Self-selection and evaluation of influenza vaccination effectiveness among elderly.
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Biomedical subjects
Publications and source records attributed to Scott Grosse.
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The purpose of this chapter is to review the principles of quality monitoring for newborn screening programs at both a hospital and a public health level. The focus is on quality assurance in Early Hearing Detection and Intervention (EHDI). The chapter addresses the need for a systems approach to quality, beginning with the birth screening, moving to follow-up re-screening and on to confirmatory evaluations and life-long intervention and management for the infants identified with permanent hearing loss. Benchmarks are identified to assist those involved in establishing programs or in improving program performance. As the use of electronic information systems in EHDI becomes widespread, the importance of strict computer-based logic rules to assure patient privacy is addressed.
BACKGROUND: Lead is a component of tobacco and tobacco smoke, and smokers have higher blood lead levels than do nonsmokers. METHODS: We examined the relation between second-hand smoke exposure and blood lead levels in a nationally representative sample of 5592 U.S. children, age 4-16 years, who participated in the Third National Health and Nutrition Examination Survey (1988-1994). Linear and logistic regression modeling was used to adjust for known covariates. RESULTS: Geometric mean blood lead levels were 1.5 mug/dL, 1.9 mug/dL, and 2.6 mug/dL for children with low, intermediate, and high cotinine levels, respectively. The adjusted linear regression model showed that geometric mean blood lead levels were 38% higher (95% confidence interval [CI] = 25-52%) in children with high cotinine levels compared with children who had low cotinine levels. The logistic regression models showed that children with high cotinine levels were more likely to have blood lead levels >/=10 mug/dL than were children with low cotinine levels (odds ratio [OR] = 4.4; CI = 1.9-10.5). CONCLUSIONS: Second-hand smoke could be associated with increased blood lead levels in U.S. children aged 4-16 years.