Population and disease-based prevalence of the common mutations associated with surfactant deficiency.

The prevalence of the common mutations in the surfactant protein-B (121ins2), surfactant protein-C (I73T), and ATP-binding cassette member A3 (E292V) genes in population-based or case-control cohorts of newborn respiratory distress syndrome (RDS) is unknown. We determined the frequencies of these mutations in ethnically diverse population and disease-based cohorts using restriction enzyme analysis (121ins2 and E292V) and a 5' nuclease assay (I73T) in DNA samples from population-based cohorts in Missouri, Norway, South Korea, and South Africa, and from a case-control cohort of newborns with and without RDS (n = 420). We resequenced the ATP-binding cassette member A3 gene (ABCA3) in E292V carriers and computationally inferred ABCA3 haplotypes. The population-based frequencies of 121ins2, E292V, and I73T were rare (<0.4%). E292V was present in 3.8% of newborns with RDS, a 10-fold greater prevalence than in the Missouri cohort (p < 0.001). We did not identify other loss of function mutations in ABCA3 among patients with E292V that would account for their RDS. E292V occurred on a unique haplotype that was derived from a recombination of two common ABCA3 haplotypes. E292V was over-represented in newborns with RDS suggesting that E292V or its unique haplotype impart increased genetic risk for RDS.

Translating and disseminating research- and practice-based criteria to support evidence-based intervention planning.

UNLABELLED: Evidence-based public health is a decision-making process To determine the best intervention approach for addressing a particular health issue, population, and setting. The decision-making process involves the identification and evaluation of criteria supporting or Refuting use of intervention approaches based on previous work in the field. OBJECTIVE: The purpose of this article is to describe the identification and evaluation of Research- and practice-based evidence criteria. METHODS: These criteria were derived through literature Review and expert panel interviews. RESULTS AND CONCLUSIONS: These evidence criteria provide the foundation for the translation and dissemination of evidence-based intervention planning processes through a Web-based technical advisement system for public healthcare practitioners. Limitations and future directions are considered.

Prioritization MICA: a Web-based application to prioritize public health resources.

Although setting priorities is an important step in making public health policy, the benefit of using epidemiology to prioritize scarce public health resources has not been fully recognized. This situation is mostly due to the complexity of proposed models for setting priorities. We describe a public health priority setting model, Missouri Information for Community Assessment Priority Setting Model (Priority MICA), which uses epidemiologic measures available in most surveillance systems across the United States. Priority MICA uses data from birth and death certificates, hospital discharges, emergency departments, risk factors from the Behavioral Risk Factors Surveillance System, and eight epidemiologic measures to construct six priority criteria: size (the number of emergency department visits, hospitalizations, and deaths), severity (number of deaths of people younger than 65), urgency (trends in deaths and hospital morbidity), preventability (evidence-based score), community support (score of social support for preventive action), and racial-disparity (race comparison through death and morbidity rate ratio). Priority MICA is part of a Web-based interactive tool that makes available data from a wide variety of surveillance systems (http://www.dhss.mo.gov/MICA). The top 10 priority diseases determined by Priority MICA were compared to a more traditional method of ranking diseases by mortality rates. Using the additional criteria in Priority MICA identified four more priority diseases than were identified using just mortality while the ranking of the other six priority diseases differed between methods.

Measuring 2010 national objectives and leading indicators at the state and local level.

This article examines to what extent data are typically available at the state and local level to track the Healthy People 2010 (HP 2010) objectives. It is estimated that there is a data source to track 56 percent of the relevant HP 2010 objectives at the state level and only 33 percent of the objectives can be tracked at the county level. The main solution for tracking more objectives at the state and county level is to expand the number of questions and coverage of the BRFSS and YRBS.

The Missouri experience in providing tools and resources to promote community assessment.

The Missouri Department of Health (MDOH) has dedicated staff that provides technical assistance to communities that are conducting assessments and intervention strategies to meet community health needs. The MDOH developed a web site that is designed to make health data easily available at the local level. The Missouri Hospital Association partners in the process by making funds available to communities that have proposed interventions in response to their community assessment. This article describes this public/private relationship and some of the state and local experiences.