Comparison of indoor air quality management strategies between the school and district levels in New York State

BACKGROUND: Good school indoor air quality (IAQ) can affect the health and functioning of school occupants. Thus, it is important to assess the degree to which schools and districts employ strategies to ensure good IAQ management. We examined and compared the patterns of IAQ management strategies between public elementary schools and their school districts in New York State. METHODS: District‐level information obtained from surveys of district facilities managers in 326 districts was described and stratified by district size and socioeconomic status. School‐level information obtained from surveys of head custodians in 770 elementary schools was then compared with the district‐level information in 241 districts. RESULTS: About 47% of participating school districts reported having a district‐wide IAQ program, with a large range in the prevalence of specific IAQ management strategies. Airing out newly painted areas was the most commonly reported (92%) and having a classroom animal policy was the least commonly reported (29%). Larger districts and districts with a district‐wide IAQ program were more likely to report certain IAQ strategies than other districts. Elementary schools and their districts were most likely to report airing out newly painted areas (76%). The most common area of disagreement was construction after hours (50%). The top strategy not reported at either level was having an IAQ coordinator (53%). CONCLUSIONS: Many school districts lack key IAQ management strategies, and differences exist between district‐level policy and school‐level practice. Districts and schools should work together to formalize and expand existing IAQ policies and inform stakeholders about these strategies.     

Potential overestimation of HPV vaccine impact due to unmasking of non-vaccine types: quantification using a multi-type mathematical model

Introduction

Estimates of human papillomavirus (HPV) vaccine impact in clinical trials and modelling studies rely on DNA tests of cytology or biopsy specimens to determine the HPV type responsible for a cervical lesion. DNA of several oncogenic HPV types may be detectable in a specimen. However, only one type may be responsible for a particular cervical lesion. Misattribution of the causal HPV type for a particular abnormality may give rise to an apparent increase in disease due to non-vaccine HPV types following vaccination (“unmasking”).

Methods

To investigate the existence and magnitude of unmasking, we analysed data from residual cytology and biopsy specimens in English women aged 20–64 years old using a stochastic type-specific individual-based model of HPV infection, progression and disease. The model parameters were calibrated to data on the prevalence of HPV DNA and cytological lesion of different grades, and used to assign causal HPV types to cervical lesions. The difference between the prevalence of all disease due to non-vaccine HPV types, and disease due to non-vaccine HPV types in the absence of vaccine HPV types, was then estimated.

Results

There could be an apparent maximum increase of 3–10% in long-term cervical cancer incidence due to non-vaccine HPV types following vaccination.

Conclusion

Unmasking may be an important phenomenon in HPV post-vaccination epidemiology, in the same way that has been observed following pneumococcal conjugate vaccination.     

Publication rates of abstracts presented at the Association of Chiropractic Colleges Educational Conference/Research Agenda Conference from 2002 to 2008

Objective

The purposes of this study were to investigate the overall publication rates of presentations at the Association of Chiropractic Colleges Educational Conference/Research Agenda Conference (ACC/RAC) meetings (2002–2008), differences in the publication rates of platform vs poster presentations, and the consistency of the meeting abstract compared to the full-length journal article.

Methods

Abstracts were obtained from proceedings published in the Journal of Chiropractic Education. Literature searches using PubMed and the Index to the Chiropractic Literature (ICL) were performed to locate peer-reviewed journal articles based upon those abstracts. Whether the article was based upon a poster or platform presentation, and the congruence of the information in the abstract and article were recorded.

Results

We identified 776 proceeding abstracts, 249 of which eventually were published between 2002 and 2012. The overall publication rate was 32.2%. A total of 42.7% of platform presentations eventually were published vs 20.3% of posters. Congruency showed that 43.2% had the same title as the meeting abstract, 59.7% had the same authorship, and 88.8% had the same methods.

Conclusion

Publication rates of abstracts from spine and orthopedic surgery national meetings range from 34% to 59%. The ACC/RAC meetings have similar publication rates. More platform than poster presentations reach full publication. The congruency of ACC/RAC abstracts to published articles is higher than national meetings in other fields.Key Indexing Terms: Journal Article (Publication Type), Publication Formats (Publication Type), Congresses (Publication Type), Chiropractic     

Successful umbilical cord blood stem cell transplantation for chronic granulomatous disease

Chronic granulomatous disease (CGD) causes growth failure, inflammatory lung damage and often early death. Prophylactic cotrimoxazole improves medium-term survival, but cannot prevent inflammatory sequelae. We report the first patient with CGD who underwent successful HLA identical sibling umbilical cord stem cell transplantation (UCSCT) after myeloablative conditioning. The patient presented with colitis, confirmed as CGD at 2 years of age. Following BU16/CY200 conditioning, he had UCSCT from his unaffected HLA identical sister. A year post-transplant, his colitis had resolved clinically and on radioisotope scan growth has improved. Neutrophil oxidative burst was 92% normal with full donor lymphocyte reconstitution.     

Maximal inspiratory and expiratory pressures in adolescents. Normal values

The measurement of maximal inspiratory and expiratory pressures at the mouth (MIP and MEP, respectively) provides a noninvasive clinical method for evaluating the strength of respiratory muscles. In an attempt to reconcile the widely divergent normal values reported in the literature for healthy adolescents, we have measured, using simple manometry, MIP and MEP in 112 white subjects, 76 adolescents and 36 healthy adults. For female adolescents the values for MIP and MEP were 76 +/- 25 and 86 +/- 22 cm H2O, respectively, and were significantly less than those for male adolescents (p less than 0.01), whose mean values were 107 +/- 26 and 114 +/- 35 cm H2O, respectively. Mean values for adolescents were comparable to values measured in adult control subjects, and for both adolescents and adults, mean values approximated the lower end of the previously reported ranges of normal values in healthy subjects. Thus, MIP and MEP in healthy adolescents are significantly greater in male subjects than female subjects, but are comparable to those of healthy adults of the same sex. Furthermore, these studies suggest that the choice of normal values for MIP and MEP must take into account significant methodologic differences among laboratories.     

Bacteriuria in a population-based cohort of women.

A survey for bacteriuria was conducted in a community-wide, unselected population of women 16--69 years old. The overall prevalence of bacteriuria was 3.5%. The prevalence of bacteriuria increased with age with a linear trend, but with a significant nonlinear component as well. Bacteriuria was associated with parity after correction for the effects of age. Current symptoms of dysuria and a history of previous urinary tract infection were slightly but significantly more common in women with bacteriuria. The population described should serve as an adequate base for continuing studies of the possible consequences of bacteriuria.     

Effectiveness and safety of salmeterol in nonspecialist practice settings

STUDY OBJECTIVES: To evaluate the effectiveness and safety of inhaled salmeterol in patients managed in nonspecialist practice settings. DESIGN: A randomized, double-blind, 6-month, parallel-group study involving 253 centers. SETTING: Primarily nonspecialist practices (n = 232). PATIENTS: A total of 911 subjects (417 men; 494 women) who met American Thoracic Society asthma criteria were enrolled and randomized to treatment with either twice-daily salmeterol aerosol (50 microg; n = 455) or matching placebo twice daily (n = 456). Both groups were allowed to take salbutamol as needed. All subjects were previously treated with anti-inflammatory maintenance therapy that was continued throughout the study. MEASUREMENTS AND RESULTS: The primary outcome variable was the proportion of subjects with serious asthma exacerbations defined as an exacerbation requiring hospitalization, emergency department visit, or use of prednisone during the treatment period. A total of 712 subjects competed the study. There was no significant difference in the proportion of subjects experiencing serious exacerbations between the salmeterol and placebo groups (20.8% vs 20.9%, respectively; p = 0.935; power > 88%). Peak expiratory flow was significantly higher in the salmeterol group (398 L/min vs 386 L/min for placebo; p < 0.01). Median daily use of salbutamol was two inhalations for the salmeterol group and three inhalations for placebo (p < 0.001). The proportion of subjects sleeping through the night was significantly higher in the salmeterol group (74%) as compared to placebo (68%; p = 0.028). CONCLUSIONS: Salmeterol treatment is effective in subjects typically cared for in the primary-care setting and does not increase the frequency of severe exacerbations.