Foodborne surveillance needs in Australia: harmonisation of molecular laboratory testing and sharing data from human, animal, and food sources.
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Animals↗
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Results for “Public Health Informatics”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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DROPS: an automated web-based system for the reporting of drug-related health statistics in New South Wales.
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Humans↗
Monitoring and reporting alcohol and drug use trends in California: the California Substance Abuse Research Consortium meetings.
For over 15 years, a semiannual meeting sponsored by the California Department of Alcohol and Drug Programs has served as a forum for aggregating data from a variety of sources to examine and monitor the fluctuations in the type, amount, and consequences of alcohol and drug use in California. These meetings of what is now called the Substance Abuse Research Consortium (SARC) have provided California policymakers with an ongoing mechanism for the compilation and sharing of epidemiological information on California alcohol and drug use trends. The tradition of SARC is based on collecting and reviewing epidemiological information: that is, the communication of trends and patterns of alcohol and drug use, emerging drug combinations, shifting user demographics, and new user populations. This article presents a historical perspective of the evolution of the group started under the name "The Statewide Epidemiology Work Group (SEWG)" to its current status as SARC (a more comprehensive history of SARC appears in an article by Anglin and Urada in this issue). It also provides a summary snapshot of the current substance abuse situation in California through the use of substance-related statistics and regional reports.
California↗
Rapid response to a conjunctivitis outbreak: the use of technology to leverage information.
When an outbreak of conjunctivitis was identified at a rural New England college early in 2002, the college health center medical staff used various information management and communication systems to alert the community to the situation. They called upon the state Department of Human Services and the Centers for Disease Control and Prevention to help them understand and manage the outbreak. Technological systems already in place at the college allowed for rapid collection of data by means of a survey delivered over the Internet and a carriage study facilitated by a Web-based appointment and communication system. Within days, the data were collected and analyzed and an immediate response to contain the outbreak was launched.
Adult↗
Vaccination or immunization? The impact of search terms on the internet.
With steadily rising use of the Internet as a source of health information, public health authorities have expressed concern about the increasing visibility of unscientific information promulgated on the Internet by opponents of childhood vaccination. Searches were made on the four most popular Internet search engines using different combinations of the terms, "vaccination," "immunization," "immunisation," "immunize," "immunise," "vaccine," and "shots." Thirty results were tabulated for each search engine. Searching with the keyword "vaccination" resulted in a significantly higher percentage of antivaccination websites as compared with searches with all other keywords. Of all child-related websites retrieved, the single keyword "vaccination" yielded 40% provaccination sites and 60% antivaccination sites. By contrast, the single keyword "immunization" yielded 98% provaccination sites and 2% antivaccination sites. Using a combination of the words "vaccination" and "immunization" produced results between these two extremes. Thus, any use of the term "vaccination" during an Internet search is likely to expose a parent to a significant amount of antivaccination information. Recommendations are discussed for future research and methods to reduce the impact of misinformation on health consumers using the Internet.
Humans↗
FilaBavi, a demographic surveillance site, an epidemiological field laboratory in Vietnam.
BACKGROUND: This Supplement to the Scandinavian Journal of Public Health brings together a collection of community-based studies for which the common denominator is a demographic surveillance site, FilaBavi, established in northern Vietnam in 1999. This introductory paper sets out some of the background to FilaBavi as well as setting the scene for the individual studies.
Demography↗
Community-based assessment of unintentional injuries: a pilot study in rural Vietnam.
AIMS: Although unintentional injuries are recognised as a major public health problem globally, little is known about their patterns and rates at the community level in most low-income countries. Rapid social development, leading to increased traffic and industrialization, may be changing patterns of injury. Injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries in Vietnam, largely because they have not been effectively counted. This study took place in northern Vietnam, in the context of a longitudinal community surveillance site called FilaBavi, as a pilot project aiming to determine the community incidence of unintentional injury and to explore appropriate methods for community-based injury surveillance. METHODS: An initial study population of 23,807 was identified and asked about their experience of injury in the preceding three months. RESULTS: Overall 450 new injuries were detected over 5,952 person-years, a rate of 76 per 1,000 person-years. Males were injured at 1.6 times the rate of females, and home and road traffic accidents were most common. Most injuries occurred during unpaid household tasks. Cutting and crushing injuries occurred most frequently. Of 221 deaths from all causes in the FilaBavi population during 1999 among 43,444 person-years, 25 were attributed to unintentional injuries and two to suicide. Unintentional injury was the third leading cause of death in this community, with a case-fatality rate of 0.8%. DISCUSSION: The findings suggest that greater attention needs to be directed toward the prevention of injuries occurring in the home in rural Vietnam. On the basis of this pilot study, a one-year study using the same approach is under way to characterize the patterns of unintentional injury in more detail, including any seasonal variation.
Accidents↗
Use of on-line evidence databases by Australian public health practitioners.
OBJECTIVE: To investigate use of a web-based portal, known as the Clinical Information Access Program (CIAP), and evidence databases in an Australian population health workforce. METHODS: Self-administered postal survey of 104 staff in a regional Division of Population Health in Sydney, Australia. The main outcome measures were CIAP use and organization support for CIAP use. Two thirds of the respondents agreed that using CIAP was a legitimate part of their practice. However, half agreed that staff were encouraged to use it. One in five respondents (21%) used CIAP weekly. CIAP use was significantly associated with medical qualification or, among non-medical staff, with having at least a Masters qualification. CIAP use was not associated with occupational category, gender, age, employment status nor years of experience. Use of specific evidence databases such as Cochrane also differed significantly by respondents' characteristics. CONCLUSIONS: There has been only partial uptake of on-line databases among this population health workforce, particularly according to attainment of relevant postgraduate qualifications. As CIAP is a resource for evidence-based practice, greater effort to increase its use is recommended to ensure population health does not fall behind hospital-based clinicians.
Adult↗
Alcohol and drowning in Australia.
OBJECTIVES: To examine the contribution of alcohol to drowning deaths in Australia. METHODS: Drowning deaths that occurred in Australia (excluding Queensland) from 1 July 2000 to 30 June 2001 were identified using the National Coroners Information System (NCIS). The current analysis was based on those deaths for which the Coronial process was completed by March 2003 ('Closed' cases). Comparison was made with the Australian Bureau of Statistics (ABS) national deaths data and with currently used values of attributable fractions for alcohol and drowning in Australia (these values are based on USA data on drownings from 1980 to 1984). RESULTS: 289 drowning deaths were identified, 5% less than comparable ABS data. Of these deaths, 240 were 'Closed' cases, and valid blood alcohol measurements were available for 137 (58%) of these. Alcohol appeared to contribute to approximately 19% of these fatal drowning incidents (25% for recreational aquatic activity; 16% for incidental falls into water; 12% for drowning due to suicide). Using > or = 0.10 g/100 ml as the cut-off, the estimated all-ages proportions of unintentional drowning attributed to alcohol was 17% in the current study, compared to the 34% currently used for Australia based on data from North America. CONCLUSIONS AND IMPLICATIONS: A high level of alcohol appears to be present less frequently among recent drowning deaths in Australia than has been assumed to be the case to date. Nevertheless, many drowning victims have high levels of blood alcohol, and public health efforts to minimize the use of alcohol in association with activity on or near water should be continued. Despite some deficiencies, the NCIS appears to be a very useful source of information on public health issues, and to provide a better basis for assessing and monitoring alcohol-related drowning deaths in Australia than the published attributable fractions used to date.
Accidental Falls↗
The Stockholm Manifesto. Creating a safe environment for children in Europe.
The European Child Safety Alliance is an initiative of the European Consumer Safety Association with a network of child injury prevention organizations within 25 Member States in Europe. The Alliance, launched in 2001, focuses on strategies that assist in the reduction of injury related deaths and disability amongst children 0 to 18 years of age in the European Union Members States. The Alliance work is done in partnership with stakeholders from various disciplines involved in child injury prevention in order to promote a coordinated and consistent approach across Europe.
Benchmarking↗
Designing the European Road Safety Observatory.
The unavailability of consistent traffic accident data and road safety information limits the opportunities to provide target approaches to reduce road crashes. The European commission has decided to meet the demand for this data by establishing a new Road Safety Observatory. The structure and much of the initial content is being developed within the SafetyNet Integrated Project. This paper describes the structure of its key components.
Accidents, Traffic↗
The Functional Capacity Index, second revision: morbidity in the first year post injury.
As the field of injury outcomes measurement has moved beyond counting deaths and injuries, the need for instruments to measure long-term outcomes has increased. Early validation efforts indicated that the Functional Capacity Index (pFCI12) was a promising tool for predicting functional loss 12 months post trauma, but that the predictive validity for lower extremity fractures was low. The pFCI12 was recently revised in conjunction with the 2005 revision of the Abbreviated Injury Scale (AIS). This preliminary study was undertaken to assess the performance of the revised pFCI12 in predicting outcomes for patients with lower extremity trauma. This case review study used the Crash Injury Research and Engineering Research (CIREN) database which includes AIS codes, extensive clinical data and 3- and 12-month outcomes. Generally predicted functional loss at 12 months was greater with the pFCI12 (AIS 2005) than with the original FCI based on AIS 1990. All patients whose pFCI12 scores predicted functional loss experienced some morbidity at 1 year. The pFCI12 appears to provide improved predictions of functional outcome 12-months post-trauma for persons experiencing lower extremity trauma.
Abbreviated Injury Scale↗
Epidemiology of volatile substance abuse (VSA) cases reported to US poison centers.
Volatile substance abuse (VSA) is believed to be widespread. The Toxic Exposure Surveillance System (TESS) of the American Association of Poison Control Systems offers an opportunity to evaluate the epidemiology of volatile substance abuse using a data set that captures data from a large geographic area covering a wide-ranging group of socioeconomic strata, ethnic groups, and demographics. To utilize this potential we analyzed a data set of TESS for the 6-year period of 1996 through 2001 involving all cases of intentional inhalational abuse of nonpharmaceutical substances. Over the study period there was a mean annual decline of 9% of reported VSA with an overall decline of 37% from 1996 to 2001. Volatile substance abuse was reported primarily in children, with 6358 cases (54%) in children 13-19 yr and 1803 (15%) cases in children 6-12 yr. Fifty-two cases were reported in children < 5 or = 5 yr. A total of 2330 (20%) VSA cases had a serious outcome, defined as either moderate effect (n = 2000), major effect (n = 267), or death (n = 63). The top five categories of substances abused were gasoline (41%), paint (13%), propane/butane (6%), air fresheners (6%), and formalin (5%). Three categories were responsible for the majority of deaths: gasoline (45%), air fresheners (26%), and propane/butane (11%). While there was a decline in reported cases, there was no decline in major outcomes or fatalities. Volatile substance abuse was reported in all 50 states, with case distribution similar to population distribution. However, seven states had > 2 times the expected rate based on their population; three western states, two midwestern states, and two Appalachian states. The role of urban vs. rural population may possibly explain the difference in numbers, with a greater incidence of VSA cases reported in states with large rural populations. The mean monthly occurrence rate was 162 VSA cases/month (S.D. +/- 10.85). There were 4 months that were > 2 standard deviations from the mean, with two peak months (May, 192/month and March, 187/month) and two trough months (December, 126/month and January, 137/month). This report presents a broad picture of VSA in the United States. Volatile substance abuse, as reported to U.S. poison centers, appears to be on the decline, but continues to be an ongoing problem. Volatile substance abuse is reported throughout the U.S. in all areas of the country, with a higher incidence in states with large rural populations. A small group of substances appears responsible for the majority of deaths. It is imperative that we continue to educate the public and healthcare professionals regarding the risks of VSA and hopefully impact the incidence of VSA.
Administration, Inhalation↗
The community epidemiology work group approach.
"Drug abuse" provides many unique challenges to the research community. Some of these involve fundamental epidemiologic issues, such as measuring the extent of the problem, identifying and assessing changes in patterns and trends, detecting emerging "drugs of abuse", characterizing vulnerable populations and determining health and social consequences. A number of research methods are employed to address these issues. This paper describes one of these--a model in which ongoing surveillance of "drug abuse" is maintained through a network of community-based researchers, local officials, academics, and other interested and qualified members of the community. Timely, accurate, and cost-effective data can be generated through systematic collection and analysis of indirect indicators of "drug abuse" that are often routinely produced by a variety of community sources. This information, in turn, can be used to make informed public health policy decisions. The community-based network model has been implemented at the city, state, national, regional, and international levels, and a case is made that this type of program could be useful, as well, in understanding the dynamics of "drug abuse" in rural areas of the country.
Community Networks↗
Utilizing technology: the challenges and opportunities facing "substance abuse" professionals in rural communities.
Many rural communities are actively pursuing technology as a resource for solving education, health care, and economic development issues. These communities are establishing a technology and telecommunication infrastructure that makes them appealing to individuals and companies from urban communities. But this has created a challenge and an opportunity for the mental health industry in general, and more specifically, "substance abuse" professionals. The opportunity for the "substance abuse" profession is to design and use new services using the exact same technologies that may precipitate the need for the services.
Humans↗
Administrative databases provide inaccurate data for surveillance of long-term central venous catheter-associated infections.
BACKGROUND: Efficient methods are needed to monitor infections associated with long-term central venous catheters (CVCs) in both inpatient and outpatient settings. Automated medical records and claims data have been used for surveillance of these infections without evaluation of their accuracy or validity. OBJECTIVE: To determine the feasibility of using electronic records to identify CVC placement and design a system for identifying CVC-associated infections. DESIGN AND SETTING: Retrospective cohort study at an HMO and two teaching hospitals in Boston, one adult (hospital A) and one pediatric (hospital B), between January 1991 and December 1997. Tunneled catheters, totally implanted catheters, and hemodialysis catheters were examined. Claims databases of both the HMO and the hospitals were searched for 10 CPT codes, 2 ICD-9 codes, and internal charge codes indicating CVC insertion. Lists were compared with each other and with medical records for correlation and accuracy. PATIENTS: All members of the HMO who had a CVC inserted at one of the two hospitals during the study period. RESULTS: There was wide variation in the CVC insertions identified in each database. Although ICD-9 codes at each hospital and CPT/ICD-9 combinations at the HMO found similar total numbers of CVCs, there was little overlap between the individuals identified (62% for hospital A with HMO and 4% for hospital B). CONCLUSION: Claims data from different sources do not identify the same CVC insertion procedures. Current administrative databases are not ready to be used for electronic surveillance of CVC-associated complications without extensive modification and validation.
Boston↗
The standardized incidence ratio as a reliable tool for surgical site infection surveillance.
OBJECTIVE: To evaluate whether the standardized incidence ratio (SIR) is a more reliable tool for comparing rates and temporal trends of surgical site infection (SSI) in surgery wards than the incidence rate among patients with an National Nosocomial Infections Surveillance system (NNIS) risk index category of 0. DESIGN: Observational, prospective cohort study in a sequential SSI surveillance system. SETTING: Volunteer surgery wards in a surveillance network in northern France that annually conducted SSI surveillance for 3 months from 1998 to 2000. METHODS: The incidence rate was the number of SSIs divided by the number of patients included, stratified by the NNIS risk index category. SIR was the observed number of SSIs divided by the expected number computed using a multiple regression model. RESULTS: Overall, 26,904 patients in 67 surgery wards were enrolled. Between 1998 and 2000, the SSI incidence rate among patients with NNIS risk index category 0 decreased from 2.1% to 1.4%, which was a 33% reduction (P=.002). The SIR decreased from 1.2 (95% confidence interval [CI], 1.1-1.3) to 0.8 (95% CI, 0.7-0.9), which was a 20% decrease per year and an overall 33% reduction. The number of SSIs was significantly higher than expected in 17 of 201 surveillance periods over the 3 years. The classification of the wards according to the 2 indicators over the 3 years showed that wards with a high SIR did not consistently have the highest SSI incidence rate among patients with NNIS risk index category 0, partly because the type of surgical procedure and the duration of follow-up are not taken into account in the NNIS risk index. CONCLUSION: SIR should be considered a reliable indicator to estimate the reduction in SSI incidence that results from implementation of infection control policies and for comparison of SSI rates between wards.
Adult↗
Purdue University-Banfield National Companion Animal Surveillance Program for emerging and zoonotic diseases.
A National Companion Animal Surveillance Program (NCASP) was established at Purdue University to monitor clinical syndromes and diseases using the electronic medical records of >80,000 companion animals visiting >500 Banfield hospitals weekly in 44 states. With funding from the Centers for Disease Control and Prevention, NCASP was initially developed for syndromic surveillance of Category A agents of bioterrorism. Surveillance was expanded through inclusion of electronic reports from Antech Diagnostics, a nationwide network of integrated veterinary diagnostic laboratories serving >18,000 private veterinary practices. NCASP characterizes and displays temporal and spatial patterns of diseases in dogs, cats, and other companion animals. It detects unusual clusters of potential emerging/zoonotic infections and monitors flea and tick activity. Data is processed and analyzed using SAS and ESRI software products. The NCASP can be used by veterinarians to enhance their practice of evidence-based medicine by providing information needed to individualize vaccine protocols for animals in specific geographic areas.
Animals↗