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Impact of the Minnesota Parental Notification Law on abortion and birth.

BACKGROUND: The impact of the Minnesota Parental Notification Law on abortion and birth was examined. METHODS: Using linear models, outcome parameters were compared before and after enactment of the law. Time by age group interactions also were examined. RESULTS: The pre-enactment to post-enactment change in the Minnesota abortion rate reflected a greater decline for minors (less than or equal to 17 years old) than for 18-19 year-olds (who were not under the law). An increase in abortion rate occurred for women ages 20-44. The law appeared to have had no impact on birth rate in minors. Following the enactment of the law, the rate of early abortions (less than or equal to 12 weeks) declined among minors more than the rate of late abortions (greater than 12 weeks). This resulted in a pre-enactment to post-enactment increase in the ratio of late-to-early abortions among minors. CONCLUSIONS: These data suggest that parental notification facilitated pregnancy avoidance in 15-17 year-old Minnesota women. Abortion rates declined unexpectedly while birth rates continued to decline in accordance with a long-term trend.

Abortion, Legal↗

STD screening, testing, case reporting, and clinical and partner notification practices: a national survey of US physicians.

OBJECTIVES: This study presents results from a national survey of US physicians that assessed screening, case reporting, partner management, and clinical practices for syphilis, gonorrhea, chlamydia, and HIV infection. METHODS: Surveys were mailed to a random sample of 7300 physicians to assess screening, testing, reporting, and partner notification for syphilis, gonorrhea, chlamydia, and HIV. RESULTS: Fewer than one third of physicians routinely screened men or women (pregnant or nonpregnant) for STDs. Case reporting was lowest for chlamydia (37 percent), intermediate for gonorrhea (44 percent), and higher for syphilis, HIV, and AIDS (53 percent-57 percent). Physicians instructed patients to notify their partners (82 percent-89 percent) or the health department (25 percent-34 percent) rather than doing so themselves. CONCLUSIONS: STD screening levels are well below practice guidelines for women and virtually nonexistent for men. Case reporting levels are below those legally mandated; physicians rely instead on patients for partner notification. Health departments must increase collaboration with private physicians to improve the quality of STD care.

Adult↗

Foodborne disease in Australia: incidence, notifications and outbreaks. Annual report of the OzFoodNet network, 2002.

In 2002, OzFoodNet continued to enhance surveillance of foodborne diseases across Australia. The OzFoodNet network expanded to cover all Australian states and territories in 2002. The National Centre for Epidemiology and Population Health together with OzFoodNet concluded a national survey of gastroenteritis, which found that there were 17.2 (95% C.I. 14.5-19.9) million cases of gastroenteritis each year in Australia. The credible range of gastroenteritis that may be due to food each year is between 4.0-6.9 million cases with a mid-point of 5.4 million. During 2002, there were 23,434 notifications of eight bacterial diseases that may have been foodborne, which was a 7.7 per cent increase over the mean of the previous four years. There were 14,716 cases of campylobacteriosis, 7,917 cases of salmonellosis, 505 cases of shigellosis, 99 cases of yersiniosis, 64 cases of typhoid, 62 cases of listeriosis, 58 cases of shiga toxin producing E. coli and 13 cases of haemolytic uraemic syndrome. OzFoodNet sites reported 92 foodborne disease outbreaks affecting 1,819 persons, of whom 5.6 per cent (103/1,819) were hospitalised and two people died. There was a wide range of foods implicated in these outbreaks and the most common agent was Salmonella Typhimurium. Sites reported two outbreaks with potential for international spread involving contaminated tahini from Egypt resulting in an outbreak of Salmonella Montevideo infection and an outbreak of suspected norovirus infection associated with imported Japanese oysters. In addition, there were three outbreaks associated with animal petting zoos or poultry hatching programs and 318 outbreaks of suspected person-to-person transmission. Sites conducted 100 investigations into clusters of gastrointestinal illness where a source could not be identified, including three multi-state outbreaks of salmonellosis. OzFoodNet identified important risk factors for foodborne disease infection, including: Salmonella infections due to chicken and egg consumption, bakeries as a source of Salmonella infection, and problems associated with spit roast meals served by mobile caterers. There were marked improvements in surveillance during 2002, with all jurisdictions contributing to national cluster reports, increasing use of analytical studies to investigate outbreaks and 96.9 per cent of Salmonella notifications on state and territory surveillance databases recording complete information about serotype and phage type. During 2002, there were several investigations that showed the benefits of national collaboration to control foodborne disease. Sharing surveillance data from animals, humans and foods and rapid sharing of molecular typing information for human isolates of potentially foodborne organisms could further improve surveillance of foodborne disease in Australia.

Adolescent↗

Tuberculosis notifications in Australia, 2003.

The National Notifiable Disease Surveillance System (NNDSS) received 982 tuberculosis (TB) notifications in 2003, of which 947 were new cases, 33 were relapses and two were cases with unknown history. The incidence of TB in Australia has remained at a stable rate since 1985 and was 4.9 cases per 100,000 population in 2003. The high-incidence groups remain people born overseas and Indigenous Australians at 19.9 and 8.7 cases per 100,000 population, respectively. By contrast the incidence in non-Indigenous Australians was 0.9 per 100,000. Comparison of the 2003 TB notification data against the performance indicators set by National Tuberculosis Advisory Committee highlights that enhanced TB control measures should be considered among these high-risk groups.

Adolescent↗

Tuberculosis notifications in Australia, 2004.

The National Notifiable Disease Surveillance System received 1,076 tuberculosis (TB) notifications in 2004, of which 1,043 were new cases and 33 were relapses. The incidence of TB in Australia has remained at a stable rate since 1985 and was 5.4 cases per 100,000 population in 2004. The high-incidence groups remain people born overseas and Indigenous Australians at 21.7 and 8.1 cases per 100,000 population, respectively. By contrast, the incidence of TB in the non-Indigenous Australian-born population was 1.0 cases per 100,000 population. Comparison of the 2004 TB notification data against the performance indicators set by National Tuberculosis Advisory Committee highlights that enhanced TB control measures should be considered among these high-risk groups.

Adolescent↗

Notifications of imported malaria in Western Australia, 1990-2001: incidence, associated factors and chemoprophylaxis.

OBJECTIVE: To assess changes in and factors associated with recent malaria notifications in Western Australia (WA). DESIGN: Retrospective analysis of the WA Notifiable Infectious Diseases Database and enhanced surveillance questionnaires completed by attending medical practitioners. PATIENTS: Cases of malaria notified between January 1990 and December 2001. MAIN OUTCOME MEASURES: Annual notifications by demographic variables (including age, sex, occupation and place of residence), region/country of acquisition, chemoprophylaxis used, Plasmodium species and outcome. RESULTS: 482 patients were notified (mean age, 31 years; 80% male); 57% lived in Perth, 31% in country areas and 12% in an immigration detention centre. Comparison between the 6-year periods 1990-1995 and 1996-2001 showed that Plasmodium falciparum cases increased from 29 (14%) to 108 (44%; P < 0.001), while Plasmodium vivax cases decreased from 157 (77%) to 122 (50%; P < 0.001); immigrants in detention, defence force personnel and cases from Africa were increasingly represented (P < 0.05 in each case). Only 31% of patients took regular chemoprophylaxis and, among these, the regimen was appropriate in only a quarter. There was a median period of 3 days between symptom onset and diagnosis. One patient died. CONCLUSIONS: There has been an increase in P. falciparum cases in WA since 1990. This reflects the influx of immigrants in detention, deployment of military personnel to East Timor and increasing numbers of cases from Africa. A significant number of Australian travellers who developed malaria had not taken chemoprophylaxis either regularly or at all, and, of those who had, the regimen was inadequate in most.

Adolescent↗

[Measles epidemiology in the Netherlands: a exploratory analysis of notification].

OBJECTIVE: Explorative analysis of the effects of vaccination policy on measles incidence. DESIGN: Retrospective study and mathematical modelling. METHOD: Analysis of national and regional case notifications of measles provided by the Inspectorate of Health in the Netherlands over the period from January 1976 (when vaccination was started) through September 1999. Also computer simulations with a mathematical epidemic model of measles were used to calculate the incidence of measles from 1976 onwards. RESULTS: According to the model results, measles should not persist with the current vaccination programme. However, the case notification data showed that measles appeared to persist at a nation-wide level. At a regional level, measles did not persist, not even in regions with low vaccine coverage. A possible cause of the unexpected persistence at the national level is the asynchronous regional course of the 6-year epidemic cycle of measles, where measles infection 'jumps' from one region to the other.

Child↗

Development of a computer linkage system for a blood recipient notification program in Nova Scotia.

OBJECTIVES: To assess the potential uses of computer-assisted record linkage in the surveillance of infectious diseases, using the Nova Scotia blood recipient notification program as the example. METHODS: We developed a computer-assisted, multiple-pass, probabilistic record linkage to link records for blood recipients identified by the Nova Scotia notification program (Nova Scotia Phase I Blood Bank File information) with corresponding Nova Scotia Health Card Registration File records to obtain current mailing addresses to contact potentially living recipients. We used variables available from both files (e.g., name, date of birth, gender, and health care registration number) to link records, after eliminating duplicates/deceased cases. RESULTS: Among 23,925 eligible records in the Nova Scotia Phase I Blood Bank File (1984-1990), there were 1,818 (7.8%) duplications and 8,675 deceased cases, leaving 13,432 cases for linkage. 8,713 (65%) cases were successfully linked to the 1998 Health Card Registration Data File for current mailing addresses. INTERPRETATION: Multiple-pass linkage seems acceptable for maximizing detection of correctly matched records for look-back projects. To overcome quality/lack of information obstacles, future look-back linkages should explore the use of supplementary data files (tax files, voter lists, license files, other provincial databases) to obtain most current addresses.

Disease Notification↗

[Notification rate of TB in Japan (1949-2001)].

Notification of TB cases was introduced since 1947 in Japan, and statistics on notified TB cases by sex and age groups was available since 1949. Sex and age specific TB notification rates per 100,000 from 1949 to 2001 were tabulated together with the number of notified TB cases since 1969.

Age Factors↗

Food poisoning notification: time for a rethink.

The notification of food poisoning is a statutory obligation of medical practitioners in the United Kingdom. Its objectives and methods are vague and ill documented, and the value of its output doubtful. Statutory notification of food poisoning is poor at identifying outbreaks, or single cases of severe disease, or as a measure of longer term trends. It should be fundamentally reformed.

Disease Notification↗

Trends in viral meningitis hospitalisations and notifications in the North Eastern Health Board (1997 - 2001): a cause for concern?

This study aimed to compare trends in both hospital admissions and notifications of viral meningitis in the North Eastern Health Board (NEHB). Hospital admissions from 1997 to 2001, involving NEHB residents with an infectious disease diagnosis, were examined and viral meningitis cases were analyzed. During this period 265 NEHB residents were admitted to hospital with viral meningitis--an increase of 429% between 1997 and 2001 with the bulk of this increase during 2000 and 2001. A total of 1,234 bed days were taken up by this cohort and the mean length of stay was 4.5 days (95% CI 4.2 - 4.9). The number of viral meningitis notifications in the NEHB was 38 (ranging from 4 in 1997 to 11 in 2001). This number is much lower than expected given the corresponding number of hospital admissions for the same period. Thus, most cases were not notified which means that current surveillance systems under-estimate the disease burden of viral meningitis. Such under-reporting has implications for infectious disease policy in Ireland.

Adolescent↗

Audit of the detection and notification of meningococcal disease at a North London university district hospital.

The microbiology department at a North London hospital audited notifications of suspected meningococcal disease in response to a reported high rate, which it suspected was due to over-reporting out of hours to public health specialists. All cases notified over a 14-month period were assessed with regards to time of reporting and subsequent microbiological confirmation. Of 36 notifications, 18 were confirmed as bacterial, mostly meningococcal meningitis. Of the four types of sample readily obtainable on admission (blood culture, ethylene diamine tetra-acetic acid [EDTA] blood sample, throat swab and acute serum) all were obtained in only two cases. The reporting was considered appropriate, reflecting the relatively high incidence of meningococcal disease (MD) within the local population. Further cases might perhaps have been laboratory confirmed had all samples been sent on admission. A single form requesting all four samples in suspected meningococcal disease cases is recommended. Informing public health specialists out of hours could be rationalised.

Adolescent↗

Accident experience and notification rates in people with recent seizures, epilepsy or undiagnosed episodes of loss of consciousness.

Collaborating neurologists provided a central office with clinical information, driving experience and accident rates in all drivers they counselled after diagnosing seizures or other unexplained episodes of loss of consciousness. Each patient received and was asked to return a notification slip to DVLA. Of 638 patients counselled, 11% had been involved as a driver in a road traffic accident in the previous year. Six patients had been involved in an accident producing serious injury. These estimates do not differ from those expected in a population of non-epileptic drivers with the same age and sex distribution. Of patients counselled, 27.1% returned a reply slip to the DVLA. Notification was more likely if the patient was aged 50 or over at the time of counselling, if the counselling was undertaken by a consultant, if an accident had occurred in the previous year and if the subject had also been advised to start or was already taking anti-epileptic drugs. Patients counselled after a single seizure were more likely to notify than those with a diagnosis of epilepsy.

Accidents, Traffic↗

Notification of pesticide poisoning in the western Cape, 1987-1991.

There is a paucity of data on pesticide-related morbidity and mortality in South Africa. A review of notifications to the western Cape office of the Department of National Health and Population Development from 1987 to 1991 was undertaken to describe the epidemiological profile of pesticide poisoning in the region. Two hundred and twenty-five cases of pesticide poisoning were identified, of which the majority were from rural areas. Farmers, farm workers and their families were most frequently involved in poisoning events, which included accidents arising outside of workplace production (44%), self-inflicted injury (35%) and direct occupational contamination (11%). Farm pesticide stores were the most frequent source of pesticide and a seasonal variation in the trend of poisoning events could be discerned; this corresponded to agricultural spraying practices in the region. The mortality rate was significantly higher among those with self-inflicted injury, particularly farm workers. A concurrent review of hospital admissions for 1991 found that 78% of cases had not been notified. In view of the key role of surveillance in reducing pesticide-related morbidity and mortality, a call is made to improve notification of pesticide poisoning so as to facilitate control of an important potential public health problem.

Adolescent↗

[Experiences with the Swiss mandatory disease notification].

Advantages and setbacks of the existing Swiss disease notification system are reviewed. The public takes interest in the notification data output. The voluntary sentinels provide useful early warning. Currently, 60 conditions are notifiable. It is intended to lower this number to < 30. Other measures to upgrade the system include annual review and publication of an updated list of notifiable diseases, limitation to an essential core of parameters collected from physicians on initial and follow-up questionnaires, and practical advice on diagnostic and control measures provided for in questionnaires for the infectious disease under query.

Disease Notification↗

Perspective on the content of worker notifications.

The concept of worker notification has evolved over the years to a prevailing view that workers should be notified of all epidemiologic studies that make use of their medical information. To adequately communicate health information to workers, epidemiologists must consider the intended audience along with its need for risk information that is scientifically valid and clearly outlines areas of uncertainty. This goal is facilitated by full disclosure to workers of information pertinent to the planning, conduct, and interpretation of research efforts. Subjectivity in choosing unanticipated research findings for inclusion in worker notifications may permit bias toward a personal viewpoint, but this can be minimized by prestudy agreement on appropriate criteria for selecting which research findings to communicate. Epidemiologic theory and principles of causal inference should guide the development of appropriate criteria. The timeliness of worker communications has received limited attention, and workers have often been the "last to know" about important studies. This may influence workers' receptivity to the risk message. Sponsoring organizations should ensure that an acceptable communications plan is included in research protocols and that the plan accords priority to notifying workers about study results.

Causality↗

Social aspects of high-risk notification among chromium-exposed workers.

This study, based on 169 telephone interviews, explores how a sample of chromium-exposed workers responded to notification of their cohort's elevated risk of lung cancer. It is important to recognize that notified workers do not react as isolated individuals. Their responses are social, actively constructed through interaction with others, unfolding over time within a context of relationships and shared symbols that mediate the risk information. This report illustrates some of the ways that socially-based beliefs and interaction with the social environment can influence worker response, and suggests a more sociologically sophisticated concept of notification to fit the realities of workers' lives.

Adult↗

Evaluation issues in the Drake Chemical Workers Notification and Health Registry Study.

The Drake Chemical Workers' Health Registry combined notification of workers about bladder cancer risk with access to a free program for screening and diagnosis. Evaluation of the project has given rise to several findings and new research questions. Findings in this article illustrate the following evaluation issues: 1) studying the combination of strategies that are most effective and cost effective to notify workers of their disease risks, 2) determining the realistic yield from strategies to gain participation in health screening and other protective services for notified workers, 3) identifying the notification strategies that were most effective for different kinds of participants, 4) using process evaluation to identify key activities for ensuring continued participation of cohort members in screening, and 5) examining the extent to which participants are willing to quit smoking to protect their health.

2-Naphthylamine↗