Matern Child Health J

ObjectiveTo better understand the knowledge, attitudes and practices of obstetrician-gynecologists with respect to screening and treatment for iron deficiency anemia (IDA).MethodsA total of 1,200 Fellows and Junior Fellows of the American College of Obstetricians and Gynecologists were invited to participate in a survey on blood disorders. Respondents completed a questionnaire regarding their patient population, screening and treatment practices for IDA, and general knowledge about IDA and its risk factors.ResultsOverall response rate was 42.4%. Thirty-eight percent of respondents screen non-pregnant patients regularly, based on risk factors; 30.5% screen only when symptoms of anemia are present. For pregnant patients, 50.0% of respondents screen patients at their initial visit, while 46.2% screen every trimester. Sixty-one percent of respondents supplement pregnant patients when there is laboratory evidence of anemia; 31.6% supplement all pregnant patients. Forty-two percent of respondents screen post-partum patients based on their risk factors for IDA. However, when asked to identify risk factors for postpartum anemia, slightly more than half of respondents correctly identified young age and income level as risk factors for post-partum anemia; only 18.9% correctly identified pre-pregnancy obesity as a risk factor.ConclusionThere are opportunities for increased education on IDA for obstetrician-gynecologists, specifically with respect to risk factors. There also appears to be substantial practice variance regarding screening and supplementation for IDA, which may correspond to variability in professional guidelines. Increased education on IDA, especially the importance of sociodemographic factors, and further research and effort to standardize guidelines is needed.CC999999/Intramural CDC HHS/United States2018-01-09T00:00:00Z28251440PMC5759051vault:2579

JAMA Ophthalmol

IMPORTANCERoutine eye care is important to maintaining eye health and preventing visual impairment. However, poor knowledge of ocular risk factors and disease as well as minimal exposure to eye health information may compromise adherence to eye care recommendations. Studies have shown that Hispanic/Latino people have poor eye care utilization, but little is known about their knowledge of eye health and exposure to eye health information.OBJECTIVETo examine factors associated with more eye health knowledge and greater exposure to eye health information among Hispanic/Latino people.DESIGN, SETTING, AND PARTICIPANTSThis was a cross-sectional ocular study of 1235 participants living in the Miami, Florida, site of the Hispanic Community Health Study/Study of Latinos, a multisite epidemiologic study of disease prevalence and development among Hispanic/Latino people. Data were collected from October 1, 2011, through September 30, 2013, and data analyses were conducted between May 28, 2014, and March 18, 2015. Descriptive and multivariable regression analyses were performed for 3 ocular health care outcomes. Regression models were built sequentially, with variables conceptually grouped according to Andersen\u2019s Behavioral Model of Health Services Use and Behavioral Model for Vulnerable Populations.MAIN OUTCOMES AND MEASURESAbility to identify 8 factors on a general eye health knowledge scale and number of eye health information sources seen or heard about in the past 12 months.RESULTSOf the 1235 participants, 748 (73.4%) self-identified as being of Cuban descent and 407 (19.2%) self-identified as being from Central or South America, 478 (46.7%) were women and 757 (53.3%) were men, and the mean (SD) age was 53.6 (8.1) years. Participants with at least a high school degree or general educational development certificate had greater eye health knowledge (incidence rate ratio [IRR], 1.08; 95%CI, 1.01\u20131.15 and IRR, 1.11; 95%CI, 1.04\u20131.17, respectively) as did those with a higher mental health score on the Short Form 12-Item, version 2, Health Survey (IRR, 1.03; 95%CI, 1.01\u20131.04). Those with educational attainment beyond a high school degree or a general educational development certificate (IRR, 1.29; 95%CI, 1.07\u20131.54), those who were 60 years or older (IRR, 1.32; 95%CI, 1.06\u20131.63), and those with a household income in US dollars of $20 001 to$40 000 (IRR, 1.23; 95%CI, 1.05\u20131.44) or greater than $40 000 (IRR, 1.25; 95%CI, 0.98\u20131.59) were more likely to be exposed to at least 5 sources of eye health information in the past 12 months.CONCLUSIONS AND RELEVANCEAmong Hispanic/Latino people, age, educational level, income, and mental health may be important correlates of eye disease knowledge and eye health information exposure. These findings might be used to support the development of targeted interventions designed to improve eye health in this population.U58 DP002652/DP/NCCDPHP CDC HHS/United States2018-08-01T00:00:00Z28662239PMC581797

Am J Public Health

ObjectivesTo present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States.MethodsThis analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology.ResultsTransgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months.ConclusionsAlthough they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.CC999999/Intramural CDC HHS/United States2018-01-01T00:00:00Z29161069PMC571892

Rad/Nuc EMS Response Roundtable, 8/19-20/2010

The Radiation Studies Branch (RSB) of the Centers for Disease Control and Prevention\u2019s (CDC) National Center for Environmental Health (NCEH) convened a meeting August 19\u201320, 2010, in Atlanta, Georgia. The meeting, a roundtable of Emergency Management Services (EMS) experts, was held at the Westin Atlanta Perimeter North Hotel. Attachment 1 lists those attending.The meeting\u2019s goals, described by RSB Chief Dr. Charles Miller, were 1) to discuss the extent of the EMS community\u2019s preparedness for a mass casualty radiation incident, what it may need, and how CDC could help, and 2) to explore other questions that should be posed and addressed. The input from this and other similar meetings will contribute to the development of new or updated training aids and educational materials.Publication date from document properties.cdc-ems-radiation-roundtable-report-508.pd

Cancer Epidemiol Biomarkers Prev

BackgroundColorectal cancer (CRC) incidence and mortality rates vary across race/ethnicity. Socioeconomic status (SES) also influences CRC rates; however, these associations might be inconsistent across racial/ethnic groups and tumor subsite. We examined associations between area-level SES and CRC incidence and mortality in a population-based registry study of non-Hispanic Whites, African Americans, Hispanics, and Asians/Pacific Islanders from California.MethodsData on 52,608 incident CRC cases (1998\u20132002) and 14,515 CRC deaths (1999\u20132001) aged 6550 years were obtained from the California Cancer Registry. Based on 2000 U.S. Census data, each cancer case and death was assigned a multidimensional census tract-level SES index. SES-specific quintiles of CRC incidence and mortality rates, incidence rate ratios (IRR) and mortality rate ratios, and 95% confidence intervals (CI) were estimated. Analyses were stratified by anatomical site, including left- versus right-sided tumors, race/ethnicity, and stage of disease.ResultsOverall CRC incidence and SES did not show a clear association, yet patterns of associations varied across tumor subsite and race/ethnicity. Positive associations between SES and CRC incidence were found in Hispanics [SES Q5 v. Q1: IRR = 1.54, CI = 1.39\u20131.69], irrespective of the subsite. For Whites [SES Q5 v. Q1: IRR = 0.80, CI = 0.77\u20130.83], and African Americans [SES Q5 v. Q1: IRR = 0.83, CI = 0.70\u20130.97] inverse associations were observed, predominantly for left-sided tumors. Mortality rates declined with increasing SES in Whites, whereas in Hispanics mortality rates significantly increased with SES.ConclusionsOur findings show that SES differences in CRC incidence and mortality vary considerably across anatomical subsite and race/ethnicity.ImpactStudies combining area- and individual-level SES information are warranted.20122017-12-21T00:00:00ZHHSN261201000034C/PHS HHS/United StatesHHSN261201000035C/PC,CA/None/NoneHHSN261201000140C/CA/NCI NIH HHS/United StatesHHSN261201000035C/PHS HHS/United StatesU58 DP000807/DP/NCCDPHP CDC HHS/United States1U58 DP000807-01/DP/NCCDPHP CDC HHS/United StatesHHSN261201000035I/CA/NCI NIH HHS/United StatesHHSN261201000034C/CA/NCI NIH HHS/United StatesHHSN261201000140C/PHS HHS/United StatesN01 PC035137/PC/NCI NIH HHS/United States22911333PMC5738465714

State snapshot : Texas

Texas Department of State Health ServicesTop 5 Public Health Priorities1. Enhance public health response to disasters anddisease outbreaks2. Prevent chronic diseases and infectious diseases3. Improve the health of infants and women4. Meet increased regulatory demands due to business growth5. Increase emphasis on health care qualityTotal NCCDPHP Funding: FY 2014 $9,041,961dCS258145AWCDC/NCCDPHP Programs -- Helpful Links -- Key Contacts

Trans Soc Min Metall Explor Inc

Research by the U.S. National Institute for Occupational Safety and Health (NIOSH) has shown that heat/humidity buildup is a major concern within coal mine refuge alternatives. High temperature and humidity levels inside a refuge alternative may expose occupants to heat stress. Due to the safety risks associated with testing using human subjects, NIOSH partnered with ThermoAnalytics Inc. to create detailed thermal simulation models of refuge alternatives with human occupants. The objective of this effort was to predict a miner's core temperature response and moisture loss in environments that may be encountered in a coal mine refuge alternative. These parameters were studied across a range of temperatures and relative humidity values to determine if the current 35 \ub0C (95 \ub0F) apparent temperature limit for refuge alternatives is reasonable. The results indicate that the apparent temperature limit is protective, provided that miners are supplied with sufficient water. The results also indicate that the body core temperature does not reach dangerous levels even at an apparent temperature of 54 \ub0C (130 \ub0F). However, the results show that moisture loss increases with apparent temperature. Therefore, if the apparent temperature limit were raised, the water provided in a refuge alternative would have to be increased to offset moisture loss.CC999999/Intramural CDC HHS/United States2018-03-13T00:00:00Z29545729PMC5849269vault:2755

J Correct Health Care

U.S. Immigration and Customs Enforcement (ICE) is responsible for detaining unauthorized aliens during immigration proceedings. During 2014 to 2015, adult ICE detainees at a California facility were invited to complete a survey concerning self-reported varicella history and risk factors. Participants underwent serological testing for varicella-zoster virus (VZV) IgG; susceptible individuals were offered varicella vaccination. Among 400 detainees with available serology results, 48 (12%) were susceptible to varicella. Self-reported varicella history was negatively associated with susceptibility (adjusted odds ratio = 0.16; 95% confidence interval [0.07, 0.35]). Among 196 detainees reporting a positive history, 95% had VZV IgG levels suggestive of varicella immunity. Among 44 susceptible detainees offered vaccination, 86% accepted. Given relatively high varicella susceptibility, targeted screening and vaccination among ICE detainees lacking a positive history might reduce varicella transmission risks.CC999999/Intramural CDC HHS/United States2018-02-28T00:00:00Z28945148PMC5828995vault:2742

J Matern Fetal Neonatal Med

ObjectiveTo describe fetal and neonatal mortality due to congenital anomalies in Colombia.MethodsWe analyzed all fetal and neonatal deaths due to a congenital anomaly registered with the Colombian vital statistics system during 1999\u20132008.ResultsThe registry included 213,293 fetal deaths and 7,216,727 live births. Of the live births, 77,738 (1.08%) resulted in neonatal deaths. Congenital anomalies were responsible for 7321 fetal deaths (3.4% of all fetal deaths) and 15,040 neonatal deaths (19.3% of all neonatal deaths). The fetal mortality rate due to congenital anomalies was 9.9 per 10,000 live births and fetal deaths; the neonatal mortality rate due to congenital anomalies was 20.8 per 10,000 live births. Mortality rates due to congenital anomalies remained relatively stable during the study period. The most frequent fatal congenital anomalies were congenital heart defects (32.0%), central nervous system anomalies (15.8%), and chromosomal anomalies (8.0%). Risk factors for fetal and neonatal death included: male or undetermined sex, living in villages or rural areas, mother's age >35 years, low and very low birthweight, and <28 weeks gestation at birth.ConclusionsCongenital anomalies are an important cause of fetal and neonatal deaths in Colombia, but many of the anomalies may be preventable or treatable.CC999999/Intramural CDC HHS/United States2018-07-01T00:00:00Z28532280PMC5741518vault:2570

Obstet Gynecol

Health care providers must be equipped to provide appropriate advice to reproductive-aged patients for protection against the potentially devastating consequences of prenatal Zika virus exposure. The goal of this commentary is to summarize what is known about the safety and toxicity of N,N-diethyl-meta-toluamide (DEET) as a topical insect repellant and the pyrethroid permethrin for treatment of fabric, endorsed in the fight against Zika virus. Reviews assessing the safety and toxicity of DEET conducted by the U.S. Environmental Protection Agency and the Canadian Pest Management Regulatory Agency conclude that DEET has low acute toxicity and does not appear to pose a significant health concern to humans when used as directed. Some experimental animal and limited epidemiologic data suggest that prenatal pyrethroid exposure may adversely affect learning and behavior, but this level of evidence pales in comparison to the known risks of Zika virus to the fetal brain. The available evidence has led to the strong recommendation by the Centers for Disease Control and Prevention for use of these products by pregnant women as personal protection against mosquito bites in the fight against Zika virus infection. This message has been affirmed by our obstetrics and gynecology professional organizations. Because Zika virus is unlikely to be the last disease requiring vector control, those with environmental health expertise must continue to join with infectious disease specialists to communicate the potential vulnerability of our youngest (fetuses, infants, and young children) to vector-borne disease, both to the disease itself and to the strategies employed to mitigate the spread of such disease.K23 ES021471/ES/NIEHS NIH HHS/United StatesU61 TS000237/TS/ATSDR CDC HHS/United States2017-12-20T00:00:00Z27548647PMC573775