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PubMed2005

[The importance of the National Public Health Compass for public health].

The National Public Health Compass provides an online overview of the current state of public health in the Netherlands. The Compass contains largely the same information as the Dutch Public Health Status and Forecasts Reports, the 2002 edition of which showed stagnation of public health improvement. This highlights the role of these overviews in the signalling of public health problems. The quality of the reporting on public health has been shown to be high and the reports are successful in providing information for Dutch health policy. However, if the Dutch are to regain their leading position in Europe, more policy efforts are required.

Databases, Factual↗
PubMed2005

[Health and disease in the Netherlands: the Dutch National Public Health Compass as a source of information].

--The Dutch National Public Health Compass has been available on the Internet (www.nationaalkompas.nl) since 2001. This website, developed and managed by the National Institute for Public Health and the Environment, contains data and information on the population's health status, its determinants, prevention and care. The Compass brings together information from various data sources, research and expert opinions. --On the basis of this Compass, an overview has been made of the health of the Dutch population. --Both the life expectancy and the healthy life expectancy in the Netherlands increased after 1980. --Mortality from coronary heart disease, cerebrovascular accidents and lung cancer decreased, but they are still the most important causes of death. --Especially psychological disorders (alcohol dependence, anxiety disorders and depression), coronary heart disease and COPD are associated with a significant decrease in quality of life. --There are important health differences in the Netherlands between rich and poor, urban and rural areas, natives and immigrants. --The difference in life expectancy between men and women will decrease from more than 5 years in 2000 to less than 4 years in 2020. --A permanent facility for the provision of accurate public-health information is of great importance. The collaboration of registration holders and experts in maintaining the Compass is and will remain essential so that an integral overview of the health of the Dutch population can also be made in the future.

Actuarial Analysis↗
PubMedDate not supplied

The NSW & ACT Hereditary Cancer Registers.

BACKGROUND: The NSW & ACT Hereditary Cancer Registers (HCR) offer registration to people from families at risk for hereditary cancer. OBJECTIVE: This article describes the Hereditary Cancer Registers and provides information to the treating health professional to register patients at risk of hereditary cancer to the HCR. DISCUSSION: The HCR collaborates with treating doctors and familial cancer clinics to play an important role in the management of people at risk of hereditary bowel cancer.

Adenomatous Polyposis Coli↗
PubMed2005

Building momentum.

Explore the source record for details and available documents.

Academies and Institutes↗
PubMed2005

On the coding and reporting of race and ethnicity in New Hampshire for purposes of cancer reporting.

BACKGROUND: The objective was to investigate how data on race and ethnicity are collected by hospitals reporting to the New Hampshire State Cancer Registry (NHSCR). METHOD: NHSCR surveyed hospitals asking how information on race and ethnicity were collected. A review of relevant legal mandates and national guidelines was undertaken. RESULTS: Many hospitals lack policies on collection, computer systems fail to support national guidelines, and staff rely on visual inspection. CONCLUSIONS: Hospital staffs are not now culturally equipped to collect race and ethnicity in a meaningful way. The numerator in cancer incidence rates is most likely not accurate and for some smaller populations very biased. A new framework is needed that takes into account the needs of the democracy.

Admitting Department, Hospital↗
PubMed2005

National plan for reliable tuberculosis laboratory services using a systems approach. Recommendations from CDC and the Association of Public Health Laboratories Task Force on Tuberculosis Laboratory Services.

Since the mid-1990s, public health laboratories have improved tuberculosis (TB) test performance, which has contributed to the resumption of the decline in TB incidence in the United States. However, to eliminate TB in the United States, further improvements are needed in laboratory services to support TB treatment, prevention, and control. A critical step is the development of an integrated system that ensures prompt and reliable laboratory testing and flow of information among laboratorians, clinicians, and TB-control officials. Challenges to developing such a system include 1) establishing lines of communication among laboratorians, clinicians, and TB-control officials; 2) expediting reporting of laboratory results, which can avoid delayed or inappropriate treatment and missed opportunities to prevent transmission; 3) developing evidence-based recommendations for use of new laboratory technologies; 4) maintaining staff proficiency in light of declining numbers of specimens to test, workforce shortages, and loss of laboratory expertise; and 5) upgrading laboratory information systems and connecting all partners. The report of the Association of Public Health Laboratories Task Force presents a framework to improve the future of TB laboratory services and describes the role of the laboratory in TB treatment and control, Task Force processes, general principles and benchmarks, and steps for the dissemination of the Task Force recommendations. This MMWR expands on the Task Force report by describing specific actions and performance measures to guide development and implementation of an integrated system for providing TB laboratory services. CDC and the Association of Public Health Laboratories have developed these guidelines so that laboratorians, clinicians, public health officials, administrators, and funding entities can work together to ensure that health-care providers and TB-control officials have the information needed to treat TB patients, prevent TB transmission, and ultimately eliminate TB in the United States.

Clinical Laboratory Information Systems↗
PubMed2004

Trends in laryngeal cancer incidence in Lithuania: a future perspective.

OBJECTIVES: The aim of the present study was to assess the incidence of larynx cancer in Lithuania in the years 1978-2001 and to outline possible future trends. MATERIALS AND METHODS: The number of new laryngeal cancer cases in 1978-2001 was obtained from the Lithuanian Cancer Registry. The Lithuanian Department of Statistics provided data on the population being at the same age in the same years. The data were adjusted for age, using the direct method in accordance with the European standard; a linear regression analysis of trends in the larynx cancer incidence was performed. RESULTS: After standardization of data for the period of 1978-2001, an upward trend was registered for both men and women: in 1978 the incidence was 10.73 for men and 0.26 for women per 100000 population, in 2001 the corresponding data were 11.6 and 0.7. Throughout the study period the incidence was higher in men than in women and the mean age of male and female larynx cancer patients was increasing: mean age for men was annually increasing by 0.1566 years and for women by 0.0602 years. The forecast for men in 2006 is 13.88 and for women 0.54 cases per 100000 population. CONCLUSIONS: The increase in larynx cancer incidence is growing more rapidly among women than among men, and the mean age of the patients is also increasing. The forecast is that in 2006 the incidence rate will be increasing, and both men and women will get ill at an older age.

Adolescent↗
PubMed2005

Using administrative databases to measure waiting times for patients undergoing major cancer surgery in Ontario, 1993-2000.

PURPOSE: To determine how long patients in Ontario waited for major breast, colorectal, lung or prostate cancer surgery in the years 1993-2000. METHODS: "Surgical waiting time" was defined as the interval from date of preoperative surgeon consult to date of hospital admission for surgery. We created patient cohorts by linking appropriate diagnosis and procedure codes from Canadian Institutes of Health Information data. Scrambled unique surgeon identifiers were obtained from Ontario Health Insurance Plan data. Changes in median surgical waiting times were assessed with univariate time-trend analyses and multilevel models. Models were controlled for year of surgery and other patient (age, gender, comorbid conditions, income level, area of residence) and hospital level characteristics (teaching status, procedure volume status). RESULTS: Compared with 1993, median surgical waiting times in the year 2000 increased 36% for patients with breast cancer (to 19 d), 46% with colorectal (to 19 d), 36% with lung (to 34 d) and 4% with prostate cancer (to 83 d). Multilevel models confirmed significant increases in waiting times for all procedures. There were no concerning or consistent differences in waiting times among the categories of hospitals and patients examined. DISCUSSION: There were significant increases in surgical waiting times among patients undergoing breast, colorectal, lung or prostate cancer surgery in Ontario over years 1993-2000. Administrative databases can be used to efficiently measure such waits.

Breast Neoplasms↗
PubMed2005

A deficient public health system as a contributing cause of Severe Acute Respiratory Syndrome (SARS) epidemic in mainland China.

SARS (Severe Acute Respiratory Syndrome) is a newly emerging infectious disease which spread over 32 countries and areas, infected more than 8,000 people and causing more than 900 deaths from November 2002 to August 2003. More than 90% of the SARS cases and death were reported from China. Nevertheless, we still know little about this disease, particularly in etiology. SARS, as an emergency of Public Health System (PHS), alarmed health workers throughout the world proving there is still the potential for an epidemic of an emerging infection both in developed and developing areas. Many reports indicated that the insufficiency of the PHS of China was one of the critical factors contributing to the outbreak of SARS. In this study, we attempt to demonstrate some of the categories of PHS that contributed to the SARS epidemic. Two of the categories studied were the living environment and health resources. In the living environment area, the population and population density were examined. Health resources include the medical facilities, health workers, and per capita public health expenditures. An understanding of these areas is important to prevent future epidemic.

China↗
PubMed2003

Data integration and warehousing: coordination between newborn screening and related public health programs.

At birth, patient demographic and health information begin to accumulate in varied databases. There are often multiple sources of the same or similar data. New public health programs are often created without considering data linkages. Recently, newborn hearing screening (NHS) programs and immunization programs have virtually ignored the existence of newborn dried blood spot (DBS) newborn screening databases containing similar demographic data, creating data duplication in their 'new' systems. Some progressive public health departments are developing data warehouses of basic, recurrent patient information, and linking these databases to other health program databases where programs and services can benefit from such linkages. Demographic data warehousing saves time (and money) by eliminating duplicative data entry and reducing the chances of data errors. While newborn screening data are usually the first data available, they should not be the only data source considered for early data linkage or for populating a data warehouse. Birth certificate information should also be considered along with other data sources for infants that may not have received newborn screening or who may have been born outside of the jurisdiction and not have birth certificate information locally available. This newborn screening serial number provides a convenient identification number for use in the DBS program and for linking with other systems. As a minimum, data linkages should exist between newborn dried blood spot screening, newborn hearing screening, immunizations, birth certificates and birth defect registries.

Birth Certificates↗
PubMed2003

Mass newborn screening in Singapore.

Births in Singapore are almost exclusively in hospitals and this is conducive to mass newborn screening. Mass newborn screeningbegan in 1965 for G6PD deficiency and has led to successful eradication of the complicating kernicterus. Screening has also identified the distinct ethnic and sex linked variations in incidence. The predominant molecular abnormality is the Canton variant. Congenital hypothyroidism screening was started as a pilot project in 1981, then became institution-based in 1985 and nationwide in 1990. The screening is carried out on the cord blood and is now a primary TSH screen. Anincidence of about 1 in 3000 is being obtained and treatment has been started within 2 weeks of birth in almost all babies. A pilot Newborn Screening for hearing impairment started in 1999. Ituses the measurement of Transient Evoked Oto-Acoustic Emissions, is hospital based andcovers about 10% of the newborn population. The program has identified hearing impairment requiring intervention at a rate of about 1:1000 births. A program covering about 50% of the national births has been commissioned by the Ministry of Health to establish epidemiologic data and to document the outcome of early intervention. Mass newborn screening for inborn errors of metabolism is being considered.

Congenital Hypothyroidism↗
PubMed2003

Birth defects ascertainment in the Philippines.

In the Philippines, congenital anomalies rank among the top 20 causes of death across the life span and are already the third leading cause of death in the infancy period (Philippine Department of Health, 1996). Despite the magnitude of the problem, no formal systematic registration of birth defects has been done in the country up until 1999. Various attempts have been made by different study groups to gather data but there was never a formal effort to consolidate the information and establish a centralized registry. Data from various modes of ascertainment are hereby presented: 1) Philippine Birth Defects Registry Project, 2) Hospital In-Patient and Out-Patient Registries, 3) Prenatal Inventory and Neonatal Outcome Study Group, 4) Hospital Pathology Reports, and 5) Community Outreach Programs. Birth Defects Registry Project had the largest reporting of the different methods presented here. The most common birth defects were multiple congenital anomalies, congenital malformations of the tongue, mouth, and pharynx (ankyloglossia), cleft palate with cleft lip, Down Syndrome, congenital deformities of the feet (talipes equinovarus), anencephaly, other congenital malformations of the face and neck, congenital malformations of the musculoskeletal system (diaphragmatic hernia, gastroschisis), hypospadias, congenital hydrocephalus, polydactyly, syndactyly, and cleft lip.

Congenital Abnormalities↗
PubMed2005

The SARS epidemic in Hong Kong--a human calamity in the 21st century.

PURPOSE: This paper reviews the epidemiology and control measures of the SARS epidemic in Hong Kong. It sets out proposals for better preparedness to tackle the disease in future. BACKGROUND: Severe Acute Respiratory Syndrome (SARS) started to strike Hong Kong in March 2003. A total of 1,755 SARS cases with 298 deaths were reported. Prior to the occurrence of the disease in Hong Kong, an intense outbreak of atypical pneumonia was reported in the nearby Guangdong Province in Mainland China. RESULTS: There were three phases in the epidemic. The first phase in March 2003 involved a teaching hospital. The infection originated from a visiting professor from Guangdong, He developed SARS in Hong Kong and died in a Hong Kong hospital. The second phase in April was the spread of the infection from the hospital to the community. The third phase in May was the declining period which ended in June following the removal of Hong Kong from the list of infected areas by WHO. CONCLUSION: Hong Kong was ill-prepared at the early stage of the epidemic. The epidemic produced not only health but also social, economic and humanitarian problems. The epidemic, however, created a strong sense of unity among all sectors of the population in the fight against the disease.

Carrier State↗
PubMed2005

Health Risk Appraisal using Internet technology.

OBJECTIVE: To develop a Web-based Health Risk Appraisal (HRA) system as a tool for health education based on personal health examination data. METHODS: A Japanese health examination database was analyzed to develop models for HRA, which were designed to predict each of ten laboratory values in a year with and without lifestyle modifications. The HRA models were embedded into a server. RESULTS: The Web-based HRA system has been introduced into a Japanese health care association having 37 branch centers. Following a health examination, an individual health education program using the Web-based HRA system is provided to a given client at each branch center or at a client's office. A measured laboratory value and corresponding predicted laboratory values in a year with and without lifestyle modifications are displayed on the screen in forms of both numerical values and graphs. A trained nurse or another health care provider operates the system and explains the HRA result. CONCLUSION: The Web-based HRA system will be a practical tool for individual health education following health examination.

Computer-Assisted Instruction↗
PubMed2005

The immunization data quality audit: verifying the quality and consistency of immunization monitoring systems.

OBJECTIVE: To evaluate the consistency and quality of immunization monitoring systems in 27 countries during 2002-03 using standardized data quality audits (DQAs) that had been launched within the framework of the Global Alliance for Vaccines and Immunization. METHODS: The consistency of reporting systems was estimated by determining the proportion of third doses of diphtheria-tetanuspertussis (DTP-3) vaccine reported as being administered that could be verified by written documentation at health facilities and districts. The quality of monitoring systems was measured using quality indices for different components of the monitoring systems. These indices were applied to each level of the health service (health unit, district and national). FINDINGS: The proportion of verified DTP-3 doses was lower than 85% in 16 countries. Difficulties in verifying the doses administered often arose at the peripheral level of the health service, usually as the result of discrepancies in information between health units and their corresponding districts or because completed recording forms were not available from health units. All countries had weaknesses in their monitoring systems; these included the inconsistent use of monitoring charts; inadequate monitoring of vaccine stocks, injection supplies and adverse events; unsafe computer practices; and poor monitoring of completeness and timeliness of reporting. CONCLUSION: Inconsistencies in immunization data occur in many countries, hampering their ability to manage their immunization programmes. Countries should use these findings to strengthen monitoring systems so that data can reliably guide programme activities. The DQA is an innovative tool that provides a way to independently assess the quality of immunization monitoring systems at all levels of a health service and serves as a point of entry to make improvements. It provides a useful example for other global health initiatives.

Child↗