Session 11: \u3cem\u3eData and Epidemiology: The Need to Educate the Public\u3c/em\u3e

Unlike previous pandemics, the COVID pandemic came at a time of political polarization and extensive use of social media. Early in the outbreak, it soon became clear that the general lack of understanding of simple epidemiologic principles led to confusion and mistrust. Using data posted to the South Dakota Department of Health dashboard, summaries of daily data were provided via email and blog to individuals from university emergency management staff to city council members, retirees, and the general public. Weekly videos were produced by the city and posted to social media accounts. The goal of these data updates and videos was to provide graphic summaries of the current situation in Brookings County and the state of South Dakota and educate the public on the general principles of epidemiology

South Dakota Pregnancy Risk Assessment Monitoring System (PRAMS)

The Pregnancy Risk Assessment Monitoring System (PRAMS) was developed by the Centers for Disease Control and Prevention (CDC) in 1987 and is done in collaboration with various state health departments. PRAMS is a statewide survey that collects valuable information from new mothers to find out why some babies are born healthy and others are not. The PRAMS provides state agencies and the CDC with data so they can monitor changes in maternal and child health indicators such as the prevalence of unintended pregnancy, prenatal care, breastfeeding, and smoking and drinking behaviors. PRAMS data can be used to identify groups of women and children who are at high risk for health problems and to measure the progress of goals that are developed to improve the health of women and children. PRAMS data also can be used by researchers to investigate emerging issues of maternal and child health, by state and local governments to design or review maternal and child health programs and policies, and by state agencies to help plan maternal and child health programs. Currently forty states and New York City participate in the PRAMS, representing approximately 78% of all U.S. live births. The Ethel Austin Martin Program at South Dakota State University, in partnership with the South Dakota Department of Health, is conducting the state’s first-ever statewide PRAMS

Influence of Rapid Growth on Skeletal Adaptation to Exercise

During rapid growth, increased body weight and muscle strength result in increased loads on bone. Bone adapts to these increased strains by increasing bone modeling and remodeling. As the growth rate decreases, bone that was formed as a result of these adaptations continues to mineralize and catch up , and bone modeling and remodeling decreases. Bone benefits of exercise in childhood are reported in some studies, although we observed less BMC gain at trabecular-rich sites during the peri-pubertal period in children who jumped than those who did not. Data from 13 existing pediatric exercise studies were compiled to determine whether similar patterns of age-related bone changes could be identified, and whether the bone benefit of exercise differed depending upon pubertal stage. The benefit of exercise on total body BMC gains occurred across all ages, whereas greater exercise-induced gains at the spine and hip were observed in younger children compared to older children. The majority of studies found a positive effect of exercise on bone, but typically this involved limiting the analysis to specific sub-populations (i.e., higher calcium intake, lower baseline activity levels, smaller body size). Limitations of the studies published to date are discussed

Role of Physical Activity on Bone Mineral Content in Young Children

Previous studies identifying factors that influence peak bone mass have typically focused on older children, although it has been suggested that environmental factors early in life also may be important in optimizing the genetic potential for bone gain1 . Physical activity and calcium intake are considered major environmental factors influencing bone mass accretion. Longitudinal studies beginning in childhood show that high activity early in life is associated with high adult bone density2,3. The long-term effect between bone mass accretion and early calcium intake is less clear, with most trials finding that the beneficial bone effect of high calcium intake does not persist once the supplementation is withdrawn4 . Results of several studies related to bone changes and physical activity that we conducted in young children are reviewed belo

Early Hearing Detection Intervention (EHDI) Program: What is the Data Telling Us?

Hearing impairments in infants can negatively impact speech and language development, academic achievement, and social and emotional development if left undetected. These negative impacts can be reduced through early intervention. There are three goals of the EHDI Program: All newborns will be screened for hearing loss before 1 month of age, preferably before hospital discharge. All infants who screen positive will have a diagnostic audiologic evaluation before three months of age. All infants diagnosed with a hearing loss will receive appropriate early intervention services before 6 months of age. The South Dakota Department of Health recently evaluated 2010-2015 EHDI data to identify weaknesses in the surveillance program in order to identify where to focus efforts for program improvemen

Incidence and Pattern of Lethal Congenital Anomalies in South Dakota, 2006-2013

In 2012, South Dakota ranked 50th in the US in infant mortality and reducing infant mortality is a public health priority in South Dakota. Congenital anomalies are the most common cause of infant death and represent about one fourth of the total infant deaths between 2006 and 2013 in South Dakota. We used information from vital records (birth and death certificates) to describe the incidence and pattern of major congenital anomalies in South Dakota among infant deaths

Pregnancy Intendedness and Birth Control Use: Data from the South Dakota 2014 Pregnancy Risk Assessment Monitoring System (PRAMS)-like Survey

The health status of South Dakotans is commonly reported from public health surveillance surveys. Surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) provide information that is used by policy makers, public health professionals, advocacy groups, health care organizations, and others to develop initiatives to improve the health of the population. South Dakota has one of the highest infant mortality rates in the U.S., ranking in the bottom half of states, yet there are little data available on factors that influence health behaviors and attitudes of mothers that can ultimately influence birth outcomes. The Pregnancy Risk Assessment Monitoring System (PRAMS) survey is a Centers for Disease Control and Prevention (CDC) recommended tool to provide this type of information

Trends in Preterm Birth: South Dakota, 2006-2015

This report summarizes the 2006-2015 preterm deliveries among singleton gestations using birth certifi-cate data from South Dakota Vital Records. Preterm deliveries were limited to births from 24 to 36 weeks of gestation. Preterm deliveries were divided into three types: (1) spontaneous labor with intact membranes (spontaneous preterm birth), (2) preterm premature rupture of the membranes (PPROM), and (3) labor induc-tion or caesarean delivery for maternal or fetal indications (medically indicated)

Walking Age Does Not Explain Term Versus Preterm Difference in Bone Geometry

OBJECTIVE: To elucidate the relationship between bone geometry and onset of walking in former term and preterm children.STUDY DESIGN: We conducted a cross-sectional study of 128 preschool children aged 3 to 5 years who underwent peripheral quantitative computerized tomography measures of bone size at the distal tibia. Linear models were developed, stratifying by sex, to determine whether bone differences between children born term and preterm were caused by differences in walking age.RESULTS: Children with a history of preterm birth walked later than children born at term (12.4 +/- 0.5 versus 10.9 +/- 0.2 months; P = .004); however, gestation-corrected walking age (11.4 +/- 0.5 for children born preterm) did not differ. In multiple regression analysis, boys born preterm had larger periosteal and endosteal circumferences and smaller cortical thickness and area than boys born term (least square means, 49.7 +/- 1.3 mm, 43.0 +/- 1.8 mm, 1.1 +/- 0.11 mm, and 49.3 +/- 3.2 mm2 versus 47.0 +/- 0.5 mm, 38.5 +/- 0.7 mm, 1.4 +/- 0.04 mm, and 56.9 +/- 1.2 mm2, respectively; all P \u3c .05). Preterm birth remained statistically significant after adding the age of walking to the models, but no longer significant when current activity levels were included.CONCLUSION: Greater periosteal and endosteal circumferences, with smaller cortical bone thickness and area, were found in former preterm boys, but not girls, and were explained by differences in current activity levels, not age of walking

Muscle-bone Relationships in the Lower Leg of Healthy Pre-pubertal Females and Males

Muscle-bone relationships in healthy pre-pubertal children were investigated using four muscle measures as predictors of tibial strength: 66% tibia cross-sectional muscle area (CSMA) by pQCT; leg lean mass (LLM) by DXA; and muscle power (Power) and force (Force) measured during a two-footed jump. Polar strength strain index (pSSI), a calculated surrogate for bone strength at the 20% distal tibia, was obtained on 105 (54 male) self-assessed pre-pubertal children. The amount of muscle (CSMA, LLM) may influence bone strength more than muscle strength (Power, Force) during periods of rapid growth. Correlations and multiple regression partial-R values from models controlling for age, sex, height and weight were obtained for each muscle predictor. CSMA, LLM, Power and Force were positively correlated with pSSI (R=0.84, 0.92, 0.85; 0.66, respectively, all p\u3c 0.01). Partial-R values were highest for LLM (partial-R=0.21), similar for CSMA and Power (0.14, 0.15, respectively) and lowest for Force (0.04) in predicting pSSI. Muscle predictors were associated with total and cortical area (R=0.59 to 0.90; p\u3c 0.01 for all), but not cortical vBMD at the 20% distal tibia site. These data support relationships between muscle predictors and bone parameters measured by pQCT in healthy pre-pubertal children