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At least 451 records · Page 25Linked to original sources
PubMed2006

Ascertainment of Hispanic ethnicity on California death certificates: implications for the explanation of the Hispanic mortality advantage.

OBJECTIVES: We determined the size and correlates of underascertainment of Hispanic ethnicity on California death certificates. METHODS: We used 1999 to 2000 vital registration data. We compared Hispanic ethnicity reported on the death certificate to Hispanic ethnicity derived from birthplace for the foreign-born and an algorithm that used first and last name and percentage of Hispanics in the county of residence for the US-born. We validated death certificate nativity by comparing data with that in linked Social Security Administration records. RESULTS: Ethnicity and birthplace information was concordant for foreign-born Hispanics, who have mortality rates that are 25% to 30% lower than those of non-Hispanic Whites. Death certificates likely underascertain deaths of US-born Hispanics, particularly at older ages, for persons with more education, and in census tracts with lower percentages of Hispanics. Conservative correction for under-ascertainment eliminates the Hispanic mortality advantage for US-born men. CONCLUSIONS: Hispanic ethnicity is accurately ascertained on the California death certificate for immigrants. Immigrant Hispanics have lower age-adjusted mortality rates than do non-Hispanic Whites. For US-born Hispanics, the mortality advantage compared with non-Hispanic Whites is smaller and may be explained by underreporting of Hispanic ethnicity on the death certificate.

Adolescent↗
PubMed2002

The Defense Medical Surveillance System and the Department of Defense serum repository: glimpses of the future of public health surveillance.

The Defense Medical Surveillance System (DMSS) is the central repository of medical surveillance data for the US armed forces. The DMSS integrates data from sources worldwide in a continuously expanding relational database that documents the military and medical experiences of service members throughout their careers. The Department of Defense Serum Repository (DoDSR) is a central archive of sera drawn from service members for medical surveillance purposes. Currently, the DMSS contains data relevant to more than 7 million individuals who have served in the armed forces since 1990, and the DoDSR contains more than 27 million specimens that are linkable to data in the DMSS. Recent applications of the DMSS and DoDSR provide glimpses of the capabilities and uses of comprehensive public health surveillance systems.

Confidentiality↗
PubMed2003

Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures--the public health disparities geocoding project.

Use of multilevel frameworks and area-based socioeconomic measures (ABSMs) for public health monitoring can potentially overcome the absence of socioeconomic data in most US public health surveillance systems. To assess whether ABSMs can meaningfully be used for diverse race/ethnicity-gender groups, we geocoded and linked public health surveillance data from Massachusetts and Rhode Island to 1990 block group, tract, and zip code ABSMs. Outcomes comprised death, birth, cancer incidence, tuberculosis, sexually transmitted infections, childhood lead poisoning, and nonfatal weapons-related injuries. Among White, Black, and Hispanic women and men, measures of economic deprivation (e.g., percentage below poverty) were most sensitive to expected socioeconomic gradients in health, with the most consistent results and maximal geocoding linkage evident for tract-level analyses.

Adolescent↗
PubMed2003

Agreement between administrative data and patients' self-reports of race/ethnicity.

OBJECTIVES: We examined agreement of administrative data with self-reported race/ethnicity and identified correlates of agreement. METHODS: We used Veterans Affairs administrative data and VA 1999 Large Health survey race/ethnicity data. RESULTS: Relatively low rates of agreement (approximately 60%) between data sources were largely the result of administrative data from patients whose race/ethnicity was unknown, with least agreement for Native American, Asian, and Pacific Islander patients. After exclusion of patients with missing race/ethnicity, agreement improved except for Native Americans. Agreement did not increase substantially after inclusion of data from individuals indicating multiple race/ethnicities. Patients for whom there was better agreement between data sources tended to be less educated, non-solitary living, younger, and White; to have sufficient food; and to use more inpatient Department of Veterans Affairs (VA) care. CONCLUSIONS: Better reporting of race/ethnicity data will improve agreement between data sources. Previous studies using VA administrative data may have underestimated racial disparities.

Databases, Factual↗
PubMed2003

Healthy People 2010 and Asian Americans/Pacific Islanders: defining a baseline of information.

OBJECTIVES: Healthy People 2010: Understanding and Improving Health lists 6 areas of disparity in minority health services: infant mortality, cancer, cardiovascular disease, HIV/AIDS, diabetes, and immunizations. This study compiles existing Asian American and Pacific Islander (AAPI) health data to establish a baseline. METHODS: For federally-sponsored research (1986-2000), the Computer Retrieval of Information on Specific Projects (CRISP) database was analyzed. AAPI initiatives were divided by subpopulation and disparity area. MEDLINE articles (1966-2000) were similarly scrutinized. RESULTS: Few federal health-related grants (0.2%) and MEDLINE articles (0.01%) mention AAPIs. For the 6 disparity areas, significant AAPI data gaps remain. CONCLUSIONS: To reach the Healthy People 2010 goals and have useful data, researchers and grant makers must focus on obtaining baseline data for disaggregated AAPI subgroups.

Asia↗
PubMed2003

Domestic elder abuse and the law.

OBJECTIVES: The authors evaluated the impact of state adult protective service legislation on rates of investigated and substantiated domestic elder abuse. METHODS: Data were collected on all domestic elder abuse reports, investigations, and substantiations for each US state and the District of Columbia for 1999. State statutes and regulations pertaining to adult protective services were reviewed. RESULTS: There were 190 005 domestic elder abuse reports from 17 states, a rate of 8.6 per 1000 elders; 242 430 domestic elder abuse investigations from 47 states, a rate of 5.9; and 102 879 substantiations from 35 states, a rate of 2.7. Significantly higher investigation rates were found for states requiring mandatory reporting and tracking of numbers of reports. CONCLUSIONS: Domestic elder abuse documentation among states shows substantial differences related to specific aspects of state laws.

Aged↗
PubMed2003

Occupational health of Southeast Asian immigrants in a US city: a comparison of data sources.

OBJECTIVES: This study sought to characterize occupational injury and illness cases identified through 3 different sources of data on a population of immigrant workers. METHODS: Participants were Cambodian and Lao workers living in Lowell, Mass. A household survey allowed comparisons between characteristics of work-related cases documented in workers' compensation wage replacement records and hospital records and characteristics of self-reported cases. RESULTS: The household survey captured types of cases missing from existing data, particularly illnesses self-reported to be associated with chemical exposures. Injuries and illnesses affecting the study population appeared to be significantly underrepresented in workers' compensation wage replacement data. CONCLUSIONS: Community-based methods can supplement available occupational health data sources.

Accidents, Occupational↗
PubMed2003

Acute pesticide-related illnesses among working youths, 1988-1999.

OBJECTIVES: The goal of this study was to describe acute occupational pesticide-related illnesses among youths and to provide prevention recommendations. METHODS: Survey data from 8 states and from poison control center data were analyzed. Illness incidence rates and incidence rate ratios were calculated. RESULTS: A total of 531 youths were identified with acute occupational pesticide-related illnesses. Insecticides were responsible for most of these illnesses (68%), most of which were of minor severity (79%). The average annual incidence rate among youths aged 15 to 17 years was 20.4 per billion hours worked, and the incidence rate ratio among youths vs adults was 1.71 (95% confidence interval = 1.53, 1.91). CONCLUSIONS: The present findings suggest the need for greater efforts to prevent acute occupational pesticide-related illnesses among adolescents.

Acute Disease↗
PubMed2003

Markers of access to and quality of primary care for aboriginal people in Ontario, Canada.

OBJECTIVES: We evaluated primary care accessibility and quality for Ontario's aboriginal population. METHODS: We compared a defined aboriginal cohort with nonaboriginal populations with analogous geographic isolation and low socioeconomic status. We determined rates of hospitalization for the following indicators of adequacy of primary care: ambulatory care-sensitive (ACS) conditions and utilization of referral care-sensitive (RCS) procedures from administrative databases. RESULTS: ACS hospitalization rates, relative to the general population, were 2.54, 1.50, and 1.14 for the aboriginal population, the geographic control populations, and the socioeconomic control populations, respectively. The relative RCS procedure utilization rates were 0.64, 0.91, and 1.00, respectively. CONCLUSIONS: The increased ACS hospitalization rate and reduced RCS procedure utilization rate suggest that northern Ontario's aboriginal residents have insufficient or ineffective primary care.

Acute Disease↗
PubMed2003

Innovative surveillance methods for rapid detection of disease outbreaks and bioterrorism: results of an interagency workshop on health indicator surveillance.

A system designed to rapidly identify an infectious disease outbreak or bioterrorism attack and provide important demographic and geographic information is lacking in most health departments nationwide. The Department of Defense Global Emerging Infections System sponsored a meeting and workshop in May 2000 in which participants discussed prototype systems and developed recommendations for new surveillance systems. The authors provide a summary of the group's findings, including expectations and recommendations for new surveillance systems. The consensus of the group was that a nationally led effort in developing health indicator surveillance methods is needed to promote effective, innovative systems.

Bioterrorism↗
PubMed2004

Recent irregularities in Table II of Morbidity and Mortality Weekly Report.

Table II of Morbidity and Mortality Weekly Report each week displays the cumulative year-to-date provisional number of cases of selected notifiable diseases in the United States, by state. Thus comparisons between the same weeks for different years can allow a rough rapid tracking of trends. In recent years, particularly 2004, the reported provisional cases showed incongruities. As of April 16, 2004, for example, no AIDS cases at all appeared in Table II. Responses from government public health officials (Centers for Disease Control and Prevention (CDC) and State of California) indicate instabilities and problems in the public health surveillance and reporting system. Such instabilities and problems, if serious and enduring enough, could impair detection of threats to public health.

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

LASIK complications and the Internet: is the public being misled?

BACKGROUND: LASIK (Laser in Situ Keratomileusis) is a very popular combined surgical and laser procedure, which is used to correct myopia (shortsightedness) and hyperopia (farsightedness). There is concern that the public is being misled regarding the safety of the procedure. OBJECTIVES: To assess the quality and quantity of the information on complications on LASIK Web sites. METHOD: Serial analysis and evaluation of the authorship, content, and technical quality of the information on the complications of LASIK on 21 Web sites. RESULTS: Of the 21 LASIK Web sites visited, 17 were commercial. Of the 21 Web sites, 5 (24%) had no information on complications. Of the 16 sites that had information on complications the author of the information was clearly identified in 5 (31%), the content was only referenced in 2 (12.5%), and evidence of the information having been updated was only seen in 2 (12.5%). The quantity of information is generally minimal and the information itself is generally difficult to understand and locate. CONCLUSION: The quality and quantity of the information on the Web on the complications of LASIK are poor. More work is required to encourage clear, accurate, up-to-date, clearly authored, and well-referenced, balanced ophthalmic information.

Authorship↗
PubMed2003

Reasons for consulting a doctor on the Internet: Web survey of users of an Ask the Doctor service.

BACKGROUND: In 1998 the Swedish noncommercial public health service Infomedica opened an Ask the Doctor service on its Internet portal. At no charge, anyone with Internet access can use this service to ask questions about personal health-related and disease-related matters. OBJECTIVE: To study why individuals choose to consult previously-unknown doctors on the Internet. METHODS: Between November 1, 2001, and January 31, 2002 a Web survey of the 3622 Ask the Doctor service users, 1036 men (29%) and 2586 (71%) women, was conducted. We excluded 186 queries from users. The results are based on quantitative and qualitative analysis of the answers to the question "Why did you choose to ask a question at Infomedica's 'Ask the Doctor' service?" RESULTS: 1223 surveys were completed (response rate 36 %). Of the participants in the survey 322 (26%) were male and 901 (74%) female. As major reasons for choosing to consult previously-unknown doctors on the Internet participants indicated: convenience (52%), anonymity (36%), "doctors too busy" (21%), difficult to find time to visit a doctor (16%), difficulty to get an appointment (13%), feeling uncomfortable when seeing a doctor (9%), and not being able to afford a doctors' visit (3%). Further motives elicited through a qualitative analysis of free-text answers were: seeking a second opinion, discontent with previous doctors and a wish for a primary evaluation of a medical problem, asking embarrassing or sensitive questions, seeking information on behalf of relatives, preferring written communication, and (from responses by expatriates, travelers, and others) living far away from regular health care. CONCLUSIONS: We found that that an Internet based Ask the Doctor service is primarily consulted because it is convenient, but it may also be of value for individuals with needs that regular health care services have not been able to meet.

Access to Information↗
PubMed2005

Emerging technologies for cancer prevention and other population health challenges.

Emerging technologies, such as information and communication technologies (including future versions of the Internet), microelectromechanical systems, nanotechnologies, genomics, robotics, artificial intelligence, and sensors, provide enormous opportunities for enhancing health and quality of life. Population health technologies (PHTs) encompass the various applications of emerging technologies to improve the health of populations and communities. These technologies may change many population health paradigms, including those related to cancer prevention and control. In the future, emerging technologies will allow true customization of health communication to individuals, and existing tailoring approaches will be considered very crude. Environmental monitoring systems based on emerging technologies could also provide real-time information that health officials and community residents could use immediately to ameliorate potential carcinogenic or unhealthy exposures. Accelerating the application and diffusion of emerging technologies to population health challenges will require a multipronged approach, including new transdisciplinary programs, increased funding, supportive infrastructure, and policy changes.

Communication↗
PubMedDate not supplied

Evaluating the use of a comprehensive pretravel database by travel medicine experts and novices for advice building.

BACKGROUND: The practice of travel medicine is particularly dependent on knowledge that must be continuously updated, and that can be found in professional electronic documents (PEDs), as specialized websites or comprehensive off-line databases. In this study, we show to what extent the use of a comprehensive pretravel database can compensate for a lack of knowledge in travel medicine during advice building, despite inexperience in using such systems. METHODS: Sixteen physicians, novices and experts in travel medicine, were solicited for building adequate recommendations about real cases of international travel with the help of a specialized PED. The physician's verbalizations, browsing in the documentation and final recommendations have been analyzed for the purpose of identifying and counting the requests addressed to the system and the informative elements in the recommendations. RESULTS: Novices make 2.5 times as many requests for information as experts (p=.0009), and look for a greater variety of information, specifically connected to health precautions (p=.0012), immunizations (p=.0001), health care resources (p=.0037) and climate (p=.019), whereas experts focus their requests mainly on health risks (64.81% of requests, p5.0009). The recommendations from the two groups included equivalent quantities of about 12 pieces of information, but experts used 92.34% of the information found in the documentation, whereas novices used 72.37% (p=.00005). The most used informative elements, whatever the expertise level is, are related to immunizations and health precautions, but experts include more information about health risks (p=0.017), drug characteristics (p=0.014) and chemoprophylaxis (p=0.026). CONCLUSIONS: The PED actually increases the novices' travel medicine expertise, and is particularly efficient for immunizations and health precautions. The PED helps a novice to build advice that is, on the whole, equivalent to an expert's in terms of nature, if not of quality. Implications for the benefits of comprehensive PEDs in the practice of travel medicine are discussed.

Clinical Competence↗
PubMed2005

Comparing aberration detection methods with simulated data.

We compared aberration detection methods requiring historical data to those that require little background by using simulated data. Methods that require less historical data are as sensitive and specific as those that require 3-5 years of data. These simulations can determine which method produces appropriate sensitivity and specificity.

Computer Simulation↗