Socio-Environmental Factors Associated With Pubertal Development in Female Adolescents: The Role of Prepubertal Tobacco and Alcohol Use

This cross-sectional study of 3,106 female adolescents, aged 11–21 years, evaluated the association between prepubertal alcohol and tobacco use and the onset of puberty. Ages at initial breast development, body hair growth, and menarche were self-reported. Prepubertal alcohol and tobacco use were defined as the age at first use before the age of pubertal development and accompanied by regular use. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazard models. Logistic regression was used to estimate the association between substance use and delayed puberty, defined as lack of breast development by the age of 13 years

A comparison of meningococcal carriage by pregnancy status

Neisseria meningitidis is the second leading cause of invasive meningitis. A prerequisite for infection is colonization of the nasopharynx, and asymptomatic carrier rates are widely reported in the range of 10-15%. Recent reports have indicated an increased likelihood that a pediatric admission for Neisseria meningitidis will have a mother who is pregnant in the home. We hypothesized that this association may relate to immunologic changes in pregnancy leading to higher carrier rates

Office of Aerospace Medicine Federal Aviation Administration 800 Independence Ave

Introduction: This paper describes the results from a two-year review of the Conditions an AME Can Issue (CACI) monitoring safety assurance process. When an aviation medical examiner (AME) examines an airman during the medical certification process, there are conditions for which an AME must defer to Aerospace Medicine before the airman's certificate is issued. In 2013, the Office of Aerospace Medicine implemented changes for nine specific medical conditions to allow AMEs to process more applicants immediately following the examination. This process became known as Conditions an AME Can Issue (CACI). A review was needed to document the certification changes over time. Methods: Medical certification data from 2013 and 2014 were analyzed to determine the number of CACIrelated conditions processed in the system. The study criteria for the first analysis included only those certificates that had at least one of the CACI pathologies and where the AME issued a non-time limited certificate. Criteria for the second analysis included certificates that only had one condition assigned to it, and that condition was a CACI. Certificates were individually examined to determine whether AMEs utilized the CACI process appropriately. Results: The percentage of CACI certificates AMEs issued correctly increased slightly from 85% in 2013 to 91% in 2014. The percentage of certificates that also contained the proper CACI documentation improved from 19% in 2013 to 47% in 2014. When the certificates were categorized by each specific condition, the results of most categories improved between the two years. For the second analysis where CACI was assessed in the most ideal setting, the percentage of certificates where the AMEs issued correctly and wrote proper CACI documentation in the comments increased from 17% in 2013 to 51% in 2014. AMEs mismanaged 39% of the certificates in 2013 compared to only 9% in 2014. Discussion: The results of our study indicate AMEs are applying the CACI criteria without decreasing pilot safety. There was a substantial improvement in AME compliance over the two-year study. However, the study identified opportunities for continuing AME education aimed at what is required to issue appropriately for specific medical conditions. As more conditions are added to the CACI protocol list, systematic safety and quality assurances need to be implemented. 17

Socio-Environmental Factors Associated With Pubertal Development in Female Adolescents: The Role of Prepubertal Tobacco and Alcohol Use

This cross-sectional study of 3,106 female adolescents, aged 11–21 years, evaluated the association between prepubertal alcohol and tobacco use and the onset of puberty. Ages at initial breast development, body hair growth, and menarche were self-reported. Prepubertal alcohol and tobacco use were defined as the age at first use before the age of pubertal development and accompanied by regular use. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazard models. Logistic regression was used to estimate the association between substance use and delayed puberty, defined as lack of breast development by the age of 13 years