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Chronic Disease or Injury

Adverse childhood experiences are childhood traumas which influence the developing child and derail healthy developmental processes. The developing child attempt to cope by adopting health risk behaviors such as smoking which has been associated with adverse health outcomes which may not be apparent until many years after exposure.1,2 Research and surveillance on adverse childhood experiences and smoking is a substantially neglected area in Sub Saharan Africa including Nigeria.

Objective

To assess the relationship between Adverse Childhood Experiences (ACEs) and Smoking behaviors among urban youths in Oyo State, South Western Nigeria.

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There is a clear need for improved surveillance of chronic diseases to guide public health practice and policy. Chronic disease surveillance has tended to use administrative data, due to the need to link encounters for an individual over time and to have complete capture of all encounters. Case-detection algorithms generally combine variables found in the data using Boolean operators (i.e., AND, OR, NOT). For example, a commonly used algorithm for DM surveillance requires a patient to have one hospitalization or two physician visits within two years with a diagnostic code for DM. While this approach to defining case-detection algorithms is straightforward, it has limitations. For example, if more than simple combinations of one or two variables are used, then it becomes unwieldy to represent the algorithm and it can be difficult to identity how different variables in the definition contribute to detection accuracy. A multivariable probabilistic case-detection algorithm can address these problems and facilitate exploration of how the multiple variables available from different data sources might improve case-detection accuracy1. In this research, we develop an approach for probabilistic multivariable case-detection and apply the method to a cohort of older adults with known DM status to demonstrate and evaluate the method.

Objective

To develop and validate a multivariable probabilistic algorithm for detecting cases of diabetes mellitus (DM) using clinical and demographic data.

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In the United States, 800,000-1.4 million people are chronically infected with hepatitis B virus (HBV); these persons are at increased risk for chronic liver disease and its sequelae. Current national viral hepatitis surveillance is a passive laboratory-initiated reporting system to state or local health departments with only 39 health departments reporting chronic HBV infection in the National Notifiable Disease Surveillance System. Since active HBV surveillance can be expensive and labor-intensive, the ICD-9 coding system has been proposed for surveillance of chronic hepatitis B.

 

Objective

To evaluate the sensitivity, specificity, positive and negative predictive values of the ICD-9 coding system for surveillance of chronic hepatitis B virus infection (HBV) using data from an observational cohort study in which ICD-9-coded HBV cases were validated by chart review

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Presented July 10, 2018.

Why global mental health surveillance is important – understanding current issues in global mental health surveillance and learning strategies to improve mental health surveillance worldwide, particularly in low and middle –income countries.

Presenter

Shalini Ahuja, MA-HMPP, DHM, BPT, Global Mental Health Researcher, Centre for Implementation Science, Health Services and Population Research Department, King’s College London

Syndromic surveillance information can be a useful for the early recognition of outbreaks, acute public health events and in response to natural disasters. Inhalation of particulate matter from wildland fire smoke has been linked to various acute respiratory and cardiovascular health effects. Historically, wildfire disasters occur across Southern California on a recurring basis. During 2003 and 2007, wildfires ravaged San Diego County and resulted in historic levels of population evacuation, significant impact on air quality and loss of lives and infrastructure. In 2011, the National Institutes of HealthNational Institute of Environmental Health Sciences awarded Michigan Tech Research Institute a grant to address the impact of fire emissions on human health, within the context of a changing climate. San Diego County Public Health Services assisted on this project through assessment of population health impacts and provisioning of syndromic surveillance data for advanced modeling.

Objective

This presentation describes how syndromic surveillance information was combined with fire emission information and spatio-temporal fire occurrence data to evaluate, model and forecast climate change impacts on future fire scenarios.

Submitted by uysz on

Concern over oral health-related ED visits stems from the increasing number of unemployed and uninsured, the cost burden of these visits, and the unavailability of indicated dental care in EDs [1]. Of particular interest to NC state public health planners are Medicaid-covered visits. Syndromic data in biosurveillance systems offer a means to quantify these visits overall and by county and age group.

Objective

The objective was to use syndromic surveillance data from the North Carolina Disease Event Tracking and Epidemiologic Collection Tool NCDETECT and from BioSense to quantify the burden on North Carolina (NC) emergency departments of oral health-related visits more appropriate for care in a dental office (ED). Calculations were sought in terms of the Medicaid-covered visit rate relative to the Medicaid-eligible population by age group and by county.

Submitted by uysz on

There are several reports of zinc deficiency in pathogenesis of acute and chronic diarrhea. The literature review showed children with diarrhea and chronic gastroduodenitis performed zinc deficiency in majority of cases (1). The normal values of zinc in blood serum are 12.8-27.8 µmol/l (2). There is a threshold of 13µmol/l zinc concentration for zinc deficiency diagnosis. The zinc level 8.2 µmol/l and below is poor prognostic criteria (3).

Objective

To study the blood serum zinc concentration in children with acute diarrhea (AD) in in-patient facilities before and after therapy.

Submitted by uysz on

Extreme temperatures are consistently shown to have an effect on CVD-related mortality [1, 2]. A large multi-city study of mortality demonstrated a cold-day and hot-day weather effect on CVD-related deaths, with the larger impact occurring on the coldest days [3]. In contrast, the association between weather and CVD-related morbidity is less clear [4, 5]. The purpose of this study is to characterize the effect of temperature on CVD-related emergency department (ED) visits, hospitalizations, and mortality on a large, heterogeneous population. Additionally, we conducted a sensitivity analysis to determine the impact of air pollutants, specifically fine particulates (PM2.5) and ozone (O3), along with temperature, on CVD outcomes.

Objective

To examine the effects of temperature on cardiovascular-related (CVD) morbidity and mortality among New York City (NYC) residents.

Submitted by uysz on

Research has indicated several risk and protective factors for arthritis, including cigarette smoking, alcohol consumption, obesity, and physical activity (1–4). However, it is not well understood how all these factors interact to increase/decrease the risk of arthritis.

Objective

To examine how cigarette smoking, alcohol consumption, obesity, and physical activity are associated with the risk and severity of arthritis among adults living in Delaware.

Submitted by uysz on

Researchers have demonstrated benefits to identifying and developing interventions for patients that frequently seek healthcare services in the ED. The New Yorker Magazine, recently published an article titled The Hot Spotters, summarizing work being done in the United States to lower medical costs by giving the neediest patients better healthcare (1). In Camden, NJ, Physician Jeffrey Brenner closed his regular practice to focus on Hot Spotter patients (directing resources and brainpower to help their improvement) and measured a 40% reduction in hospital inpatient and ED visits and a 56% medical cost reduction for the first 36 Hot Spotters. A 2008 NH Office of Medicaid Business and Policy (OMBP) outpatient Medicaid ED frequency visit study was conducted, which cited that frequent ED users were more likely to have higher costs and rates of illness or disease than all Medicaid members (2). It was noted that increased prevention and wellness could reduce frequent ED use and increase cost savings (5% of the NH Medicaid population contributed to approximately 38% of ED costs). The NH Division of Public Health Services initiated a pilot project to examine NH Emergency Department (ED) surveillance data to identify high utilizer patients and realize improved health benefits and medical cost reductions.

Objective:

To develop a manageable surveillance methodology to detect Emergency Department (ED) patients with the highest healthcare utilization, and monitor their targeted treatment improvement and medical health cost reductions over time for overall improvements in statewide health.

 

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