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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles
News and training opportunities
American Adults are Choosing Healthier Foods, Consuming Healthier Diets
USDA research shows improvements in diet quality between 2005 and 2010. http://www.usda.gov/wps/portal/usda/usdahome?contentid=2014/01/0008.xml&contentidonly=true
APHA: Despite Some Key Investments, President's Budget Leaves Room for Improvement
President Barack Obama has announced a proposed budget for fiscal year 2015 that despite some targeted investments in public health, is disappointing, according to the American Public Health Association. http://www.apha.org/about/news/pressreleases/2014/Presidentsbudget2014.htm
CDC Study Shows That Child Passenger Deaths Have Decreased 43 Percent from 2002-2011
Motor vehicle crash deaths among children age 12 and younger decreased by 43 percent from 2002-2011; however, still more than 9,000 children died in crashes during that period, according to a new Vital Signs report from the Centers for Disease Control and Prevention. http://www.cdc.gov/media/releases/2014/p0204-child-passenger-deaths.html
FDA Launches Its First National Public Education Campaign to Prevent, Reduce Youth Tobacco Use
The U.S. Food and Drug Administration is launching a national public education campaign to prevent youth tobacco use and reduce the number of kids ages 12 to 17 who become regular smokers. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm384049.htm
MMWR Continuing Education
Continuing Education (CE) credit for reading MMWR weekly and serial publications. Persons seeking CE credit need to register and take an examination. http://www.cdc.gov/mmwr/cme/conted_info.html
Multidrug-Resistant Tuberculosis: Tools for Tackling a New Face of an Old Foe
March 18, 1:00-2:00 PM. This session of CDC Grand Rounds will discuss how more patients can benefit from advances in diagnostic and treatment options, resulting in an overall reduction in morbidity from Multidrug-resistant Tuberculosis (MDR TB). http://www.cdc.gov/about/grand-rounds/archives/2014/March2014.htm
National Conference on Health Communication, Marketing, and Media
August 19 -21, 2014, Atlanta, GA. This conference will bring together individuals representing academia, public health researchers and practitioners from federal and state government and the private sector, and provides a forum for collegial dialogue within and across these disciplines. http://www.cdc.gov/nchcmm/index.html
NNPHI 2014 Annual Conference: Leading Change Through Innovative Solutions
May 19-21, 2014, New Orleans, LA. This year's theme, Leading Change Through Innovative Solutions, will explore the role of public health institutes in developing strategies, new partnership opportunities, and innovative approaches that are leading population health improvement. https://www.regonline.com/builder/site/Default.aspx?EventID=1418023
National Public Health Week 2014 Theme is Public Health: Start Here
APHA brings together communities across the United States to observe National Public Health Week as a time to recognize the contributions of public health and highlight issues that are important to improving our nation. http://www.nphw.org/
New IOM Discussion Paper: Paying for Population Health
IOM has released a new discussion paper that describes one state's creative use of the Medicaid waiver. In Texas, the state's use of the waiver provides support for the population-based prevention activities of local public health agencies, and this state policy has the potential to transform the health of Texas communities. http://www.iom.edu/Activities/PublicHealth/PopulationHealthImprovementRT/PayingForPopHealth.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewIomNewsAndAnnouncements+%28New+IOM+News+and+Announcements%29
Cool websites and reports on hot topics*
CDC: Flu Vaccine 61% Effective, But Too Few Adults Get It
Federal health officials have reported that this year's seasonal influenza vaccine provides an estimated 61% level of protection overall, and also said that low vaccination coverage among working-age adults may help explain why that age-group has been hit unusually hard by the flu this year. http://www.cidrap.umn.edu/news-perspective/2014/02/cdc-flu-vaccine-61-effective-too-few-adults-get-it
Allows users to browse a sample of CDC's popular data sets and create visualizations of data to embed on websites that update automatically when data changes. https://data.cdc.gov/
FDA Proposes Updates to Nutrition Facts Label on Food Packages
The U.S. Food and Drug Administration has proposed to update the Nutrition Facts label for packaged foods to reflect the latest scientific information, including the link between diet and chronic diseases such as obesity and heart disease. The proposed label also would replace out-of-date serving sizes to better align with how much people really eat, and it would feature a fresh design to highlight key parts of the label such as calories and serving sizes. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm387418.htm
Mysterious Polio-Like Illness Found in Five California Children
Researchers have reported an unexplained polio-like illness that struck five children in the state and left them with poor limb function, the American Academy of Neurology (AAN) reported. https://www.aan.com/PressRoom/Home/PressRelease/1246
Twitter data for health topics at the national level and for specified geographic areas. The information can serve as an indicator of potential health issues emerging in the population, build a baseline of trend data, engage the public on trending health topics, and be used as cross-reference with other data sources. http://nowtrending.hhs.gov/
Provides summaries and full-text of selected systematic reviews on the prevention and treatment of diseases and conditions. http://www.ncbi.nlm.nih.gov/pubmedhealth/
Twogether in Texas - Helping Couples Create Strong Marriages
During its 5-year existence, the program has made classes available to more than 196,000 individuals, giving them the foundation they need to start a new life; one in which two lives become one. http://twogetherintexas.com/UI/Homepage.aspx
Interesting journal articles
Acetaminophen Use During Pregnancy, Behavioral Problems, and Hyperkinetic Disorders [published online ahead of print February 24, 2014]. Liew Z, Ritz B, Rebordosa C, Lee PC, Olsen J. JAMA Pediatr. doi: 10.1001/jamapediatrics.2013.4914.
IMPORTANCE Acetaminophen (paracetamol) is the most commonly used medication for pain and fever during pregnancy in many countries. Research data suggest that acetaminophen is a hormone disruptor, and abnormal hormonal exposures in pregnancy may influence fetal brain development. OBJECTIVE To evaluate whether prenatal exposure to acetaminophen increases the risk for developing attention-deficit/hyperactivity disorder (ADHD)-like behavioral problems or hyperkinetic disorders (HKDs) in children. DESIGN, SETTING, AND PARTICIPANTS We studied 64 322 live-born children and mothers enrolled in the Danish National Birth Cohort during 1996-2002. EXPOSURES Acetaminophen use during pregnancy was assessed prospectively via 3 computer-assisted telephone interviews during pregnancy and 6 months after child birth. MAIN OUTCOMES AND MEASURES To ascertain outcome information we used (1) parental reports of behavioral problems in children 7 years of age using the Strengths and Difficulties Questionnaire; (2) retrieved HKD diagnoses from the Danish National Hospital Registry or the Danish Psychiatric Central Registry prior to 2011; and (3) identified ADHD prescriptions (mainly Ritalin) for children from the Danish Prescription Registry. We estimated hazard ratios for receiving an HKD diagnosis or using ADHD medications and risk ratios for behavioral problems in children after prenatal exposure to acetaminophen. RESULTS More than half of all mothers reported acetaminophen use while pregnant. Children whose mothers used acetaminophen during pregnancy were at higher risk for receiving a hospital diagnosis of HKD (hazard ratio = 1.37; 95% CI, 1.19-1.59), use of ADHD medications (hazard ratio = 1.29; 95% CI, 1.15-1.44), or having ADHD-like behaviors at age 7 years (risk ratio = 1.13; 95% CI, 1.01-1.27). Stronger associations were observed with use in more than 1 trimester during pregnancy, and exposure response trends were found with increasing frequency of acetaminophen use during gestation for all outcomes (ie, HKD diagnosis, ADHD medication use, and ADHD-like behaviors; P trend < .001). Results did not appear to be confounded by maternal inflammation, infection during pregnancy, the mother's mental health problems, or other potential confounders we evaluated. CONCLUSIONS AND RELEVANCE Maternal acetaminophen use during pregnancy is associated with a higher risk for HKDs and ADHD-like behaviors in children. Because the exposure and outcome are frequent, these results are of public health relevance but further investigations are needed.
Added Sugar Intake and Cardiovascular Diseases Mortality Among US Adults [published online ahead of print February 3, 2014]. Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. JAMA Intern Med. doi: 10.1001/jamainternmed.2013.13563.
IMPORTANCE Epidemiologic studies have suggested that higher intake of added sugar is associated with cardiovascular disease (CVD) risk factors. Few prospective studies have examined the association of added sugar intake with CVD mortality. OBJECTIVE To examine time trends of added sugar consumption as percentage of daily calories in the United States and investigate the association of this consumption with CVD mortality. DESIGN, SETTING, AND PARTICIPANTS National Health and Nutrition Examination Survey (NHANES, 1988-1994 [III], 1999-2004, and 2005-2010 [n = 31 147]) for the time trend analysis and NHANES III Linked Mortality cohort (1988-2006 [n = 11 733]), a prospective cohort of a nationally representative sample of US adults for the association study. MAIN OUTCOMES AND MEASURES Cardiovascular disease mortality. RESULTS Among US adults, the adjusted mean percentage of daily calories from added sugar increased from 15.7% (95% CI, 15.0%-16.4%) in 1988-1994 to 16.8% (16.0%-17.7%; P = .02) in 1999-2004 and decreased to 14.9% (14.2%-15.5%; P < .001) in 2005-2010. Most adults consumed 10% or more of calories from added sugar (71.4%) and approximately 10% consumed 25% or more in 2005-2010. During a median follow-up period of 14.6 years, we documented 831 CVD deaths during 163 039 person-years. Age-, sex-, and race/ethnicity-adjusted hazard ratios (HRs) of CVD mortality across quintiles of the percentage of daily calories consumed from added sugar were 1.00 (reference), 1.09 (95% CI, 1.05-1.13), 1.23 (1.12-1.34), 1.49 (1.24-1.78), and 2.43 (1.63-3.62; P < .001), respectively. After additional adjustment for sociodemographic, behavioral, and clinical characteristics, HRs were 1.00 (reference), 1.07 (1.02-1.12), 1.18 (1.06-1.31), 1.38 (1.11-1.70), and 2.03 (1.26-3.27; P = .004), respectively. Adjusted HRs were 1.30 (95% CI, 1.09-1.55) and 2.75 (1.40-5.42; P = .004), respectively, comparing participants who consumed 10.0% to 24.9% or 25.0% or more calories from added sugar with those who consumed less than 10.0% of calories from added sugar. These findings were largely consistent across age group, sex, race/ethnicity (except among non-Hispanic blacks), educational attainment, physical activity, health eating index, and body mass index. CONCLUSIONS AND RELEVANCE Most US adults consume more added sugar than is recommended for a healthy diet. We observed a significant relationship between added sugar consumption and increased risk for CVD mortality.
Assessing progress in reducing the burden of cancer mortality, 1985-2005. Soneji S, Beltrán-Sánchez H, Sox HC. J Clin Oncol. 2014;32(5):444-8.
PURPOSE: Measuring the effect of cancer interventions must take into account rising cancer incidence now that people live longer because of declines in mortality from cardiovascular disease (CVD). Cancer mortality rates in the population do not accomplish this objective. We sought a measure that would reveal the effects of changing mortality rates from other diseases. METHODS: We obtained annual breast, colorectal, lung, and prostate cancer mortality rates from the Surveillance, Epidemiology, and End Results registries; we obtained noncancer mortality rates from national death certificates, 1975 to 2005. We used life-table methods to calculate the burden of cancer mortality as the average person-years of life lost (PYLL) as a result of cancer (cancer-specific PYLL) and quantify individual-and perhaps offsetting-contributions of the two factors that affect cancer-specific PYLL: mortality rates as a result of cancer and other-cause mortality. RESULTS: Falling cancer mortality rates reduced the burden of mortality from leading cancers, but increasing cancer incidence as a result of decreasing other-cause mortality rates partially offset this progress. Between 1985 and 1989 and between 2000 and 2004, the burden of lung cancer in males declined by 0.1 year of life lost. This decline reflects the sum of two effects: decreasing lung cancer mortality rates that reduced the average burden of lung cancer mortality by 0.33 years of life lost and declining other-cause mortality rates that raised it by 0.23 years. Other common cancers showed similar patterns. CONCLUSION: By using a measure that accounts for increased cancer incidence as a result of improvements in CVD mortality, we find that prior assessments have underestimated the impact of cancer interventions.
Comparative genomic hybridisation array and DNA sequencing to direct treatment of metastatic breast cancer: a multicentre, prospective trial (SAFIR01/UNICANCER). André F, Bachelot T, Commo F, et al. Lancet Oncol. 2014. pii: S1470-2045(13)70611-9.
BACKGROUND: Breast cancer is characterised by genomic alterations. We did a multicentre molecular screening study to identify abnormalities in individual patients with the aim of providing targeted therapy matched to individuals' genomic alterations. METHODS: From June 16, 2011, to July 30, 2012, we recruited patients who had breast cancer with a metastasis accessible for biopsy in 18 centres in France. Comparative genomic hybridisation (CGH) array and Sanger sequencing on PIK3CA (exon 10 and 21) and AKT1 (exon 4) were used to assess metastatic biopsy samples in five centres. Therapeutic targets were decided on the basis of identified genomic alterations. The primary objective was to include 30% of patients in clinical trials testing a targeted therapy and, therefore, the primary outcome was the proportion of patients to whom a targeted therapy could be offered. For the primary endpoint, the analyses were done on the overall population registered for the trial. This trial is registered with ClinicalTrials.gov, number NCT01414933. FINDINGS: 423 patients were included, and biopsy samples were obtained from 407 (metastatic breast cancer was not found in four). CGH array and Sanger sequencing were feasible in 283 (67%) and 297 (70%) patients, respectively. A targetable genomic alteration was identified in 195 (46%) patients, most frequently in PIK3CA (74 [25%] of 297 identified genomic alterations), CCND1 (53 [19%]), and FGFR1 (36 [13%]). 117 (39%) of 297 patients with genomic tests available presented with rare genomic alterations (defined as occurring in less than 5% of the general population), including AKT1 mutations, and EGFR, MDM2, FGFR2, AKT2, IGF1R, and MET high-level amplifications. Therapy could be personalised in 55 (13%) of 423 patients. Of the 43 patients who were assessable and received targeted therapy, four (9%) had an objective response, and nine others (21%) had stable disease for more than 16 weeks. Serious (grade 3 or higher) adverse events related to biopsy were reported in four (1%) of enrolled patients, including pneumothorax (grade 3, one patient), pain (grade 3, one patient), haematoma (grade 3, one patient), and haemorrhagic shock (grade 3, one patient). INTERPRETATION: Personalisation of medicine for metastatic breast cancer is feasible, including for rare genomic alterations.
Conformal piezoelectric energy harvesting and storage from motions of the heart, lung, and diaphragm. Dagdeviren C, Yang BD, Su Y, et al. Proc Natl Acad Sci U S A. 2014;111(5):1927-32.
Here, we report advanced materials and devices that enable high-efficiency mechanical-to-electrical energy conversion from the natural contractile and relaxation motions of the heart, lung, and diaphragm, demonstrated in several different animal models, each of which has organs with sizes that approach human scales. A cointegrated collection of such energy-harvesting elements with rectifiers and microbatteries provides an entire flexible system, capable of viable integration with the beating heart via medical sutures and operation with efficiencies of ∼2%. Additional experiments, computational models, and results in multilayer configurations capture the key behaviors, illuminate essential design aspects, and offer sufficient power outputs for operation of pacemakers, with or without battery assist.
General and specific effects of early-life psychosocial adversities on adolescent grey matter volume. Walsh ND, Dalgleishc T, Lombardod MV, et al. NeuroImage: Clinical. 2014;4:308–318.
Exposure to childhood adversities (CA) is associated with subsequent alterations in regional brain grey matter volume (GMV). Prior studies have focused mainly on severe neglect and maltreatment. The aim of this study was to determine in currently healthy adolescents if exposure to more common forms of CA results in reduced GMV. Effects on brain structure were investigated using voxel-based morphometry in a cross-sectional study of youth recruited from a population-based longitudinal cohort. 58 participants (mean age = 18.4) with (n = 27) or without (n = 31) CA exposure measured retrospectively from maternal interview were included in the study. Measures of recent negative life events (RNLE) recorded at 14 and 17 years, current depressive symptoms, gender, participant/parental psychiatric history, current family functioning perception and 5-HTTLPR genotype were covariates in analyses. A multivariate analysis of adversities demonstrated a general association with a widespread distributed neural network consisting of cortical midline, lateral frontal, temporal, limbic, and cerebellar regions. Univariate analyses showed more specific associations between adversity measures and regional GMV: CA specifically demonstrated reduced vermis GMV and past psychiatric history with reduced medial temporal lobe volume. In contrast RNLE aged 14 was associated with increased lateral cerebellar and anterior cingulate GMV. We conclude that exposure to moderate levels of childhood adversities occurring during childhood and early adolescence exerts effects on the developing adolescent brain. Reducing exposure to adverse social environments during early life may optimize typical brain development and reduce subsequent mental health risks in adult life.
Increased Risk of Acute Cardiovascular Events After Partner Bereavement: A Matched Cohort Study [published online ahead of print February 24, 2014]. Carey IM, Shah SM, Dewilde S, Harris T, Victor CR, Cook DG. JAMA Intern Med. doi: 10.1001/jamainternmed.2013.
IMPORTANCE The period immediately after bereavement has been reported as a time of increased risk of cardiovascular events. However, this risk has not been well quantified, and few large population studies have examined partner bereavement. OBJECTIVE To compare the rate of cardiovascular events between older individuals whose partner dies with those of a matched control group of individuals whose partner was still alive on the same day. DESIGN, SETTING, AND PARTICIPANTS Matched cohort study using a UK primary care database containing availale data of 401 general practices from February 2005 through September 2012. In all, 30 447 individuals aged 60 to 89 years at study initiation who experienced partner bereavement during follow-up were matched by age, sex, and general practice with the nonbereaved control group (n = 83 588) at the time of bereavement. EXPOSURES Partner bereavement. MAIN OUTCOMES AND MEASURES The primary outcome was occurrence of a fatal or nonfatal myocardial infarction (MI) or stroke within 30 days of bereavement. Secondary outcomes were non-MI acute coronary syndrome and pulmonary embolism. All outcomes were compared between the groups during prespecified periods after bereavement (30, 90, and 365 days). Incidence rate ratios (IRRs) from a conditional Poisson model were adjusted for age, smoking status, deprivation, and history of cardiovascular disease. RESULTS Within 30 days of their partner's death, 50 of the bereaved group (0.16%) experienced an MI or a stroke compared with 67 of the matched nonbereaved controls (0.08%) during the same period (IRR, 2.20 [95% CI, 1.52-3.15]). The increased risk was seen in bereaved men and women and attenuated after 30 days. For individual outcomes, the increased risk was found separately for MI (IRR, 2.14 [95% CI, 1.20-3.81]) and stroke (2.40 [1.22-4.71]). Associations with rarer events were also seen after bereavement, including elevated risk of non-MI acute coronary syndrome (IRR, 2.20 [95% CI, 1.12-4.29]) and pulmonary embolism (2.37 [1.18-4.75]) in the first 90 days. CONCLUSIONS AND RELEVANCE This study provides further evidence that the death of a partner is associated with a range of major cardiovascular events in the immediate weeks and months after bereavement. Understanding psychosocial factors associated with acute cardiovascular events may provide opportunities for prevention and improved clinical care.
Initial and Long-Term Costs of Patients Hospitalized with West Nile Virus Disease [published ahead of print February 10, 2014]. Staples JE, Shankar M, Sejvar JJ, Meltzer MI, Fischer M. Am J Trop Med Hyg.
There are no published data on the economic burden for specific West Nile virus (WNV) clinical syndromes (i.e., fever, meningitis, encephalitis, and acute flaccid paralysis [AFP]). We estimated initial hospital and lost-productivity costs from 80 patients hospitalized with WNV disease in Colorado during 2003; 38 of these patients were followed for 5 years to determine long-term medical and lost-productivity costs. Initial costs were highest for patients with AFP (median $25,117; range $5,385-$283,381) and encephalitis (median $20,105; range $3,965-$324,167). Long-term costs were highest for patients with AFP (median $22,628; range $624-$439,945) and meningitis (median $10,556; range $0-$260,748). Extrapolating from this small cohort to national surveillance data, we estimated the total cumulative costs of reported WNV hospitalized cases from 1999 to 2012 to be $778 million (95% confidence interval $673 million-$1.01 billion). These estimates can be used in assessing the cost-effectiveness of interventions to prevent WNV disease.
MicroRNA biomarkers in whole blood for detection of pancreatic cancer. Schultz NA, Dehlendorff C, Jensen BV, et al. JAMA. 2014;311(4):392-404.
IMPORTANCE: Biomarkers for the early diagnosis of patients with pancreatic cancer are needed to improve prognosis. OBJECTIVES: To describe differences in microRNA expression in whole blood between patients with pancreatic cancer, chronic pancreatitis, and healthy participants and to identify panels of microRNAs for use in diagnosis of pancreatic cancer compared with the cancer antigen 19-9 (CA19-9). DESIGN, SETTING, AND PARTICIPANTS: A case-control study that included 409 patients with pancreatic cancer and 25 with chronic pancreatitis who had been included prospectively in the Danish BIOPAC (Biomarkers in Patients with Pancreatic Cancer) study (July 2008-October 2012) plus 312 blood donors as healthy participants. The microRNA expressions in pretreatment whole blood RNA samples were collected and analyzed in 3 randomly determined subcohorts: discovery cohort (143 patients with pancreatic cancer, 18 patients with chronic pancreatitis, and 69 healthy participants), training cohort (180 patients with pancreatic cancer, 1 patient with chronic pancreatitis, and 199 healthy participants), and validation cohort (86 patients with pancreatic cancer, 7 patients with chronic pancreatitis, and 44 healthy participants); 754 microRNAs were screened in the discovery cohort and 38 microRNAs in the training cohort and 13 microRNAs in the validation cohort. MAIN OUTCOMES AND MEASURES: Identification of microRNA panels (classifiers) for diagnosing pancreatic cancer. RESULTS: The discovery cohort demonstrated that 38 microRNAs in whole blood were significantly dysregulated in patients with pancreatic cancer compared with controls. These microRNAs were tested in the training cohort and 2 diagnostic panels were constructed comprising 4 microRNAs in index I (miR-145, miR-150, miR-223, miR-636) and 10 in index II (miR-26b, miR-34a, miR-122, miR-126*, miR-145, miR-150, miR-223, miR-505, miR-636, miR-885.5p). The test characteristics for the training cohort were index I area under the curve (AUC) of 0.86 (95% CI, 0.82-0.90), sensitivity of 0.85 (95% CI, 0.79-0.90), and specificity of 0.64 (95% CI, 0.57-0.71); index II AUC of 0.93 (95% CI, 0.90-0.96), sensitivity of 0.85 (95% CI, 0.79-0.90), and specificity of 0.85 (95% CI, 0.80-0.85); and CA19-9 AUC of 0.90 (95% CI, 0.87-0.94), sensitivity of 0.86 (95% CI, 0.80-0.90), and specificity of 0.99 (95% CI, 0.96-1.00). Performances were strengthened in the validation cohort by combining panels and CA19-9 (index I AUC of 0.94 [95% CI, 0.90-0.98] and index II AUC of 0.93 [95% CI, 0.89-0.97]). Compared with CA19-9 alone, the AUC for the combination of index I and CA19-9 was significantly higher (P = .01). The performance of the panels in patients with stage IA-IIB pancreatic cancer was index I AUC of 0.80 (95% CI, 0.73-0.87); index I and CA19-9 AUC of 0.83 (95% CI, 0.76-0.90); index II AUC of 0.91 (95% CI, 0.87-0.94); and index II and CA19-9 AUC of 0.91 (95% CI, 0.86-0.95). CONCLUSIONS AND RELEVANCE: This study identified 2 diagnostic panels based on microRNA expression in whole blood with the potential to distinguish patients with pancreatic cancer from healthy controls. Further research is necessary to understand whether these have clinical implications for early detection of pancreatic cancer and how much this information adds to serum CA19-9.
Restoring natural sensory feedback in real-time bidirectional hand prostheses. Raspopovic S, Capogrosso M, Petrini FM, et al. Sci Transl Med. 2014;6(222):222ra19.
Hand loss is a highly disabling event that markedly affects the quality of life. To achieve a close to natural replacement for the lost hand, the user should be provided with the rich sensations that we naturally perceive when grasping or manipulating an object. Ideal bidirectional hand prostheses should involve both a reliable decoding of the user's intentions and the delivery of nearly "natural" sensory feedback through remnant afferent pathways, simultaneously and in real time. However, current hand prostheses fail to achieve these requirements, particularly because they lack any sensory feedback. We show that by stimulating the median and ulnar nerve fascicles using transversal multichannel intrafascicular electrodes, according to the information provided by the artificial sensors from a hand prosthesis, physiologically appropriate (near-natural) sensory information can be provided to an amputee during the real-time decoding of different grasping tasks to control a dexterous hand prosthesis. This feedback enabled the participant to effectively modulate the grasping force of the prosthesis with no visual or auditory feedback. Three different force levels were distinguished and consistently used by the subject. The results also demonstrate that a high complexity of perception can be obtained, allowing the subject to identify the stiffness and shape of three different objects by exploiting different characteristics of the elicited sensations. This approach could improve the efficacy and "life-like" quality of hand prostheses, resulting in a keystone strategy for the near-natural replacement of missing hands.
Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed. Washington, D.C. : American Psychiatric Association, 2013.
Dimensions of long-term care management : an introduction. Chicago : Health Administration Press, 2012.
Family and HIV/AIDS : cultural and contextual issues in prevention and treatment. New York : Springer, 2012.
HIV treatments as prevention (TasP) : primer for behavior-based implementation. Kalichman, Seth C. New York : Springer, 2013.
Implementing culture change in long-term care : benchmarks and strategies for management and practice. Jurkowski, Elaine Theresa. New York : Springer, 2013.
Jekel's epidemiology, biostatistics, preventive medicine, and public health. 4th ed. Katz, David L. Philadelphia, PA : Saunders, 2014.
Maternal and child health : programs, problems, and policy in public health. 3rd ed. Sudbury, MA : Jones & Bartlett Learning, 2013.
Novick & Morrow's public health administration: principles for population-based management. 3rd ed. Shi, Leiyu. Burlington, MA : Jones & Bartlett Learning, 2014.
Returning home from Iraq and Afghanistan : assessment of readjustment needs of veterans, service members, and their families. Washington, D.C. : National Academies Press, 2013.
Thank you for your service. Finkel, David. New York : Farrar, Straus and Giroux, 2013.
Financing Long-Term Services and Supports for Individuals with Disabilities and Older Adults: Workshop Summary (2014).
Financing Long-Term Services and Supports for Individuals with Disabilities and Older Adults is the summary of a workshop convened in June 2013 by the Forum on Aging, Disability, and Independence of the Institute of Medicine and the National Research Council to examine the financing of long-term services and supports for working-age individuals with disabilities and among individuals who are developing disabilities as they age. The workshop covered both older adults who acquire disabilities and younger adults with disabilities who may acquire additional impairments as they age, the target population of the Forum's work. The challenges associated with financing long-term services and supports for people with disabilities impacts all age groups. While there are important differences between the characteristics of programs developed for different age groups, and specific populations may have different needs, this workshop addressed the financing sources for long-term services and supports in general, noting specific differences as appropriate.
Preventing Psychological Disorders in Service Members and Their Families: An Assessment of Programs (2014).
Preventing Psychological Disorders in Service Members and Their Families evaluates risk and protective factors in military and family populations and suggests that prevention strategies are needed at multiple levels - individual, interpersonal, institutional, community, and societal - in order to address the influence that these factors have on psychological health. This report reviews and critiques reintegration programs and prevention strategies for PTSD, depression, recovery support, and prevention of substance abuse, suicide, and interpersonal violence.
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