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PubMedDate not supplied

[Cross infection in a high risk nursery: comparison of two epidemiologic surveillance methods].

Two methods of surveillance for nosocomial infection--routine notification and active case finding--were compared during three consecutive months at the high risk newborn unit of the Hospital de Base of the Federal District, involving 66 newborns, which represented 93% of the total patient population referred to that unit for specialized care. Our purpose was to measure the efficiency of routine notification. While this method involved infection notification forms routinely filled by the physician at discharge time, active surveillance consisted of physical examination and chart review of all the newborns, carried out, independently, twice a week: routine notification estimated a 27.3 per cent prevalence rate, versus a 30.3 per cent by active-case finding, considered by the authors a superior surveillance method. Although infection rates were similar, routine surveillance resulted in many false-positive and false-negative notifications, reaching a sensitivity of 60.0 per cent and a specificity of 86.9 per cent. The resulting positive predictive value was 66.7 per cent and negative, 83.3 per cent. The data collected by routine notification was often incomplete and inconsistent. In conclusion, the results seem to indicate that control programs based solely on routine surveillance could be producing inaccurate nosocomial infection rates and, consequently inadequate control measures.

Analysis of Variance↗
PubMedDate not supplied

[Surveillance of health status in an agrarian environment: proposal for a method. 1. Epidemiological data].

In order to evaluate the risk of the exposure of the pesticides and N-nitroso compounds in the agricultural environment not only farm-hands have to be considered but also their families. So it is necessary to prepare survey methodologies to examine the state of health of all individuals who are exposed to same kind of risk (pesticides and nitroso compounds), even if in different ways and intensity. We have therefore chosen four farms situated on the same territory which cultivate vegetables. Three, of these farms, made wide use of pesticides and fertilizers, the fourth one was used as a "control farm" because it did not employ any chemicals. For every farm data about the neighbouring territory, the climate, the kind of cultivation, the pesticides and other employed chemicals were collected. Every subject (in all 25) residing in the farm was interviewed with a standard questionnaire about personal data, the duties performed on the farm, the way in which chemicals were used, their medical history as well as the life style. Samples of blood were drawn periodically in different seasons, over a two year period, to determine both nitrosoamine (NA) and the enzymes which reveal hepatic damage: Alkaline phosphatase (ALP), Leucinoaminopeptidase (LAP), Gamma-glutamyltransferase (GGT) and Acetylcholinesterase (Ach). We have observed that: a. the most frequent pathologies concern skin (16% of the people) and liver (12% of the people), which are favourite targets for agricultural chemicals though the serum enzymes did not show any important change; b. 8% of the subjects had acute pesticide poisoning; we therefore observed neither particular precautionary safety measures, nor a particular knowledge of acute and chronic toxic effects depending on the use of pesticides. So we suggest: 1) that the Sanitary Authorities control the state of health not only of the farm-hands but also of their families, if exposed to risk; this can be realized through the strict collaboration of the Occupational Physician and the Family doctor; 2) capillary action of health education regarding agricultural risks; 3) to increase research to find more sensitive and efficient biological indicators in order to evaluate the hazards of agricultural chemicals.

Adult↗
PubMed1989

[A questionnaire method of epidemiological testing].

The predictive value of risk factors of colorectal cancer was studied on the basis of the results of a complex epidemiologic survey aimed at identifying risk groups. An optimal combination of these factors and the multi-factor technique of mathematical statistics were used in working out a decision instruction enabling one to select persons at high risk of colorectal cancer with an 80.7 per cent credibility. The study indicated the efficacy of the proposed technique for setting up risk groups during screening procedures.

Adult↗
PubMed1988

[Is it necessary to promote leadership in nursing for the advancement of teaching-inservice programs?].

The author provides some material for reflection on the issue of developing leadership in the health sector; in this case, in the specific area of nursing. Within this context, her proposition is that leadership is a process which comprises different levels of development, having an individual and collective dimension as well as conceptual, methodological and operational aspects. She proposes the adoption of policies which would point to the need of encouraging nurses to play an effective role in the processes that lead to the making of important decisions in the sector; she advocates that nurses participate in drawing up national health plans and in the management of community health services. It is pointed out that "the power of nursing as a profession lies in its practice"; this entails the need for basic changes, both in services and in the area of education, if the leadership position that has emerged in several countries during the last decade is to be strengthened. Lastly, the article suggests that in order to strengthen nurses' potential leadership and managerial skills, they should begin to receive leadership training at the undergraduate level, thus awakening in the students the greatest possible interest in the scientific method and in the epidemiological method for the analysis of health and related problems.

Decision Making↗