Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html

September 4, 2009

************************************************************

Special Notice: The National Institutes of Health convened a state-of-the-science conference on August 24-26, 2009, in Bethesda, Maryland, to review the evidence on the role of family history, its validity in the primary care setting, and its effect on individual and population health outcomes. The panel's draft statement, conference abstracts, archived Webcast, evidence-based practice center report, conference questions, sponsors, agenda, and media resources are available at http://consensus.nih.gov/2009/Fhx%20images/familyhistory_draftstmt.pdf

************************************************************

1. MCH LIBRARY RELEASES NEW EDITION OF KNOWLEDGE PATH ABOUT CHILDREN WITH SPECIAL HEALTH CARE NEEDS

Children with Special Health Care Needs: Knowledge Path is an electronic guide to resources that analyze data, describe effective programs, and report on policy and research aimed at developing systems of care for children and youth with special health care needs that are family-centered, community-based, coordinated, and culturally competent. The new edition of the knowledge path, produced by the Maternal and Child Health (MCH) Library at Georgetown University, contains information on Web sites, publications, databases, and social media for health professionals, program administrators, policymakers, educators, researchers, and families. Separate sections address specific aspects of care and development, such as early intervention and education, financing services, rehabilitation, screening, and transition. The knowledge path will be updated periodically. The knowledge path is available at http://www.mchlibrary.info/KnowledgePaths/kp_cshcn.html

MCH Library knowledge paths on other topics are available at http://www.mchlibrary.info/KnowledgePaths/index.html. The MCH Library welcomes feedback on the usefulness and value of these knowledge paths. A feedback form is available at http://www.mchlibrary.info/feedback/index.html

• Clear definitions describing both ascertainment and reporting criteria of cases need to be established, with guidelines describing a systematic approach to reviewing the data. Multiple sources of information are needed for case finding.
• Basic demographic information is a minimum requirement for data collection. The ideal data set would reflect all available information necessary to inform on strategies to reduce risk factors, potential causes, and associated conditions with each event. Fetal autopsy and placental histopathology are two essential components to an adequate evaluation that are often not routinely and systematically performed.
• Long-term strategies involving multiple stakeholders are needed to improve the quality of data generated and recorded when stillbirth occurs. These strategies include the development of guidelines for postmortem evaluation, along with awareness, education, and training for health professionals in the appropriate use of these protocols and guidelines. Likewise, ongoing awareness and training are needed at the state level to educate health professionals on the various reporting requirements for fetal deaths.

• A majority (78.7 percent) responded that they stock and administer at least one vaccine. The most common were HPV and influenza.
• Physicians who provide primary care were more likely than other physicians to administer vaccinations (85.5 percent vs. 75.4 percent).
• Most of the physicians either disagreed (40.9 percent) or strongly disagreed (24.6 percent) with the following statement "routine screening for vaccine-preventable diseases falls outside of the routine practice of an ob/gyn."
• The physicians primarily reported that their immunization training during medical school and residency was barely adequate (39.8 percent and 34.9 percent, respectively).
• Most of the physicians (86.2 percent) indicated that their practices would benefit from continuing medical education on immunization.
• Barriers to administering vaccinations can be divided into three categories: financial, not usual practice, and safety concerns.
• Most of the physicians were aware that the influenza (89.8 percent), hepatitis B (64.9 percent), and Tdap (58.6 percent) vaccines are safe to administer during pregnancy, and that MMR (97.5 percent) and varicella (92.9 percent) are not.

• At second pregnancy, 55 percent of the women remained overweight, 33 percent had BMI 30 or more (obese), and 12 percent had BMI 24.9 or less (normal or underweight).
• The shift from overweight pre-pregnancy status to obese status at the second pregnancy was statistically significant for the variables of being unmarried and having a long interval between the first and the second pregnancy (18 months or more).
• The shift from overweight pre-pregnancy status to normal or underweight status at the second pregnancy was statistically significant for the variable of pregnancy low-normal weight gain.