Disease Control (CDC) in 1951 as a combined training and service program in the practice of applied epidemiology. Since 1951, more than 1,700 professional have served in this 2-year program of the Public Health Service. In the decade of the 1980s, EIS underwent dramatic changes in response to the increased breadth of the CDC mission and the rapid expansion of epidemiologic methods. Modifications in the experience of an EIS Officer have resulted from the increased need for more sophisticated analytic methods and the use of microcomputers, as well as CDC's expanded mission into chronic diseases, environmental health, occupational health, and injury control. Officers who have entered the EIS in the past decade tend to be older than their predecessors, tend to enter the program with more experience and training in epidemiology, and are more likely to stay in public health either at the Federal level or in State and local health departments. The EIS Program continues to be a critical source for men and women to respond to the need and demand for epidemiologic services both domestically and internationally.

Centers for Disease Control and Prevention, U.S.↗
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The Centers for Disease Control program to prevent primary and secondary disabilities in the United States.

The Disabilities Prevention Program builds on traditional Centers for Disease Control (CDC) strengths in public health surveillance, epidemiology, and technology transfer to State and local governments in translating the findings of research into prevention programs. The objectives of the CDC program are to provide a national focus for the prevention of primary and secondary disabilities, build capacity at the State and community levels to maintain programs to prevent disabilities, and increase the knowledge base necessary for developing and evaluating effective preventive interventions. During 1989, CDC, in consultation with the National Council on Disabilities and members of the disability community, has elected to focus its effort in three areas: developmental disabilities, injuries to the head and spinal cord, and secondary complications among persons with physical disabilities.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Alcohol and fatal injuries: temporal patterns.

Although alcohol use has been established as a risk factor for injuries associated with motor vehicle crashes, the role of alcohol for other unintentional and intentional injuries is less defined. A review of 102,401 deaths investigated by North Carolina medical examiners in the period 1973-1983 characterized the temporal patterns of ethyl alcohol in unintentional injury fatalities, suicides, homicides, and persons who died of natural or unknown causes. Victims of homicides (85.9%) and suicides (77.7%) were tested for alcohol more frequently than were fatalities resulting from unintentional injury (67.5%) or natural causes (61.6%). Alcohol was present in 62.8% of homicide victims, 48.6% of unintentional injury fatalities, 35.3% of suicides, and 14.4% of deaths from natural causes. The percentage of alcohol-associated deaths for each manner of death showed little yearly or seasonal variation. Alcohol was most frequently detected in persons fatally injured on the weekend and from 6 PM to 6 AM. This study highlights the magnitude of alcohol's role in intentional and unintentional injuries, especially for persons injured at night and on weekends.

Accidents↗
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Rocky Mountain spotted fever in Georgia, 1961-75: analysis of social and environmental factors affecting occurrence.

For the period of 1961 through 1975, 10 geographic and sociologic variables in each of the 159 counties of Georgia were analyzed to determine how they were correlated with the occurrence of Rocky Mountain spotted fever (RMSF). Combinations of variables were transformed into a smaller number of factors using principal-component analysis. Based upon the relative values of these factors, geographic areas of similarity were delineated by cluster analysis. It was found by use of these analyses that the counties of the State formed four similarity clusters, which we called south, central, lower north and upper north. When the incidence of RMSF was subsequently calculated for each of these regions of similarity, the regions had differing RMSF incidence; low in the south and upper north, moderate in the central, and high in the lower north. The four similarity clusters agreed closely with the incidence of RMSF when both were plotted on a map. Thus, when analyzed simultaneously, the 10 variables selected could be used to predict the occurrence of RMSF. The most important variables were those of climate and geography. Of secondary, but still major importance, were the changes over the 15-year period in variables associated with humans and their environmental alterations. Detailed examination of these factors has permitted quantitative evaluation of the simultaneous impacts of the geographic and sociologic variables on the occurrence of RMSF in Georgia. These analyses could be updated to reflect changes in the relevant variables and tested as a means of identifying new high risk areas for RMSF in the State. More generally, this method might be adapted to clarify our understanding of the relative importance of individual variables in the ecology of other diseases or environmental health problems.

Climate↗
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A controlled trial of disease surveillance strategies.

Active surveillance techniques using routine telephone contacts with providers improved the reporting of measles, rubella, salmonellosis, and hepatitis by a factor of 4.6 among private physicians in Monroe County, New York, and increased reporting for these target diseases from all sources by 51 percent. The timeliness of reporting was not improved by active surveillance. Reporting patterns varied by disease and source of report, suggesting the desirability of various approaches to surveillance based on local resources and priorities. Although reporting rates were higher for diseases among persons from census tracts of low socioeconomic status, physicians providing care to persons living in low-income areas responded no differently to active reporting than did those providing care to patients from middle- and high-income areas.

Hepatitis↗
PubMedDate not supplied

[New method of epidemiological surveillance of influenza mortality in the USA].

This paper describes a new method of forecasting the expected number of pneumonia and influenza (P and I) deaths on the basis of time-series analysis of historical mortality data. The new method is different in three aspects from the regression method developed by Serfling and used by the Centres for Disease Control (CDC) since 1963 in that it uses the ratio of P and I deaths to deaths from all causes in lieu of the total number of P and I deaths in forecasting the expected numbers. Also, instead of deleting epidemic periods in the forecast, these weeks are replaced by expected numbers. Finally, forecasting is done with a time-series model instead of the regression model.

Adolescent↗
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Public health surveillance in child-care settings.

To investigate the potential contribution of public health surveillance systems to the health of children and workers in out-of-home child-care settings, we review existing public health surveillance practice in the United States. We identify issues that are of particular concern for surveillance in child-care settings. We propose a framework for developing public health surveillance systems that uses sentinel child-care sites, notifiable disease surveillance, modification of existing surveillance systems, and population surveys. Successful surveillance in these settings depends on the active participation of child-care providers, public health practitioners, and clinicians in (a) the selection of high priority diseases and injuries for surveillance; (b) the development of practical case definitions; (c) the augmentation of current surveillance systems to include disease and injury related to child care; and (d) the implementation, assessment, dissemination, and evaluation of new approaches for surveillance in child-care settings.

Child↗
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Assessing prevention effectiveness using data to drive program decisions.

The measure of the effectiveness of health promotion and disease prevention activities is the impact of prevention policies, programs, and practices on public health and clinical medicine. Assessing prevention effectiveness involves continuing quantitative analysis of health outcomes resulting from prevention practices. Additionally, assessment involves evaluation of disease- and injury-prevention activities, including their medical, legal, ethical, and economic impacts. Although assessing the effectiveness of prevention activities involves measuring efficacy, safety, and cost, the primary criterion is to improve health at a reasonable cost, not merely to contain costs. Policy makers can use the results of assessments to set priorities in public health. The authors use case studies to illustrate various approaches to evaluating prevention programs, including programs for preventing measles, breast cancer, and diabetic retinopathy. Rigorous evaluation of the effectiveness of prevention activities is essential to the wide acceptance of preventive interventions and the willingness to pay for them.

Breast Neoplasms↗