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Medical and Research Library News - April 2021

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Training opportunities
Websites and reports on trending topics
Journal articles of note           

April 2021

Training opportunities

Note: The following webinars and online classes are not affiliated with DSHS or the DSHS Library. They are presented here as opportunities to learn more information of interest to public health personnel. All times listed are in Central Daylight Time.

April 8, 2021; 12-1 p.m. Texas KIDS COUNT: Health equity for every Texas child. All children deserve the opportunity for a healthy life. In Texas, not all children have the health insurance, food security, and economic security needed for a healthy childhood, due to disparities rooted in systemic racism. Public policy can improve health equity for all Texas children. Presented by The Michael & Susan Dell Center for Healthy Living. https://register.gotowebinar.com/register/8160359111212337933

April 13, 2021; 12-1 p.m. Addressing food insecurity among young children during the pandemic: Innovations from Vermont and Washington State. This webinar, made possible by the Robert Wood Johnson Foundation, will explore practical strategies to assess and address hunger needs faced by families during the pandemic and beyond, including leveraging early childhood systems and the Help Me Grow system model to address child food insecurity. It will highlight innovative solutions used in Vermont and Washington State, with examples from federal, state, and community-level resources. https://www.chcs.org/resource/addressing-food-insecurity-among-young-children-during-the-pandemic-innovations-from-vermont-and-washington-state/?utm_source=CHCS+Email+Updates&utm_campaign=87a863f48c-AECM+Webinar+3%2F26%2F21&utm_medium=email&utm_term=0_bbced451bf-87a863f48c-152131573

April 20, 2021; 10-11 a.m. Social and environmental determinants of maternal health disparities and a roadmap to effective solutions. This Emerging Trends webinar series presentation will describe historical and contemporary pathways by which features of the physical and social environments likely contribute to maternal health disparities. Potential interventions along with priorities for future research will also be described. Presented by Network of the National Library of Medicine. https://nnlm.gov/class/social-and-environmental-determinants-maternal-health-disparities-and-roadmap-effective

April 22, 2021; 12:30-2 p.m. When it comes to your health, does your zip code matter more than your genetic code? Join this lecture from Dr. Anthony B. Iton to learn about the strength of the relationship between life expectancy and neighborhood. Using hundreds of thousands of death certificates, GIS mapping and other simple data analyses, a profile of life expectancy by neighborhood in seven different cities and regions will be presented. The implications for US health spending and population health management will be discussed and a model for understanding the social determinants of health will be presented. Sponsored by The Michael & Susan Dell Center for Healthy Living. https://register.gotowebinar.com/register/1890477616262252047

Websites and reports on trending topics

Environmental Health and COVID-19 Resource Library - As a result of the ongoing COVID-19 pandemic, environmental health staff at local health departments have had to adapt existing programs and respond to new challenges. To support local health officials, National Association of County and City Health Officials (NACCHO) has gathered and developed resources to address the needs of environmental public health staff during the COVID-19 pandemic. https://www.naccho.org/programs/our-covid-19-response/environmental-health-and-covid-19-resource-library

Interactive State Disability Map - Visual aids such as interactive maps and dashboards can help illuminate vital insights that might otherwise be overlooked. These insights can help states and counties identify their progress and their unmet needs. To assist decision makers, Mathematica’s Center for Studying Disability Policy recently created interactive state disability maps that reveal important patterns in state- and county-level prevalence of disability among working-age adults across the United States as well as how that prevalence compares with Social Security Disability Insurance (DI) and Supplemental Security Income (SSI) participation rates. https://www.mathematica.org/dataviz/state-disability-maps

Opioid Industry Documents Archive - The University of California, San Francisco (UCSF) and  Johns Hopkins University recently launched a digital repository of publicly disclosed documents from recent judgments, settlements, and ongoing lawsuits concerning the opioid crisis. It includes emails, memos, presentations, sales reports, budgets, audit reports, Drug Enforcement Administration briefings, meeting agendas and minutes, expert witness reports, and depositions of drug company executives. The archive serves as a living repository of information that can be used to learn from the opioid epidemic so as to improve and safeguard public policy and public health, and to ensure that the opioid-related harms that have taken place never occur again. https://www.industrydocuments.ucsf.edu/drug/collections/opioids/

Population health science in the United States: Trends, evidence, and implications for policy: Proceedings of a joint symposium – In October 2018, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine and the Interdisciplinary Association for Population Health Science convened a joint symposium in Washington, DC to consider the current state of population health science in the United States. At the symposium, speakers and participants reviewed the status of population health in the United States, including current trends in health and mortality, and racial, ethnic, and socioeconomic disparities; explored the complexities of policy implementation with attention to evidence generation and to surfacing and mitigating negative unintended consequences of policies for population health; and shared perspectives on finding common ground to move population health forward. This publication summarizes the presentation and discussion of the workshop. https://www.nap.edu/catalog/25631/population-health-science-in-the-united-states-trends-evidence-and

Journal articles of note

Chung M, Dekker D, Gridley-Smith C, Dearing JW. An emergent network for the diffusion of innovations among local health departments at the onset of the COVID-19 pandemic. Prev Chronic Dis. 2021;18:E19. Published 2021 Mar 4. doi:10.5888/pcd18.200536
Introduction: Communication networks among professionals can be pathways for accelerating the diffusion of innovations if some local health departments (LHDs) drive the spread of knowledge. Such a network could prove valuable during public health emergencies such as the novel coronavirus disease 2019 (COVID-19) pandemic. Our objective was to determine whether LHDs in the United States were tied together in an informal network to share information and advice about innovative community health practices, programs, and policies.
Methods: In January and February 2020, we conducted an online survey of 2,303 senior LHD leaders to ask several questions about their sources of advice. We asked respondents to rank up to 3 other LHDs whose practices informed their work on new public health programs, evidence-based practices, and policies intended to improve community health. We used a social network analysis program to assess answers.
Results: A total of 329 LHDs responded. An emergent network appeared to operate nationally among 740 LHDs. Eleven LHDs were repeatedly nominated by peers as sources of advice or examples (ie, opinion leaders), and 24 acted as relational bridges to hold these emergent networks together (ie, boundary spanners). Although 2 LHDs played both roles, most LHDs we surveyed performed neither of these roles.
Conclusion: Opinion leading and boundary spanning health departments can be accessed to increase the likelihood of affecting the rate of interest in and adoption of innovations. Decision makers involved in disseminating new public health practices, programs, or policies may find our results useful both for emergencies and for practice-as-usual.

Foo ACY, Thompson PM, Chen SH, et al. The mosquito protein AEG12 displays both cytolytic and antiviral properties via a common lipid transfer mechanism. Proc Natl Acad Sci U S A. 2021;118(11). doi:10.1073/pnas.2019251118
The mosquito protein AEG12 is up-regulated in response to blood meals and flavivirus infection though its function remained elusive. Here, we determine the three-dimensional structure of AEG12 and describe the binding specificity of acyl-chain ligands within its large central hydrophobic cavity. We show that AEG12 displays hemolytic and cytolytic activity by selectively delivering unsaturated fatty acid cargoes into phosphatidylcholine-rich lipid bilayers. This property of AEG12 also enables it to inhibit replication of enveloped viruses such as Dengue and Zika viruses at low micromolar concentrations. Weaker inhibition was observed against more distantly related coronaviruses and lentivirus, while no inhibition was observed against the nonenveloped virus adeno-associated virus. Together, our results uncover the mechanistic understanding of AEG12 function and provide the necessary implications for its use as a broad-spectrum therapeutic against cellular and viral targets.

Mandra AM, Superior MJ, Guagliardo SAJ, et al. Myopericarditis associated with smallpox vaccination among US army personnel - Fort Hood, Texas, 2018 [published online ahead of print, 2021 Mar 15]. Disaster Med Public Health Prep. 2021;1-7. doi:10.1017/dmp.2020.478
Objective: In March 2018, the US Department of Defense (DOD) added the smallpox vaccination, using ACAM2000, to its routine immunizations, increasing the number of persons receiving the vaccine. The following month, Fort Hood reported a cluster of 5 myopericarditis cases. The Centers for Disease Control and Prevention and the DOD launched an investigation.
Methods: The investigation consisted of a review of medical records, establishment of case definitions, causality assessment, patient interviews, and active surveillance. A 2-sided exact rate ratio test was used to compare myopericarditis incidence rates.
Results: This investigation identified 4 cases of probable myopericarditis and 1 case of suspected myopericarditis. No alternative etiology was identified as a cause. No additional cases were identified. There was no statistically significant difference in incidence rates between the observed cluster (5.23 per 1000 vaccinated individuals, 95% CI: 1.7-12.2) and the ACAM2000 clinical trial outcomes for symptomatic persons, which was 2.29 per 1000 vaccinated individuals (95% CI: 0.3-8.3).
Conclusions: Vaccination with ACAM2000 is the presumptive cause of this cluster. Caution should be exercised before considering vaccination campaigns for smallpox given the clinical morbidity and costs incurred by a case of myopericarditis. Risk of myopericarditis should be carefully weighed with risk of exposure to smallpox.

Stone KW, Felkner M, Garza E, et al. Epidemiology surveillance and capacity improvement: A characterization of Texas, 2017 [published online ahead of print, 2021 Mar 17]. Disaster Med Public Health Prep. 2021;1-8. doi:10.1017/dmp.2020.471
Objectives: In response to increasing caseloads of foodborne illnesses and high consequence infectious disease investigations, the Texas Department of State Health Services (DSHS) requested funding from the Texas Legislature in 2013 and 2015 for a new state-funded epidemiologist (SFE) program.
Methods: Primary cross-sectional survey data were collected from 32 of 40 local health departments (LHDs) via an online instrument and analyzed to quantify roles, responsibilities, and training of epidemiologists in Texas in 2017 and compared to similar state health department assessments.
Results: Sixty-six percent of SFEs had epidemiology-specific training (eg, master's in public health) compared to 45% in state health department estimates. For LHDs included in this study, the mean number of epidemiologists per 100,000 was 0.73 in medium LHDs and 0.46 in large LHDs. SFE positions make up approximately 40% of the LHD epidemiology workforce of all sizes and 56% of medium-sized LHD epidemiology staff in Texas specifically.
Conclusions: Through this program, DSHS increased epidemiology capacity almost twofold from 0.28 to 0.47 epidemiologists per 100,000 people. These findings suggest that capacity funding programs like this improve epidemiology capacity in local jurisdictions and should be considered in other regions to improve general public health preparedness and epidemiology capacity.

Vogel WB, Morris HL, Muller K, et al. Cost-effectiveness of the Wellness Incentives and Navigation (WIN) program. Value Health. 2021;24(3):361-368. doi:10.1016/j.jval.2020.06.019
Objectives: Promoting patient involvement in managing co-occurring physical and mental health conditions is increasingly recognized as critical to improving outcomes and controlling costs in this growing chronically ill population. The main objective of this study was to conduct an economic evaluation of the Wellness Incentives and Navigation (WIN) intervention as part of a longitudinal randomized pragmatic clinical trial for chronically ill Texas Medicaid enrollees with co-occurring physical and mental health conditions.
Methods: The WIN intervention used a personal navigator, motivational interviewing, and a flexible wellness expense account to increase patient activation, that is, the patient's knowledge, skills, and confidence in managing their self-care and co-occurring physical and mental health conditions. Regression models were fit to both participant-level quality-adjusted life years (QALYs) and total costs of care (including the intervention) controlling for demographics, health status, poverty, Medicaid managed care plan, intervention group, and baseline health utility and costs. Incremental costs and QALYs were calculated based on the difference in predicted costs and QALYs under intervention versus usual care and were used to calculate the incremental cost-effectiveness ratios (ICERs). Confidence intervals were calculated using Fieller's method, and sensitivity analyses were performed.
Results: The mean ICER for the intervention compared with usual care was $12,511 (95% CI $8971-$16,842), with a sizable majority of participants (70%) having ICERs below $40,000. The WIN intervention also produced higher QALY increases for participants who were sicker at baseline compared to those who were healthier at baseline.

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Last updated April 7, 2021