Limited Number Of States Research Articles

Surveillance of Occupational Asthma Under the SENSOR Model

SENSOR is a system for linking physicians who recognize occupational disease cases to public health officials who can direct intervention at specific workplaces and alert other physicians to settings where occupational disease may be occurring in their state. Certain features of occupational asthma may make it suitable for surveillance under the SENSOR model. Experience from a limited number of states indicates that many physicians are willing to report occupational asthma cases to state health officials and that case reports can be used to identify workplaces with remediable health hazards. From early experience, SENSOR shows promise as an approach to providing occupational asthma surveillance and identifying opportunities for primary and secondary prevention. More widespread and sustained application of the SENSOR method requires that certain issues be addressed. Confirmation and investigation of occupational asthma cases are labor-intensive and demand certain types of expertise. As with notifiable communicable diseases, underreporting is a persistent problem. To encourage reporting, sufficient resources must be devoted to assure timely, quality follow-up of patients and to demonstrate the utility of reporting to providers. Further efforts are needed to increase physician recognition of occupational disease. These efforts should include dissemination of reporting criteria, surveillance data, and other educational material to providers through the SENSOR surveillance system.

Adaptive Finite-State Models of Manual Control Systems

A model of human operator behavior is presented based on the following assumptions: that the input and output are quantized into a limited number of states and that data processing is performed on asynchronous samples of this coarsely quantized input, i.e., that the human operator behaves as a finite-state machine. A hybrid element or hybrid actuator is used to achieve a continuous variation of output position.

Vital and Health Statistics of the Future

Before speculating about the future, a brief background is in order on the vital and health statistics presently available. Vital statistics is a fairly well developed system of birth and death statistics, although statistics for the entire country have been available only since 1933. The statistics on marriages, divorces and fetal deaths are still in a primitive stage. Despite national coverage, complete registration and data on causes of fetal deaths are still problems. The present series on marriage and divorce includes data for a limited number of states, and nationwide statistics are yet to be obtained.

Trends in Age Distribution of Diphtheria in the United States

adults. The present study has been carried out for the purpose of determining the validity of the statement that diphtheria is actually becoming more common in adults. It was felt that a study of the trends of both morbidity and mortality by age groups over a period of years in certain States and cities would give a fairly accurate estimate of such a change if one actually has occurred. Only a limited number of States and cities have published, or have available, tabulations of reported cases of diphtheria by age groups for a sufficiently long period of time to permit a study of trends. Those with data covering a period of 20 years or more include five northern States, three of which have a high proportion of urban population (Massachusetts, Connecticut, and New Jersey) and two which are predominantly rural (Minnesota and Kansas). Two are typical southern States (North Carolina ancd Alabama) and one borderline (Maryland). In addition to these, data are available for one western State (California) and for two cities, the District of Columbia and Baltimore. The trend of distribution in upper New York State has been reported by Ingraham and Korns (1) and is not repeated here. The 5-year period ending in 1944 was made the endpoint of the study because there are no dependable estimates of populations by age groups since the 1940 census. No separation was made of cases and deaths by race except for Alabama. Data for Maryland, used in this study, are exclusive of Baltimore. When calculating morbidity rates, all cases of unknown age were distributed according to the percentage distribution of cases of known age. In this report the trend of morbidity and mortality will be emphasized more than any differences in rates in one

A Proposed Plan for the Establishment of a Morbidity Registration Area

Plans for the establishment of a morbidity registration area have been considered by this conference on several previous occasions. Various factors have intervened to prevent the development and coinpletion of the plans presented at preceding meetings. Lack of funds available for the execution of the plans has been, perhaps, the most important cause of the delay in their inauguration. A practicable plan for a morbidity registration area is by no means as simple a matter as it may appear on casual examination. Many questions at once present themselves for consideration. For this reason the Public Health Service does not presume to present to you a finished plan at this time; rather it is desired to submit certain tentative suggestions for consideration and discussion. The problem of a morbidity registration area has as many factors to be considered as there are States which are to be included in it or diseases which are to be reported. In order to ascertain the views of the various State health departments regarding certain suggested plans which the Public Health Service was considering in connection with this problem, a representative of the Service recently visited a few State health departments and discussed the matter with the State health authorities. A number of very helpful suggestions were received. It is regretted that, by reason of the short time elapsing between the formulation of the plans and this meeting, it was possible to visit only a limited number of States. It was anticipated, however, that this conference would provide the opportunity for a comprehensive discussion of the entire problem. Broadly speaking, the principal phases of this matter appear to resolve themselves into three fundamental questions: 1. Is the establishment of a morbidity registration area for the United States desirable?