Professional Documents
Culture Documents
With the aging of the population and the increasing patient preference for
receiving care in their own homes, remote home care is one of the fastest growing
areas of health care in Taiwan and many other countries. Many remote home-
monitoring applications have been developed and implemented to enable both
formal and informal caregivers to have remote access to patient data so that they
can respond instantly to any abnormalities of in-home patients. The aim of this
technology is to give both patients and relatives better control of the health care,
reduce the burden on informal caregivers and reduce visits to hospitals and thus
result in a better quality of life for both the patient and his/her family. To facilitate
their widespread adoption, remote home-monitoring systems take advantage of
the low-cost features and popularity of the Internet and PCs, but are inherently
exposed to several security risks, such as virus and denial-of-service (DoS)
attacks. These security threats exist as long as the in-home PC is directly
accessible by remote-monitoring users over the Internet. The purpose of the study
reported in this paper was to improve the security of such systems, with the
proposed architecture aimed at increasing the system availability and
confidentiality of patient information. A broker server is introduced between the
remote-monitoring devices and the in-home PCs. This topology removes direct
access to the in-home PC, and a firewall can be configured to deny all inbound
connections while the remote home-monitoring application is operating. This
architecture helps to transfer the security risks from the in-home PC to the
managed broker server, on which more advanced security measures can be
implemented. The pros and cons of this novel architecture design are also
discussed and summarized.
Publication Types:
Using geographical information systems (GIS) tools, the present study analyzed
the association between children's lung function development and their long-term
exposure to air pollution. The study covered the cohort of 1492 schoolchildren
living in the vicinity of a major coal-fired power station in the Hadera sub-district
of Israel. In 1996 and 1999, the children underwent subsequent pulmonary
function tests (PFT) (forced vital capacity (FVC) and forced expiratory volume
during the first second (FEV(1))), and the children's parents completed a detailed
questionnaire on their health status and household characteristics. A negative
association was found between changes in the results of PFT and the estimated
individual levels of air pollution. A sensitivity test revealed a FEV(1) decline
from -4.3% for the average pollution level to -10.2% for the high air pollution
level. The results of a sensitivity test for FVC were found to be similar.
Association with the reported health status was found to be insignificant. As we
conclude, air pollution from a coal-fired power station, although not exceeding
local pollution standards, had a negative effect on children's lung function
development. As argued, previous studies carried out in the region failed to show
the above association because they were based on zone approaches that assign
average concentration levels of air pollutants to all individuals in each zone,
leading to a misclassification bias of individual exposure.
Publication Types:
Kawakami T.
ILO Subregional Office for East Asia, United Nations Building, Rajadamnern
Nok Avenue, Bangkok 10200, Thailand.
Many workers in Asia are in the informal economy. They often work in
substandard conditions, exposed to hazards in the workplace. Learning from the
recent successes of participatory training programmes to improve safety and
health in Asia, the ILO has strengthened its partnership efforts with local people
to improve safety and health of informal economy workplaces. The target groups
were: (1) home workplaces in Cambodia and Thailand, (2) salt fields and fishing
villages in Cambodia where many young workers are working, and (3) small
construction sites in Cambodia, Laos, Mongolia, Thailand and Vietnam. The
walk-through survey results showed that the workers and owners in the target
informal economy workplaces had the strong will to improve safety and health at
their own initiatives and needed practical support. In the participatory, action-
oriented training workshops carried out, the participated workers and owners were
able to identify their priority safety and health actions. Commonly identified were
clear and safe transport ways, safer handling of hazardous substances, basic
welfare needs such as drinking water and sanitary toilets, and work posture. The
follow-up visits confirmed that many of the proposed actions were actually taken
by using low-cost available materials. These positive changes were possible by
applying the participatory training tools such as illustrated checklists and
extensive use of photographs showing local good examples and placing emphasis
on facilitator roles of trainers. In conclusion, the target informal economy
workplaces in Asia made positive changes in safety and health through the
participatory, action-oriented training focusing on local initiative and low-cost
improvement measures. Local network support mechanisms to share lessons from
good practices played essential roles in encouraging the voluntary implementation
of practical improvement actions. It is important to increase our joint efforts to
reach more informal economy workplaces in industrially developing countries
and provide practical support measures focusing on local self-help initiatives.
Publication Types:
• Research Support, Non-U.S. Gov't
PulseNet USA, the national molecular subtyping network for foodborne disease
surveillance, began functioning in the United States in 1996 and soon established
itself as a critical early warning system for foodborne disease outbreaks,
particularly those in which cases may be geographically dispersed. The PulseNet
network is now being replicated in different ways in Canada, Europe, the Asia
Pacific region, and Latin America. These independent networks work together in
PulseNet International allowing public health officials and laboratorians to share
molecular epidemiologic information in real-time and enabling rapid recognition
and investigation of multi-national foodborne disease outbreaks. Routine
communication between the various international PulseNet networks will provide
early warning on foodborne disease outbreaks to participating public health
institutions and countries.
Afifi MM.
The study aimed to identify mental health publications in Arab countries cited in
PubMed from 1987 to 2002 and to analyse the year of publication, journal and
field of research, specifically for child and adolescent mental health studies. A
PubMedsearch was performed for all mental health publications followed by an
analysis of child and adolescent mental health citations. The total number of
mental health research citations published in Arab countries over the last 15 years
was 338, 1.2% of the total number of citations for biomedical research; 17% were
on child and adolescent mental health. The most dynamic fields of mental health
research are anxiety and mood disorders and substance abuse. Child psychiatry,
especially attention deficit hyperactivity disorder and child autism, are not gaining
much interest from Arab researchers.
Vymetal S.
Lin LC.
AIM: The purpose of this paper is to compare and contrast the systems of risk
management between a hospital in the USA and a hospital in Taiwan.
BACKGROUND: By comparing both systems, nurses and managers will have a
better understanding of risk management improvements and be in a better position
to protect their patients and themselves. EVALUATION: Two interviews were
conducted and literature were collected and reviewed by the author to support the
argument. The gathered information was analysed to demonstrate the strengths
and weaknesses of both hospital systems. KEY ISSUES: Although risk
management is not difficult to understand, nurses and managers usually pay
insufficient attention to it. CONCLUSION: Health care providers should work as
a team to complete risk assessment and management in their workplaces. There
are weaknesses to be improved and strengths to be continued and addressed in
Taiwan and in the USA.
Publication Types:
• Comparative Study
• Research Support, Non-U.S. Gov't
PMID: 16600011 [PubMed - indexed for MEDLINE]
Publication Types:
• Comparative Study
Ali M, Park JK, von Seidlein L, Acosta CJ, Deen JL, Clemens JD.
International Vaccine Institute, SNU Research Park, San 4-8 Bongcheon-7 dong,
Kwanak-gu, Seoul, Korea. mali@ivi.int
Publication Types:
PMCID: PMC1450272
613: Bull World Health Organ. 2006 Mar;84(3):239-45. Epub 2006 Mar 22.
Related Articles, Links
Cause-of-death data derived from verbal autopsy (VA) are increasingly used for
health planning, priority setting, monitoring and evaluation in countries with
incomplete or no vital registration systems. In some regions of the world it is the
only method available to obtain estimates on the distribution of causes of death.
Currently, the VA method is routinely used at over 35 sites, mainly in Africa and
Asia. In this paper, we present an overview of the VA process and the results of a
review of VA tools and operating procedures used at demographic surveillance
sites and sample vital registration systems. We asked for information from 36
field sites about field-operating procedures and reviewed 18 verbal autopsy
questionnaires and 10 cause-of-death lists used in 13 countries. The format and
content of VA questionnaires, field-operating procedures, cause-of-death lists and
the procedures to derive causes of death from VA process varied substantially
among sites. We discuss the consequences of using varied methods and conclude
that the VA tools and procedures must be standardized and reliable in order to
make accurate national and international comparisons of VA data. We also
highlight further steps needed in the development of a standard VA process.
Publication Types:
614: Bull World Health Organ. 2006 Mar;84(3):233-8. Epub 2006 Mar 22.
Related Articles, Links
This study evaluates the collection and flow of mortality and cause-of-death
(COD) data in Thailand, identifying areas of weakness and presenting potential
approaches to improve these statistics. Methods include systems analysis,
literature review, and the application of the Health Metrics Network (HMN) self-
assessment tool by key stakeholders. We identified two weaknesses underlying
incompleteness of death registration and inaccuracy of COD attribution: problems
in recording events or certifying deaths, and problems in transferring information
from death certificates to death registers. Deaths occurring outside health
facilities, representing 65% of all deaths in Thailand, contribute to the inaccuracy
of cause-of-death data because they must be certified by village heads with
limited knowledge and expertise in cause-of-death attribution. However, problems
also exist with in-hospital cause-of-death certification by physicians. Priority
should be given to training medical personnel in death certification, review of
medical records by health personnel in district hospitals, and use of verbal
autopsy techniques for assessing internal consistency. This should be coupled
with stronger collaboration with district registrars for the 65% of deaths that occur
outside hospitals. Training of physicians and data coders and harmonization of
death certificates and registries would improve COD data for the 35% of deaths
that take place in hospital. Public awareness of the importance of registering all
deaths and the application of registration requirements prior to funerals would
also improve coverage, though enforcement would be difficult.
Publication Types:
Comment on:
Publication Types:
• Comment
• Letter
The objective of this survey was to obtain a self-reported assessment of the use of
information technology (IT) by final year medical students. Two hundred and
sixty five students responded to a questionnaire survey. 81.5% of students
considered their computer skills adequate, while 87.9% had access to computers
outside the campus. Most students reported adequate skills at word processing, e-
mailing and surfing the Internet. Fifty three percent of students spent three hours
or more each week on the computer. While students indicated a general
willingness to access Internet-based materials, further steps need to be taken to
increase the use of this method of instruction.
YR Gaitonde Cente for AIDS Research and Education, Chennai, Tamil Nadu,
India.
Comment in:
Karam EG, Mneimneh ZN, Karam AN, Fayyad JA, Nasser SC, Chatterji S,
Kessler RC.
Publication Types:
PMCID: PMC2030488
Publication Types:
PMCID: PMC1444928
From 2000 to 2004, 36, 58, 72, 78, and 86 laboratories participated in an external
quality assessment scheme (EQAS) organized by the Department of Transfusion
Medicine, Faculty of Medicine Siriraj Hospital. Each year the staff was requested
to perform ABO grouping, D typing, antibody screening, antibody identification,
and DATs on eight blood samples. Each participant received information on the
correct test results and a coded summary. Regarding ABO grouping, the error rate
ranged from 0.3 to 1.3 percent, mostly due to human errors. Error rates in D
typing ranged from 0.7 to 5.7 percent, the most problematic being weak D
phenotype interpretation. Although every sample was negative by the DAT, error
rates due to false positive test results were determined to be 0.4 to 2.1 percent.
Antibody screening errors were also found; however, errors steadily decreased
from 4.2 percent in 2000 to 0.3 percent in 2004. Only 69.4 to 87.2 percent of
laboratories performed antibody identification; however, correct results increased
from 78.4 to 91.0 percent. In conclusion, an EQAS in RBC serology should be
used to compare results from different laboratories and to identify those
laboratories that need improvement in testing procedures.
AIM: This paper is a report of a study describing the quality of working life of
nurses in Taiwan. The purpose of the study was to gather data on which to base a
questionnaire to be used in further research. BACKGROUND: Nurses often
complain of overwork and underpay. Problems persist with nurses' job
satisfaction, stress, organizational commitment and intent to leave. 'Quality of
working life' is a system of analysing how people experience work: it relates to
job satisfaction, intent to leave, turnover rate, personality and work stress.
However, reliable information on hospital nurses' quality of working life is
limited. METHOD: A descriptive study was carried out with a convenience
sample. A total of 16 focus groups in one medical centre and five regional
hospitals informed a quality of working life framework. Each group had three to
five participants who were Registered Nurses in medical or surgical wards with at
least 2 years' nursing experience, and who held a position below assistant nurse
manager. The data were collected in 2000. FINDINGS: A total of 56 nurses'
quality of working life categories were identified and fitted into six dimensions:
socio-economic relevance, demography, organizational aspects, work aspects,
human relation aspects and self-actualization. In this paper, we focus on issues
emphasized by focus group participants. These were managing shift work within
the demands of family life; accommodation; support resources; and nurses'
clinical ladder system and salary system. CONCLUSIONS: Further research is
needed with other groups of nurses in a wider variety of settings in order to
examine strengths and weaknesses in the total healthcare work environment and
to develop appropriate strategies for nurses' quality of working life.
Sleeboom M.
BACKGROUND: Concern has been raised about the potential risks related to
radiation exposure from CT scans, particularly among children. However, to date,
there are few data available describing the magnitude of pediatric CT utilization.
OBJECTIVE: The aim of the study was to explore patterns of CT use in pediatric
patients, with respect to time, use of multiple scans, body regions imaged, and
medical diagnoses. MATERIALS AND METHODS: Records of 22,223 scans
performed on 18,075 people aged < or =18 years over the period 1999-2003,
including diagnoses recorded within 21 days after the examination, were obtained
from a large Israeli Health Maintenance Organization (1,600,000 members).
RESULTS: The highest annual CT examination rate (per 1,000) was recorded in
2001 (10.1) compared to 7.0 and 6.3 in 1999 and 2003, respectively. The lowest
rate (three scans per 1,000) was found for 3-year-old children, with increasing
rates with age. The head was the most frequently scanned region, both in young
children (78%) and adolescents (39%). Symptoms of ill-defined conditions and
injuries were documented in 22% and 10% of all scans, respectively.
CONCLUSIONS: Although the results suggest that children comprise only 3% of
all patients undergoing CT, this important modality must be carefully used
because of their increased radiosensitivity, higher effective radiation doses, and
longer life expectancy.
Publication Types:
Publication Types:
• Comparative Study
This study uses knowledge discovery concepts to analyze large amounts of data
step by step for the purpose of assisting in the formulation of environmental
policy. We performed data cleansing and extracting from existing nation-wide
databases, and used regression and classification techniques to analyze the data.
The current water hardness in Kaohsiung, Taiwan contributes to the prevention of
cardiovascular disease (CVD) but exacerbates the development of renal stones
(RS). However, to focus on water hardness alone to control RS would not be cost
effective at all, because the existing database parameters do not adequately allow
for a clear understanding of RS. Analysis of huge amounts of data can most often
turn up the most reliable and convincing results and the use of existing databases
can be cost-effective.
[Article in Japanese]
Ishikawa K.
Publication Types:
• English Abstract
This study examined nursing research performance in Taiwan from 1991 to 2004
by conducting bibliometric analysis of papers published by researchers affiliated
with nursing institutes in Taiwan. Bibliometric information of papers that were
published between 1991 and 2004 and had contact address including the words
"Taiwan", and "nursing" were downloaded from the ISI Web of Knowledge
website. The information used for this research included number of papers,
number of authors, number of references listed, impact factors of publishing
journals, times cited, and whether the paper was written through international or
domestic collaboration. The information was coded and tabulated. Bibliometric
characteristics were compared between 1995- 1999 and 2000-2004. Furthermore,
an exponential model was fitted to show the past growth trend in research outputs.
The results showed that there was a significant growth in quantity of papers from
1991 to 2004. In general, recent papers had averaged more authors, more
domestic collaboration, more international collaboration, higher impact factors,
and more references listed than earlier papers. Papers written with collaboration
tended to have a higher average number of authors and more references listed, and
tended to be published in journals with higher impact factors. The exponential
model proved to be in good fit with the past growth pattern. The authors speculate
that the recent increase in research collaboration, both internationally and
domestically, may have contributed to the significant increase in output. It is not
clear whether the growth in quantity of papers will continue or for how long.
Based on past data, however, no sign of leveling off has been observed. More
research is needed to understand what societal and individual level factors were
involved in fueling such a dramatic increase in quantity in the last decade.
Furthermore, as the quantity of papers has increased steadily, more focus can be
placed on improving the quality of research papers.
Publication Types:
• Review
Some weather and holiday seasons are associated with increased incidence of
acute myocardial infarction (AMI). We studied the influence of one such season,
Islamic holiday season of "Eid Al-Fitr", on the incidence of AMI in a Muslim
country. This was carried out by examining the admissions to the coronary care
unit of a large hospital over six consecutive years (from 1997 to 2003),
encompassing six consecutive holiday seasons in Kuwait. We compared the
admission rates during three time intervals in each of those 6 years; the Eid
holiday season, the 2 months before and the 2 months after. A total of 964 AMI
admissions occurred, with a mean age of 55 years. When the admission rates were
compared, the Islamic holiday seasons were associated with a significant increase
in AMI admission rate (45 cases vs. 31 cases, p < 0.01). This increase occurred
mainly on the second day of the 4-day holiday season. This finding was
confirmed using Locally Weighted Smooth Regression (LOESS) regression
models with different smoothing levels. Our finding might have potential
implications for preventive health campaigns in Muslim countries.
BACKGROUND: Major concerns about the quality of basic hospital care for
children have been raised in developing countries, but no formal assessment
applying international standards has been done in the Commonwealth of
Independent States. METHODS: We assessed 17 hospitals in Kazakhstan, the
Republic of Moldova, and the Russian Federation with a generic WHO hospital
assessment framework adapted for use in the WHO European region. WHO
management guidelines for paediatric care in peripheral hospitals were used as
standards. FINDINGS: Hospital access for children was generally good. Good
health networks existed, and skilled and committed doctors cared for children.
Case-fatality rates were low. However, unnecessary and lengthy hospital stays
were common, and most children received excessive and ineffective treatment (in
one country median number of drugs prescribed concurrently was 5, IQR 2-6).
Several conditions were systematically overdiagnosed, especially neurological
disease, or overinvestigated, such as acute diarrhoea. Reasons for these practices
included absence of clear evidence-based clinical guidelines, regulations tying
duration of admission to financial reimbursement, generalisation of disease-
control methods from rare problems to common illnesses, and regulations
maintaining financial and professional status of some subspecialties. Many
disincentives to efficient practice existed. INTERPRETATION: To improve
quality of hospital care for children in the Commonwealth of Independent States,
several issues must be addressed, including: adoption of international guidelines
for inpatient management; complementary guidelines for outpatient management;
reforms to health regulations governing admission and discharge criteria;
improvement of quality of training, availability of medical information, and
systems to promote and certify quality of care.
Publication Types:
632: J Cancer Res Clin Oncol. 2006 Jul;132(7):439-43. Epub 2006 Mar 15.
Related Articles, Links
Publication Types:
Erratum in:
Publication Types:
• Review
This study tests whether the effect of a vaccine trial varies in space and why.
Analytical z-score maps identify unusually high- and low-efficacy values in a trial
area. Relationships between neighborhood efficacy and ecological variables are
measured to explain why efficacy varies in space. Efficacy was found to vary
regardless of neighborhood size and the variation is related to several ecological
determinants. Local efficacy measures can help public health practitioners make
better decisions about when and where to vaccinate populations. The concepts
offered in this study are pertinent for any health intervention trial, not just
vaccines.
Publication Types:
Shiloh S, Orgler-Shoob M.
[Article in Japanese]
Publication Types:
• English Abstract
Comment in:
Lin HY, Lin SP, Chen YJ, Hung HY, Kao HA, Hsu CH, Chen MR, Chang
JH, Ho CS, Huang FY, Shyur SD, Lin DS, Lee HC.
Publication Types:
• Comparative Study
• Research Support, Non-U.S. Gov't
Huang WF, Hsiao FY, Tsai YW, Wen YW, Shih YT.
BACKGROUND: Using national data (2001-2003), this study explored the risk
of acute myocardial infarction (AMI), angina, stroke and transient ischaemic
attack (TIA) in long-term users of rofecoxib and celecoxib in Taiwan and
compared this data with that for those using meloxicam. METHODS: Patients
included in the study had used celecoxib, rofecoxib or meloxicam for at least 180
days. Data were taken from National Health Insurance database for the period
from 2001 to 2003. Main outcome measurements were the occurrence of AMI,
angina, stroke or TIA after the initiation of long-term continuous use of these
drugs. Person-time exposures and hazard ratios (HRs) were calculated based on
data from 9602 eligible patients. RESULTS: In patients without a history of a
cardiovascular event within the year before drug treatment began, the overall rates
of AMI, angina, stroke and TIA were 1.1%, 0.6%, 2.0% and 0.6%, respectively.
In those with cardiovascular events in the year before treatment began, the overall
rates of AMI, angina, stroke and TIA were 5.0%, 4.8%, 6.6% and 5.8%,
respectively. Compared with meloxicam users, celecoxib users had lower HRs for
the development of AMI (HR 0.78, 95% CI 0.63, 0.96) and stroke (HR 0.81, 95%
CI 0.70, 0.93). Rofecoxib users were at no higher risk of cardiovascular events
than those receiving meloxicam. Regardless of treatment, having had a
cardiovascular event in the year before treatment began played a significant role
in the development of the same cardiovascular event during the prescription
period; the HRs associated with having had the same cardiovascular event in the
past year, versus not having had such an event, were 3.02 (95% CI 1.44, 6.32) for
AMI, 5.82 (95% CI 3.19, 10.63) for angina, 2.44 (95% CI 1.79, 3.33) for stroke
and 7.16 (95% CI 3.70, 13.87) for TIA. CONCLUSIONS: Patients taking
celecoxib had a lower risk of cardiovascular events than those taking meloxicam.
Patients taking rofecoxib were not found to be at higher cardiovascular risk than
those taking meloxicam. The most significant determinant of cardiovascular risk
was a history of such cardiovascular disease in the year preceding treatment
initiation. Patients with a history of other medical conditions also appeared to be
at higher risk of adverse cardiovascular events.
Publication Types:
• Comparative Study
Publication Types:
• Comparative Study
Publication Types:
Publication Types:
Toyabe S, Kouhei A.
PMCID: PMC1388212
646: Nutrition. 2006 Mar;22(3):283-7.
Related Articles, Links
Publication Types:
Leung GM, Tin KY, Yeung RY, Rannan-Eliya R, Leung ES, Lam DW, Lo
SV.
648: Comput Biol Med. 2007 Feb;37(2):206-13. Epub 2006 Feb 21.
Related Articles, Links
In Taiwan's medical system, the Healthcare IC Card is used as form of secure data
storage. This research applies the Healthcare IC Card to record the chronic
disease patient's recent drug doses, diagnoses and prescriptions. With the Hospital
Information System, this research combines the diagnosis records stored in the
Healthcare IC Card to establish a platform which could simulate the procedures of
a doctor in examining a patient and checking the circumstances of the patient's
repetitive drug doses and drugs interactions. The experiment is based on a data
log of about 22,000 items of drug prescribed to 43 diabetes patients and about
88,200 items to 192 high blood pressure patients. The results show that the
proposed approach would have reduced the waste of medical resources,
strengthened Taiwan's medical system and increased the public's health.
Publication Types:
651: Int J Med Inform. 2006 Oct-Nov;75(10-11):764-70. Epub 2006 Feb 17.
Related Articles, Links
Publication Types:
• Research Support, Non-U.S. Gov't
SETTINGS: Burdur is the most important dairy cattle breeding and milk
production area of Turkey, and Burdur slaughterhouse is one of the biggest
slaughterhouses in the southern part of the country. No scientific information is
available on the prevalence of tuberculosis (TB) in cattle in Burdur. A survey was
therefore undertaken to determine the prevalence of disseminated TB infection in
cattle in this district. OBJECTIVES: To implement a disease monitoring system
in Burdur slaughterhouse to estimate the annual prevalence of disseminated TB in
cattle slaughtered and inspected in 2003-2004. DESIGN: Epidemiological survey.
RESULTS: Prevalence of bovine TB was investigated in Burdur slaughterhouse
from January 2003 to December 2004. All of the affected animals were Holstein
breed. The prevalence of disseminated TB in all slaughtered cattle was 0.38% in
this period. The value of the condemned meat and organs was calculated to
establish economic loss. CONCLUSION: Despite a strict eradication programme,
bovine TB is still an important health issue among cattle and remains one of the
greatest threats to cattle and human health in southern Turkey. Veterinarians and
cattle producers in this region are encouraged to develop and work on herd plans
aimed at controlling and eradicating TB.
Publication Types:
The JPN Guidelines for the Management of Acute Pancreatitis are organized
under the subject headings: epidemiology, diagnosis, management strategy,
severity assessment and transfer criteria, management of gallstone pancreatitis,
nonsurgical management, and surgical management. The Guidelines contain
cutting-edge information on each of these subjects, as well as a section on the
Japanese medical insurance system which provides information that should prove
useful to physicians in other countries. The quality of the evidence was evaluated
by the evidence-based classification method used at the Cochrane Library. The
levels of recommendation of the individual management methods contained in the
Guidelines were determined on the basis of the evaluation of evidence by the
consensus of the members of the Working Group (see below). The Japanese
Society for Abdominal Emergency Medicine, the Japan Pancreas Society, and the
Research Group for Intractable Diseases and Refractory Pancreatic Diseases
(which is sponsored by the Japanese Ministry of Health, Labour, and Welfare)
were commissioned to produce the JPN Guidelines for the Management of Acute
Pancreatitis. A Working Group of 20 physicians specializing in pancreatic
diseases and emergency medicine investigated and analyzed 14821 cases
retrieved by means of a Medline (1960-2004) search and discussed the available
literature on acute pancreatitis (limited to human pancreatitis). The Working
Group held many general discussions in order to reach a consensus on the content
of the Guidelines. After producing a draft, the Publishing Committee of the JPN
Guidelines for the Management of Acute Pancreatitis posted it on a website and
asked for comments and criticisms. Subsequently, a final version of the
Guidelines was published in Japanese in 2003. The Publishing Committee is now
making the Guidelines available to a much wider readership by bringing out an
English version.
Publication Types:
• Practice Guideline
Publication Types:
Publication Types:
[Article in Japanese]
Publication Types:
• English Abstract
Publication Types:
• Comparative Study
The purpose of this paper is to give basic information about the status of dental
hygienists in Korea. This paper examines the changing process of the dental
hygiene education system in Korea, from its start in 1965 until the present, 2003,
the composition of dental personnel in Korea, the specialised areas and roles of
dental hygienists after they receive their licenses, employment of dental
hygienists, dental hygiene-related organisations, and the status and direction of
dental hygienists in Korea. This paper shows the organisational, educational,
governmental and individual efforts to increase the level of professionalism,
education and quality of care delivered to Korean citizens nationwide.
School of Oral Health Care Science, Faculty of Dentistry, Tokyo Medical and
Dental University, Tokyo, Japan. minny.sdh@tmd.ac.jp
The aim of this report is to provide basic information about the historical
development, current status and future needs of education and training of dental
hygienists in Japan. The first formal training of dental hygienists in Japan started
at Tokyo in 1949. Restructure and modification of the dental hygiene education
system has been reiterated over the years in order to satisfy the needs of the
constantly changing society. Although previously only vocational training was
provided for dental hygienists, higher-level education has been conducted. The
present legislation of dental hygiene has gone through a complicated process. The
student should take the dental hygienist licensing examination which is held once
a year by the National Board organized by the Ministry of Health, Labour and
Welfare. Currently there are 136 dental hygiene schools and the total enrolment is
about 7000. The duration of dental hygiene education course has been prolonged
from 2 to 3 years since 2001. In 2004, the 4-year course started. The 2-year dental
hygiene education program is expected to be replaced with the 3- and 4-year
courses by 2010. The dental hygiene education system in Japan will be improved
in many ways as dental hygienists are expected to participate in health promotion
and preventive care, and to gain knowledge of the economics and organization of
health care in relation to oral hygiene.
Erratum in:
Tavakoli R, Rashidi-Jahan H.
[Article in Japanese]
It became say the preventive times than a treatment now. We did "the remoteness
examination" that it was at home possible for from 1986 while the making of
consciousness to "follow one's health by oneself' was demanded. I begin colon
cancer examination, and now an examination item menu extends to 58 kinds.
Remoteness examination is inspection and a support system of the making of
health to assume medical call center a nucleus of 24 hours. Such a system
described the times setting which became necessary and gathered up a role of the
at-home examination system which aimed at cancer and a lifestyle-related disease
and early discovery and a review of a habit and significance, the future prospects
about a problem.
Publication Types:
• English Abstract
• Review
[Article in Japanese]
Publication Types:
• English Abstract
668: Eur J Cardiovasc Nurs. 2006 Dec;5(4):311-6. Epub 2006 Jan 19.
Related Articles, Links
Chaim Sheba Medical Center, Nursing Division, Tel Hashomer, 52621 Tel
Hashomer, Israel. orly@sheba.health.gov.il
Open Source Web GIS software systems have reached a stage of maturity,
sophistication, robustness and stability, and usability and user friendliness
rivalling that of commercial, proprietary GIS and Web GIS server products. The
Open Source Web GIS community is also actively embracing OGC (Open
Geospatial Consortium) standards, including WMS (Web Map Service). WMS
enables the creation of Web maps that have layers coming from multiple different
remote servers/sources. In this article we present one easy to implement Web GIS
server solution that is based on the Open Source University of Minnesota (UMN)
MapServer. By following the accompanying step-by-step tutorial instructions,
interested readers running mainstream Microsoft(R) Windows machines and with
no prior technical experience in Web GIS or Internet map servers will be able to
publish their own health maps on the Web and add to those maps additional layers
retrieved from remote WMS servers. The 'digital Asia' and 2004 Indian Ocean
tsunami experiences in using free Open Source Web GIS software are also briefly
described.
Publication Types:
• Editorial
PMCID: PMC1352347
Publication Types:
PMCID: PMC1363718
Opar A, Pfaff A, Seddique AA, Ahmed KM, Graziano JH, van Geen A.
This study documents the response of 6500 rural households in a 25 km(2) area of
Bangladesh to interventions intended to reduce their exposure to arsenic contained
in well water. The interventions included public education, posting test results for
arsenic on the wells, and installing 50 community wells. Sixty-five percent of
respondents from the subset of 3410 unsafe wells changed their source of drinking
water, often to new and untested wells. Only 15% of respondents from the subset
of safe wells changed their source, indicating that health concerns motivated the
changes. The geo-referenced data indicate that distance to the nearest safe well
also influenced household responses.
Publication Types:
Publication Types:
PMCID: PMC1351203
[Article in Hebrew]
Hefer E.
When scientific researches are being published one should consider carefully the
different possible influences which may change the results. These influences may
be of two kinds: Non-Causal explanations, and Casual explanations. Researchers
may arrive at their results and not have considered all the causative explanations.
Occams's Razor is the basic rule by which most reasonable explanations are
chosen. A statistical result and an appropriate simple theory to explain it, is not
sufficient to prove causative effect. In many cases though, the media and public
tend to accept a statistically significant result as if it was a proven cause and effect
relation. There are several conditional demands called Bradford Hill criteria of
which epidemiological data and results are only one, the more results arrived by
using the Bradford Hill criteria, the better chances exist that the examined
variable is the cause for the effect. Finally, there is a gap between a proven causal
factor for disease or the harmful effects of treatment and a "clear cut" health
policy. There are several intermediate powerful influences which are involved in
the process of stating a new health policy. These influences include among others,
the involvement of decision makers, political influences and civil service
professionals. As an example three different issues of a well proven clinical
research will be presented. The research of Rofecoxib = "Vioxx" cardiac effects,
the research of Hormonal Replacement Treatment health effects on post
menopausal women and the last of Health risks presented by mobile phone use.
Although the results of those researches were proven to be statistically significant,
Health Policy in each case is different and less clear. Health Policy is not based
solely on figures and statistical results, but rather on a far wider and more
complex influences and judgment.
Publication Types:
• Editorial
• English Abstract
Publication Types:
• Comparative Study
Andersson N, Mitchell S.
Publication Types:
Pradhan MR.
Publication Types:
• Review
The public long-term care insurance program for the elderly in Japan set out in
2000 toward establishing a new system whereby citizens can be assured that they
will receive care and be supported by the society as a whole. The insurance
program includes computer-aided certification processes to estimate the needs for
nursing care for clients. In this work, we show the applicability of an adaptive
local nonlinear approximation method associated with the Japanese national
database for automatic inference of the care class.
Publication Types:
Kawamura T, Sobue T.
Statistics and Cancer Control Division, Research Center for Cancer Prevention
and Screening, National Cancer Center.
Publication Types:
• Comparative Study
MacDermott A, Crowe B.
685: Health Policy Plan. 2006 Mar;21(2):132-42. Epub 2005 Dec 22.
Related Articles, Links
Publication Types:
[Article in Chinese]
Wang G, Wu W.
Ecological security assessment and early warning research have spatiality; non-
linearity; randomicity, it is needed to deal with much spatial information. Spatial
analysis and data management are advantages of GIS, it can define distribution
trend and spatial relations of environmental factors, and show ecological security
pattern graphically. The paper discusses the method of ecological security spatial
differences of west areas of Liaohe River based on GIS and ecosystem non-
health. First, studying on pressure-state-response (P-S-R) assessment indicators
system, investigating in person and gathering information; Second, digitizing the
river, applying fuzzy AHP to put weight, quantizing and calculating by fuzzy
comparing; Last, establishing grid data-base; expounding spatial differences of
ecological security by GIS Interpolate and Assembly.
Publication Types:
• English Abstract
• Research Support, Non-U.S. Gov't
He JL, Rehnstrom J.
In the last two years, we have seen a remarkable intensification in the response to
AIDS in China. A number of organizations have joined and contributed to the
efforts of the Chinese government in responding the AIDS epidemic in China.
This article specifically describes the role of the United Nations (UN) in
supporting and strengthening those responses. Achievements of the United
Nations highlighted in the article include: strengthened leadership and political
commitment to respond to AIDS; improved HIV/AIDS surveillance and
information; expanded prevention efforts; improved treatment, care and support to
people living with HIV and increased resources for AIDS programs. Additional
roles of the United Nations system in the near future include strengthening
national leadership by supporting the 'three ones', i.e., one national plan on AIDS;
one national coordinating authority for AIDS; and one monitoring and evaluation
system for AIDS. In addition, the UN system is expected to strengthen alignment
and harmonization of activities of all international organizations and improved
accountability and oversight. Remaining challenges identified include increasing
awareness of AIDS and reducing stigma and discrimination; reducing
vulnerability and risk behaviour among specific groups; providing improved
treatment, care and support for people living with HIV; promoting stronger
engagement by civil society, and; addressing the gender dimensions of AIDS.
He N, Detels R.
The first case of AIDS was reported in 1985 in China, but by the early 21st
century, the government estimated that there were 840,000 citizens living with
HIV/AIDS. The number is increasing rapidly. The major risk groups are injection
drug users (IDUSs; 43%) and former plasma donors (27%), but rates among
heterosexual groups are rising rapidly. Sentinel surveillance was initiated in 1986,
and now includes IDUs, men-who-have-sex-with-men, sexually transmitted
disease clinic attendees, antenatal women, long-distance truck drivers, and sex
workers. Although the government was slow to respond to the epidemic in the late
20th century, it has made a vigorous response in the early 21st century.
Components of that response include implementation and evaluation of harm
reduction programs for IDUs, education to increase knowledge and reduce stigma,
treatment and social support for rural and poor HIV/AIDS patients, widespread
testing, and increased funding for HIV/AIDS programs. International agencies
have been generous in their support of the government initiatives. To successfully
combat the epidemic, China needs to develop and train the necessary
infrastructure to implement its intervention programs, particularly in the rural
areas, to vigorously combat stigma and discrimination, support research
especially in the universities and research institutions other than the China
Centers for Disease Control, develop a system for efficient exchange of research
and program information, and update legislation to reflect the current situation.
Publication Types:
Wang IK, Wang ST, Chang HY, Lin CL, Kuo HL, Chen TC, Lee CH,
Chuang FR.
• Comparative Study
[Article in Japanese]
Hashimoto N.
692: J Neurol Sci. 2006 Feb 15;241(1-2):83-90. Epub 2005 Dec 15.
Related Articles, Links
Hartmann JE.
Six hundred and sixteen patients were referred for consultation to the author who
served as the neurologist on the 252nd Neurosurgical Team in Kuwait in support
of Operation Iraqi Freedom between April and October, 2003. Demographic and
military data were collected. The cohort of neurologic patients showed significant
differences from the total population of the United States Army contemporarily
deployed to Operation Iraqi Freedom. Versus the deployed personnel, the
neurologic cohort was older in age (p<0.001), had a greater percentage of females
(p<0.00001), had an excessive representation for the military rank of sergeant
(p<0.00001), with a deficit of other ranks (junior enlisted and officers), and were
more likely to soldiers from the Reserves (p<0.00001) and National Guard
(p=0.0021) than from the Regular Army. Seven categories of chief complaints
and ten categories of diagnoses constituted some 80% of patients. The incidence
of neurologic disease was calculated to be 634 per 100,000 people/year. This
information provides valuable information for military neurologists concerning
their anticipated duties in future deployments and for non-neurologists by
focusing their skills in the evaluation of common neurologic presentations, yet
further research is needed to optimize the neurologist's role in a field
environment.
Publication Types:
• Comparative Study
Cai QC, Xu QF, Xu JM, Guo Q, Cheng X, Zhao GM, Sun QW, Lu J, Jiang
QW.
Many epidemiologists have agreed that a refined estimate of the incubation period
of severe acute respiratory syndrome (SARS) would need a sample size of about
200 cases and appropriate statistical methods enabling the inclusion of cases with
defined periods of exposure. However, no such studies have been reported so far.
Besides, determinants of the SARS incubation period remain unclear. In this
study, 209 probable SARS cases with documented episodes of exposure between
March 1 and May 31, 2003, in mainland China were included. A nonparametric
method was used to analyze these data with defined periods of exposure to obtain
the refined estimate of the SARS incubation period. Furthermore, the authors also
explored the influence of various factors on the SARS incubation period by
analysis of variance, linear regression analysis, and analysis of covariance. The
estimates of mean and variance of the SARS incubation period were 5.29 days
and 12.33 days(2), respectively; 90% of patients would have an incubation period
of less than 11.58 days with a probability of 0.8, and 99% of patients would have
an incubation of less than 22.22 days with a probability of 0.9. The affected area
showed a highly significant effect on the incubation period (p < 0.001), but the
contact pattern, occupation, gender, and age did not.
Publication Types:
Talikowski L, Gillieatt S.
Centre for International Health, Curtin University of Technology, Perth,
Australia.
The aim of the study was to understand traffic law enforcement (TLE) carried out
by the police to reduce non-compliance with traffic laws on the roads of
Hyderabad city in India for 2001-2003. The Traffic Police database of citations
issued to drivers who violated traffic laws in Hyderabad was analysed for the
years 2001-2003 to describe the TLE activities of the police, to describe and
compare the TLE activities for the different types of vehicles and to compare the
TLE activities for the 3 years. The violations were classified in five categories -
those related to driving, parking, vehicle, document and others; and TLE into
safety and other TLE. A total of 646 161 traffic-law violations were registered in
2001, 904 447 in 2002 and 964 275 in 2003 for Hyderabad. Driving and parking
violations were the most common violations registered in all 3 years, with parking
violations slightly higher in 2001 (43.5%) and driving violations slightly higher in
2002 (35%) and 2003 (36.4%). Auto-rickshaws (three-wheel commercial
passenger vehicles) accounted for the highest violations registered in 2001
(41.4%) whereas motorized two-wheelers had the highest registered violations in
2002 (35.5%) and 2003 (33.2%). Safety TLE activity (detecting and registering
driving violations) was only one-third of all the TLE activity performed by the
police in the 3 years, and disobeying traffic signals was the most common
violation registered under safety TLE. Indian rupees 50 (US$1.1) were collected
by way of a fine in 87% of the cases registered. Age and gender of the violators
were not recorded in the database. These data can be used for planning,
monitoring and evaluating TLE in Hyderabad. These can help identify traffic
control and human factors that could lead to traffic noncompliance, and help
identify priorities for improving road safety. These data indicate a need to
enhance the safety TLE activity of the police, to make TLE more visible in
Hyderabad, and to assess the effectiveness of the current legal action as
deterrence to improve road safety. Recommendations to enhance TLE within the
given resources of the police are made. More effort is needed towards systematic
collection and analysis of data on TLE in India to facilitate long-term
improvements in TLE for safer roads.
Publication Types:
• Comparative Study
696: Int Arch Occup Environ Health. 2006 May;79(5):441-4. Epub 2005 Dec 7.
Related Articles, Links
OBJECTIVES: The objective of the study was to clarify the relationship between
major subjective symptoms and autonomic nervous system function by power
spectral analysis of heart rate variability (HRV). METHODS: Short-term HRV
was examined for 413 male workers in a Japanese information service company
aged 19-45 years, and questionnaire survey on subjective symptoms and
biochemical measurements were conducted at annual health checkup. RESULTS:
The most prevalent subjective symptom (> or =10%) was dullness, followed by
fatigue, backache, diarrhea, sleep disorder, and irritation. HRV in high frequency
(HF 0.15-0.40 Hz) bands and the coefficient of variance in the
electrocardiographic R-R interval (CVrr) were lower in the subjects with any of
these six symptoms than in those without the symptoms. Both parameters were
negatively associated with the reporting of any of the six symptoms by multiple
regression analyses, controlling for the significant effects of age (HF and CVrr)
and plasma cortisol levels (HF). CONCLUSION: It was suggested that the
reporting of the subjective symptoms is one of good predictors for reduced
parasympathetic tones.
Publication Types:
PURPOSE: The aim of the present study was to elucidate the trends in drug
interactions for pharmaceutical products in Japan by examining safety profile
updates. METHODS: All 12 422 prescription drugs currently on the Japanese
market were included in the study. Revisions to their product information (or
package insert: PI) were investigated from January 2000 to December 2003. The
publication 'Drug Safety Update,' which is a summary of the revisions made to the
precautions in PIs and is issued by The Society of Japanese Pharmacopoeia and
The Federation of Pharmaceutical Manufacturers' Associations of Japan under the
supervision of the Ministry of Health, Labour and Welfare (MHLW), was used as
a data source. The revised drug interactions were categorized according to
measures, mechanisms, and evidence from published references. RESULTS AND
CONCLUSIONS: The results revealed 426 new interactions, including 75
contraindicative combinations, during the survey period. About 45% and 27% of
the new interactions involved metabolic and pharmacological processes,
respectively, with metabolic interactions involving cytochrome P450 3A4 being
the dominant reason for the revision of PIs. Only 37% of the new interactions
cited scientific journals and/or books, and 58% of these references cited were
published more than 5 years prior to the date of revision. In conclusion, metabolic
interactions were the major reasons for the update of safety information after
2000. Published references should be provided in order to assist with clinical
management and avoid the undesirable effects of new drug interactions.
Publication Types:
In Japan, the main source of dioxins is incinerators. This study examined the
relationship between the distance of schools from municipal waste incineration
plants and the prevalence of allergic disorders and general symptoms in Japanese
children. Study subjects were 450,807 elementary school children aged 6-12 years
who attended 996 public elementary schools in Osaka Prefecture in Japan. Parents
of school children completed a questionnaire that included items about illnesses
and symptoms in the study child. Distance of each of the public elementary
schools from all of the 37 municipal waste incineration plants in Osaka Prefecture
was measured using geographical information systems packages. Adjustment was
made for grade, socioeconomic status and access to health care per municipality.
Decreases in the distance of schools from the nearest municipal waste incineration
plant were independently associated with an increased prevalence of wheeze,
headache, stomach ache, and fatigue (adjusted odds ratios [95% confidence
intervals] for shortest vs. longest distance categories =1.08 [1.01-1.15], 1.05
[1.00-1.11], 1.06 [1.01-1.11], and 1.12 [1.08-1.17], respectively). A positive
association with fatigue was pronounced in schools within 4 km of the second
nearest municipal waste incineration plant. There was no evident relationship
between the distance of schools from such a plant and the prevalence of atopic
dermatitis or allergic rhinitis. The findings suggest that proximity of schools to
municipal waste incineration plants may be associated with an increased
prevalence of wheeze, headache, stomach ache, and fatigue in Japanese children.
Publication Types:
Publication Types:
•
Japanese guidelines-based management of lipid levels in a
hypercholesterolemia education class.
Marugame T, Mizuno S.
Publication Types:
• Comparative Study
702: Soc Sci Med. 2006 May;62(10):2551-64. Epub 2005 Nov 21.
Related Articles, Links
Johnston JM, Leung G, Saing H, Kwok KO, Ho LM, Wong IO, Tin KY.
This study tests whether socio-economic status (SES), at either the individual or
ecologic levels, exerts a direct impact on non-attendance or an indirect impact on
attendance through longer waiting time for appointments and/or doctor-shopping
behavior at four public specialist outpatient centers in Hong Kong. We collected
information through three main sources, namely patients' referral letters,
telephone interviews with both open- and closed-ended questions (e.g. doctor-
shopping data) and hospital administrative databases from a total of 6495
attenders and non-attenders enrolled from July 2000 through October 2001.
Individual-level SES was measured by education, occupation and monthly
household income. Tertiary planning unit (TPU)-level SES data consisted of
proportion unemployed, proportion with tertiary education, median income and
Gini coefficient. Direct effects of SES on non-attendance were examined by
logistic regression. Indirect contributions mediated through waiting time and
doctor-shopping were analyzed by structural equation modeling. We found that
SES, at the individual or ecologic level, did not exert a direct effect on non-
attendance. Instead, TPU-level SES contributed positively to waiting time
(beta=0.06+/-0.03, p=0.048), i.e. worse-off neighborhoods (and those with greater
income inequality) had a shorter waiting time. Individual-level SES was also
directly associated with the likelihood of doctor-shopping (beta=0.16+/-0.02,
p<0.001), i.e. the poor were less likely to doctor-shop. Both waiting time
(beta=0.12+/-0.02, p<0.001) and doctor-shopping (beta=0.37+/-0.02, p<0.001)
were significantly related to non-attendance. Our findings suggest a highly
equitable specialist ambulatory care public system in Hong Kong. Health care
resources are appropriately targeted at the socially indigent, and the poor are not
discriminated against and pushed to seek alternative sources of care by the
system. These results should be confirmed using a prospective design.
Arnold JL, Dembry LM, Tsai MC, Dainiak N, Rodoplu U, Schonfeld DJ,
Paturas J, Cannon C, Selig S.
The Hospital Emergency Incident Command System (HEICS), now in its third
edition, has emerged as a popular incident command system model for hospital
emergency response in the United States and other countries. Since the inception
of the HEICS in 1991, several events have transformed the requirements of
hospital emergency management, including the 1995 Tokyo Subway sarin attack,
the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory
Syndrome (SARS) outbreaks in eastern Asia and Toronto, Canada. Several
modifications of the HEICS are suggested to match the needs of hospital
emergency management today, including: (1) an Incident Consultant in the
Administrative Section of the HEICS to provide expert advice directly to the
Incident Commander in chemical, biological, radiological, nuclear (CBRN)
emergencies as needed, as well as consultation on mental health needs; (2) new
unit leaders in the Operations Section to coordinate the management of
contaminated or infectious patients in CBRN emergencies; (3) new unit leaders in
the Operations Section to coordinate mental health support for patients, guests,
healthcare workers, volunteers, and dependents in terrorism-related emergencies
or events that produce significant mental health needs; (4) a new
Decedent/Expectant Unit Leader in the Operations Section to coordinate the
management of both types of patients together; and (5) a new Information
Technology Unit Leader in the Logistics Section to coordinate the management of
information technology and systems. New uses of the HEICS in hospital
emergency management also are recommended, including: (1) the adoption of the
HEICS as the conceptual framework for organizing all phases of hospital
emergency management, including mitigation, preparedness, response, and
recovery; and (2) the application of the HEICS not only to healthcare facilities,
but also to healthcare systems. Finally, three levels of healthcare worker
competencies in the HEICS are suggested: (1) basic understanding of the HEICS
for all hospital healthcare workers; (2) advanced understanding and proficiency in
the HEICS for hospital healthcare workers likely to assume leadership roles in
hospital emergency response; and (3) special proficiency in constituting the
HEICS ad hoc from existing healthcare workers in resource-deficient settings.
The HEICS should be viewed as a work in progress that will mature as additional
challenges arise and as hospitals gain further experience with its use.
To investigate the impact of overtime work, sleep duration, and perceived job
characteristics on physical and mental status, a cross-sectional study was
conducted on 377 workers (average age; 28 years old) in an information-
technology (IT) company, engaged in consultation, system integration solution,
and data management relevant to IT system. The psychophysical outcomes of
overtime work were assessed using the Hamilton Depression Scale (HDS), Profile
of Mood Status (POMS), major physical symptoms, and overtime work data for
the preceding three-months. Sleep duration was directly asked by a physician. A
job strain index was defined as the ratio of job-demands to job-control scores
evaluated using the Job Content Questionnaire (JCQ). In a univariate analysis,
overtime work was significantly related with HDS scores, POMS anger-hostility
scores, and the total physical symptom count in both sexes (all p < 0.05), but not
in multiple regression models, after controlling for sleep duration and the job
strain index. Sleep duration was negatively related to the symptom count in men
and to POMS tension-anxiety scores in women (both p < 0.05); the job strain
index was positively related to POMS anger-hostility scores in both sexes and to
HDS scores and POMS tension-anxiety scores in men (all p < 0.05). Although
overtime work was associated with physical and mental complaints, sleep
duration and the job strain index seemed to be better indicators for physical and
mental distress in overloaded workers.
Publication Types:
The Indian health system is mainly funded by out-of-pocket payments. More than
80% of health care expenditure is borne by individual households. Only about 3%
of the population, mostly those in the formal sector, benefit from some form of
health insurance. Several Indian Non-Governmental Organisations (NGOs) have
initiated Community Health Insurance (CHI) schemes within their existing
development programmes. This article describes the principal features of the
design and functioning of a selection of 10 CHI schemes and presents a brief
overview of the current landscape of CHI in India. The schemes explicitly target
the poorest and most vulnerable households in Indian society-scheduled tribes,
scheduled castes and poor women. Three CHI management models can be
distinguished. The first model consists of local NGOs acting as both insurer and
provider. In the second model, the NGO is the insurer but does not itself provide
care, which is then purchased from a private provider. In the third model, the
NGO neither does provide health care nor acts as an insurer: the NGO, on behalf
of a community, links with an insurer and purchases health care from a provider.
The benefit packages generally include both primary and secondary care and most
of the providers are in the private sector. Most of the schemes require external
resources for financial sustainability. There is currently little information on the
impact of CHI schemes on the performance of local health systems and more
research is warranted in that respect.
Publication Types:
The medical abortion drugs mifepristone and misoprostol are now widely
available in rural Tamil Nadu, India, and the practice of abortion is being
transformed. This paper reports on current attitudes and practices concerning
medical abortion among qualified abortion providers in a rural area of Tamil
Nadu. Interviews were carried out with a purposive sample of 40 doctors, 15
informants at chemist shops, 10 village health nurses and 23 women who had
recently had an abortion. Twelve of the 37 private doctors who were providing
abortions, were providing medical abortion to 70-80% of their patients and 12
others to a selected minority. Eleven had largely rejected it and still used D&C,
two had never heard of it. A number of doctors were using misoprostol for
cervical dilatation prior to D&C. Some doctors and women who were concerned
about incomplete abortion and heavy bleeding did not have a clear idea of what
normal bleeding with medical abortion was. Incorrect regimens with second
trimester medical abortions might have been responsible for cases of excessive
bleeding. Most chemist shops said they were selling the tablets only on
prescription, but doctors reported widespread over-the-counter sales. Medical
abortion appeared to be quite acceptable to most women, and women were
increasingly requesting it. Mechanisms are needed for sharing information about
medical abortion among professionals, community health workers and rural
families. The state government should develop a comprehensive plan for
incorporating medical abortion into the public health system.
Publication Types:
709: J Clin Forensic Med. 2006 Jan;13(1):21-5. Epub 2005 Nov 10.
Related Articles, Links
It is well recognized that the most pervasive form in gender violence is violence
against women by their intimate male partners. Domestic violence (DV) crosses
all cultures, races, and socioeconomic levels, affecting people of all ages and both
sexes, but particularly women and children. DV refers to the chronic physical,
sexual and psychological maltreatment of one family member against another in
order to control. DV represents a significant health threat to women. It may also
be an important precipitating factor of female suicide. As the literature has begun
to document the extent of interfamilial violence, attention has focused on forensic
documentation. The aim of this study is to review female victims presented at the
Branch of Legal Medicine of Malatya, Turkey, regarding gender-based violence
and DV in relation towards sexual offenses and suicide attempts. Accordingly,
recommendations were presented to increase the awareness of DV by setting
policies and in response legislative recommendations. The legal reports of women
(n=2245) were reviewed. In respect of the Turkish Penal Code (TPC), paragraph
456/1, 2, 3 and 4, which covers the act of assault and battery, the severity of the
injuries have been categorized into three groups according to the Turkish Injury
Scale (TIS) covered by TPC 456/1, 2 and 4, into the issues of functional
incapacitation according to TPC 456/2 and 3, and with regard to the presence of a
mark of an injury on the face according to TPC 456/2 tables. Because of
incomplete data, not all results be categorized as positive for DV. Despite the
large number of blunt force injuries (699 cases out of 2245) and the high
percentage of external lesions, 76% of 1796 files, found, recognition of DV was
uncommon. According to TPC 456/4, in cases of small trauma-related injuries,
legal proceedings are dependent upon a victim's making a complaint. The
percentage of 80.4% (n=2245) represents the need for information regarding legal
requirements. The frequency of sexual assault cases, 144 victims out of 162, and
in suicide attempts, 95 women out of 145, in the 15-24 year age span may also
reflect a society's accusative approach towards women based on moral values.
Unless prosecuting DV cases purely on the evidence in regard to victim's safety,
withdrawal of complaints will continue. It is essential to identify to 'name' DV
when it occurs. Recognizing the serious immediate and future long-term
implications for health, multifaceted intervention is important. DV has to undergo
some fundamental and far-reaching reformation in Turkey regarding how the
legal system deals with it appropriately.
710: Childs Nerv Syst. 2006 Apr;22(4):346-51. Epub 2005 Nov 10.
Related Articles, Links
Publication Types:
• Evaluation Studies
Health Systems Financing, Evidence and Information for Policy, World Health
Organization, Switzerland.
Publication Types:
PMCID: PMC1283271
Kaneko S.
Statistics and Cancer Control Division, Research Center for Cancer Prevention
and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
stkaneko@ncc.go.jp
The World Health Organization (WHO) has recommended that countries develop
national cancer control programs in order to reduce the number of deaths due to
preventable cancers. The national cancer control program should be
comprehensive and systematic with evidence-based priority-setting and the
efficient use of limited resources. In order to provide evidence-based information,
cancer surveillance systems must be established with registration as a focus.
Cancer registration monitors the incidence, mortality, survival, and prevalence of
cancers. In Japan, however, cancer registration systems have not been either well
developed or standardized until recently. In 2003, the Ministry of Health, Labour
and Welfare of Japan launched the Third Term Comprehensive 10-Year Strategy
Program for Cancer Control, which gave grants to several projects to enhance the
dissemination and standardization of cancer registries. However, the
establishment of a cancer registration system is merely the first step in the process
to provide a comprehensive surveillance system that leads to a national cancer
control program, as proposed by the WHO. To provide the best cancer care
services equitably in Japan, cancer surveillance systems should be established
without delay.
Sadan B, Chejk-Saul T.
On the surface, it would appear that patients would welcome the opportunity to
relinquish their traditional subordination to doctors in therapeutic decision
making, and that doctors would be pleased to have partners with whom to share
the burden involved in making such fateful decisions. We investigated the
attitudes and practices of patients and physicians towards "patient autonomy" in
an outpatient clinic of an internal medicine department prior to the enactment of
the Patient's Rights Bill in Israel. There were 81 patients randomly chosen from
those attending the study clinic and 21 physicians randomly selected from among
the physicians treating them. They were all administered the Krantz, the
Abramson Health Index, and the Christie Ethical Decision Making pre-tested
questionnaires. They were also queried on demographic and background material.
The results indicated that the patient sample was neither particularly interested in
participating in medical decision making (average score of 3 out of 9 in the
Krantz behavioral involvement sub-scale) nor in receiving medical information
(average score of 4 out of 7 in the Krantz preference of information sub-scale).
The physicians exhibited a willingness to establish equal relations with their
patients, and claimed to prefer their taking an active role in decision making.
However, when presented with ethical dilemmas, the physicians were not
consistent in their attitude in terms of respecting "patient autonomy." The findings
of an Israeli survey conducted three years after the bill's passage showed that only
one-third of the studied physicians had read the Israel Medical Association
booklet's explaining the new law and most of them claimed that the new law had
no affect on their daily encounter with patients, meaning that the law did not
affect any change in these physicians' pattern of behavior. We concluded that if
the Patient's Rights Bill is to achieve its goals, it will have to be accompanied by a
widespread educational campaign to encourage the public to appreciate the value
and the importance of the autonomy granted to them, and to guide them in
exercising this autonomy to its best advantage. In parallel, the medical profession
will need to be aware of the importance of achieving the therapeutic goals while
upholding ethical and moral values in health care.
AIM: This paper describes a study identifying the impact of key aspects of
Chinese culture on the responses of mid-aged Chinese-Australians to their
advanced cancer in order to make recommendations about their care within the
health system. BACKGROUND: Studies conducted in the 1960s and 1970s
focused on understanding people's psychological responses to their experiences of
terminal illness, but the issue of culture was not addressed. In recent years, a few
studies have been conducted with Chinese-Australians, but were limited to issues
related to their information needs and the disclosure of a cancer diagnosis. There
is a lack of understanding of the impact of Chinese culture on the experiences of
these patients. METHOD: A grounded theory approach was used to generate a
substantive theory to explain how mid-aged Chinese-Australians respond to
advancing cancer. Eleven participants were recruited and data were collected
from face-to-face interviews, telephone contacts, observation and researcher field
notes. Data generation occurred between 1997 and 1999. FINDINGS: Four modes
of response to advanced cancer were identified: acute crisis, combat, despondency
and waiting for death. This paper deals particularly with the combat mode which
incorporated five culturally specific strategies used by participants in their
struggle against advanced cancer. These were traditional Chinese medicine,
traditional Chinese beliefs on the use of food for health maintenance, qi gong (a
form of exercise), feng shui (which involves paying attention to spatial
organization) and the worship of ancestors and gods. Deeply entrenched within
these responses is the influence of Chinese culture, rooted in the beliefs and
practices of traditional Chinese medicine and the philosophy of harmony and
balance of yin and yang and qi. CONCLUSION: Health care professionals need
to be aware of the cultural practices and beliefs of the different ethnic groups for
whom they care, and of the importance of accommodation to and negotiation
about these cultural practices.
Publication Types:
[Article in Japanese]
Publication Types:
• English Abstract
Publication Types:
Health Systems and Infectious Diseases Division, ICDDR,B: Centre for Health
and Population Research, GPO Box 128, Dhaka 1000, Bangladesh.
dnasrin@icddrb.org
Publication Types:
[Article in Dutch]
Publication Types:
• English Abstract
Publication Types:
Sano H, Hamashima C.
Statistics and Cancer Control Division, Research Center for Cancer Prevention
and Screening, National Cancer Center, Tokyo, Japan.
Publication Types:
• Comparative Study
Randhawa G.
The percentage of South Asians on the kidney transplant waiting list in the United
Kingdom is 3 times their percentage in the general population. Obviously, organ
donation and transplantation among South Asians in the United Kingdom needs
improvement. In recent years, ethnically targeted campaigns in the mass media
have specifically attempted to attract donors from the South Asian communities.
A number of pilot studies have been done to evaluate the effectiveness of these
initiatives in providing information about organ donation to South Asians. Results
indicate that detailed information related to transplantation was learned mainly by
people within the community receiving transplants and was transmitted through
various informal community networks rather than through the resources provided
by the Department of Health. This article provides an overview of who South
Asians are and how these community networks were established. Transplant
professionals must devise effective strategies to access these community
networks, thereby raising the consciousness of transplantation among South
Asians in the United Kingdom.
Publication Types:
• Review
Kang JO, Kim MH, Hong SE, Jung JH, Song MJ.
Comment in:
Wahlqvist ML.
Publication Types:
• Review
726: Eur Urol. 2005 Nov;48(5):712-22; discussion 722-3. Epub 2005 Apr 1.
Related Articles, Links
Publication Types:
• Review
College of Nursing, Seattle University, 901 12th Ave, P.O. Box 222000, Seattle,
WA 98122-1090, USA. sinm@seattleu.edu
Publication Types:
• Evaluation Studies
• Research Support, N.I.H., Extramural
• Research Support, Non-U.S. Gov't
• Research Support, U.S. Gov't, P.H.S.
Publication Types:
James H.
The boxing day tsunami of 26 December 2004 caused devastation and loss of life
around the Indian ocean. International disaster victim identification efforts were
centred in Thailand, with many odontologists from over 20 countries contributing
to the examination of deceased, collection of antemortem information,
comparison and reconciliation of data. The contribution of forensic odontology to
the identification process conducted in Thailand in response to the tsunami
devastation is presented in a composite of short reports focused on the five phases
associated with disaster victim identification. To date 1,474 deceased have been
identified. Dental comparison has been the primary identifier in 79% of cases and
a contributor in another 8%, a total of 87%.
Andersen Torpet L.
Erratum in:
BACKGROUND: In Korea, the drug use process has changed significantly since
the new pharmacy law was implemented in 2000, separating the prescribing and
dispensing functions between physicians and pharmacists and mandating
prospective drug use review (DUR) practice by pharmacists immediately before
dispensing medications. However, a high prevalence of inappropriate prescribing
has been suspected by the public, pharmacists, and health insurance managers,
possibly due to suboptimal DUR practice by pharmacists. OBJECTIVE: To assess
overall patterns of drug usage and potential problems of inappropriate use in
outpatient settings by analyzing prescription data that were electronically
submitted to the national health insurance manager with a computerized DUR
system and develop a computerized adjudication system model for drug claims.
METHODS: The national prescription drug claims data that were submitted
electronically by pharmacies located in the northern part of Korea during 15 days
in 2002 were retrospectively screened against the predetermined DUR standards
of the selected criteria on drug dosage, duration of therapy, and drug interaction
using the DUR screening system. The results of all the DUR conflicts were
further validated manually by an expert panel and statistically analyzed to
determine drug use patterns. RESULTS: Of 31,994,260 drugs prescribed,
3,325,760 (10.4%) items showed a conflict with at least one of the DUR
standards. The average number of drugs prescribed on each prescription was 4.07,
and even more troubling was the high incidence of under-dosing, over-dosing,
and contraindicated drug prescribing. CONCLUSIONS: It is evident that
inappropriate drug prescribing is very common in Korea; thus, a great deal of
attention is urgently needed in the country with respect to proper prescribing and
supportive interventions.
Publication Types:
733: Acta Crystallogr D Biol Crystallogr. 2005 Oct;61(Pt 10):1364-72. Epub 2005
Sep 28.
Related Articles, Links
Publication Types:
Publication Types:
Research Center for Material Cycles and Waste Management, and Endocrine
Disruptors and Dioxin Research Project, National Institute for Environmental
Studies, Tsukuba, Ibaraki, Japan. nansai.keisuke@nies.go.jp
Owen T, Slaymaker O.
Centre for the Study of Civil War, International Peace Research Institute, Oslo.
taylor.owen@jesus.ox.ac.uk
A new methodology for measuring human security is presented. The three stages
of the methodology are: i) threat assessment, ii) data collection and organization,
and iii) data visualization and analysis, using Geographic Information Systems.
Results from a Cambodia case study are highlighted. The United Nations
Development Program's notion of human security, which gives equal weight to
economic, health, food, political, personal, and environmental factors, is used.
Country-specific threats in each category are determined, and local, spatially
referenced data are collected. In this paper, poverty, dengue fever, and
tuberculosis are used as examples of the analytic process. Regions of Cambodia
exposed to all three of these threats ("hot spots") are located, and spatial
correlation between poverty, dengue fever, and tuberculosis is calculated. The
methodology i) advances a broad concept of human security, ii) will potentially
assist policy and decision makers, and iii) identifies research questions that cannot
be resolved using single-sector analysis.
Llido LO.
Room 315-316, MAB, Nutrition Support Services, St. Luke's Medical Center, E.
Rodriguez Sr. Avenue, Quezon City, Metro-Manila, Philippines.
llido2001@yahoo.com
BACKGROUND & AIMS: To improve hospital health care delivery by
identifying malnutrition in all admitted patients and following up those identified
to be malnourished and "at risk of developing malnutrition" a hospital nutrition
support program based on the JCAHO system was initiated in 1999. Two major
problems were encountered: first, the inability to perform a nutrition surveillance
process due to failure by the staff to implement existing nutrition screening tools
and second, the lack of awareness and support from the medical staff in this
initiative. Two solutions were implemented in 2000: computerization of the
nutrition screening and nutrition support process and synchronizing this with the
whole nutrition support program. METHODS: A computer program was
developed which performs BMI-based nutrition screening, produces lists of all
malnourished patients, and computes the different formulas for either nutritional
requirement or parenteral and/or enteral formulation. It also generates patient
status reports based on encoded data from the nutrition support team, which
prioritized these patients for management based on the data output. RESULTS:
From 2000 to 2003, improvement was seen in these areas: entry of height and
weight in the patient record increased from 30% to 90%; nutrition surveillance
shows nutritional status distribution to be: normal (58%), underweight (9%),
overweight (25%), and obese (8%), referrals to the nutrition support team based
on the screen notification increased from 37% to 100%, patient coverage by
nutrition support services increased from 7374 (38.8%) in 2000 to 11,369 (83%)
in 2003, and critical care patients seen increased from 10% in 2000 to 99% in
2003. More improvement is needed in physician response to nutrition support
recommendations, which still remains low (11.2-24%). CONCLUSIONS:
Computerization helps to improve nutrition support delivery in the hospital, but
more cooperation and support from the medical staff is still needed for better
results.
Stone R.
Publication Types:
• News
Ali M, Canh GD, Clemens JD, Park JK, von Seidlein L, Minh TT, Thiem
DV, Tho HL, Trach DD; The Vaccine Safety Datalink Group.
Publication Types:
741: Int Arch Occup Environ Health. 2006 Feb;79(2):115-22. Epub 2005 Sep 27.
Related Articles, Links
Publication Types:
743: Bull World Health Organ. 2005 Aug;83(8):618-25. Epub 2005 Sep 22.
Related Articles, Links
Mortality statistics systems provide basic information on the levels and causes of
mortality in populations. Only a third of the world's countries have complete civil
registration systems that yield adequate cause-specific mortality data for health
policy-making and monitoring. This paper describes the development of a set of
criteria for evaluating the quality of national mortality statistics and applies them
to China as an example. The criteria cover a range of structural, statistical and
technical aspects of national mortality data. Little is known about cause-of-death
data in China, which is home to roughly one-fifth of the world's population. These
criteria were used to evaluate the utility of data from two mortality statistics
systems in use in China, namely the Ministry of Health-Vital Registration (MOH-
VR) system and the Disease Surveillance Point (DSP) system. We concluded that
mortality registration was incomplete in both. No statistics were available for
geographical subdivisions of the country to inform resource allocation or for the
monitoring of health programmes. Compilation and publication of statistics is
irregular in the case of the DSP, and they are not made publicly available at all by
the MOH-VR. More research is required to measure the content validity of cause-
of-death attribution in the two systems, especially due to the use of verbal autopsy
methods in rural areas. This framework of criteria-based evaluation is
recommended for the evaluation of national mortality data in developing countries
to determine their utility and to guide efforts to improve their value for guiding
policy.
Publication Types:
• Evaluation Studies
• Research Support, N.I.H., Extramural
• Research Support, U.S. Gov't, P.H.S.
Registration of births, recording deaths by age, sex and cause, and calculating
mortality levels and differentials are fundamental to evidence-based health policy,
monitoring and evaluation. Yet few of the countries with the greatest need for
these data have functioning systems to produce them despite legislation providing
for the establishment and maintenance of vital registration. Sample vital
registration (SVR), when applied in conjunction with validated verbal autopsy
procedures and implemented in a nationally representative sample of population
clusters represents an affordable, cost-effective, and sustainable short- and
medium-term solution to this problem. SVR complements other information
sources by producing age-, sex-, and cause-specific mortality data that are more
complete and continuous than those currently available. The tools and methods
employed in an SVR system, however, are imperfect and require rigorous
validation and continuous quality assurance; sampling strategies for SVR are also
still evolving. Nonetheless, interest in establishing SVR is rapidly growing in
Africa and Asia. Better systems for reporting and recording data on vital events
will be sustainable only if developed hand-in-hand with existing health
information strategies at the national and district levels; governance structures;
and agendas for social research and development monitoring. If the global
community wishes to have mortality measurements 5 or 10 years hence, the
foundation stones of SVR must be laid today.
Publication Types:
Hagelin J.
joakim.hagelin@hsl.gov.uk
Publication Types:
• Historical Article
[Article in Japanese]
Publication Types:
• English Abstract
In 2001, a system was created to improve patient service, improve the quality of
medical care, and achieve efficient medical care. A Data Center was established
to accumulate and manage clinical information in the regions and share clinical
information safely and appropriately. The system has already been in operation
for 3 years. Even though a patient may have been examined at multiple hospitals,
his medical record information will be integrated at the Center. This ensures
medical care continuity and enables the patient to view his own medical records at
home. Its usefulness in obtaining informed consent has been demonstrated as
well. XML instances established in the MML standards (MML (Medical Markup
Language): http.//www.medxml.net/E_mml30/mmlv3_E_index.htm Accessed
July 2004; Jpn. J. Med. Informatics (JJMI) 17(3):203-207, 1997; J. Med. Syst.
24(3):195-211, 2000; J. Med. Syst. 27(4):357-366, 2003; J. Med. Syst. 28(6):523-
533, 2004) are used for Electronic Medical Record System data exchange
between the Data Center and each medical institution. The openness provided by
XML makes it possible to connect diverse electronic medical records to the
Center. As of the year 2004, over 10 types of electronic medical records have an
MML interface, enabling connection to the Center.
Institute for Research in Medical Statistics (ICMR), Ansari Nagar, New Delhi
110-029, India.
Publication Types:
The three links theory applied in trauma emergency care system refers to an
integrated system with the three important components of trauma emergency care
system, viz. prehospital trauma services, hospital trauma services and critical care
services. The development of the trauma emergency care system should be guided
by the three links theory so as to set up a practical and highly efficient system: a
prompt operating and monitoring transportation system, a smooth and real-time
information system, a rational and sustainable system of regulations and
contingency plans, and a system for cultivating all-round trauma physicians.
Publication Types:
• Review
Publication Types:
• Evaluation Studies
• Research Support, Non-U.S. Gov't
751: Soc Sci Med. 2006 Apr;62(7):1685-96. Epub 2005 Sep 19.
Related Articles, Links
Stigmatizing experience and structural discrimination associated
with the treatment of schizophrenia in Hong Kong.
Publication Types:
752: Childs Nerv Syst. 2006 Apr;22(4):352-62. Epub 2005 Sep 17.
Related Articles, Links
Pediatric neurotrauma in Kathmandu, Nepal: implications for
injury management and control.
Publication Types:
Tanaka S, Sobue T.
Statistics and Cancer Control Division, Research Center for Cancer Prevention
and Screening, National Cancer Center, 1-1 Tsujiki 5-chome, Chuo-ku, Tokyo
104-0045, Japan..
Publication Types:
• Comparative Study
Publication Types:
758: Forensic Sci Int. 2005 Oct 29;153(2-3):161-7. Epub 2004 Nov 11.
Related Articles, Links
The outbreak of Severe Acute Respiratory Syndrome is the first severe and
readily transmissible disease to emerge in the 21st century. Often one new
infection meant tracing of several people to monitor their health conditions as
well. In Singapore, several agencies coordinated their efforts to quickly bring the
outbreak under control. The current breed of health-care information systems
(HCIS) was not sufficient to handle new information-sharing needs during the
crisis. In this paper, we take a look at the measures taken during the crisis in
Singapore through a knowledge integration perspective. This perspective reveals
interesting implications for HCIS.
762: Int J Med Inform. 2006 May;75(5):369-83. Epub 2005 Aug 29.
Related Articles, Links
Chiu YH, Chen LS, Chan CC, Liou DM, Wu SC, Kuo HS, Chang HJ, Chen
TH.
Publication Types:
763: Diabetes Res Clin Pract. 2005 Oct;70(1):71-80. Epub 2005 Apr 9.
Related Articles, Links
Janghorbani M, Amini M.
764: Int J Med Inform. 2006 Feb;75(2):173-81. Epub 2005 Aug 24.
Related Articles, Links
Publication Types:
• Evaluation Studies
• Research Support, U.S. Gov't, Non-P.H.S.
Publication Types:
• Comparative Study
Hazreen AM, Myint Myint S, Farizah H, Abd Rashid M, Chai CC, Dymna
VK, Gilbert W, Sri Rahayu S, Seri Diana MA, Noor Huzaimnah H.
To assess the level of knowledge, attitude and practice (KAP) on SARS and its
preventive measures among the rural population of Kuala Kangsar district. This
KAP study was also done to identify the expectation and preference of rural
population upon obtaining health information. This is a cross-sectional study of
201 households from four villages in Kuala Kangsar. Face-to-face interview was
done regarding knowledge, attitude and practice on SARS and its preventive
measures. Statistical analyses were performed with SPSS (Version 10.0). A
scoring system was used to assess the level of knowledge, attitude and practice
towards SARS. Ninety one percent of the study population was aware of SARS.
Majority of them have good attitude towards SARS based on the formulated
scoring system. Television was found to be the first hand information about
SARS and most preferred source of information by the rural population.
Knowledge and attitude of respondents concerning SARS were good. Television
was found to be the preference among the rural population in obtaining health
information.
Publication Types:
• Comparative Study
• Evaluation Studies
767: Int J Med Inform. 2005 Dec;74(11-12):952-9. Epub 2005 Aug 22.
Related Articles, Links
This study analyzed what nurses wrote in narrative nursing notes for cardiac-
surgery patients. The nursing notes of 46 patients were analyzed based on the
nursing process. Eight patterns were extracted according to different combinations
of nursing process components, of which an assessment alone was the most
frequent nursing phrase (45.8%), followed by assessment or diagnosis-
intervention-outcome (25.9%). The content of the nursing notes was also
classified into 15 categories, of which nursing outcomes were recorded more
frequently in nursing care driven mainly by physician's order such as disease-
related symptom management, insomnia care, respiratory care, and pain control,
than in independent nursing care such as education and emotional care. A survey
on the attitudes of nurses toward the nursing record revealed that they do not
document nursing outcomes as much as they think they do. The main reasons for
this discrepancy were insufficient time for recording and lack of knowledge about
why, how, and what to evaluate. Even though there is room for improvement,
nursing notes represent a useful resource for determining nursing contributions to
patient outcomes.
Evidence for Public Health Unit, School of Epidemiology and Health Sciences,
University of Manchester, Manchester, UK. patrick.mcelduff@man.ac.uk
Strulov A.
School of Public Health, Faculty of Social Welfare and Health Studies, Haifa
University, Haifa, Israel. astrulov@univ.haifa.ac.il
Until the end of the 1980s almost no intensive intervention plan was applied to
narrow the vast gap (over 100%) in infant mortality between Jews and Arabs in
the Western Galilee region of Israel. A special committee appointed by the
Ministry of Health instituted measures to reduce the gap, including monitoring
mortality rates by establishing an online and real-time computerized information
system to analyze the information without delay. Based on the epidemiologic
findings, an intervention program was implemented, using health education to
reduce mortality due to seasonal infections--gastroenteritis in summer and upper
respiratory and hyperthermia in winter. Within 1 year these infections had abated,
resulting in significantly reduced mortality. The next step was the development of
an ultrasound preventive campaign using sophisticated sonography to screen
pregnant women in risk groups for lethal congenital defects and convincing them
to discontinue the pregnancy. These two measures reduced infant mortality
dramatically. The campaign has been widened to the entire northern district and is
presently addressing, as a primary prevention, the traditionally difficult problem
of consanguineous marriages--the major cause of congenital defects in the Arab
population.
[Article in Japanese]
Publication Types:
• English Abstract
Wen SW.
Publication Types:
• Letter
• Research Support, Non-U.S. Gov't
PMID: 16100630 [PubMed - indexed for MEDLINE]
Asia contributes more than 90% to the world's aquaculture production. Like other
farming systems, aquaculture is plagued with disease problems resulting from its
intensification and commercialization. This paper describes the various factors,
providing specific examples, which have contributed to the current disease
problems faced by what is now the fastest growing food-producing sector
globally. These include increased globalization of trade and markets; the
intensification of fish-farming practices through the movement of broodstock,
postlarvae, fry and fingerlings; the introduction of new species for aquaculture
development; the expansion of the ornamental fish trade; the enhancement of
marine and coastal areas through the stocking of aquatic animals raised in
hatcheries; the unanticipated interactions between cultured and wild populations
of aquatic animals; poor or lack of effective biosecurity measures; slow awareness
on emerging diseases; the misunderstanding and misuse of specific pathogen free
(SPF) stocks; climate change; other human-mediated movements of aquaculture
commodities. Data on the socio-economic impacts of aquatic animal diseases are
also presented, including estimates of losses in production, direct and indirect
income and employment, market access or share of investment, and consumer
confidence; food availability; industry failures. Examples of costs of investment
in aquatic animal health-related activities, including national strategies, research,
surveillance, control and other health management programmes are also provided.
Finally, the strategies currently being implemented in the Asian region to deal
with transboundary diseases affecting the aquaculture sector are highlighted.
These include compliance with international codes, and development and
implementation of regional guidelines and national aquatic animal health
strategies; new diagnostic and therapeutic techniques and new information
technology; new biosecurity measures including risk analysis, epidemiology,
surveillance, reporting and planning for emergency response to epizootics;
targeted research; institutional strengthening and manpower development
(education, training and extension research and diagnostic services).
Publication Types:
• Review
SETTING: Private for-profit health care providers are prominent in the health
system of the Philippines. OBJECTIVES: To examine the practices of the private
practitioners in Malabon, Metropolitan Manila, Philippines, concerning diagnosis
and treatment of tuberculosis (TB). DESIGN: Forty-five private practitioners of
Malabon who treat adult TB patients were interviewed. RESULTS: For diagnosis,
most private practitioners relied on the clinical presentation and result of an X-
ray. Only 13% of the respondents routinely also asked for sputum examination.
Ninety-six percent used X-ray as a tool to monitor treatment. Sixty percent of the
respondents prescribed a regimen consisting of isoniazid, rifampicin,
pyrazinamide, and ethambutol. Except for rifampicin, over-dosage was common.
For re-treatment cases, none prescribed the WHO-recommended re-treatment
regimen. The private practitioners perceived the main reasons for patient non-
adherence to be the patients' lack of finances to buy drugs and patients' perceived
well being after a certain period of treatment. Patients' lack of money was seen as
the main obstacle to compliance. The only case holding mechanism mentioned
was occasional clinic appointments of the TB patients. CONCLUSION: Private
practices for diagnosis and treatment of TB typically deviate from guidelines. The
quality of care among private practitioners needs improvement. Innovative
strategies are required.
Publication Types:
774: Int J Med Inform. 2006 Feb;75(2):148-55. Epub 2005 Aug 10.
Related Articles, Links
Results of a survey on medical error reporting systems in Korean
hospitals.
Publication Types:
Takamoto S.
Publication Types:
• Editorial
Publication Types:
Publication Types:
Publication Types:
• Clinical Trial
• Research Support, N.I.H., Extramural
• Research Support, U.S. Gov't, P.H.S.
[Article in Hebrew]
Publication Types:
• English Abstract
[Article in Japanese]
Publication Types:
• Comparative Study
• English Abstract
Publication Types:
• Multicenter Study
• Research Support, Non-U.S. Gov't
Beiki O, Beiki D.
Publication Types:
PMCID: PMC1175808
785: J Am Med Inform Assoc. 2005 Nov-Dec;12(6):642-7. Epub 2005 Jul 27.
Related Articles, Links
Park RW, Shin SS, Choi YI, Ahn JO, Hwang SC.
Publication Types:
PMCID: PMC1294035
Publication Types:
Leonardo LR, Rivera PT, Crisostomo BA, Sarol JN, Bantayan NC, Tiu WU,
Bergquist NR.
Publication Types:
Imamura Y, Mizuno S.
Publication Types:
• Comparative Study
Kaminuma T.
In this article, we describe the results of nine focus groups in which women were
asked to discuss their perception of the women's health care delivery system in
Israel. The focus groups, held in Israel in 2001, included nearly 150 women with
diverse demographic characteristics. This project solicited focused input from
women of different ages from the periphery as well as highly populated areas. The
responses were categorized into designated themes and are presented here to
demonstrate the range of women's feelings toward health care. The qualitative
findings of this research show that place of residence affects the women's sense of
responsibility for their health and their use of private care. Age was found to
affect knowledge and use of health information, the frequency of visits to the
doctor, and the general level of satisfaction with the system. These findings are
important to improve health care delivery and can serve as a basis for forging
policy changes in Israel.
Publication Types:
Tezel A.
The aim of the present study was to describe the prevalence and distribution of
symptoms of musculoskeletal complaints among Turkish nurses who are
practicing general nursing. The study population consisted of 120 nursing staff
from four large general hospitals in Erzurum, Turkey. In every hospital six
departments (surgery, medical, obstetric and gynecology, psychiatry, pediatric,
and neurology) were selected. A Nordic standardized questionnaire described by
Kuorinka et al. (1987) about complaints of the musculoskeletal system and a self-
administered questionnaire involved information on the respondent's job and
employment history, individual characteristics, physical and psychosocial risk
factors at work, and general health status, were used by the researchers. Test data
were analyzed for the difference between two population proportion and
percentage. In the total population, 90% of all nurses reported at least one
musculoskeletal complaint, 60% reported at least two, and 36% reported spells of
three complaints in the past 6 months. Low back complaints were the most
prevalent of musculoskeletal complaints, reported by 69% of the nurses. Neck
complaints were less prevalent than shoulder (46% and 54%, respectively).
Nurses with back complaint more often reported neck (28%) and shoulder (34%)
complaints. Chronic low back, neck, and shoulder complaints were experienced
by 41%, 25%, and 33% nurses, respectively. On the other hand, chronic
complaints showed a correlation with working departments. The nurses working
in surgery and obstetric and gynecology departments have more chronic
complaints than the nurses working in other department (p<.05). The article's
findings do not differ from those of other countries. Despite its limitations, this
study points to the importance of perceived worked-related physical demands in
relation to reported neck, shoulder, and back musculoskeletal complaints in
Turkish nurses. But, further inquiries are needed to identify other physical
exposures that may be related to musculoskeletal complaints.
Publication Types:
• Multicenter Study
PMID: 16019580 [PubMed - indexed for MEDLINE]
[Article in Chinese]
Guo L, Yu S.
By adopting the Landsat images of 1986 and 2001, and through field
investigation, this paper studied the characteristics and genesis of the spatial-
temporal changes of Taishan Mountains scenery area landscape patterns in
Shandong Province of East China since mid-80 s of last century, and approached
the effects of anthropogenic disturbances on them. The results showed that the
anthropogenic disturbances at that time were the main reasons of inducing the
significant changes of landscape patterns, and the large-scale pure forest
reconstruction and scenery area construction in late 80s of last century made the
forest vegetation patches more fragmented and the superiority of landscape types
decreased. The results also showed that the area of Pinus forest significantly
decreased, mainly due to its conversion to Quercus and mixed forests. The
increase of landscape patches intensified the fragmentation of certain landscape
patterns, and in particular, the increase of bare substrate on steep slopes could
potentially damage the health of mountain ecosystem.
Publication Types:
• English Abstract
• Research Support, Non-U.S. Gov't
Comment in:
The objective of this study was to determine the prevalence of neck pain (NP) in
the world population and to identify areas of methodological variation between
studies. A systematic search was conducted in five databases (MEDLINE,
EMBASE, CINAHL, OSH-ROM, and PsycINFO), followed by a screening of
reference lists of relevant papers. Included papers were extracted for information
and each paper was given a quality score. Mean prevalence estimates were
calculated for six prevalence periods (point, week, month, 6 months, year, and
lifetime), and considered separately for age, gender, quality score, response rate,
sample size, anatomical definition, geography, and publication year. Fifty-six
papers were included. The six most commonly reported types of prevalence were
point, week, month, 6 months, year, and lifetime. Except for lifetime prevalence,
women reported more NP than men. For 1-year prevalence, Scandinavian
countries reported more NP than the rest of Europe and Asia. Prevalence
estimates were not affected by age, quality score, sample size, response rate, and
different anatomical definitions of NP. NP is a common symptom in the
population. As expected, the prevalence increases with longer prevalence periods
and generally women have more NP than men. At least for 1-year prevalence
Scandinavian countries report higher mean estimates than the rest of Europe and
Asia. The quality of studies varies greatly but is not correlated with the prevalence
estimates. Design varies considerably and standardisation is needed in future
studies.
Publication Types:
• Review
Publication Types:
• Comparative Study
Publication Types:
• Research Support, Non-U.S. Gov't
797: Sci Total Environ. 2005 Jun 15;346(1-3):184-99. Epub 2005 Jan 7.
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Publication Types:
Databases in peril.
Publication Types:
• Editorial
[Article in Chinese]
Women's health problems are increasing among teenage girls in modern society.
However, there are only a few programs related to women's health consultation on
campuses. Three issues are explored in this paper - the health rights of teenage
girls, women's health consultations, and teenage girls' subjective views about the
establishment of a women's health consultation service on their campus. In the
course of our research of teenage girls' subjective views, three hundred and
eighty-seven young girl students responded to questionnaires and seven volunteer
students among them were invited to do in-depth interviews. Most students
(98.2%) thought that it was necessary to set up a women's health consultation
service on campus, because they hoped to get personal health information that
could not be found in a textbook. Three hundred and five (78.8%) students
perceived that they had women's health problems. Their health problems are
ranked as follows: dysmenorrhea, irregularity of menstrual periods, unusual
vaginal secretions and questions of contraception and urinary system health. They
suggested that campus consultation centers should have the following
characteristics: protection of students' privacy, provision of multiple channels for
consultation, strict limitation on numbers of people in the consulting office, and a
non-discriminatory policy towards all clients. Hopefully, an information database
can provide a good reference for establishing a women's health consultation
service on campus in the near future.
Publication Types:
• English Abstract
PMID: 15986296 [PubMed - indexed for MEDLINE]