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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles*
News and training opportunities
February 7, 2017 at 2:00pm (CST): The Power of Storytelling: Giving Life to Voices and Data
When personal stories from community members are blended with data and statistics, the combination can be a powerful tool for change in a community. Join us as we learn how a 'Living Storybook’ portrays community member voices, personal stories, and co-created milestones to reveal the unfolding change of a Community Living Model in New Haven, CT. Register at https://attendee.gotowebinar.com/register/3836921026939577345
February 9, 2017 from noon to 1:30 PM (CST): Whole Community Disaster Planning: Inclusive Approaches to Recovery and Preparedness by Jeanine Finley. This webinar will explore how a focus on the whole community in planning efforts can improve preparedness and recovery for all stakeholders, including minorities, low-income populations, limited English proficiency populations, people with disabilities, and those who are unfamiliar with local planning processes. Register at https://www.eventbrite.com/e/whole-community-disaster-planning-inclusive-approaches-to-recovery-and-preparedness-tickets-30467448960?aff=erelexpmlt
February 15, 2017 from 11 am to noon (CST): Healthy Literacy Webinar Series: Developing Written Education Materials, presented by the Pennsylvania state government. Register at https://copa.webex.com/mw3100/mywebex/default.do?nomenu=true&siteurl=copa&service=6&rnd=0.8282941254650276&main_url=https%3A%2F%2Fcopa.webex.com%2Fec3100%2Feventcenter%2Fevent%2FeventAction.do%3FtheAction%3Ddetail%26%26%26EMK%3D4832534b00000002e4195b7c2e361d05d032aa0d13616b992d6c5bd5a179bf5208cedbe27e103710%26siteurl%3Dcopa%26confViewID%3D2980288770%26encryptTicket%3DSDJTSwAAAAIb6qeJ4bpgvF2gtN7JNPh02mW0f_xfgd12hZQfyggvJg2%26
February 16, 2017 from 7:30am to 5:00 pm (CST): The North Texas 2017 Transitional Care Conference will be held at the University of North Texas Health Science Center in Fort Worth, TX. The focus of the 2017 conference will be on the transition from pediatric to adult care for patients with chronic disease or developmental disabilities. Register at http://ce.unthsc.edu/live/2137
February 16, 2017 from 12:00 PM - 1:00 PM CST: Public Health Reports Webinar series presents, How to Get Published in Peer Reviewed Journals. This webinar will help public health practitioners at the state and local-levels turn their work into manuscripts for publication. Register at http://attendee.gotowebinar.com/register/4293837377529341955
Cool websites and reports on hot topics*
Action Collaborative on Clinician Well-Being and Resilience, sponsored by the National Academy of Medicine, this action collaborative will provide the venue for a set of collaborative activities, grounded in evidence-based knowledge, to assess and understand the underlying causes of clinician burnout and suicide, and advance solutions that reverse the trends in clinician stress, burnout, and suicide. See https://nam.edu/initiatives/clinician-resilience-and-well-being/
Addendum Guidelines for the Prevention of Peanut Allergy in the United States Summary for Parents and Caregivers by the National Institute of Allergy and Infectious Diseases was issued in January 2017. See https://www.niaid.nih.gov/sites/default/files/peanut-allergy-prevention-guidelines-parent-summary.pdf A Summary for Clinicians was also issued. The addendum provides three separate guidelines for infants at various levels of risk for developing peanut allergy. See https://www.niaid.nih.gov/sites/default/files/peanut-allergy-prevention-guidelines-clinician-summary.pdf
Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2010–2014, National Vital Statistics Reports, Vol. 65, No. 10, December 20, 2016. Analysis of the literal text from death certificates can be used to identify patterns in the specific drugs most frequently involved in drug overdose deaths. From 2010 through 2014, the top ten drugs involved were the same, but the relative ranking and age-adjusted rates for deaths involving these drugs changed. See https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_10.pdf
Healthcare-Associated Infections and Antibiotic Resistance: Communication Toolkit for Health Departments, 2016. The Association of State and Territorial Health Officials developed this toolkit in collaboration with the CDC to help public health departments enhance communication and coordination around preventing healthcare-associated infections and reducing the spread of antibiotic resistance. This toolkit includes several resources for use across both traditional and social media channels. See http://www.astho.org/Enhancing-HAI-Prevention-and-Outbreak-Response/Communication-Toolkit/
Immunization Educational and Promotional Resources for Partners. Prepared by the CDC, these educational resources and promotional materials will help supplement vaccine conversations and outreach with parents, pregnant women, and adults, as well as healthcare professionals. See https://www.cdc.gov/vaccines/partners/
Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009–2014, HCUP Statistical Brief #219, December 2016. Between 2005 and 2014, the national rate of opioid-related inpatient stays increased 64.1% and the national rate of opioid-related emergency department visits increased 99.4%. See https://www.hcup-us.ahrq.gov/reports/statbriefs/sb219-Opioid-Hospital-Stays-ED-Visits-by-State.pdf
Reported Tuberculosis in the United States, 2015: Surveillance Report by the CDC presents summary data for tuberculosis cases verified and counted during 2015. See https://www.cdc.gov/tb/statistics/reports/2015/default.htm.
Roadmap to Ending the HIV Epidemic in Houston, December 2016. This roadmap prepared by the City of Houston, outlines five core areas to end the HIV epidemic in Houston, including HIV prevention, access to HIV care, social determinants of health, criminal justice reforms, and public policies and funding. See http://endhivhouston.org/wp-content/uploads/2016/11/END-Roadmap.pdf
Strategies to Improve Mental Health Care for Children and Adolescents, Comparative Effectiveness Review Number 181, AHRQ, December 2016. Findings suggest that several approaches can improve both intermediate and final health outcomes and resource use. Twelve of the 17 included studies significantly improved at least one such outcome or measure. See https://www.effectivehealthcare.ahrq.gov/ehc/products/599/2372/mental-health-children-executive-161219.pdf
Trends in Emergency Department Visits Involving Mental and Substance Use Disorders, 2006-2013, HCUP Statistical Brief #216, from the Agency for Healthcare Research and Quality. This report presents data on trends from 2006 to 2013 in the rate of emergency department visits involving the following categories of mental and substance use disorders: substance use disorders; depression, anxiety or stress reactions; and psychoses or bipolar disorders. See https://www.hcup-us.ahrq.gov/reports/statbriefs/sb216-Mental-Substance-Use-Disorder-ED-Visit-Trends.jsp?utm_source=AHRQ&utm_medium=EN-1&utm_term=&utm_content=1&utm_campaign=AHRQ_EN1_10_2017
What's Your ROI? A Web-based Tool to Estimate Economic Returns on Investments for Public Health Agency Projects. Prepared by ASTHO, the tool can be used prospectively as a decision-making tool for new projects or initiatives; during quality improvement implementation to track ROI; or retrospectively to show economic returns of investments already made. See http://www.astho.org/Programs/Evaluation/
Interesting journal articles*
Bullying victimization among school-aged immigrant youth in the United States. Maynard BR, Vaughn MG, Salas-Wright CP, Vaughn S. J Adolesc Health. 2016 Mar;58(3):337-44.
Purpose: Bullying is a serious sociodevelopmental issue associated with a range of short- and long-term problems among youth who are bullied. Although race and ethnicity have been studied, less attention has been paid to examining prevalence and correlates of bullying victimization among immigrant youth. Methods: Using data from the Health Behavior in School-Aged Children (N = 12,098), we examined prevalence and correlates of bullying victimization among U.S. immigrant youth. Results: after controlling for several demographic variables, findings indicate that immigrant youth are more likely to experience bullying victimization than native-born youth. Furthermore, immigrant youth who experience bullying victimization were more likely to report interpersonal, socioemotional, health, and substance use problems. Conclusions: Given the greater risk and unique challenges experienced by immigrant youth, prevention and intervention programs may need to be tailored to their specific needs and circumstances. Further research is needed to understand the specific factors and mechanisms involved in bullying victimization among immigrant youth.
A chapter a day: association of book reading with longevity. Bavishi A, Slade MD, Levy BR. Soc Sci Med. 2016 Sep;164:44-8.
Although books can expose people to new people and places, whether books also have health benefits beyond other types of reading materials is not known. This study examined whether those who read books have a survival advantage over those who do not read books and over those who read other types of materials, and if so, whether cognition mediates this book reading effect. The cohort consisted of 3635 participants in the nationally representative Health and Retirement Study who provided information about their reading patterns at baseline. Cox proportional hazards models were based on survival information up to 12 years after baseline. A dose-response survival advantage was found for book reading by tertile (HRT2 = 0.83, p < 0.001, HRT3 = 0.77, p < 0.001), after adjusting for relevant covariates including age, sex, race, education, comorbidities, self-rated health, wealth, marital status, and depression. Book reading contributed to a survival advantage that was significantly greater than that observed for reading newspapers or magazines (tT2 = 90.6, p < 0.001; tT3 = 67.9, p < 0.001). Compared to non-book readers, book readers had a 23-month survival advantage at the point of 80% survival in the unadjusted model. A survival advantage persisted after adjustment for all covariates (HR = .80, p < .01), indicating book readers experienced a 20% reduction in risk of mortality over the 12 years of follow up compared to non-book readers. Cognition mediated the book reading-survival advantage (p = 0.04). These findings suggest that the benefits of reading books include a longer life in which to read them.
Creating highly reliable health care. Vogus TJ, Iacobucci D. ILR Rev. 2016 Aug;69(4):911-938.
Hospitals are increasingly looking to new work practices and processes to reduce the epidemic of medical errors. The authors examine one such innovative approach emulating high-reliability organizations (e.g., nuclear power plants) that use a combination of specific work practices and behavioral processes to detect and adapt to unexpected events to operate in a nearly error-free manner. They explore whether and how reliability-enhancing work practices (REWPs) help enable such processes and improve performance (i.e., reduce errors). Using survey and archival data from 1,685 registered nurses and 95 nurse managers in 95 hospital nursing units, the authors examine how REWPs affect a set of attitudinal (affective commitment and organizational citizenship behavior) and discursive (respectful interaction and mindful organizing) processes and, in turn, patient safety. They find the greater use of REWPs are directly and indirectly (through respectful interaction and mindful organizing) associated with fewer medication errors and patient falls. In contrast, organizational citizenship behavior was associated with more medication errors and patient falls.
Epidemic arboviral diseases: priorities for research and public health. Wilder-Smith A, Gubler DJ, Weaver SC, et al. Lancet Infect Dis. 2016 Dec 20. pii: S1473-3099(16)30518-7. doi: 10.1016/S1473-3099(16)30518-7. [Epub ahead of print]
For decades, arboviral diseases were considered to be only minor contributors to global mortality and disability. As a result, low priority was given to arbovirus research investment and related public health infrastructure. The past five decades, however, have seen an unprecedented emergence of epidemic arboviral diseases (notably dengue, chikungunya, yellow fever, and Zika virus disease) resulting from the triad of the modern world: urbanisation, globalisation, and international mobility. The public health emergency of Zika virus, and the threat of global spread of yellow fever, combined with the resurgence of dengue and chikungunya, constitute a wake-up call for governments, academia, funders, and WHO to strengthen programmes and enhance research in aedes-transmitted diseases. The common features of these diseases should stimulate similar research themes for diagnostics, vaccines, biological targets and immune responses, environmental determinants, and vector control measures. Combining interventions known to be effective against multiple arboviral diseases will offer the most cost-effective and sustainable strategy for disease reduction. New global alliances are needed to enable the combination of efforts and resources for more effective and timely solutions.
Financial care for older adults with dementia. Pan X, Lee Y, Dye C, Roley LT. Int J Aging Hum Dev. 2016 Jan 1:91415016685327. doi: 10.1177/0091415016685327. [Epub ahead of print]
This article describes an examination of the sociodemographic characteristics of adult children, particularly Baby Boomer caregivers, who provide financial care to older parents with dementia. The sample including 1,011adult children dementia caregivers aged 50 to 64 years is selected from a nationally representative sample in the 2010 Health and Retirement Study. Exact logistic regression revealed that race, provision of financial assistance to caregiver children, and the number of their children are significantly associated with financial caregiving of parents. Non-White caregivers are more likely to provide financial care to their parents or parents-in-law with dementia; those who have more children and provide financial assistance to their children are less likely to provide financial care to parents with dementia. The current findings present valuable new information on the sociodemographic characteristics of adult children who provide financial assistance to parents with dementia and inform research, programs, and services on dementia caregiving.
Genetic risk, adherence to a healthy lifestyle, and coronary disease. Khera AV, Emdin CA, Drake I, et al. N Engl J Med. 2016 Dec 15;375(24):2349-2358.
Background: Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown. Methods: Using a polygenic score of DNA sequence polymorphisms, we quantified genetic risk for coronary artery disease in three prospective cohorts - 7814 participants in the Atherosclerosis Risk in Communities (ARIC) study, 21,222 in the Women's Genome Health Study (WGHS), and 22,389 in the Malmö Diet and Cancer Study (MDCS) - and in 4260 participants in the cross-sectional BioImage Study for whom genotype and covariate data were available. We also determined adherence to a healthy lifestyle among the participants using a scoring system consisting of four factors: no current smoking, no obesity, regular physical activity, and a healthy diet. Results: The relative risk of incident coronary events was 91% higher among participants at high genetic risk (top quintile of polygenic scores) than among those at low genetic risk (bottom quintile of polygenic scores) (hazard ratio, 1.91; 95% confidence interval [CI], 1.75 to 2.09). A favorable lifestyle (defined as at least three of the four healthy lifestyle factors) was associated with a substantially lower risk of coronary events than an unfavorable lifestyle (defined as no or only one healthy lifestyle factor), regardless of the genetic risk category. Among participants at high genetic risk, a favorable lifestyle was associated with a 46% lower relative risk of coronary events than an unfavorable lifestyle (hazard ratio, 0.54; 95% CI, 0.47 to 0.63). This finding corresponded to a reduction in the standardized 10-year incidence of coronary events from 10.7% for an unfavorable lifestyle to 5.1% for a favorable lifestyle in ARIC, from 4.6% to 2.0% in WGHS, and from 8.2% to 5.3% in MDCS. In the BioImage Study, a favorable lifestyle was associated with significantly less coronary-artery calcification within each genetic risk category. Conclusions: Across four studies involving 55,685 participants, genetic and lifestyle factors were independently associated with susceptibility to coronary artery disease. Among participants at high genetic risk, a favorable lifestyle was associated with a nearly 50% lower relative risk of coronary artery disease than was an unfavorable lifestyle.
Mere experience of low subjective socioeconomic status stimulates appetite and food intake. Cheon BK, Hong YY. Proc Natl Acad Sci U S A. 2017 Jan 3;114(1):72-77.
Among social animals, subordinate status or low social rank is associated with increased caloric intake and weight gain. This may reflect an adaptive behavioral pattern that promotes acquisition of caloric resources to compensate for low social resources that may otherwise serve as a buffer against environmental demands. Similarly, diet-related health risks like obesity and diabetes are disproportionately more prevalent among people of low socioeconomic resources. Whereas this relationship may be associated with reduced financial and material resources to support healthier lifestyles, it remains unclear whether the subjective experience of low socioeconomic status may alone be sufficient to stimulate consumption of greater calories. Here we show that the mere feeling of lower socioeconomic status relative to others stimulates appetite and food intake. Across four studies, we found that participants who were experimentally induced to feel low (vs. high or neutral) socioeconomic status subsequently exhibited greater automatic preferences for high-calorie foods (e.g., pizza, hamburgers), as well as intake of greater calories from snack and meal contexts. Moreover, these results were observed even in the absence of differences in access to financial resources. Our results demonstrate that among humans, the experience of low social class may contribute to preferences and behaviors that risk excess energy intake. These findings suggest that psychological and physiological systems regulating appetite may also be sensitive to subjective feelings of deprivation for critical nonfood resources (e.g., social standing). Importantly, efforts to mitigate the socioeconomic gradient in obesity may also need to address the psychological experience of low social status.
Preclinical Alzheimer's disease: definition, natural history, and diagnostic criteria. Dubois B, Hampel H, Feldman HH, et al. Alzheimers Dement. 2016 Mar;12(3):292-323.
During the past decade, a conceptual shift occurred in the field of Alzheimer's disease (AD) considering the disease as a continuum. Thanks to evolving biomarker research and substantial discoveries, it is now possible to identify the disease even at the preclinical stage before the occurrence of the first clinical symptoms. This preclinical stage of AD has become a major research focus as the field postulates that early intervention may offer the best chance of therapeutic success. To date, very little evidence is established on this "silent" stage of the disease. A clarification is needed about the definitions and lexicon, the limits, the natural history, the markers of progression, and the ethical consequence of detecting the disease at this asymptomatic stage. This article is aimed at addressing all the different issues by providing for each of them an updated review of the literature and evidence, with practical recommendations.
Preparedness in Long-Term Care: A Novel Approach to Address Gaps in Evacuation Tracking. Prot EY, Clements B. Disaster Med Public Health Prep. 2016 Dec 29:1-3.
With an aging population, the number of elderly individuals residing in long-term care (LTC) facilities will continue to grow and pose unique challenges to disaster preparedness and response. With this rapidly growing vulnerable population, it becomes imperative to identify enhanced and novel preparedness strategies and measures. LTC residents not only have complicated medical needs, including the timing of dispensing multiple medications, but frequently have cognitive and mobility deficits as well. In nearly every major disaster, elderly populations have suffered disproportionate morbidity and mortality. This is often due to elderly evacuees getting overlooked in the chaos of an initial response. Instituting measures to rapidly recognize this population in a crowd during an evacuation will reduce their risk. This commentary reviews the LTC facility evacuation challenges of the 2013 explosion of the West Fertilizer Company plant in West, Texas, and offers a novel solution of mandating the wearing of pink vests by all nursing home residents in case of an evacuation. The pink vests quickly alert disaster rescue and response workers of LTC residents with special needs.
Reducing recreational sedentary screen time: a community guide systematic review. Ramsey Buchanan L, Rooks-Peck CR, Finnie RK, et al. Am J Prev Med. 2016 Mar;50(3):402-15.
Context: Sedentary time spent with screen media is associated with obesity among children and adults. Obesity has potentially serious health consequences, such as heart disease and diabetes. This Community Guide systematic review examined the effectiveness and economic efficiency of behavioral interventions aimed at reducing recreational (i.e., neither school- nor work-related) sedentary screen time, as measured by screen time, physical activity, diet, and weight-related outcomes. Evidence Acquisition: For this review, an earlier ("original") review (search period, 1966 through July 2007) was combined with updated evidence (search period, April 2007 through June 2013) to assess effectiveness of behavioral interventions aimed at reducing recreational sedentary screen time. Existing Community Guide systematic review methods were used. Analyses were conducted in 2013-2014. Evidence Synthesis: The review included 49 studies. Two types of behavioral interventions were evaluated that either (1) focus on reducing recreational sedentary screen time only (12 studies); or (2) focus equally on reducing recreational sedentary screen time and improving physical activity or diet (37 studies). Most studies targeted children aged ≤13 years. Children's composite screen time (TV viewing plus other forms of recreational sedentary screen time) decreased 26.4 (interquartile interval= -74.4, -12.0) minutes/day and obesity prevalence decreased 2.3 (interquartile interval= -4.5, -1.2) percentage points versus a comparison group. Improvements in physical activity and diet were reported. Three study arms among adults found composite screen time decreased by 130.2 minutes/day. Conclusions: Among children, these interventions demonstrated reduced screen time, increased physical activity, and improved diet- and weight-related outcomes. More research is needed among adolescents and adults.
Reputation and accountability relationships: managing accountability expectations through reputation. Busuioc M, Lodge M. Public Admin Rev. 2017 Jan/Feb;77(1):91-100.
Accountability is said to be about the management of expectations. Empirical studies reveal considerable variation in organizational interest, intensity, and investment in accountability relationships. Less is known, however, about what explains these observed variations. Drawing on accountability and reputation-concerned literatures, this article argues that a reputation-based perspective on accountability offers an underlying logic that explains how account-giving actors and account-holding forums actually manage these expectations and how organizations make sense of and prioritize among accountability responsibilities. Reputational considerations act as a filtering mechanism of external demands and help account for variations in degrees of interest in, and intensity of, accountability. The resulting accountability outcomes are coproduced by the reputational investment of both account-giver and account-holder, resulting in distinct accountability constellations and outcomes.
Risks of developing breast and colorectal cancer in association with incomes and geographic locations in Texas: a retrospective cohort study. Liu Z, Zhang K, Du XL. BMC Cancer. 2016 Apr 26;16:294. doi: 10.1186/s12885-016-2324-z.
Background: No study has been conducted to investigate the spatial pattern and association of socioeconomic status (such as income) with breast and colorectal cancer incidence in Texas, United States. This study aimed to determine whether median household income was associated with the risk of developing breast and colorectal cancer in Texas and to identify higher cancer risks by race/ethnicity and geographic areas. Methods: This was a retrospective cohort study with an ecological component in using aggregated measures at the county level. We identified 243,677 women with breast cancer and 155,534 men and women with colorectal cancer residing in 254 counties in Texas in 1995-2011 from the public-use dataset of Texas Cancer Registry. The denominator population and median household income at the county level was obtained from the U.S. Bureau of the Census. Cancer incidence rates were calculated as number of cases per 100,000 persons and age-adjusted using the 2000 US population data. We used the ArcGIS v10.1 (geographic information system software) to identify multiple clustered counties with high and low cancer incidences in Texas. Results: Age-adjusted breast cancer incidence rate in the highest median income quintile group was 151.51 cases per 100,000 in 2008-2011 as compared to 98.95 cases per 100,000 in the lowest median income quintile group. The risk of colorectal cancer appeared to decrease with increasing median income in racial/ethnic population. Spatial analysis revealed the significant low breast cancer incidence cluster regions located in southwest US-Mexico border counties in Texas. Conclusions: This study demonstrated that higher income was associated with an increased risk of breast cancer and a decreased risk of colorectal cancer in Texas. There were geographic variations with cancer incidence clustered in high risk areas in Texas. Future studies may need to explore more factors that might explain income and cancer risk associations and their geographic variations.
Self-reported traumatic brain injury and mild cognitive impairment: increased risk and earlier age of diagnosis. LoBue C, Denney D, Hynan LS, et al. J Alzheimers Dis. 2016;51(3):727-36.
This study examined whether history of traumatic brain injury (TBI) is associated with increased risk and earlier onset of mild cognitive impairment (MCI). Subjects with MCI (n = 3,187) and normal cognition (n = 3,244) were obtained from the National Alzheimer's Coordinating Center database. TBI was categorized based on lifetime reported TBI with loss of consciousness (LOC) without chronic deficit. Logistic regression was used to examine TBI history as a predictor of MCI, adjusted for demographics, apolipoprotein E-ɛ4 (ApoE4), a composite vascular risk score, and history of psychiatric factors. ANCOVA was used to examine whether age at MCI diagnosis and estimated age of onset differed between those with (TBI+) and without (TBI-) a history of TBI. TBI history was a significant predictor (p < 0.01) and associated with increased odds of MCI diagnosis in unadjusted (OR = 1.25; 95% CI = 1.05-1.49) and adjusted models, accounting for age, education, ApoE4, and a composite vascular score (OR = 1.32; 95% CI = 1.10-1.58). This association, however, was largely attenuated (OR = 1.14; 95% CI = 0.94-1.37; p = 0.18) after adjustment for reported history of depression. MCI was diagnosed a mean of 2.3 years earlier (p < 0.001) in the TBI+ group, and although TBI+ subjects had an estimated mean of decline 1.7 years earlier, clinician-estimated age of onset failed to differ (p = 0.13) when gender and psychiatric factors were controlled. This is the first report of a possible role for TBI as a risk factor in MCI, but its association may be related to other factors such as gender and depression and requires further investigation.
Statin use for the primary prevention of cardiovascular disease in adults: US Preventive Services Task Force recommendation statement. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. JAMA. 2016 Nov 15;316(19):1997-2007.
Importance: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States, accounting for 1 of every 3 deaths among adults. Objective: To update the 2008 US Preventive Services Task Force (USPSTF) recommendation on screening for lipid disorders in adults. Evidence Review: The USPSTF reviewed the evidence on the benefits and harms of screening for and treatment of dyslipidemia in adults 21 years and older; the benefits and harms of statin use in reducing CVD events and mortality in adults without a history of CVD events; whether the benefits of statin use vary by subgroup, clinical characteristics, or dosage; and the benefits of various treatment strategies in adults 40 years and older without a history of CVD events. Conclusions and Recommendations: The USPSTF recommends initiating use of low- to moderate-dose statins in adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of 10% or greater (B recommendation). The USPSTF recommends that clinicians selectively offer low- to moderate-dose statins to adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors and a calculated 10-year CVD event risk of 7.5% to 10% (C recommendation). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of initiating statin use in adults 76 years and older (I statement).
Towards an integrated primary and secondary HIV prevention continuum for the United States: a cyclical process model. Horn T, Sherwood J, Remien RH, et al. J Int AIDS Soc. 2016 Nov 17;19(1):21263. doi: 10.7448/IAS.19.1.21263.
Introduction: Every new HIV infection is preventable and every HIV-related death is avoidable. As many jurisdictions around the world endeavour to end HIV as an epidemic, missed HIV prevention and treatment opportunities must be regarded as public health emergencies, and efforts to quickly fill gaps in service provision for all people living with and vulnerable to HIV infection must be prioritized. Discussion: We present a novel, comprehensive, primary and secondary HIV prevention continuum model for the United States as a conceptual framework to identify key steps in reducing HIV incidence and improving health outcomes among those vulnerable to, as well as those living with, HIV infection. We further discuss potential approaches to address gaps in data required for programme planning, implementation and evaluation across the elements of the HIV prevention continuum. Conclusions: Our model conceptualizes opportunities to monitor and quantify primary HIV prevention efforts and, importantly, illustrates the interplay between an outcomes-oriented primary HIV prevention process and the HIV care continuum to move aggressively forward in reaching ambitious reductions in HIV incidence. To optimize the utility of this outcomes-oriented HIV prevention continuum, a key gap to be addressed includes the creation and increased coordination of data relevant to HIV prevention across sectors.
1. Determinants in the Acceptance of HL7 V3 Messaging Standard by Wilfred Bonney.
2. The First Two Rules of Leadership: Don't Be Stupid, Don't Be a Jerk by David Cottrell.
3. HL7 for Busy Professionals: Your No Sweat Guide to Understanding HL7 by Rahul Bhagat and Calvin Hui.
4. Medicaid Politics and Policy, 2nd ed., by David G. Smith and Judith D. Moore.
5. PMP: Project Management Professional Exam Study Guide, 8th ed., by Kim Heldman.
6. Presenting an Effective and Dynamic Technical Paper: A Guidebook for Novice and Experienced Speakers in a Multicultural World by William B. Krantz.
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