From <@uga.cc.uga.edu:owner-mednews@ASUACAD.BITNET> Sun Apr 2 13:31:26 1995 with BSMTP id 5772; Sun, 02 Apr 95 13:10:52 EDT UGA.CC.UGA.EDU (LMail V1.2a/1.8a) with BSMTP id 4338; Sun, 2 Apr 1995 13:08:32 -0400 HICNet Medical News Digest Sun, 02 Apr 1995 Volume 08 : Issue 12 Today's Topics: [MMWR] Vaccination Coverage Surveys in County Health Departments -- [MMWR] National Public Health Week [MMWR] Availability of Recommendations for Preventing Vancomycin Managing in Academic Health Centers National AIDS Clearinghouse FAXBack Service 13th Asia Pacific Cancer Conference Announcment FDA Approves Drug For Non-Small Cell Lung Cancer McGill Journal of Medicine - Submissions Invited FDA's 1994 Medication Approvals NASA Tests Painless Ways of Measuring Intracranial Pressure 42nd Annual Course in Oral Pathology - AFIP Public Health Research Training Grants 1995-1996 Int'l Workshop on Information Processing in Cells and Tissues New Computer Programs/Files on UC Irvine Ftp Server +------------------------------------------------+ ! ! ! Health Info-Com Network ! ! Medical Newsletter ! +------------------------------------------------+ Editor: David Dodell, D.M.D. 10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA Telephone +1 (602) 860-1121 FAX +1 (602) 451-1165 Internet: mednews@stat.com Bitnet: ATW1H@ASUACAD Mosaic WWW *Asia/Pacific: http://biomed.nus.sg/MEDNEWS/welcome.html *Americas: http://cancer.med.upenn.edu:3000/ *Europe: http://www.dmu.ac.uk/ln/MEDNEWS/ Compilation Copyright 1995 by David Dodell, D.M.D. All rights Reserved. License is hereby granted to republish on electronic media for which no fees are charged, so long as the text of this copyright notice and license are attached intact to any and all republished portion or portions. The Health Info-Com Network Newsletter is distributed biweekly. Articles on a medical nature are welcomed. If you have an article, please contact the editor for information on how to submit it. If you are interested in joining the automated distribution system, please contact the editor. Associate Editors: E. Loren Buhle, Jr. Ph.D. Dept. of Radiation Oncology, Univ of Pennsylvania Tom Whalen, M.D., Robert Wood Johnson Medical School at Camden Douglas B. Hanson, Ph.D., Forsyth Dental Center, Boston, MA Lawrence Lee Miller, B.S. Biological Sciences, UCI Dr K C Lun, National University Hospital, Singapore W. Scott Erdley, MS, RN, SUNY@UB School of Nursing Jack E. Cross, B.S Health Care Admin, 882 Medical Trng Grp, USAF Albert Shar, Ph.D. CIO, Associate Prof, Univ of Penn School of Medicine Stephen Cristol, M.D. MPH, Dept of Ophthalmology, Emory Univ, Atlanta, GA Subscription Requests = mednews@stat.com anonymous ftp = vm1.nodak.edu; directory HICNEWS FAX Delivery = Contact Editor for information ---------------------------------------------------------------------- To: hicnews Departments -- Vaccination Coverage Surveys in County Health Departments -- Kansas, 1993-1994 The objective of the Childhood Immunization Initiative (CII) is to protect all children in the United States by their second birthday against nine vaccine-preventable diseases. Specific objectives for 1994 were to increase coverage levels to at least 85% for the third dose of diphtheria and tetanus toxoids and pertussis vaccine (DTP3) and the first dose of measles, mumps, and rubella vaccine (MMR1); 75% for the third doses of oral poliovirus vaccine (OPV3) and Haemophilus influenzae type b vaccine (Hib3); and 30% for the third dose of hepatitis B vaccine (HepB3) (1). To determine whether county health departments in Kansas had achieved the national vaccination objectives, in 1993 staff from the Kansas Department of Health and Environment (KDHE) began assessing vaccination coverage rates for children aged 2 years served by county health departments in that state. This report presents the results of the first vaccination coverage assessments of all 105 county health departments in Kansas during November 1993-November 1994. The Clinic Assessment Software Application (CASA), which was developed by CDC to assist in the measurement of vaccination coverage rates (2,3), was used to assess coverage rates of DTP3, MMR1, OPV3, and Hib3 at the second birthday (4). Coverage rates for HepB3 were not assessed because universal hepatitis B vaccination of infants had not been implemented statewide. KDHE staff conducted 104 assessments; CDC conducted one. Most (100 [95%]) assessments were conducted onsite at county health departments; four (4%) were conducted offsite using copies of county health department vaccination records. The assessments reviewed records for all children aged 2 years and excluded those who were documented to have moved or gone elsewhere for health care. Because county health departments are administratively autonomous in Kansas, methods for maintaining vaccination records are not standardized. In health departments maintaining records for all children receiving services at the department for any reason, the assessment targeted all children with a medical record, including those who had never been vaccinated; in health departments maintaining only vaccination records, the assessment was restricted to children who had received at least one vaccination from the health department. Initially, systematic random sampling was done in health departments with greater than or equal to 50 records; during the assessment, this was changed to include only health departments maintaining greater than 200 records (approximately 20% of all health departments). Systematic random sampling ensured the computation of a 95% confidence interval within seven percentage points of the estimated coverage rate (2). All eligible records were assessed in the remaining health departments (3). Overall, the median number of records reviewed in a health department assessment was 86 (range: seven to 284). Median coverage rates at the second birthday for individual vaccines ranged from 89% for DTP3 to 75% for OPV3 (Table 1). The 1994 goal for all four vaccines assessed was met by 35 (33%) of the health departments; 82 (78%) met or surpassed the goal for Hib3, and 41 (39%) met or surpassed the goal for MMR1. None of the goals were met by 17 (16%) health departments. The median size of the birth cohort of 2-year-olds in counties with health departments achieving the four 1994 goals assessed was 51 (range: 24- 364), compared with a median of 411 (range: 36-7580) in health departments not achieving any of these objectives. Health departments in which the survey population included all children with a medical record were less likely to meet the objectives than those that included only children who had received at least one vaccination: a survey population consisting of all children with a medical record was assessed in 13 (77%) of the 17 health departments not meeting any of the objectives, while only one (3%) of the 35 health departments that met the four 1994 goals assessed a comparable population. KDHE provided findings of each assessment to county health department personnel and reviewed possible improvements in recordkeeping and vaccination practices. In addition, health departments were provided lists of children (based on the study sample) whose vaccinations were not up-to-date. Reported by: S Bowden, M Burt, J Calder, DVM, J Hansen, M Mayer, L Perry, MS, G Pezzino, MD, C Schiffelbein, D Silvius, MA, L Wilberschied, MS, Bur of Disease Control, AR Pelletier, MD, Acting State Epidemiologist, Kansas Dept of Health and Environment. Div of Field Epidemiology, Epidemiology Program Office; Program Operations Br, Div of Immunization Svcs, National Immunization Program, CDC. Editorial Note: The approach of KDHE illustrates the potential advantages of assessing provider-specific vaccination coverage levels, including objective characteristics of the vaccine provider's recordkeeping and vaccination practices. The use of a computer-based package such as CASA enables completion of the assessment onsite and immediate dissemination to health department staff. Assessments also enable determination of whether vaccination coverage can be improved through simultaneous administration of multiple vaccines and through elimination of missed opportunities by reviewing a child's vaccination status at every visit to the health department and providing vaccinations when appropriate (5). The coverage estimates in Kansas are subject to at least four limitations. First, these estimates reflect vaccination coverage only for children attending county health departments and cannot be used as countywide, population-based vaccination rates. Second, criteria for determining when to assess a sample of eligible records was changed during the statewide assessment. Third, because of differences in recordkeeping systems, the populations on which the assessments were based varied; therefore, coverage rates for county health departments in Kansas cannot be compared directly. Finally, estimated reported coverage rates may vary from actual coverage rates. Overestimation can occur in health departments where the assessment of vaccination status includes only children who had received at least one vaccination from the health department. These health departments were more likely to have met the four vaccination goals than those where the assessment of vaccination status includes children seen for any reason. In contrast, underestimation can occur when the records either do not document when children move or do not document vaccinations that were obtained from other providers. In Kansas, underestimation may be more common in larger counties because of the numbers of children to be tracked and the numbers of providers of vaccine. KDHE has developed plans to improve and expand the assessment process to meet future vaccination coverage goals. The national vaccination coverage objectives set by the CII for 1996 are 90% for DTP3, MMR1, OPV3, and HIB3, and 70% for HepB3 (1) at the second birthday. Therefore, beginning in 1995, the scope of the assessments in Kansas was expanded to examine coverage rates for hepatitis B vaccine, reflecting the statewide implementation of universal hepatitis B vaccination of infants. Uniform criteria were developed for determining which children had moved and should no longer be included in the survey population. In addition, KDHE is considering options for standardizing vaccination recordkeeping to ensure comparability and consistency of assessments. States receiving Immunization Action Plan funds during 1995 are required to assess all public health clinics annually.* To assist with these assessments, CASA software is available at no charge to public and private providers from the National Immunization Program, CDC, telephone (404) 639-8392. References 1. CDC. Reported vaccine-preventable diseases--United States, 1993, and the Childhood Immunization Initiative. MMWR 1994;43:57-60. 2. CDC. Guidelines for assessing vaccination levels of the 2-year-old population in a clinic setting. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, 1992. 3. CDC. Clinic assessment software application (CASA): user's guide. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, 1994. 4. ACIP. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1994;43(no. RR-1). 5. CDC. Standards for pediatric immunization practices: recommended by the National Vaccine Advisory Committee--approved by the U.S. Public Health Service. MMWR 1993;42(no. RR-5). *Public Law 103-333. ------------------------------ To: hicnews National Public Health Week April 3-9, 1995, has been designated National Public Health Week. Federal, state, and local public health agencies throughout the country will collaborate with private organizations and educational institutions on activities to promote healthy lifestyles and to heighten awareness of the essential services and benefits of public health. The Public Health Service, the American Public Health Association, the Association of State and Territorial Health Officials, the National Association of County and City Health Officials, and other national public health organizations have suggested activities to their constituents to increase understanding of the role of public health in protecting and improving the health status of individuals and communities. The theme for the week, "Public Health Is You, Too," focuses on the role persons can play in protecting their own health and that of their families and communities. Additional information about National Public Health Week is available from the Office of Disease Prevention and Health Promotion, Room 2132, 330 C Street, SW, Washington, DC 20201; telephone (202) 205-5968; and the American Public Health Association, 1015 15th Street, NW, Washington, DC 20005; telephone (202) 789-5600. ------------------------------ To: hicnews Vancomycin Availability of Recommendations for Preventing Vancomycin Resistance In February 1995, the Hospital Infection Control Practices Advisory Committee published Recommendations for Preventing the Spread of Vancomycin Resistance (1). Copies of the recommendations are available from the National Technical Information Service, 5285 Port Royal Road, Springfield, VA 22161; telephone (703) 487-4650. Reference 1. Hospital Infection Control Practices Advisory Committee. Recommendations for preventing the spread of vancomycin resistance. Infect Control Hosp Epidemiol 1995;16:105-13. ------------------------------ To: hicnews MANAGING IN ACADEMIC HEALTH CENTERS May 21-25, 1995 The William and Ida Friday Continuing Education Center The University of North Carolina at Chapel Hill Managing in Academic Health Centers is an intensive management program examining topics most pressing in today's academic health center community. Presented by nationally-recognized faculty, sessions include topics such as understanding the issues and challenges now facing academic health centers, enhancing the educational process, developing productive organizations, managing people, finding and controlling funds, and using technology effectively. Leaders from across the academic health center are encouraged to attend, including academic and professional leaders in Schools of allied health, dentistry, medicine, nursing, pharmacy, and public health; administrators in teaching hospitals and university-operated health clinics; and others managing in the academic health center environment. THE FEE for the entire five-day management program is $1295. It includes all educational materials (including the book, Managing in Academics: A Health Care Model, by program co-director Jill Ridky and faculty member George Sheldon), instructional sessions, coffee breaks, a welcome reception, lunch each day, a reception and dinner on Sunday night, and a North Carolina "pig pickin'" on Tuesday night. Enrollment in the program is limited to maintain interaction among participants and the faculty, so early registration is strongly advised. MANAGING IN ACADEMIC HEALTH CENTERS is sponsored by the Institute for Academic and Professional Leadership, the Division of Health Affairs, and the Division of Continuing Education at The University of North Carolina at Chapel Hill. FOR ADDITIONAL INFORMATION: Contact program co-director Chip Pate at the address below. ********************************************************************** William S. (Chip) Pate, Jr., Ph.D. | Phone: 919-962-3276 Program Director | FAX: 919-962-2061 Institute for Academic and | Email: iapl@unc.edu Professional Leadership | The Friday Center, CB #1020 | The IAPL offers professional UNC-Chapel Hill | development to leaders in Chapel Hill, NC 27599-1020 | higher education. ********************************************************************** ------------------------------ To: hicnews NAC FAX Document List CDC National AIDS Clearinghouse March 1995 NAC FAX -- A free, 24 hour fax-back service of the CDC National AIDS Clearinghouse. Now selected documents, including CDC fact sheets, surveillance report tables, and Clearinghouse information can be faxed from the Clearinghouse directly to you! To access NAC FAX, call (800) 458-5231 and select option 5 from the voice menu prompt. Below is the current list of available documents from NAC FAX. List of Available Documents Description Pages Document Number List of available documents 2 1 Draft C&T Guidelines Pregnant Women 21 4000 CDC FACTS ABOUT... Health-Care Workers, 10/94 1 287 Scope of the Epidemic, 11/93 3 288 Adolescents and HIV/AIDS, 12/94 4 289 Women and HIV/AIDS, 2/95 3 290 HIV/AIDS and Race/Ethnicity, 11/93 3 293 HIV/AIDS and U.S. Blacks, 10/93 2 725 CDC HIV/AIDS Prevention Act 11/93 6 292 Condoms Use in Preventing HIV..1/95 3 444 Drug Use and HIV/AIDS, 9/93 3 543 HIV and Its Transmission, 5/94 4 318 HIV Prevention/Community Plan 10/94 3 400 úÿ úÿ(Continued from last message) HIV/AIDS SURVEILLANCE TABLES, 6/94 AIDS cases by state 1 001 AIDS cases by metropolitan area 2 002 AIDS cases by age, exposure category 1 003 Male..AIDS cases by exposure..race.. 1 004 Female..AIDS cases by exposure..race.. 1 005 Pediatric AIDS cases by exposure, race.. 1 006 AIDS cases.. This is a periodic announcement of new files added to the MED-ED anonymous FTP site at the University of California, Irvine. For instructions on how to ADD or REMOVE yourself from this list, please see below. ------------------------------------------------------------------------- ---- MSDOS ----- Directory ftp/med-ed/msdos/education Filename Type Length Date Description ======================================================================== == AHADISK1.EXE B 951667 950126 *American Heart Association Cholesterol AHADISK2.EXE B 984013 950126 Education Program. Jointly developed byy the American Heart Association and Sandoz Pharmaceuticals Corp. APECS.ZIP B 1330268 941007 *Demo of Advanced Patient Education Computer System. Patient controlled graphic demonstration of surgeries, etc. VGA and Mouse required. ARDDISK1.EXE B 620248 950126 *AIDS-Related Diarrhea Computer Education ARDDISK2.EXE B 524914 950126 Program, by Sandoz Pharmaceuticals Corp. Requires MSWindows 3.x. BAYES.EXE B 41384 950126 Pseudo-Bayesian estimates for contigency tables (with zero cell values). BRAINIAC.ZIP B 986392 941007 *Brainiac! Version 1.5 Demonstration Version 8/1/94. Brainiac is a state of the art computerized neuroanatomy atlas. Now you can easily follow the path of each structure through its extent in the brain. Brainiac!'s intuitive "point and click" interface allows you to quickly and easily navigate through the central nervous. Whether you're learning neuroanatomy for the first time or need a quick review, Brainiac! can help you. This program requires Microsoft Windows 3.1 and a video graphics card capable of displaying at 640x480 resolution in 256 colors. BRAINIAC.TXT A 4698 941007 +Text file describing BRAINIAC installation, function and cost. GAMUSIC.ZIP B 396301 950126 *GAMusic 1.0: The genetic algorithim melody evolver for Windows. GAMusic is a user-friendly interactive demonstration of a simple genetic algorithm (GA). Here, the GA generates short melodies and the user assigns the fitnesses. The iterative stepping, mutation frequency and recombination frequency are all controlled by the user. Each series of musical notes is represented in binary form in an array 128 elements in length. This allows a maximum of 30 notes per melody and provides a solution space with approximately 3.4 * 10^38 possible melodies. GAMusic 1.0 was programmed with Microsoft Visual Basic 3.0 for Windows 3.1x. This program should run fine on any system running Microsoft Windows 3.1x. No special sound card is required. OUTCOMES.EXE B 129244 950126 *Windows hypertext help file containing reference materials I use for a doctoral level course at the University of Texas School of Public Health on Medical Outcomes Assessment. The materials are organized into several major topic areas: The Outcomes Assessment Approach, Concepts and Policy Analysis, Practice Guidelines, Tools, Examples, and References. By Carl H. Slater, M.D. This is a self-extracting Windows file. RENAL.ZIP B 258202 950126 *Renal Function Tests for Windows v1.01. This program assists in the sorting and calculation of quantitative renal function tests. Features a simple, graphical interface and online information about each tests. Authors: Brian C. Fong, Dr. D.J. Doyle, Institute of Biomedical Engineering, University of Toronto, Canada, Department of Anaethesia, The Toronto Hospital, Toronto, Canada. System Requirements: IBM PC Compatible System running Microsoft Windows v3.0 or greater. SPINE_1.ZIP B 671520 941007 *The Dynamic Spine Demonstration Version SPINE_2.ZIP B 1290800 941007 copyright 1994 MMS. The Dynamic Spine is SPINE_3.ZIP B 863760 941007 an interactive laserdisk-based tutorial on the axial skeleton covering anatomy, pathology, biomechanics and manual medicine techniques used in treating the spine. Three-dimensional animations give students an appreciation of the dynamic nature of the human spine. This demonstration requires Microsoft Windows 3.1, Microsoft Video For Windows (provided on disk 1) and a super VGA card capable of displaying 640x480 in 256 colors. SPINE.TXT A 3104 941007 +Text file describing SPINE installation, function and cost. ======================================================================== ===== To remove yourself from this list, please send electronic mail to listserv@stat.com and include the command UNSUBSCRIBE UCI-FTP-UPDATE as the first line of your message. To add yourself to this list, please send electronic mail to listserv@STAT.COM and include the command SUBSCRIBE UCI-FTP-UPDATE as the first line of your message. Requests for help should be sent to: uci-ftp-update-request@stat.com ======================================================================== ===== SUBMITTING SOFTWARE AND OTHER FILES Uploads are welcome. We actively solicit information and software which you have personally developed or have found useful in your local medical education efforts, either as an instructor or student. The site address is "FTP.UCI.EDU". Once you have connected to the site via FTP, cd (change directory) to either the med-ed/mac/incoming or the med-ed/msdos/incoming directories, change the mode to binary (type "tenex" or "binary") and "send" or "put" your files. Note that you won't be able to see the files with the "ls" or "dir" commands. Please compress your files as appropriate to the operating system (ZIP for MSDOS; Compactor or something similar for Macintosh) to save disk space. After uploading, please send email to Steve Clancy (slclancy@uci.edu) (for MSDOS) or Albert Saisho (saisho@uci.edu) (for MAC) describing the file(s) you have uploaded and any other information we might need to describe it. Note that we can only accept software or information that has been designated as shareware, public-domain or that may otherwise be distributed freely. Please do not upload commercial software! Doing so may jeopardize the existence of this FTP site. If you wish to upload software for other operating systems, please contact either Steve Clancy, M.L.S. or Albert Saisho, M.D. at the addresses above. ------------------------------ End of HICNet Medical News Digest V08 Issue #12 *********************************************** --- Editor, HICNet Medical Newsletter Internet: david@stat.com FAX: +1 (602) 451-1165 Bitnet : ATW1H@ASUACAD