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Medical and Research Library News - August 2020

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Training opportunities
Websites and reports on trending topics*
Journal articles of note*

August 2020

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. All times listed are in Central Daylight Time.

August 5, 2020; 1-2 p.m. In their words: Promoting positive adolescent health behaviors and outcomes. Join the Board on Children, Youth, and Families of the National Academies of Sciences, Engineering, and Medicine and the University of Michigan’s MyVoice team to hear what youth think about our recent report, Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st Century. https://nasem.zoom.us/webinar/register/WN_binU85YtRma7klEGSZjkaA

August 5, 2020; 1:30-2:30 p.m. Thirty years after the Americans with Disabilities Act: Where are we now, and where are we heading? Join Mathematica’s Center for Studying Disability Policy for an online roundtable discussion with a panel of experts about the current state of policies and initiatives designed to help people with disabilities fully participate in the labor force and, more broadly, in society. The event will be moderated by Gina Livermore, a Mathematica senior fellow and the director of the Center for Studying Disability Policy. https://www.mathematica.org/events/thirty-years-after-the-americans-with-disabilities-act-where-are-we-now-and-where-are-we-heading

August 12, 2020; 11 a.m.-12 p.m. Action collaborative on bridging public health, health care and community - University of Texas Dell Medical School's community-driven initiatives. Join this webinar to learn about the Community-Driven Initiatives Program, which seeks to support and implement health solutions proposed by and for residents of Austin and Central Texas communities. Through the Call for Ideas Program, the team advances ideas by fostering partnerships, advising on areas of opportunity, promoting leadership development and much more. Hosted by the The National Academies of Sciences, Engineering, and Medicine. https://www.nationalacademies.org/event/08-12-2020/action-collaborative-on-bridging-public-health-health-care-and-community-university-of-texas-dell-medical-schools-community-driven-initiatives

August 14, 2020; 9-11:15 a.m. COVID-19's impact on hurricane evacuation and sheltering. Predictions of an active hurricane season are quickly and coming to fruition, with eight named storms already. Emergency managers are increasingly concerned about when and where to call for evacuations if a major storm hits. With COVID-19 cases rising in a handful of hurricane-prone states, building in social distancing safeguards, securing needed personal protective equipment and supplies, and minimizing public confusion are all top-of-mind considerations. Rep. Stacey Plaskett, former FEMA Administrator Brock Long, and other emergency management experts will join us to explore the latest thinking on protocols, plans, and guidance for safe sheltering and evacuation. Presented by the Bipartisan Policy Center. https://bipartisanpolicy.org/event/covid-19s-impact-on-hurricane-evacuation-and-sheltering/

August 21, 2020; 11 a.m.-12 p.m. Environmental health: Air pollution, COVID-19 & health disparities. Researchers in the US have suggested air pollution has significantly worsened the COVID-19 pandemic and potentially led to more deaths than if pollution-free skies were the norm. This webinar will explore how different neighborhoods in the same city can have vastly different air quality and what that means for their residents’ short- and long-term health outcomes. Presented by The National Institute for Health Care Management (NIHCM). https://www.nihcm.org/events/upcoming-events/event/environmental-health-air-pollution-covid-19-health-disparities

Websites and reports on trending topics*

AJPH Supplement 2 2020 Testing new ways of connecting the nation's fragmented medical, social, and public health systems - Multisectoral collaborations linking medical, public health, and social services are integral to addressing social determinants of health. However, finding practical ways to implement these services system-wide has proved challenging. This open-access supplement of the American Journal of Public Health aims to bridge that gap. https://ajph.aphapublications.org/toc/ajph/110/S2

COVID-19 One-Stop Shop Toolkits – Find the tools you need to successfully communicate with your audiences. Included are videos, PSAs, print resources, checklists, FAQs, and web resources. From the Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/coronavirus/2019-ncov/communication/toolkits/index.html

Encouraging adoption of protective behaviors to mitigate the spread of COVID-19: Strategies for behavior change - This rapid expert consultation from the Societal Experts Action Network helps decision makers, at the federal, state, and local levels, identify what is known about strategies to increase adherence to protective behaviors to mitigate the spread of COVID-19. By understanding these strategies, decision makers can choose the ones that work best for their community. https://www.nap.edu/resource/25881/interactive/

HSRProj: Health Services Research Projects in Progress – This tool from the National Library of Medicine allows you to find information about ongoing health services research and public health projects before results are available in a published format. Use the map feature to find organizations conducting projects in your state. https://wwwcf.nlm.nih.gov/hsr_project/home_proj.cfm

The public’s role in COVID-19 vaccination: Planning recommendations informed by design thinking and the social, behavioral, and communication sciences - This report considers human factors in relation to future vaccines against the novel coronavirus (SARS-CoV-2), drawing on insights from design thinking and the social, behavioral, and communication sciences. It provides recommendations—directed to both US policymakers and practitioners, as well as nontraditional partners new to public health’s mission of vaccination—on how to advance public understanding of, access to, and acceptance of vaccines that protect against COVID-19. From the Johns Hopkins Center for Health Security. https://www.centerforhealthsecurity.org/our-work/publications/the-publics-role-in-covid-19-vaccination

Journal articles of note*

Kipp EJ, de Almeida M, Marcet PL, et al. An atypical case of autochthonous cutaneous leishmaniasis associated with naturally infected phlebotomine sand flies in Texas, United States [published online ahead of print, 2020 Jul 6]. Am J Trop Med Hyg. 2020;10.4269/ajtmh.20-0107. doi:10.4269/ajtmh.20-0107
In the United States, phlebotomine sand flies carrying Leishmania (Leishmania) mexicana are endemic along the southern border. However, relatively little is known about the enzootic and zoonotic transmission of L. (L.) mexicana within the United States, and autochthonous cases of the consequent disease are rarely reported. We investigated an atypical case of cutaneous leishmaniasis (CL) caused by L. (L.) mexicana in a patient from central Texas which did not respond to a typical antileishmanial chemotherapy. We also investigated sand fly vectors around the patient's residence. PCR followed by DNA sequencing was used for determination of Leishmania spp., sand fly species, and host blood meal source. The L. (L.) mexicana genotype from the patient was identical to one found in a positive sand fly. Moreover, this genotype presented the same single-nucleotide polymorphisms as other historical CL cases acquired in Texas over the last 10 years, but distinct from those originating in Mexico and Central America. Three sand fly species were identified among the samples analyzed (n = 194), the majority of which were Lutzomyia (Dampfomyia) anthophora (n = 190), of which four specimens tested positive for Leishmania and two blood-fed specimens showed the presence of a human blood meal. This study highlights the complexity of clinical management of CL in a setting where the disease is infrequently encountered. The detection of human blood in Lu. (D.) anthophora is the first documentation of anthropophagy in this species. This is the first report of wild-caught, naturally infected sand flies found in association with an autochthonous case of human leishmaniasis and the specific strain of Leishmania (Leishmania) mexicana in the United States.

Manning JE, Oliveira F, Coutinho-Abreu IV, et al. Safety and immunogenicity of a mosquito saliva peptide-based vaccine: A randomised, placebo-controlled, double-blind, phase 1 trial. Lancet. 2020;395(10242):1998-2007. doi:10.1016/S0140-6736(20)31048-5
Background: In animal models, immunity to mosquito salivary proteins protects animals against mosquito-borne disease. These findings provide a rationale to vaccinate against mosquito saliva instead of the pathogen itself. To our knowledge, no vector salivary protein-based vaccine has been tested for safety and immunogenicity in humans. We aimed to assess the safety and immunogenicity of Anopheles gambiae saliva vaccine (AGS-v), a peptide-based vaccine derived from four A gambiae salivary proteins, in humans.
Methods: In this randomised, placebo-controlled, double-blind, phase 1 trial, participants were enrolled at the National Institutes of Health Clinical Center in Bethesda, MD, USA. Participants were eligible if they were healthy adults, aged 18-50 years with no history of severe allergic reactions to mosquito bites. Participants were randomly assigned (1:1:1), using block randomisation and a computer-generated randomisation sequence, to treatment with either 200 nmol of AGS-v vaccine alone, 200 nmol of AGS-v with adjuvant (Montanide ISA 51), or sterile water as placebo. Participants and clinicians were masked to treatment assignment. Participants were given a subcutaneous injection of their allocated treatment at day 0 and day 21, followed by exposure to feeding by an uninfected Aedes aegypti mosquito at day 42 to assess subsequent risk to mosquito bites in a controlled setting. The primary endpoints were safety and immunogenicity at day 42 after the first immunisation. Participants who were given at least one dose of assigned treatment were assessed for the primary endpoints and analysis was by intention to treat. The trial was registered with ClinicalTrials.gov, NCT03055000, and is closed for accrual.
Findings: Between Feb 15 and Sept 10, 2017, we enrolled and randomly assigned 49 healthy adult participants to the adjuvanted vaccine (n=17), vaccine alone (n=16), or placebo group (n=16). Five participants did not complete the two-injection regimen with mosquito feeding at day 42, but were included in the safety analyses. No systemic safety concerns were identified; however, one participant in the adjuvanted vaccine group developed a grade 3 erythematous rash at the injection site. Pain, swelling, erythema, and itching were the most commonly reported local symptoms and were significantly increased in the adjuvanted vaccine group compared with both other treatment groups (nine [53%] of 17 participants in the adjuvanted vaccine group, two [13%] of 16 in the vaccine only group, and one [6%] of 16 in the placebo group; p=0·004). By day 42, participants who were given the adjuvanted vaccine had a significant increase in vaccine-specific total IgG antibodies compared with at baseline than did participants who were give vaccine only (absolute difference of log10-fold change of 0·64 [95% CI 0·39 to 0·89]; p=0·0002) and who were given placebo (0·62 [0·34 to 0·91]; p=0·0001). We saw a significant increase in IFN-? production by peripheral blood mononuclear cells at day 42 in the adjuvanted vaccine group compared with in the placebo group (absolute difference of log10 ratio of vaccine peptide-stimulated vs negative control 0·17 [95% CI 0·061 to 0·27]; p=0·009) but we saw no difference between the IFN-? production in the vaccine only group compared with the placebo group (0·022 [-0·072 to 0·116]; p=0·63).
Interpretation: AGS-v was well tolerated, and, when adjuvanted, immunogenic. These findings suggest that vector-targeted vaccine administration in humans is safe and could be a viable option for the increasing burden of vector-borne disease.

Sellers K, Leider JP, Lamprecht L, Liss-Levinson R, Castrucci BC. Using public health workforce surveillance data to prioritize retention efforts for younger staff [published online ahead of print, 2020 Jul 16]. Am J Prev Med. 2020;S0749-3797(20)30175-6. doi:10.1016/j.amepre.2020.03.017
Introduction: The public health enterprise has a people problem. An aging workforce coupled with a sustained, strong economy and healthcare sector has made the recruitment and retention of young, educated staff challenging. Approximately one third of public health staff aged 33 years and younger are considering leaving their organization in the next year. Their reasons for leaving, and considerations for staying, are not well characterized within public health.
Methods: Data were drawn from the Public Health Workforce Interests and Needs Survey, a nationally representative survey of state and local governmental public health employees across the U.S. In 2017, a total of 43,701 staff responded. Descriptive statistics across age groups were examined, and reasons for leaving were characterized. A latent class model and an intent-to-leave logit model were fit in 2019.
Results: Pay and lack of opportunities for advancement were most frequently selected as reasons for considering leaving. Results of a logit model showed that being somewhat or very dissatisfied (versus somewhat or very satisfied) was associated with higher odds of intending to leave (AOR=4.4, p<0.0001), as was pay dissatisfaction (AOR=2.0, p<0.0001). Scoring higher than the agency median on a construct measuring perceived lack of organizational support (AOR=1.8, p<0.0001) and on a scale measuring burnout (AOR=2.6, p<0.0001) was also associated with higher odds of intending to leave.
Conclusions: Many factors associated with an increased intent to leave are present among all age groups. However, support is needed for managers as they attempt to develop and implement solutions that seek to retain the younger workforce in particular. Creating paths for promotion, competitive pay practices, organizational support, and engagement are all critical for retention in this group.

South EC, Kondo MC, Razani N. Nature as a community health tool: The case for healthcare providers and systems [published online ahead of print, 2020 Jul 2]. Am J Prev Med. 2020;S0749-3797(20)30182-3. doi:10.1016/j.amepre.2020.03.025
Social and economic factors, health behaviors, and neighborhood conditions combine to significantly shape individual and community health. These social determinants of health (SDH) are the “conditions in which people are born, grow, live, work, and age... [that are] shaped by the distribution of money, power, and resources at global, national, and local levels.” Recognition that access to care and quality of care are not enough to be healthy has led to a recent rapid growth of SDH interventions within health care. Nature is an example of a neighborhood condition and a commonly accepted SDH. Nature impacts health
through boosted immune response, improved air quality, reduced urban heat island effect, reduced stress, increased physical activity, and development of social connections. In fact, nature has been proposed as a tool to reduce deeply entrenched geographic and socioeconomic health disparities. Despite the acceptance of nature as an SDH, the abundant evidence linking nature and health, and the calls for providers to discuss nature with patients from public health and medical professional organizations, nature is generally missing from the rapidly growing pool of healthcare-generated SDH interventions. This represents a missed opportunity to leverage nature as a community health tool, especially for low-resourced neighborhoods. This article makes the case for nature as an SDH intervention, including healthcare providers engaging in nature contact counseling and health systems investing in creating new local neighborhood green space.

Spinelli MA, Lowery B, Shuford JA, et al. Use of drug-level testing and single-genome sequencing to unravel a case of HIV seroconversion on PrEP [published online ahead of print, 2020 Jul 20]. Clin Infect Dis. 2020;ciaa1011. doi:10.1093/cid/ciaa1011
Cases of seroconversion on PrEP should be carefully investigated given their public health implications and rarity. We report a case of transmitted drug resistance causing seroconversion on PrEP in spite of high adherence, confirmed with dried blood spot and segmental hair drug-level testing and single-genome sequencing.

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Last updated August 6, 2020