Developing a framework for comprehensive cancer prevention and control in the United States: an initiative of the Centers for Disease Control and Prevention.

The Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, is working with state health agency staff and other stakeholders to develop a comprehensive and integrated approach to cancer control. To help stakeholders visualize the approach, a graphic model was developed based on stakeholder input and a literature review of existing models. Phases of the model include setting optimal objectives (data driven), determining optimal strategies (science driven), establishing feasible priorities (capacity driven), and implementing effective strategies (outcome driven). The model currently is being validated through case studies of state-level cancer planning in six states.     

New CDC director. Centers for Disease Control and Prevention

On October 5, 1998, Dr. Jeffrey Koplan will be appointed the director of the Centers for Disease Control and Prevention (CDC). Dr. Koplan has been in the health field for many years, more recently as the president of the Prudential Center for Health Care Research. The CDC deputy director will remain as the acting director until October, when Dr. Koplan takes office. Dr. Koplan replaces Dr. David Satcher, who was named the surgeon general in February 1998.     

Prevention and control of infections with hepatitis viruses in correctional settings. Centers for Disease Control and Prevention.

This report consolidates previous recommendations and adds new ones for preventing and controlling infections with hepatitis viruses in correctional settings. These recommendations provide guidelines for juvenile and adult correctional systems regarding 1) identification and investigation of acute viral hepatitis; 2) preexposure and postexposure immunization for hepatitis A and hepatitis B; 3) prevention of hepatitis C virus infection and its consequences; 4) health education; and 5) release planning. Implementation of these recommendations can reduce transmission of infections with hepatitis viruses among adults at risk in both correctional facilities and the outside community. These recommendations were developed after consultation with other federal agencies and specialists in the fields of corrections, correctional health care, and public health at a meeting in Atlanta, March 5-7, 2001. This report can serve as a resource for those involved in planning and implementing health-care programs for incarcerated persons.     

TOPSIS法在疾病预防控制机构综合效益评价中的应用

目的探索疾病预防控制（CDC）机构综合效益评价的方法，为各疾控机构之间的横向比较和机构自身之间的纵向比较提供量化依据。方法选择经Delphi法、变异系数法和聚类分析法等3种方法筛选后的17个指标做为评价指标，应用TOPSIS法对杭州地区13家疾控机构2004年各自的综合效益进行评价，并进行质量优劣的评定。结果CDC2的综合效益值位居第一，而CDC6则位居末位，这与实际情况相符。结论Topsis法是一种较为准确、实用的综合评价方法。     

CDC explains testing procedure. Centers for Disease Control and Prevention

Guidelines from the Centers for Disease Control and Prevention (CDC) January 1993 bulletin on HIV testing procedures state that doctors should not tell patients HIV-positive results until confirmatory tests are done. The first step in the process is an ELISA screening test, which detects HIV-antibodies. A reactive result should not be considered positive until confirmatory tests are done. A more specific antibody test, such as the Western blot or immunofluorescence assay, should be used. The confirmatory test is essential since antibodies for diseases other than HIV sometimes react to an ELISA screen.     

An update on cancer cluster activities at the Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) continues to be aware of the need for response to public concern as well as to state and local agency concern about cancer clusters. In 1990 the CDC published the "Guidelines for Investigating Clusters of Health Events," in which a four-stage process was presented. This document has provided a framework that most state health departments have adopted, with modifications pertaining to their specific situations, available resources, and philosophy concerning disease clusters. The purpose of this present article is not to revise the CDC guidelines; they retain their original usefulness and validity. However, in the past 15 years, multiple cluster studies as well as scientific and technologic developments have affected duster science and response (improvements in cancer registries, a federal initiative in environmental public health tracking, refinement of biomarker technology, cluster identification using geographic information systems software, and the emergence of the Internet). Thus, we offer an addendum for use with the original document. Currently, to address both the needs of state health departments as well as public concern, the CDC now a) provides a centralized, coordinated response system for cancer cluster inquiries, b) supports an electronic cancer cluster listserver, c) maintains an informative web page, and d) provides support to states, ranging from laboratory analysis to epidemiologic assistance and expertise. Response to cancer clusters is appropriate public health action, and the CDC will continue to provide assistance, facilitate communication among states, and foster the development of new approaches in duster science.     

Community-based participatory research: lessons learned from the Centers for Children's Environmental Health and Disease Prevention Research

Over the past several decades there has been growing evidence of the increase in incidence rates, morbidity, and mortality for a number of health problems experienced by children. The causation and aggravation of these problems are complex and multifactorial. The burden of these health problems and environmental exposures is borne disproportionately by children from low-income communities and communities of color. Researchers and funding institutions have called for increased attention to the complex issues that affect the health of children living in marginalized communities--and communities more broadly--and have suggested greater community involvement in processes that shape research and intervention approaches, for example, through community-based participatory research (CBPR) partnerships among academic, health services, public health, and community-based organizations. Centers for Children's Environmental Health and Disease Prevention Research (Children's Centers) funded by the National Institute of Environmental Health Sciences and U.S. Environmental Protection Agency were required to include a CBPR project. The purpose of this article is to provide a definition and set of CBPR principles, to describe the rationale for and major benefits of using this approach, to draw on the experiences of six of the Children's Centers in using CBPR, and to provide lessons learned and recommendations for how to successfully establish and maintain CBPR partnerships aimed at enhancing our understanding and addressing the multiple determinants of children's health.     

浅谈疾病预防控制中心的质量管理

国家级、省级、市县级疾病预防控制中心（以下简称疾控中心）肩负着全社会卫生防病、处理突发公共卫生事件、保障人民身体健康和生命安全的重任。为了完成上述任务，疾控中心的检测实验室为社会提供的检测数据必须确保公正可靠。因此，从收样到检测全过程以及报告审核到签发等各个环节需要有严格的质量管理制度。我们依据计量认证审查认可（验收）评审准则编制了较完整的质量手册及程序文件，制定了严格的管理制度，从而保证了检测的规范化，具体做法如下。     

CDC suspends testing of newborns. Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention (CDC) has announced the suspension of their anonymous HIV testing program for newborn infants. The announcement came on the heels of legislation introduced by Gary Ackerman, D-N.Y., requiring states to tell parents or other legal guardians if their newborn babies test positive for HIV antibodies. CDC officials said the survey was useful in tracking the epidemic, but it was time to reevaluate whether the $10 million annual cost could be better spent preventing HIV infection among women and newborns. The CDC advocates the implementation of their proposed guidelines, for physicians to counsel all pregnant women about their HIV risks and offer, but not require, testing. Those who test positive for HIV antibodies should be given nonjudgmental information about the risks and benefits of taking AZT. The CDC cites a recent study which shows that pregnant women may reduce by two-thirds the risk of transmitting HIV to their babies if they take the antiviral drug AZT during pregnancy, labor and delivery. If the decision to suspend the survey becomes final, activists are concerned that Ackerman might change the legislation to mandate testing of all pregnant women. The CDC plans to convene a panel of outside experts to evaluate its guidelines for counseling and voluntary testing.     

Bioterrorism-related anthrax: international response by the Centers for Disease Control and Prevention

After reports of the intentional release of Bacillus anthracis in the United States, epidemiologists, laboratorians, and clinicians around the world were called upon to respond to widespread political and public concerns. To respond to inquiries from other countries regarding anthrax and bioterrorism, the Centers for Disease Control and Prevention established an international team in its Emergency Operations Center. From October 12, 2001, to January 2, 2002, this team received 130 requests from 70 countries and 2 territories. Requests originated from ministries of health, international organizations, and physicians and included subjects ranging from laboratory procedures and clinical evaluations to assessments of environmental and occupational health risks. The information and technical support provided by the international team helped allay fears, prevent unnecessary antibiotic treatment, and enhance laboratory-based surveillance for bioterrorism events worldwide.     

Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention.

These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery anesthesiology interventional radiology pulmonary medicine, pediatric medicine, and nursing. The working group was led by the Society of Critical Care Medicine (SCCM), in collaboration with the Infectious Disease Society of America (IDSA), Society for Healthcare Epidemiology ofAmerica (SHEA), Surgical Infection Society (SIS), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), American Society of Critical Care Anesthesiologists (ASCCA), Association for Professionals in Infection Control and Epidemiology (APIC), Infusion Nurses Society (INS), Oncology Nursing Society (ONS), Society of Cardiovascular and Interventional Radiology (SCVIR), American Academy of Pediatrics (AAP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) of the Centers for Disease Control and Prevention (CDC) and is intended to replace the Guideline for Prevention of Intravascular Device-Related Infections published in 1996 These guidelines are intended to provide evidence-based recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.