"Do good and talk about it". A CHRISTUS health study emphasizes the importance of telling our stories to the public

In a time of public scrutiny, it is paramount that Catholic health care organizations examine their commitments to their communities and effectively communicate community benefit activities to stakeholders-employees, physicians, patients, and the public. CHRISTUS Academy, a leadership development program at CHRISTUS Health, Irving, TX, conducted two studies regarding community benefit. The first researched community benefit practices at more than 20 highly respected, tax-exempt CHA- and VHA-member organizations, comparing them with the practices of about 40 publicly traded, for-profit organizations. The primary conclusion was that community benefit is not just about measuring the numbers-it is also about "telling the story." Unlike the for-profit organizations, tax-exempt health care organizations tend to struggle with adequately measuring and reporting their community contributions. In a second study, the academy surveyed CHRISTUS Health's employees and physicians regarding their knowledge of the system's commitment vis-à-vis identifying and meeting community needs. The vast majority said the system is important to the community and is actively involved in understanding and meeting the needs of the community. However, they also ranked the system lower in terms of working with other community organizations, being a leader in community health, and being known for sponsoring volunteer activities. These lower rankings indicate that the community benefit activities are not well publicized or known within the organization. Catholic health organizations must take an active approach in communicating their work to the public, the media, and each other. In doing so, they fulfill an integral part their mission.     

A study of work-related musculoskeletal case reports to The Health and Occupation Reporting network (THOR) from 2002 to 2003

BACKGROUND: Occupational musculoskeletal disorders are frequently seen by occupational physicians and rheumatologists, and there are well-established UK-based schemes set-up for reporting these conditions. An apparent fall in case reporting for work-related musculoskeletal disorders in Great Britain to The Health and Occupation Reporting network (THOR) was observed from 2002 to 2003. AIMS: To investigate changes in case reporting for musculoskeletal disorders sent by occupational physicians to Occupational Physicians Reporting Activity (OPRA) and by rheumatologists to Musculoskeletal Occupational Surveillance Scheme (MOSS) between 2002 and 2003. METHODS: Musculoskeletal cases returned by more than 800 physicians from Great Britain reporting to OPRA and MOSS in 2002-2003 were analysed. Changes in reporting are described at individual physician and group levels in: numbers of participants, levels of response, and numbers of case reports by disease category and major occupational and industrial groups. RESULTS: In 2002-2003, musculoskeletal disease was the most frequently reported major disease category in OPRA. Between 2002 and 2003, the proportion of musculoskeletal case reporting fell by 37% in OPRA, and 7% in MOSS. This fall was seen in many disease categories, across a wide range of occupations and industries. In OPRA, the greatest fall in reporting (74%) was for the category Raynaud's/Hand-Arm Vibration Syndrome/Vibration White Finger. CONCLUSIONS: The fall in occupational musculoskeletal case reporting between 2002 and 2003 cannot be explained by internal factors within the reporting system. This observation highlights the need for systematic investigation of trends in case reporting for work-related ill-health.     

Impact of Untreated Psychosis on Quality of Life in Patients with First-episode Schizophrenia

Despite increasing interest in the quality of life (QOL) of psychiatric patients in recent years, few studies have focused on the potential adverse effects of the illness on QOL during the period of untreated psychosis. Our study compares the QOL of patients with first-episode schizophrenia when they first presented to the psychiatric service with that of the normal population, and identifies possible relationships with various clinical parameters. One hundred and seventeen patients with schizophrenia (aged 14–28 years) who entered the Early Assessment Services for Young People with Psychosis (EASY) programme in Hong Kong from June 2001 to January 2004 were assessed with the MOS 36 item Short Form Health Survey (SF-36) and the World Health Organization Quality of Life Measure, abbreviated Hong Kong version (WHOQOL-BREF(HK)). We compared their SF-36 scores with controls from the normal population matched by age, sex, marital status and educational level. We assessed clinical parameters including positive, negative and depressive symptoms by the Positive and Negative Syndrome Scale (PANSS), the Scale for Assessment of Negative Symptoms (SANS), and the Montgomery and Asberg Depression Rating Scale (MADRS). When compared with matched controls from the normal population, significantly lower scores in all of the eight scales of the SF-36 were found in our patient group (p < 0.005). Various QOL domain scores had significant inverse correlations with the total MADRS score. However, there was no significant correlation with other clinical parameters. Young patients with first-episode schizophrenia have poorer QOL in the period of untreated psychosis than their counterparts in the community. Amongst various clinical parameters, the severity of depressive symptoms correlates most with QOL.     

Interorganizational Collaboration in Occupational Rehabilitation: Perceptions of an Interdisciplinary Rehabilitation Team

Introduction: Various obstacles to and facilitators of collaboration between an interdisciplinary work rehabilitation team and the stakeholders (workers, insurers, physicians, and employers) exist, but are not well characterized. Methods: An observational study was conducted, using videotapes of interdisciplinary team discussions of ongoing cases involving 22 workers absent from work due to musculoskeletal disorders. The actions taken and strategies adopted by the team in an effort to overcome the obstacles to collaboration were studied. Results: Various factors influence collaboration between the rehabilitation team and the stakeholders. In general, stakeholder endorsement of the team's therapeutic principles and confidence in their approach emerged as particularly important factors. Diverse strategies, most often, education and awareness-raising, were used by the team to foster collaboration among the parties. Conclusions: This study provides greater insight into the factors affecting collaboration among a rehabilitation team, an injured worker and other stakeholders. The results may improve understanding of the actions taken by rehabilitation teams and help to optimize their practices.     

West Nile virus-infected mosquitoes, Louisiana, 2002

Human cases of West Nile virus (WNV) disease appeared in St. Tammany and Tangipahoa Parishes in southeastern Louisiana in June 2002. Cases peaked during July, then rapidly declined. We conducted mosquito collections from August 3 to August 15 at residences of patients with confirmed and suspected WNV disease to estimate species composition, relative abundance, and WNV infection rates. A total of 31,215 mosquitoes representing 25 species were collected by using primarily gravid traps and CO2-baited light traps. Mosquitoes containing WNV RNA were obtained from 5 of 11 confirmed case sites and from 1 of 3 sites with non-WNV disease. WNV RNA was detected in 9 mosquito pools, including 7 Culex quinquefasciatus, 1 Cx. salinarius, and 1 Coquillettidia perturbans. Mosquito infection rates among sites ranged from 0.8/1,000 to 10.9/1,000. Results suggest that Cx. quinquefasciatus was the primary epizootic/epidemic vector, with other species possibly playing a secondary role.     

Rapid identification of emerging pathogens: coronavirus

We describe a new approach for infectious disease surveillance that facilitates rapid identification of known and emerging pathogens. The process uses broad-range polymerase chain reaction (PCR) to amplify nucleic acid targets from large groupings of organisms, electrospray ionization mass spectrometry for accurate mass measurements of PCR products, and base composition signature analysis to identify organisms in a sample. We demonstrate this principle by using 14 isolates of 9 diverse Coronavirus spp., including the severe acute respiratory syndrome-associated coronavirus (SARS-CoV). We show that this method could identify and distinguish between SARS and other known CoV, including the human CoV 229E and OC43, individually and in a mixture of all 3 human viruses. The sensitivity of detection, measured by using titered SARS-CoV spiked into human serum, was approximate, equals1 PFU/mL. This approach, applicable to the surveillance of bacterial, viral, fungal, or protozoal pathogens, is capable of automated analysis of >900 PCR reactions per day.