Iowa Family Planning Program.
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A knowledge based system (KBS) which helps health service managers to interpret immunization coverage rates was installed in two provinces of Papua New Guinea. It was assessed over a period of 4 months to determine whether it was a potentially useful management tool. One province used the system but did not adjust its activities significantly because it was meeting its targets for immunization. In the other province the KBS helped provincial managers to detect problems and respond to them. Consequently, improvements in performance indicators were detected. It is difficult to attribute the improvements entirely to the KBS but several actions were taken to strengthen immunization services and the KBS appeared to support these. It appears that interventions which make routinely collected data more understandable and readily usable by health service managers can lead to improvements in the delivery of health services.
Effective health information services require action on three major levels: identifying and acquiring appropriate resources; applying appropriate methodologies for management of information and its communication; and stimulating local initiatives and applications. WHO's Programme of Library and Health Literature Services proposes its methodologies and products for creating and improving effective information services to health workers.
The prerequisite for future development and assessment of serial electrocardiographic analysis programs is the availability of easy to use database management systems for storage and retrieval of electrocardiographic data and results and efficient means for electronic interchange of digital electrocardiographic data. The basic aim of project 2026 of the European program for advanced informatics in medicine is to encourage "open European data interchange and processing for electrocardiography" (OEDIPE) and to provide objective decision support techniques in the field of quantitative electrocardiology. The final objective is to develop demonstration systems for the follow-up evaluation of (1) selected populations with heart disease, (2) integrating serial analysis, (3) decision support, (4) open databases, and (5) communication protocols, which will foreshadow large-scale monitoring of ambulatory or critically ill patients at home, during their transportation in an emergency vehicle, or during their stay in a hospital. The first-year objectives and achievements of the OEDIPE project are briefly described. Emphasis is put on the management of serial electrocardiographic records and data and on the control strategies for the management of the serial analysis process.
In July-August 1992, a directory was made of research projects on socio-behavioural aspects of HIV infection and AIDS in Zimbabwe. A total of 92 research projects were identified, most of which were already completed. Whilst there was a wide variety of topics, populations and geographical areas covered, there was a strong bias towards AIDS awareness and knowledge, attitudes and practices (KAP) studies. Many of these were not linked with any specific AIDS prevention programme or with policy making. Suggestions are given to make better use of existing scientific information. A call is made upon researchers to conduct action-oriented studies and to consult HIV/AIDS programme implementers when specifying 'researchable' problems, so as to increase the likelihood that the study results will indeed have an impact on policy making and programme implementation.
Surveillance is the foundation of public health practice. This review examines the experience of surveillance in the Expanded Programme on Immunization (EPI). Surveillance systems include routine reporting, sentinel surveillance, and community-based reporting. Data from ongoing surveillance should be linked with those from supervision, health facility assessments, population surveys, and outbreak investigations to provide information for programme planning, implementation, evaluation, and modification. Evaluation of surveillance systems should assess the extent to which data are used for policy-making and programme improvement, and the simplicity, accuracy, completeness, timeliness and cost of the data. The surveillance of vaccine-preventable diseases has evolved as programmes mature, to monitor progress towards disease control targets. The establishment of goals to reduce measles cases by 90%, eliminate neonatal tetanus, and eradicate poliomyelitis has put increased emphasis on the need for effective disease surveillance. This opportunity should be taken to promote strengthening of national routine systems for disease surveillance, to make them effective instruments for prevention and control of diseases of public health importance.
In order to improve the efficiency of the collection, compilation and dissemination of information on 35 communicable diseases in China's Sichuan Province, a computerized network has been established. In 1987 a microcomputer link was set up between the Provincial Health and Anti-epidemic Centre at Chengdu and the Health Information Centre in Beijing, and in 1990 a microcomputer network was established between Chengdu and the 21 prefectures in the province. Substantial progress in disease control is already apparent as a consequence of these developments.
The provision of technical information on health in developing countries is discussed, with particular reference to the Diarrhoeal Diseases Information Services Centre in Bangladesh. Progress towards meeting the pressing needs of the Third World in this field can undoubtedly be made by increasing the use of micrographic, computer and videodisc technologies and by reorganizing and promoting the facilities on offer.
Health service restructuring in South Africa provides an opportunity to introduce appropriate Health Information System (HIS) technology. This is particularly relevant given the emerging HIV epidemic and the need to capture, translate and disseminate new experiences in HIV/AIDS care, support and clinical research. In 1994, a number of clinicians and health-care providers working in South Africa had begun to establish basic computerized databases to assist in research on HIV, but no standardized nomenclature or framework for collaboration was created. This paper describes a clinical and research database that could be used as an example for a standardized system by clinicians working in South Africa. The authors, with assistance from the National AIDS Research Programme of the Medical Research Council, created a prototype relational database using Microsoft Access. To test the prototype, 1057 HIV-positive patients from the infectious Disease Clinic at Johannesburg General Hospital were entered.
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An interactive system for the storage, retrieval and analysis of numerous clinical data is described. Due to the simple structure of the dialogue, no special knowledge of computer handling is required by the experimenter. The program is written for the Hewlett-Packard HP-41C pocket calculator and is suitable for a number of moderately sized experiments.
MOTIVATION: International sequencing efforts are creating huge nucleotide databases, which are used in searching applications to locate sequences homologous to a query sequence. In such applications, it is desirable that databases are stored compactly, that sequences can be accessed independently of the order in which they were stored, and that data can be rapidly retrieved from secondary storage, since disk costs are often the bottleneck in searching. RESULTS: We present a purpose-built direct coding scheme for fast retrieval and compression of genomic nucleotide data. The scheme is lossless, readily integrated with sequence search tools, and does not require a model. Direct coding gives good compression and allows faster retrieval than with either uncompressed data or data compressed by other methods, thus yielding significant improvements in search times for high-speed homology search tools.
"The purpose of this paper is to define the data processing methods that will be used in the 1990 population censuses in the different countries of Latin America.... The countries are divided into four groups, and procedures and methodologies are suggested for each of the main eight stages of a census processing." In general, microcomputers are recommended at the initial stages of processing census data, with the exception of data entry for populations over 10 million, for which the utilization of optical readers is recommended. For the final stages of consistency, tabulation, and data base management, microcomputers are recommended only for populations less than a million. (SUMMARY IN ENG)
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Morbidity and mortality data are necessary bases for the decision-making processes relevant to allocation of public funds for animal disease diagnoses and research. A system for information storage and retrieval capable of handling diagnostic data such as results of microbiology, parasitology, necropsy, and histopathology as well as demographic data such as owner, species, sex, breed, or geographic origin of the animal is described. This information is available to veterinarians, epidemiologists, herdsmen, and others involved in disease prevention or control efforts. The system described utilizes natural language, thus overcoming difficulties encountered in systems with numerical intermediates. Used and revised for the last 10 years, the system described has proved useful for annual administrative quantitation of services performed. In fact, the Concordance Index serves as the annual report of the University of Missouri Veterinary Medical Diagnostic Laboratory. Having accurate detailed information on individual cases, as well as a variety of composite data, has been extremely helpful in the documentation necessary for attracting funding for study of specific disease states.
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Operational concerns, coupled with rising workers' compensation costs and the proliferation of regulatory requirements, call for a new approach to occupational health data base management. To meet this challenge, an automated system to store and manage worker and workplace exposure data is being developed. The system will include individual minicomputers at local Air Force bases and a central host computer for long-term storage and retrieval. The first step in establishing this data base is the standardization of data entry and storage at base level. This manual system, known as the Standardized Occupational Health Program (SOHP), serves as the basic building block for the Computerized Occupational Health Program (COHP). Standardization and automation of all relevant industrial hygiene, occupational medicine, and environmental data will significantly enhance the flow of information needed by those charged with providing a healthful work environment for Air Force personnel.