National Identification Number Research Articles

Setting up and utilizing Norwegian twin panels

In the late 1970s, a Norwegian twin panel was set up. It included all like-sexed twin pairs, born in the period1915 to 1960, where both members were alive and had a known address in Norway at the time. The workwas initiated through a grant from the National Institutes of Health in the United States. The aim was to estimatematernal effects to understand the causes of variation in traits and diseases that originate in pregnancy.However, the twin panel was also utilized for estimating genetic and environmental effects on a series ofphenotypes, for instance lipoproteins, receptors, coagulation factors, cognitive abilities, educational attainmentand left-handedness. A short zygosity questionnaire was sent together with the first invitation letter tothe twins. Later questionnaires on general health, lifestyles and pregnancy outcomes were sent out. Oneimportant finding was that the fetal genotype had much stronger influence on variation in fetal growth thanwhat had been assumed previously. In the early 1990s, the New Norwegian Twin Panel was created, basedon information on plural births in the Medical Birth Registry of Norway (MBRN). The panel included bothlike-sexed and opposite-sexed pairs born in the years 1967 to 1974. After linking the MBRN to presentaddresses, using a national identification number, a questionnaire on zygosity, with a few items on healthand social background, was sent out. This panel was later expanded to include twins born 1975-1979 and tocollect more data on health, well-being and lifestyle factors. The data have been utilized for a series of subprojects,including psychiatric interviews and the collection of DNA samples. Linkage to Norwegian healthregistries has provided important research opportunities for a variety of phenotypic outcomes.

Treatment for substance use disorders: the Belgian Treatment Demand Indicator registration protocol.

BackgroundRegistration of patients with substance use disorders is of key importance to get insights and to study trends in patients characteristics and substance use patterns. The Treatment Demand Indicator (TDI) is gathering this information at European level since 2000. In Belgium, this registration started at national level in 2011 and an increasing number of facilities of different types are participating in this data collection since then.Methods/DesignThis surveillance register collects information on every treatment episode started by patients for their substance use disorder. Information is collected on socio-demographic characteristics of the patient, treatment history and substance use patterns. Patients are identified uniquely using their national identification number in order identify multiple episodes followed by a same person. A large range of treatment facilities have the possibility to participate in this registration to allow a wide coverage of the population.DiscussionThe objective of the paper is to facilitate the use of data by authorities or researchers by correctly describing all aspects of the indicator. The case definition, the variables collected and the way data should be reported are of key importance to use and interpret the data correctly. An overview of the data registered in 2014 gives also an idea of the content of the database. The article also pictures the strengths and limitations of the register and foresees some future improvements.

Death from liver disease in a cohort of injecting opioid users in a Swedish city in relation to registration for opioid substitution therapy.

Injecting opioid users are at elevated risk of death. Although liver disease (especially hepatitis C) is common, its impact on mortality is low in active injectors. Because opioid substitution therapy (OST) reduces the risk of death from directly drug related causes, we hypothesised that the proportion of liver-related deaths would increase in subjects receiving OST. We investigated liver-related mortality in a cohort of injecting opioid users attending a needle exchange program (NEP) in a Swedish city in relation to OST exposure. Participants enrolled in the NEP between 1987 and 2011 with available national identity numbers, and registered use of opioids, were included. Linkage based on national identity numbers was performed with national registers for death, emigration and prescription of OST. Participants were categorised as non-OST recipients until the registered date of first OST prescription, and hence as OST recipients. Hazard ratios were calculated by Cox regression for overall and liver-related mortality in relation to OST, with OST as a time-dependent variable. Among 4494 NEP participants, 1488 opioid users were identified; 711/1488 had been prescribed OST. During a follow-up period of 15 546 person-years 368 deaths occurred. Sixteen deaths were caused by liver disease; 10 of these occurred in OST recipients. The risk of liver-related death was significantly increased in OST receiving participants (hazard ratio 3.08, 95% confidence interval [1.09, 8.68], P = 0.03). Liver related mortality among opioid users was significantly elevated in OST recipients, showing the long-term importance of chronic liver disease in this population. [Jerkeman A, Håkansson A, Rylance R, Wagner P, Alanko Blomé M, Björkman P. Death from liver disease in a cohort of injecting opioid users in a Swedish city in relation to registration for opioid substitution therapy. Drug Alcohol Rev 2017;36:424-431].

Iranian regional cancer incidence is misclassified in neighborhood's provinces.

Cancer is one of the most important causes of death worldwide. There are 14 million new cases of cancer, which recorded globally each year (1). In Iran, cancer is an important health problem (2) and the gastrointestinal cancers are the most frequent cancers among Iranian males and second among females (3, 4). Cancer registration is an important source for measuring the burden of cancer in a population and these data would be useful for policy makers in order to responsible for the provision of health and oncology services, calculating burden of diseases, medical consultations, etc (5). The World Health Assembly passed a resolution in May 2005, recommending all governments to create and implement cancer control plans (6). Iranian ministry of health commenced a National Cancer Registry in 2004, and its data became available by 2006. On that date, in Iran, cancer services were overwhelmed and most patients, who went to a providing care facility, had advanced diseases, with no specific record of diagnosis. Therefore, a Comprehensive National Cancer Control Program (CNCCP) was designed (7) to assess this objective. However, the history of cancer registry foundation was backed in 1955, when the first activities to organizing cancer reporting were initiated by establishing the Cancer Institute at University of Tehran (8). In cancer registry, the complete coverage of all cases is the key criterion for data quality (9). Completeness is defined as the proportion of incident cancer cases that is registered (10). The completeness level of cancer registration is one of the main parts of quality control in such registration system (11). In the absence of this completeness, there would be an underestimation for incidence (and also burden) of any cancers. One problem regarding cancer registry is the geographical part that cancer cases diagnosed and the real hometown of the corresponding registered patients. A population-based cancer registry is usually easier to achieve in smaller countries, while in a vast geographical territory, such as Iran, with different climate and cultural diversity, there are technical and logistic problems. A study on the accuracy of gastric cancer incidence in Ardabil province indicated that none of the sources of pathology reports, death certificates and medical records individually or collectively fully cover the incidence of gastric cancer (12). Although legislations in place are indeed helpful in establishing pathology-based registries (8), misclassification in reported new cancer cases among provinces is still a potential problem for achieving a full registry in each territory. Misclassification occurs when new cancer cases are diagnosed and registered in neighborhood provinces (instead of their hometown) due to a low facility in their own provinces, which causes people moving to the neighborhood provinces for their diagnosis or other medical treatments. According to the Iranian annual of national cancer registration report for the year 2008 (13), Razavi Khorasan, North and South Khorasans, (located in the East of Iran) as the neighborhood provinces were presented. Also, Ardabil, as well as East and West Azerbaijan (located in the northwest of Iran) are in neighborhoods. These six provinces were selected to imply the misclassified coverage of registered cancer cases. The reported coverage for Razavi Khorasan exceeds than what was expected, according to the national cancer registration reports (155.5%), whereas the other two provinces with only 34.8% and 41.4% of the expected coverage. There was a same story for East Azerbaijan with 123.6% and its neighbors. Meaning, there were a bunch of diagnosed cases that moved there due to better medical facility, and registered as the resident of where they were diagnosed. Although in cancer registry system, the address and telephone number is asked as the extracted information, it is still some patients who are registered in wrong places. A study on cancer registry of Fars province, which investigated the coverage of registered data in southern Iran for almost ten years, revealed that the data was still deficient in recording patients’ phone number and address. In addition, the information for the patients’ national identification number was inadequate (14).

Abstract P1-07-20: The smoking related risk of breast cancer and proportion of avoidable breast cancer cases due to passive and active smoking in middle-aged women in Norway in 2012: The Norwegian women and cancer study 1991-2012

Abstract Background: The burden of smoking on society may be underestimated as previous estimates of cancer due to smoking have generally not included breast cancer. We utilized the Norwegian Women and Cancer Study, a nationally representative prospective cohort study to examine the risk of breast cancer due to passive and active smoking. We also estimated the proportion of breast cancer attributable to passive and active smoking. Material and methods: Our study included 130053 women, aged 34 to 70 years, who completed a baseline questionnaire between 1991 and 2007. We followed the women through linkages to the Cancer Registry of Norway and the Norwegian Central Population Register, to identify all cancer cases, emigrations, and deaths, respectively, using the unique national 11-digit personal identification number. Person-years were calculated from the start of follow-up to the date of any incident cancer diagnosis, emigration, death, or the end of follow-up December 31, 2012, whichever came first. Breast cancer cases were classified according to the original codes in the International Classification of Diseases, Seventh Revision including estrogen and progesterone hormone tumor receptor status. We used Cox proportional hazards models, adjusting for relevant confounders, to estimate multivariate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Never smokers, excluding passive, served as the reference group. We estimated attributable fractions in smokers and in the population with 95% CIs. Results: Ever compared with passive and never smokers were younger at breast cancer diagnosis, at first childbirth and at menopause; they were less likely to have higher education, more likely to have used hormonal contraceptives and postmenopausal hormone therapy and to consume alcohol. The alcohol drinkers were consuming more alcohol. During follow-up 4293 women developed invasive breast cancer confirmed by histology. Compared with never smokers, the multivariate adjusted breast cancer HR was for ever smokers 1.21 (1.08-1.34). Compared with parous never smokers, the HR estimate for breast cancer for ever smokers who had smoked five or more years before giving birth was 1.29 (1.14-1.46) after adjustment. A trend test for number of pack-years and breast cancer risk was significant (ptrend= 0.007). We found similar HR estimates when we stratified by menopausal and parous status at entry. The attributable fraction for breast cancer was 17.3 (7.4-25.4) for active smokers. The population attributable fraction of breast cancer for active smoking was 11.9 (5.3-18.1). Conclusion: In smokers, one in six, and in the population almost one in eight breast cancer cases could have been avoided in the absence of smoking. Citation Format: Gram IT, Little MA, Lund E, Braaten T. The smoking related risk of breast cancer and proportion of avoidable breast cancer cases due to passive and active smoking in middle-aged women in Norway in 2012: The Norwegian women and cancer study 1991-2012. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-07-20.

On Political Islam in Palestine

Abstract: This article deals with analyzing the place and the political Islam occupies on the Palestinian territories. The author tries to prove that despite the “Arab spring” and growing popularity of Islamism in the neighbor Arab countries its popular support among Palestinians is low. The main reason for this is Israeli total control of political, economic and - partially - social processes taking place in the West Bank. Position of the officials in Ramallah who together with Tel-Aviv strictly contain spread of Islamism throughout the West Bank also has a strong suppressing effect. Central Palestinian leadership may be called one of the few secular political establishments that are still in power in the Arab countries. The main explanation for this is the desire to make a positive effect on the international community, which Palestine totally depends on in political and financial terms. Also one should keep in mind secular beliefs of the current political elite in Palestine. President Mahmoud Abbas with his counterparts from FATAH and PLO represent old type of Arab nationalist politicians, almost all of who were stripped from power after the beginning of “Arab spring” in 2011. Finally, Palestinian society itself still feels united by the idea of national liberation from the Israeli occupation. This helps Palestinians to put aside the issue of religious self-identification. According to the surveys, most of Palestinians still rank their national identity number while describing their identity, while religion comes only second (despite the strong stable tendency for growing Islamization of their views). The only Palestinian enclave where political Islam has gained ground is isolated Gaza Strip. However ruling there “Islamic Resistance Movement” (HAMAS), despite declared anti-Zionism and Islamism, in reality show pragmatic readiness for certain coordination of its actions with Israel and central government in Ramallah. Nowadays one can witness the deepening conflict within the Islamist camp - between HAMAS and more radical Salafists, who support “Islamic State” in Iraq and Syria. In the final end the fate of Political Islam in Palestine will depend on the success of Middle East peace process.

Registry based perinatal epidemiology: The importance of sibling and generation data

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Proposing national identification number on dental prostheses as universal personal identification code - A revolution in forensic odontology.

The proper identification of a decedent is not only important for humanitarian and emotional reasons, but also for legal and administrative purposes. During the reconstructive identification process, all necessary information is gathered from the unknown body of the victim and hence that an objective reconstructed profile can be established. Denture marking systems are being used in various situations, and a number of direct and indirect methods are reported. We propose that national identification numbers be incorporated in all removable and fixed prostheses, so as to adopt a single and definitive universal personal identification code with the aim of achieving a uniform, standardized, easy, and fast identification method worldwide for forensic identification.

Health insurance and accessibility to health services among Roma in settlements in Belgrade, Serbia--the journey from data to policy making.

The Serbian constitution and health-related laws assert that citizens and residents are universally entitled to health care, provided that they hold health insurance. However, until 2010, persons who did not hold a national identification number (ID) were required to present a plethora of documents to be granted one. We assessed the relationship between citizenship, residency and possession of health insurance cards, together with utilization of health services, among Roma residing in disadvantaged settlements in Belgrade. The Roma Health and Nutrition Survey was conducted in 2009 to assess the social determinants of health among Roma. Data were analysed, using logistic regression, to examine health insurance status and utilization of services by citizenship and residency. Eighty-nine per cent of respondents said they were Serbian citizens. Approximately 11% were refugees, 7% internally displaced persons (IDPs) and remainder domicile. Multivariate analysis revealed that non-citizens were more likely to lack health insurance [odds ratio (OR) = 9.2, confidence interval (CI) (3.5, 24.1)], as were refugees and IDPs [OR = 3.1, CI (1.4, 6.9), OR = 4.0, CI (1.4, 11.5), respectively]. Having health insurance was a positive predictor for being seen by a physician [OR = 2.3, CI (1.3, 4.2), OR = 2.3, CI (1.3, 3.9)]. Data from this survey indicated that non-citizen Roma had limited access to health services. These findings led the Serbian Ministry of Health and National Health Insurance Fund to reduce the administrative and legislative hurdles in obtaining health insurance, to ensure the Roma rights to health care. This demonstration of data-driven policies on Roma health could serve as a model for other countries.

Evaluation of record linkage of mortality data between a health and demographic surveillance system and national civil registration system in South Africa

Background: Health and Demographic Surveillance Systems (HDSS) collect independent mortality data that could be used for assessing the quality of mortality data in national civil registration (CR) systems in low- and middle-income countries. However, the use of HDSS data for such purposes depends on the quality of record linkage between the two data sources. We describe and evaluate the quality of record linkage between HDSS and CR mortality data in South Africa with HDSS data from Agincourt HDSS. Methods: We applied deterministic and probabilistic record linkage approaches to mortality records from 2006 to 2009 from the Agincourt HDSS and those in the CR system. Quality of the matches generated by the probabilistic approach was evaluated using sensitivity and positive predictive value (PPV) calculated from a subset of records that were linked using national identity number. Matched and unmatched records from the Agincourt HDSS were compared to identify characteristics associated with successful matching. In addition, the distribution of background characteristics in all deaths that occurred in 2009 and those linked to CR records was compared to assess systematic bias in the resulting record-linked dataset in the latest time period. Results: Deterministic and probabilistic record linkage approaches combined linked a total of 2264 out of 3726 (60.8%) mortality records from the Agincourt HDSS to those in the CR system. Probabilistic approaches independently linked 1969 (87.0%) of the linked records. In a subset of 708 records that were linked using national identity number, the probabilistic approaches yielded sensitivity of 90.0% and PPV of 98.5%. Records belonging to more vulnerable people, including poorer persons, young children, and non-South Africans were less likely to be matched. Nevertheless, distribution of most background characteristics was similar between all Agincourt HDSS deaths and those matched to CR records in the latest time period. Conclusion: This study shows that record linkage of mortality data from HDSS and CR systems is possible and can be useful in South Africa. The study identifies predictors for death registration and data items and registration system characteristics that could be improved to achieve more optimal future matching possibilities.

Incidence and Types of Malignancy Post Kidney Transplantation in Saudi Arabia.

Cancer development is a common s=cause of mortality post organ transplantation. Specific types of cancer are more common to occur because of Immunosuppresion and been mediated by viral pathogens. incidence and types of cancers are not studied before in our region. we aimed to study the incidence and types of cancer post kidney transplantation in our region. This is a bidirectional single center study of all kidney transplantation performed in a tertiary care center. all patients charts and electronic medical record were reviewed and patients were prospectively surveyed for cancer development. In addition, national cancer registry data were compared using national identification number to insure capturing all patients and to calculate normalized incidence ratio. results; total of 2077 patients underwent kidney transplantation at this center from 1981 to end of 2013. Age range between 1.5 to 71 years, 61% were men and 432 patients were younger than 18 years. Induction with depleting agents was used in 45% of patients and with interleukin blocking agents in 19 % of patients. Viral hepatitis was prevalent in 29 % of patients, 6.5 with hepatitis B and 22.5% with hepatitis C infection. Average followup was 110.4 months and it ranges between 1-370 months post transplantation. 98 (4.7) patients developed cancer post transplantation, of these 16 were younger than 18 years old and 72 ere adults. 42 % of these patients had diseased donor transplantation. Post transplantation lymphoprolierative disorder occurred in 30 patients, 16 of them were EBV mismatched pediatric patients, 53% were nodal disease and 10 were neurological. All PTLD were of B cell except one t Cell derived. Kaposi sarcoma occurred in 17 patients, 2 of them had gastric involvement and rest were skin limited disease. hepatocellular carcinoma developed in 7 patients all of them had viral hepatitis. Skin basal and squemce cell carcinoma developed in 8 patients, no cases of melanoma were seen. Cervical cancer developed in 2 patients only. rest of cancers were solid organ cancers. In conclusion we noted a low incidence of cancer in our region with 4.7% of patients developing cancer. PTLD and Kaposi sarcoma were commonest types of cancer. in comparison to international data, we noticed more hepatocellular carcinoma probably related to prevalence of viral hepatitis in this region and lower skin carcinoma.

OP0199 No Increased Risk of Congenital Malformations after Preconception Paternal Exposure to Dmards

BackgroundThe risk of congenital malformations in offspring of men with inflammatory joint diseases (IJD) treated with disease modifying antirheumatic drugs (DMARDs) before conception is largely unknown.ObjectivesTo study the occurrence of...

Assessment of Response Consistency and Respective Participant Profiles in the Internet-based NutriNet-Sante Cohort

Whereas the feasibility and effectiveness of Internet-based epidemiologic research have been established, methodological support for the quality of such data is still accumulating. We aimed to identify sociodemographic differences among members of a French cohort according to willingness to provide part of one's 15-digit national identification number (personal Social Security number (PSSN)) and to assess response consistency based on information reported on the sociodemographic questionnaire and that reflected in the PSSN. We studied 100,118 persons enrolled in an Internet-based prospective cohort study, the NutriNet-Santé Study, between 2009 and 2013. Persons aged 18 years or more who resided in France and had Internet access were eligible for enrollment. The sociodemographic profiles of participants with discordant data were compared against those of participants with concordant data via 2-sided polytomous logistic regression. In total, 84,442 participants (84.3%) provided the first 7 digits of their PSSN, and among them 5,141 (6.1%) had discordant data. Our multivariate analysis revealed differences by sex, age, education, and employment as regards response consistency patterns. The results support the quality of sociodemographic data obtained online from a large and diverse volunteer sample. The quantitative description of participant profiles according to response consistency patterns could inform future methodological work in e-epidemiology.

Gender inequality in the clinical outcomes of equally treated acute coronary syndrome patients in Saudi Arabia

BACKGROUND AND OBJECTIVESGender associations with acute coronary syndrome (ACS), remain inconsistent. Gender-specific data in the Saudi Project for Assessment of Coronary Events registry, launched in December 2005 and currently with 17 participating hospitals, were explored.DESIGN AND SETTINGSA prospective multicenter study of patient with ACS in secondary and tertiary care centers in Saudi Arabia were included in this analysis.PATIENTS AND METHODSPatients enrolled from December 2005 until December 2007 included those presented to participating hospitals or transferred from non-registry hospitals. Summarized data were analyzed.RESULTSOf 5061 patients, 1142 (23%) were women. Women were more frequently diagnosed with non ST-segment elevation myocardial infarction (NSTEMI [43%]) than unstable angina (UA [29%]) or ST-segment elevation myocardial infarction (STEMI [29%]). More men had STEMI (42%) than NSTEMI (37%) or UA (22%). Men were younger than women (57 vs 63 years) who had more diabetes, hypertension, and hyperlipidemia. More men had a history of coronary artery disease. More women received angiotensin receptor blockers (ARB) and fewer had percutaneous coronary intervention (PCI). Gender differences in the subset of STEMI patients were similar to those in the entire cohort. However, gender differences in the subset of STEMI showed fewer women given β-blockers, and an insignificant PCI difference between genders. Thrombolysis rates between genders were similar. Overall, in-hospital mortality was significantly worse for women and, by ACS type, was significantly greater in women for STEMI and NSTEMI. However, after age adjustment there was no difference in mortality between men and women in patients with NSTEMI. The multivariate-adjusted (age, risk factors, treatments, door-to-needle time) STEMI gender mortality difference was not significant (OR=2.0, CI: 0.7–5.5; P=.14).CONCLUSIONThese data are similar to other reported data. However, differences exist, and their explanation should be pursued to provide a valuable insight into understanding ACS and improving its management.

Familial risk of obstetric anal sphincter injuries: registry‐based cohort study

To investigate the aggregation of obstetric anal sphincter injuries (OASIS) in relatives. Population-based cohort study. The Medical Birth Registry of Norway from 1967 to 2008. All singleton, vertex-presenting infants weighing 500g or more. Through linkage by national identification numbers, 393856 mother-daughter pairs, 264675 mother-son pairs, 134889 mothers whose sisters later became mothers, 132742 fathers whose brothers later became fathers, 131702 mothers whose brothers later became fathers and 88557 fathers whose sisters later became mothers were provided. Comparison of women with and without a history of OASIS in their relatives. Relative risk of OASIS after a previous OASIS in the family. The risk of OASIS was increased if the woman's mother or sister had OASIS in a delivery (aRR 1.9, 95% CI 1.6-2.3; aRR 1.7, 95% CI 1.6-1.7, respectively). If OASIS occurred in one brother's partner at delivery, the risk of OASIS in the next brother's partner was modestly increased (aRR 1.2, 95% CI 1.1-1.4). If OASIS occurred in one sister at delivery, the risk of OASIS in the brother's partner was also increased a little (aRR 1.2, 95% CI 1.1-1.4). However, there was no excess occurrence in sisters whose brothers' partners had previously had OASIS (aRR 1.1, 95% CI 0.9-1.3). There appears to be increased familial aggregation of OASIS. These risks are stronger through the maternal rather than the paternal line of transmission, suggesting a strong genetic role that shapes aggregation of OASIS within families. These observations must be cautiously interpreted because of bias from unmeasured confounding factors may have impacted the findings.

If Relative Has Schizophrenia, Autism Risk Increases

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessIf Relative Has Schizophrenia, Autism Risk IncreasesJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:7 Sep 2012https://doi.org/10.1176/pn.47.17.psychnews_47_17_16-aAbstractMany years ago, autism spectrum disorders were sometimes regarded as childhood schizophrenia. Then, in 1980, with the publication of an updated edition of APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III), autism spectrum disorders and schizophrenia came to be defined as separate disorders. That continues to be the case today.In 2005, however, Danish researchers reported that having a parent with schizophrenia was linked with having an autism spectrum disorder, suggesting that schizophrenia and autism spectrum disorders might have some genetic overlap. And now an international team has produced similar findings.The lead researcher was Patrick Sullivan, M.D., a professor of psychiatry and genetics at the University of North Carolina. The results were published online July 2 in the Archives of General Psychiatry.Sullivan and his team looked to see whether they could find a link between having a parent or sibling with schizophrenia and having autism spectrum disorders in three large population samples. One came from Stockholm, Sweden; one from Sweden overall; and one from Israel. The samples included national personal identification numbers, multi-generation registry data, a national pre-conscription mental health assessment, or other attributes that made them ideal for testing such a hypothesis.“The findings were clear,” Sullivan and his group reported. “The presence of schizophrenia…in first-degree relatives was a consistent and significant risk factor for autism spectrum disorders in all three samples.”They found in the Stockholm and Swedenwide cohorts that if an individual had a parent or a sibling with schizophrenia, the chances of having an autism spectrum disorder were three times greater than for individuals without a parent or a sibling with schizophrenia.And they found in the Israeli cohort that if a person had a sibling with schizophrenia, then his or her chances of having an autism spectrum disorder were 12 times greater than those of individuals without a sibling with schizophrenia.Thus this study, as well as the Danish one, suggest that schizophrenia and autism spectrum disorders appear to share certain genes. Other scientists have reported that some rare variations in gene copy number—notably in genes on chromosomes 15, 16, and 22—are strong risk factors for developing schizophrenia and autism spectrum disorders.And given the increasing evidence for a genetic overlap between schizophrenia and bipolar disorder, Sullivan and his colleagues also looked to see in their study populations whether having a parent with bipolar disorder was linked with a child’s heightened risk of having an autism spectrum disorder.And they did find such a link. But the link was weaker than that for schizophrenia and autism. That is, an individual having a parent with bipolar disorder was twice as likely to have an autism spectrum disorder as was an individual having a parent without bipolar disorder, in contrast to findings for schizophrenia, where the odds ratio was 3 to 1.A possible implication of these findings, the researchers indicated, is that schizophrenia and autism spectrum disorders—and perhaps bipolar disorder and autism spectrum disorders—may share certain clinical characteristics that have previously eluded scientists. For instance, some individuals with an autism spectrum disorder might experience psychotic symptoms.The challenge now, the researchers said, is to identify genetic variants common to schizophrenia, bipolar disorder, and autism spectrum disorders. Scientists participating in the Psychiatric Genomics Consortium (PGC) will be attempting to do so, they said.The PGC is an international project to identify genetic variants that underlie schizophrenia, bipolar disorder, autism spectrum disorders, major depressive disorder, and attention-deficit/hyperactivity disorder. It was founded in 2007 and is headed by Sullivan. PGC scientists are from more than 60 institutions in 19 countries. “Family History of Schizophrenia and Bipolar Disorder as Risk Factors for Autism” is posted at http://archpsyc.jamanetwork.com/article.aspx?articleid=1206780. ISSUES NewArchived

Bayesian Classifier Web Object Filters for User Navigation with Validation Cross Point

caching and pre fetching plays a significant role among the users and websites in reducing the response time of user requests and saving the network bandwidth. The websites which are most likely visited are stored under web cache and web pre-fetch to retrieve them later shortly. Thus web caching and web pre-fetch are one of the most thriving resolutions for enhancing the performance of the web-based systems. However, the complexity in formatting the ideal Web objects that will be re-visited in the prospect is still a trouble faced by an existing conventional cluster based caching techniques. In this work, Bayesian classifier is used for web object filtering process which enhances the performance of caching techniques. Apart from that, the validation process is also being taken place to improve the user navigation process under web based systems. The validation is made of user identity on web product navigation is done with User-profile relativity to national identification number. Web services enable the product vendor regarding the demand of their products by specific valid users. The validation is done with both the existing cluster based web object filters and the proposed classifier based web object filters and compares the results with it. An experimental evaluation is done with the several log files to estimate the performance of the proposed validation check for Bayesian classifier and cluster based web object filters for web user navigation in terms of efficiency of classification, validation, performance rate and compared with an existing cluster based web object filters and identified the better web caching technique. Keywordscache, Web pre-fetch, BNN classifier, and validation process.

The use of regional platforms for managing electronic health records for the production of regional public health indicators in France

BackgroundIn France, recent developments in healthcare system organization have aimed at strengthening decision-making and action in public health at the regional level. Firstly, the 2004 Public Health Act, by setting 100 national and regional public health targets, introduced an evaluative approach to public health programs at the national and regional levels. Meanwhile, the implementation of regional platforms for managing electronic health records (EHRs) has also been under assessment to coordinate the deployment of this important instrument of care within each geographic area. In this context, the development and implementation of a regional approach to epidemiological data extracted from EHRs are an opportunity that must be seized as soon as possible. Our article addresses certain design and organizational aspects so that the technical requirements for such use are integrated into regional platforms in France. The article will base itself on organization of the Rhône-Alpes regional health platform.DiscussionDifferent tools being deployed in France allow us to consider the potential of these regional platforms for epidemiology and public health (implementation of a national health identification number and a national information system interoperability framework). The deployment of the Rhône-Alpes regional health platform began in the 2000s in France. By August 2011, 2.6 million patients were identified in this platform. A new development step is emerging because regional decision-makers need to measure healthcare efficiency. To pool heterogeneous information contained in various independent databases, the format, norm and content of the metadata have been defined. Two types of databases will be created according to the nature of the data processed, one for extracting structured data, and the second for extracting non-structured and de-identified free-text documents.SummaryRegional platforms for managing EHRs could constitute an important data source for epidemiological surveillance in the context of epidemic alerts, but also in monitoring a number of indicators of infectious and chronic diseases for which no data are yet available in France.

HIV Counseling and Testing in an Urban Reproductive Primary Health Clinic in South Africa

This letter to the editor focuses on the gender differences for HIV counseling and testing in South Africa. It describes the profile of men and women testing positive for HIV at an urban reproductive health facility in Durban and explains the methods and results of the study.

Completeness and timeliness of tuberculosis notification in Taiwan

Tuberculosis (TB) is a notifiable disease by the Communicable Disease Control Law in Taiwan. Several measures have been undertaken to improve reporting of TB but the completeness and timeliness of TB notification in Taiwan has not yet been systemically evaluated.MethodsTo assess completeness and timeliness of TB notification, potential TB cases diagnosed by health care facilities in the year 2005-2007 were identified using the reimbursement database of national health insurance (NHI), which has 99% population coverage in Taiwan. Potential TB patients required notification were defined as those who have TB-related ICD-9 codes (010-018) in the NHI reimbursement database in 2005-2007, who were not diagnosed with TB in previous year, and who have been prescribed with 2 or more types of anti-TB drugs. Each potential TB case was matched to the national TB registry maintained at Taiwan Centers for Disease Control (CDC) by using national identity number or, if non-citizen, passport number to determine whether the patients had been notified to local public health authorities and Taiwan CDC. The difference in the number of days between date of anti-tuberculosis treatment and date of notification was calculated to determine the timeliness of TB reporting.ResultsOf the 57,405 TB patients who were prescribed with 2 or more anti-tuberculosis drugs, 55,291 (96.3%) were notified to National TB Registry and 2,114 (3.7%) were not. Of the 55,291 notified cases, 45,250 (81.8%) were notified within 7 days of anti-tuberculosis treatment (timely reporting) and 10,041(18.2%) after 7 days (delayed reporting). Factors significantly associated with failure of notification are younger age, previously notified cases, foreigner, those who visited clinics and those who visited health care facilities only once or twice in 6 months.ConclusionA small proportion of TB cases were not notified and a substantial proportion of notified TB cases had delayed reporting, findings with implication for strengthening surveillance of tuberculosis in Taiwan. Countries where the completeness and timeliness of TB notification has not yet been evaluated should take similar action to strengthen surveillance of TB.