martes, 1 de marzo de 2011

CDC - National Report on Human Exposure to Environmental Chemicals - NER

CDC’s National Report on Human Exposure to Environmental Chemicals, Updated Tables, February 2011



Today, the Centers for Disease Control and Prevention (CDC) posted on its website updated data tables for the National Report on Human Exposure to Environmental Chemicals, an ongoing assessment of the U.S. population’s exposure to environmental chemicals using laboratory technology known as biomonitoring.

The Exposure Report, Updated Tables, February 2011 presents exposure data from the National Health and Nutrition Examination Survey for the civilian, non-institutionalized U.S. population over a two-year survey period of 2007–2008. The Updated Tables are cumulative and include data reported in earlier updates. Therefore, the Updated Tables, February 2011 includes data that were reported in the previous Updated Tables, July 2010. The Updated Tables, February 2011 presents data from the 2005–2006 and 2007–2008 NHANES survey periods for 54 of the chemicals previously reported through 2004 in the Fourth Report, 2009, along with nine more recently added chemicals.

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CDC - National Report on Human Exposure to Environmental Chemicals - NER





The Fourth National Report on Human Exposure to Environmental Chemicals 2009 and the Updated Tables, February 2011, together are the most comprehensive assessment of environmental chemical exposure in the U.S. population. Since 1999, CDC has measured 219 chemicals in people’s blood or urine. The Fourth Report, 2009, includes the findings from national samples for 1999-2000, 2001-2002, and 2003-2004.

The blood and urine samples were collected from participants in CDC’s National Health and Nutrition Examination Survey (NHANES), which obtains and releases health-related data from a nationally representative sample in two-year cycles.

The Updated Tables add more recent and new data to the Fourth Report, 2009. The Updated Tables are cumulative and include data reported in earlier updates. Therefore, the Updated Tables, February 2011 includes data that were reported in the previous Updated Tables, July 2010. The Updated Tables, February 2011 presents data from the 2005-2006 and 2007-2008 NHANES survey periods for 54 of the chemicals previously reported through 2004 in the Fourth Report, 2009, along with nine more recently added chemicals. The data are analyzed separately by age, sex, and racial/ethnic groups.


Download the Fourth Report
Full Report [PDF - 6,517 KB - 524 pages]

http://www.cdc.gov/exposurereport/pdf/FourthReport.pdf

Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt


OI: 10.3201/eid1704.101353
Suggested citation for this article: Talaat M, Afifi S, Dueger E, El-Ashry N, Marfin A, Kandeel A, et al. Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt. Emerg Infect Dis. 2011 Apr; [Epub ahead of print]


Effects of Hand Hygiene Campaigns on Incidence of Laboratory-confirmed Influenza and Absenteeism in Schoolchildren, Cairo, Egypt
Maha Talaat, Salma Afifi, Erica Dueger, Nagwa El-Ashry, Anthony Marfin, Amr Kandeel, Ehmad Mohareb, and Nasr El-Sayed

Author affiliations: US Naval Medical Research Unit No. 3 (NAMRU-3), Cairo (M. Talaat, S. Afifi, E. Dueger, A. Marfin, E. Mohareb); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (E. Dueger, A. Marfin); and Ministry of Health, Cairo, Egypt (N. El-Ashry, A. Kandeel, N. El-Sayed)

To evaluate the effectiveness of an intensive hand hygiene campaign on reducing absenteeism caused by to influenza-like illness (ILI), diarrhea, conjunctivitis, and laboratory-confirmed influenza, we conducted a randomized control trial in 60 elementary schools in Cairo, Egypt. Children in the intervention schools were required to wash hands twice daily, and health messages were provided through entertainment activities; Data were collected on student absenteeism and reasons for illness. School nurses collected nasal swabs from students with ILI, which were tested by using a qualitative diagnostic test for influenza A and B. Compared with results for the control group, in the intervention group, overall absences caused by ILI decreased (reduced 40%, p<0.0001), diarrhea (reduced 30%, p<0.0001), conjunctivitis (reduced 67%, p<0.0001), and laboratory-confirmed influenza (reduced 50%, p<0.0001). An intensive hand hygiene campaign was effective in reducing absenteeism caused by these illnesses. Acute respiratory infections (ARIs) and diarrheal diseases cause substantial illness and death worldwide. Most of the estimated 5.5 million deaths associated with ARI and diarrhea occur in children from resource-limited countries. In these settings, where access to health services is often lacking, effective prevention methods are paramount. ARIs cause >4 million...

full-text: [15 pages]
http://www.cdc.gov/eid/content/17/4/pdfs/10-1353.pdf?source=govdelivery

Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist

Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist
Press Release Date: February 28, 2011




Improvements in health care quality continue to progress at a slow rate—about 2.3 percent a year; however, disparities based on race and ethnicity, socioeconomic status and other factors persist at unacceptably high levels, according to the 2010 National Healthcare Quality Report and National Healthcare Disparities Report issued today by the Department of Health & Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ).

The reports, which are mandated by Congress, show trends by measuring health care quality for the Nation using a group of credible core measures. The data are based on more than 200 health care measures categorized in several areas of quality: effectiveness, patient safety, timeliness, patient-centeredness, care coordination, efficiency, health system infrastructure, and access.

"All Americans should have access to high-quality, appropriate and safe health care that helps them achieve the best possible health, and these reports show that we are making very slow progress toward that goal," said AHRQ Director Carolyn M. Clancy, M.D. "We need to ramp up our overall efforts to improve quality and focus specific attention on areas that need the greatest improvement."

Gains in health care quality were seen in a number of areas, with the highest rates of improvement in measures related to treatment of acute illnesses or injuries. For example, the proportion of heart attack patients who underwent procedures to unblock heart arteries within 90 minutes improved from 42 percent in 2005 to 81 percent in 2008.

Other very modest gains were seen in rates of screening for preventive services and child and adult immunization; however, measures of lifestyle modifications such as preventing or reducing obesity, smoking cessation and substance abuse saw no improvement.

The reports indicate that few disparities in quality of care are getting smaller, and almost no disparities in access to care are getting smaller. Overall, blacks, American Indians and Alaska Natives received worse care than whites for about 40 percent of core measures. Asians received worse care than whites for about 20 percent of core measures. And Hispanics received worse care than whites for about 60 percent of core measures. Poor people received worse care than high-income people for about 80 percent of core measures.

Of the 22 measures of access to health care services tracked in the reports, about 60 percent did not show improvement, and 40 percent worsened. On average, Americans report barriers to care one-fifth of the time, ranging from 3 percent of people saying they were unable to get or had to delay getting prescription medications to 60 percent of people saying their usual provider did not have office hours on weekends or nights. Among disparities in core access measures, only one—the gap between Asians and whites in the percentage of adults who reported having a specific source of ongoing care—showed a reduction.

Each year since 2003, AHRQ has reported on the progress and opportunities for improving health care quality and reducing health care disparities. The National Healthcare Quality Report focuses on national trends in the quality of health care provided to the American people, while the National Healthcare Disparities Report focuses on prevailing disparities in health care delivery as it relates to racial and socioeconomic factors in priority populations.

The quality and disparities reports are available online at
http://www.ahrq.gov/qual/qrdr10.htm, by calling 1-800-358-9295 or by sending an E-mail to ahrqpubs@ahrq.hhs.gov.

For more information, please contact AHRQ Public Affairs: (301) 427-1892 or (301) 427-1855.

Use Twitter to get AHRQ news updates: http://www.twitter.com/ahrqnews/

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Internet Citation:

Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist. Press Release, February 28, 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/press/pr2011/qrdr10pr.htm

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Health Care Quality Still Improving Slowly, but Disparities and Gaps in Access to Care Persist

Future Directions for the National Healthcare Quality and Disparities Reports

Future Directions for the National Healthcare Quality and Disparities Reports
Institute of Medicine Report
By the Committee on Future Directions for the National Healthcare Quality and Disparities Reports, Board on Health Care Services, Cheryl Ulmer, Michelle Bruno, and Sheila Burke, Editors



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The National Healthcare Quality and Disparities Reports (NHQR and NHDR) play a fundamental role in examining quality improvement and disparities reduction. In this report, prepared at the request of the Agency for Healthcare Research and Quality (AHRQ), the Institute of Medicine (IOM) suggests ways to reformulate and enhance our Nation's essential measures of quality and equity, to facilitate informed decisionmaking, and to help set the strategic direction of the Nation's quality improvement enterprise.


Select to download the print version of the report (PDF File, 2.5 MB; 247 pages)
http://www.ahrq.gov/research/iomqrdrreport/iomqrdrreport.pdf

Internet Citation:

Future Directions for the National Healthcare Quality and Disparities Reports. December 2010. AHRQ Publication No. 11-0026-EF. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/iomqrdrreport/

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full-contents:
Future Directions for the National Healthcare Quality and Disparities Reports

2010 National Healthcare Disparities and Quality Reports

2010 National Healthcare Quality & Disparities Reports



For the eighth year in a row, the Agency for Healthcare Research and Quality (AHRQ) has produced the National Healthcare Quality Report (NHQR) and the National Healthcare Disparities Report (NHDR). These reports measure trends in effectiveness of care, patient safety, timeliness of care, patient centeredness, and efficiency of care. New this year are chapters on care coordination, health system infrastructure. The reports present, in chart form, the latest available findings on quality of and access to health care.

The National Healthcare Quality Report tracks the health care system through quality measures, such as the percentage of heart attack patients who received recommended care when they reached the hospital or the percentage of children who received recommended vaccinations. The National Healthcare Disparities Report summarizes health care quality and access among various racial, ethnic, and income groups and other priority populations, such as residents of rural areas and people with disabilities.

The reports have been revised based on recommendations from the Institute of Medicine that can be found in their report, Future Directions for the National Healthcare Quality and Disparities Reports.

Note: The reports provided here are prepublication drafts and may contain minor editorial errors or inconsistencies. Final printed versions will be available from AHRQ's clearinghouse in March or April 2011. We anticipate posting updated electronic versions of the printed reports and accessible versions of the reports by March. Users needing assistance with accessibility matters may E-mail Doreen Bonnett at Doreen.Bonnett@ahrq.hhs.gov or call Ms. Bonnett at (301) 427-1899.

full-text and related reports:
2010 National Healthcare Disparities and Quality Reports


▲ National Healthcare Quality Report
Full Report (PDF File, 4.4 MB; 205 pages)
http://www.ahrq.gov/qual/nhqr10/nhqr10.pdf

AHRQ Publication No. 11-0004
Current as of February 2011











▲▲ National Healthcare Disparities Report
AHRQ Publication No. 11-0005
Current as of February 2011
Full Report (PDF File, 4.3 MB; 248 pages)
http://www.ahrq.gov/qual/nhdr10/nhdr10.pdf

NIH launches largest oil spill health study, February 28, 2011 News Release - National Institutes of Health (NIH)

Monday, February 28, 2011 Contact:
Christine Bruske Flowers
919-541-3665
National Institute of Environmental Health Sciences (NIEHS)



NIH launches largest oil spill health study
GuLF STUDY to follow 55,000 cleanup workers and volunteers for up to 10 years


A new study that will look at possible health effects of the Gulf of Mexico’s Deepwater Horizon oil spill on 55,000 cleanup workers and volunteers begins today in towns across Louisiana, Mississippi, Alabama, and Florida.

The GuLF STUDY (Gulf Long-term Follow-up Study) is the largest health study of its kind ever conducted among cleanup workers and volunteers, and is one component of a comprehensive federal response to the Deepwater Horizon oil spill. The study is being conducted by the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health, and is expected to last up to 10 years Many agencies, researchers, outside experts, as well as members of the local community, have provided input into how the study should be designed and implemented.

"Over the last 50 years, there have been 40 known oil spills around the world. Only eight of these spills have been studied for human health effects," said Dale Sandler, Ph.D., chief of the Epidemiology Branch at NIEHS and principal investigator of the GuLF STUDY. "The goal of the GuLF STUDY is to help us learn if oil spills and exposure to crude oil and dispersants affect physical and mental health."

Over time, the GuLF STUDY will generate important data that may help inform policy decisions on health care and health services in the region. Findings may also influence responses to other oil spills in the future.

"We are enrolling workers and volunteers because they were closest to the disaster and had the highest potential for being exposed to oil and dispersants," said Sandler.

The GuLF STUDY will reach out to some of the 100,000 people who took the cleanup worker safety training and to others who were involved in some aspect of the oil spill cleanup. The goal is to enroll 55,000 people in the study. Individuals may be eligible for the study if they:

•Are at least 21 years old
•Did oil spill cleanup work for at least 1 day
•Were not directly involved in oil spill cleanup but supported the cleanup effort in some way, or completed oil spill worker training

Working from lists of people who trained or worked in some aspect of the oil spill response, the GuLF STUDY will contact potential participants by mail, inviting them to take part in the study.

The study was developed to make participation as easy and convenient as possible. In addition, the GuLF STUDY incorporates safeguards to protect the privacy and confidentiality of personal information.

All participants will be asked to complete an initial telephone interview, and provide updated contact information once a year. During the telephone interview, participants will be asked questions about the work they did with the oil spill cleanup, and about their health, lifestyle, and job history. About 20,000 participants will be invited to take part in the second phase of the study, which involves a home visit and follow-up telephone interviews in subsequent years. Small samples of blood, urine, toenail clippings, hair, and house dust will be collected during the home visit, and clinical measurements such as blood pressure, height and weight, urine glucose, and lung function will be taken.

If at any time in the course of the study, the need for mental or medical health care is evident, participants will be given information on available healthcare providers or referred for care. The study leaders have up-to-date information on healthcare providers and a medical referral process in place as part of the study. Materials will be available in English, Spanish, and Vietnamese.

The NIH is funding the GuLF STUDY. A small part of the funds have been provided by BP made to NIH specifically for research on the health of Gulf area communities following the spill, though BP is not involved in the study.

For more information, call the GuLF STUDY toll-free number at 1-855-NIH-GULF (1-855-644-4853) or visit the GuLF STUDY Web site at http://www.niehs.nih.gov/GuLFSTUDY.

The NIEHS supports research to understand the effects of the environment on human health and is part of NIH. For more information on environmental health topics, visit www.niehs.nih.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.


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NIH launches largest oil spill health study, February 28, 2011 News Release - National Institutes of Health (NIH)

National Institutes of Health launches summer institute on mHealth, Monday, February 28, 2011 News Release - National Institutes of Health (NIH)


For Immediate Release
Monday, February 28, 2011 Contact:
Ann C. Benner, NIH
301-594-4574
NIH Office of Behavioral and Social Sciences Research (OBSSR) - Home
Christie Thoene, Qualcomm
858-651-5130


National Institutes of Health launches summer institute on mHealth

The National Institutes of Health today announced the creation of the first NIH mHealth, or mobile health, Summer Institute. Scheduled for the summer of 2011, this week-long workshop will bring together leaders in mobile health technologies, behavioral science researchers, federal health officials and members of the medical community to provide early career investigators with an opportunity to learn about mHealth research. The Office of Behavioral and Social Sciences Research (OBSSR), part of NIH, partnered with Qualcomm, a developer of wireless technologies, to cosponsor the course.

Mobile technologies have the potential to transform medical research and enable health care providers to more rapidly and accurately assess biological processes, behavior, attitudes, and the environment. These technologies also allow providers to help patients improve their health in real time—enabling them to personalize health care options and monitor progress.

“NIH is committed to harnessing the power and reach of mobile technologies to extend healthy life and to reduce the burden of illness and disability,” explained Director of the National Institute of Biomedical Imaging and Bioengineering, Dr. Roderic Pettigrew.

Through the use of mobile applications and technology, mHealth solutions hold the promise of reducing costs and errors, removing geographical and economic disparities and personalizing health care. These technologies have helped to bring about a convergence of science, medicine, engineering and communications technologies to improve the quality and provision of health care, while striving to reduce costs and inefficiencies.

Wireless technologies allow patients with chronic diseases to monitor and manage their illnesses on a consistent basis. Remote monitoring allows health care providers to manage their patients’ medications, potentially reducing the frequency of hospital visits, and improving patient care. Today, wireless technologies enable everyday home-use medical devices to transfer information from blood glucometers, (a device used by diabetics to measure the amount of glucose in the blood) blood pressure cuff monitors, pulse oximeters, (a device used to monitor oxygen in a patient's blood) weight scales and medication adherence tools, into patient and electronic health records.

Medical device software that operate on smart phones such as diagnostic radiology applications, ultrasound imaging displays, patient vital signs data, live cardiac rhythm information and other waveform data, are increasingly being relied upon by physicians. In developing countries, mobile technology provides doctors who collaborate long-distance with community health workers the ability to accurately and efficiently diagnosis patients in rural villages without leaving the clinic.

NIH’s mHealth Summer Institute will provide an overview of the engineering, behavioral science and clinical aspects of wireless research and will facilitate interaction between participants and experts from across the mHealth spectrum. The institute will cover the current state of the science in mobile technology and engineering, behavior change theory and clinical applications, and will highlight the intersection of these areas for health-related research. Interdisciplinary teams of participants will develop potential mHealth research projects. To register, please visit: http://obssr.od.nih.gov/training_and_education/mhealth/index.aspx

“Qualcomm is committed to enhancing wireless health technologies and to furthering opportunities for advancing research in this critical area,” said Don Jones, vice president of Qualcomm Wireless Health. “We are proud to partner with NIH on the launch of the mHealth Summer Institute and believe it is an important step in realizing the promise of wireless health care technologies.”

Qualcomm Incorporated is a world leader in 3G and next-generation mobile technologies. For 25 years, Qualcomm ideas and inventions have driven the evolution of wireless communications, connecting people more closely to information, entertainment and each other. Today, Qualcomm technologies are powering the convergence of mobile communications and consumer electronics, making wireless devices and services more personal, affordable and accessible to people everywhere. For more information, visit Qualcomm around the Web: www.qualcomm.com.

The Office of Behavioral and Social Sciences Research (OBSSR) opened officially on July 1, 1995. The U.S. Congress established the Office of Behavioral and Social Sciences Research (OBSSR) in the Office of the Director, NIH, in recognition of the key role that behavioral and social factors often play in illness and health. The OBSSR mission is to stimulate behavioral and social sciences research throughout NIH and to integrate these areas of research more fully into others of the NIH health research enterprise, thereby improving our understanding, treatment, and prevention of disease. For more information, please visit http://obssr.od.nih.gov.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.


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National Institutes of Health launches summer institute on mHealth, Monday, February 28, 2011 News Release - National Institutes of Health (NIH)