Journal of urban health : bulletin of the New York Academy of Medicine
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To describe practice trends for total abdominal hysterectomy (TAH) and supracervical abdominal hysterectomy (SCH) in New York State and to identify fiscal features associated with these two operations, all inpatient discharges for TAH and SCH performed for benign indications from 1990 to 1996 were reviewed using the Statewide Planning and Resource Cooperative System, a centralized data reporting system. For each year examined, the number of TAHs and SCHs performed, the procedure rates adjusted for the total New York State female population, and the per diem charge (calculated from mean institutional charge as a function of average length of stay) were evaluated. ⋯ The per diem institutional charge for SCH was consistently higher than for TAH in each year studied. The changes in charge and relative frequency of TAH and SCH in New York State invite further study to describe these trends more fully.
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Building on decades of Academy activities related to substance use, this report emphasizes three guiding principles: 1. Drug treatment should be accessible to all drug users seeking care, including those who are incarcerated. Because turning users away when programs are operating at or above capacity represents lost opportunities for care, programs should be prepared to commence treatment at the time users request it. 2. ⋯ Steps need to be taken to reduce the health-related harms associated with injection drug use, including the transmission of human immunodeficiency virus (HIV), hepatitis B and C, and other blood-borne pathogens. Harm reduction incorporates many modalities, such as HIV prevention education, including condom use and safer sex counseling and education; referrals for drug treatment and other health care and social services; interim methadone maintenance; and syringe and needle availability and exchange programs. Each of these interventions represents important medical and public health strategies that may decrease some of the secondary medical consequences of injection drug use.
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Biography Historical Article Classical Article
Active immunization against poliomyelitis. April 2, 1953.
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Insights into the evolution of virulence may aid efforts to control or even prevent emerging diseases. Specifically, dangerous pathogens can be distinguished from those that pose relatively little threat by identifying characteristics that favor intense exploitation of hosts by pathogens, hence causing high virulence. ⋯ These insights may improve the return on investments in disease control by directing effort and resources to the most-dangerous emerging pathogens. The approach also should help us to identify those control measures that will guard against the future emergence of dangerous pathogens, even those that have not yet been identified.