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Medical and Research Library News - December 2018

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

December 2018

mrl-diamondNews 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.

December 4, 2018; 1 - 2 p.m. Health and Nutrition Literacy: The Social Determinants of Health, Healing & Patient Safety. We know that by eating well, staying active, not smoking, avoiding nicotine, getting immunizations, screening tests, and adequate sleep plus having access to healthcare when sick all influence our health. The ability to understand these factors plays a key role in our health and ultimately reflects in our recovery response to healthcare services. This presentation will not only explain these intersections of life, health literacy and society, but also offer community-based and programmatic solutions. Sponsored by the National Network of Libraries of Medicine South Central Region. https://news.nnlm.gov/sea/2018/10/30/webinar-announcement-health-and-nutrition-literacy-the-social-determinants-of-health-healing-patient-safety/

December 11, 2018; 1 – 2 p.m. From the Mountains to the Sea: Rural Health Issues and Resources. Evidence shows that there are marked health disparities between those living in rural areas versus their urban counterparts. Not only do rural residents suffer from higher incidence of chronic illness, they also have limited access to primary care services and are more likely to be uninsured or under-insured. This session will describe hallmarks of rural America, identify other access challenges of living in rural communities, and equip participants with tools to service the health information needs of those living in rural communities. Sponsored by the National Network of Libraries of Medicine South Central Region. https://nnlm.gov/class/mountains-sea-rural-health-issues-and-resources/9063

December 12, 2018; 11 a.m. – Noon. HIPAA FAQs: Real-Life HIPAA Challenges in Primary Care. The Health Insurance Portability and Accountability Act (HIPAA) 
can be complex and challenging to interpret and apply. Using common themes and scenarios that health centers are likely to encounter, this webinar will explore HIPAA privacy and security FAQs and identify tools and resources to anticipate and address these real-life challenges. Presented by ECRI Institute on behalf of The Health Resources and Services Administration (HRSA). https://register.gotowebinar.com/register/5948191175197621251

December 13, 2018; 1 - 2 p.m. Infectious Disease Consequences of Opioid Use. Join ASTHO and CDC to learn about opportunities to assess, prepare, and implement programs that prevent the spread of HIV, viral hepatitis, and other infectious diseases related to the opioid epidemic. Expert panelists will discuss evidence-based practices that reduce the harmful health outcomes associated 
with injection drug use and link clients to treatment programs. State and local representatives from Vermont will share their perspectives on policy levers and activities needed at the community level to implement syringe services programs (SSPs). Representatives will share lessons learned related to developing and implementing SSPs and building linkages to treatment for substance misuse. https://netforumpro.com/eWeb/DynamicPage.aspx?Site=ASTHO&WebCode=EventDetail&evt_key=0102eb93-2c7a-4fa1-a236-f5342dea30c6

December 13, 2018; 2 – 3 p.m. Behavioral Health Workforce Development Training Across the Various Behavioral Health Disciplines. The need to address the behavioral health workforce shortage has never been greater. Behavioral health education and training targeted at the needs of health centers is a way to make an impact. Training the next generation to deliver behavioral health and primary care services as a part of integrated, inter-professional teams, including opioid use disorder and other substance use disorder treatments, is crucial to establishing a strong, dedicated behavioral health workforce in health centers. During this webinar, you will hear from the CHCI’s Chief Behavioral Health Officer and CHCI Behavioral Health Staff as they provide insight into the crucial components of effectively training behavioral health students working toward different behavioral health degrees. Hosted by Community Health Center, Inc. https://chc1.zoom.us/webinar/register/WN_YwvsLXe9RG-x9rL3V2hW1w?utm_source=Workforce+Development+NCA+Announcments&utm_campaign=5b6b81593a-NCA2017ResLC_COPY_01&utm_medium=email&utm_term=0_44e71a91e9-5b6b81593a-91757133

December 18, 2018; 1 – 2 p.m. Healthy Brain Initiative Road Map - State and Local Public Health Partnerships to Address Dementia. This webinar will describe the newly released Road Map and how Washington designed and is implementing a successful program aligned with Centers for Disease Control and Prevention’s (CDC) Healthy Brain Initiative. https://content.govdelivery.com/accounts/USACL/bulletins/21ccf59

December 18, 2018; 1 - 2 p.m. Reducing Underage Drinking with Practical Tools that Develop Social and Emotional Skills. A recent study found that Montana parents with higher social and emotional parenting skills were over six times more likely to engage in best practices to reduce underage drinking. This free webinar presented by the Montana State University Center for Health and Safety Culture will review social and emotional skills, how they are protective for youth, and a project creating practical tools for parents to reduce underage drinking and strengthen social and emotional skills. Sponsored by the American Public Health Association (APHA). https://www.apha.org/events-and-meetings/apha-calendar/webinar-events/2018/reducing-underage-drinking

mrl-diamondCool websites and reports on hot topics*

2018 Lancet Countdown on Health and Climate Change Brief for the United States of America – This 32-page brief focuses on connections between climate change and health in the United States in 2017. It draws out some of the most nationally-relevant findings of the global 2018 Lancet Countdown on Health and Climate Change report with U.S.-specific data to highlight the key threats, including elevating the risk of mosquito-, tick-, and water-borne diseases, and opportunities climate change poses for the health of Americans. http://www.lancetcountdown.org/media/1426/2018-lancet-countdown-policy-brief-usa.pdf

Bad Blood: The Gift of Giving – This supplemental content on JPHMP Direct is the third case study from the Journal of Public Health Management & Practice’s Backstories in Epidemiology: True Medical Mysteries series. It gives an account of a malaria outbreak in New York City. https://jphmpdirect.com/2018/10/18/bad-air-bad-blood/

CDC Workplace Health Resource Center – The CDC Workplace Health Resource Center (WHRC) is a one-stop shop for workplace health promotion that gives employers resources to create a healthy work environment. It has credible tools and step-by-step resources employers can use to tailor a health promotion program to their unique workplace needs. https://www.cdc.gov/workplacehealthpromotion/initiatives/resource-center/index.html

Sheltering in Danger: How Poor Emergency Planning and Response Put Nursing Home Residents at Risk During Hurricanes Harvey and Irma – This report examines the decisions that were made before, during, and after Hurricanes Harvey and Irma in 2017, when many nursing homes and assisted living facilities chose to shelter-in-place, putting residents at risk. It details gaps in federal regulations currently on the books, and makes recommendations on how to avoid these types of tragedies in the future. While this report focuses on the dangers presented by hurricanes, the findings and recommendations can be applied to other natural disasters. https://www.finance.senate.gov/imo/media/doc/Sheltering in Danger Report (2 Nov 2018).pdf

Stemming the Superbug Tide: Just A Few Dollars More – This report reviews policies currently in place in high-income countries and identifies a set of "best buys" to tackle antimicrobial resistance (AMR) that, if scaled up at the national level, would provide an affordable and cost-effective instrument in the fight against AMR. https://read.oecd-ilibrary.org/social-issues-migration-health/stemming-the-superbug-tide_9789264307599-en#page1

Trauma-Informed Care Implementation Resource Center – This website developed by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation, offers a one-stop information hub for health care providers and other stakeholders interested in implementing trauma-informed care. https://www.traumainformedcare.chcs.org/?utm_source=CHCS+Email+Updates&utm_campaign=dada8a1f29-TIC+RC+Launch+11%2F28%2F18&utm_medium=email&utm_term=0_bbced451bf-dada8a1f29-152131573

mrl-diamondInteresting journal articles*

Goldstein N, Suder J, Purtle J. Trends and Characteristics of Proposed and Enacted State Legislation on Childhood Vaccination Exemption, 2011-2017. Am J Public Health. 2018 Nov 29:e1-e6. [Epub ahead of print]
OBJECTIVES: To examine trends and characteristics of proposed and enacted state legislation that would directly affect states' immunization exemption laws.
METHODS: We performed content analysis of proposed bills in state legislatures from 2011 to 2017. We classified bills as pro-vaccination or anti-vaccination.
RESULTS: State legislators proposed 175 bills, with the volume increasing over time: 92 (53%) bills expanded access to exemptions, and 83 (47%) limited the ability to exempt. Of the 13 bills signed into law, 12 (92%) limited the ability to exempt. Bills that expanded access to exemptions were more likely to come from Republican legislators and Northeastern and Southern states.
CONCLUSIONS: Although most proposed legislation would have expanded access to exemptions, bills that limited exemptions were more likely to be enacted into law. Legal barriers to exempt one's children from vaccination persist despite vaccine hesitancy, which is encouraging for public health. Public Health Implications. Most vaccine exemption laws introduced in state legislatures would pose threats to the public's health. There is a need for constituents to engage their elected legislators and advocate pro-vaccination policies. 

Iwanicki J, Severtson S, Margolin Z, Dasgupta N, Green J, Dart R. Consistency Between Opioid-Related Mortality Trends Derived from Poison Center and National Vital Statistics System, United States, 2006-2016. Am J Public Health. 2018; 108(12):1639-1645. 
OBJECTIVES: To determine the association between poison center opioid exposure calls and National Vital Statistics System (NVSS) deaths.
METHODS: We categorized Centers for Disease Control and Prevention NVSS mortality and the Researched Abuse, Diversion and Addiction-Related Surveillance System poison center program cases from 2006 to 2016 by International Classification of Diseases, Tenth Revision, codes (heroin [T40.1]; natural or semisynthetic opioids [T40.2]; methadone [T40.3]; synthetic opioids, other than methadone [T40.4]). We scaled rates by 100,000 population and calculated Pearson correlation coefficients. Sensitivity analysis excluded polysubstance cases involving either heroin or synthetic opioids as well as natural and semisynthetic opioids.
RESULTS: The NVSS mortality and poison center program exposure rates showed similar trends from 2006 to 2012, and diverged after 2012 for all opioids combined, natural and semisynthetic opioids, and synthetic opioids (r = -0.37, -0.12, and 0.30, respectively). Sensitivity analysis with removal of heroin or synthetic opioid polysubstance deaths markedly improved correlations for all opioids combined and natural and semisynthetic opioids (r = 0.87 and 0.36, respectively).
CONCLUSIONS: The NVSS mortality and poison center exposure rates showed similar trends from 2006 to 2012 then diverged, with sensitivity analysis suggesting polysubstance cases also involving heroin or illicit fentanyl as the cause. Public Health Implications. The NVSS and poison center program may provide complementary data when trends diverge. Public health interventions must include both licit and illicit opioids for maximal impact.

Kegler S, Dahlberg L, Mercy J. Firearm Homicides and Suicides in Major Metropolitan Areas - United States, 2012-2013 and 2015-2016. MMWR Morb Mortal Wkly Rep. 2018; 67(44):1233-1237. 
Firearm homicides and suicides represent a continuing public health concern in the United States. During 2015-2016, a total of 27,394 firearm homicides (including 3,224 [12%] among persons aged 10-19 years) and 44,955 firearm suicides (including 2,118 [5%] among persons aged 10-19 years) occurred among U.S. residents (1). This report updates an earlier report (2) that provided statistics on firearm homicides and suicides in major metropolitan areas during 2006-2007 and 2009-2010, and places continued emphasis on youths, in recognition of the importance of early prevention efforts. Firearm homicide and suicide rates were determined for the 50 most populous U.S. metropolitan statistical areas (MSAs)* during 2012-2013 and 2015-2016 using mortality data from the National Vital Statistics System (NVSS) and population data from the U.S. Census Bureau. In contrast to the earlier report, which indicated that firearm homicide rates among persons of all ages had been declining both nationally and in large MSAs overall, current findings show that rates have returned to levels comparable to those observed during 2006-2007. Consistent with the earlier report, these findings show that firearm suicide rates among persons aged ≥10 years have continued to increase, both nationally and in large MSAs overall. Although firearm suicide rates among youths remain notably lower than those among persons of all ages, youth rates have also increased both nationally and in large MSAs collectively. These findings can inform ongoing development and monitoring of strategies directed at reducing firearm-related violence.

Magill S, O'Leary E, Janelle S, et al. Changes in Prevalence of Health Care-Associated Infections in U.S. Hospitals. N Engl J Med. 2018; 379(18):1732-1744. 
BACKGROUND: A point-prevalence survey that was conducted in the United States in 2011 showed that 4% of hospitalized patients had a health care-associated infection. We repeated the survey in 2015 to assess changes in the prevalence of health care-associated infections during a period of national attention to the prevention of such infections.
METHODS: At Emerging Infections Program sites in 10 states, we recruited up to 25 hospitals in each site area, prioritizing hospitals that had participated in the 2011 survey. Each hospital selected 1 day on which a random sample of patients was identified for assessment. Trained staff reviewed medical records using the 2011 definitions of health care-associated infections. We compared the percentages of patients with health care-associated infections and performed multivariable log-binomial regression modeling to evaluate the association of survey year with the risk of health care-associated infections.
RESULTS: In 2015, a total of 12,299 patients in 199 hospitals were surveyed, as compared with 11,282 patients in 183 hospitals in 2011. Fewer patients had health care-associated infections in 2015 (394 patients [3.2%; 95% confidence interval {CI}, 2.9 to 3.5]) than in 2011 (452 [4.0%; 95% CI, 3.7 to 4.4]) (P<0.001), largely owing to reductions in the prevalence of surgical-site and urinary tract infections. Pneumonia, gastrointestinal infections (most of which were due to Clostridium difficile [now Clostridioides difficile]), and surgical-site infections were the most common health care-associated infections. Patients' risk of having a health care-associated infection was 16% lower in 2015 than in 2011 (risk ratio, 0.84; 95% CI, 0.74 to 0.95; P=0.005), after adjustment for age, presence of devices, days from admission to survey, and status of being in a large hospital.
CONCLUSIONS: The prevalence of health care-associated infections was lower in 2015 than in 2011. To continue to make progress in the prevention of such infections, prevention strategies against C. difficile infection and pneumonia should be augmented. (Funded by the Centers for Disease Control and Prevention.).

Mantey D, Omega-Njemnobi O, Kelder S. E-Cigarette Use is Associated with Intentions to Lose Weight among High School Students. Nicotine Tob Res. 2018 Nov 19. doi: 10.1093/ntr/nty245. [Epub ahead of print]
INTRODUCTION: Recent literature has demonstrated individuals may be using e-cigarettes as a method of weight loss/management. Furthermore, e-cigarette companies are developing and patenting technologies related to e-cigarettes and weight loss. This study aims to determine the association between intentions to lose weight and e-cigarette use behaviors among a nationally representative sample of high school students.
METHODS: Data were obtained from the 2015 Youth Risk Behavior Survey. Participants were 12,847 students in grades 9-12 in the United States. 
Multivariate multinomial logistic regression models assessed the association between past 30-day e-cigarette use and weight loss intentions among 9-12 
grade students. Subsample analyses were conducted, stratified by sex. Covariates included perceived weight, sex, race/ethnicity, grade, and past 30-day tobacco use.
RESULTS: Overall, 23.7% of the sample used e-cigarettes in the past 30-days.  E-cigarette use was associated with 1.38 (1.07 - 1.78) greater risk of intentions to lose weight among the full sample, controlling for covariates. Among girls, e-cigarette use was associated with 1.44 (1.05 - 1.97) greater risk of intentions to lose weight, controlling for covariates. Among boys, e-cigarette use was associated with 1.40 (1.04 - 1.88) greater odds of intentions to gain weight, controlling for covariates.
CONCLUSION: Findings show a significant association between e-cigarette use and intentions to lose weight among high school students, among the full sample. Interestingly, e-cigarette use was statistically associated with intentions to gain weight among boys. Longitudinal study is needed to further examine this relationship.
IMPLICATIONS AND CONTRIBUTION: This is the one of the first studies reporting on e-cigarette use and weight loss intentions among adolescents; both highly prevalent among this population. These findings are an important development in the study of e-cigarette use given the established link between conventional cigarette smoking and weight loss/management.

Omura J, Hyde E, Watson K, Sliwa S, Fulton J, Carlson S. Prevalence of children walking to school and related barriers - United States, 2017. Prev Med. 2018; 118:191-195. [Epub ahead of print]
Children and adolescents can engage in an active lifestyle by walking to school; however, several barriers may limit this behavior. This study estimates the prevalence of walking to school and related barriers as reported by U.S. parents. Data from the 2017 SummerStyles, a Web-based survey conducted on a nationwide sample of U.S. adults, were analyzed in 2017. Parents of children aged 5-18 years (n = 1137) were asked whether their youngest child walked to or from school during a usual school week and what barriers make this difficult. Frequencies are presented overall and by parent characteristics. About 1 in 6 parents (16.5%) reported their youngest child walks to or from school at least once during a usual week. Prevalence differed by parental race/ethnicity, marital status, region, and distance from school. The most common barrier was living too far away (51.3%), followed by traffic-related danger (46.2%), weather (16.6%), "other" barrier (14.7%), crime (11.3%), and school policy (4.7%). The frequency at which parents reported certain barriers varied by their child's walking status, distance to school, age of youngest child, race/ethnicity, education level, household income, and metropolitan statistical area status. However, the relative ranking of barriers did not differ by these characteristics. Prevalence of walking to school is low in the U.S., and living too far away and traffic-related danger are common barriers reported by parents. Implementing Safe Routes to School programs and other initiatives that utilize strategies to overcome locally-relevant barriers could help increase the prevalence of children walking to school.

Piercy K, Troiano R, Ballard R, et al. The Physical Activity Guidelines for Americans. JAMA. 2018; 320(19):2020-2028. 
IMPORTANCE: Approximately 80% of US adults and adolescents are insufficiently active. Physical activity fosters normal growth and development and can make people feel, function, and sleep better and reduce risk of many chronic diseases.
OBJECTIVE: To summarize key guidelines in the Physical Activity Guidelines for Americans, 2nd edition (PAG).
PROCESS AND EVIDENCE SYNTHESIS: The 2018 Physical Activity Guidelines Advisory Committee conducted a systematic review of the science supporting physical activity and health. The committee addressed 38 questions and 104 sub-questions and graded the evidence based on consistency and quality of the research. Evidence graded as strong or moderate was the basis of the key guidelines. The Department of Health and Human Services (HHS) based the PAG on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report.
RECOMMENDATIONS: The PAG provides information and guidance on the types and amounts of physical activity to improve a variety of health outcomes for multiple population groups. Preschool-aged children (3 through 5 years) should be physically active throughout the day to enhance growth and development. Children and adolescents aged 6 through 17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. They should also do muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week. Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities. Recommendations emphasize that moving more and sitting less will benefit nearly everyone. Individuals performing the least physical activity benefit most by even modest increases in moderate-to-vigorous physical activity. Additional benefits occur with more physical activity. Both aerobic and muscle-strengthening physical activity are beneficial.
CONCLUSIONS AND RELEVANCE: The Physical Activity Guidelines for Americans, 2nd edition, provides information and guidance on the types and amounts of physical activity that provide substantial health benefits. Health professionals and policy makers should facilitate awareness of the guidelines and promote the health benefits of physical activity and support efforts to implement programs, practices, and policies to facilitate increased physical activity and to improve the health of the US population.

*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.

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Last updated February 19, 2019