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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles
New eBooksNews and training opportunities
ASPPH/CDC Public Health Fellowship Program, deadline to apply, September 18, 2014
ASPPH is pleased to offer recent graduates from ASPPH-member, Council on Education for Public Health (CEPH)-accredited Schools and Programs of Public Health an exciting opportunity to gain practical public health experience at the Centers for Disease Control and Prevention (CDC). Applications are currently being accepted for the 2015 ASPPH/CDC Public Health Fellowship Program; the deadline to apply is Thursday, September 18. https://fellowships.aspph.org/programs/details.cfm?programID=10
More physicians and hospitals are using EHRs than before
Significant increases in the use of electronic health records (EHRs) among the nation's physicians and hospitals are detailed in two new studies published today by the HHS Office of the National Coordinator for Health Information Technology (ONC). http://www.hhs.gov/news/press/2014pres/08/20140807a.html
Prevention and population health education across the health professions: a Healthy People 2020 Spotlight on Health webinar
September 9, 2014, 1:00-2:30 PM. Participants will learn how to access resources for developing curricula and collaborative learning experiences to improve prevention and population health education across various health professions. https://hhs-hp.webex.com/mw0307l/mywebex/default.do?nomenu=true&siteurl=hhs-hp&service=6&rnd=0.571862309790749&main_url=https%3A%2F%2Fhhs-hp.webex.com%2Fec0606l%2Feventcenter%2Fevent%2FeventAction.do%3FtheAction%3Ddetail%26confViewID%3D1749810083%26%26MK%3D663132208%26%26%26siteurl%3Dhhs-hp
The PHF Performance Management Toolkit has arrived
The Public Health Foundation (PHF) is pleased to share the new Performance Management Toolkit, a repository of performance management resources and tools, including case stories, white papers, and self-assessments that can help individuals and organizations move from learning to application. The purpose of this toolkit is to help public health professionals understand performance management and how to develop successful performance management systems. http://www.phf.org/news/Pages/PHF_Performance_Management_Toolkit_Has_Arrived.aspx
Public health messaging: How it is said can influence behaviors: Beyond the facts
Publishing in health communication journals: what you need to know
September 17, 2014, 2:00 PM EDT. Learn more about what health communication journals want in this moderated discussion with Dr. Teri Thompson, editor of Health Communication, and Dr. Renata Schiavo, editor of Journal of Communication in Healthcare: Strategies, Media, and Engagement in Global Health. http://hcwg.enterthemeeting.com/m/Q7JPU2MM
Social media impact for health communication
September 11, 2014, 10:00-11:30 AM ET. Learn about both the potential impact and limitations of social media as a tool for health communication. Two experts will present their research findings on the use of social media for health organizations. https://docs.google.com/forms/d/18y0Ui3f8YZyiioVZQe_s6hD3rys2l7SG8V4IvoX79qg/viewform
Cool websites and reports on hot topics*
Biggest ever weekly rise in Ebola cases, U.N. agency says
About 500 new infections reported across West Africa, including first case in Senegal. http://www.nlm.nih.gov/medlineplus/news/fullstory_148126.html
Chikungunya vaccine shows promise
A chikungunya vaccine gave encouraging results in an early-stage clinical trial. A vaccine could prevent outbreaks of the disease, which recently reached the U.S. mainland. http://www.nih.gov/researchmatters/august2014/08252014chikungunya.htm
Drug gives 'new hope' against heart failure, expert says
Experimental medication beat standard treatment at reducing hospitalizations, cardiovascular deaths. http://www.nlm.nih.gov/medlineplus/news/fullstory_148139.html
Ebola Is rapidly mutating as it spreads across West Africa
For the first time, scientists have been able to follow the spread of an Ebola outbreak almost in real time, by sequencing the virus' genome from people in Sierra Leone. http://www.npr.org/blogs/goatsandsoda/2014/08/28/343734184/ebola-is-rapidly-mutating-as-it-spreads-across-west-africa
Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak
In its largest outbreak, Ebola virus disease is spreading through Guinea, Liberia, Sierra Leone, and Nigeria. We sequenced 99 Ebola virus genomes from 78 patients in Sierra Leone to ~2,000x coverage. We observed a rapid accumulation of interhost and intrahost genetic variation, allowing us to characterize patterns of viral transmission over the initial weeks of the epidemic. This West African variant likely diverged from Middle African lineages ~2004, crossed from Guinea to Sierra Leone in May 2014, and has exhibited sustained human-to-human transmission subsequently, with no evidence of additional zoonotic sources. Since many of the mutations alter protein sequences and other biologically meaningful targets, they should be monitored for impact on diagnostics, vaccines, and therapies critical to outbreak response. http://www.sciencemag.org/content/early/2014/08/27/science.1259657.full.pdf
HHS contracts with Mapp Biopharmaceutical to develop Ebola drug
The development of a medication to treat illness from Ebola will be accelerated under a contract with the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR). This contract supports the government-wide response to the Ebola outbreak in West Africa. http://www.hhs.gov/news/press/2014pres/09/20140902b.html
Millions of underserved women in the US have benefitted from CDC’s breast and cervical screening program
More than 4.3 million women with limited access to health care received breast and cervical cancer screening and diagnostic services in the first 20 years of the CDC’s National Breast and Cervical Cancer Early Detection Program. http://www.cdc.gov/media/releases/2014/p0806-cancer-screening.html
Monkey trial supports Ebola drug that may have helped 2 stricken Americans
All 18 rhesus monkeys infected with the virus survived after getting the experimental medication, researchers report. http://www.nlm.nih.gov/medlineplus/news/fullstory_148128.html
Single animal to human transmission event responsible for 2014 Ebola outbreak
NIH-funded scientist uses latest genomic technology to make discovery. http://www.nih.gov/news/health/aug2014/od-29.htm
Therapies for children with autism spectrum disorder: behavioral interventions update
A growing evidence base suggests that behavioral interventions can be associated with positive outcomes for children with ASD. http://effectivehealthcare.ahrq.gov/ehc/products/544/1945/autism-update-report-140806.pdf
Interesting journal articles
Biological insights from 108 schizophrenia-associated genetic loci. Schizophrenia Working Group of the Psychiatric Genomics Consortium. Nature. 2014;511(7510):421-7.
Schizophrenia is a highly heritable disorder. Genetic risk is conferred by a large number of alleles, including common alleles of small effect that might be detected by genome-wide association studies. Here we report a multi-stage schizophrenia genome-wide association study of up to 36,989 cases and 113,075 controls. We identify 128 independent associations spanning 108 conservatively defined loci that meet genome-wide significance, 83 of which have not been previously reported. Associations were enriched among genes expressed in brain, providing biological plausibility for the findings. Many findings have the potential to provide entirely new insights into aetiology, but associations at DRD2 and several genes involved in glutamatergic neurotransmission highlight molecules of known and potential therapeutic relevance to schizophrenia, and are consistent with leading pathophysiological hypotheses. Independent of genes expressed in brain, associations were enriched among genes expressed in tissues that have important roles in immunity, providing support for the speculated link between the immune system and schizophrenia.
Civilian stressors associated with alcohol use disorders in the National Guard. Cerdá M, Richards C, Cohen GH, et al. Am J Prev Med. 2014;S0749-3797(14)00313-4.
BACKGROUND: Alcohol use disorders are a serious public health concern among soldiers. Although deployment-related exposures have been linked with alcohol use disorders in soldiers, less is understood about the link between modifiable, civilian stressors and post-deployment alcohol use disorders. PURPOSE: To (1) compare the influence of civilian stressors and deployment-related traumatic events and stressors on post-deployment alcohol use disorders among Army National Guardsmen primarily deployed to Afghanistan and Iraq; and (2) evaluate whether civilian stressors influence a different set of alcohol use disorder phenotypes than deployment-related traumatic events and stressors. METHODS:
A cohort of Ohio National Guard soldiers was recruited in 2008-2009 and interviewed three times over 3 years. The analytic sample included Ohio National Guard soldiers who had been deployed by 2008-2009, had participated in at least one follow-up wave, had reported consuming at least one alcoholic drink in their lifetime, and had non-missing data on alcohol use disorders (n=1,095). Analyses were conducted in 2013. RESULTS: In a model including measures of civilian stressors and deployment-related traumatic events, only civilian stressors (OR=2.07, 95% CI=1.46, 2.94) were associated with subsequent alcohol use disorder. The effects of civilian stressors were only present among people with no history of alcohol use disorder. CONCLUSIONS: Independent of deployment-related exposures, post-deployment civilian stressors are associated with the onset of alcohol use disorder among reserve-component soldiers. Concerted investment to address daily civilian difficulties associated with reintegration into civilian life may be needed to prevent new cases of alcohol use disorders among returning military personnel.
Diabetes mellitus increases the risk of early gastric cancer development. Sekikawa A, Fukui H, Maruo T, Tsumura T, Okabe Y, Osaki Y. Eur J Cancer. 2014;50(12):2065-71.
BACKGROUND: The significance of diabetes mellitus (DM) in gastric carcinogenesis still remains unclear. We investigated whether DM would be a risk factor for the development of early gastric cancer. METHODS: Factors related to the presence of gastric cancer were examined in patients undergoing medical health checkups. We then investigated whether DM was related to the development of early gastric cancer during an endoscopic follow-up study. RESULTS:
Gastric cancer was detected in 14 (1.0%) of 1463 patients at the first endoscopic examination and was significantly associated with the severity of gastric atrophy and the presence of DM. During the follow-up period (range 36-108 months; mean 70.0 months), early gastric cancer was newly detected in 26 (1.8%) of the 1449 patients in whom gastric cancer had not been detected at the first examination. Gastric cancer was detected in 17 (1.3%) of 1301 patients without DM, and in 9 (6.1%) of 148 patients with DM (P < 0.0001). Multivariate analyses demonstrated that open-type gastric atrophy and DM were independently related to the development of early gastric cancer (P < 0.0001 and P = 0.020, respectively). Gastric cancer was identified in 14 (5.1%) of 274 patients who had open-type atrophic gastritis without DM, whereas it was identified in 8 (16.0%) of 50 patients who had both open-type atrophic gastritis and DM (P = 0.0042). CONCLUSION: DM increases the risk of early gastric cancer development.
Efficacy of high-dose versus standard-dose influenza vaccine in older adults. DiazGranados CA, Dunning AJ, Kimmel M, et al. N Engl J Med. 2014;371(7):635-45.
BACKGROUND: As compared with a standard-dose vaccine, a high-dose, trivalent, inactivated influenza vaccine (IIV3-HD) improves antibody responses to influenza among adults 65 years of age or older. This study evaluated whether IIV3-HD also improves protection against laboratory-confirmed influenza illness. METHODS: We conducted a phase IIIb-IV, multicenter, randomized, double-blind, active-controlled trial to compare IIV3-HD (60 μg of hemagglutinin per strain) with standard-dose trivalent, inactivated influenza vaccine (IIV3-SD [15 μg of hemagglutinin per strain]) in adults 65 years of age or older. Assessments of relative efficacy, effectiveness, safety (serious adverse events), and immunogenicity (hemagglutination-inhibition [HAI] titers) were performed during the 2011-2012 (year 1) and the 2012-2013 (year 2) northern-hemisphere influenza seasons. RESULTS: A total of 31,989 participants were enrolled from 126 research centers in the United States and Canada (15,991 were randomly assigned to receive IIV3-HD, and 15,998 to receive IIV3-SD). In the intention-to-treat analysis, 228 participants in the IIV3-HD group (1.4%) and 301 participants in the IIV3-SD group (1.9%) had laboratory-confirmed influenza caused by any viral type or subtype associated with a protocol-defined influenza-like illness (relative efficacy, 24.2%; 95% confidence interval [CI], 9.7 to 36.5). At least one serious adverse event during the safety surveillance period was reported by 1323 (8.3%) of the participants in the IIV3-HD group, as compared with 1442 (9.0%) of the participants in the IIV3-SD group (relative risk, 0.92; 95% CI, 0.85 to 0.99). After vaccination, HAI titers and seroprotection rates (the percentage of participants with HAI titers ≥ 1:40) were significantly higher in the IIV3-HD group. Conclusions: Among persons 65 years of age or older, IIV3-HD induced significantly higher antibody responses and provided better protection against laboratory-confirmed influenza illness than did IIV3-SD.
Estimating the impact of unsafe water, sanitation and hygiene on the global burden of disease: evolving and alternative methods. Clasen T, Pruss-Ustun A, Mathers CD, Cumming O, Cairncross S, Colford JM Jr. Trop Med Int Health. 2014;19(8):884-93.
The 2010 global burden of disease (GBD) study represents the latest effort to estimate the global burden of disease and injuries and the associated risk factors. Like previous GBD studies, this latest iteration reflects a continuing evolution in methods, scope and evidence base. Since the first GBD Study in 1990, the burden of diarrhoeal disease and the burden attributable to inadequate water and sanitation have fallen dramatically. While this is consistent with trends in communicable disease and child mortality, the change in attributable risk is also due to new interpretations of the epidemiological evidence from studies of interventions to improve water quality. To provide context for a series of companion papers proposing alternative assumptions and methods concerning the disease burden and risks from inadequate water, sanitation and hygiene, we summarise evolving methods over previous GBD studies. We also describe an alternative approach using population intervention modelling. We conclude by emphasising the important role of GBD studies and the need to ensure that policy on interventions such as water and sanitation be grounded on methods that are transparent, peer-reviewed and widely accepted.
From evidence to action to deliver a healthy start for the next generation. Mason E, McDougall L, Lawn JE, et al. Lancet. 2014;384(9941):455-67.
Remarkable progress has been made towards halving of maternal deaths and deaths of children aged 1-59 months, although the task is incomplete. Newborn deaths and stillbirths were largely invisible in the Millennium Development Goals, and have continued to fall between maternal and child health efforts, with much slower reduction. This Series and the Every Newborn Action Plan outline mortality goals for newborn babies (ten or fewer per 1000 livebirths) and stillbirths (ten or fewer per 1000 total births) by 2035, aligning with A Promise Renewed target for children and the vision of Every Woman Every Child. To focus political attention and improve performance, goals for newborn babies and stillbirths must be recognised in the post-2015 framework, with corresponding accountability mechanisms. The four previous papers in this Every Newborn Series show the potential for a triple return on investment around the time of birth: averting maternal and newborn deaths and preventing stillbirths. Beyond survival, being counted and optimum nutrition and development is a human right for all children, including those with disabilities. Improved human capital brings economic productivity. Efforts to reach every woman and every newborn baby, close gaps in coverage, and improve equity and quality for antenatal, intrapartum, and postnatal care, especially in the poorest countries and for underserved populations, need urgent attention. We have prioritised what needs to be done differently on the basis of learning from the past decade about what has worked, and what has not. Needed now are four most important shifts: (1) intensification of political attention and leadership; (2) promotion of parent voice, supporting women, families, and communities to speak up for their newborn babies and to challenge social norms that accept these deaths as inevitable; (3) investment for effect on mortality outcome as well as harmonisation of funding; (4) implementation at scale, with particular attention to increasing of health worker numbers and skills with attention to high-quality childbirth care for newborn babies as well as mothers and children; and (5) evaluation, tracking coverage of priority interventions and packages of care with clear accountability to accelerate progress and reach the poorest groups. The Every Newborn Action Plan provides an evidence-based roadmap towards care for every woman, and a healthy start for every newborn baby, with a right to be counted, survive, and thrive wherever they are born.
Hygiene and health: systematic review of handwashing practices worldwide and update of health effects. Freeman MC1, Stocks ME, Cumming O, et al. Trop Med Int Health. 2014;19(8):906-16.
OBJECTIVE: To estimate the global prevalence of handwashing with soap and derive a pooled estimate of the effect of hygiene on diarrhoeal diseases, based on a systematic search of the literature. METHODS: Studies with data on observed rates of handwashing with soap published between 1990 and August 2013 were identified from a systematic search of PubMed, Embase and ISI Web of Knowledge. A separate search was conducted for studies on the effect of hygiene on diarrhoeal disease that included randomised controlled trials, quasi-randomised trials with control group, observational studies using matching techniques and observational studies with a control group where the intervention was well defined. The search used Cochrane Library, Global Health, BIOSIS, PubMed, and Embase databases supplemented with reference lists from previously published systematic reviews to identify studies published between 1970 and August 2013. Results were combined using multilevel modelling for handwashing prevalence and meta-regression for risk estimates. RESULTS: From the 42 studies reporting handwashing prevalence we estimate that approximately 19% of the world population washes hands with soap after contact with excreta (i.e. use of a sanitation facility or contact with children's excreta). Meta-regression of risk estimates suggests that handwashing reduces the risk of diarrhoeal disease by 40% (risk ratio 0.60, 95% CI 0.53-0.68); however, when we included an adjustment for unblinded studies, the effect estimate was reduced to 23% (risk ratio 0.77, 95% CI 0.32-1.86). CONCLUSIONS: Our results show that handwashing after contact with excreta is poorly practiced globally, despite the likely positive health benefits.
Impact of windows and daylight exposure on overall health and sleep quality of office workers: a case-control pilot study. Boubekri M, Cheung IN, Reid KJ, Wang CH, Zee PC. J Clin Sleep Med. 2014;10(6):603-11.
STUDY OBJECTIVE: This research examined the impact of daylight exposure on the health of office workers from the perspective of subjective well-being and sleep quality as well as actigraphy measures of light exposure, activity, and sleep-wake patterns. METHODS: Participants (N = 49) included 27 workers working in windowless environments and 22 comparable workers in workplaces with significantly more daylight. Windowless environment is defined as one without any windows or one where workstations were far away from windows and without any exposure to daylight. Well-being of the office workers was measured by Short Form-36 (SF-36), while sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI). In addition, a subset of participants (N = 21; 10 workers in windowless environments and 11 workers in workplaces with windows) had actigraphy recordings to measure light exposure, activity, and sleep-wake patterns. RESULTS: Workers in windowless environments reported poorer scores than their counterparts on two SF-36 dimensions--role limitation due to physical problems and vitality--as well as poorer overall sleep quality from the global PSQI score and the sleep disturbances component of the PSQI. Compared to the group without windows, workers with windows at the workplace had more light exposure during the workweek, a trend toward more physical activity, and longer sleep duration as measured by actigraphy. CONCLUSIONS: We suggest that architectural design of office environments should place more emphasis on sufficient daylight exposure of the workers in order to promote office workers' health and well-being.
Indirect and direct associations between personality and psychological distress mediated by dispositional coping. Panayiotou G, Kokkinos CM, Kapsou M. J Psychol. 2014;148(5):549-67.
The present study examines the association between coping and personality, by testing the hypothesis that dispositional coping mediates the relationship between personality and psychological distress. Canonical correlations evaluated the degree of the association among personality and coping dimensions in a community sample (N = 489) from Cyprus. Results partially support the hypothesized mediation model with Agreeableness predicting distress through the full mediation of avoidant coping, expression of negative feelings and active-positive coping. Partial mediation was found for Neuroticism and Openness. Canonical correlations deciphered how coping relates to the Big Five dimensions. Neuroticism was mostly associated with maladaptive coping, whereas Conscientiousness and Extraversion with adaptive coping.
A single localized dose of enzyme-responsive hydrogel improves long-term survival of a vascularized composite allograft. Gajanayake T, Olariu R1, Leclère FM1, et al. Sci Transl Med. 2014;6(249):249ra110.
Currently, systemic immunosuppression is used in vascularized composite allotransplantation (VCA). This treatment has considerable side effects and reduces the quality of life of VCA recipients. We loaded the immunosuppressive drug tacrolimus into a self-assembled hydrogel, which releases the drug in response to proteolytic enzymes that are overexpressed during inflammation. A one-time local injection of the tacrolimus-laden hydrogel significantly prolonged graft survival in a Brown Norway-to-Lewis rat hindlimb transplantation model, leading to a median graft survival of >100 days compared to 33.5 days in tacrolimus only-treated recipients. Control groups with no treatment or hydrogel only showed a graft survival of 11 days. Histopathological evaluation, including anti-graft antibodies and complement C3, revealed significantly reduced immune responses in the tacrolimus-hydrogel group compared with tacrolimus only. In conclusion, a single-dose local injection of an enzyme-responsive tacrolimus-hydrogel is capable of preventing VCA rejection for >100 days in a rat model and may offer a new approach for immunosuppression in VCA.
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