MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports
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The Task Force on Community Preventive Services (the Task Force) has conducted systematic reviews of the evidence of effectiveness of selected population-based interventions to prevent and control dental caries (tooth decay), oral (mouth) and pharyngeal (throat) cancers, and sports-related craniofacial injuries. The Task Force strongly recommends community water fluoridation and school-based or school-linked pit and fissure sealant delivery programs for prevention and control of dental caries. Using the rules of evidence it has established, the Task Force found insufficient evidence of effectiveness or ineffectiveness of the remaining interventions reviewed. ⋯ The Task Force's finding of insufficient evidence indicates the need for more research on intervention effectiveness. Until the results of such research become available, readers are encouraged to judge the usefulness of these interventions by other criteria. This report presents additional information regarding the recommendations, briefly describes how the reviews were conducted, and provides information designed to help apply the strongly recommended interventions locally.
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The Task Force on Community Preventive Services (the Task Force) has conducted systematic reviews of community interventions to increase physical activity. The Task Force either strongly recommends or recommends six interventions: two informational approaches (i.e., communitywide campaigns and point-of-decision prompts to encourage use of stairs); three behavioral and social approaches (i.e., school-based physical education, social support interventions in community settings [e.g., setting up a buddy system or contracting with another person to complete specified levels of physical activity], and individually adapted health behavior change programs); and one intervention to increase physical activity by using environmental and policy approaches (i.e., creation of or enhanced access to places for physical activity, combined with informational outreach activities). The Task Force found insufficient evidence on which to base recommendations for classroom-based health education focused on information provision, behavioral skills, and social support interventions in family settings because of inconsistent findings; mass media campaigns, college-age physical education, and health education because of an insufficient number of studies; and classroom-based health education focusing on reducing television viewing and video game playing because of the lack of a demonstrated link between reduced time spent watching television or playing video games and increased physical activity. This report provides additional information regarding the recommendations, briefly describes how the reviews were conducted, and provides information that can help in applying the interventions locally.
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These recommendations concern the use of aluminum hydroxide adsorbed cell-free anthrax vaccine (Anthrax Vaccine Adsorbed [AVA], BioPort Corporation, Lansing, MI) in the United States for protection against disease caused by Bacillus anthracis. In addition, information is included regarding the use of chemoprophylaxis against B. anthracis.
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Practice Guideline Guideline
Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients.
CDC, the Infectious Disease Society of America, and the American Society of Blood and Marrow Transplantation have cosponsored these guidelines for preventing opportunistic infections (OIs) among hematopoietic stem cell transplant (HSCT) recipients. The guidelines were drafted with the assistance of a working group of experts in infectious diseases, transplantation, and public health. For the purposes of this report, HSCTis defined as any transplantation of blood- or marrow-derived hematopoietic stem cells, regardless of transplant type (i.e., allogeneic or autologous) or cell source (i.e., bone marrow, peripheral blood, or placental or umbilical cord blood). ⋯ The guidelines were developed for use by HSCT recipients, their household and close contacts, transplant and infectious diseases physicians, HSCT center personnel, and public health professionals. For all recommendations, prevention strategies are rated by the strength of the recommendation and the quality of the evidence supporting the recommendation. Adhering to these guidelines should reduce the number and severity of OIs among HSCT recipients.
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Fall-related injuries are the leading cause of injury deaths and disabilities among older adults (i.e., persons aged > or = 65 years). The most serious fall injury is hip fracture; one half of all older adults hospitalized for hip fracture never regain their former level of function. In 1996, a total of 340,000 hospitalizations for hip fracture occurred among persons aged > or = 65 years, and 80% of these admissions occurred among women. From 1988 to 1996, hip fracture hospitalization rates for women aged > or = 65 years increased 23%. ⋯ Persons aged > or = 65 years constitute the fastest-growing segment of the U.S. population. Without effective intervention strategies, the number of hip fractures will increase as the U.S. population ages. Fall prevention programs have reduced falls and fall-related injuries among high-risk populations using multifaceted approaches that include education, exercise, environmental modifications, and medication review. These programs need to be evaluated among older adults aged > or = 65 years who are living independently in the community. In addition, secondary prevention strategies are needed to prevent hip fractures when falls occur. Effective public health strategies need to be implemented to promote behavioral changes, improve current interventions, and develop new fall prevention strategies to reduce future morbidity and mortality associated with hip fractures among older adults.