Trends in obesity and abdominal obesity among adults in the United States from 1999-2008
Ford ES , Li C , Zhao G , Tsai J . Int J Obes (Lond) 2010 35 (5) 736-43 BACKGROUND AND OBJECTIVE: The United States has experienced a large increase in the prevalence of obesity since the 1970s. Our objective was to describe recent trends in obesity and abdominal obesity among adults in the United States. DESIGN: Trend study of cross-sectional studies. SUBJECTS: We used data from up to 22 872 men and non-pregnant women aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 1999-2008. MAIN OUTCOME MEASURES: Main outcome measures are mean body mass index and waist circumference, percentages of obesity and abdominal obesity. Obesity was defined as a body mass index ≥30 kg m(-2), and abdominal obesity was defined as a waist circumference ≥102 cm in men and ≥88 cm in women. RESULTS: In men, the age-adjusted mean body mass index, mean waist circumference, and prevalence of obesity and abdominal obesity were 27.8 kg m(-2), 99.1 cm, and 26.9 and 37.8%, respectively, during 1999-2000 and 28.5 kg m(-2) (P (trend)=0.001), 100.8 cm (P (trend)=0.002), and 32.0 (P (trend)=0.001) and 43.7% (P (trend)=0.002), respectively, during 2007-2008. In women, the age-adjusted mean body mass index, mean waist circumference, and prevalence of obesity and abdominal obesity were 28.2 kg m(-2), 92.2 cm, and 33.2 and 55.8%, respectively, during 1999-2000 and 28.6 kg m(-2) (P (trend)=0.181), 94.9 cm (P (trend)=0.006), and 35.2 (P (trend)=0.180) and 61.8% (P (trend)=0.036), respectively, during 2007-2008. Significant linear trends for increasing prevalence of obesity were noted among men with the least and most education. CONCLUSION: Between 1999 and 2008, both obesity and abdominal obesity increased in men, and abdominal obesity increased in women.International Journal of Obesity advance online publication, 7 September 2010; doi:10.1038/ijo.2010.186. |
Prevalence and correlates of elevated blood pressure in youth with diabetes mellitus: the SEARCH for diabetes in youth study
Rodriguez BL , Dabelea D , Liese AD , Fujimoto W , Waitzfelder B , Liu L , Bell R , Talton J , Snively BM , Kershnar A , Urbina E , Daniels S , Imperatore G . J Pediatr 2010 157 (2) 245-251 e1 OBJECTIVE: To determine the prevalence and correlates of elevated blood pressure (BP) in youth with type 1 or type 2 diabetes mellitus by using data from the SEARCH Study. STUDY DESIGN: The analysis included youth aged 3 to 17 years with type 1 (n = 3691) and type 2 diabetes mellitus (n = 410) who attended a research visit. Elevated BP was defined as systolic or diastolic values >or=95 percentile, regardless of drug use. In youth with elevated BP, awareness was defined as self-report of an earlier diagnosis. Control was defined as BP values <90th percentile and <120/90 mm Hg in youth with an earlier diagnosis who were taking BP medications. RESULTS: The prevalence of elevated BP in youth with type 1 diabetes mellitus was 5.9%; minority ethnic groups, obese adolescents, and youth with poor glycemic control were disproportionately affected. In contrast, 23.7% of adolescents with type 2 diabetes mellitus had elevated BP (P < .0001), Similarly, 31.9% of youth with type 2 diabetes mellitus and elevated BP were aware, compared with only 7.4% of youth with type 1 diabetes mellitus (P < .0001). Once BP was diagnosed and treated, control was similar in type 1 (57.1%) and type 2 diabetes mellitus (40.6%). CONCLUSIONS: Our findings identify high-risk groups of youth with diabetes mellitus at which screening and treatment efforts should be directed. |
Prevalence of urinary incontinence in men: results from the National Health and Nutrition Examination Survey
Markland AD , Goode PS , Redden DT , Borrud LG , Burgio KL . J Urol 2010 184 (3) 1022-7 PURPOSE: We estimated the prevalence of urinary incontinence in the United States adult male population and identified associated factors. MATERIALS AND METHODS: Data were analyzed for 5,297 men 20 years old or older who participated in the 2005 to 2006 and 2007 to 2008 cycles of the National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey of the United States noninstitutionalized population. Urinary incontinence (score of 3 or greater on a validated incontinence severity index, indicating moderate to severe leakage) was assessed. Potential associated factors included age, race/ethnicity, education, self-reported health status, prior diagnosis of prostate cancer and/or enlarged prostate (men 40 years old or older), chronic diseases and depression status. Prevalence ORs were estimated from a multivariable logistic regression analysis using appropriate sampling weights. RESULTS: The prevalence of moderate/severe urinary incontinence was 4.5% (95% CI 3.8, 5.4). Prevalence increased with age from 0.7% (95% CI 0.4, 1.6) in men 20 to 34 years old, to 16.0% (95% CI 13.0, 19.4) in men 75 years old or older (p <0.001). We found no difference in prevalence by racial/ethnic group (p = 0.38). Factors significantly associated (p <0.05) with urinary incontinence were age (per 10-year increase, OR 1.8; 95% CI 1.6, 2.0), major depression (OR 2.7; 95% CI 1.6, 4.0) and hypertension (OR 1.3; 95% CI 1.1, 1.5). CONCLUSIONS: Age and race adjusted prevalence estimates for urinary incontinence in men are consistent with other estimates using a similar definition. To our knowledge this is the first study that identifies factors associated with moderate to severe urinary incontinence in men. |
Independent associations of serum concentrations of 25-hydroxyvitamin D and parathyroid hormone with blood pressure among US adults
Zhao G , Ford ES , Li C , Kris-Etherton PM , Etherton TD , Balluz LS . J Hypertens 2010 28 (9) 1821-8 OBJECTIVE: Vitamin D deficiency or high levels of parathyroid hormone (PTH) appear to be emerging risk factors for hypertension. This study examined whether serum concentrations of 25-hydroxyvitamin D [25(OH)D] and PTH were independently associated with blood pressure and the presence of hypertension or prehypertension among the United States adults. METHODS: Cross-sectional data from 7228 participants (aged > or =20 years) in the 2003-2006 National Health and Nutrition Examination Survey were analyzed. The least square means and the regression coefficients of systolic blood pressure, diastolic blood pressure, and pulse pressure across quintiles of serum 25(OH)D and PTH were estimated by conducting multiple linear regression analyses. The adjusted prevalence ratios with 95% confidence intervals for hypertension and prehypertension were estimated using the log-binomial method. RESULTS: Among participants not taking blood pressure medications (n = 5414), the mean age- and sex-adjusted systolic and diastolic blood pressure decreased linearly across quintiles of serum 25(OH)D but increased linearly across quintiles of serum PTH (P < 0.001 for all); these relationships remained significant even after extensively adjusting for covariates. Similarly, across quintiles of serum 25(OH)D, the age-adjusted prevalence of hypertension and the adjusted prevalence ratios for both hypertension and prehypertension decreased linearly (P < 0.001 for all). In contrast, the prevalence of hypertension and prehypertension increased nonlinearly (P < 0.05 for both) and the adjusted prevalence ratios for hypertension increased linearly across quintiles of serum PTH (P < 0.001). CONCLUSION: Serum concentrations of 25(OH)D and PTH were independently associated with blood pressure and with the presence of hypertension or prehypertension among the United States adults, though casual relationships remain to be elucidated. |
Rotavirus disease in Guinea-Bissau, West Africa: a review of longitudinal community and hospital studies
Fischer TK , Aaby P , Molbak K , Rodrigues A . J Infect Dis 2010 202 Suppl S239-42 Rotavirus is one of the most common causes of childhood diarrheal disease and deaths in sub-Saharan Africa. This article reviews community- and hospital-based surveillance of rotavirus disease in Bissau, Guinea-Bissau, West Africa. Here, rotavirus infections exhibit a seasonal pattern, with annual epidemics occurring during the relatively dry and cooler months, from January to April, and few cases registered from May to December. Most children (74%) experience their first infection before the age of 2 years, and rotavirus has been identified as the most pathogenic of all diarrheal agents during 2 large prospective studies involving several hundred children <5 years of age. In the hospital setting, rotavirus accounts for a high case-fatality ratio (8%) and a high rate of nosocomial transmission; during the rotavirus season, 23% of all children admitted for nonrotavirus diarrheal disease acquired rotavirus infection during hospitalization (>48 h after admission). |
Rotavirus in Africa: shifting the focus to disease prevention
Neuzil KM , Armah GE , Parashar UD , Steele AD . J Infect Dis 2010 202 Suppl S1-4 On 5 June 2009, the Strategic Advisory Group of Experts on Immunization of the World Health Organization (WHO) recommended that rotavirus vaccines be included in the immunization programs of all countries of the world [1]. This recommendation came 10 years after a previous rotavirus vaccine was withdrawn from the market in the United States because of concerns over its association with intussusception. During that decade, it is estimated that >2 million children have died from rotavirus disease on the African continent alone [2]. This historic policy decision should serve as a catalyst for efforts to ensure that the next decade heralds reductions in deaths due to diarrheal disease, the second leading cause of death among young children in Africa. | The commitment and hard work of literally hundreds of individuals, organizations, and governments over many years contributed to this notable policy decision on rotavirus vaccines. The initial step forward was establishing the burden of rotavirus illness in Africa. The first surveillance studies in the continent, though geographically limited, established rotavirus as an important cause of severe rotavirus gastroenteritis among young African children [3–6]. As rotavirus surveillance expanded, so did the realization that rotavirus infection was an important and ubiquitous disease throughout the continent. In 2008, the WHO reported that, as in the rest of the world, rotavirus was the most common cause of severe diarrheal disease hospitalizations in young children in Africa [7]. Although this surveillance was limited to 4 countries, the consistency of the results among those countries, and with results from other studies in Africa and throughout the world, was striking. |
Treatment of methicillin-resistant Staphylococcus aureus pediatric head and neck infections: results of a national survey of otolaryngologists in the United States
Cohen AL , Naseri I , Pinell X , Sobol SE , Gorwitz R . J Otolaryngol Head Neck Surg 2010 39 (4) 468-73 OBJECTIVE: Little information is available concerning the treatment of pediatric head and neck infections caused by methicillin-resistant Staphylococcus aureus (MRSA), which is resistant to antimicrobial agents such as cephalosporins. The objective of this investigation is to describe clinical characteristics of pediatric MRSA head and neck infections in the United States and how they are treated. DESIGN: National survey. SETTING: United States. METHODS: Practicing members of the American Academy of Otolaryngology-Head and Neck Surgery were surveyed regarding patients aged < 18 years with MRSA head and neck infections during 2006. MAIN OUTCOME MEASURES: Clinical characteristics and treatment of pediatric MRSA infections. RESULTS: Of 701 surveys sent, 201 were completed (adjusted response rate 30%). Otolaryngologists responding to the survey reported treating a total of 1123 pediatric MRSA head and neck infections in 2006. Forty-seven percent reported treating pediatric patients with MRSA infections in the otologic region, 39% in the oropharyngeal/neck region, and 17% in the sinonasal region. The antimicrobials most frequently used to treat these infections were clindamycin, trimethoprim-sulfamethoxazole, and vancomycin. Cephalosporins and fluoroquinolones were also commonly prescribed. CONCLUSIONS: Otolaryngologists in the United States reported treating a broad range of MRSA head and neck infections in pediatric patients. Although most were treated with appropriate antimicrobials, some were treated with agents not active against MRSA. |
Tuberculosis in humans and animals: an overview
Lobue PA , Enarson DA , Thoen CO . Int J Tuberc Lung Dis 2010 14 (9) 1075-8 Tuberculosis (TB) is a significant disease for both humans and animals. Susceptibility to Mycobacterium tuberculosis is relatively high in humans, other primates and guinea pigs. Cattle, rabbits and cats are susceptible to M. bovis and are quite resistant to M. tuberculosis. Wild hoofed stock is generally susceptible to M. bovis, but few reports are available on the isolation of M. tuberculosis. Swine and dogs are susceptible to both M. bovis and M. tuberculosis. M. bovis accounts for only a small percentage of the reported cases of TB in humans; however, it is a pathogen of significant economic importance in wild and domestic animals around the globe, especially in countries where little information is available on the incidence of M. bovis infection in humans. Unlike transmission of M. bovis from cattle to humans, the role of human-to-human airborne transmission in the spread of M. bovis has been somewhat controversial. Investigations are needed to elucidate the relative importance of M. bovis on TB incidence in humans, especially in developing countries. Efforts should be concentrated in countries where human immunodeficiency virus (HIV) infection is widespread, as HIV-infected individuals are more susceptible to mycobacterial disease. Eradication of M. bovis in cattle and pasteurisation of dairy products are the cornerstones of the prevention of human disease. |
A primary school outbreak of pandemic 2009 influenza A (H1N1) in China
Huai Y , Lin J , Varma JK , Peng Z , He J , Cheng C , Zhong H , Chen Y , Zheng Y , Luo Y , Liang W , Wu X , Huang Z , McFarland J , Feng Z , Uyeki TM , Yu H . Influenza Other Respir Viruses 2010 4 (5) 259-66 BACKGROUND: We investigated the first known outbreak of pandemic 2009 influenza A (H1N1) at a primary school in China. OBJECTIVES: To describe epidemiologic findings, identify risk factors associated with 2009 H1N1 illness, and inform national policy including school outbreak control and surveillance strategies. METHODS: We conducted retrospective case finding by reviewing the school's absentee log and retrieving medical records. Enhanced surveillance was implemented by requiring physicians to report any influenza-like illness (ILI) cases to public health authorities. A case-control study was conducted to detect potential risk factors for 2009 H1N1 illness. A questionnaire was administered to 50 confirmed cases and 197 age-, gender-, and location-matched controls randomly selected from student and population registries. RESULTS: The attack rate was 4% (50/1314), and children from all grades were affected. When compared with controls, confirmed cases were more likely to have been exposed to persons with respiratory illness either in the home or classroom within 7 days of symptom onset (OR, 4.5, 95% CI: 1.9-10.7). No cases reported travel or contact with persons who had traveled outside of the country. CONCLUSIONS: Findings in this outbreak investigation, including risk of illness associated with contacting persons with respiratory illness, are consistent with those reported by others for seasonal influenza and 2009 H1N1 outbreaks in school. The outbreak confirmed that community-level transmission of 2009 H1N1 virus was occurring in China and helped lead to changes in the national pandemic policy from containment to mitigation. |
Characterization of human rotavirus strains from children with diarrhea in Nairobi and Kisumu, Kenya, between 2000 and 2002
Nyangao J , Page N , Esona M , Peenze I , Gatheru Z , Tukei P , Steele AD . J Infect Dis 2010 202 Suppl S187-92 Rotavirus infection is a major cause of diarrheal illness and hospitalization in children <5 years old in Kenya and has been described in various settings and locations across the country and for different time points. In this study, we expand on the molecular characterization of rotavirus strains collected in Nairobi and Kisumu, Kenya, between 2000 and 2002. Rotavirus strains were typed by reverse-transcription polymerase chain reaction and characterized using VP6 monoclonal antibodies and RNA electrophoresis of the viral genome. A large proportion of specimens could not be genotyped; 41% did not produce a G type result, and 43% did not produce a P type result. Of the strains that could be genotyped, G1P[8] strains were predominant, followed by G2P[4] strains. In addition, G8 and G9 strains were seen in similar proportions Interestingly, the G and P combinations were more diverse among G8 and G9 rotavirus strains, suggesting the recent introduction of these strains into the human population. These observations are a link between the occasional observation of G8 and G9 strains at the turn of the century and the high predominance of G9P[8] strains observed in Kenya in 2005. |
Comparison of incidence of bloodstream infection with methicillin-resistant Staphylococcus aureus between England and United States, 2006-2007
Lessa FC , Mu Y , Davies J , Murray M , Lillie M , Pearson A , Fridkin SK . Clin Infect Dis 2010 51 (8) 925-8 We compared incidence of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection (BSI) in the United States and England by using population-based surveillance. The incidence of community-onset MRSA BSI was 6.3-fold higher in the United States than in England, whereas the incidence of hospital-onset MRSA BSI was similar between the 2 countries. |
Changes in capacity among local coordinated community response coalitions (CCRs) supported by the DELTA program
Cox PJ , Finkelstein DM , Perez VE , Rosenbach ML . J Fam Soc Work 2010 13 (4) 375-392 Coalitions are often the means through which communities plan and coordinate services for individuals and address larger environmental issues associated with social problems. Since 2003, the Centers for Disease Control and Prevention (CDC) has supported local coordinated community response coalitions (CCRs) in 14 states to prevent intimate partner violence (IPV) through its Domestic Violence Prevention Enhancements and Leadership Through Alliances (DELTA) Program. Utilizing quantitative and qualitative evaluation data from 2003 and 2006 from DELTA-funded CCRs (N = 59), this article reports on improvements in internal CCR capacity and external supports that can affect the ability of CCRs to prevent IPV. Data are examined through the Interactive Systems Framework for Dissemination and Implementation (ISF) to convey how CCR internal capacity and external supports contribute to the substantial infrastructure needed to effectively address IPV. Family social workers will gain an understanding of the capacities needed by CCRs to prevent IPV, the multiple organizations and systems that support the work of these CCRs, and how they themselves can work to strengthen the capacities of local coalitions that address IPV. |
Levamisole: a dangerous new cocaine adulterant
Chang A , Osterloh J , Thomas J . Clin Pharmacol Ther 2010 88 (3) 408-11 Levamisole has increasingly been discovered in street cocaine as an adulterant. Recent reports have linked levamisole in street cocaine to agranulocytosis in cocaine users. It is well known that agranulocytosis is associated with therapeutic use of levamisole, and this may have led to the withdrawal of the drug from the US market. Levamisole was a US Food and Drug Administration-approved drug that has been used as an immunomodulator, a chemotherapy adjuvant, and anthelmintic medication. The purpose of adulterating street cocaine with levamisole is not known, but it has been speculated that it is added intentionally in order to potentiate the effects of cocaine. This may be supported by the recent report of metabolism of levamisole to aminorex in racehorses. Aminorex and related compounds, specifically 4-methylaminorex, or "ice," have high abuse potential because of their amphetamine-like pharmacological activity. This metabolism has not been reported in humans, and therefore the intended role of levamisole in street cocaine remains an enigma. |
State-based estimates of mammography screening rates based on information from two health surveys
Davis WW , Parsons VL , Xie D , Schenker N , Town M , Raghunathan TE , Feuer EJ . Public Health Rep 2010 125 (4) 567-78 OBJECTIVES: We compared national and state-based estimates for the prevalence of mammography screening from the National Health Interview Survey (NHIS), the Behavioral Risk Factor Surveillance System (BRFSS), and a model-based approach that combines information from the two surveys. METHODS: At the state and national levels, we compared the three estimates of prevalence for two time periods (1997-1999 and 2000-2003) and the estimated difference between the periods. We included state-level covariates in the model-based approach through principal components. RESULTS: The national mammography screening prevalence estimate based on the BRFSS was substantially larger than the NHIS estimate for both time periods. This difference may have been due to nonresponse and noncoverage biases, response mode (telephone vs. in-person) differences, or other factors. However, the estimated change between the two periods was similar for the two surveys. Consistent with the model assumptions, the model-based estimates were more similar to the NHIS estimates than to the BRFSS prevalence estimates. The state-level covariates (through the principal components) were shown to be related to the mammography prevalence with the expected positive relationship for socioeconomic status and urbanicity. In addition, several principal components were significantly related to the difference between NHIS and BRFSS telephone prevalence estimates. CONCLUSIONS: Model-based estimates, based on information from the two surveys, are useful tools in representing combined information about mammography prevalence estimates from the two surveys. The model-based approach adjusts for the possible nonresponse and noncoverage biases of the telephone survey while using the large BRFSS state sample size to increase precision. |
The value of national diabetes registries: SEARCH for Diabetes in Youth Study
Dabelea D , Mayer-Davis EJ , Imperatore G . Curr Diab Rep 2010 10 (5) 362-9 Diabetes mellitus is one of the most common severe chronic diseases of childhood. Much of our knowledge of the epidemiology of diabetes in young people has been generated by large collaborative efforts based on standardized registry data, such as the DIAMOND Project worldwide and the EURODIAB study in Europe. These registries showed that although at the start of the 20th century childhood diabetes was rare, by the end of the century a steady increase in incidence had been reported in many parts of the world. However, epidemiologic data for temporal trends in pediatric diabetes are still lacking or are minimal for most of the global population of youth, including in the United States. In addition, the epidemiology of diabetes in youth is changing. As youth are becoming increasingly overweight, we are seeing more obese children with a clinical phenotype of type 2 diabetes or "adult-onset" diabetes. It is imperative that efforts directed at surveillance of diabetes in young people continue and expand, not only to understand its complex etiology, but also because of its increasing public health importance. |
Population-based surveillance for rare congenital and inherited disorders: models and challenges
Jackson JM , Crider KS , Olney RS . Adv Exp Med Biol 2010 686 133-50 Worldwide, an estimated 7.9 million children are affected by congenital and inherited disorders. Some disorders are relatively common, affecting tens of thousands of newborns annually; others are rare, involving disorders that, in extreme cases, can affect less than 30 infants per year. However, this infrequency does not reduce the impact or burden on individuals and their families. Congenital defects can cause long-term disability, have a lifelong impact on health, and cost billions of dollars in care. Collection of population-based surveillance data ideally enables the discovery of etiologies for rare congenital disorders of unknown cause, allows for examining outcomes, and evaluating treatments and interventions for children with all types of congenital and inherited disorders. Many challenges are associated with performing population-based surveillance, such as difficulty in ascertaining appropriate diagnoses and frequent unavailability of necessary resources. This chapter focuses on the importance of population-based data and uses national and international surveillance systems as models for how these rare disorders can be better understood. |
Burden and epidemiology of rotavirus diarrhea in selected African countries: preliminary results from the African Rotavirus Surveillance Network
Mwenda JM , Ntoto KM , Abebe A , Enweronu-Laryea C , Amina I , McHomvu J , Kisakye A , Mpabalwani EM , Pazvakavambwa I , Armah GE , Seheri LM , Kiulia NM , Page N , Widdowson MA , Steele AD . J Infect Dis 2010 202 Suppl S5-S11 Severe rotavirus diarrhea in children <5 years of age is a major public health problem; however, limited regional and country specific data on rotavirus disease burden are available from sub-Saharan Africa. In June 2006, the World Health Organization Regional Office for Africa initiated rotavirus surveillance in selected African countries. With use of standardized methodology developed by the World Health Organization, children <5 years of age who were hospitalized with severe diarrhea were enrolled, and stool specimens were collected for detection of rotavirus strains with use of a commercial enzyme immunoassay. Rotavirus strains were further characterized for G and P types with use of a reverse-transcriptase polymerase chain reaction. From June 2006 through December 2008, rotavirus surveillance was established at 14 sites in 11 African countries. Of 5461 stool samples collected from children enrolled in 8 countries with 1 or 2 complete years of data, 2200 (40%) were positive for rotavirus. Ninety percent of all rotavirus hospitalizations occurred among children aged 3-12 months. Predominant types included G1P[8] (21%), G2P[4] (7%), and P [8] (29%); however, unusual types were also detected, including G8P[6] (5%), G8P[8] (1%), G12P[6] (1%), and G12P[6] (1%). A high percentage of mixed rotavirus infections was also detected. These preliminary results indicate that rotavirus is a major cause of severe diarrheal disease in African children. |
The contribution of rare diseases to understanding the epidemiology of neurodevelopmental disabilities
Schendel D , Rice C , Cunniff C . Adv Exp Med Biol 2010 686 433-53 Our objective is to describe the contribution of rare diseases to our understanding of the epidemiology of neurodevelopmental disabilities (NDDs) by comparing and contrasting the epidemiologic features of NDDs classified according to key characteristics of developmental delay or deviance in such areas as behavior or cognition (the phenotypic approach; autism spectrum disorders and intellectual disability as examples) versus classification based on the identification of an etiologic diagnosis (the etiologic approach; 22q11.2 deletion syndrome and fragile X syndrome as examples). We suggest specific applications in which consideration of rare etiology-based NDDs might further our understanding of NDD epidemiology overall; what is needed to integrate the two classification approaches; and identify practical challenges in achieving that integration. Understanding commonalities and differences in the epidemiologic features of the phenotypically and etiologically defined NDD classifications provides a useful framework for furthering our understanding of the prevalence, distribution, and causes of NDDs, as well as delivering appropriate diagnostic resources, appropriate treatments, accurate prognostic information, and estimates of recurrence risk for these disorders. |
Evaluation of the validity and utility of genetic testing for rare diseases.
Grosse SD , Kalman L , Khoury MJ . Adv Exp Med Biol 2010 686 115-31 The conventional criteria for evaluating genetic tests include analytic validity, clinical validity, and clinical utility. Analytical validity refers to a test's ability to measure the genotype of interest accurately and reliably. Clinical validity refers to a test's ability to detect or predict the clinical disorder or phenotype associated with the genotype. Clinical utility of a test is a measure of its usefulness in the clinic and resulting changes in clinical endpoints. In addition, the utility to individuals and families of genomic information, or personal utility, should be considered. This chapter identifies methodological and data issues involved in assessing each type of validity or utility. The validity and utility of a test must be considered in a specific context, which include diagnostic testing, newborn screening, prenatal carrier screening, and family or cascade screening. Specific rare disorders addressed include cystic fibrosis, fragile X syndrome, Duchenne and Becker muscular dystrophy, spinal muscular atrophy, Huntington disease, as well as cancer associated with BRCA mutations. |
Microdeletions of 3q29 confer high risk for schizophrenia
Mulle JG , Dodd AF , McGrath JA , Wolyniec PS , Mitchell AA , Shetty AC , Sobreira NL , Valle D , Rudd MK , Satten G , Cutler DJ , Pulver AE , Warren ST . Am J Hum Genet 2010 87 (2) 229-36 Schizophrenia (SZ) is a severe psychiatric illness that affects approximately 1% of the population and has a strong genetic underpinning. Recently, genome-wide analysis of copy-number variation (CNV) has implicated rare and de novo events as important in SZ. Here, we report a genome-wide analysis of 245 SZ cases and 490 controls, all of Ashkenazi Jewish descent. Because many studies have found an excess burden of large, rare deletions in cases, we limited our analysis to deletions over 500 kb in size. We observed seven large, rare deletions in cases, with 57% of these being de novo. We focused on one 836 kb de novo deletion at chromosome 3q29 that falls within a 1.3-1.6 Mb deletion previously identified in children with intellectual disability (ID) and autism, because increasing evidence suggests an overlap of specific rare copy-number variants (CNVs) between autism and SZ. By combining our data with prior CNV studies of SZ and analysis of the data of the Genetic Association Information Network (GAIN), we identified six 3q29 deletions among 7545 schizophrenic subjects and one among 39,748 controls, resulting in a statistically significant association with SZ (p = 0.02) and an odds ratio estimate of 17 (95% confidence interval: 1.36-1198.4). Moreover, this 3q29 deletion region contains two linkage peaks from prior SZ family studies, and the minimal deletion interval implicates 20 annotated genes, including PAK2 and DLG1, both paralogous to X-linked ID genes and now strong candidates for SZ susceptibility. |
Molecular epidemiology of infectious diseases - expanding horizons for IJMEG
Xiao L , Kehoe PG . Int J Mol Epidemiol Genet 2010 1 (3) 245-247 With the publication in this issue of the first article on molecular epidemiology of hepatitis C virus in this issue [1], IJMEG has broadened its scope of coverage of molecular epidemiology from purely focusing on chronic diseases to include both chronic and infectious diseases. Accordingly, IJMEG has begun to make adjustments to its editorial board. | Molecular and genetic tools are widely used in studies in the epidemiology of both chronic and infectious diseases. This is reflected in the considerable number of recent publications in both areas. A search of “All databases” hosted by the ISI Web of Knowledge resource (http://apps.isiknowledge.com/) on July 6th, 2010 us-ingthe keyword “molecular epidemiology” in the search heading of “Topic” identified a total of 13,863 entries recorded for the last five years across the databases Web of Science® and Medline®. Of these, 10,083 of the entries were listed under the subject area of “Genetics and Heredity” while the number of articles also listed under the subject area of “Infectious Diseases” was a relatively comparable 9,086 entries. As many of the same molecular/genetic diagnostic approaches and analytic tools are used in molecular epidemiologic studies of both chronic and infectious diseases, it is logical to have some scientific journals that cover both areas and for articles to be listed under both subject areas. |
Emergence and characterization of serotype G9 rotavirus strains from Africa
Page N , Esona M , Armah G , Nyangao J , Mwenda J , Sebunya T , Basu G , Pyndiah N , Potgieter N , Geyer A , Steele AD . J Infect Dis 2010 202 Suppl S55-63 Serotype G9 strains have been detected sporadically and in localized outbreaks in various African countries, including South Africa, Botswana, Malawi, Kenya, Cameroon, Nigeria, Ghana, Guinea-Bissau, Libya, and Mauritius. Serotype G9 strains were analyzed to investigate genogroup characteristics, including subgroup specificity, electropherotype, and P and G genotypes. In addition, the antigenic composition of the South African G9 strains was assessed. African G9 strains were associated with both DS-1-like characteristics and Wa-like characteristics, indicating the predisposition of G9 strains to frequently reassort. Despite these reassortment events, serotype G9 strains appear to maintain antigenic character in the outer capsid protein, as evident with the reaction of the South African G9 strains with the G9-specific monoclonal antibody F45:1. Phylogenetic analysis clustered African G9 strains geographically, regardless of genogroup characteristics, into 1 lineage (IIId). Two groups of G9 strains, originating in India and Japan, were identified in this lineage. Continuous surveillance of circulating rotavirus strains in Africa is vital to prepare for future vaccine implementation on a continent that clearly needs such preventative medicines. |
Hybrid models identified a 12-gene signature for lung cancer prognosis and chemoresponse prediction
Wan YW , Sabbagh E , Raese R , Qian Y , Luo D , Denvir J , Vallyathan V , Castranova V , Guo NL . PLoS One 2010 5 (8) e12222 BACKGROUND: Lung cancer remains the leading cause of cancer-related deaths worldwide. The recurrence rate ranges from 35-50% among early stage non-small cell lung cancer patients. To date, there is no fully-validated and clinically applied prognostic gene signature for personalized treatment. METHODOLOGY/PRINCIPAL FINDINGS: From genome-wide mRNA expression profiles generated on 256 lung adenocarcinoma patients, a 12-gene signature was identified using combinatorial gene selection methods, and a risk score algorithm was developed with Naive Bayes. The 12-gene model generates significant patient stratification in the training cohort HLM & UM (n = 256; log-rank P = 6.96e-7) and two independent validation sets, MSK (n = 104; log-rank P = 9.88e-4) and DFCI (n = 82; log-rank P = 2.57e-4), using Kaplan-Meier analyses. This gene signature also stratifies stage I and IB lung adenocarcinoma patients into two distinct survival groups (log-rank P<0.04). The 12-gene risk score is more significant (hazard ratio = 4.19, 95% CI: [2.08, 8.46]) than other commonly used clinical factors except tumor stage (III vs. I) in multivariate Cox analyses. The 12-gene model is more accurate than previously published lung cancer gene signatures on the same datasets. Furthermore, this signature accurately predicts chemoresistance/chemosensitivity to Cisplatin, Carboplatin, Paclitaxel, Etoposide, Erlotinib, and Gefitinib in NCI-60 cancer cell lines (P<0.017). The identified 12 genes exhibit curated interactions with major lung cancer signaling hallmarks in functional pathway analysis. The expression patterns of the signature genes have been confirmed in RT-PCR analyses of independent tumor samples. CONCLUSIONS/SIGNIFICANCE: The results demonstrate the clinical utility of the identified gene signature in prognostic categorization. With this 12-gene risk score algorithm, early stage patients at high risk for tumor recurrence could be identified for adjuvant chemotherapy; whereas stage I and II patients at low risk could be spared the toxic side effects of chemotherapeutic drugs. |
Nurses, smoking, and immunity: a review
Nakata A , Swanson NG , Caruso CC . Rehabil Nurs 2010 35 (5) 198-205 Nurses regularly are exposed to a variety of occupational hazards. In addition to documented occupational hazards, exposure to smoking remains a major concern. This article reviews the prevalence of smoking among nurses working in the United States and discusses their reasons for smoking. Researchers conducted a state-of-the-art review on the effects of cigarette smoking and exposure to secondhand smoke (Si-IS) on the immune system. Smoking prevalence among nurses working in the United States ranged from 7%-12%, and high work stress, poor work environment, shift work, and peer influence were suspected major risk factors influencing smoking behavior. A review of the effects of smoking on immunity revealed that both active smoking and exposure to SHS negatively affects immune function. When rehabilitation nurses stop smoking, their health improves and nonsmokers are exposed to less SHS. Rehabilitation nurses are encouraged to share knowledge of the immunological benefits of smoking cessation with patients to facilitate nurse-led rehabilitation programs. |
Factors associated with effectiveness of the first dose of hepatitis B vaccine in China: 1992-2005
Cui F , Li L , Hadler SC , Wang F , Zheng H , Chen Y , Gong X , Hutin YJ , Cairns KL , Liang X , Yang W . Vaccine 2010 28 (37) 5973-8 BACKGROUND: In China, the prevalence of chronic hepatitis B infection was high because of perinatal and early childhood transmission. A three-dose hepatitis B vaccine schedule with a first dose as soon as possible after birth was introduced in 1992 and generalized in 2002 in the Expanded Programme of Immunization (EPI). In 2006, a serological survey evaluated the effectiveness of vaccination. METHODS: We conducted a restricted analysis of the national serological survey that sampled children and collected information on demographic characteristics, birth history, hepatitis B vaccination and hepatitis B surface antigen (HBsAg) status as determined by ELISA testing. We compared children who received the first dose in a timely way (i.e., within 24h of birth) with others in terms of HBsAg status, stratified by birth cohort and place of birth. RESULTS: Three-dose hepatitis B vaccine coverage increased from 60.8% for children born in 1992-1997 to 93.2% for children born in 2002-2005. Meanwhile, timely birth dose coverage increased from 38.7% to 74.4%. Among 29,410 children born in 1992-2005 who had received three vaccine doses and no hepatitis B immune globulin, factors associated with being HBsAg-negative in multivariate analysis included receiving a timely birth dose (p=0.04), birth after 1998 (p<0.001), living in an urban setting (p=0.008) and hospital birth (p=0.001). The relative prevalence of HBsAg among children receiving the timely birth dose was lower for children born in county or larger hospitals (0.39), intermediate in township hospitals (0.73) and highest at home (0.87). CONCLUSIONS: Hospital birth and receiving a timely birth dose are the main determinants of the field effectiveness of the first dose of hepatitis B vaccine. Efforts to increase the proportion of hospital deliveries are key to increasing timely birth dose coverage and its effectiveness. |
Piloting the use of personal digital assistants for tuberculosis and human immunodeficiency virus surveillance, Kenya, 2007
Auld AF , Wambua N , Onyango J , Marston B , Namulanda G , Ackers M , Oluoch T , Karisa A , Hightower A , Shiraishi RW , Nakashima A , Sitienei J . Int J Tuberc Lung Dis 2010 14 (9) 1140-6 SETTING: Improved documentation of human immunodeficiency virus (HIV) testing and care among tuberculosis (TB) patients is needed to strengthen TB-HIV programs. In 2007, Kenya piloted the use of personal digital assistants (PDAs) instead of paper registers to collect TB-HIV surveillance data from TB clinics. OBJECTIVE: To evaluate the acceptability, data quality and usefulness of PDAs. DESIGN: We interviewed four of 31 district coordinators who collected data in PDAs for patients initiating TB treatment from April to June 2007. In 10 of 93 clinics, we randomly selected patient records for comparison with corresponding records in paper registers or PDAs. Using Cochran-Mantel-Haenszel tests, we compared missing data proportions in paper registers with PDAs. We evaluated PDA usefulness by analyzing PDA data from all 93 clinics. RESULTS: PDAs were well accepted. Patient records were more frequently missing (28/97 vs. 1/112, P < 0.001) and data fields more frequently incomplete (148/1449 vs. 167/2331, P = 0.03) in PDAs compared with paper registers. PDAs, however, facilitated clinic-level analyses: 48/93 (52%) clinics were not reaching the targets of testing ≥80% of TB patients for HIV, and 8 (9%) clinics were providing <80% of TB-HIV co-infected patients with cotrimoxazole (CTX). CONCLUSION: PDAs had high rates of missing data but helped identify clinics that were undertesting for HIV or underprescribing CTX. |
The rape prevention and education (RPE) theory model of community change: connecting individual and social change
Cox PJ , Lang KS , Townsend SM , Campbell R . J Fam Soc Work 2010 13 (4) 297-312 Social work practice has long focused on the connections between an individual and the social environment that affect the individual's social functioning. The Rape Prevention and Education (RPE) Program's theory model, Creating Safer Communities: The Rape Prevention and Education Model of Community Change, provides family social workers with a framework for examining and changing the individual and social factors that lead to sexual violence. This model connects two societal change theories, community readiness and diffusion of innovations, with three individual level theories, theory of reasoned action, theory of planned behavior and the health belief model, for the purpose of ending sexual violence. The Centers for Disease Control and Prevention (CDC) created this theory model to promote the use of theory-based prevention strategies among RPE Program grantees. In this article the authors (1) describe the theoretical underpinnings of the RPE theory model; (2) explore how one RPE grantee, supported with funding from the EMPOWER Program, used the RPE theory model to create a state sexual violence prevention plan; and (3) discuss how family social workers can utilize the model to promote sexual violence prevention within their own states and communities. |
Strengthening systems for the primary prevention of intimate partner violence and sexual violence: CDC's DELTA and EMPOWER programs
Cox PJ , Ortega S , Cook-Craig PG , Conway P . J Fam Soc Work 2010 13 (4) 287-296 Over the past three decades, the effect of intimate partner violence (IPV) and sexual violence (SV) on indivduals and families has become better understood by practitioners, researchers, and society as a whole. Myths that once promoted societal complacency, such as the myth that victims of IPV provoke their perpetrator or that SV is mainly committed by strangers, are increasingly challenged by laws, civil and criminal court systems, and social service systems. |
Effects of intimate partner violence on pregnancy trauma and placental abruption
Leone JM , Lane SD , Koumans EH , DeMott K , Wojtowycz MA , Jensen J , Aubry RH . J Womens Health (Larchmt) 2010 19 (8) 1501-9 AIMS: Intimate partner violence (IPV) during pregnancy increases women's risk of pregnancy complications and adverse birth outcomes. The goal of this study was to examine the association between IPV and prenatal trauma and placental abruption during pregnancy. METHODS: Prenatal and hospital obstetrical charts were reviewed for 2873 women who gave birth between January 2000 and March 2002 in a Northeastern city. We examined associations among sociodemographic characteristics, health-related variables, IPV, and pregnancy trauma and placental abruption using univariate and multivariate logistic regression. RESULTS: Of the 2873 women in the analyses, 105 (3.7%) reported IPV during prenatal care. After controlling for sociodemographic variables; tobacco, alcohol, and drug use; preeclampsia; and gestational diabetes during pregnancy, women who reported IPV also had higher odds of pregnancy trauma and placental abruption (adjusted odds ratio [OR] 32.08, 95% confidence interval [CI] 14.33-71.80, p < 0.01, and OR 5.17, 95% CI 1.37-19.51, p < 0.05, respectively). CONCLUSIONS: This study found that IPV is a significant and independent risk factor for pregnancy trauma and placental abruption after controlling for factors typically associated with these outcomes. This study has implications for partner violence screening and intervention policies among pregnant women and highlights the importance of making distinctions about the type of IPV that women experience. |
Stability of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol in urine samples stored at various temperatures
Xia Y , Bernert JT . J Anal Toxicol 2010 34 (7) 411-5 Urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and NNAL-glucuronide, which are metabolites of the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), are valuable biomarkers of tobacco exposure. In epidemiologic investigations, it is often necessary for samples to be collected and stored for various periods of time prior to analysis, and as a consequence, it is important to determine the stability of these analytes during storage. In this study, two urine pools were stored at six different temperatures ranging from -70 degrees C to 55 degrees C. Free NNAL and NNAL-glucuronide were measured at scheduled time intervals for 28 days, after which samples stored at -20 degrees C and -70 degrees C were further monitored for an additional four years. NNAL-glucuronide was not completely stable at room temperature (ca. 22 degrees C) or above. At those temperatures, a gradual loss of NNAL-glucuronide with concomitant increases in free NNAL was observed. However, both free NNAL and NNAL-glucuronide appeared to be stable for at least four weeks when stored in the refrigerator (4 degrees C) and for at least four years at -20 degrees C and -70 degrees C, respectively. These results suggest that valid NNAL concentrations can be measured in frozen urine samples that have been stored for an extended period of time prior to analysis. |
Structures of receptor complexes of a North American H7N2 influenza hemagglutinin with a loop deletion in the receptor binding site
Yang H , Chen LM , Carney PJ , Donis RO , Stevens J . PLoS Pathog 2010 6 (9) e1001081 Human infections with subtype H7 avian influenza viruses have been reported as early as 1979. In 1996, a genetically stable 24-nucleotide deletion emerged in North American H7 influenza virus hemagglutinins, resulting in an eight amino acid deletion in the receptor-binding site. The continuous circulation of these viruses in live bird markets, as well as its documented ability to infect humans, raises the question of how these viruses achieve structural stability and functionality. Here we report a detailed molecular analysis of the receptor binding site of the North American lineage subtype H7N2 virus A/New York/107/2003 (NY107), including complexes with an avian receptor analog (3'-sialyl-N-acetyllactosamine, 3'SLN) and two human receptor analogs (6'-sialyl-N-acetyllactosamine, 6'SLN; sialyllacto-N-tetraose b, LSTb). Structural results suggest a novel mechanism by which residues Arg220 and Arg229 (H3 numbering) are used to compensate for the deletion of the 220-loop and form interactions with the receptor analogs. Glycan microarray results reveal that NY107 maintains an avian-type (alpha2-3) receptor binding profile, with only moderate binding to human-type (alpha2-6) receptor. Thus despite its dramatically altered receptor binding site, this HA maintains functionality and confirms a need for continued influenza virus surveillance of avian and other animal reservoirs to define their zoonotic potential. |
Vaginal swab specimen processing methods influence performance of rapid semen detection tests: a cautionary tale
Hobbs MM , Steiner MJ , Rich KD , Gallo MF , Warner L , Macaluso M . Contraception 2010 82 (3) 291-5 BACKGROUND: Detection of semen biomarkers in vaginal fluid can be used to assess women's recent exposure to semen. Quantitative tests for detection of prostate-specific antigen (PSA) perform well, but are expensive and require specialized equipment. We assessed two rapid immunochromatographic strip tests for identification of semen in vaginal swabs. STUDY DESIGN: We tested 581 vaginal swabs collected from 492 women. Vaginal secretions were eluted into saline, and PSA was measured using the quantitative IMx (Abbott Laboratories, Abbott Park, IL, USA) assay. Specimens were also tested using the ABAcard p30 test (Abacus Diagnostics, West Hills, CA, USA) for detection of PSA and RSID-Semen test (Independent Forensics, Hillside, IL, USA) for detection of semenogelin (Sg). RESULTS: Vaginal swab extraction using saline was compatible with direct assessment of vaginal swab eluates using ABAcard for PSA detection, but not for Sg detection using RSID. The rapid PSA test detected 91% of specimens containing semen compared to 74% by the rapid Sg test. CONCLUSION: Investigators are urged to optimize vaginal swab specimen preparation methods for performance of RSID or other tests to detect semen components other than PSA. Previously described methods for PSA testing are not uniformly applicable to other tests. |
Mice lacking both TNF and IL-1 receptors exhibit reduced lung inflammation and delay in onset of death following infection with a highly virulent H5N1 virus
Perrone LA , Szretter KJ , Katz JM , Mizgerd JP , Tumpey TM . J Infect Dis 2010 202 (8) 1161-70 BACKGROUND: Highly pathogenic avian influenza viruses of the H5N1 subtype continue to cross the species barrier to infect humans and cause severe disease. It has been suggested that an exaggerated immune response contributes to the pathogenesis of H5N1 virus infection in mammals. In particular, H5N1 virus infections are associated with a high expression of the proinflammatory cytokines, including interleukin-1 (IL-1) and tumor necrosis factor alpha (TNF-alpha). METHODS: We investigated the compounding affects of both cytokines on the outcome of H5N1 virus disease by using triple mutant mice deficient in 3 signaling receptors, TNF-R1, TNF-R2, and IL-1-RI. RESULTS: Triple mutant mice exhibited reduced morbidity and a significant delay in mortality following lethal challenge with a lethal H5N1 virus, whereas no such differences were observed with the less virulent A/PR/8/34 (H1N1) virus. H5N1-infected triple mutant mice displayed diminished cytokine production in lung tissue and a quantifiable decrease of macrophages and neutrophils in the lungs postinfection. Moreover, morphometric analysis of airway sections revealed less extensive inflammation in H5N1-infected triple mutant mice, compared with infected wild-type mice. CONCLUSIONS: The combined signaling from the TNF or IL-1 receptors promotes maximal lung inflammation that may contribute to the severity of disease caused by H5N1 virus infection. |
Comparative field performance and adherence to test results of four malaria rapid diagnostic tests among febrile patients more than five years of age in Blantyre, Malawi
Chinkhumba J , Skarbinski J , Chilima B , Campbell C , Ewing V , San Joaquin M , Sande J , Ali D , Mathanga D . Malar J 2010 9 209 BACKGROUND: Malaria rapid diagnostics tests (RDTs) can increase availability of laboratory-based diagnosis and improve the overall management of febrile patients in malaria endemic areas. In preparation to scale-up RDTs in health facilities in Malawi, an evaluation of four RDTs to help guide national-level decision-making was conducted. METHODS: A cross sectional study of four histidine rich-protein-type-2- (HRP2) based RDTs at four health centres in Blantyre, Malawi, was undertaken to evaluate the sensitivity and specificity of RDTs, assess prescriber adherence to RDT test results and explore operational issues regarding RDT implementation. Three RDTs were evaluated in only one health centre each and one RDT was evaluated in two health centres. Light microscopy in a reference laboratory was used as the gold standard. RESULTS: A total of 2,576 patients were included in the analysis. All of the RDTs tested had relatively high sensitivity for detecting any parasitaemia [Bioline SD (97%), First response malaria (92%), Paracheck (91%), ICT diagnostics (90%)], but low specificity [Bioline SD (39%), First response malaria (42%), Paracheck (68%), ICT diagnostics (54%)]. Specificity was significantly lower in patients who self-treated with an anti-malarial in the previous two weeks (odds ratio (OR) 0.5; p-value < 0.001), patients 5-15 years old versus patients > 15 years old (OR 0.4, p-value < 0.001) and when the RDT was performed by a community health worker versus a laboratory technician (OR 0.4; p-value < 0.001). Health workers correctly prescribed anti-malarials for patients with positive RDT results, but ignored negative RDT results with 58% of patients with a negative RDT result treated with an anti-malarial. CONCLUSIONS: The results of this evaluation, combined with other published data and global recommendations, have been used to select RDTs for national scale-up. In addition, the study identified some key issues that need to be further delineated: the low field specificity of RDTs, variable RDT performance by different cadres of health workers and the need for a robust quality assurance system. Close monitoring of RDT scale-up will be needed to ensure that RDTs truly improve malaria case management. |
Deoxygedunin, a natural product with potent neurotrophic activity in mice
Jang SW , Liu X , Chan CB , France SA , Sayeed I , Tang W , Lin X , Xiao G , Andero R , Chang Q , Ressler KJ , Ye K . PLoS One 2010 5 (7) e11528 Gedunin, a family of natural products from the Indian neem tree, possess a variety of biological activities. Here we report the discovery of deoxygedunin, which activates the mouse TrkB receptor and its downstream signaling cascades. Deoxygedunin is orally available and activates TrkB in mouse brain in a BDNF-independent way. Strikingly, it prevents the degeneration of vestibular ganglion in BDNF -/- pups. Moreover, deoxygedunin robustly protects rat neurons from cell death in a TrkB-dependent manner. Further, administration of deoxygedunin into mice displays potent neuroprotective, anti-depressant and learning enhancement effects, all of which are mediated by the TrkB receptor. Hence, deoxygedunin imitates BDNF's biological activities through activating TrkB, providing a powerful therapeutic tool for treatment of various neurological diseases. |
Use of screening dried blood spots for estimation of prevalence, risk factors, and birth outcomes of congenital cytomegalovirus infection
Kharrazi M , Hyde T , Young S , Amin MM , Cannon MJ , Dollard SC . J Pediatr 2010 157 (2) 191-7 OBJECTIVES: To determine the birth prevalence of cytomegalovirus (CMV) in a population-based sample of newborns by use of dried blood spots compared with previous studies that used established detection methods, and to evaluate risk factors and birth outcomes for congenital CMV infection. STUDY DESIGN: A total of 3972 newborn dried blood spots collected for the California Newborn Screening Program were tested for presence of CMV DNA. Demographic and pregnancy data were obtained from linked newborn screening and live-birth records. RESULTS: CMV prevalence among newborns by maternal race and ethnicity was 0.9% for blacks, 0.8% for Hispanics, 0.6% for whites, and 0.6% for Asians. Among Hispanics (n = 2053), infants who were infected had younger mothers (23 vs 26 years, P = .03), and prevalence was higher for children with no father information provided (2.6% vs 0.6%, P = .03). Overall CMV infection was associated with low birth weight (prevalence ratios [95% CI]: 3.4 [1.4-8.5]) and preterm birth (2.7 [1.4-5.1]). CMV viral loads were inversely related to birth weight and gestational age (both P = .03). CONCLUSIONS: CMV prevalence measured with dried blood spots was similar to reports using standard viral culture methods. Dried blood spots may be suitable for detection of CMV infection in newborns and warrant further evaluation. Congenital CMV infection may contribute to low birth weight and preterm birth. |
Risk factors associated with patient assaults of home healthcare workers
Galinsky T , Feng HA , Streit J , Brightwell W , Pierson K , Parsons K , Proctor C . Rehabil Nurs 2010 35 (5) 206-215 This study used surveys from 677 home healthcare aides and nurses to explore factors associated with assaults by patients. Among respondents, 4.6% reported one or more patient assaults (being hit, kicked, pinched, shoved, or bitten) during the past year Logistic regression analysis examined associations between several potential risk factors and assaults. Three factors were significant, including having one or more patients with dementia (OR = 4.31, 95% CI 1.47-12.67), routinely handling patients (OR = 8.48, 95% CI 1.89-37.94), and perceiving threats of violence by others in and around patients' homes (OR = 4.45, 95% CI 7.75-11.32). Assaults were not significantly associated with worker age, gender, race, job title, hours of work, or use of needles during patient care. Assaulted workers and workers who perceived threats of violence by others were significantly more likely to have shortened home care visits. More detailed research is needed to confirm these results and evaluate methods to reduce assault risk. |
Safe patient handling for rehabilitation professionals
Waters TR , Rockefeller K . Rehabil Nurs 2010 35 (5) 216-222 Every day, thousands of physical therapists and rehabilitation nurses are required to perform physically demanding therapeutic patient handling tasks that are stressful to the caregiver and increase his or her risk of developing work-related musculoskeletal disorders (MSDs). In rehabilitation, patient handling tasks might be classified as"traditional"or"therapeutic."Traditional tasks have a practical goal, such as transferring a patient from bed to a wheelchair, and therapeutic tasks have more targeted goals such as facilitating patient function and independence. Therapeutic patient handling tasks present a greater risk for caregivers to sustain work-related MSDs than typical patient handling tasks do because caregivers are exposed to high mechanical loads on the spinal tissues for longer amounts of time. The Veterans Health Administration, Association of Rehabilitation Nurses, and the American Physical Therapy Association endorse the use of modern patient handling technology as part of a comprehensive safe patient handling program for providing therapy in rehabilitation settings. Information about patient handling technology that is effective in reducing the risk of work-related MSDs from performing therapeutic patient handling and movement tasks is also presented and discussed in this article. |
Strategies for nurses to prevent sleep-related injuries and errors
Caruso CC , Hitchcock EM . Rehabil Nurs 2010 35 (5) 192-197 Rehabilitation nurses work shift schedules or long hours to provide essential patient services around the clock. These demanding hours can lead to sleep difficulties, declines in performance, and increased worker errors. This article gives an overview of selected declines in cognitive performance that are associated with inadequate sleep and several factors that increase risk for fatigue-related errors. Selected strategies for nurses and managers to reduce these risks are discussed, such as better sleep practices, improved work schedule design, naps, caffeine, exposure to light, and rest breaks. Both nurses and managers share responsibility for implementing strategies to reduce risks from inadequate sleep. |
Mental health research with Latino farmworkers: a systematic evaluation of the short CES-D
Grzywacz JG , Alterman T , Muntaner C , Shen R , Li J , Gabbard S , Nakamoto J , Carroll DJ . J Immigr Minor Health 2010 12 (5) 652-8 Mental health research among Latino farmworkers is hampered by the absence of measurement evaluation that ensures farmworkers understand and can consistently and appropriately respond to questions about mental health. Cross-sectional data were obtained from 409 farmworkers via interviewer-administered survey questionnaires. Mental health was operationalized with the short-form Center for Epidemiologic Studies, Depression (CES-D) scale. The structured interviewer-administered survey questionnaires included measures to capture personal and work-related factors that could affect farmworkers' ability to understand and respond to mental health questions probed by the CES-D. Good variability in item response was observed across the 10 short-form CES-D items. There was no evidence of differential response across sub-groups of farmworkers for six of the 10 items. Responses to four of the 10 items differed by educational attainment, country of origin, and language preference. Overall, the internal consistency of the 10 items exceeded standard conventions, and observed differences in depressive symptoms were as expected. Researchers in farmworker mental health must remain attentive to the strength and validity of available measures for migrants, different ethnic groups and different socioeconomic backgrounds. Nevertheless, the overall pattern suggests that the CES-D is a viable tool for advancing farmworker mental health research. |
Occupational health and safety for nurses benefits patients, too
Caruso CC . Rehabil Nurs 2010 35 (5) 176, 222 This issue of Rehabilitation Nursing is devoted to worker safety and health. We greatly appreciate our authors' efforts to share their expertise for this special issue. Their articles discuss risks posed by violence, smoking, fatigue and sleep loss, and patient lifting. |
Exposure science can increase protection of workers and their families from exposure to asbestos and inform on the effects of other elongate mineral particles
Howard J , Middendorf P . J Expo Sci Environ Epidemiol 2010 20 (6) 485-6 Exposure science is fundamental to refining our scientific understanding about the health effects arising from asbestos and other elongate mineral particles, as well as helping improve our public health protection and regulatory efforts to safeguard workers, their families, and community residents. |
Introduction to ergonomics for healthcare workers
Waters TR . Rehabil Nurs 2010 35 (5) 185-191 Healthcare workers who handle and move patients as part of their jobs suffer a disproportionately high number of work-related musculoskeletal disorders (MSDs). The majority of reported work-related MSDs are back pain cases that result in significant numbers of lost work days. It is likely that these lost workdays have a substantial impact on the quality and cost of health care. Patient care ergonomics can reduce the risk of work-related MSDs by helping safety experts design the work so it can be safely performed by most workers. This article provides a general overview of ergonomics what it is, how it can be used to help design safe work, and why all healthcare workers and administrators should know and understand how excessive work demands can lead to increased risk of work-related MSDs. The article will also explain technological solutions that can be implemented to reduce the risk of work-related MSDs for healthcare workers. |
Job satisfaction, common cold, and sickness absence among white-collar employees: a cross-sectional survey
Nakata A , Takahashi M , Irie M , Ray T , Swanson NG . Ind Health 2010 49 (1) 116-21 The purpose of this study is to examine the independent association of job satisfaction with common cold and sickness absence among Japanese workers. A total of 307 apparently healthy white-collar employees (165 men and 142 women), aged 22-69 (mean 36) yr, completed a questionnaire survey during April to June, 2002. Global job satisfaction was measured by a 4-item scale from the Japanese version of a generic job stress questionnaire with higher scores indicating greater satisfaction. Information about whether the employees had a common cold (within the past 6 months) and sickness absence (within the past 12 months) was self-reported. Hierarchical log-linear Poisson regression analysis controlling for confounders revealed that greater job satisfaction was inversely correlated with days (B=-0.116; p<0.001) and times (B=-0.058; p=0.067) of common cold and days (B=-0.160; p<0.001) and times (B=-0.141; p<0.001) of sickness absence. Our findings suggested that poor job satisfaction is associated with both common cold and sickness absence. |
Hot topic: medical tourism
Reed CM . Plast Surg Nurs 2010 30 (3) 187-90 Travel for the purpose of obtaining health care abroad has received a great deal of attention in the popular media recently- even Wikipedia has recently devoted a section to the practice. However, it is not the only form of "medical tourism." The term has also been applied to travel by healthcare professionals for the purpose of providing health care. The extent of either form of travel is not well chracterized, but the overarching issues for both types of travelers, their primary health-care providers, and travel medicine providers are outlined below. |
Mental health and access to services among US women of reproductive age
Farr SL , Bitsko RH , Hayes DK , Dietz PM . Am J Obstet Gynecol 2010 203 (6) 542 e1-9 OBJECTIVE: The objective of the study was to estimate prevalence of depression and serious psychological distress (SPD) and mental health service receipt among reproductive-age women. STUDY DESIGN: We used 2006-2007 nationally representative data to estimate the prevalence of depression and SPD among nonpregnant women aged 18 to 44 years. Using logistic regression, we individually examined predictors of depression and SPD and characteristics associated with clinical diagnosis and current treatment. RESULTS: More than 14% of women had current depression and 2.7% had current SPD. Risk factors for major depression and SPD included older age, less education, being unmarried, inability to work/unemployed, and low income. Among depressed women, 18-24 year-olds, nonwhite women, those with children, the employed, and urban women had a lower odds of clinical diagnosis. Among women with SPD, Hispanic, employed, and those without health insurance had lower odds of receiving treatment. CONCLUSION: Mental health conditions are prevalent among women of reproductive age and a substantial proportion goes untreated. |
Evaluation of Syracuse Healthy Start's program for abnormal flora management to reduce preterm birth among pregnant women
Koumans EH , Lane SD , Aubry R , Demott K , Webster N , Levandowski BA , Berman S , Markowitz LE . Matern Child Health J 2010 15 (7) 1020-8 Randomized trials of bacterial vaginosis (BV) treatment among pregnant women to reduce preterm birth have had mixed results. Among non-pregnant women, BV recurs frequently after treatment. Randomized trials of early BV treatment for pregnant women in which recurrence was retreated have shown promise in reducing preterm birth. Syracuse's Healthy Start (SHS) program began in 1997; in 1998 prenatal care providers for pregnant women living in high infant mortality zip codes were encouraged to screen for abnormal vaginal flora at the first prenatal visit. Vaginal swabs were sent to a referral hospital laboratory for Gram staining and interpretation. SHS encouraged providers to treat and rescreen women with bacterial vaginosis or abnormal flora (BV). We abstracted prenatal and hospital charts of live births between January 2000 and March 2002 for maternal conditions and treatments. We merged abstracted data with local electronic data. We evaluated the effect of BV screening before 22 weeks gestation, treatment, and rescreening using a retrospective cohort study design. Among 838 women first screened before 22 weeks, 346 (41%) had normal flora and 492 (59%) women had BV at a mean of 13 weeks gestation; 202 (24%) did not have treatment documented and 290 (35%) received treatment at a mean of 15 weeks gestation; 267 (92%) of those treated were re-screened. Among pregnant women with early BV, 42 (21%) untreated women and 28 (10%) treated women delivered preterm (Odds Ratio [OR] 0.4, 95% confidence interval [CI] 0.2-0.7)). After adjustment for age, race, prior preterm birth and other possible confounders, treatment remained associated with a reduced risk of preterm birth compared to no treatment (aOR = 0.5, 95% CI 0.3-0.9); the aOR for women with normal flora was not significantly different. CONCLUSION: Screening, treatment, and rescreening for BV/abnormal flora between the first prenatal visit and 22 weeks gestation showed promise in reducing preterm births and deserves further study. |
Carraguard acceptability among men and women in a couples study in Thailand
Martin S , Blanchard K , Manopaiboon C , Chaikummao S , Schaffer K , Friedland B , Kilmarx PH . J Womens Health (Larchmt) 2010 19 (8) 1561-7 OBJECTIVE: The aim of this study is to evaluate the use and acceptability of Carraguard among men and women enrolled as couples in a microbicide trial. MATERIALS AND METHODS: Focus groups were conducted with participants in a 6-month randomized, placebo-controlled trial that enrolled sexually active, low-risk couples in Thailand. Participants were blinded as to which gel they had received at the time of the discussions. RESULTS: Most men and women liked the gel and found it acceptable. The majority of men and women thought that using the gel increased sexual pleasure, although participants disagreed about whether using the gel increased sexual frequency. Drawbacks of gel use included that it was too wet or messy, and nearly all respondents thought that the applicator was too hard. Most men and women questioned the utility of using the gel among married couples since gel use was tied to perception of HIV/STI risk. However, those who perceived themselves to be at risk expressed interest in using the product as an alternative to condoms. Many women were particularly interested in a product that also had contraceptive properties. Gel use also raised issues of trust and fidelity among couples and questions about men's ability to detect women's use of the product. CONCLUSION: Men and women in this study found the gel acceptable and thought that it should be made available if it is found to be safe and effective. Strategies for marketing a potential microbicide product must take the target population into consideration. For married couples, key considerations may be partner dynamics and trust issues, whereas messages focusing on sexual pleasure or disease prevention may resonate more strongly with sex workers or other populations. |
Content Index (Achived Edition)
- Chronic Diseases and Conditions
- Communicable Diseases
- Community Health Services
- Drug Safety
- Epidemiology and Surveillance
- Genetics and Genomics
- Health Behavior and Risk
- Immunity and Immunization
- Informatics
- Injury and Violence
- Laboratory Sciences
- Maternal and Child Health
- Occupational Safety and Health
- Public Health, General
- Reproductive Health
About
CDC Science Clips is an online, continuously updated, searchable database of scientific literature published by CDC authors. Each article features an Altmetric Attention Score to track social and mainstream media mentions. If you are aware of a CDC-authored publication that does not appear in this database, please let us know.
- Page last reviewed:Feb 1, 2024
- Page last updated:Sep 03, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure