A response to Jason et al. (2009), "evaluating the Centers for Disease Control's empirical chronic fatigue syndrome case definition"
Reeves WC , Gurbaxani BM , Lin JS , Unger ER . J Disabil Policy Stud 2010 20 (4) 229-232 The recent article by Jason, Najar, Porter, and Reh, "Evaluating the Centers for Disease Control's Empirical Chronic Fatigue Syndrome Case Definition" (2009; Journal of Disability Policy Studies, 20:2, 93L100) attempted to critically explore several pertinent issues concerning diagnosing chronic fatigue syndrome (CFS). Most of these issues have been brewing since international adoption of the 1994 CFS case definition by Fukuda et al., and it is high time to address them in a peer-reviewed and public forum. |
Vision, hearing, balance, and sensory impairment in Americans aged 70 years and over: United States, 1999-2006
Dillon CF , Gu Q , Hoffman HJ , Ko CW . NCHS Data Brief 2010 (31) 1-8 Long-term public health goals for the older U.S. adult population are to decrease morbidity, to reduce functional limitations, to preserve a good quality of life, and maintain independent functioning. Each of these areas can potentially be impacted by sensory impairment, which is also linked to increased mortality, hip fractures, and depression. Hearing and vision impairment in older adults may present particular challenges to families and caregivers. Although some degree of sensory loss may be irreversible, these data indicate that significant numbers of persons may be helped by the use of better glasses or by hearing aid use. More attention will need to be given to this basic health issue. |
Preventing complications from 2009 influenza A (H1N1) in persons with underlying lung diseases: a formidable challenge for 2010 Year of the Lung
Castro KG , Bell BP , Schuchat A . Int J Tuberc Lung Dis 2010 14 (2) 127-9 ON APRIL 17, 2009 the fi rst cases of infl uenza due to | a novel strain of swine-origin infl uenza A (H1N1) were | reported in the United States.1 As of 29 April 2009, | 91 cases had been confi rmed in the United States, and | 57 in several other countries (Mexico, Canada, United | Kingdom, Spain, Germany, New Zealand, Israel, and | Australia).2 With evidence of sustained human-tohuman transmission of this novel virus in more than | two countries, the World Health Organization (WHO) | raised the global pandemic alert to phase 5.3 Early reports of the 2009 pandemic infl uenza A outbreak suggested considerable morbidity, with, as a distinctive | feature, its occurrence in students and other relatively | young adults.4 To detect the spread of the virus and | characterize its clinical spectrum, newly developed | diagnostic tests were quickly made available by the | Cen ters for Disease Control and Prevention (CDC) | to state health departments and WHO collaborating | centers for infl uenza and other laboratories around | the world.5,6 |
Fecal occult blood testing beliefs and practices of U.S. primary care physicians: serious deviations from evidence-based recommendations
Nadel MR , Berkowitz Z , Klabunde CN , Smith RA , Coughlin SS , White MC . J Gen Intern Med 2010 25 (8) 833-9 BACKGROUND: Fecal occult blood testing (FOBT) is an important option for colorectal cancer screening that should be available in order to achieve high population screening coverage. However, results from a national survey of clinical practice in 1999-2000 indicated that many primary care physicians used inadequate methods to implement FOBT screening and follow-up. OBJECTIVE: To determine whether methods to screen for fecal occult blood have improved, including the use of newer more sensitive stool tests. DESIGN: Cross-sectional national survey of primary care physicians. PARTICIPANTS: Participants consisted of 1,134 primary care physicians who reported ordering or performing FOBT in the 2006-2007 National Survey of Primary Care Physicians' Recommendations and Practices for Cancer Screening. MAIN MEASURES: Self-reported data on details of FOBT implementation and follow-up of positive results. RESULTS: Most physicians report using standard guaiac tests; higher sensitivity guaiac tests and immunochemical tests were reported by only 22.0% and 8.9%, respectively. In-office testing, that is, testing of a single specimen collected during a digital rectal examination in the office, is still widely used although inappropriate for screening: 24.9% of physicians report using only in-office tests and another 52.9% report using both in-office and home tests. Recommendations improved for follow-up after a positive test: fewer physicians recommend repeating the FOBT (17.8%) or using tests other than colonoscopy for the diagnostic work-up (6.6%). Only 44.3% of physicians who use home tests have reminder systems to ensure test completion and return. CONCLUSIONS: Many physicians continue to use inappropriate methods to screen for fecal occult blood. Intensified efforts to inform physicians of recommended technique and promote the use of tracking systems are needed. |
Cancers of the breast, uterus, ovary and cervix among Alaska Native women, 1974-2003
Day GE , Lanier AP , Bulkow L , Kelly JJ , Murphy N . Int J Circumpolar Health 2010 69 (1) 72-86 OBJECTIVES: Alaska Native (AN) women have exhibited some of the highest incidence rates of cancer overall, and different patterns of site-specific incidence compared to other U.S. populations. This study compares incidence rates between AN and U.S. white women (USW) for cancers of the breast, uterus, ovary and cervix, and examines effects of time period and birth cohort as determinants of incidence trends among AN women. Study design. Observational, population-based study. METHODS: Cancer incidence data from the Alaska Native Tumor Registry and SEERStat, 1974-2003. Age-adjusted World Standard Population rates were calculated for a current 5-year period and over time (30 years), and compared to other populations using rate ratios with 95% confidence intervals. Log-linear regression models used to assess impact on trend of age, time period and birth cohort. RESULTS: Compared to U.S. white women, current cancer rates among AN women are not significantly different for cancer of the breast and cervix, and significantly lower for cancers of the ovary and uterus. Trends over time over a 30-year time period also differ for these cancer sites. There were significant increases in breast and uterine cancer, and in contrast, a marked decline in cervical cancer. There was no significant change for cancer of the ovary. Changes appear to be due largely to period, not birth cohort effects. CONCLUSIONS: Increases in breast cancer may be due to a combination of modifiable behaviours; increased BMI and a shift to a non-traditional diet. Increases in uterine cancer could be associated with increased BMI and diabetes. Cervical cancer rates have declined to USW levels. The marked decline is likely due to enhanced screening and control efforts within the Alaska Native Women's cancers among Alaska Natives Tribal Health System (formerly Alaska Area USPHS, Indian Health Service utilizing resources available from the Centers for Disease Control tribal and state Breast and Cervical Cancer Early Detection Programs). (Int J Circumpolar Health 2010; 69(1): 72-86) Supplementary material related to this article available at www.ijch.fi. |
Staphylococcus aureus community-onset pneumonia in patients admitted to children's hospitals during autumn and winter of 2006-2007
Kallen AJ , Reed C , Patton M , Arnold KE , Finelli L , Hageman J . Epidemiol Infect 2010 138 (5) 666-72 Staphylococcus aureus is a relatively uncommon cause of community-onset pneumonia (COP) that may complicate influenza infection. We reviewed admissions to children's hospitals to describe more systematically this entity. Records of patients hospitalized at three children's hospitals between 1 October 2006 and 30 April 2007 who had a positive S. aureus culture from a sterile site or respiratory specimen were reviewed and data were abstracted for episodes of primary S. aureus COP. Overall, 30 episodes met criteria for primary S. aureus COP; 12 (41%) involved methicillin-resistant S. aureus. Patients in 11 (37%) episodes were seen by a healthcare provider for their symptoms prior to hospital admission; three received an antimicrobial, none of which had activity against the S. aureus isolated. Mechanical ventilation was required in 21 (70%) episodes; five (17%) patients died. When evaluating patients with severe COP, providers should be aware of the potential for S. aureus, including methicillin-resistant strains. |
Sea-level-rise disaster in Micronesia: sentinel event for climate change?
Keim ME . Disaster Med Public Health Prep 2010 4 (1) 81-7 OBJECTIVES: To describe the impact of an acute-onset sea-level-rise disaster in 2 coral atoll populations and to generate hypotheses for further investigation of the association between climate change and public health. METHODS: Households of Lukunoch and Oneop islands, Micronesia, were assessed for demographics, asset damage, food availability, water quantity and quality, hygiene and sanitation, and health status. Every fourth household on Lukunoch was randomly selected (n = 40). All Oneop households were surveyed (n = 72). Heads of each household were interviewed in the local language using a standard survey tool. Prevalence data were analyzed, and 95% confidence intervals were calculated. RESULTS: A total of 112 total households were respondents representing 974 inhabitants. On Lukunoch, roughly half of all households surveyed reported at least a partial loss of their primary dietary staple and source of calories (taro and breadfruit). Six (15%) of 40 Lukunoch households surveyed (95% CI, 6%-30%) reported a complete loss of taro and four (10%) of the 40 households (95% CI, 3%-24%) reported a complete loss of breadfruit. On Oneop, nearly all households reported at least a partial loss of these same food staples. Twenty four (31%) of all 76 Oneop households reported a complete loss of taro and another 24 (31%) households reported a complete loss of breadfruit. One third of all households surveyed reported a complete loss. On Lukunoch 11 (28%) of 40 households, (95% CI, 15%-43%) reported damage from salination, but none were damaged to the point of a complete loss. Forty-nine (64%) of 76 Oneop households reported salination and five (6%) reported complete loss of their well. CONCLUSION: On March 5, 2007, an acute-onset, sea level rise event resulting in coastal erosion, shoreline inundation, and saltwater intrusion occurred in two coral atoll islands of Micronesia. The findings of this study suggest that highly vulnerable populations of both islands experienced disastrous losses involving crop productivity and freshwater sources. These findings reveal the need for effective public health research and sustainable interventions that will monitor and shape the health of small island populations predicted to be at high risk for adverse health effects due to climate change. |
Regression models to predict corrected weight, height and obesity prevalence from self-reported data: data from BRFSS 1999-2007
Jain RB . Int J Obes (Lond) 2010 34 (11) 1655-64 BACKGROUND: Surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) collect only self-reported data on height and weight to estimate obesity prevalence rates. Because of biased self-reporting of height and weight, obesity prevalence rates reported by these surveys are too low. OBJECTIVE: To develop regression models that can predict corrected height, weight and obesity prevalence from self-reported data, as well as to compare obesity prevalence rates based on self-reported and modeled data and test for trends in obesity prevalence by gender, age and race/ethnicity. DESIGN: Data from the National Health and Nutrition Examination Survey (NHANES) for the period 1999-2006 were used to develop regression models to predict corrected height, weight and obesity prevalence. Regression coefficients estimated from these models were used to predict corrected height, weight and obesity prevalence for BRFSS data for 1999-2007. RESULTS: Self-reported weights for males were higher by 0.1-0.2 kg and lower by about 1.25 kg than corrected weights for females. Underreporting of weights was lowest for Hispanics when compared with other race/ethnicities. In addition, underreporting of weight increased with an increase in body mass index. Self-reported heights for males were higher than corrected heights by about 2 cm, and for females, by about 1 cm. Overreporting of height increased with an increase in age. Self-reported obesity prevalence was 4.5-5.8% lower than corrected rates for males and by 4.4-5.1% for females. Underreporting of obesity prevalence increased with an increase in age. Obesity prevalence rates increased over time for each gender, race/ethnicity and age group for BRFSS data. CONCLUSION: Obesity prevalence calculated from self-reported data is too low and should be used with caution for health-care planning purposes. When it is not possible to have measured data, corrected heights and weights may be predicted by using models such as those presented by us from a relatively large data set that has both measured and self-reported data. International Journal of Obesity advance online publication, 13 April 2010; doi:10.1038/ijo.2010.80. |
Differences in birth weight for gestational age distributions according to the measures used to assign gestational age
Callaghan WM , Dietz PM . Am J Epidemiol 2010 171 (7) 826-36 Population-based standards for infant size for gestational age depend on accurate assessments of birth weight and gestational age; the accuracy of the latter measure has been questioned. The authors sought to explore how different methods of assigning gestational age in vital records data affect distributions of birth weight for gestational age. The 2005 US natality file was used to create 4 measures of gestational age for singleton births consisting of measures found on the 1989 (last menstrual period (LMP) and clinical estimate) and 2003 (LMP and obstetric estimate) revisions of the US standard birth certificate: clinical or obstetric estimate and LMP-based estimate agree within 7 days ("gold standard"); clinical estimate only; obstetric estimate only; and LMP-based estimate only. Birth weight for gestational age distributions differed according to the measurement of gestational age. Regardless of birth certificate revision, the median, 10th, and 90th percentile distributions were virtually identical for the gold standard, clinical estimate, and obstetric estimate. Birth weights for the LMP estimate were higher for preterm births and lower for postterm births for both birth certificate revisions. Agreement between the gold standard estimate and clinical and obstetric estimates of gestational age suggests that using the LMP-based estimate for establishing norms should be revisited. |
First report worldwide of an infant botulism case due to Clostridium botulinum type E erratum
Luquez C , Dykes JK , Yu PA , Raphael BH , Maslanka SE . J Clin Microbiol 2010 48 (3) 1017 Volume 48, no. 1, p. 326-328, 2010. Page 328, column 1, lines 27-28: “psychotropic” should read “psychrotrophic.” |
Inconsistent condom use among young men who have sex with men, male sex workers, and transgenders in Thailand
Chemnasiri T , Netwong T , Visarutratana S , Varangrat A , Li A , Phanuphak P , Jommaroeng R , Akarasewi P , van Griensven F . AIDS Educ Prev 2010 22 (2) 100-9 Young men who have sex with men (MSM) are at risk for HIV infection. We investigated inconsistent condom use among 827 sexually active young MSM (15-24 years), enrolled using venue-day-time sampling in Bangkok, Chiang Mai and Phuket, Thailand. Data was collected using palmtop computer-assisted self-interviewing. Of participants, 33.1% were regular MSM, 37.7% were male sex workers (MSWs) and 29.1% were transgenders (TGs). Of MSM, 46.7%, of MSWs, 34.9% and of TGs, 52.3% reported recent inconsistent condom use. In multivariate analysis, receptive anal intercourse (MSM, MSWs), receptive and insertive anal intercourse, living alone and a history of sexual coercion (MSWs), not carrying a condom when interviewed (MSM, TGs), lower education, worrying about HIV infection and a history of sexually transmitted infections (TGs) were significantly and independently associated with inconsistent condom use. Interventions for young MSM are needed and must consider the distinct risk factors of MSM, MSWs, and TGs. |
Sexuality education policies and sexually transmitted disease rates in the United States of America
Hogben M , Chesson H , Aral SO . Int J STD AIDS 2010 21 (4) 293-7 The aim of the study was to test for relationships between state-level sex educational policies and sexually transmitted disease (STD) rates. We analysed US case reports of gonorrhoea and chlamydial infection for 2001-2005 against state policies for abstinence coverage in sexuality education, using the proportion of the population per state who identified as black (aged 15-24 years) as a covariate. We also tested for effects on 15-19 year olds versus 35-39 year olds and tuberculosis rates (the latter to ensure findings applied only to STD). States with no mandates for abstinence had the lowest mean rates of infection among the overall population and among adolescents. States with mandates emphasizing abstinence had the highest rates; states with mandates to cover (but not emphasize) abstinence fell in between. Rates in some states covering abstinence changed faster than in others, as reflected in sharper declines (gonorrhoea) or slower increases (chlamydial infection). These effects were not shown for tuberculosis or 35-39 year olds. Having no abstinence education policy has no apparent effect on STD rates for adolescents. For states with elevated rates, policies mandating coverage may be useful, although policies emphasizing abstinence show no benefit. |
Socioeconomic influences on the effects of a genetic testing direct-to-consumer marketing campaign
Bowen DJ , Harris J , Jorgensen CM , Myers MF , Kuniyuki A . Public Health Genomics 2010 13 (3) 131-42 Direct-to-consumer marketing of genetic tests is beginning to appear in select markets, and little independent evaluation has been conducted on the effects of this marketing on consumer attitudes or behavior. The purpose of this paper is to identify the effects of socioeconomic status on women's reactions to such a campaign, including knowledge of the test, perceptions of personal risk, communications with others about the test, and interest in pursuing the test. The only United States provider of genetic testing for breast and ovarian cancer susceptibility (BRCA1/2 testing) conducted a pilot marketing campaign that targeted women aged 25-54 and their health care providers in 2 cities, Atlanta, Ga., and Denver, Colo. The design for the evaluation was a post campaign consumer survey, based on a cross-sectional stratified random sample of women in the 2 intervention sites and 2 comparison sites. The campaign had no differential impact by socioeconomic status. However, there was a consistent relationship between socioeconomic status and several outcome variables, including knowledge of the test, beliefs about the test, and desire to know about genetic risk. These data indicate that socioeconomic status may play a role in uptake of genetic services, regardless of response to a media campaign. |
Viral shedding and clinical illness in naturally acquired influenza virus infections
Lau LL , Cowling BJ , Fang VJ , Chan KH , Lau EH , Lipsitch M , Cheng CK , Houck PM , Uyeki TM , Peiris JS , Leung GM . J Infect Dis 2010 201 (10) 1509-16 BACKGROUND: Volunteer challenge studies have provided detailed data on viral shedding from the respiratory tract before and through the course of experimental influenza virus infection. There are no comparable quantitative data to our knowledge on naturally acquired infections. METHODS: In a community-based study in Hong Kong in 2008, we followed up initially healthy individuals to quantify trends in viral shedding on the basis of cultures and reverse-transcription polymerase chain reaction (RT-PCR) through the course of illness associated with seasonal influenza A and B virus infection. RESULTS: Trends in symptom scores more closely matched changes in molecular viral loads measured with RT-PCR for influenza A than for influenza B. For influenza A virus infections, the replicating viral loads determined with cultures decreased to undetectable levels earlier after illness onset than did molecular viral loads. Most viral shedding occurred during the first 2-3 days after illness onset, and we estimated that 1%-8% of infectiousness occurs prior to illness onset. Only 14% of infections with detectable shedding at RT-PCR were asymptomatic, and viral shedding was low in these cases. CONCLUSIONS: Our results suggest that "silent spreaders" (ie, individuals who are infectious while asymptomatic or presymptomatic) may be less important in the spread of influenza epidemics than previously thought. |
Lack of effect of compartmentalized drug resistance mutations on HIV-1 pol divergence in antiretroviral-experienced women
Kelley CF , Sullivan ST , Lennox JL , Evans-Strickfaden T , Hart CE . AIDS 2010 24 (9) 1361-6 OBJECTIVE: To examine the persistence of compartmentalized HIV drug resistance mutations (DRM) over time in the female genital tract and its effect on pol gene divergence compared to that in blood. DESIGN: Longitudinal cohort of 22 antiretroviral-experienced women in the Emory Vaginal Ecology study. METHODS: Blood and vaginal secretions were collected at serial clinic visits. DRM in the HIV reverse transcriptase and protease regions of pol were determined using population based sequencing. Kimura-2 pairwise DNA distances were calculated to measure blood and vaginal secretions divergence in the intervals between clinic visits. RESULTS: Only eight (36%) women had compartmentalized DRM detected at 14 (31%) of their 45 clinic visits. This compartmentalized resistance was transient; 13 of 14 mutations in blood and all 12 mutations in vaginal secretions were compartmentalized for only one clinic visit. Over time, divergence of both reverse transcriptase and protease were greater in vaginal secretions than in blood. However, divergence in blood, but not in vaginal secretions, increased significantly in the presence of drug resistance or compartmentalized drug resistance. CONCLUSION: Compartmentalized DRM between the blood and vaginal secretions are transient in nature, and the presence of DRM does not affect pol gene divergence in the vaginal secretions. Our results provide new evidence that the genital mucosa does not support an independently evolving subpopulation of HIV-1 genomes. |
Perfluorooctane sulfonate (PFOS) induces reactive oxygen species (ROS) production in human microvascular endothelial cells: role in endothelial permeability
Qian Y , Ducatman A , Ward R , Leonard S , Bukowski V , Lan Guo N , Shi X , Vallyathan V , Castranova V . J Toxicol Environ Health A 2010 73 (12) 819-36 Perfluorooctane sulfonate (PFOS) is a member of the perfluoroalkyl acids (PFAA) containing an eight-carbon backbone. PFOS is a man-made chemical with carbon-fluorine bonds that are among the strongest in organic chemistry, and PFOS is widely used in industry. Human occupational and environmental exposure to PFOS occurs globally. PFOS is non-biodegradable and is persistent in the human body and environment. In this study, data demonstrated that exposure of human microvascular endothelial cells (HMVEC) to PFOS induced the production of reactive oxygen species (ROS) at both high and low concentrations. Morphologically, it was found that exposure to PFOS induced actin filament remodeling and endothelial permeability changes in HMVEC. Furthermore, data demonstrated that the production of ROS plays a regulatory role in PFOS-induced actin filament remodeling and the increase in endothelial permeability. Our results indicate that the generation of ROS may play a role in PFOS-induced aberrations of the endothelial permeability barrier. The results generated from this study may provide a new insight into the potential adverse effects of PFOS exposure on humans at the cellular level. |
Improving molecular detection of fungal DNA in formalin-fixed paraffin-embedded (FFPE) tissues: comparison of five tissue DNA extraction methods using panfungal PCR
Munoz-Cadavid C , Rudd S , Zaki S , Patel M , Moser S , Brandt M , Gomez B . J Clin Microbiol 2010 48 (6) 2147-2153 DNA extraction from formalin-fixed paraffin-embedded (FFPE) tissues is difficult and requires special protocols in order to extract small amounts of DNA suitable for amplification. Most described methods report an amplification success rate between 60 and 80%, therefore there is a need to improve molecular detection and identification of fungi in FFPE tissue. Eighty-one archived FFPE tissues with a positive Gomori methenamine silver stain (GMS) were evaluated using five different commercial DNA extraction kits with some modifications. Three different panfungal PCR assays were used to detect fungal DNA and two housekeeping genes were used to assess the presence of amplifiable DNA and detect PCR inhibitors. The sensitivities of the five extraction protocols were compared and the quality of DNA detection (calculated for each kit as the number of housekeeping gene PCR positive / total samples) was 60-91% among the five protocols. The efficiency of the three different panfungals used (calculated as number of panfungal PCR positive / number of housekeeping gene PCR positive) was 58-93%. The panfungal PCR using ITS 3 and 4 primers yielded a product in most FFPE tissues. Two of the five DNA extraction kits (TaKaRa and QIAGEN) showed similar and promising results. However, one method (TaKaRa) could extract fungal DNA from 69 of the 74 FFPE tissues from which a housekeeping gene could be amplified, and was also cost effective, with a non-laborious protocol. Factors such as sensitivity, cost, and labor will help guide the selection of the most appropriate method for the needs of each laboratory. |
Investigation of an apparent outbreak of Rhodococcus equi bacteremia
Langer AJ , Feja K , Lasker BA , Hinrikson HP , Morey RE , Pellegrini GJ , Smith TL , Robertson C . Diagn Microbiol Infect Dis 2010 67 (1) 95-100 During January to April 2007, hospital staff reported 3 patients with Rhodococcus equi bloodstream infections. Isolates were analyzed at the Centers for Disease Control and Prevention, Atlanta, GA, to confirm identification and to assess strain relatedness; 2 were R. equi but genetically distinct, and 1 was identified as Gordonia polyisoprenivorans. Rapid reference laboratory support prevented an unnecessary outbreak investigation. |
Comparing film and digital radiographs for reliability of pneumoconiosis classifications: a modeling approach
Sen A , Lee SY , Gillespie BW , Kazerooni EA , Goodsitt MM , Rosenman KD , Lockey JE , Meyer CA , Petsonk EL , Wang ML , Franzblau A . Acad Radiol 2010 17 (4) 511-9 RATIONALE AND OBJECTIVES: The International Labour Office (ILO) system for classifying chest radiographic changes related to inhalation of pathogenic dusts is predicated on film-screen radiography. Digital radiography has replaced film in many centers. Digital images can be printed on film ("hard copy") or can be viewed at a computer workstation ("soft copy"). The goal of the present investigation was to compare the inter-reader and intra-reader agreement of ILO classifications for pneumoconiosis across image formats. MATERIALS AND METHODS: Traditional film radiographs, hard copy digital images, and soft copy digital images from 107 subjects were read by six B readers. A multiple reader version of the inter-reader kappa statistic was compared across image formats. Intra-reader kappa comparisons were carried out using an iterative least-squares approach (unadjusted analysis) as well as a two-stage regression model adjusting for readers and subject-level covariates. RESULTS: There were few significant differences in the inter-reader and intra-reader agreement across formats. For parenchymal abnormalities, inter-reader and intra-reader kappa values ranged from 0.536 to 0.646, and 0.65 to 0.77, respectively. In the covariate-adjusted analysis film-screen radiography was generally associated with a numerically greater reliability (ie, higher kappa values) than the other image formats, although differences were rarely statistically significant. CONCLUSION: Film-screen radiographs, hard copy digital images, and soft copy digital images yielded similar reliability measures. These findings provide further support to the recommendation that soft copy digital images can be used for the recognition and classification of dust-related parenchymal abnormalities using the ILO system. |
Development and evaluation of porcine cysticercosis QuickELISA in Triturus EIA analyzer
Handali S , Pattabhi S , Lee YM , Silva-Ibanez M , Kovalenko VA , Levin AE , Gonzalez AE , Roberts JM , Garcia HH , Gilman RH , Hancock K , Tsang VC . J Immunoassay Immunochem 2010 31 (1) 60-70 We evaluated three diagnostic antigens (recombinant GP50, recombinant T24H, and synthetic Ts18var1) for cysticercosis and found that all three performed well in detecting cysticercosis in humans and pigs in several assay formats. These antigens were adapted to a new antibody detection format (QuickELISA). With one single incubation step which involves all reactants except the enzyme substrate, the QuickELISA is particularly suited for automation. We formatted the QuickELISA for the Triturus EIA analyzer for testing large numbers of samples. We found that in QuickELISA formats rGP50 and rT24H have better sensitivity and specificity than sTs18var1 for detecting porcine cysticercosis. |
Differences and changes of HPV16 variant status in HIV-positive adults are not uncommon
Steinau M , Swan DC , Onyekwuluje JM , Brooks JT , Vellozzi C , Unger ER , Sun Study Investigators . J Gen Virol 2010 91 2068-2072 HPV16 genotype variants have been the subject of several investigation, but study participants were rarely sampled more than ones. Among a cohort of Human immunodeficiency virus (HIV)-infected adults, we investigated HPV16 variants in samples collected concurrently from anus and cervix, as well as in serial samples collected from the same anatomical site at twelve-month intervals. We determined HPV16 variants in stored extracts of cervical and anal samples from subjects with multiple visits and at least one sample positive for HPV16. Seven polymorphic nucleotide positions within the E6 region were analyzed by pyrosequencing to determine genotype variants. Of 364 samples examined, 176 anal and 39 cervical swabs from 84 different subjects yielded unequivocal sequences of eight major HPV16 variants. Eight samples contained probable novel HPV16 variants and in 1 sample two variants were detected. In eight of 29 (27.6%) anal-cervical sample pairs positive for HPV 16, discordant variants were found. From 57 anal and 9 cervical sample series of HPV 16 positive samples a change in HPV16 variant status over time was seen in nine (15.8%) instances (7 anal, 2 cervical) from eight different participants. Changes of HPV 16 variants in HIV-infected adults was most frequently seen when different anatomic sites were sampled, but was also observed over time. |
A perspective on CDC's efforts in Safe Motherhood: 2001 to the present
Brown-Bryant R , Brumbaugh K . J Womens Health (Larchmt) 2010 19 (5) 833-6 This article reviews selected activities to promote Safe Motherhood through scientific and programmatic activities conducted by CDC's Division of Reproductive Health. |
Associations of job strain and occupation with subclinical atherosclerosis: The CARDIA Study
Greenlund KJ , Kiefe CI , Giles WH , Liu K . Ann Epidemiol 2010 20 (5) 323-31 PURPOSE: Although occupational factors have been associated with symptomatic ischemic heart disease, associations between job strain (low decision latitude and high psychological demands) and risk for subclinical atherosclerosis measured by coronary artery calcium (CAC) have not been assessed. METHODS: CAC was measured in 3695 participants in the Coronary Artery Risk Development in Young Adults study in 2000 to 2001 and 2005 to 2006. Job characteristics measured by the demand-control model (psychological demands and decision latitude) were assessed in 1987 to 1988 and in 1995 to 1996. Associations between non-zero CAC and previous job characteristics and occupation were assessed, adjusting for potential covariates. RESULTS: Low decision latitude, high psychological demands, and job strain at either earlier examination were not associated with a positive CAC, nor were changes in the status of these job characteristics between 1987/1988 and 1995/1996. However, participants whose jobs were classified as managerial or professional in 1995/1996 were less likely to have a positive CAC than those in laborer occupations. CONCLUSIONS: Job strain measured at two earlier time points was not related to the presence of CAC at follow-up 5 to 18 years later. The association between earlier occupation and CAC may reflect socioeconomic differences or other occupational, industrial, or labor market characteristics. |
Rapid detection and suppression of mining equipment cab fires
De Rosa MI , Litton CD . Fire Technol 2010 46 (2) 425-435 The National Institute for Occupational Safety and Health (NIOSH/PRL) conducted a series of large-scale experiments to evaluate the effectiveness of optical flame detectors, photoelectric smoke detectors, and combined ionization and photoelectric smoke detectors for rapidly detecting mining equipment cab fires. The detector alarm times were then used to trigger the discharge of a fire inerting system inside the cab to suppress cab material fires. This paper discusses the types of fire detectors tested, the experiments that were conducted, and the results that were obtained. Conclusions are that rapid detection of equipment cab fires can be achieved to trigger the discharge of a fire inerting system inside the cab to protect the operator in the cab. |
Whole-body vibration exposure comparison of seat designs for low- and mid-seam shuttle cars in underground coal mines
Mayton AG , Jobes CC , Ambrose DH , Kittusamy NK . Trans Soc Min Metall Explor Inc 2010 326 132-142 In a systematic study, the National Institute for Occupational Safety and Health (NIOSH) evaluated seat designs in low- and mid-seam shuttle cars during production operations at two underground coal mines in southern West Virginia. The purpose was to support, with additional data, earlier findings that NIOSH ergonomic seat designs (featuring viscoelastic foam padding and lower-back support) may help reduce health risks to operators of coal mine shuttle cars. Eight shuttle car operators evaluated seven seat designs (one already in use in each vehicle and five NIOSH designs) relative to perceived and measured whole-body vibration (WBV) exposure (including vehicle jarring/jolting) and discomfort. Operators' perceptions using a visual analog scale (VAS) and questionnaire ratings were compared with International Standards Organization (ISO) 2631-1:1985 fatigue-decreased proficiency (FDP) limits and measured WBV levels on low- and mid-seam shuttle cars. Objective and subjective data results indicated that NIOSH seat designs (with added adjustability, lower-back support and improved seat padding) performed better to reduce vehicle jarring/jolting levels and that shuttle car operators favored them over existing seat designs. The NIOSH low- and mid-seam shuttle car seats showed 45 to 77 percent better performance in FDP and 9 to 60 percent better performance overall in operators' ratings. Considering the VAS results for low- and mid-seam shuttle cars under no-load conditions, operators rated the level of jarring/jolting 18 to 89 percent lower with the NIOSH seats. Reductions in measured vehicle jarring/jolting were 19 to 46 percent for the three-directional vector sum accelerations relative to the existing seats on the low- and mid-seam shuttle cars. Questionnaire responses indicated that operators for both shuttle car models rated NIOSH seat designs as more comfortable overall. Vehicle operators most frequently suggested adding armrests to improve the seats on the mid-seam shuttle car. A suggested improvement for the low-seam shuttle car was to make the seat a better fit for the operator compartment, which would enhance clearance between the operator and vehicle controls and allow for better seat adjustment and operator visibility. |
Postaccident mine communications and tracking systems
Novak T , Snyder DP , Kohler JL . IEEE Trans Ind Appl 2010 46 (2) 712-719 Recent mine disasters in the U. S. exposed various inadequacies and gaps in mine-safety technology. Congress responded to these tragedies by enacting the Mine Improvement and New Emergency Response Act of 2006 (MINER Act), which resulted in the most significant change to mine-safety laws in 30 years. To help meet the requirements of the MINER Act and to help eliminate future tragedies, the National Institute for Occupational Safety and Health initiated aggressive research programs for developing new, and enhancing existing, mine-safety technologies. A major research emphasis addressed the lack of postaccident communications, which surfaced as a critical deficiency in some disasters. As a result, three communications approaches emerged as viable technologies-enhanced leaky-feeder, wireless-mesh, and medium-frequency systems. This paper describes the operation, application, advantages, and disadvantages of each system, as well as the challenges associated with underground wireless communications. |
The social distancing law project template: a method for jurisdictions to assess understanding of relevant legal authorities
Leeb K , Chrysler D , Goodman RA . Disaster Med Public Health Prep 2010 4 (1) 74-80 METHODS: The Centers for Disease Control and Prevention and the Association of State and Territorial Health Officials selected 17 state and large local jurisdictions on the basis of their proximity to federal quarantine stations and collaborated with their state health department legal counsel to conduct formulaic self-assessments of social distancing legal authorities, create tables of authority, and test and report on the laws' sufficiency (ie, scope and breadth). Select jurisdictions also held tabletop exercises to test public health and law enforcement officials' understanding and implementation of pertinent laws. This report presents findings for Michigan, which completed the legal assessment and tabletop exercise and made several recommendations for change as a result. RESULTS: Officials in Michigan concluded that there are sufficient existing laws to support social distancing measures but that a spectrum of questions remained regarding implementation of these legal authorities. Based on the findings of this assessment, Michigan initiated actions to address areas for improvement. CONCLUSIONS: The results of this project highlighted the value of integrally involving the state health department's legal counsel-those most familiar with and who advise on a given state's public health laws-in the periodic identification, assessment, and testing of the state's legal authorities for social distancing and other measures used in response to many public health emergencies. |
Positive youth development as a strategy to promote adolescent sexual and reproductive health
Gavin LE , Catalano RF , Markham CM . J Adolesc Health 2010 46 S1-6 Adolescents and young adults in the Unites States experience negative sexual and reproductive health outcomes, such as sexually transmitted diseases, HIV/AIDS, and pregnancy, at alarmingly high rates. Approximately 745,000 females younger than 20 years of age become pregnant every year. Birth rates among adolescents 15–19 years of age increased 3%, from 2005 to 2006 —the first increase since 1991 [1]. One in four (26%, 3.2 million) young women between 14 and 19 years of age in the United States is infected with at least one of the most common sexually transmitted infections (STIs) [2]. In addition, more than 20,000 males and females 10–24 years of age are living with HIV/AIDS [3]. | An essential part of public health is to provide America's youth with accurate, age-appropriate information about sexual risk reduction, the benefits of abstaining from sex, teen pregnancy, HIV/AIDS, and STI. A number of sex education programs have been developed and shown to effectively reduce sexual risk behavior [4]. However, there is widespread recognition that exposure to even the most effective sex education program is not enough to promote and sustain healthy adolescent sexual and reproductive health outcomes. Sex education approaches alone have short-lived and moderate effects on adolescent sexual risk behavior [5]. Therefore, in addition to evidence-based sex education, adolescents need access to clinical services, and they need efforts that build and/or support other protective factors operating in their family, school, and community [6], [7], [8], [9]. |
High school completion rates among men with hemophilia
Drake JH , Soucie JM , Cutter SC , Forsberg AD , Baker JR , Riske B . Am J Prev Med 2010 38 S489-94 BACKGROUND: The benefits of a high school diploma are well documented. Studies indicate that people with hemophilia have lower than average academic achievement, particularly if they have >12 bleeding episodes annually. PURPOSE: This study compares the high school graduation rate of men with hemophilia to that of the U.S. population of men. METHODS: Data were obtained from the Universal Data Collection Program, a surveillance project conducted by approximately 130 hemophilia treatment centers in the nation. Data from 7842 men aged >or=18 years were evaluated to determine high school graduation status and were analyzed by race/ethnicity and severity of hemophilia. These data were collected between 1998 and 2008, and analysis was conducted in 2009. RESULTS: Men with hemophilia A had higher or similar high school graduation rates across all racial/ethnic groups and all levels of hemophilia severity, compared with U.S. men of the same age. Graduation rates for black and Hispanic men with hemophilia B were higher or similar to rates of U.S. men, but rates for whites were lower, especially among those with moderate and mild disease. However, when graduation rates were controlled for areas where Amish populations reside, differences in graduation rates for whites disappeared. CONCLUSIONS: In this study, participants obtained hemophilia care at comprehensive hemophilia treatment centers. This multidisciplinary, family-centered care emphasizes prevention of complications, encourages medically supervised disease management, and facilitates psychosocial development. The care aims to maximize the affected child's participation in school. This care approach may partially explain the higher-than-expected high school graduation rates among the study population, which is affected by a rare, chronic, and potentially debilitating disorder. |
The association of attendance at religious services and involvement in church/religious activities and youth assets, by gender, with youth's engagement in sexual intercourse
Mueller T , Bensyl D , Vesely SK , Oman RF , Aspy CB . Health Educ 2010 110 (2) 125-134 PURPOSE: Previous research has shown that religion plays a role in the lives of many youths. This paper aims to extend previous research and examine attendance at religious services and involvement in religious/church activities as separate items to determine if one aspect was more strongly associated with never having had sexual intercourse among youth in the USA. It also aims to consider the effect of other youth assets, and analyze all by gender. DESIGN/METHODOLOGY/APPROACH: Cross-sectional data were examined to assess youth assets and risk behaviors. Multivariate regression was used to determine whether the assets or religion questions were significant in the presence of the other assets/religion questions. The eight assets examined, in addition to church attendance and involvement in religious groups were adult role models, peer role models, family communication, involvement in sports and groups, community involvement, aspirations for the future, responsible choices, and good health--diet and exercise. FINDINGS: Involvement in church/religious activities, but not attendance at religious services, was associated with never having had sexual intercourse among males and females. Analysis also determined that several of the other youth assets were protective of sexual intercourse among males and among females. RESEARCH LIMITATIONS/IMPLICATIONS: Findings from this study may be limited by the validity of the self-reported measures. The data were cross-sectional, making it impossible to draw inferences about the causal directions of the relationships found in this study. Future research should focus on developing interventions to strengthen youth assets. PRACTICAL IMPLICATIONS: Developing gender and culturally specific interventions to promote youth assets may reduce the number of young people engaging in sex. ORIGINALITY/VALUE: The paper extends previous research and examines attendance at religious services and involvement in religious/church activities as separate items to determine if one aspect was more strongly associated with never having had sexual intercourse. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract). |
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