Extreme Heat and Pregnancy: A Content Analysis of Heat Health Risk Communication by US Public Health Agencies.

OBJECTIVES: Exposure to extreme heat events increases the risk for negative birth outcomes, including preterm birth. This study sought to determine the presence and content of web-based heat health information for pregnant people provided by federal, state, and local government public health websites. METHODS: This website content analysis consisted of 17 federal, 50 state, and 21 city websites, and noted which of 25 recognized pregnancy heat health data elements were included. Data for the analysis were collected from March 12, 2022, through March 16, 2022. RESULTS: The search identified 17 federal websites, 38 state websites, and 19 city websites with heat health information. Within these, only seven websites listed pregnant people as a vulnerable or at-risk population, and only six websites provided information related to heat health specifically for pregnancy. Of the 25 themes recognized as important for pregnancy risk during extreme heat exposure, only 11 were represented within these 6 websites. CONCLUSION: The presence of web-based pregnancy heat health information is infrequent and limited in content. Boosting web-based publication of extreme heat and pregnancy risks could mitigate negative maternal and child health outcomes.

School Parent Attitudes and Perceptions Relating to Animals, Animal-Assisted Interventions, and the Support of Children's Mental Health.

Growing awareness of the negative effects of trauma has led San Antonio, TX, school districts to expand efforts that can help mitigate these effects and support mental health. Given the literature around the psychological benefits of human-animal interactions, the concept of incorporating animals in treatments or interventions is not a new one. While schools have begun considering or utilizing animal-assisted interventions (AAIs), there have been limited efforts to understand existing perceptions relating to animals and AAIs among school parents in this Hispanic community. To address this gap, a cross-sectional study consisting of a 34-item survey was conducted to explore attitudes, knowledge, and perceptions relating to animals (i.e., pets), AAIs, and the need for supporting young children's mental health among parents. A total of 187 surveys from two school districts were completed and utilized for analysis. The study's findings demonstrate that parents acknowledged the importance of addressing mental health issues early on and were aware of the health benefits human-animal interactions can provide. Furthermore, parents had positive attitudes toward pets and positive perceptions toward AAIs in schools. Some implementation concerns were expressed relating to safety and well-being. Overall, these findings suggest there is existing parent support in using AAIs as a trauma-informed strategy and school innovation.

Exploring School Staff Perceptions Relating to Animals and Their Involvement in Interventions to Support Mental Health.

Given the growing awareness of the health benefits of human-animal interactions, the use of animal-assisted interventions (AAIs) in educational settings has increased over the years. While many school districts are now considering or utilizing AAIs, the literature investigating AAI-related perceptions among school stakeholders is limited with previous studies focusing on evaluating specific programs. To address this gap, a qualitative exploratory study was conducted using semi-structured interviews with school staff in the San Antonio, TX community. A total of 11 interviews were completed with staff serving preschool and elementary school age children. Data collected from interviews were analyzed using thematic analysis. Findings demonstrated that participating staff had some knowledge of the potential benefits of human-animal interactions and perceived the involvement of animals in interventions to be beneficial to children's emotions and social-emotional skills. While perceptions of AAIs were generally positive, concerns around children's safety and well-being were expressed as potential barriers in the adoption of AAIs in schools. These findings are preliminary and provide a segue to future research that can help expand our understanding of how school staff perceive AAIs, their impact on children's mental health, their compatibility with school values, and their advantage relative to other interventions.

Musculoskeletal Injuries in US Air Force Security Forces, January 2009 to December 2018.

OBJECTIVE: To determine the incidence, types, and risk factors of musculoskeletal injuries in a military security forces population. METHODS: Demographic and diagnostic data were retrieved on enlisted US Air Force security forces personnel who served on active duty between January 2009 and December 2018. Incidence rates and ratios were calculated using Poisson regression. RESULTS: During 251,787 person-years of exposure, 62,489 personnel served on active duty. Of these, 40,771 (65.2%) were diagnosed with at least one musculoskeletal injury. The majority (60.1%) of the 164,078 unique musculoskeletal injuries were inflammation and pain secondary to overuse. After adjusting for other factors, women had a 31% higher injury rate than men, and those who were overweight and obese had 15% and 30% higher rates, respectively, than normal-weight peers. CONCLUSIONS: Modifiable and non-modifiable factors contribute to musculoskeletal injuries in the security forces career field.

The pandemic of 1918 and the heart disease epidemic in middle-aged men and women in the United States.

Members of birth cohorts who were alive in 1918 and survived the influenza pandemic were likely to have been "primed" for heart disease in later life. We examine the hypothesis that the twentieth-century heart disease epidemic was a cohort effect reflecting the changing susceptibility composition of the population.We estimated heart disease death rates by single years of age for cohorts born in 1860-1949. We prepared age-specific rates for calendar years 1900-2016, as well as age-standardized cohort and calendar year rates.Males born in 1880-1919 contributed 90 per cent to 100 per cent of all heart disease deaths among males aged 40-64 from 1940 to 1959, when the heart disease epidemic was at its peak. There was no heart disease epidemic among females aged 40-64. Death from heart disease in females tends to occur at older ages.Cigarette smoking, unemployment, and other factors may have played a role in the heart disease epidemic in men and would have interacted with injury from influenza, but our results suggest that having been alive at the time of the 1918 influenza pandemic probably played an important role.

Causes for discharge of military working dogs from service: 268 cases (2000-2004).

OBJECTIVE: To determine causes for discharge of military working dogs (MWDs) from service. DESIGN: Retrospective case series. ANIMALS: 268 MWDs. PROCEDURES: Records of all MWDs approved for discharge from December 2000 through November 2004 were evaluated for cause of discharge. RESULTS: 23 dogs had been obtained through the Department of Defense breeding program but had failed to meet prepurchase or certification standards. The remaining 245 (120 German Shepherd Dogs, 100 Belgian Malinois, and 25 dogs of other breeds) had been purchased as adults or obtained through the breeding program and had passed prepurchase and certification standards. Eighty-five of the 245 (34.7%) adult dogs were 1 to < 5 years old at discharge, and 160 (65.3%) were >or= 5 years old at discharge. The proportion of adult dogs < 5 years old at discharge that were German Shepherd Dogs (69.4%) was significantly greater than the proportion of adult dogs >or= 5 years old at discharge that were German Shepherd Dogs (38.1%). Within the subgroup of dogs >or= 5 years old at discharge, median age at discharge for the German Shepherd Dogs (8.59 years) was significantly less than median age at discharge for the Belgian Malinois (10.61 years). For adult dogs < 5 years old at discharge, the most common cause for discharge was behavioral problems (82.3%). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that longevity of service for MWDs may be influenced by breed differences and that selection criteria should be evaluated to reduce behavior-related discharge from service.

Relationship between incidence of gastric dilatation-volvulus and biometeorologic events in a population of military working dogs.

OBJECTIVE: To calculate the monthly incidence of gastric dilatation-volvulus (GDV) in a population of military working dogs during a 5-year period and determine whether there was an association with synoptic climatologic indices. SAMPLE POPULATION: Medical records of all military working dogs housed at Lackland Air Force Base,Tex, from Jan 1, 1993 to Dec 31, 1997. PROCEDURE: Confirmed cases of GDV were identified from evaluation of medical records and used to calculate incidence of GDV. Factor analysis of local climatologic data was used to classify each day into 1 of 8 meteorologically homogeneous types of days for this location. Occurrence of GDV was compared with frequency of occurrence of synoptic climatologic days. RESULTS: 48 cases of GDV were identified from January 1993 through December 1997 Mean monthly incidence was 2.5 cases/1,000 dogs at risk (range, 0 to 18.5 cases/1,000 dogs; median, 2.5 cases/1,000 dogs). A seasonal increase in incidence of GDV was detected, because half of the episodes were during November, December, and January. An association with a specific synoptic climatologic day was not detected. CONCLUSIONS AND CLINICAL RELEVANCE: Seasonal fluctuations in incidence of GDV may be associated with external factors that precipitate physiologic changes resulting in GDV. Although a specific cause-effect relationship was not documented, clinicians must be alert for the potential of seasonal variation in incidence of GDV and accordingly heighten their index of suspicion for the condition, particularly in populations of dogs that are predisposed to development of GDV.

Food for thought: the use of hazard and critical control point analysis to assess vulnerability of food to terrorist attack in deployment locations.

As part of a screening study, a literature review, personal interviews, and field work at several deployment locations, we examined the historical use of biological warfare agents and the vulnerability of food at military deployment locations to bioterrorist attack. The results of our experience suggest the following: historically, food has occasionally been used as a weapon by individuals; a benchmark procedure already exists to evaluate and ensure the safety of foods procured and used by the U.S. federal government; and food sources at the deployment locations examined are vulnerable to terrorist attack as determined by a critical control point analysis. Recommendations to potentially decrease the vulnerability of the U.S. military food supply to intentional contamination are also provided.

Comparative measles incidence among exposed military and nonmilitary persons in Anchorage, Alaska.

An outbreak of measles that occurred in Anchorage, Alaska, in 1998 resulted in 33 diagnosed cases: 26 were laboratory confirmed and 7 were clinically confirmed. Twenty-nine (88%) of 33 cases occurred in individuals who had not been immunized with at least two measles-mumps-rubella (MMR) vaccinations; 25 (76%) of 33 occurred in school-age children, 0 to 19 years of age. This study identifies the difference in the incidence of measles between the civilian school-age population, who was not completely immunized (two MMR vaccinations given at least 30 days apart), and the military dependent population who had been completely immunized. All cases occurred among civilians, and most (25 of 33 confirmed cases) were associated with school attendance. The authors conclude that a two-dose regimen of MMR vaccine is required to adequately protect individuals against measles.

Investment, managerial capacity, and bias in public health preparedness.

OBJECTIVE: Nearly $7 billion has been invested through national cooperative funding since 2002 to strengthen state and local response capacity. Yet, very little outcome evidence exists to analyze funding effectiveness. The objective of this research is to analyze the relationship between investment (funding) and capacity (readiness) for public health preparedness (PHP). The aim of the authors is to use a management framework to evaluate capacity, and to explore the "immediacy bias" impact on investment stability. DESIGN: This study employs a longitudinal study design, incorporating survey research of the entire population of 68 health departments in the state of Texas. METHODS: The authors assessed the investment-capacity relationship through several statistical methods. The authors created a structural measure of managerial capacity through principal components analysis, factorizing 10 independent variables and augment this with a perceived readiness level reported from PHP managers. The authors then employ analysis of variance, correlation analyses, and other descriptive statistics. RESULTS: There has been a 539 percent coefficient of variation in funding at the local level between the years 2004 and 2008, and a 63 percent reduction in total resources since the peak of funding, using paired sample data. Results suggest that investment is positively associated with readiness and managerial capacity in local health departments. The authors also find that investment was related to greater community collaboration, higher adoption of Incident Command System (ICS) structure, and more frequent operational drills and exercises. CONCLUSIONS: Greater investment is associated with higher levels of capacity and readiness. The authors conclude from this that investment should be stabilized and continued, and not be influenced by historical cognitive biases.

Emerging zoonotic diseases: An opportunity to apply the concepts of nidality and one-medicine.

The use of animals as sentinels of human disease revolves around the concept of nidality. That is, an agent of disease occupies a particular ecologic niche and alterations in that niche will change the function of that agent relative to traditional host-agent-environment relationships. Nidality is a derivation of the root word nidus. Nidus is defined as a nest or breeding place, particularly a place where microbes such as bacteria, fungi, viruses, as well as other organisms and larger parasites, are located and multiply. Application of the concept of nidality and development of prevention strategies has most frequently been associated with military campaigns and interruption of tick-borne infections.Modern usage of the phrase "one-medicine" was popularized in the United States and Europe by Calvin Schwabe and the concept is attributed to Rudolph Virchow. It is applied today to the study of zoonotic disease and interventions in rural agricultural communities that share close living arrangements between people and their families, their pastoral work environment, and the animals for which they care.Integration of the two concepts of one-medicine and nidality provides an opportunity to apply a systems approach (i.e. general systems theory) to dealing with emerging zoonotic diseases in today's global agricultural and industrial settings.

Introduction; The history of public health and veterinary public service; Historic and future perspectives of the American College of Veterinary Preventive Medicine; Blue ribbon task force report on the future of Food Safety and Inspection Service veterinarians: public health professionals for the 21st century; The National Antimicrobial Resistance Monitoring System (NARMS) for enteric bacteria,1996- 1999: surveillance for action; Public health education of veterinarians and veterinary students for the future; Ten great veterinary public health/preventive medicine achievements in the United States, 1901 to 2000.

Historically, veterinary medicine has made its greatest contributions in the public sector and in settings other than direct care of the individual patient. So why are so many of us unaware of our profession's achievements in this arena? My introduction to veterinary preventive medicine and public health was through military service. My obligation to serve a two-year doctor draft in the United States Air Force became an adventure for my family and me, rather than an unwelcome intrusion on my ultimate desire to return to private clinical practice. The operative words are private and clinical. Why was I unaware of the opportunities available to those of us educated in this discipline sometimes referred to as comparative medicine?