Incidence of Rocky Mountain spotted fever among American Indians in Oklahoma.
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OBJECTIVE: Although the state of Oklahoma has traditionally reported very high incidence rates of Rocky Mountain spotted fever (RMSF) cases, the incidence of RMSF among the American Indian population of the state has not been studied. The authors used data from several sources to estimate the incidence of RMSF among American Indians in Oklahoma. METHODS: The authors retrospectively reviewed an Indian Health Service (IHS) hospital discharge database for 1980-1996 and available medical charts from four IHS hospitals. The authors also reviewed RMSF case report forms submitted to the Centers for Disease Control and Prevention (CDC) for 1981-1996. RESULTS: The study data show that American Indians in the IHS Oklahoma City Area were hospitalized with RMSF at an annual rate of 48.2 per million population, compared with an estimated hospitalization rate of 16.9 per million Oklahoma residents. The majority of cases in the IHS database (69%) were diagnosed based on clinical suspicion rather than laboratory confirmation. The incidence of RMSF for Oklahoma American Indians as reported to the CDC was 37.4 cases per million, compared with 21.6 per million for all Oklahoma residents (RR 1.7, 95% confidence interval [CI] 1.5, 2.1). CONCLUSIONS: Rates derived from the IHS database may not be comparable to state and national rates because of differences in case inclusion criteria. However, an analysis of case report forms indicates that American Indians n Oklahoma have a significantly higher incidence of RMSF than that of the overall Oklahoma population. Oklahoma American Indians may benefit from educationa campaigns emphasizing prevention of tick bites and exposure to tick habitats. (+info)
Microbiology subsystem of a total, dedicated laboratory computer system.
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The computer system used by the Microbiology Service of the Clinical Pathology Department, Clinical Center, National Institutes of Health is discussed. This microbiology subsystem is a part of a dedicated on-line laboratory computer system used by the entire department. The laboratory computer is connected on-line to a hospital computer which provides patient admission, transfer, and discharge data. Mark sense worksheets and cathode ray tube terminals are used for result entry and correction. Cumulative patient reports are printed. Results for both active and completed accessions can be easily retrieved on cathode ray terminals in the laboratory. All laboratory data are archived on magnetic tape from which a research data base and microfiched laboratory records are generated. The manner in which the system is integrated in the routine operation of the microbiology laboratory is emphasized. In addition, some of the costs, benefits, liabilities, and pitfalls associated with the introduction of the computer in the laboratory are reviewed. Finally, we have presented our concept of some of the future enhancements to our present system and some of the directions in which any future microbiology system might develop. (+info)
Evaluation of clinician response to wireless technology.
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The purpose of this study was to investigate the safety, use and response of clinical staff to wireless technology. A convenience sample of clinical staff was surveyed using a variety of assessment tools. The environmental assessment determined there was no interference between the wireless devices and the biomedical equipment on the patient care units. Survey results indicated a high level of acceptance for the wireless technology related to perceived usefulness, perceived ease of use, impact, adoption, advantage and future need. Results indicated a strong, significant relationship between adoption and perceived usefulness (r(s)=.71 p<.01; r(2)(s)=.50). (+info)
Prevalence and correlates of mental disorders among Native American women in primary care.
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OBJECTIVES: We examined the lifetime and the past-year prevalence and correlates of common mental disorders among American Indian and Alaska Native women who presented for primary care. METHODS: We screened 489 consecutively presenting female primary care patients aged 18 through 45 years with the General Health Questionnaire, 12-item version. A subsample (n = 234) completed the Composite International Diagnostic Interview. We examined associations between psychiatric disorders and sociodemographic variables, boarding school attendance, and psychopathology in the family of origin. RESULTS: The study participants had high rates of alcohol use disorders, anxiety disorders, and anxiety/depression comorbidity compared with other samples of non-American Indian/Alaska Native women in primary care settings. CONCLUSIONS: There is a need for culturally appropriate mental health treatments and preventive services. (+info)
Time to treatment in patients with stage III non-small cell lung cancer.
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Fighting smallpox on the Texas border: an episode from PHS's proud past.
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The motto of the Public Health Service (PHS) is "Service with Distinction." An example of how that motto was earned can be seen in the work of the professionals of the Marine Hospital Service (as PHS was then known) in a smallpox epidemic on the Texas border in 1895. Barely 2 years after Congress had given the U.S. Surgeon General the authority to intervene and prevent the spread of contagious diseases from one State to another, Surgeon General Walter Wyman, MD, stepped in. In response to a request from the Texas State Health Officer, Wyman sent a team of officers to assist the State and prevent the spread of smallpox. At that time the Surgeon General was head of the Marine Hospital Service, which became the Public Health Service in 1912. In a period of slightly more than 2 months, the epidemic was contained in the population of 411 refugees. Sixty people had died at the camp, 51 from smallpox. Although that fatality rate would be incredibly high by current standards, it was low under the circumstances. Milton Rosenau, MD, was a key to the containment of the disease and the humanitarian treatment of the survivors, a group of black Americans who had fled from Mexico after having been lured there with the promise of land that would be their own. Rosenau would later become the head of the Hygienic Laboratory, precursor of the National Institutes of Health. (+info)
Community health politics: transition of the Seattle USPHS Hospital.
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To achieve transition of the Seattle US Public Health Service Hospital from federal to local control, the community overcame large obstacles; the most difficult was federal preference for closing the hospital rather than incurring additional costs essential for transition. The Washington State Congressional Delegation, local officials, hospital staff, patients and numerous community volunteers--individuals and private organizations--worked together to save the hospital and secure federal resources for its transition. Going through the transition influenced the hospital as it developed a new corporate structure, designed new administrative systems, and prepared to operate in a new environment while facing an uncertain future. The hospital has continued to cope with issues arising from transition, such as operating in a competitive context while reaffirming its community service heritage. Despite the difficulties of transition, Seattle preserved a valuable community health resource. (+info)
PCR amplification of rRNA intergenic spacer regions as a method for epidemiologic typing of Clostridium difficile.
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From January to March 1993, a suspected outbreak of antibiotic-associated diarrhea occurred on a pediatric oncology ward of the Clinical Center Hospital at the National Institutes of Health. Isolates of Clostridium difficile obtained from six patients implicated in this outbreak were typed by both PCR amplification of rRNA intergenic spacer regions (PCR ribotyping) and restriction endonuclease analysis of genomic DNA. Comparable results were obtained with both methods; five of the six patients were infected with the same strain of C. difficile. Subsequent analysis of 102 C. difficile isolates obtained from symptomatic patients throughout the Clinical Center revealed the existence of 41 distinct and reproducible PCR ribotypes. These data suggest that PCR ribotyping provides a discriminatory, reproducible, and simple alternative to conventional molecular approaches for typing strains of C. difficile. (+info)