Chronic Disease or Injury

Hypoglycemia is a serious sequela of diabetes treatment that is not tracked by current health surveillance efforts despite substantial related morbidity and mortality. We take a novel approach to hypoglycemia surveillance, engaging members of an international online diabetes social network in reporting about this issue as members of a consented, distributed public health research cohort.

Objective

To measure the prevalence of hypoglycemic episodes and associated harms among participants in an international, online diabetes social network.

Chronic diseases are the leading causes of mortality and morbidity for Americans but public health surveillance for these conditions is limited. Health departments currently use telephone interviews, medical surveys, and death certificates to gather information on chronic diseases but these sources are limited by cost, timeliness, limited clinical detail, and/or poor population coverage. Continual and automated extraction, analysis, and summarization of EHR data could advance surveillance in each of these domains.

Objective

Develop methods for automated chronic disease surveillance and visualization using electronic health record (EHR) data.

Hearing loss is the most common birth defect, occurring at a rate of 1-3 of every 1000 births. The goal of the Louisiana Early Hearing Detection and Intervention Program (LA EHDI) is to ensure that all newborns are screened for hearing loss so that those with a diagnosis of permanent hearing loss can achieve their maximum potential. LA EHDI promotes the national EHDI goals of screening for hearing loss by 1 month of age, preferably before hospital discharge; completing diagnostic evaluations for all infants who screen positive by 3 months of age; and for all infants identified with hearing loss, receiving appropriate early intervention services by 6 months of age. The findings of this study are expected to help LA EHDI define characteristics of newborns who receive late initial hearing screening tests to be performed in the hospital. The program may consider if those characteristics are potentially related to hearing loss so that appropriate plans to prevent risk factors of hearing loss are developed appropriately.

Objective

The objective of the study was to compare the average length of time for hearing screening to be conducted prior to hospital discharge with newborns' characteristics among birth cohort of 2011 in Louisiana.

Newborn hearing screening prior to hospital discharge is implemented in all states and some U.S. territories. All newborns who fail the hearing screening are encouraged to follow up to get further tests to confirm diagnosis of hearing loss as early as possible, preferably by three months of age. Loss to follow-up of hearing screening is defined as a newborn who fails the initial hearing test before hospital discharge but does not follow up with further hearing tests to confirm diagnosis of hearing loss. Defining high risk populations of loss to follow-up is necessary not only to improve the rate of loss to follow-up, but also to enhance the capacity for early confirmed diagnosis and ease of access to care for patients with hearing loss in the state.

Objective

The objective of this study was to explore who were at high risk of loss to follow-up among newborns who failed initial hearing screening tests prior to hospital discharge in Louisiana between 2007 and 2011.

CVD is one of the leading causes of death in the US, with 800,000 deaths being linked to CVD every year. Recently, the CDC reported that 1 in 4 of these deaths could be prevented by lifestyle changes, creating healthier living spaces, as well as managing high cholesterol, blood pressure and diabetes levels [1]. The report also stressed the importance of electronic health records (EHR) in identifying patients with CVD risk factors [1]. Surveillance is a critical component of national effort to prevent CVD [2]. The Nebraska Department of Health and Human Services (NDHHS) has traditionally tracked the burden of chronic diseases by retrospective analysis of hospital discharge data (HDD). However, HDD is limited by its lack of immediate availability and its limited amount of data. Timeliness of detection and analysis of CVD events could be improved with syndromic surveillance. To enhance CVD surveillance in Nebraska, NDHHS implemented a near-real_time IP surveillance system in 2011. This surveillance system facilitates near-real_time assessment of CVD risk factors, outcomes, and prevention program efficacy.

Objective

The main objective of this project is to expand inpatient syndromic surveillance in Nebraska to include indicators of Cardiovascular Disease (CVD).

CO poisoning poses a significant public health burden. It is preventable, yet it remains a leading cause of poisoning in the United States. An effective surveillance system is very important for targeting and monitoring CO poisoning.Methods or Description: ED data was analyzed from the Missouri Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE). The ED chief complaints of CO poisoning in ESSENCE contain keywords such as 'carbon' or 'monoxide'. The Missouri Health Strategic Architectures and Information Cooperative (MOHSAIC) database was used to collect the other information about the CO poisoning cases. Statistical Analysis Software (SAS) (version 9.3) was applied for all the analyses in this study.

Objective

This study demonstrated the utility and importance of ED data as a surveillance tool as cases of CO poisoning were identified in ESSENCE that were not identified in the passive surveillance system (MOHSAIC). The study also demonstrated the potential of ED data to assist in developing effective, more targeted prevention strategies for CO poisoning.

A laboratory biosafety program (LBP) is essential to ensure the health and safety of laboratory staff and the general public from hazardous materials and infectious agents. In the US, the Occupational Safety and Health Administration (OSHA) sets federal standards governing LBPs that enforce best practices by non-regulatory organizations such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) [1]. In addition, twenty-five states and two territories established OSHA-approved biosafety standards that meet or exceed federal standards [2]. The CDC/NIH's Biosafety in Microbiological and Biomedical Laboratories [BMBL] are the primary guidelines for LBPs, and many jurisdictions use the manual in a regulatory manner [3]. Ensuring laboratory biosafety requires vigilance; laboratories must maintain equipment and materials, develop and implement security measures, and staff must be annually trained in biosafety procedures. Our evaluation of LBPs underscored the importance of the human element in biosafety compliance.

Objective

To understand the potential gaps in laboratory biosafety due to human factors.

Extreme heat events over the past 30 years have resulted in unprecedented increase in the numbers of heat-related morbidity and mortality across the world (1-3). During the same time frame, Houston residents has experienced three of the hottest summers on record since 1889, with 2011 being the hottest summer on record (4). Therefore, preparing for extreme heat events and monitoring their effects on public health is a vital role for the Houston Department of Health and Human Services (HDHHS). Since heat-related illnesses are not a reportable condition in the state of Texas, HDHHS authorities rely on other sources to provide information on the impact of heat on the population. HDHHS is currently able to monitor emergency departments (ED) visits across the Houston metropolitan area, Harris County, and the surrounding jurisdictions by using a syndromic surveillance system called Real-time Outbreak Disease Surveillance (RODS). The RODS system collects de-identified patient data that consists of their chief complaint and basic demographics (e.g. age, sex, zip code). This study is aimed at evaluating the ability of RODS to detect heat-related illnesses during heat event of the years 2009-2012 as well as identifying the areas of Houston that had the highest incidence of heat-related morbidity.

Objective

To evaluate the ability of a syndromic surveillance system to detect heat-related illnesses during a heat wave in Houston and to identify areas in Houston that requires additional resources to prevent heat-related illnesses.