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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles
News and training opportunities
Agency for Healthcare Research and Quality Sponsored Continuing Education Activities: http://www.ahrq.gov/professionals/education/continuing-ed/index.html
American Public Health Association Webinars: https://www.apha.org/events-and-meetings/webinars
The Community Tool Box offers free online courses through TRAIN to support community health assessment and community health improvement work: http://ctb.ku.edu/en/online-courses
MMWR Continuing Education: http://www.cdc.gov/mmwr/cme/conted_info.html
Protecting the Public from Mosquito-borne Illnesses: The Zika Challenge.
This is a recording of the Adobe Connect Webinar that was held on March 25, 2016. Beth P. Bell, MD, MPH, Director of CDC’s National Center for Emerging and Zoonotic Infectious Diseases, discussed the latest research findings about the current Zika outbreak and provided an overview of how health officials and health care providers can protect the public’s health from Zika virus infection.
Register at http://www.cvent.com/events/archived-webinar-protecting-the-public-from-mosquito-borne-illnesses-the-zika-challenge/event-summary-816bd08d68d64f549f25f08b5b7e6ca8.aspx
Zika Information Sources: The Texas Department of State Health Services Library Services staff have identified several web sites containing current information and research articles about the Zika virus.
To see the list, go to http://www.dshs.texas.gov/library/zikainfosources.shtm
Cool websites and reports on hot topics*
Assessing Prevalence and Trends in Obesity: Navigating the Evidence by the National Academies Press is available at https://www.nap.edu/catalog/23505/assessing-prevalence-and-trends-in-obesity-navigating-the-evidence
Hearing Health Care for Adults: Priorities for Improving Access and Affordability: This study examines the hearing health care system, with a focus on non-surgical technologies and services, and offers recommendations for improving access to, the affordability of, and the quality of hearing health care for adults of all ages. Read the report at http://www.nap.edu/catalog/23446/hearing-health-care-for-adults-priorities-for-improving-access-and
Measuring Trauma: Workshop Summary: The main goals of the workshop were to discuss options for collecting data and producing estimates on exposure to traumatic events and PTSD, including available measures and associated possible data collection mechanisms. Read the workshop summary at http://www.nap.edu/catalog/23526/measuring-trauma-workshop-summary
Obesity in the Early Childhood Years: State of the Science and Implementation of Promising Solutions: Workshop Summary. The workshop examined what is currently known about the prevalence of obesity in young children, its trends over time, and its persistence into later childhood, adolescence, and adulthood; epigenetic factors related to risk of early childhood obesity; and the development of taste and flavor preferences in the first few years of life. Read the workshop summary at http://www.nationalacademies.org/hmd/Reports/2016/Obesity-In-The-Early-Childhood-Years-WIB.aspx
Panel recommends screening newborns for 3 additional conditions by Debra Freedenberg, M.D., Ph.D., FFACMG, FAAP and Susan A. Berry, M.D., FFACMG, FAAP in AAP News, June 8, 2016. See: http://www.aappublications.org/news/2016/06/08/Genetics060816
Promoting Airport Walking: A Guide. The Airport Walking Guide was developed as part of CDC’s Walk to Fly project to encourage airport travelers (through point of decision signage) to make active choices. See the guide at http://www.cdc.gov/physicalactivity/downloads/cdc-airport-walking-guide.pdf
The Role of Public-Private Partnerships in Health Systems Strengthening: Workshop Summary
There is a growing recognition of the need to strengthen health systems more broadly and build a functional administrative and technical infrastructure that can support health services for all, improve the health of populations, increase the purchasing and earning power of consumers and workers, and advance global security. Read the workshop summary at http://www.nap.edu/catalog/21861/the-role-of-public-private-partnerships-in-health-systems-strengthening
Interesting journal articles
The association between midlife cardiorespiratory fitness and later life chronic kidney disease: The Cooper Center Longitudinal Study. DeFina LF, Barlow CE, Radford NB, Leonard D, Willis BL.
Prev Med. 2016 May 31. pii: S0091-7435(16)30113-X. doi: 10.1016/j.ypmed.2016.05.030. [Epub ahead of print]
Background: Chronic kidney disease (CKD) is a major public health problem, particularly in older age and in those with diabetes mellitus (DM), with high comorbidity and treatment costs. Study Design: Prospective observational cohort study. Setting &Participants: 17,979 participants, 22% women with a mean age of 50.0 (SD 8.8), in the Cooper Center Longitudinal Study (CCLS) seen initially between 1971 to 2009 who also received Medicare coverage from 1999 to 2009. Predictors: Age, body mass index, blood pressure, cholesterol, glucose levels, current tobacco use, and cardiorespiratory fitness. Outcomes: Incident CKD and DM were determined from Medicare administrative claims data. Results: During 116,973person-years of observation, 2022 cases of incident CKD occurred. Multivariable-adjusted proportional hazards models revealed a 24% lower risk of CKD among moderate fit (hazards ratio[HR] 0.76, 95% CI 0.67-0.85 compared to low fit) and a 34% lower risk of CKD among high fit (HR 0.66, 95% CI 0.58-0.76 compared to low fit). Even following the development of DM, fitness was associated with lower risk of CKD (HR 0.94, 95% CI 0.89-0.99) per 1-MET increment. Limitations: Relatively homogeneous population of well-educated Caucasians. Conclusion: Results of the present study suggest that higher fitness is associated with lower risk of CKD decades later even in at-risk populations such as diabetics. The findings support a role for enhancing fitness through regular physical activity in preventive strategies for CKD including those who may develop DM in later life.
The balanced scorecard and twenty-first-century thoughts on motivation. Albright TL, Burgess CM, Davis S. Journal of Corporate Accounting & Finance. 2015 May/Jun; 26(4):43-50.
How can you motivate people to accomplish an organization's goals? Is a carrot-and-stick approach the only-or even the best-way? This article suggests an approach that is potentially more effective by focusing less on the traditional approach of rewards versus punishment, relying instead largely on intrinsic motivations to help bring about desired outcomes. These efforts are consistent with the balanced scorecard concepts of goal setting and rewards that have been widely adopted as performance measurement and strategic communication systems since the early 1990s.
Insurance financing increased for mental health conditions but not for substance use disorders, 1986−2014. Mark TL, Yee T, Levit KR, et al. Health Affairs June 2016;35:6:958-965.
This study updates previous estimates of US spending on mental health and substance use disorders through 2014. The results reveal that the long-term trend of greater insurance financing of mental health care continued in recent years. The share of total mental health treatment expenditures financed by private insurance, Medicare, and Medicaid increased from 44 percent in 1986 to 68 percent in 2014. In contrast, the share of spending for substance use disorder treatment financed by private insurance, Medicare, and Medicaid was 45 percent in 1986 and 46 percent in 2014. From 2004 to 2013, a growing percentage of adults received mental health treatment (12.6 percent and 14.6 percent, respectively), albeit only because of the increased use of psychiatric medications. In the same period, only 1.2–1.3 percent of adults received substance use disorder treatment in inpatient, outpatient, or residential settings, although the use of medications to treat substance use disorders increased rapidly.
Job satisfaction: a critical, understudied facet of workforce development in public health.
Harper E, Castrucci BC, Bharthapudi K, Sellers K. J Public Health Manag Pract. 2015 Nov-Dec;21 Suppl 6:S46-55
The field of public health faces multiple challenges in its efforts to recruit and retain a robust workforce. Public health departments offer salaries that are lower than the private sector, and government bureaucracy can be a deterrent for those seeking to make a difference. Objective: The objective of this research was to explore the relationship between general employee satisfaction and specific characteristics of the job and the health agency and to make recommendations regarding what health agencies can do to support recruitment and retention. Design: This is a cross-sectional study using data collected from the 2014 Public Health Workforce Interests and Needs Survey (PH WINS). A nationally representative sample was constructed from 5 geographic (paired adjacent HHS [US Department of Health and Human Services]) regions and stratified by population and state governance type. Descriptive and inferential statistics were analyzed using the balanced repeated replication method to account for the complex sampling design. A multivariate linear regression was used to examine job satisfaction and factors related to supervisory and organizational support adjusting for relevant covariates. Setting And Participants: PH WINS data were collected from state health agency central office employees using an online survey. Main Outcome Measure: Level of job satisfaction using the Job in General Scale (abridged). Results: State health agency central office staff (n = 10,246) participated in the survey (response rate 46%). Characteristics related to supervisory and organizational support were highly associated with increased job satisfaction. Supervisory status, race, organization size, and agency tenure were also associated with job satisfaction. Conclusions: Public health leaders aiming to improve levels of job satisfaction should focus on workforce development and training efforts as well as adequate supervisory support, especially for new hires and nonsupervisors.
Leveraging social media to promote public health knowledge: example of cancer awareness via Twitter.
Xu S, Markson C, Costello KL, Xing CY, Demissie K, Llanos AA. JMIR Public Health Surveill. 2016 Apr 28;2(1):e17. doi: 10.2196/publichealth.5205.
Background: As social media becomes increasingly popular online venues for engaging in communication about public health issues, it is important to understand how users promote knowledge and awareness about specific topics. Objective: The aim of this study is to examine the frequency of discussion and differences by race and ethnicity of cancer-related topics among unique users via Twitter. Methods: Tweets were collected from April 1, 2014 through January 21, 2015 using the Twitter public streaming Application Programming Interface (API) to collect 1% of public tweets. Twitter users were classified into racial and ethnic groups using a new text mining approach applied to English-only tweets. Each ethnic group was then analyzed for frequency in cancer-related terms within user timelines, investigated for changes over time and across groups, and measured for statistical significance. Results: Observable usage patterns of the terms "cancer", "breast cancer", "prostate cancer", and "lung cancer" between Caucasian and African American groups were evident across the study period. We observed some variation in the frequency of term usage during months known to be labeled as cancer awareness months, particularly September, October, and November. Interestingly, we found that of the terms studied, "colorectal cancer" received the least Twitter attention. Conclusions: The findings of the study provide evidence that social media can serve as a very powerful and important tool in implementing and disseminating critical prevention, screening, and treatment messages to the community in real-time. The study also introduced and tested a new methodology of identifying race and ethnicity among users of the social media. Study findings highlight the potential benefits of social media as a tool in reducing racial and ethnic disparities.
Temporal association between nonfatal self-directed violence and tree and grass pollen counts. Jeon-Slaughter H, Claassen CA, Khan DA, et al. J Clin Psychiatry. 2016 Jun 7. doi: 10.4088/JCP.15m09864. [Epub ahead of print]
Objectives: Prior research suggests a possible association between pollen and suicide. No studies have examined the relationship between pollen and attempted suicide. This study examines the temporal association between airborne pollen counts and nonfatal suicidal and nonsuicidal self-directed violence (SDV) requiring an emergency department visit. Methods: Data on daily emergency department visits due to nonfatal SDV as identified by ICD-9 diagnosis criteria were extracted from emergency department medical records of Parkland Memorial Hospital in Dallas, Texas, between January 2000 and December 2003. Concurrent daily airborne tree, grass, and ragweed pollen data from the city of Dallas were extracted from the National Allergy Bureau online database. The data were analyzed using the time series method of generalized autoregressive conditional heteroskedasticity. Results: There were statistically significant and positive temporal associations between tree pollen counts and the number of nonfatal SDV events among women (P = .04) and between grass pollen counts and number of nonfatal SDV events among both men (P = .03) and women (P < .0001). There was no significant temporal association found between ragweed pollen counts and number of nonfatal SDV events. Conclusions: The study findings suggest that an increase in nonfatal SDV is associated with changes in tree and grass pollen counts. This is the first study that has examined an association between seasonal variation in tree and grass pollen levels and nonfatal SDV event data. The study also used a narrowly defined geographic area and temporal window. The findings suggest that pollen count may be a factor influencing seasonal patterns in suicidal behavior.
Ten things I wish someone had told me when I became a health officer. Frieden TR. Am J Public Health. 2016 Jul;106(7):1214-8. doi: 10.2105/AJPH.2016.303204. Epub 2016 May 19.
Public health, like politics, is the art of the possible. To maximize effectiveness, public health officers in any jurisdiction should (1) get good data and ensure timely and effective dissemination; (2) prioritize and tackle more difficult initiatives first; (3) find, fight, and win winnable battles in areas where progress is possible but not ensured without focused, strategic effort; (4) support and hire great people and protect them so they can do their jobs; (5) address communicable diseases and environmental health effectively; (6) do not cede the clinical realm-public health programs depend on clinical care and on effective coordination between health care and public health; (7) learn and manage the budget cycle; (8) manage the context; (9) never surprise their boss; and (10) follow core principles.
Trauma-informed care for youth in foster care. Fratto CM. Arch Psychiatr Nurs. 2016 Jun;30(3):439-46.
For decades, evidence has shown an undeniable connection between childhood trauma and chronic adverse reactions across the lifespan (Bilchik & Nash, 2008; Perry, 2001; Perry, 2006). Childhood traumatic experiences are associated with serious and persistent, long-term physical, psychological, and substance abuse issues. In addition to adverse effects on physical health, research indicates that early childhood trauma has particularly adverse effects on adolescent self-esteem, coping skills, school performance, self-regulation, critical thinking, self-motivation, and the ability to build healthy relationships (O'Connell, Boat, & Warner, 2009). A traumatic event is a dangerous or distressing experience, outside the range of usual human experience that overwhelms the capacity to cope and frequently results in intense emotional and physical reactions, feelings of helplessness and terror, and threatens serious injury or death (The National Child Traumatic Stress Network [NCTSNET], 2014). Approximately five million children each year in the United States experience some type of traumatic experience (Perry, 2006). Nationwide community studies estimate between 25% and 61% of children and adolescents have a history of at least one exposure to a potentially traumatic event and 38.5% of American adults claim to have experienced at least one traumatic event before the age of 13 (Briggs et al., 2012; Gerson & Rappaport, 2013). According to results of a 2002-2003 survey of 900 New York City adolescents, 24% reported a history of witnessing someone being shot, 12% reported exposure to someone being killed, and 51% reported witnessing someone being beaten or mugged (O'Connell et al., 2009). Each year, 2-3 million children are victims of maltreatment, a type of trauma, including physical and/or sexual abuse (U.S. Department of Health and Human Services, 2014; Perry, 2006). Compared to the general population, youth in foster care are significantly more likely to have experienced violence, specifically abuse and/or neglect (Burns et al., 2004). It is estimated that approximately 90-percent of children in foster care have experienced a traumatic event, with nearly half reporting exposure to four or more types of traumatic events (Stein et al., 2001). Given the widespread prevalence of traumatic exposures, it is important for the mental health professionals working with foster care youth, to be aware of the prevalence and various types of trauma that are most common. Focus in treatment is typically on behavioral and emotional reactions rather than addressing the context of these symptoms, including trauma exposure histories and trauma-specific reactions. Clinicians must maintain awareness of the frequency and impact of childhood traumatic experiences on subsequent behaviors and overall functioning. Clinicians should appreciate the link between how traumatized children understand the world and interact with others differently from other children and how to provide appropriate treatment for children with a history of traumatic exposures. Practitioners must remain alert to symptoms that may suggest a history of trauma and must have an understanding of the difficulties adolescents may face regulating their emotions and behavior, as a symptom of a past traumatic experience. The failure to address trauma through screening, assessment, and treatment has major implications for long-term public health costs and services.
Why is changing health-related behaviour so difficult? Kelly MP, Barker M. Public Health. 2016 May 13. pii: S0033-3506(16)30017-8. doi: 10.1016/j.puhe.2016.03.030. [Epub ahead of print]
Objective: To demonstrate that six common errors made in attempts to change behaviour have prevented the implementation of the scientific evidence base derived from psychology and sociology; to suggest a new approach which incorporates recent developments in the behavioural sciences. Study Design: The role of health behaviours in the origin of the current epidemic of non-communicable disease is observed to have driven attempts to change behaviour. It is noted that most efforts to change health behaviours have had limited success. This paper suggests that in policy-making, discussions about behaviour change are subject to six common errors and that these errors have made the business of health-related behaviour change much more difficult than it needs to be. Methods: Overview of policy and practice attempts to change health-related behaviour. Results: The reasons why knowledge and learning about behaviour have made so little progress in alcohol, dietary and physical inactivity-related disease prevention are considered, and an alternative way of thinking about the behaviours involved is suggested. This model harnesses recent developments in the behavioural sciences. Conclusion: It is important to understand the conditions preceding behaviour psychologically and sociologically and to combine psychological ideas about the automatic and reflective systems with sociological ideas about social practice.
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