Assessing Community-Based Injury Prevention Services in U.S. Children's Hospitals

ObjectiveNot-for-profit hospitals are required to meet federal reporting requirements detailing their community benefit activities, which support their tax-exempt status. Children''s hospitals have long provided community injury prevention (IP) programming and thus can inform public health outreach work in other areas. This work describes IP programming as a community service offered by children''s hospitals in the U.S.MethodsThe IP specialist at 232 US-based member institutions of the Children''s Hospital Association were invited to complete an assessment of their hospital''s IP outreach programming.Results47.7 percent of hospitals request financial data from IP programming for tax reporting purposes. Almost all offer injury prevention (IP) services; the majority are in the community (60.3%) and 34.5% are hospital-based. Most IP units are independent (60.3%) and 71.8% are responsible for their own budgets.ConclusionsBy integrating dissemination and implementation sciences and community health needs assessments, these findings can help advance community services provided by hospitals to impact public health.     

Methadone maintenance treatment may improve completion rates and delay opioid relapse for opioid dependent individuals under community corrections supervision

Aims

Several studies have demonstrated the importance of agonist therapies such as methadone and buprenorphine for preventing relapse for individuals being released from jail or prison to the community. No studies have examined the impact of methadone for increasing the completion of community supervision requirements and preventing opioid relapse for individuals under community corrections supervision. This observational study compared the community corrections completion rate and opioid relapse rate of individuals receiving methadone maintenance therapy (MMT) to individuals who did not.

Methods

Of the 2931 individuals enrolled under criminal justice supervision in the community, Treatment Accountability for Safer Communities (TASC), and who met criteria for opioid dependence, 329 (11%) individuals reported receiving MMT in the community.

Results

The majority of participants were White (79.8%) and male (63.5%), with a mean age of 31.33 years (SD = 9.18), and were under supervision for 10.4 months (SD = 9.1). MMT participants were less likely to fail out of supervision compared to individuals not in MMT (39.0% vs. 52.9%, p < 0.001), and had a lower rate of relapse (32.9%) and longer time to relapse (average days = 89.7, SD = 158.9) compared to the relapse rate (55.9%) and time to relapse (average days = 60.5, SD = 117.9) of those not on MMT.

Conclusions

While the observational nature of this study prevents causal inferences, these results suggest that utilization of MMT in community corrections may increase the likelihood of completing supervision requirements and delay time to opioid relapse. Providing agonist therapies to opioid dependent individuals under supervision appears to be a critical strategy in this important population.     

Antepartum Screening for Group B Streptococcus by Three FDA-Cleared Molecular Tests and Effect of Shortened Enrichment Culture on Molecular Detection Rates

Neonatal Streptococcus agalactiae infections cause significant morbidity and mortality, and antenatal screening is recommended. We compared three U.S. Food and Drug Administration (FDA)-cleared nucleic acid amplification tests (NAATs) to culture using 314 vaginal/rectal swabs after 18 to 24 h (recommended period) and 4 to 8 h (shortened period) of broth enrichment. Agreement of the NAATs with each other was high (97.1% to 98.4%), but culture was less sensitive than all NAATs (67% to 73%). A shortened period of broth culture enrichment resulted in 1 false-negative result in 68 (1.5%). The NAATs performed comparably and were more sensitive than culture.     

Auditing the Representation of Female Versus Male Athletes in Sports Science and Sports Medicine Research: Evidence-Based Performance Supplements

Although sports nutrition guidelines promote evidence-based practice, it is unclear whether women have been adequately included in the underpinning research. In view of the high usage rates of performance supplements by female athletes, we conducted a standardised audit of the literature supporting evidence-based products: β-alanine, caffeine, creatine, glycerol, nitrate/beetroot juice and sodium bicarbonate. Within 1826 studies totalling 34,889 participants, just 23% of participants were women, although 34% of studies included at least one woman. Across different supplements, 0–8% of studies investigated women exclusively, while fewer (0–2%) were specifically designed to compare sex-based responses. The annual publication of female-specific studies was ~8 times fewer than those investigating exclusively male cohorts. Interestingly, 15% of the female participants were classified as international/world-class athletes, compared with 7% of men. Most studies investigated performance outcomes but displayed poorer representation of women (16% of participants), whereas health-focussed studies had the greatest proportion of female participants (35%). Only 14% of studies including women attempted to define menstrual status, with only three studies (~0.5%) implementing best practice methodologies to assess menstrual status. New research should target the efficacy of performance supplements in female athletes, and future sports nutrition recommendations should specifically consider how well female athletes have contributed to the evidence-base.     

Identification of monoclonal antibodies capable of differentiating antigenic varieties of eastern equine encephalitis viruses

We have isolated and characterized 3 monoclonal antibody (Mab) reagents useful in the serological identification of varieties of eastern equine encephalitis (EEE) viruses. These antibodies were specific for the E1 glycoprotein of their homologous viruses. One Mab, 1B5C-3, reacted specifically with all North American (NA) EEE viruses isolated over a 50 year period. This antigenic stability of NA isolates was genetically confirmed by oligonucleotide fingerprinting. Evolutionary stability is a unique feature among alphaviruses. The Mab, 1C1J-4 reacted specifically with 1 South American isolate of EEE virus. A third Mab, 1B1C-4, was EEE virus complex reactive. While none of these antibodies had virus neutralizing activity, the identified reactivities could be demonstrated in the more rapid serological tests of enzyme-linked immunosorbent assay and indirect immunofluorescence.     

Involuntary subordination or dependency as key dimensions of depressive vulnerability?

Dependency associated with depression involves at least two forms of social behavior: (a) needs for nurturance/protection and close attachment, and an inability to function independently and (b) being (de)valued, fear of disapproval, and social status. In many studies, measures of dependency combine these two dimensions. This paper argues that this has led to confusion on the salient dimensions related to depression. It is suggested that behaviors currently regarded as dependent, and linked to depression, are better understood as forms of involuntary subordination that involve judgments of personal inferiority, and submissive-appeasement behavior. This paper presents preliminary evidence that social status, and its associated features of negative self-other comparisons and submissive behavior, may be particularly relevant to depression.     

Nutrition knowledge of active-duty Navy personnel.

As evidence continues to mount implicating diet in the etiology of disease, the US Navy is developing nutrition education programs designed to reflect the consolidated dietary recommendations of national expert agencies. The purpose of this study was to provide a baseline assessment of the level of nutrition knowledge among Navy personnel. Forty true/false questions were developed to test nutrition knowledge as conveyed by the Navy's instructional manual for nutrition educators. The questionnaire was mailed to a representative sample of all active-duty Navy personnel. Usable questionnaires were received from 2,938 participants (72.7% response rate). Mean number of correct items was 26.1 (65%). Nutrition knowledge was higher among older respondents, more highly educated personnel, whites, officers, women, and overweight individuals. Knowledge was weakest in the areas of calories/food intake and carbohydrates and strongest on vitamins/minerals and fiber. Program managers were recommended to intensify efforts to reach low-scoring subgroups, place more emphasis on the role of complex carbohydrates, disseminate guidelines for using nutrition labels on products, and develop point-of-choice nutrition education interventions for military dining facilities.