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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles
News and training opportunities
Public Health Informatics Virtual Event (PHIVE) 2014: January 7-9, 2014, 11:30 AM - 4:30 PM EST each day. This meeting will feature over 20 sessions from informatics thought leaders across government, academia, key public and health care communities, and the private sector. https://cdc.6connex.com/portal/PHIVE/login
Public Health Systems Research Interest Group 2014 Meeting: June 10-11, 2014, San Diego, CA. The Public Health Systems Research Interest Group (PHSR IG) Meeting offers researchers the opportunity to disseminate their findings and provides policymakers and practitioners with information to make sound decisions to improve public health systems and practice. http://www.academyhealth.org/Events/events.cfm?ItemNumber=12430
Webinar: Use of The Guide to Community Preventive Services to Impact Healthy Aging: January 16, 2014, 1:30 -2:30 PM ET. The webinar will focus on how United Way of the Greater Lehigh Valley in Allentown, Pennsylvania uses The Guide to Community Preventive Services (The Community Guide) to influence their investments and community-level strategies to support older adults, including the launch of the Gatekeeper Program. UseoftheGuidetoCommunityPreventiveServicestoImpactHealthyAging
Cool websites and reports on hot topics*
Americans say cost is top health problem: Nearly one-quarter of Americans (23%) say cost is the most urgent health problem facing the U.S. today, a four-percentage-point increase since last year that has allowed it to surpass access as the most pressing issue. http://www.gallup.com/poll/165965/americans-say-cost-top-health-problem.aspx?utm_source=alert&utm_medium=email&utm_campaign=syndication&utm_content=morelink&utm_term=Well-Being
CDC health disparities and inequalities report -- United States, 2013: The second CDC report to examine some of the key factors that affect health and lead to health disparities in the United States. http://www.cdc.gov/mmwr/preview/ind2013_su.html#HealthDisparities2013
CDC releases new findings and prevention tools to improve food safety in restaurants: http://www.cdc.gov/media/releases/2013/p1202-food-safety-tools.html
Gene-silencing study finds new targets for Parkinson’s disease: NIH study sheds light on treatment of related disorders. http://www.nih.gov/news/health/nov2013/ninds-24.htm
Gut microbes may affect cancer treatment: The effectiveness of certain cancer therapies may depend on microbes that live in the intestine, according to a study in mice. The findings suggest that antibiotics might hinder the effects of cancer therapies. http://www.nih.gov/researchmatters/december2013/12092013cancer.htm
Key HIV protein structure revealed: Researchers have developed a more detailed picture of the protein largely responsible for enabling HIV to enter human immune cells and cause infection. The findings could help guide vaccine design. http://www.nih.gov/researchmatters/november2013/11252013HIV.htm
Matching treatments to your genes: You’re one of a kind. Wouldn’t it be nice if treatments and preventive care could be designed just for you, matched to your unique set of genes? http://newsinhealth.nih.gov/issue/Dec2013/Feature1
New report from PI and APHA helps local elected officials make the case for prevention: A new brief by the Prevention Institute and the American Public Health Association, "Championing Change: Elected Officials Act Locally to Make their Communities Healthier," examines the approaches local elected officials are taking to improve the health of their communities. http://preventioninstitute.org/component/jlibrary/article/id-346/127.html
Project Tycho data: The Project Tycho database aims are to advance the availability and use of public health data for science and policy. The site provides open access to newly digitized U.S. weekly surveillance data for contagious diseases from 1888 to the present for use in research, education, and policy making. http://www.tycho.pitt.edu/
Researchers identify genomic variant associated with sun sensitivity, freckles: NIH-funded work finds genetic switch for pigmentation trait in non-coding, regulatory region of newly associated gene. http://www.nih.gov/news/health/nov2013/nhgri-21.htm
Spatialepidemiology.net: Provides a map-based interface for the display and analysis of infectious disease epidemiological data, including molecular data, utilizing Google Maps and Google Earth. http://www.spatialepidemiology.net/
WHO MiNDbank is an online platform which brings together a range of country and international resources, covering mental health, substance abuse, disability, general health, human rights and development. These include policies, strategies, laws, and service standards. http://www.mindbank.info/
Interesting journal articles
Aspirin and colorectal cancer: back to the future [published online ahead of print December 10, 2013]. Tougeron D, Sha D, Manthravadi S, Sinicrope FA. Clin Cancer Res.
Abundant epidemiological evidence indicates that regular and long term use of aspirin is associated with a significant reduction in the incidence of colorectal cancer (CRC). The long duration of aspirin needed to prevent CRC is believed to be due to inhibition of precursor lesions known as adenomas, whose recurrence is inhibited by aspirin in randomized trials. Aspirin intake has also been associated with a statistically significant improvement in patient survival after curative resection of CRC in large observational studies. In these cohorts, the survival benefit of aspirin was shown to depend upon the level of cyclooxygenase-2 (COX-2) expression in the primary CRC. More recent analysis of patient tumors from these observational cohorts suggests that the benefit of aspirin may be limited to specific molecular subtypes. Aspirin intake following CRC resection was associated with a significant improvement of survival in patients whose tumors carried mutant, but not wild-type, copies of the phosphatidylinositol 3-kinase (PI3KCA) gene, especially tumors that overexpressed COX-2. A mechanistic explanation is suggested by the finding that inhibition of COX-mediated prostaglandin E2 synthesis by aspirin attenuates PI3K signaling activity that is known to regulate cancer cell proliferation and survival. Aspirin has also been shown to reduce the incidence of CRCs bearing wild-type, but not mutant alleles of the BRAFV600E oncogene. While provocative, the potential utility of these molecular markers for predicting aspirin efficacy awaits prospective evaluation in clinical trials. If validated, these finding may support a personalized approach to using aspirin for the therapy of CRC.
Deathbed shock: causes and cures [published online ahead of print November 25, 2013]. Butler K, Puri S. JAMA Intern Med. doi: 10.1001/jamainternmed.2013.11125.
In this issue of JAMA Internal Medicine, Buchhalter and colleagues eloquently illustrate the current lack of patient involvement in planning for potential deactivation of cardiac devices in life’s final chapter.
Do healthier foods and diet patterns cost more than less healthy options? A systematic review and meta-analysis. Rao M, Afshin A, Singh G, Mozaffarian D. BMJ Open. 2013;3(12):e004277.
OBJECTIVE: To conduct a systematic review and meta-analysis of prices of healthier versus less healthy foods/diet patterns while accounting for key sources of heterogeneity. DATA SOURCES: MEDLINE (2000-2011), supplemented with expert consultations and hand reviews of reference lists and related citations. DESIGN: Studies reviewed independently and in duplicate were included if reporting mean retail price of foods or diet patterns stratified by healthfulness. We extracted, in duplicate, mean prices and their uncertainties of healthier and less healthy foods/diet patterns and rated the intensity of health differences for each comparison (range 1-10). Prices were adjusted for inflation and the World Bank purchasing power parity, and standardised to the international dollar (defined as US$1) in 2011. Using random effects models, we quantified price differences of healthier versus less healthy options for specific food types, diet patterns and units of price (serving, day and calorie). Statistical heterogeneity was quantified using I(2) statistics. RESULTS: 27 studies from 10 countries met the inclusion criteria. Among food groups, meats/protein had largest price differences: healthier options cost $0.29/serving (95% CI $0.19 to $0.40) and $0.47/200 kcal ($0.42 to $0.53) more than less healthy options. Price differences per serving for healthier versus less healthy foods were smaller among grains ($0.03), dairy (-$0.004), snacks/sweets ($0.12) and fats/oils ($0.02; p<0.05 each) and not significant for soda/juice ($0.11, p=0.64). Comparing extremes (top vs bottom quantile) of food-based diet patterns, healthier diets cost $1.48/day ($1.01 to $1.95) and $1.54/2000 kcal ($1.15 to $1.94) more. Comparing nutrient-based patterns, price per day was not significantly different (top vs bottom quantile: $0.04; p=0.916), whereas price per 2000 kcal was $1.56 ($0.61 to $2.51) more. Adjustment for intensity of differences in healthfulness yielded similar results. CONCLUSIONS: This meta-analysis provides the best evidence until today of price differences of healthier vs less healthy foods/diet patterns, highlighting the challenges and opportunities for reducing financial barriers to healthy eating.
The harms of screening: a proposed taxonomy and application to lung cancer screening [published online ahead of print December 9, 2013]. Harris RP, Sheridan SL, Lewis CL, et al. JAMA Intern Med. doi: 10.1001/jamainternmed.2013.12745.
IMPORTANCE Making rational decisions about screening requires information about its harms, but high-quality evidence is often either not available or not used. One reason may be that we lack a coherent framework, a taxonomy, for conceptualizing and studying these harms. OBJECTIVE To create a taxonomy, we categorized harms from several sources: systematic reviews of screening, other published literature, and informal discussions with clinicians and patients. We used this information to develop an initial taxonomy and vetted it with local and national experts, making revisions as needed. RESULTS We propose a taxonomy with 4 domains of harm from screening: physical effects, psychological effects, financial strain, and opportunity costs. Harms can occur at any step of the screening cascade. We provide definitions for each harm domain and illustrate the taxonomy using the example of screening for lung cancer. CONCLUSIONS AND RELEVANCE The taxonomy provides a systematic way to conceptualize harms as experienced by patients. As shown in the lung cancer screening example, the taxonomy also makes clear where (which domains of harms and which parts of the screening cascade) we have useful information and where there are gaps in our knowledge. The taxonomy needs further testing and validation across a broad range of screening programs. We hope that further development of this taxonomy can improve our thinking about the harms of screening, thus informing our research, policy making, and decision making with patients about the wisdom of screening.
Maternal obesity and risk of Down syndrome in the offspring [published online ahead of print December 10, 2013]. Hildebrand E, Källén B, Josefsson A, Gottvall T, Blomberg M. Prenat Diagn. doi: 10.1002/pd.4294.
OBJECTIVE: To determine if maternal obesity is associated with an increased risk of Down syndrome in the offspring and whether the risk estimates for trisomy 21 based on combined screening is affected by maternal Body Mass Index (BMI). METHOD: Study group I consisted of a Nation-wide cohort of 1,568,604 women giving birth; outcome was infants born with Down syndrome. Adjustment was made for maternal age. Study group II consisted of 10,224 women undergoing 1st trimester combined screening. Outcome was risk assessment for Down syndrome. All women were divided into six BMI groups and outcomes were evaluated over the BMI strata with BMI 18.5-24.9 as reference and correcting for maternal age. RESULTS: Obese women had an increased risk for giving birth to an infant with Down syndrome compared to normal weight women, BMI 30-34.9 OR 1.31 (95% CI 1.10-1.55), BMI 35-39.9 OR 1.12 (95%CI 0.82-1.53), BMI ≥ 40 OR 1.56 (95%CI 1.00-2.43). The observed and the expected numbers of women with a risk of Down syndrome >1/300 based on 1st trimester combined screen and maternal age were similar in each BMI group. CONCLUSION: Maternal obesity seems to increase the risk for Down syndrome births. The risk estimate for Down syndrome with 1st trimester combined screening is unaffected by BMI.
Parental factors associated with depression and anxiety in young people: A systematic review and meta-analysis [published online ahead of print November 18, 2013]. Yap MB, Pilkington PD, Ryan SM, Jorm AF. J Affect Disord. doi: 10.1016/j.jad.2013.11.007.
BACKGROUND: There is a burgeoning and varied literature examining the associations between parental factors and depression or anxiety disorders in young people. However, there is hitherto no systematic review of this complex literature with a focus on the 12-18 years age range, when the first onset for these disorders peaks. Furthermore, to facilitate the application of the evidence in prevention, a focus on modifiable factors is required. METHODS: Employing the PRISMA method, we conducted a systematic review of parental factors associated with depression and anxiety disorders in young people which parents can potentially modify. RESULTS: We identified 181 articles altogether, with 140 examining depression, 17 examining anxiety problems, and 24 examining both outcomes. Stouffer's method of combining p values was used to determine whether associations between variables were reliable, and meta-analyses were conducted to estimate the mean effect sizes of associations between each parental factor and outcome. LIMITATIONS: Limitations include sacrificing micro-level detail for a macro-level synthesis of the literature, not systematically reviewing moderators and mediators, the lack of generalizability across cultures and to younger or adult children, and the inability to conduct a meta-analysis on all included studies. CONCLUSIONS: Parental factors with a sound evidence base indicating increased risk for both depression and anxiety include less warmth, more inter-parental conflict, over-involvement, and aversiveness; and for depression additionally, they include less autonomy granting and monitoring.
Prenatal glucocorticoid treatment and later mental health in children and adolescents. Khalife N, Glover V, Taanila A, Ebeling H, Järvelin MR, Rodriguez A. PLoS One. 2013 Nov 22;8(11):e81394.
BACKGROUND: Animal studies demonstrate a clear link between prenatal exposure to glucocorticoids (GC) and altered offspring brain development. We aim to examine whether prenatal GC exposure programs long-term mental health in humans. METHODS: Using propensity-score-matching, children prenatally exposed to synthetic glucocorticoids (sGC), n=37, and controls, n=185, were balanced on important confounders related to sGC treatment - gestational age and pre-pregnancy BMI. We also used mixed-effects modeling to analyse the entire cohort - matching each sGC case, n=37, to all possible controls, n=6079, on gestational age and sex. We obtained data from the Northern Finland Birth Cohort 1986 at four waves - pregnancy, birth, 8 and 16 years. Data on pregnancy and birth outcomes came from medical records. Mental health was assessed at 8 years by teachers with the Rutter B2 scale, and at 16 years by parents with the Strengths and Weaknesses of ADHD symptoms and Normal behavior (SWAN) scale and adolescents by the Youth Self-Report (YSR) scale. RESULTS: Prenatal sGC treatment was consistently associated with adverse mental health in childhood and adolescence, as shown by both the propensity-score method and mixed-effects model. Using the propensity-score-matched subsample, linear multiple regression showed prenatal sGC was significantly linked with general psychiatric disturbance (B=8.34 [95% CI: .23-16.45]) and inattention (B= .97 [95% CI: .16-1.80]) at 8 years after control for relevant confounders. Similar findings were obtained at 16 years, but did not reach statistical significance. Mediation by birthweight/placental weight was not detected. CONCLUSIONS: This study is the first to prospectively investigate the long-term associations between prenatal exposure to sGC treatment and mental health in children and adolescents. We report an association between prenatal exposure to sGC and child mental health, supportive of the idea that sGC has a programming effect on the fetal brain.
Services for adolescents with psychiatric disorders: 12-month data from the national comorbidity survey-adolescent [published online ahead of print November 15, 2013]. Costello EJ, He JP, Sampson NA, Kessler RC, Merikangas KR. Psychiatr Serv. doi: 10.1176/appi.ps.201100518.
OBJECTIVE This study examined 12-month rates of service use for mental, emotional, and behavioral disorders among adolescents. METHODS Data were from the National Comorbidity Survey Adolescent Supplement (NCS-A), a survey of DSM-IV mental, emotional, and behavioral disorders and service use. RESULTS In the past 12 months, 45.0% of adolescents with psychiatric disorders received some form of service. The most likely were those with ADHD (73.8%), conduct disorder (73.4%), or oppositional defiant disorder (71.0%). Least likely were those with specific phobias (40.7%) and any anxiety disorder (41.4%). Among those with any disorder, services were more likely to be received in a school setting (23.6%) or in a specialty mental health setting (22.8%) than in a general medical setting (10.1%). Youths with any disorder also received services in juvenile justice settings (4.5%), complementary and alternative medicine (5.3%), and human services settings (7.9%). Although general medical providers treated a larger proportion of youths with mood disorders than with behavior disorders, they were more likely to treat youths with behavior disorders because of the larger number of the latter (11.5% of 1,465 versus 13.9% of 820). Black youths were significantly less likely than white youths to receive specialty mental health or general medical services for mental disorders. CONCLUSIONS Findings from this analysis of NCS-A data confirm those of earlier, smaller studies, that only a minority of youths with psychiatric disorders receive treatment of any sort. Much of this treatment was provided in service settings in which few providers were likely to have specialist mental health training.
Targeting a dual detector of skin and CO2 to modify mosquito host seeking. Tauxe GM, Macwilliam D, Boyle SM, Guda T, Ray A. Cell. 2013 Dec 5;155(6):1365-79.
Female mosquitoes that transmit deadly diseases locate human hosts by detecting exhaled CO2 and skin odor. The identities of olfactory neurons and receptors required for attraction to skin odor remain a mystery. Here, we show that the CO2-sensitive olfactory neuron is also a sensitive detector of human skin odorants in both Aedes aegypti and Anopheles gambiae. We demonstrate that activity of this neuron is important for attraction to skin odor, establishing it as a key target for intervention. We screen ∼0.5 million compounds in silico and identify several CO2 receptor ligands, including an antagonist that reduces attraction to skin and an agonist that lures mosquitoes to traps as effectively as CO2. Analysis of the CO2 receptor ligand space provides a foundation for understanding mosquito host-seeking behavior and identifies odors that are potentially safe, pleasant, and affordable for use in a new generation of mosquito control strategies worldwide.
Vigorous intensity exercise for glycemic control in patients with type 1 diabetes. Yardley J, Mollard R, Macintosh A, et al. Can J Diabetes. 2013 Dec;37(6):427-32.
Regular physical activity has substantial health benefits in persons with type 1 diabetes, including reduced risk of complications and cardiovascular mortality as well as improved self-rated quality of life. Despite these benefits, individuals with type 1 diabetes are often less active than their peers without diabetes. When factors such as time constraints, work pressure and environmental conditions are often cited as barriers to physical activity in the general population, 2 additional major factors may also explain the low rates of physical activity in young people with type 1 diabetes: (1) fear of hypoglycemia both during and after (particularly overnight) exercise and (2) a lack of empiric evidence for the efficacy of physical activity for achieving optimal glycemic control. A number of acute exercise trials recently showed that the inclusion of vigorous intensity physical activity in conventional moderate intensity (i.e. walking and light cycling) exercise sessions may overcome these barriers. No studies have tested the efficacy of high-intensity physical activity on glycemic control (A1C) or post-exercise hypoglycemia in a randomized controlled trial. This article summarizes the literature related to the role of physical activity for the management of blood glucose levels in individuals with type 1 diabetes and provides a rationale for the need of a randomized controlled trial examining the effects of vigorous-intensity physical activity on blood glucose control.
Engaging government employees: motivate and inspire your people to achieve superior performance. Lavigna, RJ. New York : American Management Association; 2013.
Nine minutes on Monday: the quick and easy way to go from manager to leader. Robbins, J. New York : McGraw-Hill; 2013.
Project management: absolute beginner's guide. 3rd ed. Horine, GM. Indianapolis, Indiana : Que; 2013.
SPSS survival manual: a step by step guide to data analysis using IBM SPSS. 5th ed. Pallant, J. New York : McGraw-Hill; 2013.
Start with why: how great leaders inspire everyone to take action. Sinek, S. New York : Portfolio; 2009.
Best care at lower cost: the path to continuously learning health care in America (2013). http://www.nap.edu/catalog.php?record_id=13444&utm_medium=etmail&utm_source=The%20National%20Academies%20Press&utm_campaign=Top+10+Most+Popular+Books+of+2013&utm_content=Downloader&utm_term=
America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost.
Creating equal opportunities for a healthy weight: workshop summary (2013). http://www.nap.edu/catalog.php?record_id=18553&utm_medium=etmail&utm_source=The%20National%20Academies%20Press&utm_campaign=NAP+mail+new+12.03.13&utm_content=Downloader&utm_term=
Creating Equal Opportunities for a Healthy Weight is the summary of a workshop convened by the Institute of Medicine's Standing Committee on Childhood Obesity Prevention in June 2013 to examine income, race, and ethnicity, and how these factors intersect with childhood obesity and its prevention. Registered participants, along with viewers of a simultaneous webcast of the workshop, heard a series of presentations by researchers, policy makers, advocates, and other stakeholders focused on health disparities associated with income, race, ethnicity, and other characteristics and on how these factors intersect with obesity and its prevention. The workshop featured invited presentations and discussions concerning physical activity, healthy food access, food marketing and messaging, and the roles of employers, health care professionals, and schools.
Engaging the public in critical disaster planning and decision making: workshop summary (2013). http://www.nap.edu/catalog.php?record_id=18396&utm_medium=etmail&utm_source=The%20National%20Academies%20Press&utm_campaign=NAP+mail+new+12.11.13&utm_content=Downloader&utm_term=
Engaging the Public in Critical Disaster Planning and Decision Making is the summary of a workshop held in March 2013 to discuss the key principles of public engagement during the development of disaster plans, the response phase, and during the dissemination phase when interested community partners and the general public are informed of the policies that have been adopted. Presenters provided specific examples of resources to assist jurisdictions in planning public engagement activities as well as challenges experienced and potential solutions. This report introduces key principles of public engagement, provides practical guidance on how to plan and implement a public engagement activity, and presents tools to facilitate planning.
Evaluating obesity prevention efforts: a plan for measuring progress (2013). http://www.nap.edu/catalog.php?record_id=18334&utm_medium=etmail&utm_source=The%20National%20Academies%20Press&utm_campaign=Final+Book+12.13.13+-+Evaluating+Obesity+Prevention+Efforts&utm_content=&utm_term=
This book offers a framework that will provide guidance for systematic and routine planning, implementation, and evaluation of the advancement of obesity prevention efforts. This framework is for specific use with the goals and strategies from the 2012 report and can be used to assess the progress made in every community and throughout the country, with the ultimate goal of reducing the obesity epidemic. It offers potentially valuable guidance in improving the quality and effect of the actions being implemented.
Improving and accelerating therapeutic development for nervous system disorders: workshop summary (2013): http://www.nap.edu/catalog.php?record_id=18494&utm_medium=etmail&utm_source=The%20National%20Academies%20Press&utm_campaign=NAP+mail+new+12.03.13&utm_content=Downloader&utm_term=
Improving and Accelerating Therapeutic Development for Nervous System Disorders is the summary of a workshop convened by the IOM Forum on Neuroscience and Nervous System Disorders to examine opportunities to accelerate early phases of drug development for nervous system drug discovery. Workshop participants discussed challenges in neuroscience research for enabling faster entry of potential treatments into first-in-human trials, explored how new and emerging tools and technologies may improve the efficiency of research, and considered mechanisms to facilitate a more effective and efficient development pipeline.
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