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Medical and Research Library News - August 2018

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News and training opportunities
Cool websites and reports on hot topics*
Interesting journal articles*
New Books*

August 2018

mrl-diamond(1)News and 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.

August 2, 2018 1:00-2:00 p.m. Beyond the SEA Webinar: HIV Prevention and Information Outreach Panel Discussion This presentation will discuss the collaboration between the Florida International University’s Herbert Wertheim College of Medicine’s Department of Humanities, Health and Society and the Robert Stempel College of Public Health and Social Work, where they identified the socio-economic and behavioral risks factors associated with HIV infection in the transgender women population of South Florida. Presented by the National Network of Libraries of Medicine. https://nnlm.gov/class/beyond-sea-webinar-hiv-prevention-and-information-outreach-panel-discussion/8842

August 6, 2018 1:00-1:00 p.m. ASPPH Presents Webinar: Policy, Advocacy, and the Missions of Academic Public Health This webinar will cover the numerous legislative and regulatory issues that impact schools and programs of public health. The presenters will also focus on the political dynamics in which these issues are being considered. Presented by the Association of Schools and Programs of Public Health. https://register.gotowebinar.com/register/5381864617141736449

August 7, 2018 11:00-12:00 p.m. Current Issues in Immunization NetConference: Influenza Update - 2018-2019 Immunization NetConferences are live, 1-hour presentations, collectively titled “Current Issues in Immunization,” are scheduled 4 to 5 times per year. Specific topic(s) will be announced prior to each occurrence. Each presentation is designed to provide clinicians with the most up-to-date information on immunization. And, are presented by the National Center for Immunization and Respiratory Diseases. https://www2.cdc.gov/vaccines/ed/ciinc/

August 9, 2018 12:30-1:30 p.m. Data Management in Disasters & Public Health Emergencies Nicole Strayhorn, NLM Associate Fellow, will discuss the results of her project to identify open data sources and data sharing policies used during disasters and public health emergencies. For the purposes of this short-term project, she narrowed her research to the data needs of stakeholders, and the challenges of sharing and accessing data around the ongoing Zika virus outbreak. From the Disaster Information Management Research Center (DIMRC). https://nih.webex.com/mw3200/mywebex/default.do?siteurl=nih

August 14, 2018 1:00-2:30 p.m. Emergency Preparedness Against Infectious Diseases on Public Transit This webinar will examine legal issues that transit agencies may face when an infectious disease epidemic arises. Presenters will provide an overview of federal and state laws and available court decisions affecting transit agencies' responses to infectious disease outbreaks, including potential cohesiveness among transit agencies' procedures and federal and state guidance. Presenters will also discuss developments in infectious disease response that affects transit agencies, such as the CDC's recently revised Quarantinable Communicable Disease rule. From the National Academies of Science, Engineering, and Medicine (NASEM). https://webinar.mytrb.org/Webinars/Details/1201?utm_source=HMD+Email+List&utm_campaign=3083fe50de-EMAIL_CAMPAIGN_2018_05_29_03_33_COPY_01&utm_medium=email&utm_term=0_211686812e-3083fe50de-180305773&mc_cid=3083fe50de&mc_eid=ae55f134fb

August 15, 2018 12:00-1:30 p.m. Of Mice and Men: Discovering a Deadly Hantavirus in the Americas Twenty-five years ago, a new and deadly type of Hantavirus swept through parts of southwestern U.S. Join us to hear fascinating stories about the discovery of the Sin Nombre virus and its continued public health impact. Presented by the Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/od/science/wewerethere/hantavirus/index.html

August 16, 2018 11:30-1:00 p.m. Approaches to Extending Complex Care Models into the Community This webinar, made possible by the Robert Wood Johnson Foundation, focuses on how providers are building on existing complex care program models to extend beyond the walls of a health system and into the communities where people live, work, and play. https://chcs.zoom.us/webinar/register/WN_g5u4JXQ6T-iu76Wc9eYtow

August 16, 2018 3:00-4:00 p.m. Diversifying the Health Workforce for an Equitable Future  This webinar, presented by the National Hispanic Medical Association and the Office of Minority Health’s National Partnership for Action to End Health Disparities (NPA), will highlight strategies to diversify the health workforce in order to create a more equitable future for all. https://events-na11.adobeconnect.com/content/connect/c1/1312818331/en/events/event/private/1313011123/1876592186/event_landing.html?sco-id=1876657158&_charset_=utf-8

August 17, 2017 12:00-1:00 p.m. AgriSafe Think Tank: Defining the Rural Health Care Professional's Role in the Prevention of Opioid Misuse Join AgriSafe during this virtual town hall to help formulate best practices for rural healthcare providers in response to the opioid epidemic. http://www.agrisafe.org/index.php?option=com_jevents&task=icalrepeat.detail&evid=42&Itemid=125&year=2018&month=08&day=17&title=agrisafe-think-tank-defining-the-rural-health-care-professionals-role-in-the-prevention-of-opioid-misuse&uid=1f7ea6d801891880ea2ea7101c612b0f

August 24, 2018 9:00-11:00 a.m. Health Disparities in Implementation of Genomic Medicine: Challenges and Opportunities In this seminar, presenters will discuss the state of science on health disparities in the implementation of genomic medicine and how public health can address these disparities. Presented by the Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/genomics/events/public_health_genomics_series_Aug18.htm

August 30, 2018 1:00-2:00 p.m. America's Eating Habits: Food Away From Home This webinar explores the role food away from home (FAFH) plays in the American diet. In recent decades, numerous factors have contributed to an increasing trend of FAFH consumption such as increased access and affordability to FAFH and an increase in two earner households. Presented by the National Collaborative on Childhood Obesity Research (NCCOR). https://www.eventbrite.com/e/connect-explore-americas-eating-habits-food-away-from-home-tickets-47519766902

mrl-diamondCool websites and reports on hot topics*

2017 Hurricane Season FEMA After-Action Report - Following the 2017 hurricane season, FEMA conducted an after-action review of the agency's preparations for, immediate response to, and initial recovery operations for hurricanes Harvey, Irma, and Maria. This report captures insights from a historic hurricane season that will help the Agency, the emergency management community, and the nation chart the path into the future. https://www.fema.gov/media-library/assets/documents/167249

AtlasPlus – Explore the updated NCHHSTP AtlasPlus tool and create customized tables, maps, and charts to view social and economic data in conjunction with CDC’s surveillance data on HIV, viral hepatitis, STDs, and TB. https://www.cdc.gov/features/atlasplus/index.html

Interactive Vaccine Guide -  The CDC offers an interactive guide to help families find information about recommended vaccines from birth through adulthood, including pregnancy. Click through this guide to learn about vaccine-preventable diseases—like flu, whooping cough, and HPV cancers. https://www.cdc.gov/vaccines/growing/

Long-Acting HIV Treatment and Prevention Are Coming: Preparing for Potential Game Changers – This report provides a summary of the complex issues policy makers must assess and navigate, such as FDA approval, defining the intended market, and payer coverage and access when considering long-acting HIV drugs. http://www.amfar.org/Long-Acting-ARV/

Mystery in the Pines – The Journal of Public Health Management and Practice’s Backstories in Epidemiology series is written in the spirit of Berton Roueché's classic Eleven Blue Men and Other Narratives of Medical Detection and will appeal to students, practitioners, and health professionals at all levels. The first article in this series recounts a typhoid epidemic in the Catskill Mountains. https://journals.lww.com/jphmp/Fulltext/2018/09000/Mystery_in_the_Pines.14.aspx?mkt_tok=eyJpIjoiTWpJM05tVTNaalpsTjJNNSIsInQiOiJnZFVqb0Mzdm9zcUxTRlM5bUk1N3F

Older Adults' Experiences with Opioid Prescriptions – This report presents results from a national sample of adults age 50-80 which asked about their use of opioids for pain management, the education they received, how they disposed of unused medications, and perceptions of current and proposed policies related to opioid disposal and prescribing. https://www.healthyagingpoll.org/report/july-2018-report-older-adults-experiences-opioid-prescriptions

State Strategies to Prevent and Respond to Disease Crises Through Medicaid and Public Health Partnerships - This report explores effective, collaborative approaches developed by California, Florida, and Texas that may help strengthen Medicaid and public health partnerships to prevent and better respond to communicable disease crises. https://nashp.org/state-strategies-to-prevent-and-respond-to-disease-crises-through-medicaid-and-public-health-partnerships/

Surveillance for Foodborne Disease Outbreaks — United States, 2009–2015 - This report summarizes foodborne disease outbreaks reported in the United States in which the first illness occurred between January 1, 2009, and December 31, 2015 and highlights a few large outbreaks as well as novel foods and food-pathogen pairs responsible for outbreaks during the reporting period. https://www.cdc.gov/mmwr/volumes/67/ss/ss6710a1.htm?s_cid=ss6710a1_e

mrl-diamondInteresting journal articles*

Cross R, Taylor S, Zehner D. Collaboration without burnout. Harvard Business Review. 2018; Vol. 96(4):134-137.
As organizations become more global, matrixed, and complex, they are requiring employees to collaborate with more internal colleagues and external contacts than ever before. According to research, most managers now spend 85% or more of their work time on e-mail, in meetings, and on the phone. And although greater collaboration has benefits, it also leaves significantly less time for focused individual work, careful reflection, and sound decision making. Organizational solutions are, of course, necessary to eradicate collaborative overload across the board. But research shows that with some strategic self-management, individuals can also tackle the problem on their own, clawing back 18% to 24% of their collaborative time. The first step is to understand why you take on too much work for and with others; this often involves challenging your identity as a “helper,” a “team player,” or a “star performer.” Next, figure out how you add—and from where you derive—the most value and eliminate any collaborations that distract from that work. Last, ensure that the collaboration you continue with is as productive as possible.

Edwards C, Abbe M, Shenoi R, et al. Sorting and packaging the evidence: guiding implementation of effective interventions to prevent distracted driving with a literature review. Texas Public Health Journal. 2018;70(3):17-21. 
Background: Distracted driving has joined alcohol and speeding as a leading factor in fatal and serious motor vehicle injury crashes. In 2016, 455 people were killed in crashes involving distracted driving on Texas roadways, a 5.4% increase from 2015. The Injury Prevention Committee of the Texas Governor's Emergency Medical Services (EMS) and Trauma Advisory Council conducted an extensive literature review to classify intervention strategies based on their effectiveness in reducing or preventing distracted driving. The goal was to provide practitioners with evidence-informed measures that are effective in counteracting distracted driving. Methods: The literature reviewed consisted of peer-reviewed journals, government resources, injury prevention outlets, and private corporations' websites. Inclusion criteria included English language publications during 1999-2016. Only publications including distracted driving prevention measures/ countermeasures were reviewed. The authors used the Nursing Levels of Evidence from "Evidence-based Practice in Nursing & Healthcare: A Guide to Best Practice" and the "Grading of Recommendations Assessment, Development and Evaluation" (GRADE) to determine criteria for evidence based strategies. A color-based indicator was utilized to rank studies to signal appropriate or positive outcome interventions, interventions to be used with caution, inappropriate or harmful/negative outcome interventions, and inconclusive interventions. Results: Twenty articles describing 16 interventions were identified. Two interventions were effective in reducing reported distracted driving. One intervention was found to not only be ineffective, but harmful. For three interventions, the evidence within these studies was inconclusive. Thirteen studies lacked well-designed evaluation and were classified as weak. Conclusion: Effective interventions should be replicated and those interventions determined to be ineffective or potentially harmful should be discontinued. Synthesizing research into an easy to read format may be appealing to practitioners. Future assessment and research targeting intervention implementation will determine if this method of translating research is effective.

Goel V, Rosella L, Fu L, Alberga A. The relationship between life satisfaction and healthcare utilization: a longitudinal study. Am J Prev Med. 2018;55(2):142-150. 
INTRODUCTION: Studies have highlighted the importance of life satisfaction or, more generally, happiness, on health. However, there are few studies that have prospectively assessed the relationship between life satisfaction and healthcare utilization and costs.
METHODS: Participants were from three national survey cycles conducted between 2005 and 2010 to future healthcare utilization up to 2015. Analysis was conducted in 2016-2017. Annual per person costs were calculated and individuals ranked. Adjusted multinomial logistic regression models were used to quantify the association between life satisfaction and being in the top 5% or top 6%-50%, compared to the bottom 50%, during follow-up.
RESULTS: After exclusions, the study population included 85,225 adults. Increasing life dissatisfaction was associated with higher healthcare utilization and costs. In the fully adjusted model, the odds for those with the lowest level of life satisfaction being in the top 5% of healthcare costs relative to the lowest 50% is 3.05 (95% CI=1.61, 5.80). Those with the lowest life satisfaction were also at increased odds of being in the middle utilization category (6%-50%) with a significant OR=2.24 (95% CI=1.60, 3.14). All trends for increasing dissatisfaction were significant (p<0.001).
CONCLUSIONS: Life dissatisfaction was significantly associated with being a high-cost user in the future. This relationship persisted after adjustment for demographic factors, comorbidity, socioeconomic factors, and health behaviors. This study points to the importance of considering broader correlates of well-being with respect to future healthcare utilization and costs.

Hall J, Shartzer A, Kurth N, Thomas K. Medicaid expansion as an employment incentive program for people with disabilities. Am J Public Health. 2018 Jul 19:e1-e3. 
Before the Patient Protection and Affordable Care Act (ACA), many Americans with disabilities were locked into poverty to maintain eligibility for Medicaid coverage. US Medicaid expansion under the ACA allows individuals to qualify for coverage without first going through a disability determination process and declaring an inability to work to obtain Supplemental Security Income. Medicaid expansion coverage also allows for greater income and imposes no asset tests. In this article, we share updates to our previous work documenting greater employment among people with disabilities living in Medicaid expansion states. Over time (2013-2017), the trends in employment among individuals with disabilities living in Medicaid expansion states have become significant, indicating a slow but steady progression toward employment for this group post-ACA. In effect, Medicaid expansion coverage is acting as an employment incentive program for people with disabilities. These findings have broad policy implications in light of recent changes regarding imposition of work requirements for Medicaid programs. 

Hodges N, McKenzie L, Anderson S, Katz M. Exploring lactation consultant views on infant safe sleep. Matern Child Health J. 2018; 22(8):1111-1117. 
Objectives The purpose of this qualitative study was to explore the infant safe sleep beliefs and occupational practices of lactation consultants and to determine if lactation consultants give advice to clients that is consistent with the American Academy of Pediatrics' recommendations on this topic. Methods Focus groups were conducted with certified lactation consultants in two cities in Ohio. Participants discussed the role of lactation consultants, the infant sleep advice they provide to women, their views on the American Academy of Pediatrics' infant safe sleep recommendations and related policies, and perceived benefits and barriers associated with providing infant safe sleep education as part of their work. A member-checking session was held to ensure the credibility of the findings. Results Four focus groups were conducted with 22 certified lactation consultants between September and November 2015. Major themes that emerged included: lactation consultants' beliefs regarding the importance of bedsharing for supporting breastfeeding success; their disagreement with the infant safe sleep recommendations of the American Academy of Pediatrics; their frustration with policies that restrict consultants' ability to discuss bedsharing; and the impact of infant safe sleep policies on their work and the advice they provide. Conclusions for Practice Lactation consultants interact with mothers of newborns at a critical time for infant safe sleep decision-making and may influence a woman's choices related to this topic. Women may not be receiving messages from lactation consultants that are consistent with the infant safe sleep recommendations of the American Academy of Pediatrics.

O'Neill L, Park S, Rosinia F. The role of the built environment and private rooms for reducing central line-associated bloodstream infections. PLoS One. 2018; 13(7):e0201002. 
Private hospital rooms are believed to offer some protective effect against hospital-acquired infections, including central line-associated bloodstream infections. Yet a recent meta-analysis found the evidence-base to be lacking from a policy perspective. We sought to determine whether private rooms were associated with a lower risk of central-line infections. We examined the discharge records of more than one million inpatients from 335 Texas hospitals to determine patients that stayed in private rooms. Patients who stayed in bay rooms had 64 percent more central line infections than patients who stayed in private rooms. Even after adjusting for relevant covariates, patients assigned to bay rooms had a 21 percent greater relative risk of a central line infection (p = 0.005), compared with patients assigned to private rooms. At the hospital level, a 10% increase in private rooms was associated with an 8.6% decrease in central line infections (p<0.001), regardless of individual patients' room assignment. This study demonstrates and validates the use of private rooms as a structural measure and independent predictor of hospital quality.

Perkins G, Ji C, Deakin C, Quinn T, Nolan J, Scomparin C, et al. A randomized trial of epinephrine in out-of-hospital cardiac arrest. N Engl J Med. 2018 Jul 18. [Epub ahead of print]
Background Concern about the use of epinephrine as a treatment for out-of-hospital cardiac arrest led the International Liaison Committee on Resuscitation to call for a placebo-controlled trial to determine whether the use of epinephrine is safe and effective in such patients. Methods in a randomized, double-blind trial involving 8014 patients with out-of-hospital cardiac arrest in the United Kingdom, paramedics at five National Health Service ambulance services administered either parenteral epinephrine (4015 patients) or saline placebo (3999 patients), along with standard care. The primary outcome was the rate of survival at 30 days. Secondary outcomes included the rate of survival until hospital discharge with a favorable neurologic outcome, as indicated by a score of 3 or less on the modified Rankin scale (which ranges from 0 [no symptoms] to 6 [death]). Results at 30 days, 130 patients (3.2%) in the epinephrine group and 94 (2.4%) in the placebo group were alive (unadjusted odds ratio for survival, 1.39; 95% confidence interval [CI], 1.06 to 1.82; P=0.02). There was no evidence of a significant difference in the proportion of patients who survived until hospital discharge with a favorable neurologic outcome (87 of 4007 patients [2.2%] vs. 74 of 3994 patients [1.9%]; unadjusted odds ratio, 1.18; 95% CI, 0.86 to 1.61). At the time of hospital discharge, severe neurologic impairment (a score of 4 or 5 on the modified Rankin scale) had occurred in more of the survivors in the epinephrine group than in the placebo group (39 of 126 patients [31.0%] vs. 16 of 90 patients [17.8%]). Conclusions in adults with out-of-hospital cardiac arrest, the use of epinephrine resulted in a significantly higher rate of 30-day survival than the use of placebo, but there was no significant between-group difference in the rate of a favorable neurologic outcome because more survivors had severe neurologic impairment in the epinephrine group. 

Simon G, Johnson E, Lawrence J, Rossom R, Ahmedani B, Lynch F, et al. Predicting suicide attempts and suicide deaths following outpatient visits using electronic health records. Am J Psychiatry. 2018 May 24 [Epub ahead of print]
OBJECTIVE: The authors sought to develop and validate models using electronic health records to predict suicide attempt and suicide death following an outpatient visit.
METHOD: Across seven health systems, 2,960,929 patients age 13 or older (mean age, 46 years; 62% female) made 10,275,853 specialty mental health visits and 9,685,206 primary care visits with mental health diagnoses between Jan. 1, 2009, and June 30, 2015. Health system records and state death certificate data identified suicide attempts (N=24,133) and suicide deaths (N=1,240) over 90 days following each visit. Potential predictors included 313 demographic and clinical characteristics extracted from records for up to 5 years before each visit: prior suicide attempts, mental health and substance use diagnoses, medical diagnoses, psychiatric medications dispensed, inpatient or emergency department care, and routinely administered depression questionnaires. Logistic regression models predicting suicide attempt and death were developed using penalized LASSO (least absolute shrinkage and selection operator) variable selection in a random sample of 65% of the visits and validated in the remaining 35%.
RESULTS: Mental health specialty visits with risk scores in the top 5% accounted for 43% of subsequent suicide attempts and 48% of suicide deaths. Of patients scoring in the top 5%, 5.4% attempted suicide and 0.26% died by suicide within 90 days. C-statistics (equivalent to area under the curve) for prediction of suicide attempt and suicide death were 0.851 (95% CI=0.848, 0.853) and 0.861 (95% CI=0.848, 0.875), respectively. Primary care visits with scores in the top 5% accounted for 48% of subsequent suicide attempts and 43% of suicide deaths. C-statistics for prediction of suicide attempt and suicide death were 0.853 (95% CI=0.849, 0.857) and 0.833 (95% CI=0.813, 0.853), respectively.
CONCLUSIONS: Prediction models incorporating both health record data and responses to self-report questionnaires substantially outperform existing suicide risk prediction tools.

Springer A, Davis C, Van Dusen D, Grayless M, Case K, Craft M, et al. School socioeconomic disparities in e-cigarette susceptibility and use among central Texas middle school students. Prev Med Rep. 2018; 11:105-108. 
Social-ecological theory posits that health-related behavior is shaped by the environments and settings that surround us. We examined e-cigarette susceptibility and ever use prevalence among central Texas middle school students by the level of economic disadvantage (ED) of their school. As a secondary aim, we explored gender and ethnic differences (Hispanic vs. White) in e-cigarette susceptibility across school ED levels. A cross-sectional analysis was conducted of baseline data collected in 2017 as part of the CATCH My Breath study. Participants (n = 5278) were 6th grade students from 23 central Texas public middle schools. E-cigarette susceptibility/use and demographics were self-reported; school ED was determined by Texas Education Agency. Analyses included chi-square tests and multi-level logistic regression. E-cigarette susceptibility and use varied by school ED for total sample (p < .0001) and by ethnicity (p ≤ .003). While e-cigarette susceptibility was higher in boys (p < .001), no gender differences were found for e-cigarette use. Students in the highest school ED quartile (Q4) (lowest SES) had significantly higher odds of e-cigarette susceptibility (AOR = 2.01; 95% CI: 1.49-2.71) and use (AOR = 8.12, 95% CI: 2.58-26.30) compared with Q1 students. Significant gender differences in e-cigarette susceptibility persisted within school ED quartiles 1-3 (p ≤ .001); no gender differences were found for Q4 (p = .537). Despite overall higher e-cigarette susceptibility for Hispanic students, they had similar prevalence as White students within three school ED quartiles. Findings underscore a higher risk for e-cigarette susceptibility/use among central Texas sixth graders attending high ED schools and provide foundation for further exploration of the school socioeconomic context in adolescent e-cigarette use.

Tapper E, Parikh N. Mortality due to cirrhosis and liver cancer in the United States, 1999-2016: observational study. BMJ. 2018 Jul 18;362: k2817. 
OBJECTIVE: To describe liver disease related mortality in the United States during 1999-2016 by age group, sex, race, cause of liver disease, and geographic region.
SETTING: Death certificate data from the Vital Statistics Cooperative, and population data from the US Census Bureau compiled by the Center for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (1999-2016).
MAIN OUTCOME MEASURE: Deaths from cirrhosis and hepatocellular carcinoma, with trends evaluated using joinpoint regression.
RESULTS: From 1999 to 2016 in the US annual deaths from cirrhosis increased by 65%, to 34 174, while annual deaths from hepatocellular carcinoma doubled to 11 073. Only one subgroup-Asians and Pacific Islanders-experienced an improvement in mortality from hepatocellular carcinoma: the death rate decreased by 2.7% (95% confidence interval 2.2% to 3.3%, P<0.001) per year. Annual increases in cirrhosis related mortality were most pronounced for Native Americans (designated as "American Indians" in the census database) (4.0%, 2.2% to 5.7%, P=0.002). The age adjusted death rate due to hepatocellular carcinoma increased annually by 2.1% (1.9% to 2.3%, P<0.001); deaths due to cirrhosis began increasing in 2009 through 2016 by 3.4% (3.1% to 3.8%, P<0.001). During 2009-16 people aged 25-34 years experienced the highest average annual increase in cirrhosis related mortality (10.5%, 8.9% to 12.2%, P<0.001), driven entirely by alcohol related liver disease. During this period, mortality due to peritonitis and sepsis in the setting of cirrhosis increased substantially, with respective annual increases of 6.1% (3.9% to 8.2%) and 7.1% (6.1% to 8.4%). Only one state, Maryland, showed improvements in mortality (-1.2%, -1.7% to -0.7% per year), while many, concentrated in the south and west, observed disproportionate annual increases: Kentucky 6.8% (5.1% to 8.5%), New Mexico 6.0% (4.1% to 7.9%), Arkansas 5.7% (3.9% to 7.6%), Indiana 5.0% (3.8% to 6.1%), and Alabama 5.0% (3.2% to 6.8%). No state showed improvements in hepatocellular carcinoma related mortality, while Arizona (5.1%, 3.7% to 6.5%) and Kansas (4.3%, 2.8% to 5.8%) experienced the most severe annual increases.
CONCLUSIONS: Mortality due to cirrhosis has been increasing in the US since 2009. Driven by deaths due to alcoholic cirrhosis, people aged 25-34 have experienced the greatest relative increase in mortality. White Americans, Native Americans, and Hispanic Americans experienced the greatest increase in deaths from cirrhosis. Mortality due to cirrhosis is improving in Maryland but worst in Kentucky, New Mexico, and Arkansas. The rapid increase in death rates among young people due to alcohol highlight new challenges for optimal care of patients with preventable liver disease.

mrl-diamondNew Books*

1. Cerebral Palsy: Complete Guide for Caregiving. By Freeman Miller.
2. Exceptional Child: Inclusion in Early Childhood Education. By K. Eileen Allen
3. Your Successful Preschooler: Ten Skills Children Need. By Ann E. Densmore.
4. Helping Children Develop A Positive Relationship With Food. By Jo Cormack.
5. Understanding the NICU: What Parents of Preemies and Other Hospitalized Newborns Need to Know.
6. Child Abuse: Today's Issues. By Kimberly A. McCabe.
7. 50 strategies for Communicating and Working with Diverse Families. By Janet Gonzalez-Mena.
8. Simple Signing with Young Children. By Carol Garboden Murray.

*For More Information:  Employees may contact the Medical and Research Library at library@dshs.texas.gov, call 512-776-7559, or come by Moreton Building, Room M-652, to borrow a print book, receive password access to a journal, receive other research assistance, or to obtain full-text of the articles mentioned in this month's news. If you are not located on the main campus in Austin, simply let us know what you would like to borrow and we will mail it to you.

Fine print section: If any of the internet links do not open for you, please let us know and we will send you what you need. The MRL Library News e-mail is sent about once a month or when important library news or events occur. If you have co-workers who would like to subscribe, please e-mail library@dshs.texas.gov. If for any reason you would like to unsubscribe, please send an e-mail to library@dshs.texas.gov with Unsubscribe in the subject line. Recent issues of this newsletter are on the web at http://www.dshs.texas.gov/library/news.shtm. Thank you!

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Last updated October 1, 2018