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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Among U.S. women, breast cancer is the most commonly diagnosed cancer and remains second only to lung cancer as a cause of cancer-related mortality. The American Cancer Society (ACS) estimates that 182,800 new cases of female breast cancer and 41,200 deaths from breast cancer will occur in 2000. Since the 1950s, the incidence of invasive cervical cancer and mortality from this disease have decreased substantially; much of the decline is attributed to widespread use of the Papanicolaou (Pap) test. ACS estimates that 12,800 new cases of invasive cervical cancer will be diagnosed, and 4,600 deaths from this disease will occur in the United States in 2000. ⋯ The NBCCEDP, through federal, state, territorial, and tribal governments, in collaboration with national and community-based organizations, has increased access to breast and cervical cancer screening among low-income and uninsured women. This initiative enabled the United States to make substantial progress toward achieving the Healthy People 2000 objectives for breast and cervical cancer control among racial/ethnic minorities and persons who are medically underserved. A continuing challenge for the future is to increase national commitment to providing screening services for all eligible uninsured women to ultimately reduce morbidity and mortality from breast and cervical cancer.