Still too much hospitalization, government says.
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Data Collection↗
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Issues of gender in gamete donation.
Gamete donation refers to the practice whereby either semen or eggs are donated by a third party to enable infertile individuals or couples to become parents. This paper examines the way in which gender is deployed as a resource for organizing the meanings attached to that practice. The gender aspects of gamete donation are not always immediately apparent since semen and egg donation are often described as being essentially the same. However, a closer examination indicates that behind the claim of equivalence lies a set of unstated assumptions about their difference. These assumptions are tied to ideas about the ways in which men and women are thought to behave more generally in relation to reproduction and the family. This paper draws on two sources of empirical data to reveal how these assumptions are used: first, data from a detailed analysis of the Warnock Report (established by the British Government in 1982 to inquire into and make recommendations on techniques of human fertilization and embryology), which includes a cross-national and historical comparison with other government reports; second, data from a series of in-depth interviews with members of the Warnock Committee. The analysis of the reports suggests that historically semen donation was associated with 'deviant' sexuality (masturbation, adultery, illegitimacy) though paradoxically the extant nature of semen donation was then used to justify the acceptance of egg donation in later reports. This is despite the fact that in these later reports there are clear, albeit implicit, distinctions drawn between the two procedures in terms of donor motivation, the risks of being a donor, and the consequences of donation.(ABSTRACT TRUNCATED AT 250 WORDS)
Advisory Committees↗
Statistical evaluation of mutagenicity test data: recommendations of the U.K. Environmental Mutagen Society.
Most of the many published guidelines on how to conduct mutagenicity tests do not give advice or references on statistical analysis of data. The U.K. Environmental Mutagen Society decided to address this omission, and in 1985 established 8 working groups comprising genetic toxicologists from all sectors of the science, plus at least 2 statisticians per group, to produce statistics guidelines on 10 different test systems. Each group gave advice on how to determine the suitability of data for distribution fitting, when data are unsuitable, when and how data should be transformed, which statistical tests are suitable for a given set of data, which factors govern the choice of statistical test, an order of preference, and some worked examples using real data. In addition, groups gave advice on statistical issues in the design of experiments. Strong recommendations were made that for in vitro tests, sufficient cells be treated and sampled to provide meaningful values of spontaneous mutant/aberration frequencies, for genuine, independent replicate treatments to be used, and that the acceptability of an experiment should be based on homogeneity between replicates as well as comparison of negative and positive control responses with historical ranges. It was recommended that most in vitro studies should include independent repeat experiments, and advice was given on how to check for consistency between experiments and then combine data for further significance testing.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
The Philippine national recording systems on international migration.
The author reviews migration data sources and government collection agencies in the Philippines. He finds that "despite the importance of international migration for national policy, efforts to correct the serious data limitations in the area of migration statistics have been limited and uncoordinated. In fact, most estimates of emigration levels from the Philippines still rely heavily on the data gathered by receiving countries."
Asia↗
[Data protection and data access (II): Physician's responsibility for confidentiality, federal statistics law and data collection by authorization with reference to implementing occupational medicine epidemiologic studies in Germany].
The additional legal rulings governing access to personal data for epidemiological research are the medical professional secrecy regulators and the federal statistics law. These permit access to personal data only if the individual has given his or her informed constant. Beyond this, both laws contain clauses governing the transfer of anonymous data for research and science. Thus anonymized data may be transferred on request to authorized persons or institutions, such as a physician or the regional statistics office. Finally, a custodian model is presented which provides further possibilities for research in occupational medicine and epidemiology within this very restrictive legal framework.
Cause of Death↗
[Family functioning and quality of life of the family care-giver in cancer patients].
PURPOSE: The purpose of this study was to identify the relationship among quality of life, family coherence, family hardiness, and family resources of the family care-giver caring for a cancer patient. METHOD: Data was collected by questionnaires from 137 families with a cancer patient at a General Hospital and Government Cancer Hospital. Data was analyzed using descriptive statistics, pearson correlation coefficients, and stepwise multiple regression. RESULTS: The score of quality of life showed a significant positive correlation with the score of the level of family sense of coherence, family hardiness, and family resources. The most powerful predictor of quality of life was sense of coherence and the variance was 30%. A combination of sense of coherence and family resources account for 34 % of the variance in quality of life of the family care-giver caring for a cancer patient. CONCLUSION: The results showed that family sense of coherence, hardiness, and family resources were significant influencing factors on the quality of life of the family care-giver caring for a cancer patient.
Adult↗
The federal and private sector roles in the development of minimum data sets and core health data elements.
This article presents a picture of federal and private efforts in defining minimum data sets and core data elements for health care. For more than 25 years the Federal Government has been engaged in extensive development of minimum data sets and core health data elements. As a major collector and processor of health data, the government identifies, defines, and implements standardized data in the health care field for describing data such as mortality, morbidity, and infectious diseases of the population. This article reports on 17 minimum data sets and core health data elements that are published or in draft form in health care to date. They include regulated data elements that are needed for reimbursement from the Health Care Financing Administration and core health data elements from the Health Resources and Services Administration. They also include recommended data elements for better reporting to the government, and private sector initiatives that are under development, being researched, or in use to standardize data collection for assessing access, quality, and costs of health care. This significant framework can be used in furthering research on the development of the computer-based patient record, the acceleration of data standards, and the evaluation of vocabulary in health care.
Ambulatory Care↗
Human genetic databases and liberty.
This paper examines an act of the Icelandic Parliament on health-sector databases. Both the legislation itself and the manner in which it was presented by the Government to the Parliament and the general public raise various questions about democratic parliamentary procedures, community consultation, autonomy, privacy, professional confidence, control of health data in hospitals and business relationships between medical doctors and biotechnology corporations. A major question to be asked is: In whose interest is it that such sensitive data are handed over to for-profit corporations? Furthermore, is it within the authority of the legislature to authorize politically appointed boards of health institutes to transfer such data without the direct informed consent of the patient and without the relevant physicians' having a say? Does experience teach us to entrust private companies with sensitive personal data? Should the Government be involved in the research policy-making of the biotechnology companies that have been given access to the genetic data of a population, or should the profit motive be the sole deciding influence? That is, should the interest of the shareholders of the companies prevail over the interest of underprivileged groups who are most in need of new methods or medicine to alleviate their situation due to incurable diseases? Or is the invisible hand of the market the only competent decision-maker? Finally, will the proliferation of databases containing sensitive personal data, such as human genetic data, limit our personal liberty?
Biological Specimen Banks↗
[Characteristics of medical institutions visited by 30 intractable disease patients receiving financial aid for treatment].
In order to determine the characteristics of medical institutions which patients with 30 intractable diseases visited, we analyzed data of a nationwide survey conducted by the Epidemiology of Intractable Diseases Research Committee in 1989. Each of 47 prefectural governments in Japan reported information of all patients with 30 intractable diseases who received financial aid for the diseases between April 1988 and March 1989. Information collected about each patient consisted of identification numbers, which included the disease code, sex, age, the code of the municipality where the patient lived, the medical institution which treated the patient, etc. Out of 173,637 patients whose information was reported by prefectural governments, we used data of 159,910 patients whose medical institutions were reported completely. The results can be summarized as follow: 1) Of the 159,910 patients, 8.6 percent visited medical institutions outside of the prefectures where the patients lived. Many patients living in prefectures located close to large cities, such as Tokyo, visited medical institutions in large cities. 2) The proportion of patients who visited hospitals of medical schools was 27.9 percent. 3) Patients who were affected by diseases causing physical disabilities such as SMON and malignant rheumatoid arthritis tended to visit medical institutions located in their neighborhoods and were treated in small hospitals or clinics. Old patients had the same tendency as patients with such diseases. 4) Although the number of patients receiving aid in 1988, whose data we analyzed in the current study, was larger than that in 1984, the proportion of patients visiting medical institutions outside of the prefecture where the patients lived, and the proportion of patients visiting hospitals of medical schools were nearly equal to those in 1984.
Adolescent↗
Alberta Congenital Anomalies Surveillance System.
The Alberta Congenital Anomalies Surveillance System was started in 1966 in response to the thalidomide tragedy earlier in the decade. It was one of four provincial surveillance systems on which the federal government relied for baseline statistics of congenital anomalies. The government now collects data from six provinces and one territory. The Alberta Congenital Anomaly Surveillance System originally depended on three types of notification to the Division of Vital Statistics, Department of Health, Government of Alberta: birth notice and certificates of death and stillbirth; increased sources of ascertainment have greatly improved data quality. We present the data for 1980-86 and compare the prevalence rates of selected anomalies with the rates from three other surveillance systems. Surveillance systems do not guarantee that a new teratogen will be detected, but they are extremely valuable for testing hypotheses regarding causation. At the very least they provide baseline data with which to compare any deviation or trend. For many, if not most, congenital anomalies total prevention is not possible; however, surveillance systems can be used to measure progress in prevention.
Alberta↗
Smokeless tobacco in Canada: deterring market development.
DATA SOURCES: A review of the literature identified demographic, cultural, and marketing variables related to the uptake and continuation of smokeless tobacco use. Government and industry data on production, marketing, and consumption of smokeless tobacco products are presented. METHODS: The Canadian and American markets are compared in terms of prevalence, consumption per capita, and marketing practices. Lessons to be learned from the well-orchestrated development of the American market in the past 30 years are examined. Canadian tobacco regulations are described. Strategies by which the increased exploitation of the Canadian smokeless tobacco market can be deterred are discussed. CONCLUSIONS: A long-term, independently financed strategy built around a national smokeless tobacco de-marketing organisation with a constellation of private local institutions is suggested as a means of combating smokeless tobacco marketing efforts.
Adolescent↗
Lockheed experience in processing large data bases for its commercial information retrieval service.
The last few years have seen the emergence of the information retrieval services industry. This industry consists of three tiers: data base producers, retrieval service vendors, and information centers who service the end user. The experience of Lockheed Information Systems as a retrieval service vendor is recounted as it pertains to its system and to its relationship with the data base suppliers. Government competition is seen as a potential threat to the industry.
Computers↗
An exploration of human services system contacts prior to suicide in South Carolina: an expansion of the South Carolina Violent Death Reporting System.
OBJECTIVE: To link South Carolina Violent Death Reporting System (SCVDRS) data with state government human services databases, enabling expanded analysis of suicide in South Carolina and providing a model for other jurisdictions. DESIGN: The SCVDRS database compiles data from vital statistics, coroner reports, and law enforcement incident and supplemental reports. The Office of Research and Statistics, South Carolina Budget and Control Board (ORS) created a "Data Warehouse", to which a variety of state agencies and healthcare providers submit data on a regular basis. A unique identifier was used to link SCVDRS data to the Data Warehouse so that data may be analyzed on aggregate and case-specific levels. Year 2004 suicide data from SCVDRS were linked to South Carolina Uniform Billing codes from hospital in-patient and emergency room billing records, State Department of Mental Health service records, and criminal justice databases. RESULTS: SCVDRS year 2004 suicide data are augmented by hospitalization and emergency room visit data and diagnoses; State Department of Mental Health service provision; and criminal involvement. Of the 491 suicides occurring in 2004, 282 linked with hospitalization and emergency room data, 196 linked with criminal history databases, and 91 had previous contact with the State Department of Mental Health. CONCLUSIONS: Linking SCVDRS data to additional human services databases enables greater examination of factors surrounding suicide. Results show the positive benefits of partnerships created through SCVDRS, illustrate how SCVDRS and human service databases may augment each other, and suggest practitioners should explore implementation of prevention programs in specific settings.
Adolescent↗
The evolution of a breast health program for Plains Indian women.
PURPOSE/OBJECTIVES: To discuss the development and implementation of a culturally sensitive breast cancer outreach program focusing on early detection, screening, and education for Plains Indian women living in Montana and northern Wyoming. DATA SOURCES: Professional journals, government reports, culturally sensitive materials, and field experience. DATA SYNTHESIS: Perceptions about cancer, the prevalence of poverty and alcoholism, the traditional role of the Native American woman, and rural living influence breast health and breast cancer education for Plains Indian women. An outreach program was developed specifically for this population and included individualized education, distribution of culturally sensitive materials, culturally sensitive professional education, and train-the-trainer seminars. CONCLUSIONS: After years of working with Native American women, the percentages of mammograms and clinical breast examinations increased by more than 100%. IMPLICATIONS FOR NURSING PRACTICE: Nurses can bridge the cultural gap and work effectively with Native American women by building trust and being sensitive to cultural customs and related healthcare behaviors. Furthermore, this program provides a model that nurses can use to develop culturally sensitive breast health programs.
Breast Neoplasms↗
Infectious diseases: preventable causes of infant mortality.
After almost a century of improvement, the rate of decrease in US infant mortality rates began to level off during the period of 1982 to 1984. Rates actually increased in some states. Because much of the decline in infant mortality in this century can be attributed to advances in infectious disease treatment and prevention programs, we evaluated the current impact of infectious diseases on infant mortality. The National Center for Health Statistics mortality data for 1980 contains information on as many as 20 causes of death for a given individual. Using these data, we found that infectious diseases contributed to 12.5% of all infant deaths and to almost 400,000 years of potential life lost because of infant deaths. Infectious diseases contributed to 9% of deaths of low birth weight infants and to more than 18% of all deaths in the postneonatal period. Compared with white infants, a higher proportion of nonwhite infants died of causes related to infectious diseases. For black infants, the mortality rate related to infectious diseases was twice that for white infants. These data indicate that infectious diseases still are a major contributor to infant mortality, one of the 15 areas targeted for prevention by the federal government, and the data suggest that programs for reducing infant mortality should place increased emphasis on preventing infectious diseases.
Communicable Diseases↗
Blood transfusions in the early years of AIDS in sub-Saharan Africa.
Blood transfusions transmit HIV more effectively than other means, yet there has been little examination of their role in the origins and early course of AIDS in sub-Saharan Africa. We review historical data in archives, government reports, and medical literature from African and European sources documenting the introduction, establishment, use, and growth of blood transfusions in sub-Saharan Africa. These data allow estimation of the geographic diffusion and growth of blood transfusions between 1940 and 1990. By 1955, 19 African colonies and countries reported transfusion programs-with national rates of 718 to 1372 per 100 000 by 1964, and urban rates similar to those in developed countries. We estimated 1 million transfusions per year in sub-Saharan Africa by 1970 and 2 million per year by the 1980s, indicating that transfusions were widely used throughout sub-Saharan Africa during the crucial period of 1950-1970, when all epidemic strains of HIV first emerged in this region.
Acquired Immunodeficiency Syndrome↗
An epidemiological study of sheep pox infection in Karnataka State, India.
Analysis of retrospective quantitative sheep pox epidemiological data from the Government Animal Husbandry Department, Karnataka, India, covering 24 years revealed significant information on sheep pox. The state has a dense sheep population including some valuable breeds. Data revealed the endemicity of the disease: there were a considerable number of outbreaks and attacks, high mortality and case fatality rates and low immunisation coverage. None of the years studied were free from infection. Temporally, the disease was most prevalent between November and May. Spatially, the disease was recorded in 19 out of 27 districts; in some of these districts sheep pox was highly endemic, in some it was endemic at low levels and in the remaining districts outbreaks occurred sporadically. Environmental factors influenced disease occurrence. Vaccine production met only one tenth of the requirement, and its peak utilisation was in the dry season.
Animals↗