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Medical and Research Library News - November 2021

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

November 2021         

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.

November 5, 2021; 1-2 p.m. Pediatric COVID-19 vaccine town hall. Join the Health Resources and Services Administration (HRSA) for a health center town hall to discuss pediatric COVID-19 vaccination in underserved communities. Speakers will share the latest information about COVID-19 vaccination for children ages 5-11. This includes ways to build vaccine confidence among parents and families and to support partnership between providers and families for shared decision-making. A CDC representative will also provide an overview of the pediatric vaccine rollout plan. https://lnks.gd/l/eyJhbGciOiJIUzI1NiJ9.eyJidWxsZXRpbl9saW5rX2lkIjoxMDAsInVyaSI6ImJwMjpjbGljayIsImJ1

November 10, 2021; 11 a.m.-12 p.m. Untangling chromatin: Epigenetics meets multiomics. While most of us have difficulty keeping a garden hose or headphones from bunching and forming kinks, each of our cells can compactly hold 2 meters of DNA inside micron-sized nuclei. What is even more astounding is that in these cramped quarters, DNA is accessible to numerous regulatory factors that enable gene expression. Chromatin architecture plays a key role in gene regulation and has helped usher in the field of epigenetics, the study of heritable phenotype changes that do not involve alterations in DNA sequence. In this webinar from the American Association for the Advancement of Science (AAAS), speakers will provide background information on the techniques involved in studying epigenetics, introduce the development of new molecular technologies, high-throughput DNA sequencing, and powerful computational and biophysical methods used to analyze chromatin structure, and discuss how an integrated multiomics approach can be used to identify epigenetic changes associated with disease pathology. https://view6.workcast.net/register?cpak=6042860784919285&referrer=ScienceWebsite

November 10, 2021; 12-1 p.m. Lessons learned: COVID-19 health literacy in special & vulnerable populations. There are a variety of social determinants of health (SDOH) factors that may negatively influence the ability of special and vulnerable populations to understand and make appropriate health decisions, which can put them at higher risk for hospitalization and poorer health outcomes. This webinar will discuss lessons learned related to addressing low levels of health literacy and the spread of misinformation about COVID-19, and how health centers that serve farmworker families and community-dwelling older adults can effectively support patient healthcare engagement. Presented by the National Center for Farmworker Health (NCFH). https://www.surveymonkey.com/r/R8MLFBM

November 18, 2021; 11 a.m.-12:30 p.m. Prevention as a community effort: How health centers can support diabetes prevention through their partnerships. Patients at Federally Qualified Health Centers (FQHCs), especially those experiencing homelessness or housing instability, often receive services from many types of providers that don’t efficiently communicate across sectors. Eliminating these kinds of gaps will reduce redundancies and improve health outcomes. It is critical for diabetes prevention to be approached in this holistic way, considering the many determinants of health related to diabetes. This webinar from Health Resources and Services Administration (HRSA) will explore diabetes prevention with a specific focus on how health centers can partner with community organizations to improve prevention and health promotion efforts in their community. https://csh-org.zoom.us/meeting/register/tZ0rd-ivrj8jHNS0nUrK76g_INch6WgxRdGC?_x_zm_rtaid=v-2sx5c6RFugHXwYw2998g.1634842222176.54feaf3e86af7da1ac98aa5017f22fc0&_x_zm_rhtaid=962

November 18, 2021; 1-2 p.m. Rural health resources. Evidence shows that there are marked health disparities between those living in rural areas versus their urban counterparts. Not only do rural residents suffer from higher incidence of chronic illness, they also have limited access to primary care services and are more likely to be uninsured or under-insured. This webinar from the Network of the National Library of Medicine (NNLM) will describe hallmarks of rural America, identify access challenges of living in rural communities, and equip participants with tools to service the health information needs of those living in rural communities. https://nnlm.gov/training/class/rural-health-resources-0

Websites and reports on trending topics

Communication strategies for building confidence in COVID-19 vaccines: Addressing variants and childhood vaccinations - The fourth wave of the COVID-19 pandemic in the United States has been fueled by the delta variant, which is more contagious than earlier variants, and a slowing down in new vaccinations. Most hospitalizations and deaths in the United States are occurring among people who are not vaccinated. This context affirms the importance of tackling vaccine hesitancy and communicating with parents of children who are eligible to be vaccinated and those for whom future eligibility is anticipated. This rapid expert consultation from The National Academies of Sciences, Engineering, and Medicine identifies actionable guidance that state and local decision makers can use to communicate with the public to build confidence in and promote the uptake of COVID-19 vaccines. https://www.nap.edu/catalog/26361/communication-strategies-for-building-confidence-in-covid-19-vaccines-addressing

November is National Diabetes Month - According to the CDC, more than 1 in 3 U.S. adults have prediabetes—that’s 88 million people—but the majority of people don’t know they have it. The good news is that by making small healthy lifestyle changes, it is possible to prevent type 2 diabetes and even reverse prediabetes. This resource from The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center focuses on prediabetes and provides a self-care plan, toolkit, and information resources for parents, caregivers, and youth. https://www.niddk.nih.gov/health-information/community-health-outreach/national-diabetes-month?dkrd=hisce0049

ProQuest Ebook Central – Another resource provided by DSHS Medical and Research Library affiliation, ProQuest Ebook Central is a science and technology ebook collection. It offers more than 28,000 carefully curated ebooks spanning coverage in all science and technology topics with exceptional strength in computers and IT, engineering, life and physical sciences, and math. Register here to create an account for access. https://ebookcentral.proquest.com/lib/dshstexas

Severe Maternal Morbidity in the United States: A Primer - In 2017, at a time when maternal mortality was declining worldwide, the World Health Organization (WHO) reported that the U.S. was one of only two countries to report a significant increase in its maternal mortality ratio since 2000. While U.S. maternal deaths have leveled in recent years, the ratio is still higher than in comparable countries, and significant racial disparities remain. Understanding the evidence on maternal mortality and its causes is a key step in crafting health care delivery and policy solutions at the state or federal level. This data brief from The Common Wealth Fund draws on a range of recent and historical data sets to present the state of maternal health in the United States today. https://www.commonwealthfund.org/publications/issue-briefs/2021/oct/severe-maternal-morbidity-united-states-primer

Journal articles of note

Liberman RF, Heinke D, Petersen JM, et al. Interpregnancy interval and prevalence of selected birth defects: A multistate study [published online ahead of print, 2021 Oct 21]. Birth Defects Res. 2021. doi:10.1002/bdr2.1960
Background: Both short and long interpregnancy intervals (IPIs) have been associated with adverse birth outcomes. We undertook a multistate study to describe the prevalence of selected birth defects by IPI.
Methods: We obtained data from nine population-based state birth defects registries for singleton live births in 2000-2009 among mothers with a previous live birth identified through birth certificates. IPI was calculated as the difference between prior birthdate and start of the current pregnancy (conception date). We estimated prevalence of selected defects per 10,000 live births and prevalence ratios (PRs) with 95% confidence intervals (CIs) overall and stratified by maternal age at previous birth and race/ethnicity. Primary analyses focused on short IPI < 6 months and long IPI ? 60 months compared to 18-23 months (referent). Sensitivity analyses limited to active-surveillance states and those with<10% missing IPI.
Results: Among 5,147,962 eligible births, 6.3% had short IPI while 19.8% had long IPI. Compared to referent, prevalence with short IPI was elevated for gastroschisis (3.7, CI: 3.0-4.5 vs. 2.0, CI: 1.6-2.4) and with both short and long IPI for tetralogy of Fallot (short: 3.4, 2.8-4.2 long: 3.8, 3.4-4.3 vs. 2.7, 2.3-3.2) and cleft lip ± palate (short: 9.9, 8.8-11.2 long: 9.2, 8.5-9.8 vs. 8.4, 7.6-9.2). Stratified analyses identified additional associations, including elevated prevalence of anencephaly with short IPI in younger mothers and limb defects with long IPI in those ages 25-34 at prior birth. Sensitivity analyses showed similar results.
Conclusion: In this population-based study, we observed increased prevalence of several birth defects with short and long IPI.

Tadese BK, Nutt A, Chaudhary I, Offiong C, Darkoh C. Regional outbreak of multidrug-resistant Klebsiella pneumoniae carbapenemase-producing Pseudomonas Aeruginosa [published online ahead of print, 2021 Oct 1]. Infect Control Hosp Epidemiol. 2021;1-3. doi:10.1017/ice.2021.394
Klebsiella pneumoniae carbapenemase-producing P. aeruginosa (KPC-CRPA) are rare in the United States. An outbreak of KPC-CRPA was investigated in Texas using molecular and epidemiologic methods and 17 cases of KPC-CRPA were identified. The isolates were genetically related and harbored the emerging P. aeruginosa multilocus sequence type 235, the first in the United States.

Vahidy FS, Pan AP, Hagan K, et al. Impact of mRNA vaccines in curtailing SARS-CoV-2 infection and disability leave utilisation among healthcare workers during the COVID-19 pandemic: cross-sectional analysis from a tertiary healthcare system in the Greater Houston metropolitan area. BMJ Open. 2021;11(10). Published 2021 Oct 12. doi:10.1136/bmjopen-2021-054332
Objectives: We provide an account of real-world effectiveness of COVID-19 vaccines among healthcare workers (HCWs) at a tertiary healthcare system and report trends in SARS-CoV-2 infections and subsequent utilisation of COVID-19-specific short-term disability leave (STDL).
Design: Cross-sectional study.
Setting and participants: Summary data on 27,291 employees at a tertiary healthcare system in the Greater Houston metropolitan area between 15 December 2020 and 5 June 2021. The initial 12-week vaccination programme period (15 December 2020 to 6 March 2021) was defined as a rapid roll-out phase.
Main outcomes and measures: At the pandemic onset, HCW testing and surveillance was conducted where SARS-CoV-2-positive HCWs were offered STDL. Deidentified summary data of SARS-CoV-2 infections and STDL utilisation among HCWs were analysed. Prevaccination and postvaccination trends in SARS-CoV-2 positivity and STDL utilisation rates were evaluated.
Results: Updated for 5 June 2021, 98.2% (n=26 791) of employees received a full or partial dose of one of the approved mRNA COVID-19 vaccines. The vaccination rate during the rapid roll-out phase was approximately 3700 doses/7 days. The overall mean weekly SARS-CoV-2 positivity rates among HCWs were significantly lower following vaccine roll-out (2.4%), compared with prevaccination period (11.8%, p<0.001). An accompanying 69.8% decline in STDL utilisation was also observed (315 to 95 weekly leaves). During the rapid roll-out phase, SARS-CoV-2 positivity rate among Houston Methodist HCWs declined by 84.3% (8.9% to 1.4% positivity rate), compared with a 54.7% (12.8% to 5.8% positivity rate) decline in the Houston metropolitan area.
Conclusion: Despite limited generalisability of regional hospital-based studies-where factors such as the emergence of viral variants and population-level vaccine penetrance may differ-accounts of robust HCW vaccination programmes provide important guidance for sustaining a critical resource to provide safe and effective care for patients with and without COVID-19 across healthcare systems.

Washburn DJ, Callaghan T, Schmit C, Thompson E, Martinez D, Lafleur M. Community health worker roles and their evolving interprofessional relationships in the United States [published online ahead of print, 2021 Oct 15]. J Interprof Care. 2021;1-7. doi:10.1080/13561820.2021.1974362
In the United States, growing attention to the cost of care, the social determinants of health, prevention, and population health, signals a refocusing of efforts on value-based care. Just as Accountable Care Organizations and alternative payment models exemplify this shift in attention, so does the increasing integration of Community Health Workers (CHWs) into the US health care system. CHWs are often referred to as "bridge figures," helping clients to navigate what are oftentimes complicated pathways to access a variety of needed services. The integration of CHWs into interprofessional care teams is a process that takes time, and can lead to conflict as traditional care models are disrupted. Through focus groups with CHWs in rural and urban areas of four states, this work identifies and describes three early stages in the evolving interprofessional relationships between CHWs and other care providers. These stages are characterized by: (1) a lack of knowledge and understanding of CHW roles, (2) conflict and competition, and (3) engagement and integration of CHWs into patient care teams. A better understanding of the evolving process of CHW integration is critical to facilitate education and training that will more quickly encourage the development and efficacy of modern models of interprofessional care that include CHWs.

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Last updated November 8, 2021