An estimated 800,000 - 1.4 million persons in the US have chronic hepatitis B virus (HBV) infection. The risk for chronic infection is greatest among young children;approximately 90% of infants will remain chronically...An estimated 800,000 - 1.4 million persons in the US have chronic hepatitis B virus (HBV) infection. The risk for chronic infection is greatest among young children;approximately 90% of infants will remain chronically infected with HBV. Approximately 25% of those who become chronically infected during childhood die prematurely from cirrhosis or liver cancer. Hepatitis B vaccination is the most effective measure to prevent HBV infection and its consequences. In 2006, 29 US states had Hepatitis B Vaccine Supply (HBVS) policy which either supplies hepatitis B vaccine at no cost to all providers for all children or provides hepatitis B vaccine to delivery hospitals-only free of charge for all infants;other 21 US states and the District of Columbia did not have. 17,636 infants born in 2006 obtained from 2007-2009 National Immunization Survey (NIS) were analyzed with survival analysis procedures of Kaplan-Meier estimate and Cox proportional hazards model for complex sample survey to evaluate the association between state HBVS policy and the timing of infant age in days to receipt of hepatitis B vaccination. State HBVS policy is associated with infant age in days from birth to receipt of the first dose of hepatitis B vaccine (P < 0.01), and to completion of the 3-dose hepatitis B vaccine series (P < 0.01). Receipt of the first dose of hepatitis B vaccine occurred 31% earlier among infants residing in states with HBVS policy than among infants residing in states without (adjusted hazards ratio 1.31, 95%CI (1.23, 1.39)). Completion of the 3-dose hepatitis B vaccine series were 12% sooner among infants living in states with HBVS policy than among infants living in states without (adjusted hazards ratio 1.12, 95%CI (1.06, 1.18)). State HBVS policy may help overcome barriers to timely delivery of hepatitis B vaccines to infants.展开更多
Objective:To estimate the potential contributions of reported changes in frequency of penile-vaginal sex(PVS),condom use and STI screening to changes in gonorrhea and chlamydial diagnoses from 2012 to 2019.Methods:An ...Objective:To estimate the potential contributions of reported changes in frequency of penile-vaginal sex(PVS),condom use and STI screening to changes in gonorrhea and chlamydial diagnoses from 2012 to 2019.Methods:An agent-based model of the heterosexual population in the U.S.simulated the STI epidemics.Baseline was calibrated to 2012 diagnosis rates,testing,condom use,and frequency of PVS.Counterfactuals used behaviors from the 2017-2019 NSFG,and we evaluated changes in diagnosis and incidence rates in 2019.Results:Higher testing rates increased gonorrhea and chlamydia diagnosis by 14%and 13%,respectively,but did not reduce incidence.Declining frequency of PVS reduced the diagnosis rate for gonorrhea and chlamydia 6%and 3%respectively while reducing incidence by 10%and 9%respectively.Declining condom use had negligible impact on diagnosis and incidence.Conclusion:Understanding how changing behavior drives STI incidence is essential to addressing the growing epidemics.Changes in testing and frequency of PVS likely contributed to some,but not all,of the changes in diagnoses.More research is needed to understand the context within which changing sexual behavior and testing are occurring.展开更多
1介绍鉴于美国农业部（U.S.Department of Agriculture,USDA）所实施的一些联邦学校膳食项目（如全国学校午餐计划）,学生们每天摄取的热量达一半都是在学校里获得。2012年,USDA发布了针对学校膳食的新版营养标准a。这些标准是对学校膳...1介绍鉴于美国农业部（U.S.Department of Agriculture,USDA）所实施的一些联邦学校膳食项目（如全国学校午餐计划）,学生们每天摄取的热量达一半都是在学校里获得。2012年,USDA发布了针对学校膳食的新版营养标准a。这些标准是对学校膳食项目实施超过15年来的首次重大修订,反映了当前国家的膳食指南和医药协会的建议,以满足学生的营养需求。展开更多
文摘An estimated 800,000 - 1.4 million persons in the US have chronic hepatitis B virus (HBV) infection. The risk for chronic infection is greatest among young children;approximately 90% of infants will remain chronically infected with HBV. Approximately 25% of those who become chronically infected during childhood die prematurely from cirrhosis or liver cancer. Hepatitis B vaccination is the most effective measure to prevent HBV infection and its consequences. In 2006, 29 US states had Hepatitis B Vaccine Supply (HBVS) policy which either supplies hepatitis B vaccine at no cost to all providers for all children or provides hepatitis B vaccine to delivery hospitals-only free of charge for all infants;other 21 US states and the District of Columbia did not have. 17,636 infants born in 2006 obtained from 2007-2009 National Immunization Survey (NIS) were analyzed with survival analysis procedures of Kaplan-Meier estimate and Cox proportional hazards model for complex sample survey to evaluate the association between state HBVS policy and the timing of infant age in days to receipt of hepatitis B vaccination. State HBVS policy is associated with infant age in days from birth to receipt of the first dose of hepatitis B vaccine (P < 0.01), and to completion of the 3-dose hepatitis B vaccine series (P < 0.01). Receipt of the first dose of hepatitis B vaccine occurred 31% earlier among infants residing in states with HBVS policy than among infants residing in states without (adjusted hazards ratio 1.31, 95%CI (1.23, 1.39)). Completion of the 3-dose hepatitis B vaccine series were 12% sooner among infants living in states with HBVS policy than among infants living in states without (adjusted hazards ratio 1.12, 95%CI (1.06, 1.18)). State HBVS policy may help overcome barriers to timely delivery of hepatitis B vaccines to infants.
基金supported by the CDC/NCHHSTP Epidemiological and Economic Modeling Agreement (NEEMA) (#5U38PS004650)support from the Center for Studies in Demography and Ecology (P2C HD042828)at the University of Washington.
文摘Objective:To estimate the potential contributions of reported changes in frequency of penile-vaginal sex(PVS),condom use and STI screening to changes in gonorrhea and chlamydial diagnoses from 2012 to 2019.Methods:An agent-based model of the heterosexual population in the U.S.simulated the STI epidemics.Baseline was calibrated to 2012 diagnosis rates,testing,condom use,and frequency of PVS.Counterfactuals used behaviors from the 2017-2019 NSFG,and we evaluated changes in diagnosis and incidence rates in 2019.Results:Higher testing rates increased gonorrhea and chlamydia diagnosis by 14%and 13%,respectively,but did not reduce incidence.Declining frequency of PVS reduced the diagnosis rate for gonorrhea and chlamydia 6%and 3%respectively while reducing incidence by 10%and 9%respectively.Declining condom use had negligible impact on diagnosis and incidence.Conclusion:Understanding how changing behavior drives STI incidence is essential to addressing the growing epidemics.Changes in testing and frequency of PVS likely contributed to some,but not all,of the changes in diagnoses.More research is needed to understand the context within which changing sexual behavior and testing are occurring.
文摘1介绍鉴于美国农业部（U.S.Department of Agriculture,USDA）所实施的一些联邦学校膳食项目（如全国学校午餐计划）,学生们每天摄取的热量达一半都是在学校里获得。2012年,USDA发布了针对学校膳食的新版营养标准a。这些标准是对学校膳食项目实施超过15年来的首次重大修订,反映了当前国家的膳食指南和医药协会的建议,以满足学生的营养需求。
