National Center for Education in Maternal and Child Health
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August 27, 2004
1. New Web Site Features Integrate Detailed Perinatal
Health Data
2. Redesigned Web Site Enhances Public Access to
Information on Dietary Supplements
3. Report Looks at Impact of Health Care Trends on Health
Centers
4. Authors Summarize Findings on the Role of Vaginal
Douching in the Reproductive Health of Adolescents and Young Women
5. Literature Review Investigates Firearm Ownership and
Storage Practices
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1. NEW WEB SITE FEATURES INTEGRATE DETAILED PERINATAL HEALTH DATA
A new PeriStats database and Web interface were recently implemented to
integrate access to detailed city and county data on maternal and
infant health in the United States. The new Web site represents the
first milestone of a partnership between the March of Dimes Perinatal
Data Center, the National Library of Medicine, and the New York Academy
of Medicine to increase access to city, county, state, and national
perinatal data and to improve the utility of PeriStats. More than
50,000 graphs, maps, and tables have been added to the PeriStats system
to date. Future efforts will include integrating access to relevant
biomedical literature. The Web site is intended to be used for
fact-finding, regional health assessments, grant writing, policy
development, lectures, and presentations. An overview of the new
features is available at http://www.marchofdimes.com/peristats/whatsnew.aspx?id=6.
The PeriStats Web site is available at http://www.marchofdimes.com/peristats.
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2. REDESIGNED WEB SITE ENHANCES PUBLIC ACCESS TO INFORMATION ON DIETARY
SUPPLEMENTS
The IBIDS (International Bibliographic Information on Dietary
Supplements) database has been made available to the public through a
redesigned Web interface on the National Institute of Health's Office
of Dietary Supplements (ODS) home page. The IBIDS database was
originally launched in 1999 as a result of the Dietary Supplement and
Health Education Act, which mandated the creation of a tool to assist
both scientists and the public in locating credible scientific
literature on dietary supplements. In 1998 the ODS initiated an
interagency agreement with the U.S. Department of Agriculture's Food
and Information Center at the National Agricultural Library to develop
and maintain the database. The database provides access to
bibliographic citations and abstracts from the published,
international, and scientific literature on dietary supplements and is
intended for use by individuals with varying levels of expertise. Users
can choose to search the full IBIDS database, a subset of consumer
citations only, or peer-reviewed citations only. The database is
available at http://dietary-supplements.info.nih.gov/Health_Information/IBIDS.aspx.
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3. REPORT LOOKS AT IMPACT OF HEALTH CARE TRENDS ON HEALTH CENTERS
A Nation's Health at Risk II: A Front Row Seat in a Changing Health
Care System examines trends from the health center perspective and
offers a snapshot of communities in need. The report is the second in a
series published by the National Association of Community Health
Centers (NACHC) to evaluate the state of the nation's health. The
report begins with a discussion of the importance of having a usual
source of care, the need for the safety net, and the Community Health
Centers program. The authors examine issues such as access to
preventive services, infant mortality and low birthweight, chronic
disease, racial and ethnic health disparities, and cost-effective care.
The final section explores state support of health centers and Medicaid
restrictions. The report is available at http://www.nachc.com/press/pdf/NationsHealthIISTIB7.pdf.
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4. AUTHORS SUMMARIZE FINDINGS ON THE ROLE OF VAGINAL DOUCHING IN THE
REPRODUCTIVE HEALTH OF ADOLESCENTS AND YOUNG WOMEN
"The initiation and maintenance of douching behavior in young women is
a complicated behavior influenced by many factors, including family,
sexual partners, body image, and advertising, among many others," state
the authors of an article published in the August 2004 issue of the
Journal of Pediatric and Adolescent Gynecology. The authors note that
although douching dates back centuries, the practice remains
controversial and has been implicated in adverse reproductive health
outcomes. The purpose of this article is to summarize key findings from
the published literature and ongoing research as well as to highlight
research challenges to our understanding of the role of vaginal
douching in reproductive health.
The authors reviewed key findings from recently published literature,
preliminary findings from the ongoing randomized controlled trial of a
douching behavioral intervention (B-WELL study), and findings of recent
cross-sectional surveys of university students.
The authors found that
* Numerous studies have shown that douching is prevalent and often
begins in adolescence.
* Motivation for the initiation and maintenance of douching appears
complex and presents challenges to intervention efforts. Recent studies
implicate high-risk sexual behaviors as motivators for sustaining
douching behavior.
* Douching has been implicated in numerous adverse reproductive health
outcomes such as pelvic inflammatory disease, ectopic pregnancy,
reduced fertility, and bacterial vaginosis. However, most studies
linking douching to adverse reproductive health outcomes are case
control studies; thus the causal relationship between douching and
these outcomes remains unknown. The mechanism of the associations
remains undetermined, as well.
* Recent publications involving participants from developing countries
seem to indicate that vaginal douching under certain circumstances may
be harmless or even beneficial.
The authors note that although "the need for prospective longitudinal
studies of the effects of douching was recognized decades ago . . .
very little advancement has been published in recent decades." They
suggest that "prospective studies should further examine the different
typology of douching behaviors and other behavioral influences inherent
to the acquisition of STIs [sexually transmitted infections] that may
compromise reproductive health."
Simpson T, Merchant J, Grimley DM, et al. 2004. Vaginal douching among
adolescent and young women: More challenges than progress. Journal of
Pediatric and Adolescent Gynecology 17(4):249-255.
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5. LITERATURE REVIEW INVESTIGATES FIREARM OWNERSHIP AND STORAGE
PRACTICES
"The information obtained in this review documents the presence of an
important hazard in a large proportion of U.S. households, for which
policy and programmatic safety interventions are available," state the
authors of an article published in the August 2004 issue of the
American Journal of Preventive Medicine. The authors state that firearm
injuries are a leading cause of both fatal and nonfatal injury in the
United States and that the presence of a household firearm has been
found to be associated with an increased risk for homicide, suicide,
and unintentional shootings, especially among young people. This review
summarizes journal articles published in the past decade that provide
estimates of the prevalence of household firearm ownership and storage
practices in the United States. The purposes of the review are to (1)
examine the current state of knowledge about firearm ownership and
storage in the United States, (2) provide recommendations for future
research, and (3) serve as background for those working to advance
public health research and practice about this issue.
The authors searched MedLine, CINAHL, Sociological Abstracts, and
PsycInfo to identify articles. For inclusion, articles had to include a
quantification of (1) the prevalence of firearm ownership in homes, (2)
the types of firearms owned, and/or (3) the prevalence of certain
storage practices. The articles also had to have appeared in a
peer-reviewed journal between 1992 and 2002. The final review included
42 articles.
The authors found that
* Estimates of firearm ownership among all U.S. households ranged from
30% to 33%. The estimate of the prevalence of firearms in households
with children was 35%.
*Among households with firearms, estimates of the prevalence of those
with loaded firearms ranged from 29% to 37%, of storing firearms
unlocked ranged from 49% to 53%, and of storing firearms unlocked and
loaded ranged from 21% to 22%.
* Among households with firearms and in which there were children (ages
under 18), estimates of the prevalence of those with loaded firearms
(14% to 30%) were lower than the corresponding prevalence estimates for
all U.S. households (29% to 37%).
* Among households with firearms and in which there were children,
estimates of the prevalence of storing firearms unlocked (43%) and both
unlocked and loaded (6% to 14%) were lower than the national prevalence
estimates (49% to 53% and 21% to 22%, respectively).
* The prevalence of firearm ownership was highest in the South,
followed by the Midwest. The prevalence was lowest in the Northeast.
The prevalence was lower in urban areas than in rural areas.
The authors conclude that "continued and expanded documentation of the
prevalence will permit assessment of changes in the risk profile of
U.S. households as interventions are implemented."
Johnson RM, Coyne-Beasley T, Runyan CW. 2004. Firearm ownership and
storage practices, U.S. households, 1992-2002. American Journal of
Preventive Medicine 27(2):173-182.
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MCH Alert © 2004 by
National Center for Education in Maternal and
Child Health and Georgetown University. MCH Alert is produced by
MCH Library Services at the National Center for Education in Maternal
and Child Health under its cooperative agreement (6U02 MC 00001) with
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Please contact us at the address below.
EDITORS: Jolene
Bertness, Tracy Lopez
COPYEDITOR: Ruth
Barzel
National Center for
Education in Maternal and Child Health
Georgetown University
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