Biomedical subjects
P L Graitcer
Publications and source records attributed to P L Graitcer.
Helmets and preventing motorcycle and bicycle injuries: comments and a correction.
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A review of educational and legislative strategies to promote bicycle helmets.
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Injury surveillance in developing countries.
In both developed and developing countries, injuries have a substantial effect on the public's health and on quality of life. Although epidemiologic data regarding the occurrence of injuries in developing countries are limited, recent studies have documented substantial injury-related morbidity and mortality in some of these countries. For example, recent studies in rural Papua New Guinea showed that injuries are the leading cause of death for persons ages 15-44 years. Similarly, injuries are the leading cause of hospitalization in Indonesia and Egypt. Surveillance of injuries is necessary in order for public health practitioners and planners in developing countries to direct and allocate scarce resources appropriately.
Injury coding and hospital discharge data.
Data are currently inadequate to develop, implement, and evaluate injury prevention and control programs in the United States. Information about cause of injury, which is available for fatal injuries, is rarely available for severe nonfatal injuries. Although hospital discharge data systems contain much of the important information needed for injury prevention and control programs, they rarely are coded with information about the external cause of injury (E codes). E-coded hospital discharge data systems are potentially one of the most effective and feasible means available to collect data needed to prevent and control injuries. We recommend that E codes be required elements in hospital discharge data systems, that separate fields for E codes be created, and that E-code definitions and guidelines be developed.
Epidemiological surveillance in Peace Corps Volunteers: a model for monitoring health in temporary residents of developing countries.
In 1985, the US Peace Corps developed a computerized epidemiological surveillance system to monitor health trends in over 5500 Peace Corps Volunteers working in development projects in 62 countries worldwide. Data on 31 health conditions and events are collected monthly from each country; quarterly and annual incidence rates are then calculated, and the analysed data are distributed. In 1987, the most commonly reported health problems were diarrhoea (unclassified), 48 cases per 100 volunteers per year; amoebiasis, 24 per 100 volunteers per year; injuries, 20 per 100 volunteers per year; bacterial skin infections, 19 per 100 volunteers per year; and giardiasis 17 per 100 volunteers per year. Tracking each of these common problems, as well as other selected health conditions, guides design of more specific studies and disease control efforts. Health problems with very low rates (less than 1.0/100 volunteers/year) include hepatitis, schistosomiasis, non-falciparum malaria, and filariasis. The epidemiological surveillance system provides the health data needed to plan, implement, and evaluate health programmes for Peace Corps Volunteers, and provides a model for surveillance in other groups of temporary and permanent residents of developing countries.
Evaluating community interventions to reduce drunken driving.
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Hospitalizations due to tap water scalds, 1978-1985.
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Moving from the 1990 injury control objectives to state and local surveillance systems. Introduction.
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An evaluation of the use of medical examiner data for epidemiologic surveillance.
To assess the value of medical examiner (ME) data bases for use in epidemiologic surveillance, we compared data from non-injury deaths that became ME cases to all non-injury deaths occurring in 1984 among Fulton County, Georgia residents. The decedents in the ME series were younger and included a large proportion of Black males. Although not representative of all deaths in a community, ME data bases include demographic and medical information that is often difficult to collect in community studies and in other surveillance systems.
The French connection.
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Current breast-feeding and weaning practices in Haiti.
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Measuring children: one reference for all.
Growth standards developed in industrialised countries are appropriate for measuring child growth in developing countries. From data collected among privileged groups of children in developing countries, we have concluded that child growth is mainly influenced by socioeconomic status and not by race or by ethnicity. Height, weight, and age data were collected from 2366 children aged 6-59 months in Egypt, Togo, and Haiti. These children were chosen from private day-care centres, paediatricians' offices, and families of military and Government officials. These data were compared with the NCHS/CDC reference population, which is representative of healthy U.S. children. Distributions of weight-for-height and height-for-age values for the privileged group and the reference population were nearly identical. The 5th, 50th, and 95th centiles height-for-age of the privileged group did not differ greatly from the reference population. The privileged group, however, was heavier than the reference population at heights greater than 100 cm for the 50th and 95th centiles. Overweight appears to be a greater problem in those privileged groups than in the reference population. Since growth in privileged children in these developing countries and in the U.S. children is similar, we feel that use of the NCHS/CDC reference is justified for measuring nutrition status of preschool children in developing countries.
Hemoglobins and hematocrits: are they equally sensitive in detecting anemias?
General medical and nutritional practice assumes that hemoglobin and hematocrit values are equally useful in detecting anemia and that they can be used interchangeably for anemia screening. These two tests, at presumed equivalent levels, identify varying prevalences of anemia in the same population. This study examines anemia prevalence rates using hemoglobin and hematocrit tests performed in seven separate surveys on a total of 13,040 children. These data indicate that hemoglobin and hematocrit screening tests are indeed not comparable in detecting anemia in the same population. Using only hematocrit tests, anemia is diagnosed in 1 to 10% of children with normal hemoglobin levels and is not detected in 20 to 50% of children who might be considered anemic on the basis of low hemoglobin levels.
Anthropometric indicators of nutrition status and morbidity.
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Outbreak of influenza A/USSR/77 at Marquette University.
An outbreak of influenzalike illness occurred at Marquette University, Milwaukee, Wisconsin, in February 1978. Epidemiologic and laboratory data indicate that the outbreak was due to influenza A/USSR/77 (N1H1) virus. A self-administered questionnaire inquiring about the presence and spectrum of illness was given to faculty members, dental students, and residents of an undergraduate dormitory. Age-specific attack rates were 61.5% for persons less than or equal to 22 years of age, 24.7% for those 23 or 24 years of age, and 9.7% for those greater than or equal to 25 years of age. This pattern of age-specific attack rates paralleled the age distribution of persons without hemagglutination-inhibiting antibody to influenza A/USSR/77 virus found in independent serosurveys. Prior swine influenza (H1N1) immunization provided no protection from illness in this outbreak. Past epidemic antibody titers in undergraduates were only weakly associated with clinical illness. The data on disease impact gathered in this study indicate that in a university setting influenza A/USSR/77 virus produced a short-lived outbreak of respiratory illness with a very high attack rate in young adults.
The potential for using a trauma registry for injury surveillance and prevention.
Trauma registries are a potential source of data for local injury surveillance. Data from a trauma registry in a Level 1 trauma unit were collected for 1,412 admissions during a one-year period, and the characteristics of these severely injured patients and their injuries were examined. Three-quarters of the injuries were unintentional, and half were vehicle-related injuries. The availability of variables regarding medical cost, patient outcome, and insurance status permits a determination of the impact of these injuries on society in terms of both cost and quality of life. Since the trauma registry contains an account of the patient's hospital experience from admission to discharge and is available in electronic format, it can be a useful data source for establishing priorities and evaluating the effectiveness of injury prevention programs.
The Epidemiologic Surveillance Project: a computer-based system for disease surveillance.
The Epidemiologic Surveillance Project (ESP) is a computer-based surveillance system for the rapid transmission and analysis of national morbidity data. These data are transmitted weekly by state health department computers to the Centers for Disease Control (CDC), using a commercial electronic mail facility (MINET). Participating state health departments transmit data through existing computer systems using a standard record and data transmission protocol. State and national data are rapidly analyzed at the CDC, and reports of these analyses are transmitted through MINET to the states. Maps based on these data and other tabular displays of demographic and epidemiologic characteristics of the diseases being tracked are periodically prepared and distributed. Because the efficiency, speed, and uniformity of tabulation of this system are greater than those of systems that use protocol and telephonic reports of case totals, the ESP may be a model for future surveillance systems.