Recreational Water Illness and Injury Prevention Week 2012

5/21/2012 12:00 AM

Swimming is one of the most popular sports activities in the United States. Although swimming is a physical activity that offers numerous health benefits, pools and other recreational water venues are also places where germs can be spread and injuries can happen.

May 21–27, 2012, the week before Memorial Day, marks the eighth annual Recreational Water Illness and Injury (RWII) Prevention Week. Recreational water illnesses (RWIs) are caused by germs spread by swallowing, breathing in mists or aerosols of, or having contact with contaminated water in swimming pools, hot tubs/spas, water play areas, interactive fountains, lakes, rivers, or oceans. RWIs can also be caused by chemicals in the water or chemicals that evaporate from the water and trigger indoor air quality problems. In addition to illnesses, injuries—such as drowning and slips, trips, and falls—can occur in or around the water.

For more information, visit the CDC's website for Recreational Water Illness and Injury Prevention Week.

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Flu Shots: Far From Perfect, Still Advised

10/26/2011 12:00 AM

Flu shots are safe, cheap and pretty muchuniversally recommended.

But how well do they really protect us from getting sick?

The most comprehensive review to date, just published online by The Lancet, suggests that flu vaccines aren't as effective as many of us have thought.

An analysis of 31 published studies conducted since 1998 found that vaccination against influenza is moderately effective in keeping healthy adults healthy. But evidence of protection was lacking for some of the groups who need it the most, including adults 65 and older.

"We found a number of differences in how influenza vaccine has performed in different populations of people," Michael Osterholm, the study's lead author told Shots. Osterholm heads the Center for Infectious Disease Research and Policy at the University of Minnesota.

Between 3,000 and 49,000 Americans die from the flu in an average year, a number that fluctuates so much in part because of the unpredictable nature of the disease. Flu is a unique public health problem, because it can be both seasonal and pandemic, and its severity varies from cycle to cycle.

Due to that variation, the exact cocktail in the syringe (or spritz of immunizing nasal mist) has to be updated annually, and people have to get new shots. "It's clear that what we really need is to develop new and better vaccines," Osterholm said. The ultimate goal would be a universal vaccine that's effective against all strains of flu.

But that's not going to be an easy task. At the moment, Osterholm said, there are "major barriers to new vaccines entering the market, particularly vaccines that are novel."

And those barriers have to change without the current market for flu vaccinations dropping, because the medical recommendation to get them will remain pretty universal.

"Moderate effectiveness is still effective," Dr. Andrew Pavia, an infectious diseases specialist at the University of Utah, told Shots.

He compared the influenza vaccine to seatbelts, which are accepted as an important safety measure even though they can't save lives in every car crash. "If there's a cheap, simple, safe and effective measure that will get you pretty good protection, why would you wait until there's perfect protection?" he asked.

But that same line of thinking is part of what's hurting the chances that a better vaccine will be developed. From a business perspective, it makes little sense to pour money into a new product for which there appears to be no demand, Osterholm said.

The final paragraphs of the paper highlight the need for more research and development, fewer regulatory barriers for licensing new flu vaccines, and financial models that favor the purchase of more expensive vaccines if they prove more effective.

In short, the study concludes that the effort to develop a better flu vaccine will require an active partnership between industry and government. "Pursuit of this goal now will save lives every year and when the next influenza pandemic occurs," the authors conclude. "In the meantime, we should maintain public support for present vaccines that are the best intervention available for seasonal influenza."

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Mortgage Default Associated With Substantially Increased Risk Of Depression

10/21/2011 12:00 AM

Researchers warn of a looming health crisis in the wake of rising mortgage delinquencies and home foreclosures. The study, released today in the American Journal of Public Health, is the first long-term survey of the impact the current housing crisis is having on older Americans. The study focused on adults over 50 and found high rates of depression among those behind in their mortgage payments and a higher likelihood of making unhealthy financial tradeoffs regarding food and needed prescription medications.

"More than a quarter of people in mortgage default or foreclosure are over 50," says the study's principal investigator, Dawn E. Alley, PhD, assistant professor of epidemiology and public health at the University of Maryland School of Medicine. "For an older person with chronic conditions like diabetes or hypertension, the types of health problems we saw are short term consequences of falling behind on a mortgage that could have long-run implications for that person's health."

The study was prompted in part by the rapid rise in foreclosure rates that began in 2007 following a dramatic increase in subprime lending. By 2009, 2.21 percent of all homes in the United States, a total of more than 2.8 million properties, were in some stage of foreclosure. Previous research had shown that home ownership is associated with better health while financial strain is associated with worse health and higher death rates.

"This study has pinpointed an issue that until now has been somewhat under the radar, but which threatens to become a major public health crisis if not addressed," says E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine. "Through research such as this, faculty epidemiologists and public health specialists provide valuable information and perspectives that are useful for government and private policy makers as they work to meet the health and economic needs of Americans."

The researchers examined data from the Health and Retirement Study, a nationally representative panel study of Americans older than age 50. In 2008, 2,474 participants were asked if they had fallen more than two months behind on mortgage payments since 2006. The survey included questions designed to measure psychological impairment, general health status and access to important health-relevant resources. In predicting these health outcomes, researchers controlled for demographic factors, health behaviors, chronic diseases, sources of debt and annual household income.

Among participants who were mortgage delinquent, 22 percent developed elevated depressive symptoms over the two-year period compared to only three percent of non-delinquent respondents. Twenty-eight percent of mortgage-delinquent participants reported food insecurity compared to four percent in the non-delinquent group. In addition, the delinquent group reported much higher levels of cost-related medication non-adherence (32 percent compared to five percent).

The study also found that lower-income and minority homeowners were at higher risk for mortgage default. "Our results suggest that the housing crisis may be making health disparities worse," says Dr. Alley, "because these groups had poorer health, lower incomes and higher levels of debt even before the current mortgage crisis." The researchers note that it will likely take decades for African American and Hispanic communities to recover the wealth lost during the housing crisis and that minority communities are disproportionately affected by declining home values and lost tax revenue.

The study began just as mortgage delinquencies and subsequent home foreclosures began to rise in the United States, driven mainly by increases in mortgage payments related to adjustable rate loans. Dr. Alley says the health picture is much worse today because rising mortgage defaults are compounded by unemployment. "Recent data from the Centers for Disease Control and Prevention show that the number of Americans with depression has been increasing along with rising unemployment."

Dr. Alley adds that mortgage counselors are seeing a rising tide of health issues. "We did a separate nationwide survey of mortgage counselors and found that almost 70 percent of them said many of the clients they worked with were depressed or hopeless. About a third of them said they had worked with someone in the last month who expressed intent for self harm or suicide. These are very serious and clearly ongoing issues."
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Joint Study On Tobacco Use And Risk Perceptions Announced By FDA And NIH

10/10/2011 12:00 AM

The U.S. Food and Drug Administration and the National Institutes of Health have announced a joint, large-scale, national study of tobacco users to monitor and assess the behavioral and health impacts of new government tobacco regulations.

The initiative, called the Tobacco Control Act National Longitudinal Study of Tobacco Users, is the first large-scale NIH/FDA collaboration on tobacco regulatory research since Congress granted FDA the authority to regulate tobacco products in the Family Smoking Prevention and Tobacco Control Act of 2009.

Scientific experts at NIH's National Institute on Drug Abuse and the FDA's Center for Tobacco Products will coordinate the effort.

"The launch of this study signals a major milestone in addressing one of the most significant public health burdens of the 21st century," said FDA Commissioner Margaret A. Hamburg. "The results will strengthen FDA's ability to fulfill our mission to make tobacco-related death and disease part of America's past and will further guide us in targeting the most effective actions to decrease the huge toll of tobacco use on our nation's health."

Investigators will follow more than 40,000 users of tobacco-product and those at risk for tobacco use ages 12 and older. They will examine what makes people susceptible to tobacco use; evaluate use patterns and resulting health problems; study patterns of tobacco cessation and relapse in the era of tobacco regulation; evaluate the effects of regulatory changes on risk perceptions and other tobacco-related attitudes; and assess differences in attitudes, behaviors and key health outcomes in racial-ethnic, gender, and age subgroups.

"We are pleased to collaborate with the FDA on this study that may provide us with a better understanding of the impact of product regulation on tobacco prevention and cessation," said NIH Director Francis S. Collins, M.D., Ph.D.

Westat, in Rockville, Md., was awarded the research contract in a competitive solicitation process. Study findings will help the FDA assess the impact of the Tobacco Control Act and will inform the agency about how to best use its tobacco regulatory authorities, such as making decisions about marketing of products, setting product standards, and communicating the risks from tobacco use to protect the public health.

While smoking rates have dropped significantly since their peak in the 1960s, nearly 70 million Americans ages 12 and older were current users of tobacco products in 2010. As a result, death and disease caused by tobacco use is still a tremendous public health burden. Tobacco use is the leading preventable cause of disease, disability, and death in the United States. Cigarette smoking results in more than 443,000 premature deaths in the United States each year - more than alcohol, illegal drug use, homicide, suicide, car accidents, and AIDS combined.
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21st Century Vaccines Innovation In Design And Rational Use Holds Great Promise For Global Public Health

9/23/2011 12:00 AM

Innovation in the design of vaccines is rapidly expanding their use, safety, and effectiveness for disease prevention and therapeutic interventions. The enormous potential of OMICS sciences for global health and vaccine design is examined in "Vaccines of the 21st Century and Vaccinomics," a special issue of OMICS: A Journal of Integrative Biology, the peer-reviewed journal published by Mary Ann Liebert, Inc.

"Truly a fresh new look at how we design vaccines and apply them judiciously to benefit global health is essential and timely in the present age of data enabled science and postgenomics integrative biology," writes Eugene Kolker, PhD, Editor-in-Chief of OMICS, and Chief Data Officer, Seattle Children's Hospital, and Head, Bioinformatics & High-Throughput Analysis Laboratory, Seattle Children's Research Institute, and the Special Issue Guest Editor Vural Ozdemir (Associate Professor, McGill University, Canada), and co-authors of the Introductory Editorial, Tikki Pang (World Health Organization, Geneva, Switzerland), Bartha M. Knoppers, Denise Avard, Ma'n H. Zawati (Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill University), and Samer A. Faraj (Desautels Faculty of Management, McGill University).

Despite advances in public health in the 21th century, we still lack safe and highly effective vaccines against the common pathogens seriously affecting global society such as neglected tropical diseases and helminth infections, tuberculosis, HIV, and malaria. These gaps in global health are deepened further by the lack of development of new antimicrobial drugs. The new field of vaccinomics relies on the integrated use of multi-omics data intensive biotechnologies (e.g., genomics, proteomics, metabolomics) to understand individual and population differences in immune responses to vaccines. Vaccinomics holds great promise for the design of safer and more effective vaccines, and their targeted rational use via novel postgenomics diagnostics to prevent and combat infectious diseases, and to intervene in chronic non-communicable diseases such as cancer, diabetes, and obesity.

Featuring global contributions from leading experts in Australia, Asia, Europe, and North America, "Vaccines of the 21st Century: Vaccinomics for Global Public Health" includes a series of articles on cutting-edge topics such as the conceptual basis of vaccinomics; high throughput ''game changing'' experimental approaches for 21st century vaccine design; case studies including previously neglected tropical diseases vastly affecting the developing countries (e.g., vaccinomics for helminth infections); the new therapeutic cancer vaccines; social science and policy analyses on vaccinomics and global health convergence, and the current strategies for vaccinomics-enabled rational vaccine design deployed by the vaccine industry.

An opinion piece by Alan Bernstein, Global HIV Vaccine Enterprise (New York, NY), Bali Pulendran, Emory University School of Medicine (Atlanta, GA), and Rino Rappuoli, Novartis Global Vaccines and Diagnostics (Siena, Italy) provides a forward look in the article "Systems Vaccinomics: The Road Ahead for Vaccinology."

Guest Editor Vural Ozdemir notes that "OMICS technologies and postgenomics diagnostics, when considered under a sound public health genomics framework, can offer innovative and potentially cost-effective solutions to current priorities in global health." In a concluding remark, he observes that the new science demands more than technological proficiency: "Seeking science-based solutions such as vaccinomics for the extant global public health priorities can only be achieved in a sustainable manner through a tri-partite integration of the biological, social, and political determinants of health."
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