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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles
News and training opportunities
ToxNet training: Join the NN/LM Training Office for a free, online class to discover TOXNET and other National Library of Medicine environmental health databases through videos, guided tutorials, and discovery exercises. The class is taught online, over a 4 week period, in thirteen independent modules. Take only the modules that interest you. Visit this URL to register: https://nnlm.gov/ntc/classes/class_details.html?class_id=809
Cool websites and reports on hot topics*
Ageing and Life Course is a web page from the World Health Organization. It also includes a link to the 2015 World report on ageing and health. See http://www.who.int/ageing/en/
A Closer Look at Declining Fruit and Vegetable Consumption Using Linked Data Sources
by Biing-Hwan Lin and Rosanna Mentzer Morrison, Amber Waves, July 5, 2016. See http://www.ers.usda.gov/amber-waves/2016-july/a-closer-look-at-declining-fruit-and-vegetable-consumption-using-linked-data-sources.aspx#.V4_iGfkrKUk
Ensuring Quality and Accessible Care for Children with Disabilities and Complex Health and Educational Needs: Workshop in Brief (2016). Presenters and workshop participants discussed the epidemiology of disabilities, the behavioral health implications of having multiple or chronic medical conditions, early identification and interventions in different population groups, and the role of the media in shaping perceptions and misperceptions of disabilities. See http://www.nap.edu/catalog/23544/ensuring-quality-and-accessible-care-for-children-with-disabilities-and-complex-health-and-educational-needs
Health Risks of Indoor Exposure to Particulate Matter: Workshop Summary (2016). Participants of a workshop discussed the ailments that are most affected by particulate matter and the attributes of the exposures that are of greatest concern, exposure modifiers, vulnerable populations, exposure assessment, risk management, and gaps in the science. See http://www.nap.edu/catalog/23531/health-risks-of-indoor-exposure-to-particulate-matter-workshop-summary
Meeting the Dietary Needs of Older Adults: Exploring the Impact of the Physical, Social, and Cultural Environment: Workshop Summary (2016). Participants of a workshop examined factors in the physical, social, and cultural environment that affect the ability of older adults to meet their daily dietary needs. This report summarizes the discussions from the workshop. See http://www.nap.edu/catalog/23496/meeting-the-dietary-needs-of-older-adults-exploring-the-impact
The Nation's Medical Countermeasure Stockpile: Opportunities to Improve the Efficiency, Effectiveness, and Sustainability of the CDC Strategic National Stockpile: Workshop Summary (2016). Participants explored relevant distribution lessons learned from other federal agency stockpiles and the private sector as well as opportunities to develop public-private collaborations in the purchase, warehousing, management, and distribution of medical countermeasures. See https://www.nap.edu/catalog/23532/the-nations-medical-countermeasure-stockpile-opportunities-to-improve-the-efficiency
State of America’s Fathers by Promundo-US takes an honest look at what it means to be a dad in the United States today, how it's different than ever before, and the future of this fatherhood revolution. See http://men-care.org/soaf/download/PRO16001_Americas_Father_web.pdf.
Strategies to De-escalate Aggressive Behavior in Psychiatric Patients: Evidence-Based Report. Comparative Effectiveness Review, Number 180, Agency for Healthcare Research and Quality (AHRQ). See https://www.effectivehealthcare.ahrq.gov/ehc/products/613/2256/aggression-%20executive-160713.pdf
Violence Related Trauma Resources: a website from the Office of Minority Health, US Dept. of Health and Human Services provides resources designed to help communities support emotional well-being and recovery after traumatic events such as the recent mass shootings. See http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=85
Interesting journal articles
Creating a community of transformation. Greene-Ryan, J. Nursing Management. May2016, Vol. 47 Issue 5, p18-21.
The article discusses transformative actions for healthcare leaders that support commitment to change. Topics covered include the need for a leader to be a role model for colleagues and patients to demonstrate willingness to change, to serve as inspiration for others to join the forward movement, and to be open to new approaches that challenge the status quo. Also noted is the need for a leader to help others achieve their dreams.
Genetic risk factors for type 1 diabetes. Pociot F, Lernmark Å. Lancet. 2016 Jun 4;387(10035):2331-9.
Type 1 diabetes is diagnosed at the end of a prodrome of β-cell autoimmunity. The disease is most likely triggered at an early age by autoantibodies primarily directed against insulin or glutamic acid decarboxylase, or both, but rarely against islet antigen-2. After the initial appearance of one of these autoantibody biomarkers, a second, third, or fourth autoantibody against either islet antigen-2 or the ZnT8 transporter might also appear. The larger the number of β-cell autoantibody types, the greater the risk of rapid progression to clinical onset of diabetes. This association does not necessarily mean that the β-cell autoantibodies are pathogenic, but rather that they represent reproducible biomarkers of the pathogenesis. The primary risk factor for β-cell autoimmunity is genetic, mainly occurring in individuals with either HLA-DR3-DQ2 or HLA-DR4-DQ8 haplotypes, or both, but a trigger from the environment is generally needed. The pathogenesis can be divided into three stages: 1, appearance of β-cell autoimmunity, normoglycaemia, and no symptoms; 2, β-cell autoimmunity, dysglycaemia, and no symptoms; and 3, β-cell autoimmunity, dysglycaemia, and symptoms of diabetes. The genetic association with each one of the three stages can differ. Type 1 diabetes could serve as a disease model for organ-specific autoimmune disorders such as coeliac disease, thyroiditis, and Addison's disease, which show similar early markers of a prolonged disease process before clinical diagnosis.
Head impact magnitude in American high school football. Schmidt JD, Guskiewicz KM, Mihalik JP, et al., Pediatrics. 2016 Jul 18. pii: e20154231. [Epub ahead of print]
Objectives: To describe determinants of head impact magnitudes between various play aspects in high school football. Methods: Thirty-two high school American football players wore Head Impact Telemetry System instrumented helmets to capture head impact magnitude (linear acceleration, rotational acceleration, and Head Impact Technology severity profile [HITsp]). We captured and analyzed video from 13 games (n = 3888 viewable head impacts) to determine the following play aspects: quarter, impact cause, play type, closing distance, double head impact, player's stance, player's action, direction of gaze, athletic readiness, level of anticipation, player stationary, ball possession, receiving ball, and snapping ball. We conducted random intercepts general linear mixed models to assess the differences in head impact magnitude between play aspects (α = 0.05). Results: The following aspects resulted in greater head impact magnitude: impacts during the second quarter (HITsp: P = .03); contact with another player (linear, rotational, HITsp: P < .001); initial head impact when the head is struck twice (linear, rotational, HITsp: P < .001); longer closing distances, especially when combined with a 3-point stance or when being struck in the head (linear: P = .03); the 2-point stance (linear, rotational, HITsp: P < .001); and offensive linemen not snapping the ball compared with those snapping the ball (rotational: P = .02, HITsp: P = .02). Conclusions: Preventing head impacts caused by contact with another player may reduce head impact magnitude in high school football. Rule or coaching changes that reduce collisions after long closing distances, especially when combined with the 3-point stance or when a player is being struck in the head, should be considered.
Health spending for low-, middle-, and high-income Americans, 1963-2012. Dickman SL1, Woolhandler S2, Bor J3, et al. Health Aff (Millwood). 2016 Jul 1;35(7):1189-96.
US medical spending growth slowed between 2004 and 2013. At the same time, many Americans faced rising copayments and deductibles, which may have particularly affected lower-income people. To explore whether the health spending slowdown affected all income groups equally, we divided the population into income quintiles. We then assessed trends in health expenditures by and on behalf of people in each quintile using twenty-two national surveys carried out between 1963 and 2012. Before the 1965 passage of legislation creating Medicare and Medicaid, the lowest income quintile had the lowest expenditures, despite their worse health compared to other income groups. By 1977 the unadjusted expenditures for the lowest quintile exceeded those for all other income groups. This pattern persisted until 2004. Thereafter, expenditures fell for the lowest quintile, while rising more than 10 percent for the middle three quintiles and close to 20 percent for the highest income quintile, which had the highest expenditures in 2012. The post-2004 divergence of expenditure trends for the wealthy, middle class, and poor occurred only among the nonelderly. We conclude that the new pattern of spending post-2004, with the wealthiest quintile having the highest expenditures for health care, suggests that a redistribution of care toward wealthier Americans accompanied the health spending slowdown.
Presentation of benefits and harms in US cancer screening and prevention guidelines: systematic review. Caverly TJ, Hayward RA, Reamer E, et al. J Natl Cancer Inst. 2016 Feb 24;108(6):djv436. doi: 10.1093/jnci/djv436. Print 2016 Jun.
Background: Cancer prevention and screening guidelines are ideally suited to the task of providing high-quality benefit-harm information that informs clinical practice. We systematically examined how US guidelines present benefits and harms for recommended cancer prevention and screening interventions. Methods: We included cancer screening and prevention recommendations from: 1) the United States Preventive Services Task Force, 2) the American Cancer Society, 3) the American College of Physicians, 4) the National Comprehensive Cancer Network, and 5) other US guidelines within the National Guidelines Clearinghouse. Searches took place November 20, 2013, and January 1, 2014, and updates were reviewed through July 1, 2015. Two coders used an abstraction form to code information about benefits and harms presented anywhere within a guideline document, including appendices. The primary outcome was each recommendation's benefit-harm "comparability" rating, based on how benefits and harms were presented. Recommendations presenting absolute effects for both benefits and harms received a "comparable" rating. Other recommendations received an incomplete rating or an asymmetric rating based on prespecified criteria. Results: Fifty-five recommendations for using interventions to prevent or detect breast, prostate, colon, cervical, and lung cancer were identified among 32 guidelines. Thirty point nine percent (n = 17) received a comparable rating, 14.5% (n = 8) received an incomplete rating, and 54.5% (n = 30) received an asymmetric rating. Conclusions: Sixty-nine percent of cancer prevention and screening recommendation statements either did not quantify benefits and harms or presented them in an asymmetric manner. Improved presentation of benefits and harms in guidelines would better ensure that clinicians and patients have access to the information required for making informed decisions.
Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. JAMA. 2016 May 3;315(17):1864-73.
The National Action Plan for Combating Antibiotic-Resistant Bacteria set a goal of reducing inappropriate outpatient antibiotic use by 50% by 2020, but the extent of inappropriate outpatient antibiotic use is unknown. Objective: To estimate the rates of outpatient oral antibiotic prescribing by age and diagnosis, and the estimated portions of antibiotic use that may be inappropriate in adults and children in the United States. Design, Setting, and Participants: Using the 2010-2011 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, annual numbers and population-adjusted rates with 95% confidence intervals of ambulatory visits with oral antibiotic prescriptions by age, region, and diagnosis in the United States were estimated. Exposures: Ambulatory care visits. Main Outcomes and Measures: Based on national guidelines and regional variation in prescribing, diagnosis-specific prevalence and rates of total and appropriate antibiotic prescriptions were determined. These rates were combined to calculate an estimate of the appropriate annual rate of antibiotic prescriptions per 1000 population. Results: Of the 184,032 sampled visits, 12.6% of visits (95% CI, 12.0%-13.3%) resulted in antibiotic prescriptions. Sinusitis was the single diagnosis associated with the most antibiotic prescriptions per 1000 population (56 antibiotic prescriptions [95% CI, 48-64]), followed by suppurative otitis media (47 antibiotic prescriptions [95% CI, 41-54]), and pharyngitis (43 antibiotic prescriptions [95% CI, 38-49]). Collectively, acute respiratory conditions per 1000 population led to 221 antibiotic prescriptions (95% CI, 198-245) annually, but only 111 antibiotic prescriptions were estimated to be appropriate for these conditions. Per 1000 population, among all conditions and ages combined in 2010-2011, an estimated 506 antibiotic prescriptions (95% CI, 458-554) were written annually, and, of these, 353 antibiotic prescriptions were estimated to be appropriate antibiotic prescriptions. Conclusions and Relevance: In the United States in 2010-2011, there was an estimated annual antibiotic prescription rate per 1000 population of 506, but only an estimated 353 antibiotic prescriptions were likely appropriate, supporting the need for establishing a goal for outpatient antibiotic stewardship.
Promoting value for consumers: comparing individual health insurance markets inside and outside the ACA's exchanges. McCue MJ, Hall MA. Issue Brief (Commonw Fund). 2016 Jun;12:1-10.
The new health insurance exchanges are the core of the Affordable Care Act's (ACA) insurance reforms, but insurance markets beyond the exchanges also are affected by the reforms. This issue brief compares the markets for individual coverage on and off of the exchanges, using insurers' most recent projections for ACA-compliant policies. In 2016, insurers expect that less than one-fifth of ACA-compliant coverage will be sold outside of the exchanges. Insurers that sell mostly through exchanges devote a greater portion of their premium dollars to medical care than do insurers selling only off of the exchanges, because exchange insurers project lower administrative costs and lower profit margins. Premium increases on exchange plans are less than those for off-exchange plans, in large part because exchange enrollment is projected to shift to closed-network plans. Finally, initial concerns that insurers might seek to segregate higher-risk subscribers on the exchanges have not been realized.
Risk prediction models in psychiatry: toward a new frontier for the prevention of mental illnesses. Bernardini F, Attademo L, Cleary SD, et al. J Clin Psychiatry. 2016 Jun 21. doi: 10.4088/JCP.15r10003. [Epub ahead of print]
Objective: We conducted a systematic, qualitative review of risk prediction models designed and tested for depression, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, and psychotic disorders. Our aim was to understand the current state of research on risk prediction models for these 5 disorders and thus future directions as our field moves toward embracing prediction and prevention. Data Sources: Systematic searches of the entire MEDLINE electronic database were conducted independently by 2 of the authors (from 1960 through 2013) in July 2014 using defined search criteria. Search terms included risk prediction, predictive model, or prediction model combined with depression, bipolar, manic depressive, generalized anxiety, posttraumatic, PTSD, schizophrenia, or psychosis. Study Selection: We identified 268 articles based on the search terms and 3 criteria: published in English, provided empirical data (as opposed to review articles), and presented results pertaining to developing or validating a risk prediction model in which the outcome was the diagnosis of 1 of the 5 aforementioned mental illnesses. We selected 43 original research reports as a final set of articles to be qualitatively reviewed. Data Extraction: The 2 independent reviewers abstracted 3 types of data (sample characteristics, variables included in the model, and reported model statistics) and reached consensus regarding any discrepant abstracted information. Results: Twelve reports described models developed for prediction of major depressive disorder, 1 for bipolar disorder, 2 for generalized anxiety disorder, 4 for posttraumatic stress disorder, and 24 for psychotic disorders. Most studies reported on sensitivity, specificity, positive predictive value, negative predictive value, and area under the (receiver operating characteristic) curve. Conclusions: Recent studies demonstrate the feasibility of developing risk prediction models for psychiatric disorders (especially psychotic disorders). The field must now advance by (1) conducting more large-scale, longitudinal studies pertaining to depression, bipolar disorder, anxiety disorders, and other psychiatric illnesses; (2) replicating and carrying out external validations of proposed models; (3) further testing potential selective and indicated preventive interventions; and (4) evaluating effectiveness of such interventions in the context of risk stratification using risk prediction models.
Special issue on occupational therapy for adults with traumatic brain injury. Powell JM1. Am J Occup Ther. 2016 May-Jun;70(3):7003170010p1-4. doi: 10.5014/ajot.2016.703002.
Awareness of the incidence and consequences of traumatic brain injury (TBI) has increased in recent years, along with interest in knowing how best to treat this complex condition. This editorial provides an overview of the various factors that contribute to the complexity of TBI and introduces the six systematic reviews and one qualitative study included in this special issue of the American Journal of Occupational Therapy focusing on interventions for TBI from an occupational therapy perspective. Issues with the generation and interpretation of research evidence are discussed, along with the importance of valuing clinician expertise and client perspectives along with research findings in implementing evidence-based and evidence-informed practice.
When change causes stress: effects of self-construal and change consequences. Wisse B, Sleebos E. Journal of Business & Psychology. 2016;31(2):249-264.
Organizational change can be a major stress factor for employees. We investigate if stress responses can be explained by the extent to which there is a match between employee self-construal (in personal or collective terms) and change consequences (i.e., does the change particularly have consequences for the individual or for the group). We further investigate if the interactive effect of self-construal and change consequences on stress will be mediated by feelings of uncertainty. Design/Methodology/Approach: Data were obtained in three studies. Study 1, a laboratory study, focused on physiological stress. Study 2, a business scenario, focused on anticipated stress. Study 3, a cross-sectional survey, focused on perceived stress. Studies 2 and 3 also included measures of uncertainty in order to test its mediating qualities. Findings: Change is more likely to lead to stress when the change has consequences for matters that are central to employees' sense of self, and particularly so when the personal self is salient. This effect is mediated by feelings of uncertainty. Implications: Understanding why some people experience stress during change, while others do so to a lesser extent, may be essential for improving change management practices. It may help to prevent change processes being unnecessarily stressful for employees. Originality/Value: This is one of the first studies to show that different kinds of change may be leading to uncertainty or stress, depending on employees' level of self-construal. The multi-method approach boosts the confidence in our findings.
1. Behavior Theory in Health Promotion Practice and Research
2. Behavioral Neuroscience for the Human Services: Foundations in Emotion, Mental Health, Addiction, and Alternative Therapies
3. Borderline Personality Disorder: A Guide for the Newly Diagnosed
4. The Brain-Friendly Workplace: 5 Big Ideas from Neuroscience that Address Organizational Challenges
5. Change Your Questions, Change Your Life: 12 Powerful Tools for Leadership, Coaching, and Life
6. Developing Quality Technical Information: A Handbook for Writers and Editors
7. Electronic Health Records: Understanding and Using Computerized Medical Records, 2nd ed.
8. Handbook of Informatics for Nurses & Healthcare Professionals, 5th ed.
9. Hospital Epidemiology and Infection Control, 4th ed
10. How to Write It: A complete guide to everything you'll ever write
11. Interviewing Users: How to Uncover Compelling Insights
12. Jab, Jab, Jab, Right Hook: How to Tell Your Story in a Noisy Social World
13. Management of Adults with Traumatic Brain Injury
14. Mastering the Challenges of Leading Change: Inspire the People and Succeed Where Others Fail
15. McGraw-Hill Homeland Security Handbook: Strategic Guidance for a Coordinated Approach to Effective Security and Emergency Management, 2nd ed
16. Microsoft Manual of Style, 4th ed
17. Microsoft SQL Server Step by Step 2012
18. Navigating life with multiple sclerosis
19. The Only Grant-Writing Book You’ll Ever Need, 4th ed.
20. Post-traumatic Stress Disorder and Chronic Health Conditions
21. The Process Matters: Engaging and Equipping People for Success
22. The Smart but Scattered Guide to Success: How to Use Your Brain's Executive Skills to Keep Up, Stay Calm, and Get Organized at Work and at Home
23. Statistical Analysis with Missing Data
24. Shortell and Kaluzny's health care management: organization, design, and behavior
25. Tableau Your Data!: Fast and Easy Visual Analysis With Tableau Software
26. Taking Control of Anxiety: Small Steps for Getting the Best of Worry, Stress and Fear
27. Terrorism and Public Health: A Balanced Approach to Strengthening Systems and Protecting People, 2nd ed.
28. Uncovering Happiness: Overcoming Depression with Mindfulness and Self-Compassion
29. A Web for Everyone: Designing Accessible User Experiences
30. When Psychological Problems Mask Medical Disorders: A Guide for Psychotherapists, 2nd ed.
31. Women, Work, and Autoimmune Disease: Keep Working, Girlfriend
32. Writing Skills for Social Workers
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