Maternal Child Health Newsletter 8/27/04

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Maternal Child Health Newsletter 8/27/04

Postby laura » Fri Aug 27, 2004 09:35 am

MCH Alert
Tomorrow's Policy Today

National Center for Education in Maternal and Child Health
Search past issues of the MCH Alert and other MCH Library resources at

August 27, 2004

1. New Web Site Features Integrate Detailed Perinatal Health Data
2. Redesigned Web Site Enhances Public Access to Information on Dietary
3. Report Looks at Impact of Health Care Trends on Health Centers
4. Authors Summarize Findings on the Role of Vaginal Douching in the
Reproductive Health of Adolescents and Young Women
5. Literature Review Investigates Firearm Ownership and Storage Practices



A new PeriStats database and Web interface were recently implemented to
integrate access to detailed city and county data on maternal and infant
health in the United States. The new Web site represents the first
milestone of a partnership between the March of Dimes Perinatal Data
Center, the National Library of Medicine, and the New York Academy of
Medicine to increase access to city, county, state, and national perinatal
data and to improve the utility of PeriStats. More than 50,000 graphs,
maps, and tables have been added to the PeriStats system to date. Future
efforts will include integrating access to relevant biomedical literature.
The Web site is intended to be used for fact-finding, regional health
assessments, grant writing, policy development, lectures, and
presentations. An overview of the new features is available at The PeriStats
Web site is available at



The IBIDS (International Bibliographic Information on Dietary Supplements)
database has been made available to the public through a redesigned Web
interface on the National Institute of Health's Office of Dietary
Supplements (ODS) home page. The IBIDS database was originally launched in
1999 as a result of the Dietary Supplement and Health Education Act, which
mandated the creation of a tool to assist both scientists and the public
in locating credible scientific literature on dietary supplements. In 1998
the ODS initiated an interagency agreement with the U.S. Department of
Agriculture's Food and Information Center at the National Agricultural
Library to develop and maintain the database. The database provides access
to bibliographic citations and abstracts from the published,
international, and scientific literature on dietary supplements and is
intended for use by individuals with varying levels of expertise. Users
can choose to search the full IBIDS database, a subset of consumer
citations only, or peer-reviewed citations only. The database is available



A Nation's Health at Risk II: A Front Row Seat in a Changing Health Care
System examines trends from the health center perspective and offers a
snapshot of communities in need. The report is the second in a series
published by the National Association of Community Health Centers (NACHC)
to evaluate the state of the nation's health. The report begins with a
discussion of the importance of having a usual source of care, the need
for the safety net, and the Community Health Centers program. The authors
examine issues such as access to preventive services, infant mortality and
low birthweight, chronic disease, racial and ethnic health disparities,
and cost-effective care. The final section explores state support of
health centers and Medicaid restrictions. The report is available at



"The initiation and maintenance of douching behavior in young women is a
complicated behavior influenced by many factors, including family, sexual
partners, body image, and advertising, among many others," state the
authors of an article published in the August 2004 issue of the Journal of
Pediatric and Adolescent Gynecology. The authors note that although
douching dates back centuries, the practice remains controversial and has
been implicated in adverse reproductive health outcomes. The purpose of
this article is to summarize key findings from the published literature
and ongoing research as well as to highlight research challenges to our
understanding of the role of vaginal douching in reproductive health.

The authors reviewed key findings from recently published literature,
preliminary findings from the ongoing randomized controlled trial of a
douching behavioral intervention (B-WELL study), and findings of recent
cross-sectional surveys of university students.

The authors found that

* Numerous studies have shown that douching is prevalent and often begins
in adolescence.

* Motivation for the initiation and maintenance of douching appears
complex and presents challenges to intervention efforts. Recent studies
implicate high-risk sexual behaviors as motivators for sustaining douching

* Douching has been implicated in numerous adverse reproductive health
outcomes such as pelvic inflammatory disease, ectopic pregnancy, reduced
fertility, and bacterial vaginosis. However, most studies linking douching
to adverse reproductive health outcomes are case control studies; thus the
causal relationship between douching and these outcomes remains unknown.
The mechanism of the associations remains undetermined, as well.

* Recent publications involving participants from developing countries
seem to indicate that vaginal douching under certain circumstances may be
harmless or even beneficial.

The authors note that although "the need for prospective longitudinal
studies of the effects of douching was recognized decades ago . . . very
little advancement has been published in recent decades." They suggest
that "prospective studies should further examine the different typology of
douching behaviors and other behavioral influences inherent to the
acquisition of STIs [sexually transmitted infections] that may compromise
reproductive health."

Simpson T, Merchant J, Grimley DM, et al. 2004. Vaginal douching among
adolescent and young women: More challenges than progress. Journal of
Pediatric and Adolescent Gynecology 17(4):249-255.



"The information obtained in this review documents the presence of an
important hazard in a large proportion of U.S. households, for which
policy and programmatic safety interventions are available," state the
authors of an article published in the August 2004 issue of the American
Journal of Preventive Medicine. The authors state that firearm injuries
are a leading cause of both fatal and nonfatal injury in the United States
and that the presence of a household firearm has been found to be
associated with an increased risk for homicide, suicide, and unintentional
shootings, especially among young people. This review summarizes journal
articles published in the past decade that provide estimates of the
prevalence of household firearm ownership and storage practices in the
United States. The purposes of the review are to (1) examine the current
state of knowledge about firearm ownership and storage in the United
States, (2) provide recommendations for future research, and (3) serve as
background for those working to advance public health research and
practice about this issue.

The authors searched MedLine, CINAHL, Sociological Abstracts, and PsycInfo
to identify articles. For inclusion, articles had to include a
quantification of (1) the prevalence of firearm ownership in homes, (2)
the types of firearms owned, and/or (3) the prevalence of certain storage
practices. The articles also had to have appeared in a peer-reviewed
journal between 1992 and 2002. The final review included 42 articles.

The authors found that

* Estimates of firearm ownership among all U.S. households ranged from 30%
to 33%. The estimate of the prevalence of firearms in households with
children was 35%.

*Among households with firearms, estimates of the prevalence of those with
loaded firearms ranged from 29% to 37%, of storing firearms unlocked
ranged from 49% to 53%, and of storing firearms unlocked and loaded ranged
from 21% to 22%.

* Among households with firearms and in which there were children (ages
under 18), estimates of the prevalence of those with loaded firearms (14%
to 30%) were lower than the corresponding prevalence estimates for all
U.S. households (29% to 37%).

* Among households with firearms and in which there were children,
estimates of the prevalence of storing firearms unlocked (43%) and both
unlocked and loaded (6% to 14%) were lower than the national prevalence
estimates (49% to 53% and 21% to 22%, respectively).

* The prevalence of firearm ownership was highest in the South, followed
by the Midwest. The prevalence was lowest in the Northeast. The prevalence
was lower in urban areas than in rural areas.

The authors conclude that "continued and expanded documentation of the
prevalence will permit assessment of changes in the risk profile of U.S.
households as interventions are implemented."

Johnson RM, Coyne-Beasley T, Runyan CW. 2004. Firearm ownership and
storage practices, U.S. households, 1992-2002. American Journal of
Preventive Medicine 27(2):173-182.


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MCH Alert © 2004 by National Center for Education in Maternal and Child
Health and Georgetown University. MCH Alert is produced by MCH Library
Services at the National Center for Education in Maternal and Child Health
under its cooperative agreement (6U02 MC 00001) with the Maternal and
Child Health Bureau, Health Resources and Services Administration, U.S.
Department of Health and Human Services. The Maternal and Child Health
Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use
the work for federal purposes and to authorize others to use the work for
federal purposes.

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